DRC
Regulatory Authority
Regulatory Authority
Scope of Assessment
Regulatory Fees
Ethics Committee
Ethics Committee
Scope of Review
Ethics Committee Fees
Authorizing Body
Clinical Trial Lifecycle
Submission Process
Submission Content
Timeline of Review
Trial Initiation
Safety Reporting
Progress Reporting
Sponsorship
Definition of Sponsor
Trial Authorization
Insurance
Compensation
Quality, Data & Records Management
Site/Investigator Selection
Informed Consent
Documentation Requirements
Required Elements
Compensation Disclosure
Participant Rights
Special Circumstances/Emergencies
Vulnerable Populations
Children/Minors
Pregnant Women, Fetuses & Neonates
Prisoners
Mentally Impaired
Investigational Products
Definition of Investigational Product
Manufacturing & Import
IMP/IND Quality Requirements
Labeling & Packaging
Product Management
Specimens
Definition of Specimen
Specimen Import & Export
QUICK FACTS
Clinical trial application language French or English
Regulatory authority & ethics committee review may be conducted at the same time Yes
Clinical trial registration required No
In-country sponsor presence/representation required No
Age of minors Under 18
Specimens export allowed Unspecified
Regulatory Authority > Regulatory Authority
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guideline 5
(2) (Order) Ministerial Order No. 1250 / CAB / MIN / SP / 013 / CPH / FBO / 2015 of 28 September 2015 amending and supplementing Ministerial Order No. 1250 / CAB / MJN / 025 / CJ / OMK / 2009 on the organization of the National System of Pharmacovigilance in the Democratic Republic of Congo (Order1250-SP013 - French) (September 28, 2015)
Ministry of Health
Relevant Sections: Chapter I (Article 2), Chapter III (Article 6), Chapter IV (Article 7), and Chapter VII (Article 18)
Summary

Overview

As per Additional Resource (A), the Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) of the Ministry of Health (Ministère de la Santé) is the regulatory authority responsible for allowing clinical trials, as well as authorizing and controlling drug imports and exports, in the Democratic Republic of the Congo (DRC). In addition, the G-EthicalEval indicates that an ethics committee (EC) must review the scientific validity and ethical acceptability of any research proposal involving human subjects.

Additional Resource (B) states that the DPM is comprised of six (6) divisions and 16 offices. These divisions include the Drug Management Division; the Pharmacy Division; the Division of Narcotic, Psychotropic and Dangerous Substances; the Division of Veterinary, Plant Protection, Cosmetic, and Dietary Products; the Division of Insurance and Quality Control of Medicines; and the Division for the Promotion of Medicinal Plants.

According to Additional Resource (B), the Pharmacy Division of the DPM is in charge of pharmaceutical inspection and legislation. The Pharmacy Division includes two (2) offices: inspection and control of pharmacy practice, and legislation, statistics, and archives. Pharmaceutical inspection focuses on best practices, including Good Manufacturing Practices (GMP) for manufacturing laboratories and drug production units, and Good Clinical Practices (GCP) for developing and conducting clinical trials for new drugs.

In addition, Additional Resource (B) indicates that the Pharmacy Division’s clinical trial responsibilities are carried out in collaboration with the national EC, the National Committee of Health Ethics (Comité National d'Éthique de la Santé (CNES)). CNES activities include regulatory follow up and inspecting clinical trial sites.

As per Additional Resource (B), the DPM’s Division of Insurance and Quality Control of Medicines is responsible for pharmacovigilance and has four (4) offices.

Order1250-SP013 indicates that the DRC’s National System of Pharmacovigilance, implemented by the DPM, aims to identify as early as possible all the adverse effects of health products, especially those that are serious and unexpected. It includes the DPM’s National Pharmacovigilance Commission, which evaluates the risks incurred by participants in a clinical trial and advises the DPM on the trial’s continuation or discontinuation. In addition, the National Pharmacovigilance Center, established within the University of Kinshasa’s Unit of Clinical Pharmacology and Pharmacovigilance, is responsible for collecting information from manufacturers, health professionals, and other individuals on the adverse effects of health products; establishing accountability; and assessing the relative risk.

Contact Information

Per Additional Resource (C), contact information is as follows:

Ministry of Health
Directorate of Pharmacy and Medicine (DPM)
General Secretariat of Public Health
36, Avenue de la Justice, Commune of Gombe
Kinshasa, Democratic Republic of the Congo

Phone: Int. +243 998-780-899
Email: info@dpmrdc.org

Additional Resources
(A) (Website) Directorate of Pharmacy and Medicine – Regulatory Functions (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
(B) (Website) Directorate of Pharmacy and Medicine – Organization and Organigram (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
(C) (Website) Directorate of Pharmacy and Medicine – Contact Us (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
(D) (Website) Directorate of Pharmacy and Medicine (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
Regulatory Authority > Scope of Assessment
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 4 and 5
Summary

Overview

According to Additional Resource (A), the Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) of the Ministry of Health (Ministère de la Santé) is the regulatory authority responsible for allowing clinical trials, as well as authorizing and controlling drug imports and exports, in the Democratic Republic of the Congo (DRC). In addition, the G-EthicalEval indicates that an ethics committee (EC) must review the scientific validity and ethical acceptability of any research proposal involving human subjects.

Additional Resource (B) states that the clinical trial responsibilities of the DPM’s Pharmacy Division are carried out in collaboration with the national EC, the National Committee of Health Ethics (Comité National d'Éthique de la Santé (CNES)).

As per the G-EthicalEval, the study protocol must be submitted to the EC for review concurrently with a request to the DPM for study authorization and registration. The EC must send its opinion on the protocol to the principal investigator (PI) within 15 days following the EC’s meeting. A copy of the EC’s opinion should be sent to the DPM. EC approval of the protocol must be obtained before the DPM may approve the trial.

Clinical Trial Review Process

The G-EthicalEval indicates that in the event of a favorable opinion from the EC, the DPM decides whether to approve the trial. If the EC issues an adverse opinion, the DPM cannot authorize the study. The PI may resubmit the protocol to the EC when the elements that led to the negative opinion have been modified. (See the Clinical Trial Lifecycle topic, Submission Process and Submission Content subtopics for detailed submission requirements.)

Additional Resource (C) indicates that the DRC is waiving clinical trials for four (4) investigational treatments during the current emergency outbreak of Ebola. These investigational treatments for Ebola have been available to patients on a compassionate basis pursuant to the Monitored Emergency Use of Unregistered Interventions (MEURI) protocol, a World Health Organization (WHO) ethical framework. According to Additional Resource (D), the investigational treatments are only distributed under MEURI after regulatory and EC approval, and after the patients have given their informed consent. For more details on the investigational treatments, see Additional Resources (C) and (D).

Additional Resources
(A) (Website) Directorate of Pharmacy and Medicine – Regulatory Functions (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
(B) (Website) Directorate of Pharmacy and Medicine – Organization and Organigram (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
(C) (Website) New Hope with Ebola Drug Trial (January 11, 2019)
WHO Regional Office for Africa
(E) (Website) Directorate of Pharmacy and Medicine (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
Relevant Sections: Regulatory Functions and Organization And Organigram
Regulatory Authority > Regulatory Fees
Last content review/update: August 29, 2019
Requirements
No applicable regulatory requirements
Summary

Overview

According to a subject matter expert, the Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) of the Ministry of Health (Ministère de la Santé) charges a percentage, not exceeding 2%, of the trial budget for the submission of a clinical trial application.

Additional Resources
(A) (Website) Directorate of Pharmacy and Medicine (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
Ethics Committee > Ethics Committee
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 5, 6, 9, 10, 12, 13, and 15
(2) (Order) Ministerial Order No. 1250 / CAB / MIN / S / ZKM / 043 / MC / 2006 establishing the National Committee on Health Ethics (CNES) (Order1250-ZKM043 - French) (December 18, 2006)
Ministry of Health
Relevant Sections: Title I (Articles 1 and 2) and Title II (Article 4)
Summary

Overview

According to the G-EthicalEval, any research proposal in the Democratic Republic of the Congo (DRC) involving human participants must be submitted for evaluation of its scientific validity and ethical acceptability to an ethics committee (EC). An EC may be established under the auspices of national or local health authorities, national (or centralized) medical research councils, or other national representative bodies.

The G-EthicalEval further states that the EC must be independent of the research team and approved by the Ministry of Health (Ministère de la Santé). The investigator must obtain EC approval before undertaking the research.

Order1250-ZKM043 indicates that the purpose of the DRC’s national EC, the National Committee of Health Ethics (Comité National d'Éthique de la Santé (CNES)), is to review proposals for research on human beings based on the ethical principles of respect for the individual, beneficence, and justice. The CNES is also responsible for promoting the creation of and accrediting institutional ECs across the country, among other duties. According to a subject matter expert, the CNES registers and approves institutional ECs to conduct ethics review.

EC Composition

The G-EthicalEval indicates that an EC should be made up of physicians, scientists, and representatives of other groups, such as nurses, lawyers, ethicists, and non-professionals, who are able to represent the cultural and moral values of the community and uphold the rights of the research participants. An EC must include both men and women.

According to the G-EthicalEval, to ensure the EC is composed of members that have experience as well as new members with a fresh perspective, a certain number of EC members may be renewed periodically. In addition, to ensure the independence of ECs and to avoid any conflict of interest, any member of the committee having special interests, direct or indirect, in a research proposal must exclude him/herself from the evaluation of the proposal.

Terms of Reference, Review Procedures, and Meeting Schedule

The G-EthicalEval states that the EC’s written procedures must define all EC operating standards.

According to the G-EthicalEval, an EC must clearly define the roles necessary for smooth ethical evaluation. The different roles within the EC (such as president and secretary), the requirements of each role, the terms and conditions of attaining a role, and the duties and responsibilities associated with the roles must be detailed in writing.

As per the G-EthicalEval, EC members should receive basic training and access to continuing education on the ethical and scientific aspects of biomedical research. The conditions of appointment should detail the arrangements for providing EC members with initial training on the EC's work, as well as opportunities to strengthen their expertise in conducting an ethics review. These provisions should also include the requirements or expectations for basic and continuing education of EC members. This training can be carried out in the context of cooperation with other ECs in the country or region, and also on other occasions favorable to the basic training and the continuous training of the EC’s members.

The G-EthicalEval indicates that the EC is responsible for establishing well-defined procedures for submitting an application for review. These procedures, as well as any standard forms, must be public and available to applicants. In order to aid researchers, it is desirable that these procedures and forms be harmonized among all the active ECs in the country.

The G-EthicalEval requires that ECs establish specific quorum requirements to review a proposal and make a decision. These requirements must include or specify at least the following:

  • The minimum number of members required to reach a quorum
  • The professional qualifications required and distribution of these requirements within the quorum
  • No quorum shall be composed exclusively of members of the same profession or the same sex
  • The quorum must include at least one (1) member whose primary area of expertise is not scientific and at least one (1) independent member of the institution or research site

The G-EthicalEval further requires that an EC meet regularly, on scheduled dates announced in advance in a publically available calendar. The meeting requirements must include or specify at least the following:

  • Meetings should be scheduled according to a pre-established schedule, which can be modified according to the workload
  • EC members should have sufficient time, defined before the meeting, to review submitted documents
  • Meetings must be documented in minutes, and there must be a procedure for approval of the minutes
  • The applicant, the sponsor, and/or the investigator may be invited to present their proposal or to elaborate on certain specific points
  • Independent consultants may be invited to the meeting or provide written comments, subject to the confidentiality agreements in force
  • The EC must send its opinion within 15 days of the meeting
Additional Resources
No additional resources
Ethics Committee > Scope of Review
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 4, 5, 13, 16, 17, 20, 33, and 35
Summary

Overview

The G-EthicalEval indicates that the main task of an ethics committee (EC) is to review research proposals and supporting documents, with particular attention to the process of obtaining informed consent, documentation, and the relevance and feasibility of the protocol. The EC must take into account previous scientific and ethical assessments, if any, and the requirements of applicable laws and regulations.

As delineated in the G-EthicalEval, an EC may perform its function at the institutional, local, regional, or national level. Additional Resource (A) states that the clinical trial responsibilities of the Pharmacy Division of the Ministry of Health’s (Ministère de la Santé) Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) are carried out in collaboration with the national EC, the National Committee of Health Ethics (Comité National d'Éthique de la Santé (CNES)).

According to the G-EthicalEval, ECs are responsible for protecting the rights of research participants, their safety, and their well-being. ECs must act in the interests of the potential research participants and the communities involved by evaluating the possible risks and expected benefits to participants; confirming the suitability of the investigator(s), facilities, methods and scientific design of the study; assessing the participant recruitment process; and verifying the adequacy of confidentiality and privacy safeguards.

Additional Resource (C) indicates that the DRC is waiving clinical trials for four (4) investigational treatments during the current emergency outbreak of Ebola. These investigational treatments for Ebola have been available to patients on a compassionate basis pursuant to the Monitored Emergency Use of Unregistered Interventions (MEURI) protocol, a World Health Organization (WHO) ethical framework. According to Additional Resource (D), the investigational treatments are only distributed under MEURI after regulatory and EC approval, and after the patients have given their informed consent. For more details on the investigational treatments, see Additional Resources (C) and (D).

Role in Clinical Trial Approval Process

According to Additional Resource (B) and the G-EthicalEval, the DPM and the EC must approve a clinical trial application for research involving human participants prior to the sponsor or the principal investigator (PI) initiating the clinical trial. The G-EthicalEval further specifies that the PI must submit the request for ethics review.

As per the G-EthicalEval, the study protocol must be submitted to the EC for review concurrently with a request to the DPM for study authorization and registration. The EC must communicate its opinion on the protocol to the PI within 15 days following the EC’s meeting. A copy of the EC’s opinion should be sent to the DPM. EC approval of the protocol must be obtained before the DPM may approve the trial. In the event of a favorable opinion from the EC, the DPM decides whether to approve the trial. If the EC issues an adverse opinion, the DPM cannot authorize the study. However, the PI may resubmit the protocol to the EC after modifying the elements that led to the adverse opinion.

According to the G-EthicalEval, ECs must establish procedures for expedited review of research proposals. These procedures must address certain processes, including the nature of the requests, amendments, and other considerations acceptable for expedited review, as well as the quorum requirements for expedited review.

As per the G-EthicalEval, ECs must also establish a procedure for monitoring the progress of all research that has been approved, from the date the decision was made to the end of the research. The follow-up intervals should be determined by the nature of the study and other events, although each protocol should be monitored at least once a year during the recruitment period. The EC must review and approve any protocol amendments prior to those changes being implemented. In addition, the PI must notify the EC of the closure of a study, and the EC should receive a copy of the final summary or final report of the research.

The G-EthicalEval also indicates that the PI must agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs), and the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum).

There is no stated expiration date for an EC approval in the G-EthicalEval.

(See the Clinical Trial Lifecycle topic, Submission Process subtopic for detailed submission requirements.)

Additional Resources
(A) (Website) Directorate of Pharmacy and Medicine – Organization and Organigram (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
(B) (Website) Directorate of Pharmacy and Medicine – Regulatory Functions (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
(C) (Website) New Hope with Ebola Drug Trial (January 11, 2019)
WHO Regional Office for Africa
(E) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(F) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 1.25, 4, 5.5
Ethics Committee > Ethics Committee Fees
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guideline 5
Summary

Overview

According to the G-EthicalEval, an ethics committee (EC) may charge a fee for the ethical and scientific evaluation of research protocols, to be directed toward its operating costs. The fee must be a predetermined public rate and should not exceed 2% of research costs, excluding the cost of investment.

Additional Resources
No additional resources
Ethics Committee > Authorizing Body
Last content review/update: August 29, 2019
Requirements
(1) (Order) Ministerial Order No. 1250 / CAB / MIN / S / ZKM / 043 / MC / 2006 establishing the National Committee on Health Ethics (CNES) (Order1250-ZKM043 - French) (December 18, 2006)
Ministry of Health
Relevant Sections: Title II (Article 4), Title III (Articles 12, 13, and 14)
Summary

Overview

Order1250-ZKM043 indicates that the Democratic Republic of the Congo’s (DRC) national ethics committee (EC), the National Committee of Health Ethics (Comité National d'Éthique de la Santé (CNES)), is responsible for promoting the creation of and accrediting institutional ECs across the country.

According to Order1250-ZKM043, the CNES coordinates the national network of institutional ECs, both public and private, throughout the country, and mobilizes funds for the functioning of the network of ECs. According to a subject matter expert, the CNES registers and approves institutional ECs to conduct ethics review.

CNES Composition

As per Order1250-ZKM043, the CNES has 40 members, including:

  • One (1) delegate per province from institutional ECs
  • Scientific individuals (at most 10)
  • Religious individuals (at most five (5))
  • A delegate from the Order of Physicians
  • A delegate of the Order of the Pharmacists
  • A delegate from other health professional associations
  • A delegate from the Health Administration

Order1250-ZKM043 further indicates that CNES’ mandate is five (5) years, which is renewable once. The CNES is governed by an office composed of a president, a vice-president, a secretary-rapporteur, a deputy secretary-general, and a treasurer, all elected by and from among the members. The government’s Public Health authority then appoints members of the office.

See Order1250-ZKM043 for detailed information on CNES composition and responsibilities. No information is available on registration, auditing, and accreditation responsibilities by the CNES.

Additional Resources
No additional resources
Clinical Trial Lifecycle > Submission Process
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 5 and 13
Summary

Overview

Per Additional Resource (A), the Democratic Republic of the Congo (DRC) requires clinical trial authorization from the Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) of the Ministry of Health (Ministère de la Santé). According to a subject matter expert, the sponsor, through the principal investigator (PI), obtains this authorization from DPM. In addition, the G-EthicalEval indicates that the PI is required to obtain approval from an ethics committee (EC) for any research proposal involving human subjects.

The G-EthicalEval indicates that the EC is responsible for establishing well-defined procedures for submitting an application for review, including requirements for language and assembly. These procedures, as well as any standard forms, must be public and available to applicants. In order to aid researchers, it is desirable that these procedures and forms be harmonized between all the active ECs in the country.

Delivery Address for Research Protocol

According to a subject matter expert, research protocols and relevant materials to be submitted to the national EC, the National Committee of Health Ethics (Comité National d'Éthique de la Santé (CNES)), should be sent to:

National Committee of Health Ethics
Local 5, Immeuble PNMLS, 1er Niveau, Commune of Kasa- Vubu
Kinshasa, Democratic Republic of the Congo

Delivery Address for Clinical Trial Application

Additional Resource (A) indicates that any file sent to the DPM must be filed with the management office, where it must be received and registered. Per Additional Resource (B) and a subject matter expert, applications should be submitted to:

Ministry of Health
Directorate of Pharmacy and Medicine (DPM)
General Secretariat of Public Health
36, Avenue de la Justice, Commune of Gombe
Kinshasa, Democratic Republic of the Congo

Phone: Int. +243 998-780-899
Email: info@dpmrdc.org

Assembly and Number of Copies

According to a subject matter expert, the PI must submit one (1) hard copy of the application dossier to the DPM. The CNES also requires one (1) copy of the dossier, in addition to seven (7) copies of the protocol.

Clinical Trial Application Language Requirements

Per a subject matter expert, the dossier may be submitted to the DPM in French or English. However, documents submitted to CNES must be in French.

Additional Resources
(A) (Website) Directorate of Pharmacy and Medicine – Regulatory Functions (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
(B) (Website) Directorate of Pharmacy and Medicine – Contact Us (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
Clinical Trial Lifecycle > Submission Content
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 4, 5, 13, and Glossary
Summary

Overview

Per Additional Resource (A), the Democratic Republic of the Congo (DRC) requires clinical trial authorization from the Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) of the Ministry of Health (MOH) (Ministère de la Santé). According to a subject matter expert, the sponsor, through the principal investigator (PI), obtains this authorization from DPM. In addition, the G-EthicalEval indicates that the PI is required to obtain approval from an ethics committee (EC) for any research proposal involving human subjects. EC approval of the protocol must be obtained before the DPM may approve the trial.

No information is currently available regarding the DPM’s requirements for the contents of a clinical trial application.

EC Requirements

As specified in the G-EthicalEval, the PI must file the request for ethics review. The requirements for the submission must be clearly described in the EC’s application procedures. These requirements must include or specify at least the following:

  • Name(s) and address(es) of the secretary of the EC or the member(s) to whom the application is to be filed
  • Application form(s), made available by the EC, with a list of the documentation requested by the EC
  • Format of the application, clearly referring to the title, date, and version of the protocol
  • Documentation, the study protocol, the informed consent form (ICF), the investigator's brochure (IB), the PI's Curriculum Vitae (CV), and the certificate of insurance obtained
  • Language(s) in which the (essential) documents are to be filed
  • Number of copies to be filed
  • Application deadlines, based on review dates (15 days prior to the meeting)
  • Means by which the receipt of applications will be acknowledged, including communication regarding incomplete applications
  • Deadline for notification of the decision after examination (within 15 days)
  • Time limit in case the EC requests from the PI additional information or changes to the documents
  • Application examination fee, if applicable
  • Standard procedure for requesting amendments to the protocol

As per the G-EthicalEval, the following documentation must be submitted to the EC for the proposed research:

  • Application form dated and signed by the PI
  • Proposed research protocol (clearly identified and dated), describing objectives, data collection procedures, ethical considerations, and details of the research process
  • Supporting documents for information not detailed in the protocol
  • When the research involves a product under study (such as a drug or medical device), an adequate summary of all available safety, pharmacological, pharmaceutical, and toxicological data available on the product being evaluated, as well as a summary of the clinical experience gained to date on this product
  • Current CVs of the investigator(s), dated and signed
  • Planned means (including classified advertising) for the recruitment of potential research participants, if not described in the protocol
  • Description of the procedure to obtain the informed consent of the subjects according to the degree of instruction, if not sufficiently described in the protocol
  • Information pamphlet (clearly identified and dated) and other forms of information for potential participants, in the language(s) understood by them and, if necessary, in other languages
  • ICF (clearly identified and dated) in the language(s) understood by potential participants and, if necessary, in other languages
  • Statement regarding possible compensation for research subjects, for their participation (including reimbursement of expenses and access to medical care), if not sufficiently described in the protocol
  • Description of arrangements made, if any, for compensation for injury, if not sufficiently described in the protocol or certificate of insurance
  • A copy of the sponsor’s insurance policy, for the insurance coverage of the participants (if in a language other than French, a translation into French must also be provided)
  • Statement by the investigator committing to respect the ethical principles set out in the applicable guidelines, if not sufficiently described in the protocol
  • Any significant prior decisions made by other ECs or regulatory authorities regarding the research in question (whether in the same research site or another) and an indication of the change(s) made to the protocol in this regard (reasons for previous adverse decisions must be provided)
  • Any other information, such as the establishment of a Tolerance Data Monitoring Committee, also known as Data Safety and Monitoring Board (DSMB) or Independent Committee

Clinical Protocol

According to the G-EthicalEval, the protocol should be prepared by the researcher(s) and contain a summary of the project, general information, a brief justification of the project, bibliographical references, and a documentary review. The protocol should describe the goals and objectives of the study, as well as its design and the methodology used. In addition, the protocol should address safety or tolerability considerations, monitoring, statistical data management and analysis, quality assurance, expected results and dissemination, and publication policy.

The G-EthicalEval further requires that the protocol provide guidance on the duration of the project and anticipated problems, project management and ethical considerations, the documents used to gather informed consent from subjects, the budget and funding agencies, and collaborators. Finally, the protocol should attach the CV of each researcher, listing all the projects in which he/she is currently participating and the percentage of time he/she will devote to the project. Possible financing or insurance arrangements should also be specified in documents presented to the EC.

Additional Resources
(A) (Website) Directorate of Pharmacy and Medicine – Regulatory Functions (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
Clinical Trial Lifecycle > Timeline of Review
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 4, 5, 13, and 17
Summary

Overview

As per Additional Resource (A), the Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) of the Ministry of Health (Ministère de la Santé) is the regulatory authority responsible for allowing clinical trials in the Democratic Republic of the Congo (DRC).

The G-EthicalEval indicates that for research involving human subjects, the study protocol must be submitted to an ethics committee (EC) for review concurrently with a request to the DPM for study authorization and registration. The principal investigator (PI) must obtain the EC’s approval of the protocol before the DPM may approve the trial.

DPM Approval

No official timelines are specified in the available regulatory documentation. However, according to a subject matter expert, approval for an application submission can take an average of two (2) months. Per the G-EthicalEval, in the event of a favorable opinion from the EC, the DPM decides whether to authorize the clinical trial. If the EC issues an adverse opinion, the DPM does not authorize the study.

EC Approval

As per the G-EthicalEval, the EC must communicate its opinion on the protocol to the PI within 15 days of making a decision, and send a copy to DPM. In the event of a favorable opinion from the EC, the DPM decides whether to approve the trial. If the EC issues an adverse opinion, the DPM does not authorize the study. However, the PI may resubmit the protocol to the EC after modifying the elements that led to the adverse opinion.

The G-EthicalEval further requires that ECs establish procedures for expedited review of research proposals. These procedures must address certain processes, including the nature of the requests, amendments, and other considerations acceptable for expedited review, as well as the quorum requirements for expedited review.

There is no stated expiration date for an EC approval in the regulatory resources referenced for the DRC.

Additional Resources
(A) (Website) Directorate of Pharmacy and Medicine – Regulatory Functions (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
Clinical Trial Lifecycle > Trial Initiation
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 4, 5, 13, 16, 34, and 35
Summary

Overview

As per Additional Resource (A), the Democratic Republic of the Congo (DRC) requires clinical trial authorization from the Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) of the Ministry of Health (Ministère de la Santé). According to a subject matter expert, the sponsor, through the principal investigator (PI), obtains this authorization from the DPM. According to the G-EthicalEval, for research proposals involving human participants, the PI must also obtain approval from an ethics committee (EC) before the DPM can approve the trial.

According to a subject matter expert, an import license is required for the shipment of the investigational product (IP) to be used in the trial. (See the Investigational Products topic, Manufacturing & Import subtopic for additional information).

Per the G-EthicalEval, before a trial begins, the PI must:

  • Be based in the DRC, with some exceptions
  • Ensure that the approval of a recognized EC and regulatory authority are obtained, and that the information package developed by the sponsor regarding clinical trials has been read and accepted
  • Have a good knowledge of the protocol, related documents, and regulatory requirements of the regulatory authority or other regulatory body
  • Have read, understood, and agreed to work in accordance with the protocol, the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs), the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum), or other applicable legal and regulatory documents
  • Use the IP only for the purpose of the study as described in the protocol
  • Take responsibility for the IP
  • Document the sequence of events to be followed in the conduct of the clinical trial, including the timeline, roles, and responsibilities
  • Ensure the availability of all necessary infrastructure, equipment, and finances for the conduct of the test or study
  • Develop any appropriate mechanism to obtain informed consent from the participant
  • Accept the involvement of the instructors to review and verify the quality control procedures and verification of the conduct of the data
  • Accept the possibility of an audit and/or inspection by an independent auditor engaged by the sponsor, the regulator, or the EC
  • Obtain the right to publish (it is unethical for the sponsor to reserve the right to publish the research data)
  • Ensure adequate safety reporting procedures, etc. (see ICH-GCPs-Addendum and WHO-GCPs)

Clinical Trial Agreement

The G-EthicalEval states that before submitting a clinical trial application, a memorandum of understanding must be developed between the sponsor or PI and the partner research institutions.

EC Confirmation of Review and Approval

As delineated in the G-EthicalEval, the PI must submit any research proposals involving human participants to an EC for evaluation of its scientific validity and ethical acceptability. The PI must obtain EC approval before undertaking the research. (See the Ethics Committee topic, Scope of Review subtopic and Clinical Trial Lifecycle topic, Submission Content subtopic for additional details on the EC review process).

Clinical Trials Registry

No clinical trials registry exists at this time and there is no stated requirement to register in an international registry. However, according to a subject matter expert, some trials are registered on the Pan African Clinical Trials Registry.

Data and Safety Monitoring Board (DSMB)

The G-EthicalEval indicates that, as appropriate, the EC should evaluate the adequacy of the arrangements made for monitoring and auditing research, including setting up a Data and Safety Monitoring Board (DSMB). Any information regarding the establishment of a DSMB should also be included in the documentation submitted to the EC in the clinical trial application packet.

In addition, per the ICH-GCPs-Addendum, a DSMB may be established to assess the progress of a clinical trial, including the safety data and the critical efficacy endpoints at intervals, and to recommend to the sponsor whether to continue, modify, or stop a trial.

Additional Resources
(A) (Website) Directorate of Pharmacy and Medicine – Regulatory Functions (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
(B) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(C) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 1.25, 4, 5.5
(E) (Website) Pan African Clinical Trials Registry (Current as of August 28, 2019)
Pan African Clinical Trials Registry
Clinical Trial Lifecycle > Safety Reporting
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines on Pharmacovigilance in the Democratic Republic of the Congo (G-PV - French) (October 2018)
Directorate of Pharmacy and Medicine, Ministry of Health
Relevant Sections: Introduction, I (I.1), III (III.2 and III.5), and Annex I
(2) (Order) Ministerial Order No. 1250 / CAB / MIN / SP / 013 / CPH / FBO / 2015 of 28 September 2015 amending and supplementing Ministerial Order No. 1250 / CAB / MJN / 025 / CJ / OMK / 2009 on the organization of the National System of Pharmacovigilance in the Democratic Republic of Congo (Order1250-SP013 - French) (September 28, 2015)
Ministry of Health
Relevant Sections: Chapter I (Article 2), Chapter III (Article 6), and Chapter VII (Article 18)
(3) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 13, 16, and 35
Summary

Overview

As delineated in the G-PV, the following definitions provide a basis for a common understanding of the Democratic Republic of the Congo’s (DRC) safety reporting requirements:

  • Adverse Event (AE) – Any medical event occurring after the administration of a drug to a patient or subject of a clinical trial, without necessarily being caused by that drug. This includes any harmful and unwanted reaction such as a clinical or paraclinical sign or symptom, or a disease associated with taking a drug
  • Adverse Drug Reaction (ADR) – Any response to the administration of a drug that is harmful and undesirable. An ADR may result from the use of a drug at therapeutic doses, overdose, misuse, or medication error
  • Serious Adverse Event (SAE) – Any adverse reaction that causes death, is life-threatening, requires hospitalization or prolongation of hospitalization, leads to significant or persistent disability, or causes congenital malformation
  • Unexpected Adverse Event (UAE) – Any adverse event that does not match the known information on the drug in nature, severity, or outcome

According to the G-PV, the requirements in the G-PV are based on the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum). The G-EthicalEval further indicates that before the start of the trial, the principal investigator (PI) must ensure adequate safety reporting procedures in accordance with the ICH-GCPs-Addendum and the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs).

Order1250-SP013 states that the DRC’s National System of Pharmacovigilance, implemented by the Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) of the Ministry of Health (Ministère de la Santé), aims to identify as early as possible all of the adverse effects of health products, especially those that are serious and unexpected. The National System of Pharmacovigilance includes the National Pharmacovigilance Center, which is responsible for collecting information from manufacturers, health professionals, and other individuals on the adverse effects of health products; establishing accountability; and assessing the relative risk.

Reporting Requirements for AEs/SAEs

The G-PV indicates that it is mandatory to report any AE, even when it is the result of abuse or misuse. All providers are required to systematically report AEs.

According to G-PV, all AEs that are both serious and unexpected must be reported through the expedited notification process. Any serious and unexpected AE that is fatal or life-threatening, including one (1) occurring during a clinical trial, should be notified to the National Pharmacovigilance Center as soon as the notifier becomes aware of it, within seven (7) calendar days. Updated information may be provided within an additional period not exceeding 15 calendar days. All other serious and unexpected AEs should be reported immediately, but no later than 15 calendar days after becoming aware of them. All other AEs must be reported within 90 calendar days.

In addition, according to a subject matter expert, SAEs must be reported to the national ethics committee, the National Committee of Health Ethics (Comité National d'Éthique de la Santé (CNES)).

Form Completion and Delivery Requirements

As per the G-PV, all AEs must be reported on a form (See Annex I of G-PV) and submitted in a sealed envelope or via internet to the National Pharmacovigilance Center:

Clinical Pharmacology Unit
Faculty of Medicine and Pharmaceutical Sciences
University of Kinshasa
Tel: 0998110172 / 0813261360 / 0993547926 / 0815171991 / 0815171766
Email: cnpvrdc@yahoo.fr and pharmacoclinic@unikin.ac.cd

The address of the University of Kinshasa is as follows:
Lemba
Kinshasa, Democratic Republic of Congo
B.P. 127 Kinshasa XI

Data and Safety Monitoring Board (DSMB)

The G-EthicalEval indicates that, as appropriate, the EC should evaluate the adequacy of the arrangements made for monitoring and auditing research, including setting up a Data and Safety Monitoring Board (DSMB). Any information regarding the establishment of a DSMB should also be included in the documentation submitted to the EC in the clinical trial application packet.

The ICH-GCPs-Addendum notes that a DSMB may be established to assess the progress of a clinical trial, including the safety data and the critical efficacy endpoints at intervals, and to recommend to the sponsor whether to continue, modify, or stop a trial.

Additional Resources
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 1.25, 5.5, and 5.16
(B) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
Clinical Trial Lifecycle > Progress Reporting
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 20, 35, and 36
Summary

Overview

In accordance with the G-EthicalEval, the principal investigator (PI) is responsible for submitting progress reports to the ethics committee (EC) on the status of the trial and for submitting a final study report.

The G-EthicalEval also indicates that the PI must agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs), and the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum). The ICH-GCPs-Addendum notes that the investigator should promptly provide written reports to the sponsor and the institutional EC on any changes significantly affecting the conduct of the trial, and/or increasing the risk to participants.

Interim/Progress Reports

As per the G-EthicalEval, the EC must establish a procedure for monitoring the progress of all research that has been approved, from the date the decision was made to the end of the research. The follow-up intervals should be determined by the nature of the study and other events, although each protocol should be monitored at least once a year during the recruitment period.

Final Report

According to the G-EthicalEval, the PI must notify the EC of the closure of a study, and the EC should receive a copy of the final summary or final report of the research.

The G-EthicalEval further requires that community leaders receive an adapted report specifically for their understanding, with the relevant information. The results of the clinical trial should be shared with the participants based on the context and budgetary constraints.

Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(B) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 4.10 and 4.13
Sponsorship > Definition of Sponsor
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guideline 35 and Glossary
Summary

Overview

As per the G-EthicalEval, the sponsor is defined as the person, company, institute, or organization responsible for launching, managing and/or financing a clinical trial, as well as legally responsible for the trial. In non-commercial research, it is often the case that the sponsor and the funding agency are different entities. In this case, the legal responsibility rests with the sponsor.

The G-EthicalEval indicates that for biomedical research on humans, the sponsor is the person who initiates, manages, and verifies the funding of the research.

The G-EthicalEval also indicates that the principal investigator (PI) must agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs), and the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum). The ICH-GCPs-Addendum specifies that a sponsor-investigator is an individual who both initiates and conducts, alone or with others, a clinical trial, and under whose immediate direction the investigational product is administered to, dispensed to, or used by a participant. The term does not include any person other than an individual (e.g., it does not include a corporation or an agency). The obligations of a sponsor-investigator include both those of a sponsor and those of an investigator.

The ICH-GCPs-Addendum also notes that a sponsor may transfer any or all trial-related duties and functions to a contract research organization (CRO) and/or institutional site(s). However, the ultimate responsibility for the trial data’s quality and integrity always resides with the sponsor. Any trial-related responsibilities transferred to a CRO should be specified in a written agreement. The CRO should implement quality assurance and quality control.

A sponsor may be domestic or foreign. The G-EthicalEval requires that if a sponsor is a foreign person or entity, the sponsor must work closely with the PI(s) from the partner institution(s) with which the sponsor has signed a memorandum of understanding. Each PI must be based in the Democratic Republic of Congo (DRC) and should work with one (1) or more local investigators at their site.

Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(B) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 1.53, 1.54, 5.1 and 5.2
Sponsorship > Trial Authorization
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 4, 5, and 13
Summary

Overview

According to Additional Resource (A) and a subject matter expert, the Democratic Republic of the Congo (DRC) requires that the sponsor, through the principal investigator (PI), obtain clinical trial authorization from the Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) of the Ministry of Health (Ministère de la Santé). In addition, the G-EthicalEval indicates that the PI is required to obtain approval from an ethics committee (EC) for any research proposal involving human participants. EC approval of the protocol must be obtained before the DPM may approve the trial.

See the Clinical Trial Lifecycle topic, Submission Content subtopic for submission requirements.

Additional Resources
(A) (Website) Directorate of Pharmacy and Medicine – Regulatory Functions (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
Sponsorship > Insurance
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guideline 13
Summary

Overview

As per the G-EthicalEval, the sponsor is required to carry a valid insurance policy to cover research participants. A copy of the sponsor’s insurance policy must be submitted to the ethics committee (EC) as part of the application for ethics review of the proposed research. If the insurance policy is in a language other than French, a French translation must also be provided.

Additional Resources
No additional resources
Sponsorship > Compensation
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 13 and 35
Summary

Overview

The G-EthicalEval indicates that the clinical trial application packet submitted to the ethics committee (EC) must include a statement regarding possible compensation for research subjects for their participation (including reimbursement of expenses and access to medical care), if not sufficiently described in the protocol.

The application packet must also include a description of arrangements made, if any, for compensation for injury, if not sufficiently described in the protocol or certificate of insurance.

The G-EthicalEval also indicates that the principal investigator (PI) must agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs), and the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum). The ICH-GCPs-Addendum provides guidance for sponsors on providing compensation to research participants in the event of trial-related injuries or death. The sponsor must explain to participants the compensation and/or treatment available to them in the event of trial-related injuries.

Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(B) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 4.8 and 5.8
Sponsorship > Quality, Data & Records Management
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 20, 35, and Glossary
Summary

Overview

The G-EthicalEval indicates that the principal investigator (PI) must agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs), and the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum). The ICH-GCPs-Addendum guides sponsors on quality, data, and records management.

Per the ICH-GCPs-Addendum, the sponsor should implement a system to manage quality throughout all stages of the trial process, focusing on trial activities essential to ensuring participant protection and the reliability of trial results. The quality management system should use a risk-based approach that includes:

  • During protocol development, identify processes and data that are critical to ensure participant protection and the reliability of trial results
  • Identify risks to critical trial processes and data
  • Evaluate the identified risks against existing risk controls
  • Decide which risks to reduce and/or which risks to accept
  • Document quality management activities and communicate to those involved in or affected by these activities
  • Periodically review risk control measures to ascertain whether the implemented quality management activities are effective and relevant
  • In the clinical study report, describe the quality management approach implemented in the trial and summarize important deviations from the predefined quality tolerance limits and remedial actions taken

Electronic Data Processing System

As per the ICH-GCPs-Addendum, when using electronic trial data processing systems, the sponsor must ensure that the electronic data processing system conforms to the sponsor’s established requirements for completeness, accuracy, reliability, and consistency of intended performance. The sponsor should base their approach to validate such systems on a risk assessment that takes into consideration the intended use and the potential of the system to affect participant protection and reliability of trial results. In addition, the sponsor should maintain standard operating procedures (SOPs) for the systems that cover system setup, installation, and use. The responsibilities of the sponsor, investigator, and other parties should be clear, and the system users should be provided with training. Refer to the ICH-GCPs-Addendum for additional information.

Record Management

According to the G-EthicalEval, the research protocol should address monitoring, statistical data management and analysis, quality assurance, expected results and dissemination, and publication policy.

As set forth in the ICH-GCPs-Addendum, sponsor-specific essential documents should be retained until at least two (2) years after the last approval of a marketing application, until there are no pending or contemplated marketing applications, or at least two (2) years have elapsed since the formal discontinuation of the investigational product’s clinical development. The sponsor should inform the investigator(s) and the institution(s) in writing when trial-related records are no longer needed.

In addition, the ICH-GCPs-Addendum states that the sponsor and investigator/institution should maintain a record of the location(s) of their respective essential documents including source documents. The storage system used during the trial and for archiving (irrespective of the type of media used) should allow for document identification, version history, search, and retrieval. The sponsor should ensure that the investigator has control of and continuous access to the data reported to the sponsor. The investigator/institution should have control of all essential documents and records generated by the investigator/institution before, during, and after the trial.

Audit Requirements

Per the ICH-GCPs-Addendum, the sponsor should develop a systematic, prioritized, risk-based approach to monitoring clinical trials. The extent and nature of monitoring is flexible and permits varied approaches that improve effectiveness and efficiency. The sponsor may choose on-site monitoring, a combination of on-site and centralized monitoring, or where justified, centralized monitoring. The sponsor should document the rationale for the chosen monitoring strategy (e.g., in the monitoring plan).

Premature Study Termination/Suspension

The G-EthicalEval indicates that in the event of suspension or premature termination of a trial, the PI must inform the EC of the reasons for the decision. A summary of the results up to that point must then be submitted to the EC.

According to the ICH-GCPs-Addendum, if it is discovered that noncompliance significantly affects or has the potential to significantly affect participant protection or reliability of trial results, the sponsor should perform a root cause analysis and implement appropriate corrective and preventive actions. Further, the EC should also be informed promptly and provided the reason(s) for the termination or suspension by the sponsor.

Multicenter Studies

As delineated in the ICH-GCPs-Addendum, in the event of a multicenter clinical trial, the sponsor must ensure that:

  • All investigators conduct the trial in strict compliance with the protocol agreed to by the sponsor, and given EC approval
  • The case report forms (CRFs) are designed to capture the required data at all multicenter trial sites
  • Investigator responsibilities are documented prior to the start of the trial
  • All investigators are given instructions on following the protocol, complying with a uniform set of standards to assess clinical and laboratory findings, and completing the CRFs
  • Communication among investigators is facilitated

The G-EthicalEval also states that a coordinating investigator should be appointed to coordinate activities of PIs at each site of a multicenter trial.

Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(B) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 1.65, 5.0, 5.1, 5.2, 5.5, 5.18, 5.19, 5.21, 5.23, 6.10, and 8
Sponsorship > Site/Investigator Selection
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 13, 16, and 35
Summary

Overview

According to the G-EthicalEval and a subject matter expert, the sponsor is responsible for selecting the investigator(s) for the clinical trial. The principal investigator (PI) must be a qualified and experienced person in the relevant field of research, with an understanding of the concepts and research activities, the drug, its toxicity, and its safety.

The G-EthicalEval also indicates that the PI must agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs), and the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum).

The ICH-GCPs-Addendum provides guidance to sponsors on investigator and site selection. According to the ICH-GCPs-Addendum:

  • The sponsor is responsible for selecting the investigator(s)/institution(s). Each investigator should be qualified by training and experience and should have adequate resources to properly conduct the trial for which the investigator is selected. If organization of a coordinating committee and/or selection of coordinating investigator(s) are to be utilized in multicenter trials, their organization and/or selection are the sponsor's responsibility.
  • Before entering an agreement with an investigator/institution to conduct a trial, the sponsor should provide the investigator(s)/institution(s) with the protocol and an up-to-date Investigator's Brochure, and should provide sufficient time for the investigator/institution to review the protocol and the information provided.

Furthermore, the sponsor should obtain the investigator's/institution's agreement to:

  • Conduct the trial in compliance with Good Clinical Practices (GCPs), with the applicable regulatory requirement(s), and with the approved protocol
  • Comply with procedures for data recording/reporting
  • Permit monitoring, auditing, and inspection
  • Retain the trial related essential documents until the sponsor informs the investigator/institution these documents are no longer needed

The sponsor and the investigator/institution should sign the protocol, or an alternative document, to confirm this agreement.

Data and Safety Monitoring Board (DSMB)

The G-EthicalEval indicates that, as appropriate, the ethics committee (EC) should evaluate the adequacy of the arrangements made for monitoring and auditing research, including setting up a Data and Safety Monitoring Board (DSMB). Any information regarding the establishment of a DSMB should also be included in the documentation submitted to the EC in the clinical trial application packet.

The ICH-GCPs-Addendum notes that a DSMB may be established to assess the progress of a clinical trial, including the safety data and the critical efficacy endpoints at intervals, and to recommend to the sponsor whether to continue, modify, or stop a trial.

Foreign Sponsor Responsibilities

The G-EthicalEval requires that if a sponsor is a foreign person or entity, the sponsor must work closely with the PI(s) from the partner institution(s) with which the sponsor has signed a memorandum of understanding. Each PI, who must be based in the Democratic Republic of Congo (DRC), in turn works with one (1) or more local investigators at their site.

Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(B) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: : 1.25, 5.5, and 5.6
Informed Consent > Documentation Requirements
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 13, 16, 24-26, and 35
Summary

Overview

For any biomedical research involving humans in the Democratic Republic of the Congo (DRC), the investigator must obtain the free and informed consent of the prospective participant in accordance with the requirements set forth in the G-EthicalEval, the Declaration of Helsinki, the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum), and the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs).

As per the G-EthicalEval and ICH-GCPs-Addendum, the informed consent form (ICF) is viewed as an essential document that must be reviewed and approved by an ethics committee (EC). The G-EthicalEval further states that when reviewing the informed consent process, the EC should review the arrangements for receiving and responding to requests and complaints from research participants or their representatives during the course of a study. (See the Informed Consent topic, Required Elements subtopic for details on what should be included in the form.)

In addition, the ICH-GCPs-Addendum states that that the participant and/or his/her legal representative(s) or guardian(s) must be provided with detailed research study information.

Re-Consent

The G-EthicalEval indicates that when material changes occur in the modalities or procedures of a study, or periodically for long-term studies, the investigator must again seek the informed consent of the participants. Sponsors and investigators have a duty to obtain the informed consent of each participant in the event of a significant change in the terms and conditions of the research, or if new information emerges that may affect the willingness of the participants to continue. For example, new pieces of information may have emerged from the study or from other sources (other studies or pharmacovigilance) about the risks or benefits of the products being investigated or about products to replace them. If it changes the risk, then this information must be promptly communicated to the participants. However, the results of the study will be disclosed at the end of the research after analysis of the data.

The sponsor and investigator must also seek renewed informed consent for each participant in long-term studies at predetermined intervals, even if there is no change in the design or objectives of the research.

Language Requirements

The G-EthicalEval requires that the ICF be provided in the language(s) understood by potential participants and, if necessary, in other languages. The investigator must convey the information in the informed consent process, orally and in writing, in a language that corresponds with the level of understanding of the participant. The investigator should also consider that the participant’s ability to understand the information required to express informed consent depends on the maturity, comprehension ability, level of education, and belief system of the participant.

Documentation Copies

According to the G-EthicalEval and the ICH-GCPs-Addendum, the participant and/or the participant’s legal representative(s) or guardian(s) must sign the ICF. The G-EthicalEval states that the EC may authorize, in extraordinary cases, the waiver of a signed consent form, such as in a case where the existence of a signed consent form would constitute an unreasonable threat to the privacy of the participant. In all cases, it is advisable to give participants information sheets to keep that may be similar to ICFs, but do not require a signature. The EC must approve the content of the informed consent material. When consent has been obtained orally, investigators are required to provide documentation or evidence of consent.

The G-EthicalEval indicates that if the participant is illiterate, an independent witness must sign the consent. The ICH-GCPs-Addendum further specifies that where the participant is illiterate and/or his/her legal representative(s) and/or guardian(s) is illiterate, an impartial witness should be present during the entire informed consent discussion. The witness should sign and date the ICF after the following steps have occurred:

  • The written ICF and any other written information to be provided to the participant is read and explained to the participant and his/her legal representative(s) and/or guardian(s)
  • The participant and his/her legal representative(s) and/or guardian(s), have orally consented to the participant’s involvement in the trial, and has signed and dated the ICF, if capable of doing so

Before participating in the study, the participant or his/her legal representative(s) and/or guardian(s) should receive a copy of the signed and dated ICF.

Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 2, 4.4, 4.8, 8.2, and 8.3
(C) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
Informed Consent > Required Elements
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 13, 25, 26, and 35
Summary

Overview

As delineated in the G-EthicalEval, prior to beginning a clinical trial, the principal investigator (PI) is required to obtain ethics committee (EC) approval for the written informed consent form (ICF) and any other information being provided to the research participant.

The G-EthicalEval also indicates that the PI must agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs), and the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum). The ICH-GCPs-Addendum provides guidance on the elements to include in the ICF. The ICH-GCPs-Addendum states that information about the research study should be clearly presented in both written and oral form.

No Coercion

The G-EthicalEval indicates that in the process of obtaining informed consent, sponsors and investigators must refrain from unjustified deception, attempts to exert undue influence, or intimidation. The sponsor and investigator may solicit consent only after making sure that the potential participant understands the details of participation and that he/she has been given time to consider it.

Per the ICH-GCPs-Addendum, none of the oral and written information concerning the research study, including the written ICF, should contain any language that causes the participant and/or his/her legal representative(s) and/or guardian(s) to waive or to appear to waive his/her legal rights, or that releases or appears to release the investigator(s), the institution, the sponsor, or their representatives from their liabilities for any negligence.

Required Elements

The G-EthicalEval and ICH-GCPs-Addendum state that before seeking the consent of a person to participate in research, the investigator must indicate the following to him/her using language or any other form of intelligible communication (Note: the regulations provide overlapping and unique elements so each of the items listed below will not necessarily be in each source):

  • That he/she is invited to participate in the research as a subject, the reasons for which he/she is eligible, and participation is voluntary
  • That he/she is free to refuse to participate and may at any time terminate his/her participation without being penalized or losing any advantage to which he/she would normally have been entitled
  • The purpose of the research and the procedures to be used by the investigator and the participant, and how the research departs from the usual medical care
  • For controlled trials, the modalities of the research (randomization, double-blind, etc.) and that the participant will only be informed of the assigned treatment once the study has been completed and the double-blind procedure has ended
  • The expected duration of participation (including the number and duration of visits to the research center and the resulting total duration) and the possibility of early termination of the trial or participation in the trial
  • Whether money or other types of material gratuity will be given in return for participation and, if so, their nature and amount
  • The anticipated expenses, if any, to the participant for participating in the trial
  • That, after completion of the study, the participant will be informed of the findings of the research in general terms and will be individually informed of any findings regarding his/her personal health status
  • That the participant will be able to access, upon request, data concerning him/her even if these data have no immediate clinical utility
  • That the participant or the participant's legally acceptable representative will be informed in a timely manner if information becomes available that may be relevant to the participant's willingness to continue participation in the trial
  • All risks, pain, or discomfort foreseeable for the participant (or other persons) arising from participation in the research, including risks to the health or well-being of the spouse or partner of the participant
  • The reasonably foreseeable risks or inconveniences to the participant and, when applicable, to an embryo, fetus, or nursing infant
  • Where appropriate, the direct benefits that the participant can expect from his/her participation in the research
  • The expected benefits of research for the community or society, or the contributions of this research to scientific knowledge
  • If, when, and how any of the products or interventions that research has shown to be safe and effective will most likely be made available to the participant after he/she has stopped participating in the research
  • Any intervention or alternative treatment currently available
  • That the monitor(s), the auditor(s), the EC, and the regulatory authority(ies) will be granted direct access to the participant's original medical records for verification of clinical trial procedures and/or data, without violating the confidentiality of the participant, to the extent permitted by the applicable laws and regulations and that, by signing a written ICF, the participant or the participant's legally acceptable representative is authorizing such access
  • The arrangements that will be made to ensure the participant’s privacy and the confidentiality of the files where the participant is identified
  • The legal or other limitations of the investigators' ability to maintain confidentiality and the potential consequences of breaches of confidentiality
  • The rules applicable to the use of genetic test results and family genetic information, and the precautions taken to prevent the disclosure of genetic test results of a participant to the close family or to third parties without the participant’s consent
  • The proponents of the research, the institution to which the investigators report, and the nature and sources of funding for the research
  • Possible uses, direct or secondary, of the participant’s medical record and biological samples collected as part of clinical care
  • If it is anticipated that the biological samples taken from the research will be destroyed when the research is completed, and if not, a detailed description of how they will be preserved (where, how, for how long, and how it will be disposed of) and the future uses envisaged, and whether the participant has the right to decide on these future uses, to refuse the conservation, and to demand the destruction of the material in question
  • Whether commercial products can be derived from biological samples, and whether the participant will receive pecuniary or other benefits from the development of such products
  • If the investigator's sole function is to be an investigator or if he/she is both an investigator and the treating physician of the participant
  • The extent of the investigator's responsibility for providing medical benefits to the participant
  • That treatment will be provided free of charge for specified types of physical injury related to research or for research-related complications, the nature and duration of such treatment, the name of the organization or individual treatment, and if there are uncertainties about the funding of the treatment
  • How and by which organization the participant or family, or dependents of the participant, will be compensated for any disability or death resulting from such bodily injury (or, if applicable, that nothing is provided for this purpose)
  • That an EC has approved or authorized the research protocol (name and date)
  • Foreseeable circumstances under which the investigator(s) may remove the participant without his/her consent
  • Approximate number of participants involved in the study
  • The person(s) to contact for further information regarding the trial and the rights of trial participants, and whom to contact in the event of trial-related injury

The G-EthicalEval further indicates that this list is not exhaustive, and it is recommended to follow the latest edition of the Declaration of Helsinki, the WHO-GCPs, and the ICH-GCPs-Addendum.

Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(B) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 4.4 and 4.8
Informed Consent > Compensation Disclosure
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 13, 25, and 35
Summary

Overview

In accordance with the G-EthicalEval, using language or any other form of intelligible communication during the informed consent process, the investigator should indicate to the participant that possible compensation or medical treatment is available in the event of injury.

In addition, the G-EthicalEval requires principal investigators (PIs) to work in accordance with the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum), which also requires the informed consent form (ICF) to include details regarding compensation or medical treatment.

Compensation for Participation in Research

The G-EthicalEval indicates that the clinical trial application packet submitted to the ethics committee (EC) must include a statement regarding possible compensation for research participants (including reimbursement of expenses and access to medical care), if not sufficiently described in the protocol.

Compensation for Injury

The G-EthicalEval states that before seeking the consent of a person to participate in research, the investigator must indicate to the participant that treatment will be provided free of charge for specified types of physical injury related to the research or for research-related complications. The investigator must provide information regarding the nature and duration of such treatment, the name of the organization or individual treatment, and if there are uncertainties about the funding of the treatment.

The application packet submitted to the EC must include a description of arrangements made, if any, for compensation for injury, if not sufficiently described in the protocol or certificate of insurance.

Additional Resources
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 3.1 and 4.8
Informed Consent > Participant Rights
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 25, 35 and 36
Summary

Overview

As delineated in the G-EthicalEval, a participant’s rights must be clearly addressed in the informed consent form (ICF) and during the informed consent process.

In addition, the G-EthicalEval states that the principal investigator (PI) should closely follow the guidelines provided by the Declaration of Helsinki, the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum), the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs), and the Council for International Organizations of Medical Sciences’ (CIOMS) International Ethical Guidelines for Biomedical Research Involving Human Subjects.

(See the Informed Consent topic, and the subtopics of Required Elements; Vulnerable Populations; and Children/Minors; for additional information regarding requirements for participant rights.)

The Right to Participate, Abstain, or Withdraw

As set forth in the G-EthicalEval and the ICH-GCPs-Addendum, the participant should be informed that participation is voluntary, that he/she may withdraw from the research study at any time without being penalized or losing any advantage to which he/she would normally have been entitled.

The Right to Information

As delineated in the G-EthicalEval and the ICH-GCPs-Addendum, a potential research participant has the right to be informed about the nature and purpose of the research study, its anticipated duration, study procedures, and any potential benefits, risks, or constraints. (See the Informed Consent topic, Required Elements subtopic for more detailed information regarding participant rights.)

The G-EthicalEval further states that information collected during the study should be shared with the indigenous community in the research community. Researchers must consider community input and allow dissenting voices to speak in public if differences of opinion were not resolved earlier.

The Right to Privacy and Confidentiality

According to the G-EthicalEval and the ICH-GCPs-Addendum, the participant should be informed of arrangements that will be made to ensure his/her privacy and the confidentiality of the files where the participant is identified.

The Right of Inquiry/Appeal

The ICH-GCPs-Addendum states that the research participant and/or his/her legal representative(s) or guardian(s) should be provided with contact information for the sponsor and the investigator(s) to address trial-related inquiries and/or to appeal against a violation of his/her rights. (See the Informed Consent topic, Required Elements subtopic for more detailed information regarding participant rights.)

The Right to Safety and Welfare

The G-EthicalEval states that the well-being and integrity of the participants is a responsibility of the PI. In addition, the ICH-GCPs-Addendum principles state that a research participant’s right to safety and the protection of his/her health and welfare must take precedence over the interests of science and society.

Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 2, 3.1, and 4.8
(C) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
Council for International Organizations of Medical Sciences (CIOMS)
Informed Consent > Special Circumstances/Emergencies
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guideline 35
Summary

Overview

According to the G-EthicalEval, the principal investigator (PI) must agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs), and the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum). The ICH-GCPs-Addendum makes provisions to protect the rights of a research participant during the informed consent process when the procedure is complicated by special circumstances, including medical emergencies.

Medical Emergencies

Per the ICH-GCPs-Addendum, in an emergency, if the signed informed consent form (ICF) has not been obtained from the research participant and/or his/her legal representative(s) or guardian(s), or if an effective treatment is lacking but the investigational product could address the participant’s emergency needs, the clinical trial may be conducted. However, the method used on the participant must be explained clearly in the trial protocol, and the ethics committee (EC) must approve the protocol in advance. The participant and/or his/her legal representative(s) or guardian(s) should be informed about the trial as soon as possible, and consent to continue and other consent should be requested, as appropriate.

Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(B) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 4.8
Informed Consent > Vulnerable Populations
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 24, 28, and 35, and Glossary
Summary

Overview

In all clinical trials in the Democratic Republic of the Congo (DRC), research participants selected from vulnerable populations must be provided additional protections to safeguard their health and welfare during the informed consent process in accordance with the G-EthicalEval. Vulnerable populations, which have a limited ability to give informed consent, include children and adolescents, adults with serious mental or behavioral disorders, people with reduced levels of consciousness, pregnant women, prisoners, and socio-economically disadvantaged individuals. Research on these populations must be justified in detail, and efforts must be made to obtain the consent of the legal guardian(s) of these participants.

In addition, the G-EthicalEval requires principal investigators (PIs) to work in accordance with the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum). The ICH-GCPs-Addendum includes the following as vulnerable populations: members of a group with a hierarchical structure, such as medical, pharmacy, dental, and nursing students; subordinate hospital and laboratory personnel; employees of the pharmaceutical industry; members of the armed forces; and persons kept in detention. Other vulnerable populations include persons in nursing homes, patients in emergency situations, ethnic minority groups, homeless persons, nomads, refugees, minors, and those incapable of giving consent.

See the Informed Consent topic, and the subtopics of Children/Minors; Pregnant Women, Fetuses & Neonates; and Mentally Impaired for additional information about these vulnerable populations.

Indigenous Communities and People

While not identified specifically as a vulnerable population, according to the G-EthicalEval, special provisions must also be made for research related to the traditional or sacred knowledge of an indigenous community, or its members as indigenous people. The researcher should consult with community leaders and obtain their consent before approaching members individually. After obtaining the consent of the community, the researcher must still make sure to have the prior free and informed consent of each participant.

The G-EthicalEval further states that it is advisable to establish an informed consent process for communities and individual participants early in the research process or authorization, which should take into account the legitimate decision-making processes of communities at all stages of the process.

Additional Resources
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 1.61 and 4.8
Informed Consent > Children/Minors
Last content review/update: August 29, 2019
Requirements
(1) (Legislation) Law No. 87-101 on the Family Code (FamilyCode) (April 25, 2003)
Cabinet of the President of the Republic
Relevant Sections: Book II (Section 3)
(2) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 27 and 35
Summary

Overview

According to FamilyCode, the age of majority is 18.

The G-EthicalEval recommends that children be included in the decision to participate in research based on their physical, psychological, and social developmental abilities.

As per the G-EthicalEval, a child's ability to give informed assent to participate in research is globally established at the minimum age of 13. The research team should consider the complexity of the research and other aspects to raise this age, but never go below it. A minor’s legal representative(s) and/or guardian(s) must provide consent for the minor to participate in the research. Once the minor reaches the minimum age of 13, he/she must also give his/her assent. It is therefore necessary to first obtain the consent of the legal representative(s) and/or guardian(s), and then the assent of the child.

The G-EthicalEval further indicates that the refusal of the legal representative(s) and/or guardian(s) or child constitutes dissent and precludes the child's participation in the research.

In addition, the G-EthicalEval requires principal investigators (PIs) to work in accordance with the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum). The ICH-GCPs-Addendum states that when a clinical trial includes minors, the minor should be informed about the trial to the extent compatible with his or her understanding and, if capable, he or she should sign and personally date the written informed consent.

Additional Resources
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 4.8
Informed Consent > Pregnant Women, Fetuses & Neonates
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 24 and 35, and Glossary
Summary

Overview

While G-EthicalEval lists pregnant women as a vulnerable population, there are no relevant provisions regarding any special consent procedures for pregnant women, fetuses, or neonates.

However, the G-EthicalEval requires principal investigators (PIs) to work in accordance with the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum), which states that the informed consent form should include a statement on the reasonably foreseeable risks or inconveniences to the participant, and when applicable, to an embryo, fetus, or nursing infant.

Additional Resources
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 4.8
Informed Consent > Prisoners
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guideline 24 and Glossary
Summary

Overview

While G-EthicalEval lists prisoners as a vulnerable population, there are no relevant provisions regarding any special consent procedures for them.

Additional Resources
No additional resources
Informed Consent > Mentally Impaired
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 24 and 35, and Glossary
Summary

Overview

While G-EthicalEval lists adults with serious mental or behavioral disorders as a vulnerable population, there are no relevant provisions regarding any special consent procedures for them.

However, the G-EthicalEval requires principal investigators (PIs) to work in accordance with the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum), which states that when a clinical trial includes participants with mental impairment (e.g., those with severe dementia), the participant should be informed about the trial to the extent compatible with his or her understanding and, if capable, he or she should sign and personally date the written informed consent.

Additional Resources
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 1.61, 3.1, and 4.8
Investigational Products > Definition of Investigational Product
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines on Pharmacovigilance in the Democratic Republic of the Congo (G-PV - French) (October 2018)
Directorate of Pharmacy and Medicine, Ministry of Health
Relevant Sections: I (I.1)
(2) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guideline 35
Summary

Overview

As delineated in the G-PV and the International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum), an investigational product (IP) is defined as a pharmaceutical form of an active ingredient being studied or used as a reference in a clinical trial. This includes products already authorized but used or formulated and packaged in a different way from the authorized one, when used for an unauthorized indication, or when used to gain further information about an approved use.

The G-EthicalEval indicates that the principal investigator (PI) must agree to work in accordance with the ICH-GCPs-Addendum.

Additional Resources
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 1.33
Investigational Products > Manufacturing & Import
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 2 and 35
Summary

Overview

As per Additional Resource (A), the Directorate of Pharmacy and Medicine (Direction de la Pharmacie et du Médicament (DPM)) of the Ministry of Health (Ministère de la Santé) is the regulatory authority responsible for authorizing and controlling drug imports and exports in the Democratic Republic of the Congo (DRC).

According to a subject matter expert, an import license is required for the shipment of the investigational product (IP) to be used in the trial.

The G-EthicalEval requires that the principal investigator (PI) agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) and International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum). The ICH-GCPs-Addendum requires IPs to be manufactured, handled, and stored in accordance with applicable Good Manufacturing Practices (GMPs) and used in accordance with the approved protocol.

Additional Resources
(A) (Website) Directorate of Pharmacy and Medicine – Regulatory Functions (French) (Current as of August 28, 2019)
Directorate of Pharmacy and Medicine, Ministry of Health
(B) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(C) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 2.12 and 5.13
Investigational Products > IMP/IND Quality Requirements
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 13 and 35
Summary

Overview

In accordance with the G-EthicalEval, an applicant must provide the ethics committee (EC) with the following investigational product (IP) information in the clinical trial application submission:

  • An adequate summary of all safety, pharmacological, pharmaceutical, and toxicological data available on the IP to be evaluated
  • A summary of the clinical experience to date with this IP (e.g., recent Investigator’s Brochure (IB), publication(s), and summarized product characteristics)

The G-EthicalEval indicates that the principal investigator (PI) must agree to work in accordance with the ICH-GCPs-Addendum, which provides detailed IB requirements. The ICH-GCPs-Addendum specifies that the IB must contain all of the relevant information on the IP(s) obtained through the earlier research phases, including preclinical, toxicological, safety, efficacy, and adverse event data. The sponsor should also update the IB as significant new information becomes available.

IB Content Requirements

As specified in the ICH-GCPs-Addendum, the IB must include the following sections:

  • Table of Contents
  • Summary
  • Introduction
  • Physical, Chemical, and Pharmaceutical Properties and Formulation
  • Nonclinical Studies (pharmacology, pharmacokinetics, toxicology, and metabolism profiles)
  • Effects in Humans (pharmacology, pharmacokinetics, metabolism, and pharmacodynamics; safety and efficacy; and regulatory and post-marketing experiences)
  • Summary of Data and Guidance for the Investigator(s)

See the ICH-GCPs-Addendum for detailed content guidelines.

Certificate of Analysis (CoA) and Drug Manufacturing Certificate Requirements

Per the ICH-GCPs-Addendum, the sponsor must maintain a CoA to document the identity, purity, and strength of the IP(s) to be used in the clinical trial.

Additional Resources
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 5.13, 5.14, 7, and 8.2
Investigational Products > Labeling & Packaging
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 2 and 35
Summary

Overview

The G-EthicalEval requires that the principal investigator (PI) agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) and International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum).

The ICH-GCPs-Addendum states that the investigational product (IP) should be coded and labeled in a manner that protects the blinding, if applicable. The IPs must also be suitably packaged in a manner that will prevent contamination and unacceptable deterioration during transport and storage.

Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(B) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 5.13
Investigational Products > Product Management
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 2 and 35
Summary

Overview

The G-EthicalEval requires that the principal investigator (PI) agree to work in accordance with the Declaration of Helsinki, the World Health Organization’s (WHO) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) and International Council for Harmonisation's Guideline for Good Clinical Practice E6(R2) (ICH-GCPs-Addendum).

The ICH-GCPs-Addendum provides detailed Investigator’s Brochure (IB) requirements. The ICH-GCPs-Addendum specifies that the IB must contain all of the relevant information on the investigational product(s) (IPs) obtained through the earlier research phases, including preclinical, toxicological, safety, efficacy, and adverse event data. The sponsor should also update the IB as significant new information becomes available.

Investigational Product Supply, Storage, and Handling Requirements

Per the ICH-GCPs-Addendum, the sponsor must supply the investigator(s)/institution(s) with the IP(s). The sponsor should not supply either party with the IP(s) until he/she obtains all required documentation.

The sponsor must ensure the following:

  • IP product quality and stability over the period of use
  • IP manufactured according to any applicable Good Manufacturing Practices (GMPs)
  • Proper coding, packaging, and labeling of the IP(s)
  • Records maintained for document shipment, receipt, disposition, return, and destruction of the IP(s)
  • Acceptable storage temperatures, conditions, and times for the IP(s)
  • Timely delivery of the IP(s)
  • Written procedures including instructions for handling and storage of the IP(s), adequate and safe receipt of the IP(s), dispensing of the IP(s), retrieval of unused IP(s), return of unused IP(s) to the sponsor, and disposal of unused IP(s) by the sponsor
  • Maintain sufficient quantities of the IP(s) to reconfirm specifications, should this become necessary

Record Requirements

Per the ICH-GCPs-Addendum, the sponsor should comply with the following records requirements:

  • Maintain records that document shipment, receipt, disposition, return, and destruction of the IP(s)
  • Maintain a system for retrieving IPs and documenting this retrieval (e.g., for deficient product recall, reclaim after trial completion, and expired product recovery)
  • Maintain a system for the disposition of unused IP(s) and for the documentation of this disposition
Additional Resources
(A) (WMA Guidance) Declaration of Helsinki (October 19, 2013)
World Medical Association
(B) (WHO Guidance) Guidelines for Good Clinical Practice (GCP) for Trials on Pharmaceutical Products (WHO-GCPs) (Technical Report Series No. 850, Annex 3) (1995)
World Health Organization
International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use
Relevant Sections: 2.12, 5.5, 5.12, 5.13, 5.14, and 7
Specimens > Definition of Specimen
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guideline 34
Summary

Overview

In the G-EthicalEval, a specimen is referred to as a “biological sample.” The G-EthicalEval does not define biological samples, but indicates that they should be considered a loan made to the investigator, unless otherwise specified in the research agreement. This requirement is inspired by the philosophies of the Bantu community on “bodily integrity,” according to which every product and part of the human body is an essential and sacred component of the person. The investigator should therefore consider himself/herself the guardian of the samples, rather than the owner.

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Specimens > Specimen Import & Export
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guideline 33
Summary

Overview

In accordance with the G-EthicalEval, the transfer of data or biological samples to a third party requires the consent of the researcher, the participant concerned, and the community. If the data or biological samples are transferred abroad, the applicable authorities often need to be given the Materials Transfer Agreement.

Additional Resources
No additional resources
Specimens > Consent for Specimen
Last content review/update: August 29, 2019
Requirements
(1) (Guidance) Guidelines for the Ethical Evaluation of Research Involving Human Subjects in the Democratic Republic of Congo (G-EthicalEval - French) (2011)
Ministry of Health
Relevant Sections: Guidelines 24 and 33
Summary

Overview

As per the G-EthicalEval, clinical trial participants must give consent for the use of biological samples for research purposes. Biological samples that are kept after the end of the research may only be used in a new study if the participant has given his/her consent for its continued use. It may be necessary to find the participants to make them sign a specific consent of this new study. The records and biological samples of individuals who have specifically refused such uses in the past can only be used in public health emergencies with the approval of an ethics committee (EC).

The G-EthicalEval indicates that the original consent process should include, as much as possible, a plan for future use of records or biological samples. When seeking informed consent, a member of the research team must interact with potential participants and seek their agreement on the following points:

  • Whether there will be or may be secondary use and, if so, whether this secondary use will be limited as to the type of study that may be conducted on such materials
  • The conditions under which investigators will be required to contact participants to obtain additional authorization for secondary use
  • The arrangements made by investigators, if necessary, to destroy records or samples or to erase personal identifiers
  • The rights of subjects to request the destruction or anonymization of biological samples, records, or certain items of records that they may consider particularly sensitive, such as photographs, videos, or audio recordings

The G-EthicalEval further states that before seeking the consent of a person to participate in research, the investigator must relay to him/her the rules applicable to the use of genetic test results and family genetic information, and the precautions taken to prevent the disclosure of genetic test results of a participant without his/her consent.

In addition, per the G-EthicalEval, the transfer of data or biological samples to a third party requires the consent of the researcher, the participant concerned, and the community.

(See the Informed Consent topic, Required Elements and Participant Rights subtopics for additional information on informed consent).

Additional Resources
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