Research ethics systems in Latin America
22 countries in Latin America and the Caribbean are using these indicators. Most countries have adopted legal instruments to govern research with human participants and have implemented national bodies tasked with the oversight of research ethics committees.
However, performance with regard to ethics training policies and clinical trial registration was less advanced, and efforts to adopt policies on responsible conduct of research and accelerated ethics review of emergency research did not meet the PAHO objectives in most countries.
We discuss the pending challenges and provide recommendations aimed at helping countries from Latin America and the Caribbean to achieve the indicators, and, more generally, to strengthen research ethics with a systemic approach.
Countries in Latin America and the Caribbean have seen substantial improvements in the last decade in their governance frameworks for the ethical oversight of research. Such progress, however, has targeted specific areas of research ethics.
It is a challenge to approach research ethics as a system—ie, with a comprehensive scope that pertains to all areas of research and the coordination with all relevant stakeholders.
To realize this goal, member states of the Pan American Health Organization (PAHO), which is the Regional Office for the Americas of the World Health Organization (WHO) agreed to promote a systemic approach to research ethics.
PAHO’s Regional Program in Bioethics, which is tasked with supporting member states to advance the integration of ethics in all health-related activities, consequently devised an approach based on two strategic lines of action: (1) to strengthen research ethics systems so they can ensure all research is ethical; and (2) to strengthen ethics preparedness for emergencies.
Evaluations based on the indicators allow PAHO to tailor technical cooperation plans to each country according to indicators not yet reached.
The indicators serve as markers for progress on tangible goals for countries, striking a balance between being too easy to reach and overly ambitious to motivate action. PAHO is committed to periodically review and updating the indicators, to foster progress in the region.