The global PREPARED project has been developing practical tools for those facing difficult decisions during health emergencies.

For example, in June 2024, PREPARED submitted comments to the World Medical Association Working Group developing an updated version of the Helsinki Declaration, the key global framework for research ethics. These comments, focusing on vulnerable groups and individuals, were taken on board in the revised declaration published in October 2024.

Also during 2024, the project launched the PREPARED app. This learning tool, which includes case studies and short courses, provides key information while also encouraging self-reflection on users’ attitudes and practices. It features three case scenarios on topical issues – human challenge studies, use of AI in crisis situations, and the activities of research ethics committees during the COVID-19 pandemic. It includes informative videos and polls to enable users to check their responses against those of their peers.

A draft ‘See-Saw app’ was piloted in May 2024. This app explores the trade-offs that need to be made in pandemic contexts, where actions affect different groups in different ways. Having watched video clips, users can place arguments on either side of a see-saw to see how they tilt the balance. A kiosk-based version enables users to compare their results with others. A classroom version has also been developed, allowing responses among a class group to be compared.

In February 2024, the project published a guidance document for publishers, Guidance on Fair and Fast Desk Appraisal of Submitted Manuscripts during Times of Crisis. This resource covers the initial stage of appraisal within a publications office, when a decision is made whether to circulate a manuscript for peer review. The guidance is designed to ensure consistency, efficiency and transparency in this decision-making step. A second document provides guidance to bodies such as research ethics committees on expediting ethics review during health emergencies.

The COVID-19 pandemic raised many challenging issues for policymakers and other groups. Any future pandemic will also inevitably require difficult decisions to be made, usually rapidly and with incomplete knowledge.

With multiple partners from sub-Saharan Africa, Europe and Asia, the PREPARED project has

undertaken multiple activities and developed a range of resources to promote the adoption of sound ethical principles for decision-making during a health emergency. The project is funded through the EU’s Horizon Europe programme and includes the EDCTP Association as a partner.