For many years, the perception of Africa has been that of a “mystifying jungle” whose signature is anarchy, poverty, and savagery. Africa is not peculiar: like most developing countries the continent experiences a significant proportion of disease burden and preventable death yet only about 10 % of the global funding for health research is directed to addressing the continent’s health problems. This global health research inequity termed the “10/90 gap ” represents a fatal imbalance. The disparity in the investment in health research funding, capacity building in research and development, and the disparity in public-private partnerships has decreased in recent years with an increasing number of clinical trials conducted in Africa to develop new treatments against infectious diseases which have no territorial boundaries. Additionally, there has been a shift towards creating consortia for health research projects that are relevant to the participating communities, for example, the malaria vaccine study (Mwangoka et al. 2013) and the Human Health and Heredity in Africa Initiative. However, many countries still lack the basic infrastructure and expertise to conduct health research that meets international standards (Ali et al. 2012; Dolgin 2010; Hyder et al. 2007).

The variations in the socio-economic status, political climate, legislation, culture and history between African countries reflect the resources and infrastructure available to support health research (Hofman et al. 2013; Mathooko and Kipkemboi 2014). Despite these differences, local research ethics committees have established guidelines for the review and oversight of research in their jurisdictions in order to protect research participants from risk of harm or exploitation and to support the national health agenda. These guiding principles are adopted and domesticated from existing international documents such as the Declaration of Helsinki , Council for International Organizations of Medical Sciences (CIOMS), the Belmont Report and the UNESCO Universal Declaration on Bioethics and Human Right s (UNESCO 2005). The reality is that many countries in Africa have limited capacity to conduct effective review and oversight of health research protocols. However, more recently, targeted training programs in health research ethics and the ethics review process have been established to enhance expertise in this area (Abou-Zeid et al. 2009; Adebamowo 2007; Benatar 2007; Moodley and Rennie 2011; “SARETI” 2003). In 1993, the Council for International Organizations of Medical Sciences (CIOMS), in collaboration with WHO, provided international ethical guidelines for biomedical research involving human subjects which have been subsequently revised. The oversight and conduct of medical research in developing countries was further strengthened through the adoption and implementation of these guidelines (CIOMS 2002). Emphasis was placed on the importance of grounding biomedical research to national research and health agendas and for research to be responsive to the health priorities of participating communities (Margetts et al. 1999).

There has been a proliferation of Research Ethics Committees in Africa to support the growing number of international collaborative research projects in biomedical and social sciences, new technologies and innovations (Agnandji et al. 2012; Wasunna 2005).

However, to examine the capacity of well-established Research Ethics Committees in Kenya , Lesotho, Malawi, Mauritius, Swaziland, Seychelles, Tanzania , Uganda , Zambia and Zimbabwe , a survey was recently conducted by the East, Central and Southern Africa Health Community Secretariat in Arusha, Tanzania, using a self-assessment tool for research ethics committees (Sleem et al. 2010). The results revealed non-conformities in the minimal standards for membership, tenure and operations by some of the review boards. More strikingly, the study shows disparity in the minimum training requirements for a member to serve on the Committee (unpublished report, 2013). There are also varying degrees of stringency in the review of multi-site clinical trial protocols within and between countries (Nyika et al. 2009). While considerable time and resources must be invested to ensure an effective and efficient regulatory system, most members of ethics review boards offer their time and expertise for free by balancing their professional obligations with dedicated time to altruistically undertake ethics reviews of health research proposals.

The following four initiatives demonstrate how instrumental UNESCO’s work is in bioethics development in Africa : UNESCO Assisting Bioethics Committees Program ; Regional Centers for Documentation and Research on Bioethics; Ethics Teachers Training Program; and African Representation in the Membership of UNESCO IBC.