Researchers at Oxford Population Health’s Ethox Centre have published a report commissioned by the UK Health Security Agency (UKHSA) that explores the ethical considerations for integrating research into public health emergency response strategies.
The report outlines practical recommendations for future emergency preparedness, response, and recovery efforts. Based on a rapid literature review and expert consultations, the report emphasises the critical role of research, not only during infectious disease outbreaks but also in all forms of public health emergencies.
A key argument of the report is that there exists a strong ethical obligation to reduce uncertainty and improve intervention outcomes through high-quality research. This responsibility applies to both pharmaceutical and non-pharmaceutical interventions and becomes even more pressing when such interventions are mandated.
The researchers stress the importance of using a variety of methods, including qualitative, quantitative, and mixed-methods research, as well as other forms of evidence generation like surveillance, modelling, and policy evaluation.
The report outlines several responsibilities for policymakers:
- Governments and institutions must ensure that ethical and regulatory frameworks are in place to facilitate swift research responses and minimise impact on the emergency response effort;
- Sustainable support is needed for research platforms, data-sharing systems, priority-setting mechanisms, and community engagement strategies;
- There must be a baseline commitment to generating evidence during or shortly after policy implementation, with studies launched early in emergencies to fill priority knowledge gaps;
- Policymakers should be transparent about how emerging evidence informs decisions and make explicit the values and principles guiding their choices;
- Continuous research between emergencies should be supported to build resilience and public trust, involving public input and data experts in shaping ethical and reliable data governance systems;
- A commitment to ongoing learning, including evaluating the real-world impacts of policies and their effects on inequalities, is essential to improve future responses;
- The inclusion of real-time ethical and social science research is crucial in guiding responses and supporting public trust during emergencies.
Michael Parker, Professor of Bioethics and Director of the Ethox Centre, said ‘Our report calls for a deeply integrated, ethically sound, and transparent approach to research within public health emergency strategies, positioning research as a moral imperative rather than a secondary consideration.
‘While emergencies may initially necessitate action based on limited or incomplete evidence, this should not replace a sustained commitment to evidence generation. Regardless of the methodology chosen, ethical principles such as respect for individual welfare, scientific integrity, and transparency must be upheld. Assertions that research is infeasible during emergencies should be rigorously examined, given the long-term cost of missed opportunities to build a stronger evidence base.
‘In the fast-paced context of public health emergencies, where competing priorities often arise, timely ethical guidance grounded in rigorous research is essential in supporting sound decision-making and maintaining public trust.’
The report also emphasises the importance of preparedness before emergencies arise. Proactive investment in research infrastructure, regulatory flexibility, community engagement, and ethical frameworks are essential. Building systems for rapid and effective research is a necessary part of emergency planning, and these systems should be supported continuously ‒ not only during crises.
The report highlights the importance of better integrating ethics and social science expertise into decision-making systems, particularly in the design and prioritisation of research. It emphasises the importance of building systems for rapid and effective research as a necessary part of emergency planning, and these systems should be supported continuously ‒ not only during crises.