Abstract

BackgroundGenetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. A range of ethics and regulatory issues need to be addressed through comprehensive policy frameworks that integrate with local environments. While important efforts have been made to enhance understanding and awareness of ethical dimensions of GGR in Africa, including through the H3Africa initiative, there remains a need for in-depth policy review, at a country-level, to inform and stimulate local policy development and revision on the continent.MethodsTo identify and characterize existing ethics-related guidelines and laws applicable to GGR across much of Africa, we conducted a scoping review of English language policy documents identified through databases, repositories, and web searches. Thirty-six documents were included and coded using a framework that contained a range of themes across five analytical categories: (1) respect, (2) beneficence, (3) justice, (4) independent oversight, and (5) bans and prohibitions. Data analysis software (NVivo 12) was used to organize, code, and tabulate information according to document characteristics and topics. Illustrative examples of policy requirements were selected for inclusion.ResultsDocuments that met inclusion criteria spanned 20 years; published between 1996 and 2018, with the majority (58%) published after 2009. About two-thirds were denoted as “guidelines,” and slightly more than half were non-exclusive to GGR. Very few (six) country-level documents identified were specific to GGR. Requirements related to the principle of “respect” appeared most often across all documents, relative to other principles and processes. The most commonly stated ban was on reproductive cloning. Other prohibitions applied to germline editing, undue inducements in research, sample use for commercial purposes, employee mandatory DNA testing, fetal sex selection, stem cell use, eugenics, and research without public health benefits.ConclusionsEnforceable policies that are indispensable to the ethical conduct and review of GGR are either deficient or missing in many African countries. Existing international, GGR-specific ethics guidelines can be used to inform GGR policy development at a country-level, in conjunction with insight from country specific ethics committees and other local stakeholders.

Highlights

  • Genetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges

  • Other common ethical challenges in GGR in Africa and elsewhere include issues related to informed consent [3,4,5,6,7], privacy and confidentiality [3, 4, 7, 8], community engagement [7, 9, 10], data sharing [6, 8, 11, 12], and return of research results and incidental findings [6, 13,14,15]

  • A majority (22) of the documents were published by a national institution such as a Ministry of Health, rather than by an international organization such as the World Health Organization (WHO)

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Summary

Introduction

Genetics and genomics research (GGR) is increasingly being conducted around the world; yet, researchers and research oversight entities in many countries have struggled with ethical challenges. Ali et al BMC Med Ethics (2021) 22:39 until recently, researchers within many less-resourced countries, including several across sub-Saharan Africa, who did not have access to up-to-date facilities, technologies, or training and who faced significant financial barriers, had to rely on genetic analyses being conducted outside of the countries of specimen origin. This contributed to “a sense of mistrust and exploitation,” among African researchers and research participants [3]. Other common ethical challenges in GGR in Africa and elsewhere include issues related to informed consent [3,4,5,6,7], privacy and confidentiality (e.g., re-identifiability and data breaches) [3, 4, 7, 8], community engagement [7, 9, 10], data sharing [6, 8, 11, 12], and return of research results and incidental findings [6, 13,14,15]

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