As a pediatrician, I am interested in working with children to offer them treatments that are not harmful to them. Accordingly, as a member of the National Hepatology and Tropical Medicine Research Institute (NHTMRI) ethical committee, I encourage pediatric research that ensures protective safeguards for children.
To further my efforts in supporting research involving children, I was delighted to participate in the MERETI 2017 program this past summer. I knew that participation in this program would expand my thinking about ethics and expose me to challenges faced in clinical research. It was a great opportunity for me to discuss ethical aspects and gain more experience in research ethics.
One problem I would like to review regards the current state of affairs regarding current children health services in Egypt and put forth the idea that “we are not done yet”. After about 20 years working as a children’s physician, I think that the quality of available pediatric health services is not satisfactory, especially medications and interventions. For example, the frequency of using off-label or unlicensed drugs for children is very high, reaching up to 75%. It is a problem both in developing and developed countries, and in hospitals as well as in medical clinics.
Why do physicians write offlabel/unlicensed drugs?
Usually, the information regarding drug safety is missing or incomplete, and clinical trials in children are deficient. So for many diseases in children, we do not have an approved medication or intervention.
What to do?
We need to encourage research involving children, ensuring both good scientific content and special ethical considerations. In Egyptian culture, people usually do not understand well what is meant by research, and how it differs from the usual medical service. Also, the meaning of medical research is lacking in general. In short, there is a lot of work to be done, and I am looking forward to being involved.
Ultimately, research involving children, however, challenging, is worthy and actually necessary.
Hanan Mina Fouad, a pediatrician and member of the NHTMRI ethics committee
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