Research and Development during Epidemics and Public Health Emergencies

Executive Summary

The lack of an African research ethics framework during epidemic emergencies (EE) has been a glaring concern
amongst African scholars for decades. In the context of major public health emergencies of continental and global health concern over the last five years, such as Ebola in 2019, COVID in 2020 and Mpox in 2024, and ongoing epidemics, including those of pandemic potential, the need for such a framework is evident. Ethics frameworks for research during emergencies have been published (World Health Organisation, 2016; Nuffield Council on Bioethics, 2020). However, there is currently no African and continent-wide, coherent guidance that promotes African values, elaborated by Africans for hosting research during EE on the continent. To address this gap, the African Centre for Disease Control convened an Ethics Working Group (Ethics WG) to develop an African
framework that embraces dominant African principles/values that might guide the ethical conduct of research in
Africa during EE to prevent harm to participants/communities.

This African ethical framework for research during EE draws on salient African values, which inform guiding
principles for research involving African communities. Central to this framework is fully acknowledging the historical context, including violations, ethical misconduct and harms that Africans have experienced. Emergencies have the potential to exacerbate the risk of harm, vulnerabilities, and injustices; therefore, the
framework seeks to expound on the context-specific realities, nuances, and challenges experienced in the African
context during EE.

This framework seeks to redress an image of Africa often perceived as a place where researchers from high income countries can easily engage in exploitative, unjust, and unethical research practices due to less stringent ethical standards or less oversight in Africa, so-called helicopter research and ethics dumping. Whilst taking seriously the rights of communities and regions to make informed decisions about what research to permit in their region with a specific focus on addressing priority problems, this framework also seeks to limit arbitrariness in research during emergencies “divide and research” – by setting minimum standards that are grounded in commonly accepted values across African societies. The framework aims for the long-term relevance and applicability of such standards even for secondary use of data arising from research during emergencies on the continent.

The framework seeks to meet three main objectives:

• To speak to the previous and ongoing experiences with epidemic emergencies on the continent.
• To mitigate unethical research practices during epidemic emergencies.
• To draw on the salient values to tease out principles and duties for research during epidemic
  emergencies in Africa.

The framework proposes an ‘ethical compass’ of three core values: solidarity (altruism, reciprocity and collective
responsibility), friendliness (interdependence, interconnection, respect and community survival/good) and social
justice (equitable allocation, moral responsibility, holism, hospitality and acceptability). In turn, these core values
have informed and been drafted into what we have coined the C.U.R.E framework (i.e., collaboration; responsive
utility; responsible science; and empowerment).
The framework applies these values and principles to all stages of research and considers their implications for
participants, participating communities, researchers, partners and funders.