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Overcoming Logistical Barriers to Conducting Collaborative Clinical Research Between a High-Income Country and a Low-
Surbhi Grover1, Allison Chambers2, Chinenye Azoba3
1Department of Radiation Oncology, University of Pennsylvania, Philadelphia, PA.
JCO Global Oncology
|January 23, 2026
Summary
Streamlining ethical review for international research collaborations between high-income countries (HICs) and low- and middle-income countries (LMICs) is crucial. Centralized oversight and joint meetings can overcome delays and build capacity for equitable global health research.
Area of Science:
- Global Health
- Research Ethics
- International Collaboration
Background:
- Equitable research partnerships between high-income countries (HICs) and low- and middle-income countries (LMICs) face coordination challenges with international ethical review committees.
- Effective ethical review is essential for successful international research collaborations.
Purpose of the Study:
- To present insights from acquiring ethical approval for a cervical cancer research program between the University of Pennsylvania and the University of Botswana.
- To identify strategies for strengthening ethical review processes in multinational research.
Main Methods:
- A descriptive case study of the 6-year Ipabalele project (HIC-LMIC partnership) involving three complex research protocols.
- Analysis of challenges in review procedures, timelines, and staffing.
- Documentation of strategies from Ipabalele and other global initiatives.
Main Results:
- Ethical approvals for the Ipabalele project were initially delayed by 2 years due to fragmented review processes.
- Innovations included centralizing institutional review board oversight in Botswana, joint virtual meetings, enhanced digital infrastructure, and streamlined staffing.
- These strategies addressed variable timelines and conflicting recommendations.
Conclusions:
- Empowered local leadership, centralized review, joint review mechanisms, and capacity building can overcome logistical barriers in multinational ethical review.
- Practical strategies are highlighted for improving ethical review processes in global health research.
- Strengthening ethical review capacity in LMICs is vital for equitable research collaborations.
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