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FIRST REGIONAL MEETING ON National Bioethics Committees UNESCO Cairo office & EMRO/WHO Cairo, 5-7 May 2007

FIRST REGIONAL MEETING ON National Bioethics Committees UNESCO Cairo office & EMRO/WHO Cairo, 5-7 May 2007. Bioethics & Bioethical issues in Morocco Prof. Nouzha Guessous-Idrissi Member of the Research ethics Committee of Casablanca (CERBC) & of the Moroccan Association of Bioethics .

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FIRST REGIONAL MEETING ON National Bioethics Committees UNESCO Cairo office & EMRO/WHO Cairo, 5-7 May 2007

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  1. FIRST REGIONAL MEETING ONNational Bioethics CommitteesUNESCO Cairo office & EMRO/WHO Cairo, 5-7 May 2007 Bioethics & Bioethical issues in Morocco Prof. Nouzha Guessous-IdrissiMember of the Research ethics Committee of Casablanca (CERBC)& of the Moroccan Association of Bioethics

  2. PARADOXICAL SITUATION Like other developing countries, Morocco is faced with bioethical issues of differing types and scope

  3. Some data on health and research in Morocco • Population 29 millions • Health Budget / General budget 4.5% • Research allocations / GDP 0,8% • Health expenditures /Capita / Year 50 USD • Number of medical doctors/Capita 1/1800 (839-4587) • Number of Hospital bed/ Capita 1 / 900 • Health insurance covering rate* < 15% • Maternal mortality rate 227/100.000 • Infant mortality < 5 years 6.5% • Life expectancy at birth 71 years Sources: rapport OMS, 2000; Ministère de l ’Economie et des Finances et Ministère de la Santé Maroc, 1999, 2000, 2001

  4. Day-to-day ethical issues Provision & quality of health care • Lack of quality and appropriate healthcare(rank 94th*) • Inequity in the access to health services (rank 126th*) • Lack of patient information, respect of autonomy and request of consent (Rank 152th*) * WHO rating among 191 countries, 2000

  5. “New” bioethical issues While new medical technologies are being used, there is still a marked lack of national bioethical standards & institutions • Absence or inadequacy of national jurisdictions regulating their practice • Still NO National Bioethics Committee nor Hospital Ethics Committees.

  6. Lack and/ or inadequacy of national jurisdictions • The only law passed to date(1999) is related to organs and tissues donation, removal and transplantation : over 100 kidney transplants have been performed • No national regulations for the practice of MAR : ~20 centers for IVF, Artificial Insemination and ICSI & more than 200 children have been born as a result of these techniques • No national legal standards concerning other areassuch as the practice of genetic testing, the use of end-of-life palliative care, etc..  All ethical decisions are entirely left up to the medical team

  7. Ethics of research in Life Sciences • Still no national law for the protection of the participants in biomedical research, even though medical and scientific research is conducted, both by national teams and in the framework of international projects (a Draft- law is under discussion). • Individual initiatives by health and research professionals • Local Research Ethics Committees independently set up in the Medical Schools of Casablanca (CERBC) and Rabat • The Moroccan Association for Bioethics was established in 2005

  8. Ethics Biomedical Research Committee of Casablanca (CERBC) • Autoproclamed Committee since 1989, based at the medical school of Casablanca • Protect human participants to research, clinical trials or studies • Review of the scientific and ethical aspects of research proposals and protocols : the submission to the Committee is optional (not required by law) and its opinion is advisory • Promoting and Sensitizing to Bioethics: • Seminars and Conferences • Publications.

  9. Bienvenue sur le site du Comité d'Éthique pour la Recherche Biomédicale Service de Pharmacologie, Faculté de Médecine et de Pharmacie19, rue Tarik Bnou Ziad, Casablanca, MarocTel: (212) 22 20 11 56 - 22 47 12 89 - Fax: (212) 22 47 12 90E-mail: hakkou@media.ma - Secrétariat: ouhakki@yahoo.fr 2003 2001 Sommaire

  10. Assessment of activities 1989-2005

  11. Annual Evolution Nombre de dossiers

  12. Origin of the submitted proposals Private Sector CHURABAT CHUCASABLANCA

  13. Areas of research

  14. Requested modifications Consent Forms Aggressive techniques Participants care Scientific Evaluation Administrative reasons Request of Patients Insurance Methodology

  15. Moroccan Association For Bioethics“BIOETHIC “ • To promote the bioethics among the civil society as well as among the public and private sectors and institutions concerned, • To encourage, take part and carry out any action of research, education and information, • To initiate scientific, legal and general debates and to express opinions on any bioethical issues , • To promote all kind of cooperation at the national, regional or international levels  WHO – AMB joined Workshop on Research Ethics, Fès, (Morocco), June 2005 Created in 2005  

  16. Prospects & Conclusions 1)Initiation of public information and debates on bioethical issues to promote national regulations according to Universal principles with respect to the historical and sociocultural specificities of Morocco & Creation of HEC’s and new REC’s, as well as the support to the existing one and to the AMB 2)Creation of a multidisciplinary and independent National Bioethics Committee: • Political decision • available national expertise • Support of International and regional organizations

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