NEWS RELEASE

Office of Communications
Media Contact: Ed Bodensiek
410-516-8523; ebodensiek@jhu.edu

July 2, 2007

Case Study: Cross-Cultural Bioethics Training Program Helps Fight African ‘Brain Drain’

Baltimore – When African professionals migrate to the United States or Europe, it’s often called brain drain. In the world of research ethics, at least one training program is causing the opposite effect. Now entering its eighth year of operation, the Johns Hopkins Fogarty African Research Ethics Training Program is the subject of a sweeping new case study published in the July 2007 issue of Academic Medicine. For the first time, the case study reveals some potent lessons in what it takes to deliver a successful, cross-cultural ethics training program.

 “We initially sought to increase the critical mass of African individuals professionally trained in ethics,” said Nancy Kass, ScD, deputy director for public health at the Johns Hopkins Berman Institute of Bioethics and the program’s director. “But it also turns out that our trainees are making institutional changes to policies, drafting new guidelines, and generally raising awareness of the need to support research ethics. And some trainees are not just doing these things in their home countries, but throughout the continent.”

In a region devastated by the HIV/AIDS epidemic, the trainees provide encouraging evidence of success in the global effort to work collaboratively with African professionals to develop their own ethics-based research methods. After studying in Baltimore for six months under the supervision of a mentor with similar research interests, trainees return to Africa to begin a six-month practicum on the topic of their choice related to the ethics of research. One trainee returned to Zimbabwe, eager to share his newfound expertise at more than 30 workshops in surrounding regions. Another returned to the Democratic Republic of Congo and established two Institutional Review Boards (IRBs). Yet another trainee helped design international guidelines for HVI vaccines. 

“During the practicum, trainees implement all they have learned in the classroom,” said Adnan Hyder, MD, MPH, PhD, the program’s co-director and an associate professor of international health at the Johns Hopkins Bloomberg School of Public Health. “The last half of the program attempts to mitigate a familiar problem for researchers in Africa: trying to borrow principles of ethical review from developed countries. Instead, trainees contribute to the research ethics capacity of their home country by setting the agenda themselves. The process transforms students into effective researchers and advocates for the kind of research ethics that will actually work in their own countries.”

The case study reveals that Johns Hopkins Fogarty Bioethics trainees return to Africa well-equipped for the practicum and subsequent work. While at The Johns Hopkins University, trainees attend three intensive courses, multiple seminars, and regular one-on-one mentoring sessions, as well as attend IRB meetings at the university and at the National Institutes of Health.

Despite considerable success stories, the program still faces challenges. The Academic Medicine article demonstrates the importance of maintaining regular contact with trainees upon their return, particularly as many of these trainees face many other professional demands when they return home; in four years, the program lost contact with only one trainee. The program’s directors have also learned to require monthly progress reports and to finance each practicum in stages to ensure timely completion.

Backgrounds of the 23 trainees who have gone through the program to date have varied; former trainees include a philosophy professor from West Africa, a pediatrician who works with orphans, an advisor to the Cameroon military, two IRB coordinators, and a young staff member of an HIV vaccine-ethics group.

In 2000, the Fogarty International Center of the National Institutes of Health (NIH) established the International Bioethics Education and Career Development Award. Designed to improve the quality of international ethics training, the program placed a special focus on training for professionals from developing countries. The Johns Hopkins University was one of five institutions in North America originally selected to help the NIH launch the initiative, and selected Africa as its area of focus. Three to five scientists from sub-Saharan Africa have participated in the Hopkins program each year.

NEWS RELEASE

Office of Communications
Media Contact: Ed Bodensiek
410-516-8523; ebodensiek@jhu.edu

June 20, 2007

FOR IMMEDIATE RELEASE

Study: Donated Embryos Could Result in More Than 2,000 New Embryonic Stem Cell Lines

Up to 60 Percent of Fertility Clinic Patients Willing to Donate Remaining Embryos to Stem Cell Research

In a survey of more than one thousand infertility patients with frozen embryos, 60 percent of patients report that they are likely to donate their embryos to stem cell research, a level of donation that could result in roughly 2000 to 3000 new embryonic stem cell lines. Researchers from Duke University and Johns Hopkins University report the startling findings in the July 6, 2007 issue of Science.

In August of 2001, less than two dozen embryonic stem cell lines were made eligible for federal research funding. Most scientists now agree that the eligible lines have proven inadequate in number and unsafe for transnational research. Until recently, the best estimate of human embryos currently in storage that might be available for additional stem cell research was three percent. The 2003 study showed that donations would yield, at best, less than 300 new lines.

“Until now, the debate about federal funding for embryonic stem cell research has been dominated by lawmakers and advocates. But what about the preferences of infertility patients, who are ethically responsible for, and have legal authority over, these embryos?” asked Ruth Faden, director of the Johns Hopkins Berman Institute of Bioethics and one of the study’s two co-authors. “These patients face the often morally difficult task of deciding what to do with their remaining cryopreserved embryos. In the end, it is these people who determine whether embryos are available for adoption or for medical research.”

The 1,020 couples responding to the survey currently control the disposition of between 3,900 to 5,900 embryos. Nearly half of the respondents (49 percent) indicated they were somewhat or very likely to donate their frozen embryos to medical research. When asked about stem cell research in particular, this percentage increased to 60 percent.

“Our data suggest that the way many infertility patients resolve the very personal moral challenge of what to do with their embryos is consonant with the conclusions of the majority of Americans who support embryonic stem cell research,” said Anne Lyerly, M.D., Associate Professor of Obstetrics and Gynecology at Duke University and co-author of the study. “Many infertility patients see donating their remaining embryos for medical research as preferable to simply discarding them or even to donating to another infertile couple for adoption.”

Infertility patients in the Lyerly and Faden study said they were more likely to donate their embryos to scientists for stem cell research (60 percent) than to other couples for adoption (22 percent of respondents). Embryos are currently frozen in fertility clinics because more were created than could safely be returned to a woman’s uterus at the time of fertilization or in order to increase the chances of pregnancy from a single cycle of in-vitro fertilization.