Authors:
Prof. Theresa Burgess | Stellenbosch University, Faculty of Medicine and Health Sciences | South Africa
Alda Grethe Geldenhuys | Stellenbosch University, Faculty of Medicine and Health Sciences
Siti Kabanda | Stellenbosch University, Faculty of Medicine and Health Sciences
Prof. Stuart Rennie | University of North Carolina at Chapel Hill | United States
Prof. Keymanthri Moodley | Stellenbosch University, Faculty of Medicine and Health Sciences | South Africa
Background
The COVID-19 pandemic presented significant challenges to research ethics committee (RECs) in balancing urgency of review of COVID-19 research with careful consideration of risks and benefits. In the African context, RECs were further challenged by historical mistrust of research and potential impacts on COVID-19 related research participation and vaccine hesitancy. We explored the perspectives and experiences of RECs regarding the procedural and ethical, legal and health equity challenges of COVID-19 research in South Africa.
Methods
We conducted in-depth interviews with 21 REC chairpersons or members from seven RECs at large academic health institutions across South Africa that were actively involved in the review of COVID-19 related research. In-depth interviews (60-125 min) were conducted in English using an in-depth interview guide, until data saturation was achieved. An inductive approach to thematic analysis was used to analyse data.
Results
Three key categories were identified: REC processes and procedures, research ethics issues and health equity issues. Key themes for REC processes and procedures included RECs innovation during vulnerable pandemic times, solidarity and its impact on REC processes, and a consistently cautious approach to mutual recognition of REC reviews. Research ethics themes included opportunistic research, the rapidly evolving research ethics landscape, extreme vulnerability of research participants, and complexities of stakeholder engagement. Overlapping research ethics and health equity issues emerged.
Conclusion
Numerous, significant ethical complexities and challenges were identified by South African RECs Further comparative analysis between different countries is needed to develop the discourse around COVID-19 research ethics issues.