How ethics committees and requirements are structuring health research in the Philippines: a qualitative study

Abstract

Background The last few decades have seen the rising global acknowledgment of the importance of ethics in the conduct of health research. But research ethics committees or institutional review boards (IRBs) have also been criticized for being barriers to research. This article examines the case of the Philippines, where little has been done to interrogate the health research and IRB culture, and whose circumstances can serve as reflection points for other low- and middle-income countries. Methods Semi-structured interviews were conducted from July to October 2020 to elicit health researchers’ perspectives and experiences regarding IRBs and the ethics approval process in the country, as well as counterpoint narratives from researchers who have also worked for IRBs. Results Across the fields of clinical, public health, and social science research, the issue of ethics review revealed itself to be foremost an issue of inequity. IRB processes serve as a barrier for those outside the academe; those belonging to institutions, cities, or entire regions without their own accredited IRBs; and researchers working independently, without ample budget, or on highly specialized topics—more so for non-clinical researchers who must grapple with the primarily biomedical framework of most IRBs. Consequently, the research landscape invariably favors those with the resources to do research, and researches that tend to attract funding. Conclusion The broader challenge of equity in health research will entail more fundamental reforms, but proximal interventions can be done to make the ethics approval process more equitable, such as enhancing institutional oversight, regulating IRB fees, and enabling a more supportive and welcoming environment for early-career, student, independent, and non-clinical health researchers. This article ends by reflecting on the implications of our findings toward the larger research culture.

Anthropological Responses to COVID-19 in the Philippines

“…It is clear that if anthropologists are to be empowered and equipped to address emergencies, conventional ethics processes must be reconsidered: an issue that has also been problematised by anthropologists elsewhere (Marino et al 2020). The Philippine experience suggests that some reforms are already happening (see Lasco et al 2021), but these need to be further encouraged. Crucially, these efforts must be accompanied by methodological and theoretical innovations that enable anthropologists to be more attuned to the new intimacies engendered by the pandemic (see Colas 2020;andDennis 2020a, 2020b).…”

A call for clinical trial globalization in Alzheimer's disease and related dementia

“…Lengthy turnaround times for regulatory approvals combined with complex and unclear guidelines were mentioned in most articles. [30][31][32][33]35,36 Several reports highlighted that regulatory review timelines were disruptive of grant timelines, leading to not meeting recruitment goals or grants to expire. 35,36 Limited regulatory and subject-matter experience combined with limited ethical review capacity were also reported.…”

“…[30][31][32][33]35,36 Several reports highlighted that regulatory review timelines were disruptive of grant timelines, leading to not meeting recruitment goals or grants to expire. 35,36 Limited regulatory and subject-matter experience combined with limited ethical review capacity were also reported. 30,33 These limitations were acknowledged during the 1:1 qualitative semi-structured interview across multiple disciplines.…”

“…-Delay of approval decisions. 32,33,35,36 -Complex and inefficient regulatory system without established procedures. [30][31][32]36 -Implement regular assessment of review committees and trial regulatory capacity aimed at avoiding unnecessary bureaucracy.…”

Handling Ethics Dumping and Neo-Colonial Research: From the Laboratory to the Academic Literature

“…Given that the for-profit publishing industry has both exploitative and predatory characteristics (Teixeira da Silva et al 2019b ), it is not surprising that the publishing medium serves as an additional point of exploitation of indigenous rights and sovereignty, simply because there are currently no specific verification or protective measures to offer indigenous populations rights or protections at the publication stage. There is thus a need to stimulate local IRB awareness that covers community engagement, rights and interests, institutional responsibilities, and ethical or regulatory oversight (Lasco, Yu, and Palileo-Villanueva 2021 ) and that is compatible with international publishing standards, as is suggested next.…”