TROPMED180562 42..47


Am. J. Trop. Med. Hyg., 100(Suppl 1), 2019, pp. 42–47
doi:10.4269/ajtmh.18-0562
Copyright © 2019 by The American Society of Tropical Medicine and Hygiene

Mentorship and Ethics in Global Health: Fostering Scientific
Integrity and Responsible Conduct of Research

Elizabeth A. Bukusi,1,2,3* Yukari C. Manabe,4,5 and Joseph R. Zunt2,6,7,8
1Center for Microbiology Research, Kenya Medical Research Institute, Nairobi, Kenya; 2Department of Global Health, University of Washington,
Seattle, Washington; 3Department of Obstetrics and Gynecology, University of Washington, Seattle, Washington; 4Division of Infectious Diseases,
Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, Maryland; 5Infectious Diseases Institute, Makerere University

College of Health Sciences, Kampala, Uganda; 6Department of Neurology, University of Washington, Seattle, Washington;
7Department of Epidemiology, University of Washington, Seattle, Washington; 8Department of Medicine (Infectious Diseases),

University of Washington, Seattle, Washington

Abstract. Addressing ethical issues through mentorship is key to encouraging scientific integrity and increasing
research capacity. Across the global health arena, mentorship requires helping mentees understand and negotiate the
regulatory aspects of research—which can substantially differ even between countries with similar resources. Mentorship
support spans across the research framework from obtaining ethical approval and ensuring scientific integrity, to de-
termining authorship and disseminating study results—providing multiple opportunities to model ethical behavior for
mentees. The power imbalances between the global north and south in accessing funding resources produce further
challenges in setting the research agenda and for ensuring equity in the dissemination of research findings. Gender further
complicates the aspiration for equity; the proportion of women in high administrative or research positions remains low.
This study explores four specific mentoring case scenarios commonly encountered in the global health research field in
low- and middle-income institutions.

INTRODUCTION

The increasing globalization of commerce, education, and
research has resulted in increasing collaboration across
countries. One manifestation of increased collaboration in
academia is the rise in number of scientific publications. Be-
tween 2003 and 2013, the number of scientific manuscripts
published in any of the more than 17,000 peer-reviewed sci-
entific journals monitored by SCOPUS increased from 1.1
million to nearly 2.2 million.1 Over this same timeframe, sci-
entists from low- and middle-income country (LMIC) institu-
tions increased their percentage of scientific and technical
publications from 9.5% to 13.7%.1 In addition, between 1988
and 2013, coauthorship by authors from more than one
country increased from 8% to 19% and U.S. and Chinese
scientists have reached approximate parity in total number of
publications, with each country contributing 18.8% and
18.2% of the world’s total science and engineering publica-
tions in 2013, respectively. With this increase in publications,
has come increasing reports of scientific misconduct, as well
as attention to how institutions and mentors can monitor for
scientific misconduct and provide role modeling and training
in the responsible conduct of research (RCR) to reduce mis-
conduct in trainees, especially in countries that have limited
infrastructure to detect, investigate, or penalize scientific
misconduct.2

Providing research trainees with a framework of ethical
standards for conducting research, especially in the global
multidisciplinary and multinational arenas, is essential to en-
sure that research findings are reliable, that future scientists
conduct science in an ethical manner, and that research ad-
vances our understanding of the world and its inhabitants
while respecting and protecting human and animal subjects
used in research. Responsible conduct of research is based

on ethical behavior of scientists toward their research subjects
and colleagues. Scientific integrity and institutionalization of
research oversight includes monitoring, and training. The
National Academy of Sciences, Engineering and Medicine, in
their Consensus Study Report on fostering integrity in re-
search, noted: “Practicing integrity in research means plan-
ning, proposing, performing, reporting, and reviewing research
in accordance with the values described above [objectivity,
honesty, openness, accountability, fairness and steward-
ship].”3 Perhaps equally important to practicing integrity, is
providing a structure through which scientific misconduct
can be identified, reported and addressed. The Inter-
Academy Council, a multinational organization of science
academies, stated “while procedures and institutions [are
necessary] to effectively investigate allegations of irrespon-
sible research conduct and act on the results, efforts aimed
at preventing irresponsible conduct and ensuring good
practices through mentoring and education are ultimately
more important.”4

HISTORICAL PERSPECTIVES

The World Medical Association developed the Declaration
of Helsinki adopted by its assembly in Helsinki in 1964.5 This
guide was specific for physicians regarding engagement of
their patients in research. Subsequently, in 1982 the Council
for International organizations in Medicine, using the Decla-
ration of Helsinki as a reference, provided guidelines for the
conduct of biomedical research involving humans conducted
in LMIC settings, where greater disparities in health care are
encountered than in more developed countries.6 Before the
1980s, few institutions in the United States had adopted in-
stitutional review boards (IRBs) to oversee research involving
humans or animals to respond to concerns of scientific mis-
conduct and had instead relied on independent monitoring
and regulation of scientific activities. In the 1980s, the emer-
gence of several cases of scientific misconduct in the press
led to U.S. congressional hearings that resulted in the creation

* Address correspondence to Elizabeth A. Bukusi, Center for
Microbiology Research, Kenya Medical Research Institute (KEMRI),
P.O. Box 19464, Nairobi 00202, Kenya. E-mail: ebukusi@rctp.or.ke

42

mailto:ebukusi@rctp.or.ke


of federal and institutional standards to reduce scientific mis-
conduct.7 In 1989, to ensure “that attention be directed toward
scientific integrity in the conduct of research,” the U.S. National
Institutes of Health (NIH) revised National Research Service
Award institutional training grants “to require that a program in
the principles of scientific integrity be an integral part of the
proposed research training effort.”8 Since this revision, guide-
lines have beenupdated butsome experts suggestthatdespite
these guidelines, transgressions in scientific integrity continue
to occur and consensus is lacking regarding how to teach RCR
or measure the effectiveness of such teaching.9

GLOBALIZATION OF RESEARCH

The globalization of research and publishing has also
resulted in increased awareness of the disparity of RCR
training opportunities in many countries. With the advent of
AIDS, the Fogarty International Center increased research
training support for international scientists to build capacity to
respond to epidemics through new programs, such as the
AIDS International Research Training Program, first offered in
1988, and the international Research Ethics Education and
Curriculum Development award, first offered in 2000. With the
implementation of these international training programs came
increased attention to strengthening didactic and interactive
RCR education for trainees conducting research in different
international settings. Although many of the early diaspora of
Fogarty research training programs have risen to leadership
positions and have facilitated increased availability of RCR
training at their universities and institutions, successive gen-
erations of trainees continue to struggle with many of the same
issues touching multiple facets of research—from design to
implementation, analysis, and dissemination of results.
One recent study of researchers in LMICs reported that a

common perceived factor associated with high prevalence of
research misconduct was the lack of institutional structures or
systems to support and promote research integrity—such as
offices to promote research integrity, develop and dissemi-
nate policies on research misconduct, and provide channels
for whistleblowing when misconduct was detected.10 Many
universities and training institutions in resource-rich countries
have evolved over centuries and have thus had opportunities
to refine teaching methodologies to maximize the benefits of
teaching for different stages of the educational cycle. Through
academic partnerships, which have typically been closely
aligned with research training grants, some of these advances
have trickled down to institutions in LMICs, where the time
since the countries achieved independence has been shorter
and as a result the opportunities in many countries to refine
teaching methodologies are less plentiful. In addition, these
institutions have limited resources and may not prioritize the
development of such offices and systems.11,12

Regardless of the maturity of teaching, training, and research
regulation programs, recent evaluations suggest that education
in the RCR for science and engineering students, especially for
undergraduates, remains inadequate—and poorer perfor-
mance by international trainees on measures of baseline RCR
knowledge suggest these trainees are even less exposed to
RCR training in their home countries.13 To further complicate
thisissue, codes of responsible conduct differ across countries,
although efforts in the past decade have resulted in increased
international consensus on the basic principles of RCR.4

Realizing that addressing all aspects of RCR is beyond the
scope of this manuscript, we chose four common areas for
misconduct noted in the international literature14,15 that each
of us has encountered while mentoring trainees in our pro-
grams: 1) plagiarism, 2) determining authorship, 3) the ap-
propriate useof anIRB, and4) imbalances of power, especially
across genders. These four common concerns are encoun-
tered frequently when mentoring undergraduate, graduate, or
postdoctoral trainees and represent areas where good men-
torship can decrease scientific misconduct in new trainees
and encourage the next generation of trainees to become
leaders. We provide case studies to illustrate each topic area
and discuss how mentoring and institutional structures can be
harnessed to detect and address transgressions and, when
instituted early enough, prevent scientific misconduct from
arising.
The literature review was guided by the Delphi method.

Through a series of phone and in-person conversations with
the authors involved in all chapters of this manual, we dis-
cussed potential content of each chapter. For our chapter, we
initially defined the four most common or challenging sce-
narios associated with mentor–mentee relationships across
our international settings. Through identification of key articles
by the panel of authors, PubMed search of key terms asso-
ciated with each scenario, and review of relevant articles listed
in the references of these articles, we arrived at a list of relevant
articles for our chapter; these articles were then vetted by the
panel of authors and relevant observations were included in
this chapter.

PLAGIARISM

Case study 1. The student had published one paper and
needed a second to graduate. This was a requirement of the
university adopted by the accreditation body to encourage
publication and research output. After copying and pasting
whole sections of the first paper into the second, he was
surprised when he was notified after submission that this was
self-plagiarism and was not acceptable. Shocked, the student
wondered how he could be accused of plagiarism because he
had written the first paper.
One of the most common issues affecting the integrity of

science is plagiarism. The interpretation of plagiarism is nu-
anced across cultures, and current definitions include not only
the copying of another person’s work without citation, thus
implying it is one’s own work, but also “self-plagiarism,” or
repeating portions of one’s prior work (some exception is
made for repeating sections of previously published materials
and methodology sections).16 In countries where English is
typically a second language, many graduate students are re-
quired to write in English for purposes of thesis or manuscript
publication; in this context, copying text is sometimes con-
sidered a compliment to the original author of the plagiarized
text.17 In addition, the type of publication may influence the
likelihood of plagiarism; one study in India noted that plagia-
rism was highest in review articles and was not detected in any
of the case reports reviewed.18

One study that interviewed Chinese supervisors about rea-
sons for students copying text and how to remedy this issue
concluded there were four major reasons for text-based pla-
giarism: 1) insufficient understanding of academic writing, 2)
difficulty with the English language, 3) “shortage in intellectual

MENTORSHIP ETHICS 43



and cognitive depth needed for handling a subject matter,” and
4) lack of training in the ethical conduct of research.19 Reasons
given by students for plagiarizing included: the “normalcy of
plagiarism” in their home environment; vague or nonexistent
policies regarding RCR and plagiarism; and, for non-native
English speakers, difficulty expressing oneself in English.20

The emergence of online programs to check for plagiarism,
such as iThenticate, TurnitIn, and CrossCheck, have resulted
in increased ease of assessing copied text; it is used by
teachers and students from secondary school through uni-
versity and professional levels. After the initial use of CrossRef
plagiarism screening service, one prestigious scientific journal
in China detected 692 (31%) of 2,233 submissions with “un-
original material” and noted that “in ancient China. . .students
were typically encouraged to copy the words of their mas-
ters.”21 However, these programs are not free and can have
high levels of “false positives”—they will detect similarities in
text in any section of a manuscript, including the reference
section. One study that examined the frequency of detection
of similar text in two entire issues of their journal found that
sensitivity for fraud detection was improved, and false positive
reports were decreased by adjusting the software to exclude
review of bibliography, materials and methods sections, and
reporting only similarity of sources greater than 2%.22

To successfully reduce the incidence of plagiarism among
postgraduates, one group developed a module that included a
didactic presentation about plagiarism followed by discussion
of an anonymous paper that contained plagiarism detected by
TurnItIn software. In this scenario, students were asked to
discuss if plagiarism had occurred and what action should be
taken against the student at that time or if similar reports of
plagiarism occurred in the future with the same student.23 In a
review of randomized interventions that attempted to improve
RCR, the likelihood of committing plagiarism was reduced
through practical exercises and integration of software to
detect text matching.24 Other effective methods for de-
creasing the occurrence of plagiarism include scientific writing
courses, modules on plagiarism in RCR courses, incorporating
discussion of scientific integrity into the culture of working
groups, and adhering to internationally recognized guidelines
for scientific writing. Gasparyan and others25 provided a
thoughtful review of plagiarism in the scientific setting and note
that adherence to guidelines for authors and editors published
by the Committee on Publication Ethics and the International
Committee of Medical Journal Editors (ICMJE) could lead to
marked reductions in plagiarism. One laboratory director noted
that he posted a page containing an “ethical code of research
conduct for university academics” in his laboratory, thus
establishing an expectation for scientific behavior in his labo-
ratory.19 Mentors can encourage responsible writing through
teaching as they edit by providing trainees with written and oral
feedback on written materials during one-on-one sessions, and
explicitly discussing appropriate citation of others’ work during
group meetings. With consideration for the yearly turnover of
trainees,thesetypesofdiscussionsmustberepeatedwitheach
new cohort.

AUTHORSHIP

Case study 2. Nearing the completion of a thesis, a post-
graduate student received upsetting news. The student’s
work had led to excellent findings that would add to the field of

knowledge, but the supervising professor had recently in-
formed the student that the work was to be published with the
supervisor as first author. The supervisor needed first author
papers for promotion. The student, they argued, only needed
to publish for purposes of graduating and be done with the
work. The supervisor rationalized that the student intended to
focus on clinical work anyway and was not on an academic
track. Regardless, the postgraduate scholar had put in the
most work, from conceptualizing the research idea, to col-
lecting and analyzing data, and drafting the manuscript. True,
the guidance provided by the supervisor was key to comple-
tion of his training and yes, even the publication of the paper.
But was it enough for the supervisor to take away the first
authorship?
The ICMJE has created a widely accepted definition of au-

thorship that is “intended to ensure that contributors who have
made substantive intellectual contributions to a paper are
given credit as authors, but also that contributors credited as
authors understand their roles in taking responsibility and
being accountable for what is published.”26 They propose that
authorship be based on four criteria:

1. Substantial contributions to the conception or design of the
work; or the acquisition, analysis, or interpretation of data for
the work

2. Drafting the work or revising it critically for important in-
tellectual content

3. Final approval of the version to be published
4. Agreement to be accountable for all aspects of the work in

ensuring that questions related to the accuracy or integrity
of any part of the work are appropriately investigated and
resolved.

In a questionnaire study of 607 corresponding authors from
LMICs, 77% reported that guest authorship, or adding an
author who had not substantially contributed to the manu-
script, took place at their institution, despite awareness of
ICMJE recommendations regarding the responsibilities of
authorship.10 This same publication noted that ghost au-
thorship, or omitting an author who had contributed sig-
nificantly, such as a professional writer, although less
common, occurred at slightly more than 40% of their
institutions.
The challenge with authorship of publications then is not the

lack of clarity on who or what participation should qualify one
to be an author, but the implementation of existing authorship
guidelines. Fairness and integrity when attributing authorship
should be guiding principles, especially when considering the
unequal relationships of mentor and mentee and the lack of
role models who not only talk the talk but walk the walk.
Mentorship that upholds and encourages appropriate attri-
bution of authorship can produce a critical mass of the next
generation of scientists who will continue to uphold these
values, as well as disseminate these same values into envi-
ronments where inappropriate attribution still exists. One
method to increase the likelihood of appropriate attribution of
authorship is to ask mentors to provide guidance on author-
ship, from the initial design stage through the analysis and
writing phases; discussions should include internationally
recognized criteria required for authorship, author order, as
well as guest and ghost authorship. In addition, traditional
RCR courses often include sections on authorship.

44 BUKUSI AND OTHERS



Conflicts in authorship are best avoided through early dis-
cussions and authorship contracts—which should be based
oninternationallyrecognizedguidelinesandincludeauthororder.
When authorship conflicts do arise, they are often affected by
perceived repercussions that might occur—especially if the
junior scientist is raising the concern. Resolution of conflicts
canoccur through direct dialogue between authors, mediation
via an ombudsman office (if present at the university), or peer
panels.

APPROPRIATE USE OF IRBS

Case study 3. A graduate student sought consultation on a
matter concerning research sites. The scholar had been given
approval from an accredited ethics review committee (ERC) to
conduct research in a certain facility. However, at the time of
data collection, they realized that the facility no longer had the
patient flow or number of specimens needed for the study. On
consultation with the graduate supervisor, the supervisor told
the student that it was fine to go ahead and collect the data
from a different location and when the thesis was written up,
an explanation could be provided regarding reasons for the
change in location. The supervisor noted there was no po-
tential harm to any participants because the experiments were
carried out on left over specimens after the tests needed for
clinical care had been completed.
Research integrity laws that make research illegal without the

approval of an IRB have been lagging in many LMICs. Although
there has been a strengthening of research regulatory systems,
not all LMICs have robust systems for continuing education of
researchers, clear mechanisms or guidance for review of re-
search protocols, or mechanisms for monitoring the imple-
mentation of research with corresponding procedures for
dealing with violations of ethical guidelines for human subject
protection.
There is general global consensus on the need to obtain

ethical clearance from an IRB or research ERC for investiga-
tors developing and implementing a research protocol, es-
pecially when it involves human or animal subjects.6 There has
been clear guidance from the U.S. Public Health Service re-
garding expectations of how research is defined and what
expectations are required to receive research funding from the
U.S. government, but these may not be applicable to funding
awarded through other sources.27

Although research is highly valued for innovation and find-
ing new solutions to challenges, an additional benefit are the
Facilities and Administrative, or “indirect” costs that are pro-
vided with nearly all research grant awards to institutions in the
United States and Europe. These indirect funds provide in-
stitutions with financial resources to administer grants and
strengthen institutional programs to support research, such
as IRBs and integrated programs in grant writing and RCR
training. As grants directly awarded to institutions in LMICs are
relatively new, similar indirect costs have unfortunately not
been available to support the development of similar research
infrastructure or the human resources required for research
regulation and administration.
Training and mentoring on conduct during the imple-

mentation of research therefore remains important. Examples
of potential breaches of IRB/ERC approval include but are not
limited to: change in an approved location of study imple-
mentation, change in the type of sample needed for the

research procedures, change in wording used for the con-
senting of participants for prospective studies, or the amount
of compensation provided for participation in research. The
standards of expectations on the appropriate use and com-
munication with the IRB/ERC continue to evolve. When
mentors are not well versed with the current local and relevant
international regulations governing biomedical research,
mentees can find themselves in the crosshairs between the
mentor and the IRB/ERC.

IMBALANCES OF POWER

Case study 4. A junior female scientist who was a regional
expert in a particular area, was asked to be the in-country
principal investigator (PI) for a research study for which a grant
had already been written and funded by an international
funding agency. The in-country PI worked hard to obtain the
necessary bioethical approvals, enlist staff, conduct study
training, and ultimately recruit participants and collect study
data. Ultimately, the final paper was written and the in-country
PI was included as a middle author, after never being asked to
comment on the content of the paper other than to provide
final approval.
Here, the in-country PI was being treated as solely an im-

plementer and had no role in the design of the study nor of the
original research question—which may or may not have had
any significant local or regional relevance. Because the in-
ternational PI had brought the funding, there was a clear im-
balance of power that was antithetical to the “collaborative
partnership.” Although the in-country PI was included as a
coauthor, she did not have a scientific voice, was being held to
a low scientific standard, and was recognized only for field
implementation. The opportunity for a more equitable scien-
tific role in this situation was absent largely due to failure to
provide a venue for scientific exchange and collaboration. The
tokenism of the authorship in this example is also subliminally
condescending and displayed a lack of trust. Importantly, the
in-country PI likely had to negotiate resource limitations, so-
cial, and political contextual complexities without which the
project may never have been completed and are, therefore,
equally important to the success of the project.28

This case study highlights the need for mentors from both
the global north and global south to ensure that, “[a re-
searcher’s primary ethical obligation in. . .global health expe-
riences is to improve the health and well-being of the
individuals and communities they visit.”29,30 Often as a result
of funding imbalances, because researchers in the global
south still do not have sufficient access or experience to ac-
quire local or international research funding, mentors must
include lessons on the importance of the integration of local
relevance to balance decision making in a way that empowers
local investigators.
An additional aspect of this case study that may have also

played a role is gender. As the percentage of women who enter
medicine and science increases, many seek to also enter
academic research. In a survey of 1,719 new recipients of NIH
career development (K) awards, 150 (30.4%) of the 493 female
respondents reported having experienced sexual harassment
including: sexist remarks or behavior, unwanted sexual ad-
vances, subtle bribery to engage in sexual behavior, threats to
engage in sexual behavior, or coercive advances.31 To com-
pound this issue, nearly all countries have gender inequity in

MENTORSHIP ETHICS 45



leadership positions, and women in many countries still ex-
perience outright hostility, sexual harassment or marginali-
zation in the offices, clinics, and hospital environments in
which they strive to work. These issues tend to be magnified in
LMIC research settings where the roles of women have not
traditionally included the position of PI, dean, or rector. A
growing number of activities to increase the visibility of women
in scientific leadership positions, such as Women Leaders in
Global Health, and the L’Oreal-UNESCO for Women in Sci-
ence Awards, are increasing recognition of women’s leader-
ship potential and providing opportunities for women to
develop networks of female mentor leaders to assist the
transition to more equitable leadership of research and sci-
entific programs. Although the #MeToo movement has af-
fected many areas of commerce and entertainment, attention
to sexual harassment within science has lagged behind.32 Dr.
Kathryn Clancy, author of this article, noted “many science
workplaces use legal definitions of sexual harassment to set
the standard for workplace conduct. If that is the bar that has
to be met for a disgusting behavior to be considered action-
able by a university, research institute, or field station, it is a
high one. An enormous range of disrespectful and even
frightening behavior can slip under that bar, even though it
damages the careers of victims and bystanders, holding back
scientific advancement.”32 The National Academies of Sci-
ences, Engineering, and Medicine recently released a Con-
sensus Study Report detailing the extent to which women in
the fields of science, engineering, and medicine have been
affected by sexual harassment and identifies methods to ad-
dress harassment in these settings.33

To increase equity across collaborations, institutions must
change existing research and training cultures to bolster the
ability of collaborators to participate in all stages of research—
from development of research ideas and protocols to
implementation, analysis, and dissemination of study re-
sults. Increasing global awareness of gender inequity and
sexual harassment should also lead to change—through
pressure on institutions and individuals to enforce existing
rules and regulations that are relevant to gender equity and
anti-harassment or to implement new rules and regulations
in places where none currently exist.
In conclusion, the need for research integrity as a core part

of mentoring is an important undertaking that should be
implemented from the conception of the research idea, through
the development, implementation, and dissemination of
study results. There is a great need for mentors to be aware of
and deal with the challenges that mentees are likely to face
throughout the research process. The Mentoring Compe-
tency manuscript in this supplement includes other core—
and key—competencies that mentors should strive to
achieve to ensure their trainees receive outstanding men-
toring.34 Ethics in research is not just a question of following
the letter of the law, but represents a way of conducting
oneself with integrity and as a scientist who provides a model
that sets an ethical course for others to follow. We need a
critical mass of mentors who model ethical conduct along
the entire cascade of research and who insist on the conduct
of locally relevant research. The mentorships workshops
were not designed to evaluate the before or after practice
within the institutions where they were conducted. This is a
limitation which will be addressed in future workshops where
specific attention will be focused on pre- and posttest

evaluations on specified domains of practice with regards to
ethical conduct.
If education is a life-long process, then mentoring and ethics

are key pillars of this journey, and both can be harnessed to
increase scientific integrity and research that moves the
needle of public health toward equality for all.

Received July 9, 2018. Accepted for publication October 1, 2018.

Published online November 14, 2018.

Acknowledgments: We received support from the FIC Global Health
Program for Fellows and Scholar consortia, including the University
of California GloCal Health Fellowship (FIC D43TW009343), the
Vanderbilt-Emory-Cornell-Duke Consortium for Global Health Fellows
(D43TW009337), the UNC-Johns Hopkins-Morehouse-Tulane Fogarty
Global Health Fellowship Program (D43TW009340), the Northern Pa-
cific Global Health Research Fellows Consortium (D43TW009345), the
Harvard-Boston University-Northwestern University-University of New
Mexico Fogarty Global Health Training Program (D43TW010543), and
the Yale-Berkeley-FIU-Stanford Global Health Equity Scholars
Program (D43TW010540). Additional support was provided by
Fogarty International Center D43’s for Y. C. M. (1D43TW009771,
D43TW010132).

Authors’ addresses: Elizabeth A. Bukusi, Research Care Training
Program, Center for Microbiology Research, Kenya Medical Research
Institute, Nairobi,Kenya,E-mail:ebukusi@kemri.org.Yukari C. Manabe,
Department of Medicine, Johns Hopkins University, Baltimore, MD,
E-mail: ymanabe@jhmi.edu. Joseph R. Zunt, Department of Global
Health, University of Washington, Seattle, WA, E-mail: jzunt@u.
washington.edu.

This is an open-access article distributed under the terms of the
Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the
original author and source are credited.

REFERENCES

1. NSB, 2016. Science and Engineering Indicators. Arlington, VA:
National Science Foundation.

2. Altman L, Broad W, 2005. Global Trend: More Science, More
Fraud. New York, NY: New York Times.

3. National Academies of Sciences, Engineering, and Medicine,
2017. Fostering Integrity in Research. Washington, DC: The
National Academies Press. doi: https://doi.org/10.17226/
21896.

4. IAC-IAP, 2012. Responsible Conduct in the Global Research
Enterprise. Alkamaar, The Netherlands: InterAcademy
Council.

5. World Medical Association, 2013. WMA Declaration of
Helsinki—Ethical Principles for Medical Research Involving Human
Subjects. Available at: https://www.wma.net/policies-
post/wma-declaration-of-helsinki-ethical-principles-for-medical-
research-involving-human-subjects/. Accessed March 9,
2018.

6. CIOMS International, 2002. Ethical Guidelines for Biomedical
Research Involving Human Subjects. Available at: https://
cioms.ch/wp-content/uploads/2016/08/International_Ethical_
Guidelines_for_Biomedical_Research_Involving_Human_
Subjects.pdf. Accessed March 9, 2018.

7. SteneckNH,1994.Researchuniversitiesandscientificmisconduct—
history, policies, and the future. J Higher Educ 65: 310–330.

8. NIH, 1989. Requirement for Programs on the Responsible Con-
duct of Research in National Research Service Award In-
stitutional Training Programs. Available at: https://grants.nih.
gov/grants/guide/historical/1989_12_22_vol_18_No_45.pdf.
Accessed February 28, 2018.

9. Plemmons DK, Kalichman MW, 2018. Mentoring for responsible
research: the creation of a curriculum for faculty to teach RCR in
the research environment. Sci Eng Ethics 24: 207–226.

10. Rohwer A, Young T, Wager E, Garner P, 2017. Authorship, pla-
giarism and conflict of interest: views and practices from low/

46 BUKUSI AND OTHERS

mailto:ebukusi@kemri.org
mailto:ymanabe@jhmi.edu
mailto:jzunt@u.washington.edu
mailto:jzunt@u.washington.edu
https://doi.org/10.17226/21896
https://doi.org/10.17226/21896
https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/
https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/
https://www.wma.net/policies-post/wma-declaration-of-helsinki-ethical-principles-for-medical-research-involving-human-subjects/
https://cioms.ch/wp-content/uploads/2016/08/International_Ethical_Guidelines_for_Biomedical_Research_Involving_Human_Subjects.pdf
https://cioms.ch/wp-content/uploads/2016/08/International_Ethical_Guidelines_for_Biomedical_Research_Involving_Human_Subjects.pdf
https://cioms.ch/wp-content/uploads/2016/08/International_Ethical_Guidelines_for_Biomedical_Research_Involving_Human_Subjects.pdf
https://cioms.ch/wp-content/uploads/2016/08/International_Ethical_Guidelines_for_Biomedical_Research_Involving_Human_Subjects.pdf
https://grants.nih.gov/grants/guide/historical/1989_12_22_vol_18_No_45.pdf
https://grants.nih.gov/grants/guide/historical/1989_12_22_vol_18_No_45.pdf


middle-income country health researchers. BMJ Open 7:
e018467.

11. Milford C, Wassenaar D, Slack C, 2006. Resource and needs of
research ethics committees in Africa: preparations for HIV
vaccine trials. IRB 28: 1–9.

12. Rugemalila JB, Kilama WL, 2001. Proceedings of the seminar on
health research ethics in Africa. Acta Tropica 78 (Suppl 1):
S1–S126.

13. Heitman E, Olsen CH, Anestidou L, Bulger RE, 2007. New grad-
uate students’ baseline knowledge of the responsible conduct
of research. Acad Med 82: 838–845.

14. Olesen AP, Amin L, Mahadi Z, 2017. In their own words: research
misconduct from the perspective of researchers in Malaysian
universities. Sci Eng Ethics 2017 Dec 16 [Epub ahead of print].
doi: 10.1007/s11948-017-9997-9.

15. Bouter LM, Tijdink J, Axelsen N, Martinson BC, Ter Riet G, 2016.
Ranking major and minor research misbehaviors: results from a
survey among participants of four World Conferences on Re-
search Integrity. Res Integr Peer Rev 1: 17.

16. Helgesson G, Eriksson S, 2015. Plagiarism in research. Med
Health Care Philos 18: 91–101.

17. Saldaña-Gastulo JJ, Quezada-Osoria CC, Peña-Oscuvilca A,
Mayta-Tristán P, 2010. Alta frecuencia de plagio en tesis de
medicina de una universidad pública Peruana. Rev Peru Med
Exp Salud Publica 27: 63–67.

18. Misra DP, Ravindran V, Wakhlu A, Sharma A, Agarwal V, Negi VS,
2017. Plagiarism: a viewpoint from India. J Korean Med Sci 32:
1734–1735.

19. Li Y, 2013. Text-based plagiarism in scientific publishing: issues,
developments and education. Sci Eng Ethics 19: 1241–1254.

20. Heitman E, Litewka S, 2011. International perspectives on pla-
giarism and considerations for teaching international trainees.
Urol Oncol 29: 104–108.

21. Zhang Y, 2010. Chinese journal finds 31% of submissions pla-
giarized. Nature 467: 153.

22. Lykkesfeldt J, 2016. Strategies for using plagiarism software in
the screening of incoming journal manuscripts: recommenda-
tions based on a recent literature survey. Basic Clin Pharmacol
Toxicol 119: 161–164.

23. Marshall T, Taylor B, Hothersall E, Perez-Martin L, 2011. Plagia-
rism: a case study of quality improvement in a taught post-
graduate programme. Med Teach 33: e375–e381.

24. Marusic A, Wager E, Utrobicic A, Rothstein HR, Sambunjak D,
2016. Interventions to prevent misconduct and promote in-
tegrity in research and publication. Cochrane Database Syst
Rev 4: MR000038.

25. Gasparyan AY, Nurmashev B, Seksenbayev B, Trukhachev VI,
Kostyukova EI, Kitas GD, 2017. Plagiarism in the context of
education and evolving detection strategies. J Korean Med Sci
32: 1220–1227.

26. International Committee of Medical Journal Editors (ICMJE),
2018. Defining the Role of Authors and Contributors. Available
at: http://www.icmje.org/recommendations/browse/roles-and-
responsibilities/defining-the-role-of-authors-and-contributors.
html. Accessed March 5, 2018.

27. OHRP, 2009. 45 CFR 46 Code of Federal Regulations. Available
at: https://www.hhs.gov/ohrp/regulations-and-policy/regulations/
45-cfr-46/index.html.

28. Parker M, Kingori P, 2016. Good and bad research collaborations:
researchers’ views on science and ethics in global health re-
search. PLoS One 11: e0163579.

29. Crump JA, Sugarman J, 2008. Ethical considerations for short-
term experiences by trainees in global health. JAMA 300:
1456–1458.

30. DeCamp M, Lehmann LS, Jaeel P, Horwitch C; ACP Ethics,
Professionalism and Human Rights Committee, 2018. Ethical
obligations regarding short-term global health clinical experi-
ences: an American College of Physicians position paper. Ann
Intern Med 168: 651–657.

31. Jagsi R, Griffith KA, Jones R, Perumalswami CR, Ubel P, Stewart
A, 2016. Sexual harassment and discrimination experiences of
academic medical faculty. JAMA 315: 2120–2121.

32. Clancy K, 2018. Have the Sciences Had a #MeToo Moment? Not
so Much. Washington, DC: National Geographic.

33. Committee on the Impacts of Sexual Harassment in Academic
Sciences E, and Medicine, 2018. Sexual Harassment of Women:
Climate, Culture, and Consequences in Academic Sciences,
Engineering and Medicine. Washington, DC: National Acade-
mies Press.

34. Hamer DH, Rispel L, Nxumalo N, 2019. Global health research
mentoring competencies for individuals and institutions in
low and middle-income countries. Am J Trop Med Hyg 100
(Suppl 1): 15–19.

MENTORSHIP ETHICS 47

http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html
http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html
http://www.icmje.org/recommendations/browse/roles-and-responsibilities/defining-the-role-of-authors-and-contributors.html
https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html
https://www.hhs.gov/ohrp/regulations-and-policy/regulations/45-cfr-46/index.html