Washington, DC, 26 September 2018 (PAHO/WHO) – Countries in the Region of the Americas have made considerable progress in bioethics since 2012, but recent health emergencies, particularly the 2016 Zika virus outbreak, have highlighted the need to continue strengthening bioethics, including the Region’s capacity to respond ethically to emergencies.

These are among the conclusions presented in the final report on the concept paper, Bioethics: Toward the Integration of Ethics in Health, submitted this week by the Pan American Health Organization (PAHO) to its Member States during the 56th Directing Council, which convenes the Region’s health authorities. The concept paper was adopted in 2012 to address the need to advance bioethics in the Region and to ultimately integrate ethics in health.

The report highlights that while public health ethics has gone from being an unfamiliar concept to an issue to which Ministries of Health in the Region devote attention, it is still vital that countries continue to integrate ethics into the different areas of health work in the Americas to ensure greater capacity to respond ethically to health emergencies.  

The importance of improving ethics preparedness in the Region was highlighted in the Region of the Americas in 2016 during the outbreak of the Zika virus, which was found to cause severe congenital malformations. This outbreak raised numerous ethical challenges, including determining the duties toward pregnant women, and women of reproductive age, and what an ethical public health response should entail in the midst of the uncertainty that characterizes an outbreak of an emerging disease.

According to the Report, while ethics guidance was subsequently developed by Member States in the Region following the outbreak, which has been adopted and received global recognition, some of the challenges that arose could have been avoided if existing guidance had been taken into account.

The report also highlights the Region’s progress in ensuring that research with human subjects is ethical, with 25 countries now having legal frameworks to ensure ethical standards in research. Several measures have been taken to ensure the ethical treatment of research participants, including the development of guidelines for ethical research; training and guidance for the operation of ethics review committees; the development and adoption of online tools to promote ethical standards such as PAHO’s ProEthos; and the mobilization of enhanced support from governments and research institutions. These developments are particularly important given advances in novel technologies and research fields such as gene editing and biobanking research, which pose ongoing ethical challenges when conducting research.

PAHO’s report recommends that countries continue integrating bioethics into different areas of health work. This will ensure that research ethics systems are strengthened, and that ethics is integrated into decision-making processes that impact on the population of the countries in the Americas. Furthermore, the report recommends scaling up our capacity-building efforts to integrate an ethics approach into all the Region’s health-related research, surveillance, emergency response, immunization and policy-making.


Bioethics: Towards the Integration of Ethics in Health: Final Report
Zika Ethics Consultation: Ethics Guidance on Key Issues Raised by the Outbreak