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新冠肺炎疫情期间中低等收入国家生物库面临的挑战:是否需要重新构想大流行和突发公共卫生事件的研究伦理指南?

Challenges to biobanking in LMICs during COVID-19: time to reconceptualise research ethics guidance for pandemics and public health emergencies?

机构信息

Faculty of Medicine and Health Sciences, Centre for Medical Ethics and Law, Stellenbosch University, Cape Town, South Africa

Social Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, North Carolina, USA.

出版信息

J Med Ethics. 2022 Jul;48(7):466-471. doi: 10.1136/medethics-2020-106858. Epub 2021 May 12.

Abstract

Biobanking can promote valuable health research that may lead to significant societal benefits. However, collecting, storing and sharing human samples and data for research purposes present numerous ethical challenges. These challenges are exacerbated when the biobanking efforts aim to facilitate research on public health emergencies and include the sharing of samples and data between low/middle-income countries (LMICs) and high-income countries (HICs). In this article, we explore ethical challenges for COVID-19 biobanking, offering examples from two past infectious disease outbreaks in LMICs where biobanking activities contributed to the perpetuation of global inequities. We focus on how the ethical imperative to promote the common good during public health emergencies can conflict with protecting the interests of biobank participants. We discuss how conducting biobank research under a waiver of informed consent during public health emergencies is ethically permissible, provided guidance is in place to prevent biopiracy and exploitation of vulnerable communities. We also highlight the need for biobank collaborations between LMICs and HICs to promote capacity building and benefit sharing. Finally, we offer guidance to promote the ethical oversight of biobanks and biobank research during the COVID-19 pandemic or other future public health emergencies.

摘要

生物库可以促进有价值的健康研究,从而可能带来重大的社会效益。然而,为研究目的收集、存储和共享人类样本和数据带来了众多伦理挑战。当生物库工作旨在促进公共卫生紧急情况下的研究并包括低/中等收入国家(LMICs)和高收入国家(HICs)之间的样本和数据共享时,这些挑战会更加严重。在本文中,我们探讨了 COVID-19 生物库的伦理挑战,并从过去两次发生在 LMICs 的传染病暴发中举例说明,这些生物库活动促成了全球不平等的持续存在。我们重点讨论了在公共卫生紧急情况下促进共同利益的道德必要性如何与保护生物库参与者的利益发生冲突。我们讨论了在公共卫生紧急情况下,在知情同意豁免的情况下进行生物库研究在伦理上是可以接受的,前提是有指导方针来防止生物剽窃和剥削弱势社区。我们还强调了需要在 LMICs 和 HICs 之间进行生物库合作,以促进能力建设和利益共享。最后,我们提供了在 COVID-19 大流行或其他未来公共卫生紧急情况下促进生物库和生物库研究的伦理监督的指导。

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