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African research ethics committees struggle with inadequate funding, staffing and training, and are not properly fulfilling their missions, say researchers.

On a positive note, these independent review groups — charged with reviewing medical research regulations — are becoming more numerous, according to a study published in PLoS Medicine this week (22 January).

The authors of the report recommend that African countries enforce the creation of research ethics committees and monitor their operations.

"Research ethics committees are expensive, so some countries will not create them until they are told to do so," said lead researcher Nancy Kass of the Johns Hopkins Berman Institute of Bioethics, United States.

Little is known about how research ethics committees in Africa operate, though the number of Africans participating in health research is on the rise.

The study examined the history and operational structure of 12 research ethics committees in nine African countries.

Funding was found to be a major issue, with a quarter of the committees studied having no operational budget in place. The rest relied on funding from government or foreign donors and fees paid for ethical review. According to the study, some committees approved studies simply to secure the fees.

The authors say some committees were hesitant to criticise research proposals, as a clinical study may bring jobs, medicines or prestige to communities in Africa.

Committees also lacked expertise in the ethical aspects of proposed research, and some members were inadequately trained in ethical practice — two committees had members with no training at all.

However, research ethics review is becoming more common in some parts of Africa. The authors say this may partly be due to an increase in the number of Africans submitting articles to international journals that require approval from a local research ethics committee.

Many committees had been formed recently, but the longer a committee has existed, the more likely it was to pay close attention to ethical practice and have secure funding.

Kass hopes the report will help funders manage resources for capacity development, and researchers understand the landscape of ethics review in Africa.

But Juntra Karbwang-Laothavorn of the World Health Organization said an "overall approach" to ethical decision-making in medical research was needed, not limited to the role played by ethical review committees.

"Decision-makers in health research and health policymakers need to be empowered to promote individual and public health through research by better integrating ethics into their decision-making processes," he told SciDev.Net.

Last week (18 January), at a national health research conference in Lusaka, Zambia, health minister Angela Cifire said there was an "unacceptable" trend of scientists conducting health research in Zambia without ethical clearance. She highlighted the urgent need for a Zambian ethical review board to regulate and monitor health research.

Link to full paper in PLoS Medicine

Reference: PLoS Medicine doi:10.1371/journal.pmed.0040003 (2007)

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