The importance of ethical reflection in Union activities. Report on a symposium at the 38th Union World Conference on Lung Health in Cape Town, 8-12 November 2007.

A range of ethical challenges associated with the incidence, management and control of tuberculosis (TB) needs to be recognised and addressed. The attention currently paid to such issues related to TB is disproportionately scant by comparison with that accorded to human immunodeficiency virus infection and the acquired immune-deficiency syndrome. Ethical issues of human rights, equity and justice were highlighted in examples of gross discrepancies in the adequacy of care provided in communities with disparate socio-economic status or health service provision. The ethical standards that govern research in industrialised countries are not always mirrored in developing countries. Further support for capacity building in research ethics review processes in such countries is needed to raise ethical standards and guard against exploitation of vulnerable populations. The Union Ethics Advisory Group has begun to address some of these issues, starting with research activities that involve the Union. It now aims to extend its interest over the broad span of ethical issues that are integral to a range of Union activities. The contributions to this symposium emphasised the extent of need for this involvement and the importance of efforts to promote ethical reflection among members, staff and collaborators. The dividend of these efforts could be not only to raise the quality, credibility and relevance of the work of the Union but also to enhance the impact of its activities in the fight against TB and other lung diseases.