Ethical guidelines for military-based health research: an unmet need in Africa?

Abstract

Background: Achieving the highest standards of ethics in military health research is a challenging but crucial undertaking. The military environment is complex and African military health professionals struggle to maintain a balance between ethics and military ethos. The objective of this paper is to review ten existing research ethics guidelines for their application to the military context, and describe the need for guidance in military research ethics in sub-Saharan Africa. Method: To achieve this, five prominent international research ethics guidelines and five African guidelines were selected using some inclusion/exclusion criteria. Thereafter, designed topics were used in analyzing them for their strengths and weaknesses in providing protection for military research participants. Results: Out of the five international guidelines reviewed, only the Council for International Organization of Medical Sciences (CIOMS) mentions the “armed forces”. Similarly, the only African national guideline that specifically mentions the “armed forces” is the Ugandan national guideline. Conclusions: We conclude that national and international guidelines for human subject research may be too general and not suitable for research with military populations. There is a need for additional guidance in research ethics for militaries in sub-Saharan Africa.