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Dr. Tawfik A. M. Khoja MBBS, DPHC, FRCGP, FFPH Director General – GCC Health Ministers’ Council

Dr. Tawfik A. M. Khoja MBBS, DPHC, FRCGP, FFPH Director General – GCC Health Ministers’ Council. Activities of GCC in relation to Bioethics, Ethics of Science and Technology. Dr. Mohamed S. Hussein Dr. PH,M.PH,M.Sc . Head of Studies & Research Division.

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Dr. Tawfik A. M. Khoja MBBS, DPHC, FRCGP, FFPH Director General – GCC Health Ministers’ Council

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  1. Dr. Tawfik A. M. Khoja MBBS, DPHC, FRCGP, FFPH Director General – GCC Health Ministers’ Council Activities of GCC in relation to Bioethics, Ethics of Science and Technology Dr. Mohamed S. Hussein Dr. PH,M.PH,M.Sc. Head of Studies & Research Division The Regional Meeting of National Bioethics Committees Cairo, 18-20 Rabi II, 1428 H / 5-7 May 2007 Dr.Tawfik A. M. Khoja 1

  2. Dr.Tawfik A. M. Khoja 2

  3. The Executive Board, Health Ministers’ Council for Cooperation Council States is very much interested in promoting health research in the region. It very well realizes that the health research system is the brain of the health system; it is the tool to organize, understand, operate and improve it. Research is 4 things: Brains with which to think. Eyes with which to see. Machines with which to reassure. Money And I add, et6hics to work and conduct . Dr.Tawfik A. M. Khoja 3

  4. Scientific Research should be put as the top priority on the part of decision-makers. The more investment we put in this field the more development in all its aspect, to achieve the goal of health for all. For those who think that research is very costly, I urge them to calculate the direct and indirect costs of disease. “The health of Nations is more important than the wealth of Nations”. (Will Durant, American Historian). Dr.Tawfik A. M. Khoja 4

  5. Medical Ethics in the GCC Dr.Tawfik A. M. Khoja 5

  6. The Executive Board and the Medical Ethics The interest of the Health Ministers’ Council for the Cooperation Council of the subject dates back to the nineties where the 37th Ministerial meeting in 1994 issued the resolution # 3 which was based on a recommendation (#5) made by the Executive Body in its 40th meeting. The resolution emphasized the importance of having a system for organization of the medial profession and its practice which should define the values, principles and customs which physicians and the medical community should commit themselves to in the professional conduct. Dr.Tawfik A. M. Khoja 6

  7. The 54th Ministerial meeting, held in Abu-Dhabi (Shawal 1423 H- January 2003) issued resolution # 16 which emphasized the position adopted by the international, Arab and Islamic organizations about cloning. Thus, it stressed the absolute rejection of human cloning not only in human reproduction but also for all reproductive experiments on human embryos. It was also agreed upon starting cooperation efforts between the Executive Board and the Islamic Organization for Medical Sciences to set a law that bans these experiments. Dr.Tawfik A. M. Khoja 7

  8. The medical ethics subject was discussed in the 58th meeting of the Executive Body held in Riyadh (Safar 1424 H – April 2003) which issued the recommendation # 17 which in turn was presented to the 55th Ministerial meeting held in Geneva (Rabi I, 1424 H, May 2003 G) where it issued resolution # 7 which emphasized 2 main pillars: Developing a unified Gulf System Model about human cloning Establishing a specialized task force to issue a unified Gulf Guidelines about the subject. Dr.Tawfik A. M. Khoja 8

  9. There was a great positive response on the part of the Islamic Organization for Medical Sciences in this respect through clarifying he mechanism of preparing and implementing the draft Islamic document about the ethics of medical profession, where it undertook coordination with all bodies, institutions and organizations interested in the issue of medical ethics, including the Executive Body. • The Islamic Organization will also take part in drafting the proposed law (from Kuwait) and the Arab League. Dr.Tawfik A. M. Khoja 9

  10. The 59th meeting of the Executive Body Riyadh, issued recommendation # 12 which emphasized the importance of completing establishment of the National Committees for Medical Ethics in the Cooperation Council States in addition to raising the general awareness about the various aspects and the rules and criteria of medical profession ethics at the level of workers in the healthcare field through: a comprehensive awareness workplan and at the level of the community through a media campaign. Dr.Tawfik A. M. Khoja 10

  11. The 58th Ministerial meeting (held in Oman, February 2005) issued resolution #2 which decided. • adopting the World Islamic Charter for the medical and health profession, to be considered the Unified Gulf Guidelines for ethics of the medical and health profession. • Reviewing the Islamic charter by the national committees and suggesting the mechanisms of implementation. • Urging the member states to include in their educational and training curricula the subject of the medical profession ethics. Dr.Tawfik A. M. Khoja 11

  12. Avital Mission is ahead of us Global Research Ethics 12 Dr. Tawfik A. M. Khoja 70

  13. The Executive Board is involved in building the capacity in the member states in the field of health research. Therefore: I. Many workshopshave been organized in this respect: a) Workshop on constraints of the scientific research in the field of health in the Kingdom of Saudi Arabia ( King Abdul Aziz City for Sciences and Technology, 10 Dhul Qada 1425H, 22 December 2004) and issued a lot of important recommendations. In this workshop, it was also stressed on the ethical constraint indicating that: Dr.Tawfik A. M. Khoja 13

  14. There is no clearness of the ethical side of research and its requirements both in the researchers and the researched. • Lack of national ethical guidelines and mechanisms of review of these guidelines both at the institutional and the national level. It was also stressed on the aims of conduction of research within the ethical framework, which shoulde.g. Dr.Tawfik A. M. Khoja 14

  15. Contribute in enriching the health knowledge Have a tangible positive impact at the level of improving the healthcare or solving health problems. Targeted objectives of scientific research should outweigh the risk expected to take place whether for the patient or the community. Means of scientific research should match the ethical principles and the noble objective should not justify an unethical means. Dr.Tawfik A. M. Khoja 15

  16. Scientific research hypothesis or its outcomes should not contradict with the ethical framework, and the principles of protection of humans and the community where they live in. II. Collaboration with related bodies, e.g. Council on Health Research for Development (COHRED) and WHO/EMRO, Global Forum for Health Research (GFHR) and Child Health Nutrition Research Initiatives (CHNRI) and the Islamic Organization for Medical Sciences (IOMS) and others. Dr.Tawfik A. M. Khoja 16

  17. a) A joint meeting with (COHRED) and EMRO was held in Riyadh in November 2005 where a total of 10 countries from the WHO-EMRO and GCC countries participated. • Given the consensus that all the participating countries are in a great need to strengthen their national systems of health research, it was agreed that a situation analysis should be done in the concerned countries using a tool developed by COHRED. Dr.Tawfik A. M. Khoja 17

  18. b) This was followed by another workshop held in Oman 29-30 May 2006. The aim of which was to involve the country investigators in defining the scope of the study, gain feedback on the problems facing the NHRS in their countries, review and adopt the approach on their decision-making needs, and jointly design the mapping questionnaire to be used. Dr.Tawfik A. M. Khoja 18

  19. It was decided at that workshop that a phased action-oriented approach should be taken by the initiative. The first phase was conducted a NHRS “Mapping” to help decide priorities for system strengthening. (I am not going into details in this, because may be other colleagues from EMRO might elaborate as necessary). SOMETIMES THE BEST MEDICINE IS ……. LESS MEDICINE. Dr.Tawfik A. M. Khoja 19

  20. c) Collaboration with the Islamic Organization for Medical Sciences (IOMS). • There is a great collaboration with the IOMS and the Executive Board. This collaboration was crowned by issuance of “the World Islamic Charter for Health and Medical Ethics” which was issued by the 8th world conference held by IOMS – Cairo (28 Shawal – 2 Dhul Qaeda 1425 H corresponding to 11-14 December 2004). Dr.Tawfik A. M. Khoja 20

  21. In addition, a number of extremely important recommendations were issued by the conference which numbered 15, the most prominent of which is submission of this charter to the Health Ministers’ Council for the Cooperation Council States in recognition of to the efforts exerted by the Executive Board in all phases of preparation, participation and drafting as well as support since the birth of the idea till it became a reality. Dr.Tawfik A. M. Khoja 21

  22. Invest in the Solutions at theHeart to the Problem 22 Dr. Tawfik A. M. Khoja

  23. d) Attending meetings about biomedical ethics e.g. • * The Director General attended and participated in the task force meeting about preparing the Islamic document about ethics of the medical profession (8-10 Rabi I, 1425 H – 27-29 April 2004G). • Four Gulf countries (KSA, UAE, KUWAIT, OMAN) in addition to representatives from Egypt, WHO/ EMRO and some of the high prestigious figures in the field participated in the said meeting. Dr.Tawfik A. M. Khoja 23

  24. The medical ethics documents from the 4 countries were considered basic documents to be reviewed in an attempt to have a unified document for the Islamic countries. * Issuance of the Islamic Charter for Medical and Health Ethics adopted in the Eighth World Conference held by the Islamic Organization of Medical Sciences (Cairo, 11-14 December 2004). Dr.Tawfik A. M. Khoja 24

  25. e) Exchange of information among the Gulf countries in the field of medical ethics, through dissemination of various related publications, reports, books dealing with various bioethical issues e.g. cloning, use of stem cells, genetic engineering and human reproduction, organ transplantation from living and dead people, forensic medicine, unfair promotion of drugs, etc. Dr.Tawfik A. M. Khoja 25

  26. Examples of publications disseminated are: • Proceedings for the International Conference about the Islamic Charter of the medical and health ethics (December 2004) ( C Ds have been disseminated to the Gulf countries). • Book about “Legal and medical situation towards medication with alcohol and narcotics, by Dr. Mohamed Ali Al-Bar. • An information document about “The International Islamic Conference for Ethics of Medical Practices” (Industrial and Commerce Chamber, Jeddah, 31 May – 2 June, 2005) organized by the King Abdul Aziz Medical city for the National Guard, in Jeddah. Dr.Tawfik A. M. Khoja 26

  27. QI QA

  28. Dr.Tawfik A. M. Khoja 28

  29. This book, in 2 volumes, comes to emphasize the ethical issues of medical research, theoretically and practically in our countries, within the context of our Islamic faith in its methodology, and general and private rules. This is the first book to be issued in Arabic in this subject, being a comprehensive book which I was greatly honored reviewing and editing it. 29 Dr. Tawfik A. M. Khoja

  30. Section I of the book deals with definition of the Scientists in Islam and their position, together with a historical background about our ancestors of scientists and researchers as well as the importance of research and scientific thinking in the life of people and the constraints underlying them 30 Dr. Tawfik A. M. Khoja

  31. Section II dealt in details with the issues of Islamic research, its rules, components and the methodology of research related to the medical sciences such as the experimental approach, survey and surveillance. It elaborated on methods and rules in selection of scientific hypotheses, samples and research methodology. 31 Dr. Tawfik A. M. Khoja

  32. Section III dealt with health system research and its importance, as well scientific research in the quality of healthcare. Section IV presents the most important results of the scientific applications and modern medical researches, e.g. reproduction, genetic engineering problems, clonging – abortion, euthanasia, organ transplantation in addition to the rules governing conduction of medial research. 32 Dr. Tawfik A. M. Khoja

  33. Scientific Articles in the Eastern Mediterranean Health Journal (EMHJ), Vol. 10, Number 1,2,2004 titled “Medical Practices between the errors of the doctors and complications of the disease) • Basic documents issued by the 52nd session of the EMR Committee (Cairo, 20-25 Shaban 1426 H – 24-27 September 2005). • Medical and Health Ethics. • Islamic Charter for Medical and Health Ethics. • Stem Cells and the ethical and doctrinal (Fiqh) Issues By Prof Mohamed Ali Albar. • Scientific publication from the World Health Organization about : Dr.Tawfik A. M. Khoja 33

  34. Ethics and Health • Health and Human Rights • Globalization Trade and Health • An article in the Saudi Journal for Renal disease and transplantation “Recent Thoughts about the Ethics of Renal Transplantation”. • Medical Ethics Manual issued by the World Medical Association. • Some articles in the Saudi Medial Journal • Ethical Guidelines in Genetics and Genomics – an Islamic perspective. Dr.Tawfik A. M. Khoja 34

  35. Is this clinical trial fully registered ? As statement from the International Committee of Medical Journal Editors. • The Ottawa statement in International registration of protocol information and results from human trials of health related interventions. • An article titled : “ Atitudes towards euthanasia among final year Khartoum University Medical Students,EMHJ,Vol.12,No.423,2006. Dr.Tawfik A. M. Khoja 35

  36. Scientific Medical Research & its Legal Controls (in Arabic) By Dr. Tawfik A M Khoja, which falls in 2 volumes. Section 3 of the book presented the most important results of this scientific, medical research applications, e.g. reproduction, genetic engineering problems, cloning, abortion, organ transplantation. In addition, rules regulating each medical – research procedure were dealt with in detail. Dr.Tawfik A. M. Khoja 36

  37. CONCLUSIONS PROMOTING THE Bioethics, and Ethics FOR THE NATION 37 Dr. Tawfik A. M. Khoja

  38. Quality.. continue TQM CQI We Need Strategic Plan For Good Quality and Ethical Research for Quality Health Care Quality Ethics To BE Internalize & Institutionalize in Health System 38 Dr. Tawfik A. M. Khoja

  39. Recommendations 39 Dr. Tawfik A. M. Khoja

  40. Increasing coordination with all related and concerned organizations to include the medical ethics in the educational and training curricula in the health institutes, colleges and academic institutions. • Continuously updating the bioethics guidelines available in order to cope with the recent issues evolving in the community, such as biotechnology, genomics, etc. Dr.Tawfik A. M. Khoja 40

  41. Experience Counts Dr.Tawfik A. M. Khoja 41

  42. Development of guidelines for pharmaceutical profession and other health-related professions including nursing. • Strengthening Coordination with international organizations notably the Islamic Organization for Medical Sciences. • Effective support of research in the field of biomedical ethics. Dr.Tawfik A. M. Khoja 42

  43. داعياً الله سبحانه لي ولكم بدوام الصحة والعافية والرضوان Thank you for your kind attention Wishing you all the best Dr.Tawfik A. M. Khoja 43

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