Ethical dilemmas and safety concerns in conducting research in disaster situations Morenike Ukpong-Folayan Obafemi Awolowo University, Ile-Ife Fellow, Global Health Trials Network

Outline Current health disaster situations Ethical dilemma and lessons learnt International guidelines on biomedical research conducted during disaster situations Applications for the local context Conclusion

Current health disaster situations

Ebola Virus Disease

Zika Disease

H1N1 – Swine Flu

Severe Acute Respiratory Syndrome - SARS

Ethical dilemma and lessons learnt

Lessons learnt Laws and programs on public health respons should recognise the need to conduct research during emergencies. Local epidemics receive global interest and attracts foreign researchers. Culture, norms and practices should inform the design of research design

International guidelines on biomedical research

Ethical guidelines - 1 Governments and the international community have obligations Ensure national public health laws that also addresses how to handle research conduct during emergencies. Institute mechanisms for protocol reviews during such emergencies.

Ethical guidelines - 2 Involve local communities in the design and implementation of the research Inclusiveness Be aware of vulnerabilities Be open to diverse perspectives Be transparent Be accountable

Ethical guidelines - 3 Allocation of scare resources Balance utility with equity Fulfill reciprocity based obligations Avoid corruption

Ethical guidelines - 4 Research design and implementation Involve local researchers Time sensitive ethics review Address barriers to consent Select appropriate methodology Rapid data sharing Equitable benefits to research outcomes

Ethical guidelines - 5 Emergency use of unproven interventions Guidelines on fair distribution in the face of scarce resources Minimise risk Collect and share meaningful data Engage community in decision making on product use

Applications for the local context

Consideration for Nigeria Update of our public health laws to address consideration for research and use of unproven interventions during emergencies. Strengthen our public health surveillance and our health emergency response system. Local investment in research needs to improve IRB competency needs to improve

conclusion

Be prepared Health emergencies result in large number of deaths. Emergency preparedness only reduces the severity. Does not eliminate. It is however important to be prepared. Recognising our limitation as a developing country and forming formidable forces in the region is critical.

Acknowledgement My colleagues with whom I have worked on defining ethical considerations for Ebola research – Bridget Haire, Aminu Yakubu, Kris Peterson, Tegli Jamee, Brandon Brown. GTHN for the invite. Specially Dr Glory Ogunfowokan for for the support.