Aminu Yakubu: Ethical Issues Surrounding Global Research

Our guest Aminu Yakubu discusses the current state of global research as well as some of the ethical issues brought to light by the recent Ebola epidemic. Play the podcast in the player below or download it to your computer, smart phone, or tablet. Or, subscribe to the podcast on iTunes or Stitcher, listen on Google Play Music, or sign up to be notified when a new podcast is available.

Aminu Yakubu(1)Spotlight on Global Research

Research is very much a global effort, as recently illustrated by the Ebola epidemic. The crisis brought the world together in the search for an effective treatment or vaccine. However, it shouldn't stop there.

The 10/90 gap (10% of research funding goes to areas where 90% of preventable deaths occur) is still present and a problem. Ebola has helped bring more awareness to the gap, but there is fear that global concern will remain on Ebola. A global research drive must be able to address some of the other diseases that affect the parts of the world where the burden of disease is the highest.

Ethical Issues in Research During the Ebola Crisis

Randomized Controlled Trials
Randomized controlled trials (RCT) are considered the “gold standard” in clinical research, but RCT may be ethically problematic in two ways: mistrust and case fatality rates.

Where there is chaos, RCT is only going to create more chaos. Aminu Yakubu

During the Ebola crisis, mistrust of researchers and health professionals led to people running away from quarantine and stealing medication from clinics. Under a declaration by the WHO, unproven treatment is allowed under emergency situations, and Aminu is as advocate for adaptive trials that put fewer people at risk while still allowing researchers to evaluate data on a real-time basis.

Another issue that cropped up during the Ebola epidemic related to samples taken from affected communities. A majority of research samples were taken out of affected countries without any recourse to government regulations or any kind of authorization. Affected countries feel their sovereignty was breached and that protocols should be in place to return samples to their country of origin after they are analyzed.

The Meaning of Trust in the Context of Ethical Research

Earning trust is a vital component of global research. Participants and communities involved in research must trust that researchers are there for the greater good, not for exploitative purposes. There are two things research institutions can do to earn trust:

  • Respect the role of the state: Make an effort to comply with local rules and regulations.
  • Respect the community: Find a process to ensure that research is conducted in a way that the community understands is for the greater good.

Advice for IRB members

  • Understand and respect that Africa is a huge continent - you cannot overgeneralize. Regional and local nuances need to be taken into account when reviewing protocols that pertain to the African continent
  • Be open and put a human face on global research participants. Give them the same considerations you would to research conducted in any other part of the world.
  • Remember that you can talk to an IRB in another country - just pick up the phone and call.