FABTP » Bioethics Exchange

Berman Institute Hosts Global Bioethics Week

fabtp — Mon, 17 Jun 2013 14:24:59 +0000

UPDATE: View photos from our inaugural Global Bioethics Week

The Johns Hopkins Berman Institute of Bioethics will host its first “Global Bioethics Week” June 10-14, designed to launch two unique global research ethics initiatives, in collaboration with colleagues from several African universities.

Global Bioethics Week kicks off with the inaugural meeting of a new bioethics consortium between the Berman Institute and three African universities: University of Zambia,School of Medicine;Makerere University, College of Health Sciences; and University of Botswana, Office of Research & Development. The establishment of the consortium represents a new phase of the Berman Institute’s 13-year-old Fogarty African Bioethics Training Program (FABTP), focusing on building self-sustaining capacity for research ethics work within and between African universities.

“Too often over the past decade, research ethics capacity development work in Africa has involved sending trainees away to well-resourced institutions, only to face major challenges back at home that limited their ability to implement what they had learned,” says co- program directorNancy Kass, the Deputy Director for Public Health at BI. “This consortium will deepen institutional capacity at three strong African universities to support research ethics in ways that allow local experts to build, share and sustain their own research ethics programs,” she says.

Global Bioethics Week will also include a first-of-its-kind workshop, “Ethics of Health Systems Research in Low and Middle Income Countries,” co-sponsored by the BI and the Health Systems Program in the Department of International Health at the Johns Hopkins Bloomberg School of Public Health. Representatives from the three African universities will participate, joined by faculty from across Johns Hopkins University and other experts in ethics and health systems research.

Adnan Hyder, director of the Health Systems Program, Associate Director for Global Bioethics at BI, and co-program director of FABTP with Kass, noted that there are unique ethical concerns when reviewing and conducting health systems research in countries where people are already stressed by public health, economic, social, and political instability.

“This workshop is the first such meeting bringing global scholars of varying disciplines together to discuss these challenges, and work toward novel solutions,” Hyder says. “Johns Hopkins is in a unique position to further global dialogue on ethical issues around health systems research due to the university’s strong bioethics expertise and renowned experience in international health systems.”

In addition to the Global Bioethics Week events, six faculty members from the FABTP consortium African universities will spend the month of June in bioethics intensive courses, meetings with Johns Hopkins faculty and Institutional Review Boards, and visits to the National Institutes of Health Department of Bioethics, the Food and Drug Administration and other federal agencies in Washington, DC.

For more information on the Berman Institute’s Global Bioethics Program or intensive courses (open to all) at the Johns Hopkins Berman Institute of Bioethics, contact Joseph Ali at jali@jhu.edu.

JHU Gazette Covers FABTP NIH Grant Award!

fabtp — Tue, 17 Jul 2012 15:17:59 +0000

THE JHU GAZETTE

African Bioethics Program receives NIH continuation grant

By Leah Ramsay,

The Fogarty African Bioethics Training Program at the Johns Hopkins Berman Institute of Bioethics is planning its second decade of building capacity in research ethics across sub-Saharan Africa, thanks to a five-year grant from the Fogarty International Center of the National Institutes of Health.

In the program, an African institution is selected each year to send scholars to the Berman Institute, where they spend six months engaged in course work, seminars, intensive mentoring and leadership training. The funding then provides support for these individuals to complete a six-month practicum project in research ethics at their home African institution.

“We were first funded by Fogarty to start this program 12 years ago, when there were few opportunities for training in research ethics within Africa. We are honored and humbled to be awarded an additional five years of funding by the NIH,” said Nancy Kass, co-director of the program and deputy director for public health at the Berman Institute. “Many of our FABTP alumni have become recognized international ethics experts, and we look forward to this continued funding that will allow more African institutions to develop sustainable bioethics and research ethics centers,” she said.

Oliver Mweemba, a 2012 Fogarty Scholar from the University of Zambia’s School of Medicine, said that he wants to enhance research ethics education at his home institution, and his practicum project will develop and implement a curriculum for researchers, educators and staff. Mweemba teaches health promotion, social medicine and qualitative methods to undergraduate and graduate students. He has also been involved in HIV prevention research projects at both the national and international levels, and consulted on the Population Council’s study in Zambia on the impact of male circumcision on sexual behavior and condom use negotiations.

“The Fogarty training program in bioethics has been an eye-opener for me on the links between politics, social justice and health,” Mweemba said. “Working with experienced academics in the field provided a unique experience for sharing and discussing global issues in bioethics, as well as providing me with an ethics platform to critically analyze not only moral issues in doing research but also contextualize the research agenda in the global contest of power. My goal is to pass on this experience and skills to folks in Zambia,” he said.

Adnan Hyder, co-director of the Fogarty program and associate director for global programs at the Berman Institute, said that the program’s true strength comes from scholars like Mweemba, who continue research ethics development in their home countries. “Through our scholars, the Fogarty African Bioethics Training Program has a lasting impact,” Hyder said. “Fogarty bioethics scholars build research ethics capacity across Africa by implementing lessons and projects developed in the program for long-term benefit.”

Kass and Hyder, along with their colleague Joseph Ali, recently published a paper in the journal Developing World Bioethics looking back on the first nine years of the program; it’s available online.

In addition to the University of Zambia, in recent years the program has partnered with the College of Health Sciences at Makerere University in Kampala, Uganda, and with the Office of Research and Development at the University of Botswana.

“The Fogarty African Bioethics Training Program is a cornerstone of our Global Bioethics Program at the Berman Institute,” said Ruth Faden, director of the Berman Institute. “Thanks to this continued funding, we are looking forward to continuing the program and expanding institutional support for our Fogarty scholars as they implement their practicum projects.”

The program is currently accepting applications for 2013 partner institutions, which if selected will send up to four scholars for training at The Johns Hopkins University and Berman Institute. Eligible institutions include universities, hospitals, nongovernmental organizations and governmental institutions from sub-Saharan Africa that fund, regulate, conduct, oversee or provide training related to health research with human beings.

VISIT THE ORIGINAL ARTICLE!

Call for Applications for 2013 FABTP Partnership

fabtp — Fri, 20 Apr 2012 19:19:39 +0000

The Johns Hopkins-Fogarty African Bioethics Training Program is pleased to announce a call for applications for its fourth annual capacity development partnership in research ethics.

FABTP seeks applications from eligible African institutions for a funded collaborative partnership in international research ethics. The goal of the training partnership is to enhance research ethics capacity within the selected African institution. Applicant institutions must meet institutional eligibility requirements. The training partnership will occur over a 12-month period beginning December 2012, with opportunities for continued collaboration thereafter. The program will support the capacity development of one African institution per year.

For more information about the training partnership, eligibility requirements and application processes, please see the “Prospective Institutions” tab on our website. You may also send an email to fabtp@jhsph.edu with specific questions.

The application deadline is 15 July 2012.

A PDF flyer of this announcement can be downloaded here for posting on bulletin boards and further distribution.

FABTP Announces New Institutional Partner for 2012!

fabtp — Tue, 15 Nov 2011 21:01:42 +0000

The 2012 FABTP partner institution is University of Zambia- School of Medicine (Department of Public Health). Former 2004 FABTP trainee, Dr. Bornwell Sikateyo, will serve as the University of Zambia partnership director. Dr. Sikateyo is currently the director of the UNZA Research Support Centre (RSC) for the Southern Africa Consortium for Research Excellence (SACORE). He will be supported in his efforts to lead the Zambian side of the FABTP partnership by interim Dean of the School of Medicine and Head of the Department of Public Health, Dr. Charles Michelo. This partnership will focus on University of Zambia’s commitment to creating a bioethics unit, while building capacity of staff in the public health department of the School of Medicine.

This capacity building partnership between University of Zambia (UNZA) and Johns Hopkins University (JHU) allows for both one month and one year opportunities in research ethics training, along with in-country workshops, institutional consultations and evaluations, and longer-term mentorship for each of the trainees to support the sustainable growth of bioethics at UNZA.

Other previous FABTP-Zambian trainees who will be involved in partnership activities include Mr. Derrick Elemu (2009), Ms. Juliet Katoba Ndhlovu (2008), and Mr. Musonda Simwinga (2007). Mr. Elemu is completing his practicum project, evaluating the level and integration of ethics training in medical and health sciences institutions in Zambia, whereas Ms. Katoba Ndhlovu is exploring ethical issues relating to the exportation of biological samples from Zambia. Mr. Simwinga’s practicum focused on the roles fulfilled by community advisory boards in Zambia and the function of community roles in research. Mr. Simwinga has also published research involving tuberculosis effects in Zambia, particularly in terms of children and wealth systems.

We look forward to a productive year with UNZA and are eager to collaborate with our former trainees and new colleagues!

Editorial: Broadening the Horizon of Research Ethics: A Health Systems Approach to Capacity Development

fabtp — Tue, 15 Nov 2011 20:29:31 +0000

By Joseph Ali

Capacity development for low- and middle-income countries (LMIC) in research ethics is often viewed as something best done by enabling individuals to be successful in the field; providing students or trainees with sufficient knowledge and resources to study, teach, and practice research ethics at home. Under a traditional ‘trainee-focused’ model of capacity development, where educational activities occur by-and-large for individual trainees, efforts are made to focus training on those issues that are perceived to be most relevant to the context from which trainees come. Training can therefore be of very high caliber, well resourced, and tailored.

Of course, one might rightly argue that developed country perspectives on regulations, guidelines, lessons, cases, arguments, and values that form much of the content of research ethics education have been so often articulated that, for better or worse, they have become interwoven with discourses on bioethics in the developing world. That is to say, even when one provides instruction in research ethics by using examples (or even instructors) from developing country contexts, one brings to the discussion certain developed-world notions, metaphysical outlooks, and epistemological methods that frame the pedagogical experience.

So, while research ethics capacity development, as a researcher-focused and trainee-focused discipline has its place, it also has its limitations. Most prominently, followers of such models of capacity development are often, to put it simply, ‘not sure what to do’ with home environments – which are shaped by languages, traditions, cultures and religions, as well as educational, social, economic, institutional and political realities. This may be expressed as reluctance to take on certain capacity development challenges associated with working with LMIC institutions to help secure ‘homes’ for trainees so they can best utilize and adapt their newly acquired skills in research ethics.

While some noteworthy advancements in research ethics in low- and middle-income countries can likely be attributed to the training of highly motivated individuals, it is increasingly becoming clear that without adequate institutional, national, and regional structures in place to foster research ethics, the field will be slow to flourish in LMIC settings. However, before making this claim one must first be able to describe what a properly functioning research ethics system should look like, in any given context.

In recognition of this challenge, and the increased need for institutions and nations to coordinate their research ethics policies, offerings and infrastructures with their human capital and demand, Adnan Hyder MD, MPH, PhD, proposes that more work needs to be done to understand how research ethics systems operate, how they learn and develop, how they impact individuals, and how they relate to other spheres and indicators of well-being.

Dr. Hyder’s recent talk, “Institutional Capacity Development for Research Ethics Systems in Developing Countries: A Missing Link?“ (video below) makes a case for why it is important to better appreciate the complex relationships that exist between social systems, health systems, and research ethics.

Video: Dr. Adnan Hyder Speaks About Research and Research Ethics Systems

Related Publication: Hyder AA, Dawson L, Bachani AG, Lavery JV. Moving from research ethics review to research ethics systems in low-income and middle-income countries. Lancet 2009;373:862–5.

Online Ethics ‘Bootcamp’ for Global Health Trainees

fabtp — Tue, 15 Nov 2011 15:20:33 +0000

Bioethicists at the Johns Hopkins Berman Institute of Bioethics and their colleagues in global health at Stanford University have launched a free online basic ethics course for trainees in global health programs.

The course, available at no cost online, covers 10 issues that pose significant ethical challenges in global health training, including the need to develop appropriate cultural sensitivities, ensure personal safety, and obtain informed consent for research subjects.

“Short-term global health training programs in biomedical practice and research commonly include a number of ethical issues for which trainees might be unprepared,” says Jeremy Sugarman, MD, MPH, MA, Harvey M. Meyerhoff Professor of Bioethics and Medicine at the Berman Institute. “We hope that our curriculum will help groom those with little to no prior experience working in global health.”

The course content delivered is case-based, with each case involving a series of video vignettes based on actual scenarios experienced by global health trainees. After the vignettes, participants are given multiple choice questions and real-time corrective feedback. Each case requires 5 to 10 minutes to complete. The website allows participants to print a certificate of completion they can present to their supervisors and also lists additional reading materials.

Course organizers say the site was designed to help users increase their awareness of common ethical issues arising in overseas global health training programs; develop strategies to deal with these issues; and increase confidence in navigating sensitive issues and adapting their behavior as needed.

Almost half of United States medical schools have established centers or offices for global health, in part to help reduce health disparities through research, education and service, says Sugarman. However, many programs provide trainees with little to no training in practical bioethics.

Matthew DeCamp, MD, PhD, a fellow in bioethics, health policy and internal medicine at Hopkins, says that while global health trainees head abroad with the best intentions, failure to understand the ethical issues they will face could sabotage programs and cause harm to the communities in which they work.

“Our curriculum makes high-level guidelines accessible to trainees with little or no experience,” he says, noting that the site should also have value for a broader audience, including church-based and other non-governmental philanthropic groups.

The idea for the course arose from discussions among 15 public health experts around the world participating in the international Working Group on Ethics Guidelines for Global Health Training (WEIGHT). WEIGHT proposed guidelines for ethically responsible, short-term global health training programs in 2010. The course attempts to make the guidelines accessible and practical to trainees engaging in short-term practice and research abroad. Its development was funded by the Doris Duke Charitable Foundation. WEIGHT members will present their initial work on November 13 in Montreal at the annual conference for the Consortium of Universities for Global Health.

Researchers plan to evaluate participants’ use of the online curriculum and to modify it if needed.

Links:

Johns Hopkins Berman Institute of Bioethics

Ethical Challenges in Short-Term Global Health Training

WEIGHT Guidelines for Ethically Responsible, Short-Term Global Health Training Programs

Center for Innovation in Public Health, Stanford University

Doris Duke Charitable Foundation

Trainees from MakCHS, Uganda present at Bioethics Week event

fabtp — Wed, 11 May 2011 17:26:28 +0000

As part of FABTP’s 2011 partnership with Makerere University, College of Health Sciences (MakCHS), Mr. Paul Kutyabami, Ms. Aida Nakawunde and Mr. Freddy Kitutu are currently studying at Johns Hopkins University (JHU) – undergoing coursework; observing and interacting with Institutional Review Boards; visiting with scholars and staff at the NIH, FDA and OHRP; and meeting with faculty and mentors at JHU. Freddy, Aida and Paul will remain in Baltimore through the end of June, at which time they will return to Kamapala, Uganda to implement individual practicum projects that they designed while at JHU. In addition, they will spend much of the fall laying the foundation for a future Center for Bioethics at Makerere University. With their colleague, Dr. Frederick Nakwagala, and the Principal of MakCHS, Prof. Nelson Sewankambo (pictured right), they hope to achieve this objective to better serve MakCHS and its affiliates in the region.

It is always wonderful when the opportunity arises for FABTP trainees to be recognized for their vision and capacity in bioethics. On Wednesday, May 10th, the Johns Hopkins Bloomberg School of Public Health, Health Systems Program held a lunchtime seminar entitled “International Research Ethics Capacity Development: the Makerere Experience in Uganda.” The seminar was co-hosted by the Johns Hopkins Berman Institute of Bioethics and offered as part of a week-long celebration of bioethics which includes the dedication of a new facility for the Berman Institute of Bioethics named Deering Hall.

Freddy, Paul and Aida joined Drs. Nancy Kass and Maria Merritt to present about the rationale for international research ethics capacity building and how the partnership between MakCHS and the Berman Institute of Bioethics will contribute to this aspiration.

The presentation led to important discussion about the scope of activities of the planned bioethics center, on-going community engagement initiatives at Makerere, and how quality of IRB performance is assured and improved in Uganda. Their talk was well presented, of course, and well attended.

The MakCHS team will also be involved in organizing and teaching a workshop on research ethics to be held at MakCHS in Uganda this fall. Stay tuned for more details!

You can catch Paul, Freddy and Aida making their film debut in this video.

From the Director

fabtp — Sun, 21 Nov 2010 15:12:07 +0000

Greetings again from Baltimore!

In this newsletter we introduce our one-year trainees and our partnership activities with the University of Botswana. Mr. Derrick Elemu (FABTP 2009) provides an update on his activities “in the field,” and we announce a new program faculty member. A lot has happened since January!

The Johns Hopkins-Fogarty African Bioethics Training Program (FABTP) has, for the past 9 years, offered a one-year training program in research ethics for scientists and professionals from Africa. The program has 28 alumni from 13 African countries.

In June 2009, FABTP launched a new approach for the program. Specifically, FABTP now partners each year with one African institution interested in developing greater depth in research ethics. After receiving 17 institutional applications, we selected our 2010 partner to be University of Botswana (UB), Office of Research and Development (ORD), led by 2001 FABTP Alumnus, Paul Ndebele, Assistant Director for Ethics for ORD.

The University of Botswana aims to become a “research intensive university” by 2021, becoming a leader in African and global research. To that end, UB established in 2001 the Office of Research and Development, with programs in ethics, quality, commercialization, and grants. Paul Ndebele runs the ethics program which oversees the IRB and the animal care committee.

UB partnered with FABTP with the goals of conducting more ethics training for key faculty and staff and studying organizational capacity. Dr. Joseph Gaie (faculty) and Ms. Dimpho Njadingwe (IRB staff) participated in “long term” research ethics training at JHU from January to July 2010, and Drs. Poloko Kebaabetswe (IRB chair) and Rekha Kumar (faculty) participated in intensive one-month training at JHU in June 2010. Additionally, Adnan Hyder and I visited UB in February to initiate a needs assessment and meet with UB leadership and government officials. Everyone could not have been more welcoming, we learned more about UB, we were impressed with the physical and human capacity of the University, and we engaged in strategic discussions about goals for the coming year. UB leadership is truly remarkable with its commitment to research ethics and to Paul and his programs.

More recently, we completed a second visit to Botswana in October 2010 during which we co-facilitated a workshop (page 4) to help UB faculty integrate ethics into their research methods teaching. We again met with UB leadership. We also met with officials from the Botswana Ministry of Health and the Ministry of Infrastructure, Science and Technology to discuss national legislative developments in research oversight, relevant to harmonizing national policies with university rules.

We were delighted to see Joseph, Dimpho, Rekha and Poloko again, this time on their side of the globe, and want to thank them for their past and continued contributions to the partnership. Our trainees are talented individuals who, no doubt, will help to shape the future face of research ethics in Botswana. The tremendous support they receive from UB and ORD leadership is a testament to UB’s commitment.

While this is a one-year partnership, we look forward to continuing our engagement with UB in the future. Stay tuned for future announcements about our 2011 partner and our new and improved website!

Nancy Kass

Director, FABTP

Report from the Field: Derrick Elemu

fabtp — Sun, 21 Nov 2010 14:36:49 +0000

After ethical approval from both the Johns Hopkins IRB and University of Zambia IRBs, I started my practicum research entitled, “Ethics training in medical and health sciences education in Zambia.” The primary aim of my project is to determine if and how ethics is currently being taught in health sciences institutions in Zambia. I quickly embarked on pre-fieldwork activities, including pretesting data collection tools and making contact with the prospective institutions. Questionnaires were pre-tested with faculty from the Evelyn Hone College of Arts, the School of Humanities Social Sciences (UNZA), and the Chainama College of Health Sciences situated in Lusaka.

The first phase of data collection, which began in December 2009, involved sending questionnaires to all 40 medical and health sciences training institutions in Zambia. Thanks to intensive follow-up activities, by mid-February, I had collected 29 completed questionnaires.

It was striking how consistent the responses from the 29 institutions have been. The responding medical and health sciences institutions in Zambia receive their syllabi from professional organizations such as the General Nursing Council (GNC) and the Medical Council of Zambia (MCZ).

AMANET Workshop in Lusaka, Zambia - March 2010. Pictured from left to right: OUJ Umeora, Sithembile Ruzario, Derrick Elemu

During the months of March and April, I launched my second phase which involves interviewing representatives from 14 institutions, including 6 training institutions that have responded to the questionnaires and 8 non-training stakeholders. These non-training organizations include the National Public Health Regulatory Authority (NPHRA), which coordinates all government medical and health sciences training institutions under the Ministry of Health (MoH) in the country; the Churches Health Association of Zambia (CHAZ), which coordinates all mission nursing schools in the country; the MoH, and the selected training institutions and other stakeholders that have been identified for my study. Lastly, a number of private and non-governmental stakeholders were included for in-depth interviews.

I plan to finish data collection in November. I am also finalizing a paper co-authored with my supervisor Prof. Adnan Hyder of Johns Hopkins entitled, “Bioethics education: A challenge for medical education in Africa.” I have started contacting various universities for PhD programs and scholarships so that I will have an opportunity to study research ethics from an African perspective.

I also had the opportunity to attend the AMANET Advanced Health Research Ethics workshop held in Lusaka, Zambia on March 22-26, 2010. At the workshop, I reunited with two SARETI fellows I met during my Fogarty training, OUJ from Nigeria and Sithembile from Zimbabwe. At the same workshop, I met many former Fogarty fellows and ethicists from different backgrounds. It is great to be a part of the growing network between SARETI and FABTP fellows.

Derrick Elemu

2009 FABTP Trainee

UB-FABTP Workshop 2010

fabtp — Sun, 21 Nov 2010 14:19:11 +0000

On October 12-13, 2010, we partnered with University of Botswana to hold a very productive Research Ethics Workshop in Gaborone, Botswana. The workshop, held at the University of Botswana, included eight sessions devoted to key issues in research ethics application and teaching. Six of our program trainees and alumni played integral roles in lecturing, leading and facilitating case discussions and sessions throughout the symposium.

The first day began with an introductory session chaired by Professor Isaac Mazonde, Director of UB’s Office of Research and Development. Mr. Paul Ndebele of UB-ORD and Drs. Adnan Hyder and Nancy Kass of JHU participated in the opening session. University of Botswana’s Deputy Vice Chancellor for Academic Affairs, Professor Frank Youngman closed the session by outlining the University’s vision for advancing research and research ethics.

Dr. Kass and Dr. Joseph Gaie led Session 2, entitled Ethical Analysis, Principles, & Moral Considerations. While Dr. Kass introduced core principles of research ethics, Dr. Gaie related them to the Botho philosophy. Botho, derived from the Twsana language of Botswana, signifies a person of good character, a social contract of mutual respect, and a commitment to common good of society. A case discussion about a study that documents the health conditions of an indigenous community followed, incorporating attention to cultural commitments, risks and benefits in research.

Mr. Paul Ndebele led Session 3 on Research Ethics Committees, including what faculty need to know in advising students conducting research projects.

Session 4 was devoted to group work on four case studies. The case studies were from four health and non-health related disciplines, and participants talked through the case best matched for their own backgrounds.

On Day 2, Dr. Poloko Kebaabetswe and Mr. Joseph Ali led talks about the elements and strategies of informed consent; waivers of informed consent; community engagement and undue inducement. The session ended with an informed consent scenario role-play activity that was enjoyed by all.

A session on Teaching Research Ethics was then led by Mr. Derrick Elemu of Zambia (FABTP 2009) and Dr. Hyder and discussed why teaching research ethics is important; study design and ethics; strategies for teaching research ethics in a methods course; techniques for student engagement/mentorship; and research ethics teaching resources.

Dr. Rekha Kumar, Mr. Ndebele and Dr. Kass led a session on honesty in research, covering topics related to professional integrity, data management, authorship, and mentorship. Participants disscussed of two research misconduct cases and applied UB policies to the cases.

The closing session of the workshop was run by Dr. Hyder, Mr. Ndebele, Dr. Kass and Professor Mazonde.

The workshop was tremendously successful. It was wonderful to catch up with our trainees and build a stronger relationship between UB/JHU.