Human Biobanking in South Africa

Abayoni and co-authors (2013) discuss steps required to set up a national human biobanking structure in South Africa, covering many of the issues commonly encountered but also describing some that northern hemisphere biobankers may not have considered.¹ As a continent, Africa presents a uniquely complex set of health and disease issues. Setting up a cooperative network for health research and exchange is a step forward in addressing the continent’s search for solutions. For this reason, the Human Health and Heredity in Africa (H3Africa) initiative for genomic research has already been established, and biobanking will play a large part in this project.

As Abayoni et al. show, biobanking in South Africa must be set up in the context of high rates of HIV and tuberculosis infection, in addition to the emergence of new metabolic diseases. The authors also point out that societally, biobanking in South Africa lacks a strong presence and focus among patients, and the does the country does not have strong advocacy for bioresource management. These health conditions are also ripe for picking in the same way that natural resource harvesting occurs across Africa; the authors feel that countries must resist biopiracy, where data and results vanish across borders, leaving little in the way of benefit for the donor population.

To facilitate this continental collaborative network and overcome the issues described below, the authors advise setting up a centralized administration to manage biobanking in South Africa. This would encourage adoption of standard operating procedures (SOPs) and implementation of international standards that would facilitate international collaboration for research in addition to creating a sustainable infrastructure.

Governance
Externally, South African biobanking is covered by the World Health Organization and the Helsinki Declaration; however, responsibility for bioresource management within the country lies with the Department of Science and Technology. The Department of Health and the National Health Laboratory Service also have responsibilities, with the latter providing training for staff and oversight for existing centralized biobanks. The authors feel that centralized Africa-specific governance is also needed to drive research into specific diseases and also to protect against biopiracy.

Legal and ethical issues
Biosample collection is covered under South African law: the National Health Act No. 61 governs use of biospecimens, and experimental design involving use of human subjects requires approval by the HREC ethics committee. However, the issue of informed consent and re-consent and protection of privacy through anonymizing data is less well covered under South African law.

Infrastructure
Abayoni et al. note that the key factors for infrastructure are consistent power supply, access to liquid nitrogen and dry ice, and good transportation. With issues around inconsistent power supply, they suggest backup sources in addition to switching to liquid nitrogen for biosample storage. In terms of transport, the authors note that although communications are good within South Africa and internationally, both data and goods transfer to other parts of Africa are variable.

Biorepository laboratory information management systems (LIMS)
In order to set up a national, fully collaborative biobanking network, the authors suggest early adoption of suitable LIMS for biobanking and bioresource management. Implementing an appropriate LIMS during the early stages of development should help South African biobanks to develop SOPs and adopt global data standards that could enable international collaboration.

Sustainability
As a final point, the authors address the issue of sustainability in biobanking, with particular reference to onward financial security. They point out that although South African biobanking currently receives adequate funding from the United States (National Institutes of Health) and the United Kingdom’s Wellcome Trust, it would be highly advisable to develop multiple sources for long-term stability. To manage these resources effectively, Abayoni et al. advise that biobank management implement a SMART (specific measurable achievable relevant and time bound) business model.

Reference

1. Abayomi, A., et al. (2013) “Challenges of biobanking in South Africa to facilitate indigenous research in an environment burdened with human immunodeficiency virus, tuberculosis, and emerging noncommunicable diseases,” Biopreservation and Biobanking, 11, doi: 10.1089/bio.2013.0049