Abstract

BackgroundConcerns have been expressed regarding the adequacy of ethics review systems in developing countries. Limited data are available regarding the structural and functional status of Research Ethics Committees (RECs) in the Middle East. The purpose of this study was to survey the existing RECs in Egypt to better understand their functioning status, perceived resource needs, and challenges.MethodsWe distributed a self-administered survey tool to Egyptian RECs to collect information on the following domains: general characteristics of the REC, membership composition, ethics training, workload, process of ethics review, perceived challenges to effective functioning, and financial and material resources. We used basic descriptive statistics to evaluate the quantitative data.ResultsWe obtained responses from 67% (12/18) of the identified RECs. Most RECs (10/12) have standard operating procedures and many (7/12) have established policies to manage conflicts of interests. The average membership was 10.3 with a range from 7-19. The predominant member type was physicians (69.5% of all of the REC members) with little lay representation (13.7%). Most RECs met at least once/month and the average number of protocols reviewed per meeting was 3.8 with a range from 1-10. Almost three-quarters of the members from all of the 12 RECs indicated they received some formal training in ethics. Regarding resources, roughly half of the RECs have dedicated capital equipment (e.g., meeting room, computers, office furniture, etc); none of the RECs have a formal operating budget. Perceived challenges included the absence of national research ethics guidelines and national standards for RECs and lack of ongoing training of its members in research ethics.ConclusionOur study documents several areas of strengths and areas for improvements in the operations of Egyptian RECs. Regarding strengths, many of the existing RECs meet frequently, have a majority of members with prior training in research ethics, and have written policies. Regarding areas for improvements, many RECs should strive for a more diverse membership and should receive more financial resources and administrative support personnel. We recommend that RECs include more individuals from the community and develop a continuing educational program for its members. Institutional officials should be aware of the resource capacity needs of their RECs.

Highlights

  • Concerns have been expressed regarding the adequacy of ethics review systems in developing countries

  • Recruitment and Distribution Process We identified the existence of Research Ethics Committees (RECs) in Egypt by conducting web searches, contacting REC members who attended research ethics workshops in Egypt, searching the list of registered RECs on the Office of Human Research Protections (OHRP) website, and contacting trainees of the Fogarty International Center/National Institutes of Health (FIC/NIH) who are members of Egyptian RECs [12]

  • Guidelines rated by RECs as being 'very appropriate' included the Council for International Organizations of Medical Sciences (CIOMS) guidelines (64%); the Declaration of Helsinki (78%), and the Islamic Organization for Medical Sciences (IOMS) (56%)

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Summary

Introduction

Concerns have been expressed regarding the adequacy of ethics review systems in developing countries. The purpose of this study was to survey the existing RECs in Egypt to better understand their functioning status, perceived resource needs, and challenges. Research involving human subjects has increased in various regions in the developing world, including the Middle East [1]. Commentators have voiced concerns that research ethics committees (RECs) in developing countries might not be able to promote high standards of human subject protection due to inadequate financial and material resources, lack of adequately trained REC members, insufficient diversity of membership, lack of REC independence, and inability to monitor approved protocols [2,7,8,9]. Such information would help guide policy makers (e.g., Ministry of Health and top officials at academic institutions) and training programs in their support of strengthening of such committees This survey study was undertaken to better understand the operating characteristics, status, and challenges of existing RECs in Egypt

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