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REECAO project: ethics review network in West Africa

2 July 2018

The REECAO project, a research ethics network for West Africa based on North-South collaboration, delivered its first results. The project was funded in 2017 with an EDCTP grant under its 2015 Ethics and regulatory capacities call. Until recently, REECAO (Renforcement de l’Ethique des Essais Cliniques en Afrique de l’Ouest) was coordinated by Professor Ogobara Doumbo (Mali) who unfortunately passed away on 9 June 2018.

The objective of REECAO is to reinforce ethics oversight of clinical trials in Mali, Ghana, and Guinea. The project aims to achieve this by:

  • establishment of a joint ‘ethical watch’ (through North-South and South-South collaboration);
  • creation and implementation of standardised procedures for protocol submission and evaluation;
  • training a critical mass of trainers for ethics review; and
  • reinforcement of the governance of ethics committees.

By the end of the first year of the project, REECAO had delivered the following:

  • a network of national and institutional ethics committees
  • two case studies (one national and one regional)
  • two training sessions for trainers (one in English and one in French)
  • Six training modules on:ethical principles and methods
    • governance for National Ethics Committees and Institutional Review Boards
    • ethics of biotechnology use in humans
    • ethics in emergency situations
    • ethical issues in clinical research
    • community authorisation and individual consent.
      These modules were implemented during the training sessions

The activities of the network are supported by the Ministries of Health of Mali, Ghana and Guinea, the Institutional Review Boards, and the Catholic University of Lyon, France, which contributes its experience in ethics training.

In the last ten years, West Africa has seen a huge increase of clinical trials. The need to conduct more clinical trials on malaria, TB, HIV and neglected infectious diseases and the recent epidemic of Ebola virus disease posed new challenges for ethical oversight and protection of clinical trial volunteers. As in other regions of sub-Saharan Africa, many volunteers in clinical trials belong to poor rural populations, are often illiterate, have urgent health care needs, and sometimes have very different sociocultural views. These are all important factors that limit their understanding of complex aspects of clinical research. To better protect these populations, it is crucial to strengthen the governance, operation, effectiveness and sustainability of ethics committees. Additionally, language barriers to multicentre clinical trials and the need to prepare for emergency research during epidemics indicated a need for a regional ethics network.