Global health ethics: Moral principles guiding healthcare decisions worldwide
Global health ethics: From Nuremberg trials to AI—navigating moral dilemmas
Dr. Sarah Omondi sat in the ethics committee meeting, her hands trembling slightly as she reviewed the research proposal. A pharmaceutical company wanted to test a promising new HIV vaccine in her community in rural Kenya. The science looked solid, the potential benefits enormous. But something troubled her.
“The consent forms are written in English,” she said. “Most of our community members can’t read English. They’re being promised free healthcare during the trial, but what happens when the trial ends? If the vaccine works, will our community afford it? Are we being used because we’re poor and desperate?”
These weren’t just administrative questions—they were profound ethical questions related to health. According to WHO’s work on global health ethics, ethical questions related to health, health care, and public health cover topics as diverse as moral issues around reproduction, state obligations in the provision of health care services, and appropriate measures to control infectious disease.
Dr. Omondi’s concerns echoed a dark history that changed medical ethics forever. For more on health research issues, see our articles on clinical trials and health equity at ObserverVoice.com.
From Nazi Horrors to Universal Principles
Scholars and health care professionals have debated ethical questions related to health and health care since the earliest days of medicine. Recent formal efforts to articulate international standards of ethics applicable to health and health care can be traced to the Nuremberg trials of 1947, during which the horrors of Nazi medical experiments came to light.
The principles that emerged from those trials, known as the Nuremberg Code, are broadly applicable to many types of health-related research involving human participants, including clinical trials. The Code established foundational principles: voluntary informed consent, avoidance of unnecessary suffering, benefits must outweigh risks, and participants must be free to withdraw.
The growing breadth and complexity of contemporary health challenges have produced a range of difficult questions that cannot always be adequately addressed by relying exclusively on existing policies, guidelines or codes of conduct. Debates over access to new and expensive pharmaceuticals and medical technologies, as well as increasing awareness of the gross health disparities that exist both within and between countries, have called attention to the need for an ethics of health policy and practice.
WHO’s Health Ethics & Governance department coordinates global efforts to address these challenges through developing normative guidance, building ethics capacity, and engaging the global community.
For more on historical medical ethics, see our articles on human rights in healthcare at ObserverVoice.com.
Research Ethics: Protecting Human Dignity
Research ethics govern the standards of conduct for scientific researchers. It is important to adhere to ethical principles in order to protect the dignity, rights and welfare of research participants.
The WHO Manual defines research with human subjects as any social science, biomedical, behavioural, or epidemiological activity that entails systematic collection or analysis of data with the intent to generate new knowledge, in which human beings are exposed to manipulation, intervention, observation, or other interaction with investigators either directly or through alteration of their environment; or become individually identifiable through investigator’s collection, preparation, or use of biological material or medical or other records.
WHO’s Research Ethics Review Committee (ERC) provides oversight for WHO-sponsored research. WHO published WHO guidelines on ethical issues in public health surveillance in June 2017, outlining 17 ethical guidelines for everyone involved in public health surveillance. WHO also provides a Q&A on ethics in public health surveillance.
In September 2023, WHO launched a tool for benchmarking ethics oversight of health-related research involving human participants, helping countries strengthen their research ethics systems.
WHO’s activities include ensuring ethical standards and procedures for research with human beings and framing the ethics of public health surveillance.
Ethics in Infectious Disease Control
Infectious diseases raise particularly challenging ethical questions. Immunization raises a host of challenging ethical questions that researchers, governments, funders, pharmaceutical companies, and communities must confront. TB ethical issues include questions about the equitable distribution of resources, protection of vulnerable groups, respect for patient choice of treatment options and solidarity between communities during outbreaks.
Zika has raised many specific ethical issues, in particular regarding pregnancy. At the same time, it has highlighted ethical issues that arise in vector-borne diseases more generally. The HIV epidemic has raised many ethical challenges for public health officials, researchers and clinicians, reaching from macro-level policy to micro-level clinical decisions.
During COVID-19, WHO developed extensive guidance. WHO’s Ethics and COVID-19 team coordinated responses. WHO published Q&A on ethics and COVID-19: resource allocation and priority setting, addressing impossible choices when resources are scarce.
WHO established the WHO Expert Group on Ethics & Governance of Infectious Disease Outbreaks and other Emergencies and the Public Health Emergency Preparedness and Response Ethics Network (PHEPREN).
WHO’s activities include supporting countries to manage ethical issues during outbreaks and emergencies.
For more on pandemic response, see our articles on infectious disease control at ObserverVoice.com.
New Frontiers: AI and Climate Ethics
Modern technology creates new ethical challenges. In January 2024, WHO released AI ethics and governance guidance for large multi-modal models, addressing how artificial intelligence should be developed and deployed in healthcare.
WHO established the Expert Group on Ethics and Governance of Artificial Intelligence for Health to provide ongoing guidance.
Climate change presents another urgent ethical frontier. In December 2023, WHO announced the Technical Advisory Group on Embedding Ethics in Health and Climate Change Policy (TAG-Ethics & Climate Health). WHO recognizes climate change as the biggest health threat facing humanity.
WHO published multiple reports from TAG meetings: first meeting February 2024, second meeting May 2024, and third meeting July 2024. In December 2025, WHO published Embedding ethics in health and climate change: WHO satellite meeting at 14th Global Summit.
WHO also addresses ethics of human genome editing through the Expert Advisory Committee on Developing Global Standards for Governance and Oversight of Human Genome Editing and maintains a Human Genome Editing (HGE) Registry.
Building Global Ethics Capacity
WHO coordinates multiple initiatives. The Global Network of WHO Collaborating Centres for Bioethics connects experts worldwide. The Global Summit of National Bioethics Committees provides a forum for countries to share experiences.
WHO’s Public Health Ethics Consultative Group and Working Group on Developing WHO Guidance on Clinical Ethics develop practical guidance.
WHO’s activities include developing normative guidance to address ethical challenges in global health, building ethics capacity, and engaging the global community in health ethics.
Dr. Omondi’s committee ultimately rejected the initial HIV vaccine proposal. The company came back with improved consent procedures in local languages, commitments for post-trial access, and meaningful community involvement in study design. “Ethics isn’t about saying no to research,” Dr. Omondi explained. “It’s about ensuring research respects human dignity and serves communities, not just profits.”
With WHO’s comprehensive approach to global health ethics, the principles born from Nuremberg’s darkness now illuminate difficult decisions worldwide—ensuring that as medical science advances, humanity’s moral compass remains true.
For more information, visit WHO’s global health ethics page or explore related content at ObserverVoice.com.
Frequently Asked Questions (FAQs)
According to WHO’s work on global health ethics, ethical questions related to health, health care, and public health cover topics as diverse as moral issues around reproduction, state obligations in the provision of health care services, and appropriate measures to control infectious disease. Scholars and health care professionals have debated ethical questions related to health and health care since the earliest days of medicine. Recent formal efforts to articulate international standards of ethics applicable to health and health care can be traced to the Nuremberg trials of 1947, during which the horrors of Nazi medical experiments came to light. The principles that emerged from those trials, known as the Nuremberg Code, are broadly applicable to many types of health-related research involving human participants, including clinical trials. The growing breadth and complexity of contemporary health challenges have produced a range of difficult questions that cannot always be adequately addressed by relying exclusively on existing policies, guidelines or codes of conduct. Debates over access to new and expensive pharmaceuticals and medical technologies, as well as increasing awareness of the gross health disparities that exist both within and between countries, have called attention to the need for an ethics of health policy and practice. WHO’s Health Ethics & Governance department coordinates global efforts. See our articles on medical ethics.
Research ethics govern the standards of conduct for scientific researchers. It is important to adhere to ethical principles in order to protect the dignity, rights and welfare of research participants. The WHO Manual defines research with human subjects as any social science, biomedical, behavioural, or epidemiological activity that entails systematic collection or analysis of data with the intent to generate new knowledge, in which human beings are exposed to manipulation, intervention, observation, or other interaction with investigators either directly or through alteration of their environment; or become individually identifiable through investigator’s collection, preparation, or use of biological material or medical or other records. WHO’s Research Ethics Review Committee (ERC) provides oversight for WHO-sponsored research. In September 2023, WHO launched a tool for benchmarking ethics oversight of health-related research. WHO published guidelines on ethical issues in public health surveillance June 2017 with 17 ethical guidelines. WHO’s activities include ensuring ethical standards and procedures for research with human beings and framing ethics of public health surveillance. See our articles on clinical research.
Infectious diseases raise particularly challenging ethical questions. Immunization raises challenging ethical questions that researchers, governments, funders, pharmaceutical companies, and communities must confront. TB ethical issues include equitable distribution of resources, protection of vulnerable groups, respect for patient choice of treatment options and solidarity between communities during outbreaks. Zika has raised specific ethical issues particularly regarding pregnancy while highlighting ethical issues in vector-borne diseases generally. The HIV epidemic has raised many ethical challenges for public health officials, researchers and clinicians, from macro-level policy to micro-level clinical decisions. During COVID-19, WHO’s Ethics and COVID-19 team coordinated responses. WHO published Q&A on ethics and COVID-19: resource allocation and priority setting. WHO established the Expert Group on Ethics & Governance of Infectious Disease Outbreaks and Public Health Emergency Preparedness and Response Ethics Network (PHEPREN). WHO’s activities include supporting countries to manage ethical issues during outbreaks and emergencies. See our articles on pandemic response.
Modern technology creates new ethical challenges. In January 2024, WHO released AI ethics and governance guidance for large multi-modal models, addressing how artificial intelligence should be developed and deployed in healthcare. WHO established the Expert Group on Ethics and Governance of Artificial Intelligence for Health to provide ongoing guidance. WHO also addresses ethics of human genome editing through the Expert Advisory Committee on Developing Global Standards for Governance and Oversight of Human Genome Editing and maintains a Human Genome Editing (HGE) Registry. In February 2023, WHO kicked off deliberations on ethical framework for social listening and infodemic management. WHO’s activities include developing normative guidance to address ethical challenges in global health. Related topics include WHO’s work on human genome editing and vaccines and immunization. See our articles on AI in healthcare.
Climate change presents an urgent ethical frontier. In December 2023, WHO announced the Technical Advisory Group on Embedding Ethics in Health and Climate Change Policy (TAG-Ethics & Climate Health). WHO recognizes climate change as the biggest health threat facing humanity. In furtherance of its mandate of articulating ethical principles, WHO convenes this expert group to address climate justice and health equity. WHO published multiple reports from TAG meetings: first meeting February 2024, second meeting May 2024, and third meeting July 2024. In December 2025, WHO published Embedding ethics in health and climate change: WHO satellite meeting at 14th Global Summit of National Ethics Committees. WHO coordinates multiple initiatives including the Global Network of WHO Collaborating Centres for Bioethics and Global Summit of National Bioethics Committees. WHO’s Public Health Ethics Consultative Group and Working Group on Developing WHO Guidance on Clinical Ethics develop practical guidance. WHO’s activities include building ethics capacity and engaging the global community in health ethics. See our articles on climate and health.
- WHO Global Health Ethics Topic Page
- WHO Guidelines on Ethical Issues in Public Health Surveillance (June 2017)
- WHO AI Ethics and Governance Guidance for Large Multi-Modal Models (Jan 2024)
- WHO Health Ethics & Governance Department
- Embedding Ethics in Health and Climate Change: WHO Satellite Meeting Report (Dec 2025)
Disclaimer: This article is an adaptation of publicly available information from WHO’s Global health ethics
health topic page (WHO, Geneva. Licence: CC BYNC-SA 3.0 IGO). WHO is not responsible for the
content or accuracy of this adaptation. This content is for informational and educational purposes
only and does not constitute medical advice. ObserverVoice.com is a news and information platform
— not a healthcare provider.
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