Mr. Jon-Andri Lys of the Commission for Research Partnership with Developing Countries (KFPE) in Bern, Switzerland, opened the Symposium with a presentation of the KFPE. It is a collaborative effort of the four Swiss Scientific Academies and seeks to contribute to the sustainable development of developing and transition countries through the promotion of development-oriented research and the elaboration of research strategic concepts. Mr. Lys expounded Training and Resources in Research Ethics Evaluation (TRREE), a new partnership on ethics in research in Africa that will provide training in research ethics evaluation. It will specifically address the ethics of clinical trials conducted in Africa to help ethics committee members make sure that they comply with international ethical standards. Mr. Lys highlighted that creating partnerships and rendering them successful is a task in itself that requires specific steps to ensure success and equality amongst the partners. This is too often misunderstood or underestimated, leading in some cases to avoidable failures.
Mr. Marie Hirtle from Biotika Research and Consulting in Mont-Royal, Canada, then presented the TRREE project for Africa. TRREE is a project to expand what was intially a grass-roots-led effort to provide Canadian research ethics committee members with a flexible training program adapted to their specific needs. Today, TRREE includes international members from Canada, Europe and Africa. Ms. Hirtle presented the efforts of TRREE, concentrating on the issue of protecting persons participating in research, especially in clinical drug trials. The many actors in international collaborative research must apply the highest ethical standards for research involving humans. However, many fail to apply these standards, while others, who do seek to apply them, find it difficult to ensure that these standards are applied in concrete situations. Mr. Hirtle sees the TRREE programme as an important strategy to ensure, partly through the development of a distance learning programme on research ethics, that research participant protection is improved and that the highest ethical standards are promoted in all international collaborative research.
Dr. Peter Ndumbe of the Department of Microbiology, Haematology and Infectious Diseases and the Faculty of Medicine and Biomedical Sciences at Yaoundé University, Cameroon, concluded the Symposium with a presentation on Research Ethics in Africa: Needs and Opportunities. Dr. Ndumbe concentrated on the fact that the development of health policy, as well as the teaching and practice of health sciences ought to be guided by evidence. Hence, the collection and validation of this evidence has to depend on methodologically and ethically acceptable standards. Often, the methodological issues are well respected, but ethical issues are too frequently neglected, both through ignorance and thorugh a sense that a good objective justifies the means. While it may be difficult to address ethical issues adequately in low-income countries such as Cameroon, they should not compromised.
In order to improve this situation, health training institutions should take the leadership and provide appropriate training has to be provided both to the teachers and to the students in this area. The Faculty of Medicine and Biomedical Sciences in Yaoundé has grappled with this issue for over 15 years. The major concerns that are encountered are the neglect of research in the daily decision making and the assumption that the provision of health services is inherently good and therefore cannot be challenged. Dr. Ndumbe concluded that training institutions must provide leadership in ensuring that research is conducted in an ethical manner.
The presentations were followed by a lively discussion chaired by Eduardo Gottuzo from Peru and Dominique Sprumont from Switzerland that focussed, amongst other issues, on the idea that ethical research should constitute the basis of health programs and that local communities also have a responsibility in this. Legislation will need to be improved to allow the creation of ethics committees. Assistance from high-income countries through programmes such as KFPE and TRREE can play an important role in this.
