The Ebola clinical trials: a precedent for research ethics in disasters

Journal of Medical Ethics 2018;44:3-8.
Author: P Calain
“The West African Ebola epidemic has set in motion a collective endeavour to conduct accelerated clinical trials, testing unproven but potentially lifesaving interventions in the course of a major public health crisis. This unprecedented effort was supported by the recommendations of an ad hoc ethics panel convened in August 2014 by the WHO. By considering why and on what conditions the exceptional circumstances of the Ebola epidemic justified the use of unproven interventions, the panel’s recommendations have challenged conventional thinking about therapeutic development and clinical research ethics.”
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Red Cross: $6 Million Meant to Fight Ebola Was Stolen Through Fraud

Time, 6 November 2017
Authors: Clarence Roy-Macaulay, Krista Larson
“Fraud by Red Cross workers and others wasted at least $6 million meant to fight the deadly Ebola outbreak in West Africa, the organization confirmed Saturday. The revelations follow an internal investigation of how the organization handled more than $124 million during the 2014-2016 epidemic that killed more than 11,000 people in Sierra Leone, Liberia and Guinea.”
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Cost of kidney dialysis poses ethical dilemma in sub-Saharan Africa

Reuters, 9 March 2017
Author: Ronnie Cohen
“Up to one-fourth of adults in sub-Saharan Africa suffer from chronic kidney disease and only a small fraction ever reach a dialysis treatment center, a new study finds. Of those who did begin dialysis, most quit, usually within two weeks, because they could not afford to continue, and 88 percent died, the research found. Quitting dialysis almost always proved fatal.”
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South African officials were “negligent and reckless” in transfer of vulnerable patients to cut costs

BMJ 2017; 356: j632
Author: Pat Sidley
“At least 94 patients with mental illnesses and disabilities died in appalling circumstances after a contract between a private mental hospital and the Gauteng provincial government was cancelled last year.”
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South African scandal after nearly 100 mental health patients die

The Guardian, 2 February 2017
Source: Agence France-Presse
“At least 94 patients with mental health issues died after South African authorities moved them from hospitals to unlicensed health facilities. Many of the deaths were due to pneumonia, dehydration and diarrhoea. The centres also failed to provide seriously ill patients with enough food and water, leaving them severely malnourished, underweight and in some cases dying from dehydration.”
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South Africa’s appeals court overturns ruling allowing ‘assisted dying’

Reuters, 6 December 2016
Author: Olivia Kumwenda-Mtambo
“South Africa’s Supreme Court of Appeals (SCA) on Tuesday overturned a ruling by a lower court granting a terminally ill patient the right to die, the Justice Ministry said, thereby upholding South Africa’s laws forbidding assisted suicide.”
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Curbing the circulation of counterfeit medicines in Nigeria

The Lancet, 388(10060), p2603, 2016
Author: Omotayo Fatokun
“At the recently concluded 66th session of the WHO Regional Committee for Africa, held in Addis Ababa, Aug 19–23, 2016, Nigerian policy makers again affirmed their commitment to the fight against the circulation of counterfeit medicines in the country, and urged other member states to do the same. Although Nigeria (Africa’s most populous nation) has reported progress in reducing its circulating counterfeit medicines, from 40% in 2001 to 16·7% in 2005, this problem remains a considerable challenge, particularly with regard to medicines of public health importance, such as antimalarial drugs. In 2011, 64% of antimalarial medicines circulating in Nigeria were reported to be substandard.”
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“It’s all about trust”: reflections of researchers on the complexity and controversy surrounding biobanking in South Africa

BMC Medical Ethics 2016 17:57
Authors: Keymanthri Moodley, Shenuka Singh
“Biobanks are precariously situated at the intersection of science, genetics, genomics, society, ethics, the law and politics. This multi-disciplinarity has given rise to a new discourse in health research involving diverse stakeholders. Each stakeholder is embedded in a unique context and articulates his/her biobanking activities differently. To researchers, biobanks carry enormous transformative potential in terms of advancing scientific discovery and knowledge. However, in the context of power asymmetries in Africa and a distrust in science born out of historical exploitation, researchers must balance the scientific imperative of collecting, storing and sharing high quality biological samples with obligations to donors/participants, communities, international collaborators, regulatory and ethics authorities. To date, researcher perspectives on biobanking in South Africa have not been explored and documented.”
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National ethics guidance in Sub-Saharan Africa on the collection and use of human biological specimens: a systematic review

BMC Medical Ethics 2016 17:64
Authors: Francis Barchi, Madison T. Little
“Ethical and regulatory guidance on the collection and use of human biospecimens (HBS) for research forms an essential component of national health systems in Sub-Saharan Africa (SSA), where rapid advances in genetic- and genomic-based technologies are fueling clinical trials involving HBS and the establishment of large-scale biobanks.”
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Why Africa should resist the power of Big Sugar to undermine public health

The Conversation, 8 November 2016
Author: Rob Moodie
“The junk food, sugary drink and alcohol industries claim to be part of the solution. The solution requires them to help improve their consumers’ health by decreasing advertising to children, reducing levels of salt, fat and sugar in their products, and labelling food honestly and clearly. These are all measures they are convinced are in conflict with their responsibility to make money for their shareholders.”
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