33.3 In Practice: Capacity Building for Research Ethics Review in Low- and Middle-Income Countries

All research with human participants must undergo ethical review by a research ethics committee with jurisdiction over the location of a proposed research study. Recent global infectious disease outbreaks have exposed shortcomings even in otherwise well-functioning ethical review systems in developed countries when they must meet the urgent demands of outbreak research. Moreover, relatively little global health research funding and resources have supported development of research ethics review system capacities in low- and middle-income countries. Countries with less robust ethics review systems and limited current support, less pertinent expertise, and lower administrative capabilities have been even more affected by emergency outbreaks. To be better prepared for the next outbreak or other public health emergencies, research partners must make every effort to support sustainable development of local resources and institutions, oversight of ongoing research, and review of new research proposals. This chapter will concentrate on three areas: (1) evaluation of existing research ethics review capacity, (2) partnering and exchange to immediately address gaps and needs, and (3) developing future research infrastructure and capacity to ensure epidemic ethics preparedness.