Table 3 Stakeholders with responsibilities to contribute to emergency preparedness in ethical review

• National governments/ departments of health are responsible for ensuring there is a clear strategy for ethical review within their jurisdiction, setting out its relationship with other elements of research governance and oversight systems, such as scientific review and regulatory bodies. Such a strategy is an essential pre-requisite for the development of streamlined systems that facilitate effective co-ordination between these different elements. As attendees illustrated, different strategic models will be suitable for different countries and contexts, depending on the size of the research sector, the nature of the studies being reviewed, and the level of expertise available. Governments are also responsible for ensuring that human and financial resources are rapidly made available to meet the increased demands on ethics committees at the height of an emergency

• Where countries have national research ethics bodies with a remit from national government to oversee the operation of ethical review, their designated responsibilities may include developing emergency SOPs that will facilitate rapid and responsive ethical review in emergencies, contributing, where appropriate, to regional initiatives to achieve co-ordinated review of multi-country studies, and making best use of available capacity

• The responsibilities of WHO (Regional Offices and the headquarters Health Ethics and Governance Unit) include working with national research ethics bodies and other relevant stakeholders to help support clearer lines of communication, networking and mutual learning; promote the rapid dissemination of good practice guidance; and help minimise duplication of efforts. One proposal put forward at the meeting was the establishment of an online platform to connect national research ethics committees and provide a focal point for relevant guidance. Collaboration between and within WHO departments, and with those concerned with regulatory systems, is also crucial