Mapping research ethics committees in Africa: Evidence of the growth of ethics review of health research in Africa

Mokgatla, Boitumelo; IJsselmuiden, Carel; Wassenaar, Douglas; Kasule, Mary

doi:10.1111/dewb.12146

Cited by 22 publications

(34 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Research ethics is typically common and established in most African countries [19,24] as there is abundant funding from the United States (NIH) and Europe (EDCTP) to establish RECs so that clinical trials funded by these organisations may be reviewed in Africa. Healthcare and clinical ethics are not prioritised by funders whose interest lies more with research than healthcare despite the two disciplines intersecting inextricably in multiple ways.…”

Section: Discussionmentioning

confidence: 99%

“…It is also concerning that, in Africa, ethics deliberation is mainly emphasised in the context of research but not in clinical practice. This is because research ethics is the most developed aspect of bioethics in Africa, with substantial investment and support from international funders from resource rich countries [23,24]. These funders support clinical research in Africa on local populations but do not include healthcare or clinical ethics in their research awards or capacity development initiatives [24,25].…”

mentioning

confidence: 99%

See 1 more Smart Citation

Clinical Ethics Committees in Africa: lost in the shadow of RECs/IRBs?

et al. 2020

View full text Add to dashboard Cite

Background Clinical Ethics Committees (CECs) are well established at healthcare institutions in resource-rich countries. However, there is limited information on established CECs in resource poor countries, especially in Africa. This study aimed to establish baseline data regarding existing formal CECs in Africa to raise awareness of and to encourage the establishment of CECs or Clinical Ethics Consultation Services (CESs) on the continent. Methods A descriptive study was undertaken using an online questionnaire via SunSurveys to survey healthcare professionals and bioethicists in Africa. Data were subjected to descriptive analysis and Fischer's exact test was applied to determine associations. Texts from the open-ended questions were thematically analysed. Results In total 109 participants from 37 African countries completed the survey in December 2019. A significant association was found between participants’ bioethics qualification or training and involvement in clinical ethics (p = 0.005). All participants were familiar with Research Ethics Committees (RECs), and initially conflated RECs with CECs. When CECs were explained in detail, approximately 85.3% reported that they had no formal CECs in their institutions. The constraints to developing CECs included lack of training, limited resources, and lack of awareness of CECs. However, the majority of participants (81.7%) were interested in establishing CECs. Participants listed assistance required in establishing CECs including funding, resources, capacity building and collaboration with other known CECs. The results do not reflect CECs established since the onset of COVID-19 in Africa. Conclusions This study provides a first look into CECs in Africa and found very few formal CECs on the continent indicating an urgent need for the establishment of CECs or CESs in Africa. While the majority of healthcare professionals and bioethicists are aware of ethical dilemmas in healthcare, the concept of formal CECs is foreign. This study served to raise awareness of CECs. Research ethics and RECs overshadow CECs in Africa because international funders from the global north support capacity development in research ethics and establish RECs to approve the research they fund in Africa. Raising awareness via educational opportunities, research and conferences about CECs and their role in improving the quality of health care in Africa is sorely needed.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Clinical Ethics Committees in Africa: lost in the shadow of RECs/IRBs?

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Valuable ethics tools which have resulted from EDCTP-supported bioethics-initiatives have included the "Research Ethics in Africa" free online textbook [368], the Mapping African Research Ethics Review and Medicines Regulatory Capacity (MARC) project [369], the TRREE online training programme [370], AMANET's online training programme [371], and the Pan African Clinical Trial Registry, the only WHO-endorsed registry in Africa. This serves as a potentially very effective ethics compliance tool [372], among others.…”

Section: Edctp Partnerships and Activities To Strengthen Bioethics Camentioning

confidence: 99%

“…By 2016, MARC had mapped 167 RECs from 35 African countries; 20% were national bodies and 75% were institutional bodies; 19 African countries had not registered any type of ethics committee. The authors estimated that the actual number of active African RECs could be double the number mapped, approximately 330 [369].…”

Section: Edctp Partnerships and Activities To Strengthen Bioethics Camentioning

confidence: 99%

“…Data from MARC [369] indicate that a large proportion of RECs continue to operate on a hard copy-based sys-S224 tem (48% of RECs for which data were available). There is clearly room for improvement in the management of REC applications, a gap which could be filled by technology such as the Research for Health Innovation Organizer (RHInnO) a product of the Web 4Development team of COHRED [374].…”

Section: Edctp Partnerships and Activities To Strengthen Bioethics Camentioning

confidence: 99%

See 1 more Smart Citation

Medical Ethics in the 70 Years after the Nuremberg Code, 1947 to the Present

Czech

Druml

Weindling

2018

Wien Klin Wochenschr

View full text Add to dashboard Cite

Ethics has been an integral part of medicine since ancient times. However, the atrocities committed as part of Nazi medicine necessitated a novel approach, resulting in a framework of modern bioethical standards. Since World War II, we have witnessed a broad movement towards the introduction of normative regulations for medical research. This trend initially started with the Nuremberg Medical Trials and the "Nuremberg Code" of 1947, followed by the Helsinki Declaration of the World Medical Association of 1964, including later modifications and amendments. Furthermore there are relevant recommendations issued by the organs of the Council of Europe and by the World Health Organisation, the UNESCO Declarations and EU legislation, to name only the most important examples. Since the 1970s, the rapid and global development of the life sciences, with its unprecedented possibilities to interfere with basic aspects of human life, for example in reproductive medicine, has led to an even greater necessity to confront bioethical questions worldwide. The HIV pandemic burdening the Global South has required conducting research in different areas of the world and involving especially vulnerable populations. In view of these developments, the main topic of the conference was the influence of Nazi medical crimes, the Nuremberg Medical Trial and the resulting Nuremberg Code on the development of international bioethical norms, including the enduring impact of this legacy on today's medical research. In the 70 years since the promulgation of the Code, the world has changed: Research is based on the principles of exchange and cooperation, researchers are mobile, the internet provides a supporting framework removing national barriers. Although the European situation, with special attention to Austria, was part of the discussion, an important focus of the conference was on the role played by international organisations and their endeavours to establish normative standards for clinical research with a worldwide reach.

show abstract