A perpetual source of DNA or something really different: ethical issues in the creation of cell lines for African genomics research
1 Department of Medicine, University of Cape Town, Office J52-16, UCT Centre for Clinical Research, Old Main Building, Groote Schuur Hospital, Observatory, 7925 Cape Town, South Africa
2 NSB-H3A biobank and the National Health Laboratory Services of South Africa, Stellenbosch University, Faculty of Medicine and Health Sciences, Private Bag X1, Matieland, 7602 Stellenbosch, South Africa
3 Noguchi Memorial Institute for Medical Research, University of Ghana, Legon, PO Box LG 581, Ghana
4 Wellcome Trust, Gibbs Building, 215 Euston Road, London NW1 2BE, UK
5 Division of Genomic Medicine, National Human Genome Research Institute, Building KEYSTN, Room 3130, 530 Davis Dr, MSC K3-02, Durham NC 27713-K3-02, England
6 Department of Bioethics, School of Medicine, Case Western Reserve University, 10900 Euclid Avenue, Cleveland, Ohio 44106-4976, USA
7 CERMES, 634 Bd de la Nation, PO Box 10887, YN034 Niamey, Niger
8 Cameroun Bioethics Initiative (CAMBIN), The Ark, Mendong, PO Box 31489, Yaoundé, Cameroon
9 MRC/UVRI Uganda Research Unit on AIDS, P.O. Box 49, Entebbe, Uganda
BMC Medical Ethics 2014, 15:60 doi:10.1186/1472-6939-15-60Published: 7 August 2014
The rise of genomic studies in Africa – not least due to projects funded under H3Africa – is associated with the development of a small number of biorepositories across Africa. For the ultimate success of these biorepositories, the creation of cell lines including those from selected H3Africa samples would be beneficial. In this paper, we map ethical challenges in the creation of cell lines.
The first challenge we identified relates to the moral status of cells living in culture. There is no doubt that cells in culture are alive, and the question is how this characteristic is relevant to ethical decision-making. The second challenge relates to the fact that cells in culture are a source of cell products and mitochondrial DNA. In combination with other technologies, cells in culture could also be used to grow human tissue. Whilst on the one hand, this feature increases the potential utility of the sample and promotes science, on the other it also enables further scientific work that may not have been specifically consented to or approved. The third challenge relates to ownership over samples, particularly in cases where cell lines are created by a biobank, and in a different country than where samples were collected. Relevant questions here concern the export of samples, approval of secondary use and the acceptability of commercialisation. A fourth challenge relates to perceptions of blood and bodily integrity, which may be particularly relevant for African research participants from certain cultures or backgrounds. Finally, we discuss challenges around informed consent and ethical review.
In this paper, we sought to map the myriad of ethical challenges that need to be considered prior to making cell line creation a reality in the H3Africa project. Considering the relative novelty of this practice in Africa, such challenges will need to be considered, discussed and potentially be resolved before cell line creation in Africa becomes financially feasible and sustainable. We suggest that discussions need to be undertaken between stakeholders internationally, considering the international character of the H3Africa project. We also map out avenues for empirical research.