Plenary Panel: Building an Infrastructure through Training: Best Practices and Lessons Learned from

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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
  AchíoUniversidad de Costa Rica

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Some 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

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• 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

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• 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
• 1990s 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

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• 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

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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.

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• 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

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Costa Rican MS program in Research Ethics

• 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

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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

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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

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• 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

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• 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 Childrens
  Hospital, Costa Ricas Childrens Hospital, the
  Costa Rican Social Security System and the
  Ministry of Health

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• 2. Creating Collaborative Research Ethics
  Education with Costa Rica (CREE-CR)
• Components
• MS program in clinical and public health science
  and mentored research in research ethics at
  Vanderbilt
• 5-week practicum in research ethics at Vanderbilt
• 4-day course for REC members in Costa Rica
• 4-day course for research educators in Costa Rica
• Creation and distribution of curricular materials
  in Spanish tailored to the Central American
  context, web-based, professional publications and
  presentations

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Key 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

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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

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• Thank you!