This article reviews the development and evolution of Fogarty International Center–funded research ethics training programs in West Africa over the past decade. In response to local and global challenges in bioethics and biomedical research, these programs are fostering ethical awareness, shaping local and national ethics review systems, and enhancing bioethics capacity in the region. These efforts have expanded alongside increased democratic governance, technological advances, and significant increases in global research funding and international research collaborations, particularly related to HIV/AIDS and malaria. We believe that the West Africa Bioethics (WAB) Training Program in Nigeria played a central role in this growth, serving as a model for subsequent programs in Ghana, Mali, and The Gambia. This paper describes the nature, successes, and challenges of these programs. It also outlines an agenda and strategies for future work to enhance research ethics and bioethics capacities in the region, both in terms of education and governance.
AbubakarI.DalglishS. L.AngellB.SanuadeO.AbimbolaS.AdamuA. L.AdetifaI. M. O.ColbournT.OgunlesiA. O.OnwujekweO.OwoajeE. T.OkekeI. N.AdeyemoA.AliyuG.AliyuM. H.AliyuS. H.AmehE. A.ArchibongB.EzehA.GadanyaM. A., … ZannaF. H. (2022). The lancet Nigeria commission: Investing in health and the future of the nation. The Lancet, 399(10330), 1155–1200. https://doi.org/10.1016/S0140-6736(21)02488-0
2.
AdebamowoC. A. (2007). West African bioethics training program: Raison d’être. African Journal of Medicine and Medical Sciences, 36(suppl.), 35–38. Retrieved from http://www.westafricanbioethics.net/new/eng?pg=home.
3.
AdebamowoC. A.CallierS.AkintolaS.MadukaO.JegedeA.ArimaC.OgundiranT.AdebamowoS. N., & BridELSI Project as part of the DS-I Africa BridELSI Project as part of the DS-I Africa Consortium. (2023). The promise of data science for health research in Africa. Nature Communications, 14,6084. https://doi.org/10.1038/s41467-023-41809-2
4.
AdeleyeO. A.AdebamowoC. A. (2012). Factors associated with research wrongdoing in Nigeria. Journal of Empirical Research on Human Research Ethics, 7(5), 15–24. https://doi.org/10.1525/jer.2012.7.5.15
5.
AdjeiS.SeddohA.de-Graft AikinsA. (2019). Health research in Ghana: The role of universities and research institutions. University of Ghana Press.
6.
AgyemangC.BoatemaaS.Agyemang FrempongG.de-Graft AikinsA. (2016). Obesity in sub-Saharan Africa. In R. S. Ahima (Ed.), Metabolic syndrome: A comprehensive textbook (pp. 41–53). Springer. https://doi.org/10.1007/978-3-319-11251-0_5
7.
AgyepongI. A.SewankamboN.BinagwahoA.Coll-SeckA. M.CorrahT.EzehA.FekaduA.KilonzoN.LampteyP.MasiyeF.MayosiB.MboupS.MuyembeJ.-J.PateM.SidibeM.SimonsB.TlouS.GheorgheA.Legido-QuigleyH.McManusJ., … PiotP. (2017). The path to longer and healthier lives for all Africans by 2030: The Lancet Commission on the future of health in sub-Saharan Africa. The Lancet, 390(10114), 2803–2859. https://doi.org/10.1016/S0140-6736(17)31509-X
8.
AidamJ.SombiéI. (2016). The West African Health Organization’s experience in improving the health research environment in the ECOWAS region. Health Research Policy and Systems, 14(1), 30. https://doi.org/10.1186/s12961-016-0102-7
9.
AjuwonA. J. (2015). Access to bioethics education in Nigeria: Past history, current situation, and opportunities for the future. In ten HaveH. A. M. J. (Ed.), Bioethics education in a global perspective: Challenges in global bioethics (pp. 65–71). Springer. https://doi.org/10.1007/978-94-017-9232-5_5
10.
Amoakoh-ColemanM.VieiraD.AbugriJ. (2023). Ethical considerations for biobanking and use of genomics data in Africa: A narrative review. BMC Medical Ethics, 24, 108. https://doi.org/https:/doi.org/10.1186/s12910-023-00985-y
11.
AngellB.SanuadeO.AdetifaI. M. O.OkekeI. N.AdamuA. L.AliyuM. H.AmehE. A.KyariF.GadanyaM. A.MabayojeD. A.Yinka-OgunleyeA.OniT.JaloR. I.Tsiga-AhmedF. I.DalglishS. L.AbimbolaS.ColbournT.OnwujekweO.OwoajeE. T.AliyuG.AliyuS. H.ArchibongB.EzehA.IhekweazuC.IliyasuZ.ObaroS., … AbubakarI. (2022). Population health outcomes in Nigeria compared with other West African countries, 1998–2019: A systematic analysis for the Global Burden of Disease Study. The Lancet, 399(10330), 1117–1129. https://doi.org/10.1016/S0140-6736(21)02722-7
12.
AteudjieuJ.WilliamsJ.HirtleM.BaumeC.IkinguraJ.NiaréA.SprumontD. (2010). Training needs assessment in research ethics evaluation among research ethics committee members in three African countries: Cameroon, Mali and Tanzania. Developing World Bioethics, 10(2), 88–98. https://doi.org/10.1111/j.1471-8847.2009.00266.x
13.
AwuaA.AkaziliJ.LaarA.FergusonK.AyetteyS. (2024). Funding modalities of Ethics Review Committees: Perspectives of representatives of selected ERCs in Ghana. Health Sciences Investigations Journal, 6(2), 943–950. https://doi.org/10.46829/hsijournal.2024.12.6.2.943-950
14.
BatesI.AkotoA. Y. O.AnsongD.KarikariP.Bedu-AddoG.CritchleyJ.Nsiah-AsareA. (2006). Evaluating health research capacity building: An evidence-based tool. PloS Medicine, 3(8), e299. https://doi.org/10.1371/journal.pmed.0030299
15.
BlanksonP.-K.AkumiahF.LaarA.KearnsL.OwusuS. A. (2025). The informed consent process: An evaluation of the challenges and adherence of Ghanaian researchers. Developing World Bioethics, 25(1), 55–61. https://doi.org/10.1111/dewb.12447
16.
Boafo-ArthurK. (2008). Democracy and stability in West Africa: The Ghanaian experience. Universitetstryckeriet.
17.
BorgesS.MonteiroS.RodriguesA.FurtadoM. (2019). Health research capacity building in Cabo Verde: Achievements and challenges. BMC Public Health, 19(1), 354. https://doi.org/10.1186/s12889-019-6718-5
18.
BrownstoneS.ConnorA.SteinD. (2020). Retraction: Improving measles vaccine uptake rates in Nigeria: An RCT evaluating the impact of incentive sizes and reminder calls on vaccine uptake. PLOS One, 15(7), e0236542. https://doi.org/10.1371/journal.pone.0236542
19.
CeesayS. J.Casals-PascualC.ErskineJ.AnyaS. E.DuahN. O.FulfordA. J.SesayS. S.AbubakarI.DunyoS.SeyO.PalmerA.FofanaM.CorrahT.BojangK. A.WhittleH. C.GreenwoodB. M.ConwayD. J.ConwayD. J. (2008). Changes in malaria indices between 1999 and 2007 in The Gambia: A retrospective analysis. The Lancet, 372(9649), 1545–1554. https://doi.org/10.1016/S0140-6736(08)61654-2
20.
De LangeM. C. (2005). Integrating philosophical and bioethical perspectives in life sciences facilitator education. South African Journal of Higher Education, 19(6), 1062–1073. https://doi.org/10.4314.sajhe.v19i6.25545
21.
DoumbiaS.RosenH. E.PaichadzeN.DoloH.DabitaoD.SanogoZ. L.NdebeleP. (2023). Establishment of a collaborative research ethics training program to prepare the next generation of ethics researchers in Mali. International Journal of Ethics Education, 8, 309–319. https://doi.org/10.1007/s40889-023-00170-0
22.
DoumbiaS.SogobaN.DiakiteM.ToureM.KeitaM.KonatéD.DiawaraS. I.DiarraA.SanogoD.KaneF.DiakiteS. A. S.TraoreK.ThiamS. M.TraoréS. F.CisseI.MihigoJ.CoulibalyM. B.DabitaoD.AlifrangisM.BarryA. E., … ShafferJ. G. (2022). A decade of progress accelerating malaria control in Mali: Evidence from the West Africa International Center of Excellence for Malaria Research. American Journal of Tropical Medicine and Hygiene, 107(4 Suppl.), 75–83. https://doi.org/10.4269/ajtmh.21-1309
23.
EtkinS. (2008). Pfizer in hot water over Nigerian pediatric trial. Applied Clinical Trials, 17(2), 24.
24.
EwuosoO. C. (2016). Bioethics education in Nigeria and West Africa: Historical beginnings and impacts. Global Bioethics, 27(2–4), 50–60. https://doi.org/10.1080/11287462.2016.1192448
25.
EzeomeE. R.SimonC. (2010). Ethical problems in conducting research in acute epidemics: The Pfizer meningitis study in Nigeria as an illustration. Developing World Bioethics, 10(1), 1–10. https://doi.org/10.1111/J.1471-8847.2008.00239.X
GatesB. (2020). The roll of philanthropy in global health research funding. Bill & Melinda Gates Foundation. Retrieved from https://www.gatesfoundation.org.
GlassR. (2013). International research ethics education. Journal of Empirical Research on Human Research Ethics, 8(5), 1–2. https://doi.org/10.1525/jer.2013.8.5.1
HedquistA.JonesC. M.MijumbiR. M.Sobngwi-TambekouJ.ParkhurstJ.WenhamC. (2022). Mapping regional cooperation of state actors for health research systems in Africa: A social network analysis. PLOS Global Public Health, 2(10), e0001142. https://doi.org/10.137/journal.pgph.0001142
33.
HyderA. A.WaliS. A.KhanA. N.Teoh NB.Kass NE.DawsonL. (2004). Ethical review of health research: A perspective from developing country researchers. Journal of Medical Ethics, 30(1), 68–72. https://doi.org/10.1136/jme.2002.001933
34.
IrikefeV.VaidyanathanG.NordlinL., et al. (2011). Science in Africa: The view from the front line. Nature, 474(7353), 556–559. https://doi.org10.1038/474556a
JobeS.JallowA.JattaI. (2024a). Prevalence of non-communicable diseases in The Gambia: A national health survey. BMC Public Health, 24(1), 1043. https://doi.org/10.1186/s12889-023-10515-6
37.
JobeM.MactaggartI.BellS.KimM. J.HydaraA.BascaranC.NjaiM.BadjieO.PerelP.PrenticeA. M.BurtonM. J. (2024b). Prevalence of hypertension, diabetes, obesity, multimorbidity, and related risk factors among adult Gambians: A cross-sectional nationwide study. The Lancet Global Health, 12(1), e55–e65. https://doi.org/10.1016/S2214-109X(23)00508-9
38.
KaratnyckyA. (ed.). (2000). Freedom in the World: The Annual Survey of Political Rights and Civil Liberties, 1999–2000. Freedom House.
39.
KargboA.SesayF.AlhassanM. (2021). The state of health research in Sierra Leone: A focus on post-Ebola initiatives. Sierra Leone Journal of Public Health, 6(2), 112–120.
40.
KassN. E.AliJ.HallezK.HyderA. A.Hopkins BermanJ. (2016). Bioethics training programmes for Africa: Evaluating professional and bioethics-related achievements of African trainees after a decade of Fogarty NIH investment. BMJ Open, 6(9), e012758. https://doi.org/10.1136/bmjopen-2016
41.
KirigiaJ. M.OtaM. O.MotariM.BataringayaJ. E.MouhoueloP. (2015). National health research systems in the WHO African Region: Current status and the way forward. Health Research Policy and Systems, 13(1), 61. https://doi.org/10.1186/s12961-015-0054-3
42.
KonéA.KaneF.NealA.KonateI.CoulibalyB.DabitaoD. K.DiarraB.SanogoI.SarroY. D. S.CoulibalyT. A.DialloD.SamakeS.DickoI.DialloM.DiarraA.CoulibalyM. D.KeitaD.CoulibalyN.KolomaI.PerouM., … DaoS. (2024). Adding virome capture metagenomic sequencing to conventional laboratory testing increases unknown fever etiology determination in Bamako, Mali. American Journal of Tropical Medicine and Hygiene, 112(3), 626–635. https://doi.org/10.4269/ajtmh.24-0449
43.
KozmaC.Calero MedinaC.CostasR. (2018). Research funding landscapes in Africa. In BeaudryC.MoutonJ.ProzeskyH. (Eds.), The next generation of scientists in Africa (pp. 26–42). African Minds.
44.
KrukM. E.RockersP. C.WilliamsE. H.VarpilahS. T. (2015). Liberia’s health system: Post-Ebola recovery and lessons for future resilience. The Lancet Global Health, 3(8), e428–e431. https://doi.org/10.1016/S2214-109X(15)00137-1
45.
LaarA. K.RedmanB. K.FergusonK.CaplanA. L. (2020). Institutional approaches to research integrity in Ghana. Science and Engineering Ethics, 26(6), 3037–3052. https://doi.org/10.1007/s11948-020-00257-7
46.
LoffB.JenkinsC.DitmoreM.OversC.BarberoR. (2005). Unethical clinical trials in Thailand: A community response. The Lancet, 365(9471), 1618–1619. https://doi.org/1016/S0140-6736(05)66502-6
47.
LoueS.LoffB. (2013). Mentoring international research ethics trainees: Identifying best practices. Journal of Emprirical Research on Human Research Ethics, 8(5), 52–58. https://doi.org/10.1525/jer.2013.8.5.52
48.
MatarA.GarnerS.MilliumJ.SinaB.SilvermanH. (2014). Curricular aspects of the Fogarty bioethics international training programs. Journal of Empirical Research on Human Research Ethics, 9(2), 12–23. https://doi.org/10.1525/jer.2014.9.2.12
49.
MillumJ.GradyC.KeuschG.SinaB. (2013). Introduction: The Fogarty International Research Ethics Education and Curriculum Development Program in historical context. Journal of Empirical Research on Human Research Ethics, 8(5), 3–16. https://doi.org/10.1525/jer.2013.8.5.3
50.
MillumJ.SinaB. (2014). Introduction: International research ethics education. Journal of Empirical Research on Human Research Ethics, 9(2), 1–2. https://doi.org/10.1525/jer.2014.9.2.1
51.
NdebeleP.WassenaarD.BenatarS.FleischerT.KrugerM.AdebamowoC.KassN.HyderA. A.MeslinE. M. (2014). Research ethics capacity building in sub-Saharan Africa: A review of NIH Fogarty-funded programs, 2000–2012. Journal of Empirical Research on Human Research Ethics, 9(2), 24–40. https://doi.org/10.1525/jer.2014.9.2.24
52.
NgomR.GueyeA. S.LassieurS.OlooS.ShahidR.MizeV.Lukoya OkotC.WaogodoJ. C.FallI. S. (2023). Five decades of infectious diseases outbreaks in the African region (1970–2018): A geographic snapshot. Social Sciences & Humanities Open, 8(1), 100625. https://doi.org/10.1016/j.ssaho.2023.100625
OwusuS. A.AddisonG.RedmanB.KearnsL.AmunaP.LaarA. (2022). Assessment of the operational characteristics of Research Ethics Committees in Ghana. Journal of Empirical Research on Human Research Ethics, 17(1–2), 114–128. https://doi.org/10.1177/15562646211051189
56.
PEPFAR. (2023). The U.S. President’s Emergency Plan for AID Relief (PEPFAR): 20 years of impact. U.S. Department of State. Retrieved from https://www.state.gov/pepfar.
57.
PREVAC Study Team. (2022). Randomized trial of vaccines for Zaire Ebola Virus Disease. New England Journal of Medicine, 387(26), 2411–2424. https://doi.org/10.1056/NEJMoa2200072
Roll Back Marlaria Partnership. (2022). About the Roll Back Malaria Partnership to End Malaria. World Health Organization. Retried from https://www.rollbackmalaria.org.
61.
Sam-AgunduN. A.PaintsilE.AliyuM. H.KwaraA.OgunsolaF.AfraneY. A.OnokaC.AwandareG. A.AmponsahG.CorneliusL. J.MendyG.SturkeR.GhansahA.SiberryG. K.EzeanolueE. E.EzeanolueE. E. (2016). Building sustainable local capacity for global health research in West Africa. Annals of Global Health, 82(6), 1010–1025. https://doi.org/10.1016/j.aogh.2016.10.011
62.
SawyerrA. (2004). African universities and the challenge of research capacity development. Journal of Higher Education in Africa, 2(1), 213–242. https://www.jstor.org/stable/24486132
63.
SeddohA.NazzarA.BatseZ. K.TettehE.AdjeiS. (2015). Mapping of health research institutions in Ghana: Landscaping and comparative analysis. Center for Health and Social Servicess (CHeSS).
64.
SilaigwanaB.WassenaarD. (2015). Biomedical Research Ethics Committees in sub-Saharan Africa: A collective review of their structure, functioning, and outcomes. Journal of Empirical Research on Human Research Ethics, 10(2), 169–184. https://doi.org/10.1177/1556264615575511
65.
SilvermanH.StrosbergM.LunaF.PhilpottS.HemmerieC. A. (2013). An analysis of online courses in research tethics in the Fogarty-sponsored bioethics training programs. Journal of Empirical Research on Human Research Ethics, 8(5), 59–74. https://doi.org/10.1525/jer.2013.8.5.59
SombiéI.AidamJ.KonatéB.SoméT. D.KambouS. S. (2013). The state of the research for health environment in the ministries of health of the Economic Community of the West African States (ECOWAS). Health Research Policy and Systems, 11(1), 35. https://doi.org/10.1186/1478-4505-11-35
68.
TindanaP. O.SinghJ. A.TracyC. S.UpshurR. E. G.DaarA. S.SingerP. A.FrohlichJ.LaveryJ. V. (2007). Grand Challenges in Global Health: Community engagement in research in developing countries. PLoS Medicine, 4(9), e273. https://doi.org/10.1371/journal.pmed.0040273
69.
UcheN. J.OkoyeO.Kizor-AkaraiweN.Chuka-OkosaC.UcheE. O. (2023). Determinants of participation in glaucoma genomic research in South East Nigeria: A cross-sectional analytical study. PLOS One, 18(11), e0289643. https://doi.org/10.1371/journal.pone.0289643
70.
UthmanA. U.WiysongeC. S.OtaM. O.NicolM.HusseyG. D.NdumbeP. M.MayosiB. M. (2015). Increasing the value of health research in the WHO African Region beyond 2015--Reflecting on the past, celebrating the present and building the future: A bibliometric analysis. BMJ Open, 5(3), e006340. https://doi.org/101136/bmjopen-2014-006340
