Policy Fourm The Structure and Function of Research Ethics Committees in Africa A Case Study Nancy E Kass Adnan Ali Hyder Ademola Ajuwon John Appiah Poku Nicola Barsdorf Dya Eldin Elsayed Mantoa Mokhachane Bavon Mupenda Paul Ndebele Godwin Ndossi Bornwell Sikateyo Godfrey Tangwa Paulina Tindana A ccording to international guidelines 1 2 and several nations laws 3 5 research with humans requires independent ethics committee review In the United States committees are called institutional review boards IRBs 6 elsewhere they generally are called research ethics committees RECs Committees are designed to provide third party review thereby minimizing con icts of interest protect the welfare of research participants through attention to risks bene ts and informed consent and avoid exploitation of vulnerable individuals and populations Most literature examining RECs comes from wealthier countries One US study found serious concerns with the quality of 14 of IRB reviews 7 Another found that IRBs focused predominantly on consent documentation spending less time examining voluntariness selection of participants and risk 8 Many US 9 15 and international 16 18 studies have found that different research ethics committees reach different conclusions when reviewing the same study Several scholars and advisory bodies have made recommendations to address challenges facing US IRBs 19 22 However there has been little research examining procedures strengths and challenges of RECs in developing countries Two case reports describe disagreements between host and sponsoring country RECs 23 24 and an international survey reports differences in sponsoring and host country reviews 25 Three articles describe RECs within one country Turkey 26 Granada 27 and Sudan 28 and ve within a larger region The Policy Forum allows health policy makers around the world to discuss challenges and opportunities for improving health care in their societies PLoS Medicine www plosmedicine org Rivera described 20 RECs in Latin America nding that only 45 had standard operating procedures and that members had limited training 29 Coker examined RECs in Central and Eastern Europe 30 Ten countries had national committees Most literature examining research ethics committees comes from wealthier countries most committees included nonmedical members and three provided training The World Health Organization s WHO Southeast Asian Regional Of ce nding that only some of the 16 respondents had national RECs called for capacity development in the area of research ethics 31 Funding This project was funded in part by a grant from the Fogarty International Center National Institutes of Health R25 TW01604 Competing Interests The authors have declared that no competing interests exist Citation Kass NE Hyder AA Ajuwon A AppiahPoku J Barsdorf N 2007 The structure and function of research ethics committees in Africa A case study PLoS Med 4 1 e3 doi 10 1371 journal pmed 0040003 Copyright 2007 Kass et al This is an open access article distributed under the terms of the Creative Commons Attribution License which permits unrestricted use distribution and reproduction in any medium provided the original author and source are credited Abbreviations FWA Federal Wide Assurance IRB institutional review board JHU Johns Hopkins University REC research ethics committee WHO World Health Organization Nancy E Kass is the Phoebe R Berman Professor of Bioethics and Public Health and Adnan Ali Hyder is an Assistant Professor Berman Institute of Bioethics Johns Hopkins School of Public Health Baltimore Maryland United States of America Ademola Ajuwon is a Senior Lecturer African Regional Health Education Centre Department of Health Promotion and Education College of 0026 The WHO African Regional Of ce found that 36 of member countries had no REC In the countries that did have RECs most RECs met monthly ve met quarterly and one never met 32 Finally Milford examined African RECs resource needs in the context of HIV vaccine trial preparedness nding that 97 believed African RECs had inadequate training in ethics and HIV vaccine trials and 80 believed African RECs had inadequate training in health research ethics Additional information on how African RECs function including their staf ng operating procedures strengths and challenges would be useful for African and international researchers working within Africa and for growing efforts to enhance ethics capacity on this vast continent We therefore used a case study approach to shed light on the structure and functioning of RECs in Africa Medicine University of Ibadan Ibadan Nigeria John Appiah Poku is a Lecturer and institutional review board administrator Komfo Anokye Teaching Hospital Department of Behavioral Sciences School of Medical Sciences Kwame Nkrumah University of Science and Technology Kumasi Ghana Nicola Barsdorf is Project Coordinator for the Ethics Law and Human Rights Working Group WHO UNAIDS African AIDS Vaccine Programme School of Psychology University of KwaZulu Natal Pietermaritzburg KwaZulu Natal South Africa Dya Eldin Elsayed is an Assistant Professor Department of Community Medicine Faculty of Medicine Alzaiem Alazhari University Khartoum North Sudan Mantoa Mokhachane is Head of the Neonatal Unit Chris Hani Baragwanath Hospital Meyersdal Gauteng South Africa Bavon Mupenda is Lecturer Tropical Institute of Community Health and Development in Africa Kisumu Kenya Paul Ndebele is Visiting Lecturer University of Malawi Medical Research Council of Zimbabwe Harare Zimbabwe Godwin Ndossi is Managing Director Tanzania Food and Nutrition Centre Dar es Salaam Tanzania Bornwell Sikateyo is a Research Monitoring and Evaluation Specialist Lusaka Zambia Godfrey Tangwa is Professor and Head of the Philosophy Department University of Yaounde Yaounde Cameroon Paulina Tindana is Research Of cer Bioethicist Navrongo Health Research Centre Ministry of Health Navrongo U E Region Ghana To whom correspondence should be addressed E mail nkass jhsph edu January 2007 Volume 4 Issue 1 e3 Methods The Johns Hopkins Bloomberg School of Public Health received a training grant from the Fogarty International Center in 2000 to train three African professionals in bioethics each year 33 Several of these professionals explicitly seek to increase the scholarly and administrative capacity of their African RECs In 2004 program faculty and trainees created a structured questionnaire to document the history composition functioning nancing