Centre for the AIDS Programme of Research in South Africa, University of KwaZulu-Natal, Private Bag X13, Congella, Durban 4013, South Africa.
Health, Ethics and Law Institute of Forum for Medical Ethics Society, Mumbai-Pune, India.
Bull World Health Organ. 2020 Sep 1;98(9):625-631. doi: 10.2471/BLT.20.257485. Epub 2020 Jul 6.
While governments have been focusing on the unprecedented disruption to the global economy caused by coronavirus disease 2019 (COVID-19) and the urgent need for COVID-19 research, other health research has become a casualty of the pandemic. Major research operations that are unrelated to COVID-19 have been significantly diminished or suspended entirely because of either COVID-19-related legal restrictions or logistical, staffing or operational concerns. Billions of people globally are currently affected by lockdowns or curfews. Since the timescale of such restrictive measures is unknown and subject to change, many studies are now in limbo and the welfare of tens of thousands of study participants is at risk. These circumstances have introduced complex ethical challenges that merit urgent attention from international sponsors, researchers and regulators. Certain sponsors and regulators have published guidelines on how the COVID-19-related disruptions to clinical research should be managed. Although these guidelines provide a good starting point in navigating the challenges of the evolving pandemic, they only apply to those researchers funded or governed by these bodies. Here, we provide guidelines on managing such disruptions that apply beyond these specific settings. We highlight some of the effects of the COVID-19 pandemic on other ongoing research projects that are unrelated to COVID-19 and provide practical guidance on how the welfare of affected study participants should be managed. We conclude that policy-makers, sponsors, researchers and regulators must adopt a more flexible approach to ensure participant safety, while maintaining data integrity and complying with good clinical practices.
尽管各国政府一直关注 2019 年冠状病毒病(COVID-19)给全球经济带来的前所未有的破坏,以及 COVID-19 研究的迫切需要,但其他卫生研究已成为大流行的牺牲品。与 COVID-19 无关的主要研究活动因 COVID-19 相关的法律限制或后勤、人员配备或运营问题而大幅减少或完全暂停。目前,全球数十亿人受到封锁或宵禁的影响。由于这种限制措施的时间尺度未知且可能会发生变化,因此许多研究现在陷入僵局,数以万计的研究参与者的福利面临风险。这些情况带来了复杂的伦理挑战,值得国际赞助商、研究人员和监管机构的紧急关注。某些赞助商和监管机构已经发布了关于如何管理与 COVID-19 相关的临床研究中断的指南。尽管这些指南为应对不断演变的大流行的挑战提供了一个良好的起点,但它们仅适用于这些机构资助或管理的研究人员。在这里,我们提供了适用于这些特定环境之外的管理此类中断的指南。我们强调了 COVID-19 大流行对与 COVID-19 无关的其他正在进行的研究项目的一些影响,并就如何管理受影响研究参与者的福利提供了实用指导。我们的结论是,政策制定者、赞助商、研究人员和监管机构必须采取更灵活的方法来确保参与者的安全,同时保持数据完整性并遵守良好的临床实践。