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WHO events addressing public health priorities

Citation: Annual meeting of the Eastern Mediterranean Research Ethics Review Committee, December 2021. East Mediterr Health J. 2022;28(5):390–391. https://doi.org/10.26719/2022.28.5.390

Copyright © World Health Organization (WHO) 2022. 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).

This summary is extracted from the report on the “Annual meeting of the Eastern Mediterranean Research Ethics Review Committee”, Cairo, Egypt 12 December 2021, https://applications.emro.who.int/docs/WHOEMRPC053E-eng.pdf.

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Introduction

Maintaining ethical standards is a critical aspect of medicine because advancements in medical practice often raise important questions that require ethical considerations (1). Hence, several institutions, including WHO, the World Medial Association, the Council for International Organizations of Medical Sciences, and many others, have established systems to ensure ethical compliance in biomedical research globally (2).

WHO, as the United Nations organization responsible for providing leadership on global health matters, leads on a wide range of ethics issues and provides support and guidance to Member States in handling issues relating to ethics in biomedical research within their territories. WHO articulates ethical and evidence-based policy options, promotes ethics-based approaches to health protection and promotion, and supports capacity-building to address ethical issues in public health nationally, regionally and globally (3).

In 2007, WHO/EMRO established the Eastern Mediterranean Research Ethics Review Committee (RERC) to provide leadership on medical ethics issues in the Eastern Mediterranean Region (2). Since its establishment, the Committee has played a critical role in reviewing protocols for health research projects that involve human subjects, to safeguard the dignity, integrity, human rights, safety, and well-being of human participants. The Committee continues to ensure that studies in the Region comply with WHO policies and regulations for the conduct of health research.

On 12 December 2021, RERC held its annual meeting at the WHO/EMRO office in Cairo, Egypt, with representatives of Egypt, Islamic Republic of Iran, Lebanon, occupied Palestinian territory, Pakistan, Tunisia, UNESCO, and WHO in attendance. The meeting reviewed RERC’s work during 2020/2021, shared outcomes of case studies of re­search ethics governance in 3 Member States, discussed contributions to the 2022 global bioethics summit, and plans for a regional bioethics summit.

Summary of discussions

There are currently 3 WHO collaborating centres (WHO-CC) on bioethics (4) in the Eastern Mediterranean Region (EMR): the Centre for Biomedical Ethics and Culture at the Sindh Institute of Urology and Transplantation, Karachi, Pakistan; the Medical Ethics and History of Medicine Research Center at Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran; and the newly designated Salim El-Hoss Bioethics and Professionalism Program at the Faculty of Medicine and Medical Center of the American University of Beirut, Lebanon.

The Islamic Republic of Iran currently has a national research ethics portal (5) that contains information about all accredited committees and has the infrastructure and platform for the implementation and integration of ethics in medical research at the national level. Its research ethics system is based on three pillars: introduction of research ethics standards, a disciplinary system for research misconduct, and strengthening research ethics committees at the three levels.

Lebanon recently conducted a mapping exercise of research ethics governance, which suggests a scarcity of dedicated policies on medical research ethics, except for some decrees addressing clinical and biomedical research. Ethical review processes are more formalized in universities, businesses, and hospitals, with less regulation in community settings, health care services, pharmacies, and in social research.

In Pakistan, there are research ethics committees in universities, medical colleges, and hospitals in the private and public sectors. The National Bioethics Committee (6) has a research ethics committee for human subject research and the Drug Regulatory Authority of Pakistan (7) has a clinical studies committee for clinical trials.

Recommendations

Key recommendations for the WHO included continued support for bioethics and research ethics in the Region; support for capacity-building of Member States in ethics and research methodology; strengthening the WHO collaborating centres in the Region to deliver training on research ethics, and strengthening national research ethics committees while supporting them to develop national ethics guidelines.

Member States were requested to ensure the development of databases on medical research ethics, establish accreditation systems for research ethics, strengthen the monitoring of trials involving human subjects and ensure that such trials are ethically approved, and develop national health frameworks to guide health research policies.

References

1. Mandil A; Dingwall P. Promoting bioethics in the Eastern Mediterranean Region. East Mediterr Health J. 2017;23(4):265-266. http://www.emro.who.int/emhj-volume-23-2017/volume-23-issue-4/promoting-bioethics-in-the-eastern-mediterranean-region.html.
2. Ammar M; Mandil A; El-Feky S. Ethics in health practice and research: an EMR perspective. East Mediterr Health J. 2016;22(1):62-63. http://www.emro.who.int/emhj-volume-22-2016/volume-22-issue-1/ethics-in-health-practice-and-research-an-emr-perspective.html.
3. Alwan A. Ethics and health in WHO Regional Office for the Eastern Mediterranean. East Mediterr Health J. 2016;22(1):3. http://www.emro.who.int/emhj-volume-22-2016/volume-22-issue-1/ethics-and-health-in-who-regional-office-for-the-eastern-mediterranean.html.
4. World Health Organization. Collaborating centres: Over 800 institutions in over 80 countries supporting WHO programmes. Geneva: WHO, https://www.who.int/about/collaboration/collaborating-centres.
5. Islamic Republic of Iran. Iran National Bioethics Committee, https://ethics.research.ac.ir/IndexEn.php.
6. Pakistan. National Bioethics Committee, http://nbcpakistan.org.pk/.
7. Pakistan. Drug Regulatory Authority of Pakistan, https://www.dra.gov.pk/.