Promoting health and gender equity through research ethics capacity-building: the Spanish-West African experience

Health research has historically regarded male biology as the default. Significant bodies of evidence prove that sex and gender differences influence one's vulnerability to disease, access to healthcare, and response to treatment, thus determining their health outcomes. Therefore, it is imperative to undo the culture of male-oriented research. The need for sex- and gender-sensitive research is further evidenced by the devastating impact of COVID-19 in West Africa, inflicting disproportionate socioeconomic and health burdens on women and minorities. National research ethics committees (NRECs) are in a strategic position to ensure that unethical research is not carried out, be it research without scientific or social utility or sex- and gender-blind and discriminatory research. Following the onset of COVID-19, there has been a surge in the conduct of research in West Africa, whether interventional or observational, thus indicating the need for capacity-building in research review and evaluation during health emergencies. Building the capacities of West Africa in research ethics is an EDCTP-funded action comprising Spain, Benin, Mali, and Senegal. It aims to strengthen West African research regulatory capacities through centring regional harmonization of tools and procedures, gender mainstreaming, intersectionality, and health equity. At the outset of the project, a gender-specific training needs assessment and COVID-19 impact evaluation studies took place in West Africa to map the different gaps to tackle. Findings revealed an overall lack of sex and gender considerations in research protocol evaluation, unmet needs for training on clinical trial applications evaluation and processing, and NREC management during health emergencies. Consequently, the project has trained over 150 scientists and bioethicists from 14 African countries in the aforementioned areas. It also offered a Virtual research ethics secretariat that aided NRECs in establishing sex- and gender-sensitive research evaluation tools and standard operating procedures. The secretariat currently collaborates with 7 countries. Senegal and Guinea-Bissau have already implemented the sex- and gender-sensitive guidelines for research evaluation on a national level. Our project has the potential to promote health and gender equity in research and strengthen the research ethics capacities of West Africa on a large scale, while always emphasizing African leadership, autonomy, and fair North-South partnerships.