Human subjects research in environments of scarcity and inequality requires context-sensitive ethics that incorporates basic transcultural values and promotes social change. We propose to build bioethical training and research capacity at the Kinshasa School of Public Health (KSPH), Democratic Republic of Congo (DRC) through expansion of its partnerships with the University of North Carolina (UNC), and the Catholic University of Louvain, Belgium (UCL). Four Congolese scholars will complete a one-year intensive postgraduate, master-level training program in Bioethics at UCL, and 5 months of mentored bioethics research development, curriculum building, and IRB training at UNC. Upon return to DRC, scholars at the new KSPH Center of Bioethics (CB), will reinforce local IRB capacity; perform innovative and socially relevant independent bioethics research; develop a two-week bioethics module integrated into the MPH program at KSPH; establish a bioethics documentation and consultation service; create original pedagogical material focusing on developing world bioethical issues; design a bioethics website and develop e-learning capacities, and in the fourth year, offer a 2-week intensive course in bioethics for scholars from throughout Francophone Africa. The diverse activities at the new KSPH Center of Bioethics will serve its mission to promote responsible biomedical research and clinical practice in DRC and in francophone Africa. The CB will encourage reflection on the meaning of autonomy in circumstances of poverty and injustice; co-responsibility between communities, research institutions and vulnerable subjects; creative, culturally resonant solutions to ethical conflicts raised by biomedical research; recognition of the importance and limits of procedural informed consent, and the need for 'negotiated consent' embodying mutual respect between researcher and subject. The CB is critical to deal responsibly with public health problems rooted in local and global injustice, and can contribute to social change and the establishment of a new human rights culture. ? ?
