Ethics of randomized trials in a public health emergency

2 June, 2018

Last year we had a HIFA themed discussion on Evidence-Informed Humanitarian Action, in collaboration with Evidence Aid and supported by Public Health England. We noted the reliance on lessons learned rather than systematic review of research, which relates partly to the challenges of doing high-quality research in such settings. This open-access article describes some of the ethical challenges around randomised trials.

CITATION: London AJ, Omotade OO, Mello MM, Keusch GT (2018)

Ethics of randomized trials in a public health emergency.

PLoS Negl Trop Dis 12(5): e0006313.

'The 2014–2015 outbreak of Ebola in West Africa claimed over 11,000 lives and laid bare the challenges of responding to a large-scale, swiftly evolving public health emergency. Prominent among these difficulties was disagreement about the ethics of conducting clinical research during epidemics and whether clinical trials of vaccines and therapeutics should employ randomization and concurrent controls. To facilitate rapid, well-coordinated responses to future public health emergencies, the United States National Academies of Sciences, Engineering, and Medicine established a committee to assess the clinical trials conducted in Guinea, Sierra Leone, and Liberia during the outbreak. The key findings and conclusions regarding ethical issues raised about conducting research during public health crises are briefly described here...'

Best wishes, Neil

Coordinator, HIFA Project on Library and Information Services (with special focus on Population Health, Disasters, and Disease Outbreaks)

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HIFA profile: Neil Pakenham-Walsh is coordinator of the HIFA global health campaign (Healthcare Information For All - ), a global community with more than 18,000 members in 177 countries, interacting on five global forums in three languages. He also currently chairs the Dgroups Foundation (, which supports 800 communities of practice on international development, health and social justice. Twitter: @hifa_org FB: