Rwanda, a Central African country that experienced social upheaval a generation ago, is now among the region's leaders aspiring to achieve an equitable system of healthcare. It has developed research partnerships with many scientists at Harvard and other overseas institutions to develop its capacity for medical research through the Human Resources for Health (HRH) consortium. It has established a National Ethics Committee (NEC) to oversee human research, and most Rwandan universities have Institutional Review Boards (IRBs).The Rwandan Ministry of Health has identified a need to improve coordination between the different review bodies and to keep NEC and IRB member training current, as well as to expand ethics training for younger Rwandan researchers. It asked Harvard to assist the country in developing a thorough, efficient, and just system of ethical review of medical research involving human subjects. This application represents a unique collaboration of interdisciplinary Harvard faculty and staff, seeking to collaborate with Rwandan colleagues to achieve this aim through multi-level training and other interventions. The goal is to achieve a self- sustaining, well-functioning national system of ethical review within five years. The proposed program will achieve this outcome by leveraging the relationships Harvard has established through the HRH program, its rich curricular offerings and the expertise of its diverse faculty in medicine, public health and dentistry. Resources such as the case book in research ethics developed for the World Health Organization (WHO) by Harvard T.H. Chan School of Public Health (SPH) faculty will be used to train a cadre of approximately 140 Rwandan researchers to 1) conduct ethically responsible research, 2) become research ethics trainers of the next generation, 3) develop, implement and monitor ethics review policies and procedures, and 4) become the leaders who shape research ethics education, policies and priorities for the nation and region. Rwanda has taken bold steps in recent years to address its serious health needs. It is one of the first low-income nations to establish a system of universal health coverage, a development now under study throughout the developing world. Increasing the volume and scope of health research is a key step toward lifting its heavy burden of disease, and the HRH program will likely increase the number of studies in the country. But for this Rwanda needs a fully adequate system of ethical review. If this goal is achieved, Rwanda may serve as a model and training site for other countries in the region.
The proposed project will train three cohorts of research ethics experts through an innovative, inter-professional collaboration between Harvard and Rwandan faculty. It will create a sustainable education program, strengthen the research ethics review and monitoring systems, and support the expected growth in interdisciplinary research in Rwanda from its collaborations through the Human Resources for Health project. Thus the project will promote public health through increased and responsibly conducted research.
