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Open Access Highly Accessed Debate

Access and use of human tissues from the developing world: ethical challenges and a way forward using a tissue trust

Claudia I Emerson1*, Peter A Singer1 and Ross EG Upshur23

Author Affiliations

1 McLaughlin-Rotman Centre for Global Health, University Health Network & University of Toronto, 101 College Street, Suite 406, Toronto, Ontario, M5G 1L7, Canada

2 University of Toronto Joint Centre for Bioethics, 155 College Street, Suite 754, Health Sciences Bldg, Toronto, Ontario, M5T 1P8, Canada

3 Department of Family and Community Medicine, University of Toronto, Canada

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BMC Medical Ethics 2011, 12:2  doi:10.1186/1472-6939-12-2

Published: 25 January 2011



Scientists engaged in global health research are increasingly faced with barriers to access and use of human tissues from the developing world communities where much of their research is targeted. In part, the problem can be traced to distrust of researchers from affluent countries, given the history of 'scientific-imperialism' and 'biocolonialism' reflected in past well publicized cases of exploitation of research participants from low to middle income countries.


To a considerable extent, the failure to adequately engage host communities, the opacity of informed consent, and the lack of fair benefit-sharing have played a significant role in eroding trust. These ethical considerations are central to biomedical research in low to middle income countries and failure to attend to them can inadvertently contribute to exploitation and erode trust. A 'tissue trust' may be a plausible means for enabling access to human tissues for research in a manner that is responsive to the ethical challenges considered.


Preventing exploitation and restoring trust while simultaneously promoting global health research calls for innovative approaches to human tissues research. A tissue trust can reduce the risk of exploitation and promote host capacity as a key benefit.