Workshop Analysis
The issues raised at this meeting and the approaches taken to them were consistently of a high level. The discussion appeared to be both broader in perspective and more refined in approach than much of the current discussion in leading scientific journals and the press. The participant's avoidance of taking entrenched positions and the openness to an exploratory approach aided the shared intention of finding a strong common ground on which to build. The importance of the meeting lies in the manner in which the discussion was developed and the outcome. That is, a cooperative multi-institutional and multi-national model for the ethics and science of biomedical research seems to suggest the best way forward.

The proposed Global Bioethics Forum that resulted from the Workshop would make a strong contribution to the current global discussion on ethical and scientific norms in international biomedical research. The manner in which the Forum is conceived and the approach taken to launching it holds out wide promise for a more informed and just discussion than currently exists in other international fora. The international research community will rightly have high expectations of the Forum. It remains for the Steering Committee to develop strong mechanisms that guarantee full inter-institutional and international cooperation. These mechanisms will need to be representative, democratic, and efficient if they are to achieve the aims of the Forum and engage confidence. At the same time, however inclusive this Forum would be, it would function best as a support and a catalyst for projects and undertakings by organisations, institutions, and governments. The Forum will need to act as a support, and not a hinder, to freely engaged initiatives that hold out promise for ameliorating the present situation of biomedical research.

The absence of the industry (pharmaceutical, genetic, biotech, device) was markedly felt and commented on by some present. An effective Forum would appear to require the full participation of those parties responsible for implementing good ethical and scientific practice: government, inter-governmental organisations, NGOs, academia, and industry. In addition, a broader representation of European institutions would strengthen the Forum (e.g., the European Commission, the Council of Europe, the Fondation Marcel Meriéux, the Institute for Tropical Medicine in Antwerp, Central & Eastern European representation).

The UNAIDS model of discussion carried out in the development of its forthcoming 'Guidance Document on Ethical Considerations in International Trials of HIV Preventive Vaccines' and continued in the current Training Workshops on Ethical Issues in HIV/AIDS Vaccine Research should be considered in the development of the Forum. Similarly, the Council of Europe/EU model pursued in the Demo-Droit Ethical Review of Biomedical Research Activity (DEBRA) programme should be explored. However, both of these models should be adjusted to allow for a more democratic and representative model of expertise, as was the case at the FIC Workshop.

OPAS Brazil