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Citation: Annual meeting of the Eastern Mediterranean Research Ethics Review Committee. East Mediterr Health J. 2020;26(3):xxx–xxx https://doi.org/10.26719/2020.26.3.362

Copyright © World Health Organization (WHO) 2020. Open Access. Some rights reserved. This work is available under the CC BY-NC-SA 3.0 IGO license (https://creativecommons.org/licenses/by-nc-sa/3.0/igo).

¹ This report is based on the proceedings of the Informal consultative meeting on testing and adopting planning for the global interactive Robson platform in the Eastern Mediterranean Region, 4–5 September 2019, Cairo, Egypt (http://applications.emro.who.int/docs/IMR-WRH-109-2019-EN.df?ua=1).

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Introduction

The annual meeting of the Eastern Mediterranean Research Ethics Review Committee (RERC) took place at the WHO Regional Office for the Eastern Mediterranean in Cairo, Egypt, from 17 to 18 November 2019 (1). The meeting was attended by Committee members from Egypt, Lebanon, Palestine and Tunisia, in addition to staff from the WHO Regional Office for Eastern Mediterranean, Cairo, Egypt. The objectives of the meeting were to: review progress on recommendations of the 2018 meeting; plan for the RERC’s work during 2020 and beyond; discuss the status of the upcoming regional bioethics summit; and discuss effective means for implementing the expanded agenda for RERC’s work in the Eastern Mediterranean Region.

Summary of discussions

The Committee reviewed progress on implementation of the recommendations of the previous RERC meeting in 2018 (2). Extensive discussion took place on sub-dividing proposals submitted for ethical clearance into three categories of review: “full review”, “expedited review” and “exempted from review”. In addition, the Committee felt that proposals that do not involve human participants are beyond the Committee’s mandate within its current terms of reference.

The activities of WHO’s Collaborating Centre for Bioethics in Karachi, Pakistan, were presented. The need to improve collaboration and networking with other collaborating centres, both in the Region and globally, was the main challenge identified, in addition to the limited available funding and staff. A subcommittee of the RERC, reviewed WHO online ethics-related courses and suggested two courses for ethics review committee members and researchers in the Region regarding ethics and research ethics. The courses are “Essential Elements of Ethics” (3) and “Research Ethics Online Training” (4).

Planning challenges and the outcomes of a workshop on research during emergencies, which took place in Amman, Jordan, in March 2019, were shared, highlighting several challenges faced by ethics review committees in humanitarian settings. These include the lack of ethical guidelines specific to humanitarian settings and the role of funding and international agencies in obtaining or providing ethical clearance. The need for capacity-building for ethics review committees was highlighted. There was a suggestion to build a database of all national review committees, or even institutional review committees, and make it publicly available on the WHO Regional Office website.

The United Nations Educational, Scientific and Cultural Organization (UNESCO)/League of Arab States Charter of Ethics of Science and Technology in the Arab Region was presented and discussed. The Charter is ready for dissemination among countries in the WHO Eastern Mediterranean Region; first dissemination of the Charter will be during the 13th Global Summit of National Ethics/Bioethics Committees, planned to be held in Lisbon, Portugal, during the period 18–20 March 2020.

Ethics and governance of artificial intelligence for health was also discussed. The development of an ethical framework for artificial intelligence in health is currently in progress. The process has involved several stakeholders, including academics, human rights experts and representatives of civil society, international organizations, industry and government.

Recommendations

To WHO

Reviewing the name and mandate of the RERC to go beyond “research ethics” to “ethics” in general, which would serve an unmet need within WHO and an important demand within countries of the Eastern Mediterranean Region. If approved, the Committee would have the following terms of reference: to ensure compliance with WHO’s operational guidelines for ethics committees that review biomedical research and Council for International Organizations of Medical Sciences (CIOMS)/WHO international ethical guidelines for health research involving humans; to review protocols of health/research projects involving human subjects recommended for WHO funding in the Region, including randomized controlled trials; to support the development and work of ethics review committees/institutional review boards in the Region; and to support interagency work on bioethics (especially with UNESCO), and foster the work of national ethics/bioethics committees in the Region.

Supporting bioethics/research ethics work in the Region, including capacity building.

Ethically reviewing WHO-funded proposals/protocols, including Research in Priority Areas in Public Health (RPPH) and Tropical disease Research (TDR) proposals.

Fostering work with UNESCO on bioethics and research ethics in the Region.

To Member States

Ensuring that members of research ethics committees have a minimum of bioethics/ethics training.

Using the appropriate nomenclature when establishing ethic committees, including National Bioethics Committee (NBC), National Ethics Committee (NEC), Ethics Review Committee (ERC), Institutional Review Board (IRB) and Research Ethics Committee (REC)

References

1. World Health Organization Regional Office for the Eastern Mediterranean (WHO/EMRO). Summary Report on the Annual Meeting of the Eastern Mediterranean Research Ethics Review Committee. Cairo: WHO/EMRO; 2019 (http://applications.emro.who.int/docs/EMRPC046E.pdf?ua=1)
2. World Health Organization Regional Office for the Eastern Mediterranean (WHO/EMRO). Annual meeting of the Eastern Mediterranean Region Research Ethics Review Committee 2018. Cairo: WHO/EMRO; 2018 (http://www.emro.who.int/fr/rpc/rpc-infocus/annual-meeting-eastern-mediterranean-region-research-ethics-review-committee-2018.html)
3. Global Health Training Centre. Essential elements of ethics (https://globalhealthtrainingcentre.tghn.org/essential-elements-ethics/).
4. Global Health Training Centre. Research ethics online training (https://globalhealthtrainingcentre.tghn.org/elearning/research-ethics/).