Health Research Ethics in Southern Africa: Building Capacity and Cultivating Excellence

Zaynab Essack, South African Research Ethics Training Initiative (SARETI), School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Paul Ndebele, Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington DC, USA.
Heidi Matisonn, South African Research Ethics Training Initiative (SARETI), School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Jantina de Vries, The EthicsLab, Department of Medicine, University of Cape Town, Rondebosch, Western Cape, South Africa.
Keymanthri Moodley, Division of Medical Ethics and Law, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
Stuart Rennie, Department of Social Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Joseph Ali, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Nancy Kass, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA.
Carel IJsselmuiden, South African Research Ethics Training Initiative (SARETI), School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Nhlanhla Mkhize, South African Research Ethics Training Initiative (SARETI), School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Mariana Kruger, South African Research Ethics Training Initiative (SARETI), School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Ann Strode, South African Research Ethics Training Initiative (SARETI), School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Warren Freedman, South African Research Ethics Training Initiative (SARETI), School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.
Douglas Wassenaar, South African Research Ethics Training Initiative (SARETI), School of Applied Human Sciences, University of KwaZulu-Natal, Pietermaritzburg, South Africa.

Document Type

Journal Article

Publication Date

6-30-2025

Journal

Journal of empirical research on human research ethics : JERHRE

DOI

10.1177/15562646251347549

Keywords

& RCR; Bioethics; developing countries; ethics education; research ethics; research ethics committee/IRB review

Abstract

The health research landscape in southern Africa is becoming increasingly complex as research efforts intensify to address the region's significant disease burden. The increasing volume and complexity of health research in low- and middle-income countries (LMICs) highlights the ongoing need for enhanced research ethics capacity. To supplement a review published in 2014, this paper provides an overview of research ethics capacity-building initiatives supported through substantive long-term competitive awards from the Fogarty International Center of the US National Institutes of Health between 2014 and 2024. These programs aimed to enhance the capabilities of research ethics committees (RECs) and strengthen research ethics capacity throughout Southern Africa, with broader benefits to the African continent and globally as collaborative health research increases. The programs have successfully developed and delivered comprehensive research ethics curricula tailored to research ethics concerns in the region. Trainees and graduates include clinicians, researchers, REC members, REC administrators, lawyers, and ethicists, with focused efforts to ensure gender parity. This increased representivity of scholars has improved the membership on RECs and in skilled research ethics leadership in the region. For the benefit of future planning, this paper also describes some of the many challenges faced in delivering on program goals - including COVID-19. We also describe innovative solutions developed to address these challenges and meet the needs of students, faculty and institutions, while cultivating excellence in health research ethics. The paper concludes by highlighting areas for future research, underscoring the importance of continued diverse global investment in research ethics capacity to protect research participants and maintain and improve ethical standards and practice in health research within the region and globally. This will enable the development of innovative evidence-based global health solutions based on ethical research.

Department

Global Health

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