Towards Best Practice for Benefit Sharing Involving Access to Human Biological Resources: Conclusions and Recommendations - Benefit Sharing - page 212

10.2 Benefit Sharing as a Tool
The main focus of this topic is justice, especially justice for resource providers.
Justice is an ethical principle apparent in most cultures and throughout history.
But benefit sharing has no such prominence: it is a relatively new ethical concept
going back no further than the late 20th century, and is not comparable to justice
in scope or nature. Justice is an ideal, a desideratum that we strive for, and benefit
sharing is simply a principle used as a tool to achieve that ideal. To be consid-
ered just, the users of resources have to return some benefits to resource providers.
That, in a nutshell, is benefit sharing. In an ideal world, we would all freely
exchange resources to everybody's benefit. That this is not possible today is due to
the extreme disparities in wealth and life chances that characterize any comparison
between Northern and Southern countries - disparities that are, in turn, partly due
to the related history of colonialism. In this global economic and political context
of prior exploitation and continuing disparities, benefit sharing is being mooted as
one way to achieve justice for the providers of resources.
The problem with trying out tools is that it can take a long time to refine
them to such a degree that they achieve their purpose. On an optimistic read-
ing, this is what is now happening with CBD-type benefit sharing. More than
two decades after the adoption of the CBD, few examples of successful benefit-
sharing yet exist. We have discussed several beneit sharing cases in this topic,
none of which were unproblematic (see Chap. 4 ) . One can hope, though, that
the legal clarity provided by the Nagoya Protocol will pave the way for future
successes.
The benefit-sharing tool most relevant to the donors of human biological
resources (as well as other research participants, such as those taking part in clini-
cal trials) is the principle of post-study obligations. The Declaration of Helsinki
is the most influential of all the international research ethics guidelines and has
included a reference to such obligations since 2000. Providing post-study access
to successfully developed interventions (or making alternative benefits available to
research participants) is what benefit sharing requires.
However, a tool is only useful if the user knows how to handle it. Judging
from the dearth of successful examples in either the academic literature or pol-
icy debates, the tool of post-study obligations is not useful as it stands. Providing
post-study access to successfully tested medicines or interventions for study par-
ticipants is a logistically complicated, risky measure in the quest for justice. As we
have shown (see Chap. 8 ) , a range of arguments can be raised against the useful-
ness of this tool for human research participants. Frustratingly, several problems
were also identified regarding the provision of alternative benefits. Table 10.1
summarizes some of the main challenges identified.
It is clear that the proposed mechanism of benefit sharing for human research
participants requires further refinement before it can achieve its purpose, which is
to increase equity between partners (the affluent Northern users of resources and
the poorer Southern providers of those resources).