African governments need to fund research ethics training

There has been significant growth in international collaborative research implemented in Sub-Saharan Africa over the past three decades – funded mainly by the United States, United Kingdom, Germany, Japan and other nations. This growth has in part led to debates about the ethics of some of the research.

For example, during the late 1990s there were serious debates regarding use of placebos in research on HIV treatment when treatment outcomes were already known. Some commentators accused researchers from rich countries of using poor African countries to conduct research which they could not conduct in their own countries due to the stringent protections already in place. Additionally, several papers described the weak research oversight systems in several African countries.

In response, several research ethics capacity development programmes were initiated across Sub-Saharan Africa with the support of the World Health Organization, US National Institutes of Health, Wellcome Trust, Erasmus Mundus programme, pharmaceutical companies and others.

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The initiatives have involved: training people from African institutions in ethical review; provision of funds to support strengthening of research ethics committees; the development of research ethics committee assessment tools; and sharing tools for use by research ethics committees.

Programmes have been established in Canada, the Democratic Republic of Congo, Kenya, South Africa, Nigeria, Tanzania and the US to train individuals from Sub-Saharan Africa. To date, more than 400 individuals have been trained at either diploma or masters level and more than 1,000 have participated in short-term training through workshops held in various countries.

In addition and in recognition of the need to train thought leaders across Africa, a few programmes that offer doctoral and post-doctoral training have been established with funding support from the National Institutes of Health. Bioethics centres have also been created in some African countries, including Malawi and South Africa, to support the strengthening of research ethics efforts.

Health sciences bias

One interesting observation regarding all these efforts is that the majority of training programmes are biased in favour of health sciences. This is understandable since the organisations providing the funding are based in the health sector. It is also understandable if one considers that the majority of historical abuses of research participants have occurred in the health sciences.

There are several examples of unethical research experiments conducted in various disciplines including business, military, agriculture, humanities, engineering and others; yet these cannot be compared to the heinous acts committed by some medical scientists in the name of science.

Current efforts aimed at strengthening research ethics need to be considered merely as a stimulant for further growth. African universities need to extend these initiatives by spreading them across campuses so that each institution of higher learning ends up having functional research ethics committees which cater for all research involving humans across all disciplines.

Institutions of higher learning also need to set up appropriate structures for handling research involving animals as well as research involving hazardous materials. Most institutions in Africa still do not have such structures and animals continue to be used in research that could not be conducted in academic institutions in the Global North. Some studies with negative implications for the environment also continue to be conducted across Sub-Saharan African institutions.

Research ethics training

As a next step, all African countries need to have regulations and national policies that address ethical research conduct. The regulations and policies would make it mandatory for all institutions that conduct research to train students in research ethics. Governments also need to make it mandatory for all institutions to put in place relevant policies and structures.

The World Health Organization, UNESCO and the African Union in collaboration with NEPAD – the New Partnership for Africa's Development – can play an important role in ensuring that research ethics standards are improved across Sub-Saharan Africa since they have influence over national governments. This will assist in ensuring that no African country can allow the conduct of unethical research.

Current efforts aimed at building research ethics capacity are externally funded and this raises questions about their sustainability. Due to changes in priorities, funds that are currently being availed for these programmes may not be available in the future.

A few African governments are currently providing some funds for supporting research. Governments need to wake up to the need for funding research that addresses national priorities.

African governments and institutions also need to realise that strengthening research oversight is a function that needs to be taken seriously. They therefore need to come up with mechanisms that ensure they can sustain current programmes after the initial funding phase.

These programmes can be supported in various ways, including through allocations from the treasury and allocations from research overhead charges. Additionally, programmes could be designed in such a way that they can attract trainees who are self-funded or funded from elsewhere.

Dr Paul Ndebele is a senior research regulatory specialist at George Washington University’s Milken Institute School of Public Health in the United States.