Access and use of human tissues from the developing world: ethical challenges and a way forward using a tissue trust.
BACKGROUND
Scientists engaged in global health research are increasingly faced with barriers to access and use of human tissues from the developing world communities where much of their research is targeted. In part, the problem can be traced to distrust of researchers from affluent countries, given the history of 'scientific-imperialism' and 'biocolonialism' reflected in past well publicized cases of exploitation of research participants from low to middle income countries.


CONCLUSIONS
To a considerable extent, the failure to adequately engage host communities, the opacity of informed consent, and the lack of fair benefit-sharing have played a significant role in eroding trust. These ethical considerations are central to biomedical research in low to middle income countries and failure to attend to them can inadvertently contribute to exploitation and erode trust. A 'tissue trust' may be a plausible means for enabling access to human tissues for research in a manner that is responsive to the ethical challenges considered.


CONCLUSIONS
Preventing exploitation and restoring trust while simultaneously promoting global health research calls for innovative approaches to human tissues research. A tissue trust can reduce the risk of exploitation and promote host capacity as a key benefit.
McLaughlin-Rotman Centre for Global Health, University Health Network & University of Toronto, 101 College Street, Suite 406, Toronto, Ontario, M5G 1L7, Canada. claudia.emerson@mrcglobal.org
Claudia I
CI
Emerson
Peter A
PA
Singer
Ross E G
RE
Upshur
D035843:Biomedical Research / Q000941:ethics*; D055812:Community-Based Participatory Research / Q000941:ethics; D003906:Developing Countries; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D014015:Tissue Banks / Q000941:ethics; D035502:Trust
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