Plenary Panel: “Building an Infrastructure through Training:

Best Practices and Lessons Learned from Africa, Asia,

Central-Eastern Europe and Latin America”

A Perspective from Latin AmericaMayra Achío

Universidad de Costa Rica

Some guiding ideasSome guiding ideas

Education and training in research bioethics in our countries became a relevant concern as a result of the increase of international biomedical studies and clinical trials

Requirement to meet international standards

Education and training in research bioethics in our countries became a relevant concern as a result of the increase of international biomedical studies and clinical trials

Requirement to meet international standards

Most training comes and is sponsored by developed countries, especially US.

Participation and collaboration between academics from developing countries and developed countries is necessary to create a sustainable and proactive bioethics community

Despite efforts, education and training remain a challenge in our countries

Most training comes and is sponsored by developed countries, especially US.

Participation and collaboration between academics from developing countries and developed countries is necessary to create a sustainable and proactive bioethics community

Despite efforts, education and training remain a challenge in our countries

Major research ethics development took place in developed countries

In LA, implementation of ethical regulations is still weak

Concern for education and training in research ethics is relatively recent in LA

1990’s in response to new standards in international research sponsored by pharmaceutical industry and research institutions in developed countries

establishment of national/local research ethics committees and protocol review

Major research ethics development took place in developed countries

In LA, implementation of ethical regulations is still weak

Concern for education and training in research ethics is relatively recent in LA

1990’s in response to new standards in international research sponsored by pharmaceutical industry and research institutions in developed countries

establishment of national/local research ethics committees and protocol review

Initially, international organizations and public/private institutions in developed countries offered and sponsored training programs

Development of education and training in research ethics for ethicists and researchers soon followed

At present, a substantial academic community throughout LA offers educational/training options (Argentina, Brazil, Chile, Colombia, Costa Rica)

Accessibility: main problem

Initially, international organizations and public/private institutions in developed countries offered and sponsored training programs

Development of education and training in research ethics for ethicists and researchers soon followed

At present, a substantial academic community throughout LA offers educational/training options (Argentina, Brazil, Chile, Colombia, Costa Rica)

Accessibility: main problem

The Costa Rican Experience

The Costa Rican Experience

Similar to most of LA

Costa Rica is known as a success story

Main reason: a health care system and health indicators comparable with those of USA, Canada, and European countries.

Similar to most of LA

Costa Rica is known as a success story

Main reason: a health care system and health indicators comparable with those of USA, Canada, and European countries.

Some indicators:Some indicators:Population:

4.401.894

Infant mortality rate: 9.70/1000

Life expectancy:

76.97 men,

81.35 women

Population: 4.401.894

Infant mortality rate: 9.70/1000

Life expectancy:

76.97 men,

81.35 women

Growing number of biomedical research projects in universities and teaching hospitals funded by pharmaceutical corporations, NIH and Fogarty International Center

This growth has lead to ethical regulations and research ethics review to meet international standards

Need for education in bioethics became critical as regulations were approved and RECs began to be accredited

Growing number of biomedical research projects in universities and teaching hospitals funded by pharmaceutical corporations, NIH and Fogarty International Center

This growth has lead to ethical regulations and research ethics review to meet international standards

Need for education in bioethics became critical as regulations were approved and RECs began to be accredited

Until recently: no formal in-depth education program in CR universities

2005: alliance between two main public universities resulted in the Master Degree Program in Bioethics

Until recently: no formal in-depth education program in CR universities

2005: alliance between two main public universities resulted in the Master Degree Program in Bioethics

Costa Rican MS program in Research

Ethics

Costa Rican MS program in Research

Ethics

2-year program

National and regional project with no international funding/collaboration

12 current students from different health institutions

Hopefully will impact other Central American countries as well

2-year program

National and regional project with no international funding/collaboration

12 current students from different health institutions

Hopefully will impact other Central American countries as well

Costa Rican MS Program in Research

Ethics

Costa Rican MS Program in Research

Ethics

Other Training Program in Research Ethics

Other Training Program in Research Ethics

1.TRAINING PROGRAM IN RESEARCH ETHICS

Co-Directors: Ruth Macklin, Florencia Luna

Sponsor: Fogarty International Center, NIH

Jointly planned and executed with faculty from US and LA

Four trainees recruited from all over La; award covered all expenses

One-year non-degree program with two 6-month locations: New York and Buenos Aires

1.TRAINING PROGRAM IN RESEARCH ETHICS

Co-Directors: Ruth Macklin, Florencia Luna

Sponsor: Fogarty International Center, NIH

Jointly planned and executed with faculty from US and LA

Four trainees recruited from all over La; award covered all expenses

One-year non-degree program with two 6-month locations: New York and Buenos Aires

1. TRAINING PROGRAM IN RESEARCH ETHICS - Main achievements

Learning from two viewpoints: US and LA

Possibility of application of ethical principles in societies with different cultures and socioeconomic conditions

Contrasting different North-South perspectives and experiences

1. TRAINING PROGRAM IN RESEARCH ETHICS - Main achievements

Learning from two viewpoints: US and LA

Possibility of application of ethical principles in societies with different cultures and socioeconomic conditions

Contrasting different North-South perspectives and experiences

2. Creating Collaborative Research Ethics Education with Costa Rica (CREE-CR)

Recent program with Vanderbilt University, sponsored by Fogarty International Center

A collaborative effort between Vanderbilt University Medical Center, Vanderbilt Children’s Hospital, Costa Rica’s Children’s Hospital, the Costa Rican Social Security System and the Ministry of Health

2. Creating Collaborative Research Ethics Education with Costa Rica (CREE-CR)

Recent program with Vanderbilt University, sponsored by Fogarty International Center

A collaborative effort between Vanderbilt University Medical Center, Vanderbilt Children’s Hospital, Costa Rica’s Children’s Hospital, the Costa Rican Social Security System and the Ministry of Health

2. Creating Collaborative Research Ethics Education with Costa Rica (CREE-CR)

Components:

1. MS program in clinical and public health science and mentored research in research ethics at Vanderbilt

2. 5-week practicum in research ethics at Vanderbilt

3. 4-day course for REC members in Costa Rica

4. 4-day course for research educators in Costa Rica

5. Creation and distribution of curricular materials in Spanish tailored to the Central American context, web-based, professional publications and presentations

2. Creating Collaborative Research Ethics Education with Costa Rica (CREE-CR)

Components:

1. MS program in clinical and public health science and mentored research in research ethics at Vanderbilt

2. 5-week practicum in research ethics at Vanderbilt

3. 4-day course for REC members in Costa Rica

4. 4-day course for research educators in Costa Rica

5. Creation and distribution of curricular materials in Spanish tailored to the Central American context, web-based, professional publications and presentations

Key aspects in both casesKey aspects in both cases

Fully collaborative programs and equal partnership between academic institutions, North and South

Solidarity and financial support from industrialized country

Coordination of academic in-depth degree programs with short term courses and practical training

Respect for specific needs of developing countries

Fully collaborative programs and equal partnership between academic institutions, North and South

Solidarity and financial support from industrialized country

Coordination of academic in-depth degree programs with short term courses and practical training

Respect for specific needs of developing countries

Recommendations Recommendations

Sustainability of training programs is more likely if sponsoring institutions works with universities instead of government officials, who are more vulnerable to policy changes

Regional networks and meetings should be encouraged to discuss and learn from experiences

Sustainability of training programs is more likely if sponsoring institutions works with universities instead of government officials, who are more vulnerable to policy changes

Regional networks and meetings should be encouraged to discuss and learn from experiences

Thank you!Thank you!