The landscape in research ethics has changed significantly in Latin America and the Caribbean over the past two decades. Research ethics has gone from being a largely foreign concept and unfamiliar practice to an integral and growing feature of regional health research systems. Four bioethics training programs have been funded by the Fogarty International Center (FIC) in this region in the past 12 years.

Overall, they have contributed significantly to changing the face of research ethics through the creation of locally relevant training materials and courses (including distance learning), academic publications, workshops, and conferences in Spanish, and strengthening ethics review committees and national systems of governance. This paper outlines their achievements and challenges, and reflects on current regional needs and what the future may hold for research ethics and bioethics training in Latin America and the Caribbean. Context While most Latin American and Caribbean countries have much in common—their origin as European colonies, decades of political strife and intolerance, and, with a few exceptions, the election of democratic governments that during the last few decades have replaced authoritarian regimes—the region’s population is still divided by profound socio-economic inequalities, cultural differences, and political conflicts. Moreover, despite the region’s sustained economic growth over the past decade, some countries battle inflation and economic instability, and many countries and sub-populations within countries remain very poor.

Although there is a wide range of faith traditions in the region, political and governmental systems share a deep commitment to Roman Catholicism. How To Say It Business To Business Selling Pdf Online more. The Catholic Church exerts a particularly strong influence on issues related to reproductive health and sexuality, often hampering research in this important area of public health. Across the region, limited formal review of research is further compromised by inadequate institutional accountability and lax enforcement of the law. According to Transparency International, a nongovernmental organization that issues an annual ranking of 176 countries/territories by their perceived levels of public-sector corruption, with the exception of Chile and Uruguay, Latin American and Caribbean countries have high levels of corruption.(1) Although these countries experience varying inequalities within their healthcare systems, a large percentage of the region’s population receives some form of medical service through public health systems. Ilayaraja Hits Free Download Zip File. Several cities in the region have large hospitals, comprehensive medical education systems, and training in various areas of biomedical research. However, many countries still lack a formal legal structure for the regulation and oversight of human subjects research.

Existing regulations often apply exclusively to clinical trials with pharmaceutical products, and research with human subjects in some countries is governed only by nonbinding guidelines or by regulations that are too general to inform research in practice (). Governance of clinical research is often inadequate and systems for reporting research misconduct are rare. As in many low- and middle-income countries, a significant number of clinical trials conducted in the region are multicenter studies, using protocols written in highincome countries, sponsored by foreign funding agencies or multinational pharmaceutical corporations, and often carried out by investigators from foreign institutions (). Often, little information is returned to the local population from which participants are drawn, and participants may not understand that they are taking part in research.

US institutions and funding organizations are frequently involved in these trials, and there are mixed views in the region about the US presence in research and its involvement in promoting research ethics. Methods We collated results from four sources of information. First, the paper includes data from yearly reports prepared by the training programs’ directors, one of which has also been published as a special issue of Acta Bioethica (2012). Second, it draws on comprehensive reports produced by the programs at FLACSO and University of Chile that surveyed past trainees about their professional activities after completing training. These two programs also worked with past trainees to survey the current situation in research ethics in their respective countries or areas, and held meetings to discuss their findings and overall assessment of accomplishments. A third source of information was a brief questionnaire on the specific topics covered in this paper answered by those responsible for each training program. The fourth source was an indepth, face-to-face discussion in May 2012 among the program directors, in which the topics addressed in the questionnaire were used as a basis for common reflection and consensus on the key achievements and challenges.