Building Bioethics Capacity: The Johns Hopkins Fogarty African Bioethics Consortium

 

The need for enhanced capacity in international research ethics and global bioethics is important, especially in low- and middle-income countries where there are huge leaps in health systems research but not as much parallel work on ethical implications. The Johns Hopkins-Fogarty African Bioethics Training Program (FABTP) aims to improve bioethics capacity development for institutions within Africa.

FABTP is an in-depth bioethics training program that is funded by the National Institutes of Health Fogarty International Center and directed by Drs. Adnan Hyder and Nancy Kass. The program includes bioethics training at Johns Hopkins University, independent research in the recipient’s home country, and a scholarly exchange at a different FABC member institution in Africa.

Gershom Chongwe from the University of Zambia and Dan Kaye from Makerere University were the 2018 FABTP recipients. During their stay in Baltimore from January-May they took courses in the Department of International Health at Johns Hopkins Bloomberg School of Public Health (JHSPH) and the Johns Hopkins Berman Institute of Bioethics. In May they went home to collect data and will return in August to continue their courses and analyze the data.

Dr. Chongwe has a background in medicine and public health at the University of Zambia, specifically focusing on adaptive trial designs, an emerging field of epidemiology sometimes seen as controversial because of the ethical issues surrounding it. Adaptive trial designs allow for greater flexibility and efficiency by incorporating modifications during the trial based on the data. An increase in the use of adaptive trial designs has caused a debate about whether the trials offer any significant methodological advantage compared to traditional randomized trials, as well as whether they are ethically justified.

Dr. Chongwe’s aim while studying at JHSPH is to use applied skills from the coursework to frame the right questions and clarify the ethical issues surrounding adaptive trial designs. Also an instructor at the University of Zambia, Dr. Chongwe teaches his students how to conduct clinical trials and wants to apply the insights gained through his bioethics research while in Baltimore to his lessons back home in Zambia.

Dr. Kaye is a member of the Institutional Review Board (IRB) in Uganda and is taking training that will help him improve his performance in looking up literature and analyzing and interpreting data with a focus on ethical issues, literature review, communicating findings and the informed consent process. Dr. Kaye aims to focus on the ethical questions surrounding randomized control trials (RCTs), as they are not up to standard in his home country of Uganda.

Dr. Kaye’s courses provide insight on how one can ensure an ethical conduct of research and how to avoid research misconduct. This will help him to understand the different ways in which ethical principles are applied to research and how the context of emergency care informs the consent process for RCTs, and also demonstrates the different ways ethical issues are contextualized and analyzed.

"The Fogarty African Bioethics Training Program is an excellent opportunity to foster a new cohort of researchers in bioethics research from countries where it is needed most," states director Dr. Adnan Hyder.

The coursework, research and fieldwork facilitated by FABTP will help both fellows contribute to standards and procedures back home in Uganda and Zambia, and will allow them both to lead others through instruction and mentorship.