28 April 2015 -- This document analyses the ethical issues that emerge when using convalescent whole blood and convalescent plasma as potential therapies for Ebola Virus Disease and elicits a series of recommendations to be followed when implementing these programmes. It is intended for multiple audiences, including researchers, ethics review committees, and blood transfusion services and aims to ensure that donors and recipients of convalescent whole blood and plasma are treated according to high ethical standards.
As a reaction to the Ebola outbreak in West Africa, WHO convened an expert consultation to consider and assess the ethical implications of using unregistered interventions that showed promising results in the laboratory/animal models. The group supported the use of investigational interventions during this outbreak under certain conditions.
Following the meeting, an Ethics Working Group was established to address further ethical issues arising in the context of the emergency including fair distribution of investigational interventions and ethical ways to collect data while providing optimal care under the circumstances of scarcity.
Surveillance is one of the most fundamental activities of public health, involving different areas andpractices such as non-communicable disease registers, outbreak investigations, and health systems research. Public health surveillance raises multiple ethical issues concerning, among others, the use/non-use of informed consent or the provision/non-provision of standards of care.
In 2014 WHO launched a project to develop WHO Guidelines on Ethical Issues in Public Health Surveillance, and for this purpose established an international Guideline Development Group. The guidelines are expected to be published by the end of 2015. The meeting where the essential elements of future guidelines were outlined, took place on 26–27th May 2014 in Geneva.
The 11th Global Summit of National Ethics Committees will be held in March 2016 in Berlin, Germany. Past summits have formed the basis of international collaboration, agreement, and discussion on topical ethical issues affecting world public health. Topics and details for the 2016 Summit are yet to be finalised, but will be released in due course. Governmental departments and bodies wishing to attend the Summit should contact the secretariat, the Global Health Ethics Unit at WHO, at CT_ethics@who.int.
About ethics and health
The Global Health Ethics Unit provides a focal point for the examination of ethical issues raised by activities throughout the Organization. The unit also supports Member States in addressing ethical issues that arise in their own countries. This includes a range of global bioethics topics; from public health surveillance to developments in genomics, and from research with human beings to fair access to health services.
This unit’s work is particularly important in the context of contemporary health challenges and raises and addresses difficult questions in areas such as resource allocation, new technologies, decision-making in clinical care and public health.
WHO Research Ethics Review Committee (ERC)
The ERC ensures that WHO only supports research of the highest ethical standards. The ERC reviews all research projects, involving human participants supported either financially or technically by WHO.