DRAFT UNIVERSITY OF MALAWI COLLEGE OF MEDICINE COLLEGE OF MEDICINE RESEARCH AND ETHICS COMMITTEE GUIDELINES AND OPERATION PROCEDURES 1.0 THE NEED FOR RESEARCH GUIDELINES [a] Research may be designed and conducted by University Academic Staff with the following goals:i] Academic - advancement of scientific knowledge teaching of students ii] Operational - to improve service provision - to improve the care of patients The college will encourage research that incorporates both [i] and [ii]. The College Research and Ethics Committee would like to encourage a combination of the two for obvious reasons. [b] Regardless of the goals for conducting the research study, the welfare/interest of the study population [patients] comes first [refer to the Declaration of Helsinki (1964) with its subsequent amendments] (Annex 1). [c] As a training/teaching institution, the College would encourage that any research conducted by a staff member, either within or outside our teaching hospital, should have a training component [i.e. should aim at exposing junior members of staff of the COM to research proposals development and conduct as well as writing of the final report and articles to be published in peer review journals. 2.0 [d] All research conducted by members of staff of the College of Medicine should be of the highest possible standards, to attract funding from donors; be relevant and take into consideration the national requirements or policies. [e] To ensure all the above, and facilitate the work of the College of Medicine Research and Ethics Committee, standard guidelines for proposal writing and submission by the members of staff, will be available. [f] The College Research and Ethics Committee will advise any investigator(s) on the best present their research proposal(s), either overall or particular aspect(s), depending on the needs of the investigator(s). GENERAL CONSIDERATIONS: Before writing a research proposal, the researcher should consider the following:i] What is the problem the study intends to address. ii] What are the possible reasons/determinants of the problem[s] and possible solutions[s]. iii] What method is being proposed to either study/resolve or identify causes/determinants of the problem(s) and/or the solution[s]. iv] How does one propose to do that? v] How is the study and its results/findings going to benefit the study population, the institution or the country? vi] Is there any work similar to what one is proposing to do which has been done here or elsewhere? If so, where, when, by whom, and what did it/they show (literature review). vii] Is there a need to repeat the study if a similar one has already been done? If so, why? Is the proposed study likely to show anything new! (i.e The rationale for the study). viii] What are the required or available resources to conduct the study (e.g. manpower, laboratory, human subjects, financial, transport, computer and time, etc). How does one hope to get these. ix] Is the investigator (s) qualified to undertake the research project. 2 3.0 x] What institutional facilities are available and are at the disposal of or can be utilised by the researchers. If so, what is needed to do that. If not how does one propose to accomplish the project. xi] Is the funding available or what are the possible funding. RESEARCH PROPOSAL FORMAT N.B. The College of Medicine Research and Ethics Committee is aware of the fact that different funding agencies may have different guidelines/format requirements. Where this is the case, the Principal Investigator should prepare the proposal in the required format, provided that the format used gives all or most of the details as contained in the College Research and Ethics Committee Guidelines. The Principal Investigator must provide supportive evidence for the format used to the Secretariat. Otherwise the proposed guidelines and format should be followed. The following is the recommended format for research proposals in which members of staff of the College of Medicine, University of Malawi, are involved. [a] Title This should be specific and precise. It should not be more than 2 to 3 lines long, and should indicate what one intends to do/find out. e.g. [b] "Validation of an algorithm on the management of urethral discharge in Malawi". Investigators - Full names, qualifications, academic titles of all the investigators, including trainees (Assistant lecturers or postgraduate students) and their institutional/departmental affiliation(s). The principal/main investigator (responsible for the work) should be the first one. If there are co-investigators these should be indicated as appropriate with their qualifications, academic titles and institutional affiliations. 3 [c] - A brief up to date C.V. of each of the investigators and coinvestigators should be provided. (if it has not been submitted within the past one year). N.B Most journals have restrictions on the number of authors for a paper to be published. This may be an important consideration when preparing a research proposal. Institution[s] under whose umbrella the research project will be conducted: e.g. [i] [ii] The World Health Organisation. The College of Medicine - University of Malawi. [i] [ii] The Welcome Trust Centre. The College of Medicine, University of Malawi, etc or [d] Executive Summary - This should include:The type of research study The problem [to be studied] The objectives Methodology Expected findings and their dissemination. All in summary. This should not exceed one and half pages. [e] Background information and introduction: - [f] This should include:A review of the relevant literature. It should be most current. (Majority being in the past five to ten years at most). Locally available information - either published or not. It may include clinical or laboratory observations (e.g. increasing number of adult males presenting with head injuries at the QECH during national holidays). Rationale/justification for the research project: 4 - [g] There should be a statement explaining why the researcher[s] feel the research project is important and therefore should be carried out, (i.e. the potential significance to health care delivery, or otherwise). It should not be more than a paragraph or two. Objectives of the study [i] Broad The main issues that are being looked at/for, (e.g. to survey the socio-demographic and reproductive profiles of patients with acute gonococcal urethritis at the QECH). [ii] Specific The specific issues that are being looked at/for. These must be measurable, either qualitatively or quantitatively and form a guide to the research methodology, data analysis and presentation of results. - [h] Examples:1. To survey the age distribution of patients presenting with acute gonococcal urethritis at the QECH. 2. To survey the sexual behaviour of such patients, Methodology This should be very detailed as it is your guide on how the study will be done as well as the data analysis. It should provide relevant information on:i] The type of research study, e.g - case - control prospective, descriptive randomised clinical trial double - blind clinical trial, cross sectional 5 This should reflect exactly what the researchers intend to do. ii] Study Place - Where the study is going to be conducted (e.g. ten secondary schools in Mangochi District or The Queen Elizabeth Central Hospital, Chiradzulu District Hospital and South Lunzu Health Centre). All the areas in/at which the survey/study will be carried out must be indicated. iii] Study Population - Who are to be included in the study or from which group[s] of people is the study group going to draw, e.g. - iv] v] Patients presenting with multiple pregnancy at the QECH, in Blanytre, Malawi. Study Period - The entire period of the study including preparation of the proposal, submission and approval, training (where necessary), pretesting (of the questionnaire), data collection, data analysis, report preparation, and dissemination of the findings. - If the study is in phases, each must be specified and the time for each given. Sample Size - Details on the sample size and how it has been arrived at/worked out. - It's justification. - The selection/inclusion/exclusion criteria (e.g 10th client - every 6 - randomised (and how random) - every patient who consents. - vi] Data Collection: - vii] The need for and type of consent must be specified, and how it will be obtained, e.g. - written consent - verbal consent Details on:- What information is going to be looked for/collected. - How that is going to be done (e.g. laboratory test, with provision of appropriate details). - Requirements for that, (e.g. reagents, culture media, blood samples and their relevant tests etc). It should include - who is going to do each of the aspects of data collection (e.g. who will draw blood, perform the tests, do the physical examination, interview the study group, etc). Data Management and Analysis - Details should be provided on how the collected data is going to be managed, (e.g. coding) - Details on data analysis - the computer package to be used in data entry and analysis e.g. - SPSS - EPI - INFO 6.0, etc - The type of statistical tests to be used e.g. - regression analysis - student 't' test of significance, viii] Results Presentation A brief explanation of the format of the results as they will be presented, e.g. 7 - Pie charts - Histograms - Line graphs, - Tables ix] Dissemination of the Results - Indicate the person or institution to whom the report is going to be submitted and why. - How does/do the investigator[s] propose to disseminate their research findings, such as; - attendance at local, regional or international conferences/seminars, workshops. - holding of a dissemination seminar/workshop. - publications in peer-reviewed journals etc. N.B. A copy of the final report and any published paper(s) or abstracts of papers read at conferences out of the research findings should be submitted to each of the following:- i] The College of Medicine Research and Ethics Committee (COMREC) College of Medicine Library The Health Sciences Research Committee (through the COMREC Secretariat) The University Research and Publication Committee (URPC) (through the COMREC Secretariat) Ethical Considerations - What ethical issues need to be addressed. - How are they going to be addressed. - This should include protection of human subjects [clients rights] [Declaration of Helsinki - 1964]. (Annex 1) 8 j] - If animals will be used there is need to consider the International Guiding Principles for Biomedical Research Involving Animals [WHO, 1985]. (Annex 2) - If using human tissues or other biological materials, refer to [Guidelines for the Opportunistic Procurement and Use of Human Tissue and other Biological Materials in Research, WHO 1991]. (Annex 3) Possible Constraints: - k] Any envisaged problems in undertaking the study. How these will be addressed, by whom and when. Requirements: Details should be provided on what the research project will require. e.g. - personnel - and their individual roles - training (of whom, why, when, where, by who) - paper - for the questionnaires, reports, etc. - transport - what form and for what. - reagents - which/how much of each and for what. - drugs - which, how much of each, for what, their source(s). - space - how that will be obtained, where, when. l] Budgetary Estimates - Each line item should be quantified in monetary terms. - The investigator should indicate the amount to be asked for and what the institution(s) under which the research project will be conducted, will contribute. 9 For example:- Institutional Contribution Being asked for X Y (i) Personnel - Principal Investigator's salary - Each item should be quantified if possible. If it is not possible (e.g. premises or space), it should just be mentioned as an institutional contribution. However small the institutional contribution is, it should be indicated. - Sub-totals for each group should be indicated and then the grand total. - A 10% [of the total] administrative contribution to the College of Medicine, should be included - of this - 3% will go to the individuals' department(s) - 2% will go to the College Administration - 3% will go to the College Research Committee [to assist it in its various activities, e.g. secretarial, holding of research dissemination meetings, sponsorship of research projects by students, etc). - 2% will go to the College Library. If there are two or more donor agencies supporting the study, each organisation's contribution should be shown and possibly what it is meant to support; e.g. The WHO - supply of all the reagents total cost = US dollars 20,000.00; IDRC = salary of the Principal Investigator; COM = space, etc). m] Justification of the Budget The investigators must indicate how they arrived at the amount of money being asked for, and how it is going to be disbursed. e.g. n] 2 principal investigators - for overall supervision of the project, data analysis, report production and dissemination. 10% of their time for 24 months at US dollars 300.00 = 2 x 300 x 24 = US dollars 14,400.00. References 10 - The cited literature, it should be as current as possible and include locally available information. These should be in the internationally accepted format (e.g. E. Afr. Med. J. 1995; Vol. 71. 55-60). 4.0 SUBMISSION AND REVIEW OF THE PROPOSAL: i] The Principal investigator shall prepare (4) copies of the proposal together with $100 processing fee or its equivalent. ii] The copies shall reach the Secretary - COMREC 30 days before the date of the meeting. iii] A letter from the respective head[s] of department(s) indicating that the research has the blessing of the department(s) shall be sent to the Secretariat together with the proposal. Research affiliations like Wellcome Trust, John Hopkins Project etc need a supporting letter from Head of Department. iv] Every thing should go through the head of department including resubmissions. v] A copy of a brief CV of each of the investigators shall be sent to the Secretariat [1 copy of each]. (Except those which have been submitted within the same academic year). vi] Within two weeks receipt of the proposal will be acknowledged in writing. vii] Following the review the results together with comments from the Research Committee will be sent to the Principal investigator within two week. This response will include - how to proceed e.g. resubmission or response for specific issues. viii] Resubmission shall also be at least two weeks before the following meeting. ix] Research affiliations needs a supporting letter from the head of department. 11 5.0 OPERATING PROCEDURES The mission and policies of the COMREC are contained in the Research Policy document. In this document standard operating procedures are outlined. COMREC is among the many committees in the College of Medicine responsible to the Heads of Department Committee and Management. Its main functions' include the following: Develop and promote Research activities within the College of Medicine. Ethical review and approval of research protocols Scientific Review and approval all research protocols involving Investigators within COM. Support dissemination of research results from approved research studies in the country. Monitoring of conduct of all approved research studies. COMREC as properly constituted Ethics Committees and Scientific review body is subject to all international conventions and codes involving protection of human subjects participating in medical research. 5.1 MEETINGS COMREC will meet every month, on the last Wednesday of each month unless it is a public holiday. The year's calendar of meeting is released by January 31 of each year and made available to all departments in the college. At its first meeting in January the members will discuss; the annual report, annual expenses, the annual plan, annual budget estimate renewal of ongoing studies The last review meeting is to be held no later than the second week after the dissemination conference. If the quorum cannot be achieved the meeting must be rescheduled to following Wednesday. If the Chairman is not present the Vice Chairman will Chair the meeting. If both are not present members will elect an acting chairman to chair the meeting. COMREC shall co-opt external reviewers on specific areas from college. 5.2 RESEARCH PROTOCOLS 12 Submission The submission must be accompanied by the approved amount of $100 processing fee and the appropriate number of complete copies. (4) The format of the protocol must comply with guidelines (see guideline). COMREC will consider review of a protocol in different format upon a formal request by investigators in writing (i.e. Sponsor specification, multi-center clinical trials, Students dissertation) Application documents must be received in COMREC's office by the close of business day of the indicated deadline for submission 30 days before the meeting. All applications received on time will be acknowledged indicating date received and date to be reviewed within two weeks. The complete submission must include original protocol, consent forms (English and Chichewa), investigators CV’s, forms/questionnaires both English and Chichewa. o submissions must have a supporting letter from the host department. o Covering letter from the Principal Investigator. o Where direct clinical care of patients by the investigator is involved a copy of registration from Medical Council must be included. o Where other local institutions are involved in the research a letter of collaboration or permission must included. The secretariat will make copies and distribute to all members at least 14 days before the meeting. The package will include the agenda, minutes of previous meeting, and protocols. Apologise must be communicated to the secretary 3 days before the meeting. 5.3 REVIEW OF PROPOSALS If the application is missing relevant documents the secretariat will inform the Principal Investigator within one week. Members review all protocols on the agenda prior to the meeting. All questions and queries by members must be written. The COMREC may decide to limit the number of protocols to be reviewed per session. 13 Members will discuss each protocol according to the guidelines (ethics/ science/relevance) etc. Inclusion on of the protocols on the agenda will be done on a first come first serve basis. Clarifications requiring the investigators response will be in written form only. To facilitate review process we shall introduce the practice of having primary and secondary reviewers for selected proposals and resubmissions. Primary reviewers for specific areas could be co-opted however they do not have powers to vote. They would be available only for open sessions of the meeting and not the closed sessions of the meeting which includes voting. 5.4. DISCUSSION The primary and secondary review will present a brief summary (guidelines) of each proposal. The discussions will be open to all members. All queries or questions during discussion must be written. Based on the discussion the committee will make a decision for approval or rejection. The primary/secondary review must submit their written comments to the secretary. 5.5. APPROVAL All queries and questions raised during the discussion of a protocol will be recorded in the minutes by the secretary. Options Consensus: The decision on approval will not depend consensus but on majority vote however dissenting voice will be minuted. Majority Vote: At the end of the discussion each member will be requested to give their comment and their decision to approve on NOT to approve. The decision will be made through the majority vote. 5.6 CONFLICT OF INTEREST At the beginning of the Any COMREC meeting, the Chairman will ask members to declare if they have conflict of interest and if there are they will be requested to step out of the room at the time of voting (Member is: is PI or Co-PI, member from the same department, any relationship likely to compromise objective judgement) 5.7 EXPIDITED APPROVAL: 14 During the review the committee will decide to assign specific protocols for expedited review process. An expedited approval refers to approval of a protocol in such special circumstances: After a full committee review recommends and appoints selected members to review the response to the queries and comments by the Principal Investigator. If in the judgment of the appointed members an approval be granted, the appointed members will recommend for approval in writing to the committee. The secretary will issue a letter of approval as soon as a recommendation is 'received from the appointed members in writing. The secretary will report of the decision to the full review at the following meeting for ratification by the full committee 6.0 GENERAL COMMUNICATION ON APPROVED AND UNAPPROVED RESEARCH PROPOSALS All communication from the COMREC will be addressed through the head of department to the Principal investigator through the head of department. In cases where the PI is in another country the communication will be addressed to the local Co-Investigator. This is to ensure that head of departments are responsible in making sure that correction of the research fee is being enforced. COMREC will acknowledge receipt of protocol within two weeks working days informing investigators of any problems with submission or date of review. COMREC will communicate with investigators through the Secretary in writing about its decision within two week of the review. The letter must be signed by the Research Coordinator or Chairman or an approved COMREC designee, and a copy ought to be sent to the Registrar, Finance officer, Head of Department, Post graduate dean and the Principal Investigator. The Approval letter must state the date of review or approval. The letter must also indicate the title, COMREC ref number duration of approval. If a protocol is not approved the letter to the investigator will clearly state all the reasons for the rejection. All communications by investigators must be directed to the secretary. Failure to do so may result in significant delays. 15 The COMREC will not take responsibility of erroneous information on review of protocol obtained through other than the secretary in writing. Two copies of the approved protocol will be appropriately stamped. One copy will be maintained in COMREC office and the other copy returned to the investigators. 6.1 RESUBMISSIONS A protocol may be resubmitted for review under the following conditions: A previous review rejected the protocol with comments or concerns A previous approved protocol but implementation did not start until expiry of the approval. Up to 2 resubmissions will be permitted No processing fee is required on the first resubmission. 6.2 MONITORING All research studies approved by COMREC must adhere with ICH guidelines for human subjects protection The COMREC is responsible for ensuring that approved research studies are implemented in accordance with ethical/scientific guidelines. COMREC will therefore monitor the conduct every one of its approved studies through: 1. The COMREC has established a Monitoring Subcommittee with the responsibility to ensure that research studies approved by COMREC are monitored. 2. Progress reports: Every approved research study will submit quarterly reports according to COMREC guidelines (see appendix for format) Data safety: All studies involving experimental medications or diagnostic product (registered or new products) must constitute a credible Data and Safety Monitoring Board. The COMREC may require that a DSMB include one appointee by the committee. The Principal Investigator is responsible for submitting a written DSMB report to the COMREC within 1 month of its scheduled meeting. If the DSMB is unable to meet, the investigator must inform the COMREC in writing within 2 weeks. 16 Adverse Experiences: Investigators conducting experimental studied will be required to report cases of adverse experiences considered to be related to the use of the experimental medical treatment or device to COMREC. Serious adverse events such as death of a participant must be report within 7 days of being identified unless otherwise specified in the approved protocol. Special Monitoring: The monitoring committee can at anytime conduct a special monitoring of any of its approved research studies. Monitoring may be conducted by an independent team as appointed by the subcommittee. Special monitoring on any particular study will be decided upon by COMREC and will involve the following: Visiting the study site Review study progress Review consent forms for participants Review charts of participants Interview with Principal Investigator interviews with study staff Review study procedures Review documentation of approved modifications. The Principal Investigator will be informed at least 4 weeks in advance of the monitoring visit. 7.0. COMREC MONITORING TOOL OF APPROVED RESEARCH STUDIES A. DOCUMENTATION Date Reviewed ____________________________________________________ Name of Principal Investigator ________________________________________ Names of co-investigators ____________________________________________ Proposal No. _____________________________ Title of study _______________________________________________________ _________________________________________________________________ _ 17 Copy of approved protocol including forms, questionnaires, consent forms and CV for investigators _____________________________________________________________ Approved amendments or subprotocol ___________________________________ Any correspondence with COMREC concerning the study ___________________ COMREC approval letter of the protocol__________________________________ Date started _______________________________ Numbers recruited __________________________ Participant file _____________________________ Interview with participant ______________________________________________ Consent form_______________________________________________________ Complete data/questions forms ________________________________________ _________________________________________________________________ _ Participants file – interview with participants, consent forms completed data questionnaire _________________________________________________________________ _ Likely date of completion ______________________________________________ Randomisation correctly carried out? ____________________________________ 18 Data collection and storage ____________________________________________ 10% administration fees_______________________________________________ Processing fees _____________________________________________________ Date completed _____________________________________________________ Comments of monitor B. MONITORING PROCEDURE 1. Meeting with Principal Investigator or Co-investigator and study staff. 2. Meeting, if applicable study coordinator. 3. If applicable, visit recruitment site, ward, clinic and meet with some study staff and participants. 4. Random check of patient study forms and consent forms. 5. If available manual of operation or written study procedures. 6. Type of specimens being collected, if applicable. 7. Test results of specimens collected if applicable. 8. If applicable specimens shipped outside the country. C. IMPLEMENTATION PROGRESS 1. Review Annual reports. Manuscripts, publication reports, presentation. 2. If applicable, annual review approval letters. 19 D. CAPACITY BUILDING 1. Training type, who is attending and how many 2. Type of Equipment GENERAL COMMUNICATION Members: Management Ministry of Health Other IRBs Sponsors Investigators Participants REVIEW GUIDELINES Format: refers to the presentationRelevant documents: Complete protocol, CVs of all investigators, data collection tools (forms, questionnaires), complete budget, Consent forms, safety information, letters from relevant authorities if applicable, advertising or study specific education materials 7.0. CHECK LIST OF INFORMED CONSENT PROCESS Informed consent shall include the following elements:1. Statement that the study involves research. 2. Explanation of the purposes of the research. 3. Expected duration of the subject's participation in the research. 4. Description of the procedures to be followed. 5. Identification of any procedures that are experimental. 6. Description any reasonably foreseeable risks or discomfort to the subject. 7. Description of any benefits to the subject or to others that may reasonably be expected from the research. 8. Disclosure of appropriate alternate procedures or courses of treatment, if any, 20 that might be advantageous to the subject. 9. Statement describing the extent, if any, to which confidentiality of records identifying the subjects will be maintained, and if applicable, a statement of the possibility that the food and drug administration may inspect the records. 10. For research involving more that minimal risk, an explanation as to whether any compensation is available if injury occurs, and if so, what they consist of, or where further information can be obtained. 11. Explanation of whom to contact for answers to pertinent questions about the research, research subject's rights, and whom to contact in the event of a research- related injury to the subject. 12. Statement that participation is voluntary, thatrefusa1 to participate involves no penalty or loss of benefits to which the subject is otherwise entitled, and that the subject may discontinue participation at any time without penalty or loss of benefits to which the subject is otherwise entitled. 13. Statement that significant new findings developed during the course of the research, which may relate to the subject's willingness to continue, will be provided to the subject. 14. The last sentence should explicitly read "I voluntary agree". 15. The consent form should be translated into the local language. BUDGET CONTRIBUTION Processing fee: The processing fees are intended to contribute to meeting the costs of reviewing of the protocol i.e. photocopying, meeting and communication. Submissions without the fee will not be reviewed. Ten percent budget contribution: Is a requirement by the college of Medicine. It is intended to contribute to the costs administrative costs of hosting a research study, space, utilities, staff time etc. Why charge 10% budget contribution 1. We need 10% for institutional capacity building, e.g. MMJ research support for students, research dissemination, managing of research office and buying 21 equipments for that office, paying allowance and accommodation for non College of Medicine COMREC members. 2. We charge 10% for COM institutional things which can not be budgeted for e.g. the use of College of Medicine building, the use of the name and also the value of processing and granting of approvals which costs time, money, papers and room. 3. We are in the situation where we are developing therefore we need support in order to achieve self sufficiency in lab and computer equipment so that eventually researchers may not need to import some equipment. 4. Because of this there is no exemption on 10%, but the COMREC has got the mandate to waiver when the need for exemption is properly justified. The students need to present a full budget of their proposals as part of their training. All proposals funded by locally and not foreign sources will pay 10% that can be waivered upon proper justification DISSEMINATION OF RESEARCH RESULTS Investigators will be required to disseminate their results through the journals both in international and local or through the dissemination conference organized by COMREC. Researchers are encouraged to use the local MMJ to disseminate their results. 8.0 RESPONSIBILITIES OF THE PRINCIPAL INVESTIGATOR The Principal Investigator is the individual with responsibility for the technical, administrative, and fiscal management of a project, including any applicable subcontracts. As a practical matter, it is often necessary and appropriate to rely on staff members for assistance in carrying out much of this responsibility. The Principal Investigator and/or staff must:1. Be knowledgeable, at the proposal stage, about appropriate agency and University guidelines and restrictions relative to the conduct of research, training, and service programs, and be willing to adhere to such guidelines and restrictions; 2. Conduct the work supported by the grant or contract in a timely and professional manner; 22 3. Comply with the specific terms and conditions of each award as stated in the contract or grant documents and with all administrative requirements, as set forth in various sponsoring agency and campus policy statements, concerning issues such as publication, intellectual property, equipment screening, proprietary data, consultants, human subjects, animal subjects, recombinant DNA, or regulated substances; 4. Assure that expenditures made prior to the receipt of a fully executed contract or grant award are incurred only after obtaining specific authorized approval, that expenditures do not exceed the total amount of funds awarded, and that specific budget category expenditure limits are adhered to; 5. Maintain budgetary control through the use of departmental bookkeeping and cost control systems and monthly reconciliation (e.g. detail general ledger and the distribution of payroll expense); 6. Certify that all costs charged to each contract or grant specifically benefit the project being charged by reviewing and approving certifications of effort expended by employees, staff employee time reports, payments of vendor invoices for goods and services, check requests (non payroll), travel expenses vouchers, requisitions to and acceptance of charges from campus service units, and similar charges to the project. If it becomes necessary to make after the fact adjustments in the knowledgeable academic official, must provide full justification and documentation of the costs being transferred; 7. Comply with the reporting requirements of each contract and grant which may include periodic progress reports, annual reports of project accomplishments, reports of inventions, reports of publications generated, reports of major items of equipment acquired, and financial reports; 8. Ensure that subcontractors are performing the work agreed upon in the scope of work, before authorizing any payment to the subcontractors. 9.0 REMINDER TO ALL RESEARCHERS 1. You are required to pay US $100.00 as a processing fee with your proposal. 2. Pay the 10% administration fee payable to College of Medicine Research Committee when the proposal is approved. 3. You should note that the follow-up committee will monitor the conduct of the 23 approved protocol and any deviation from the approved protocol may result in your study being stopped. 4. You will provide an interim report in the course of the study and end of study report. 5. Where the study project is longer than 12 months, you will be required to obtain an approval for continuation. 6. All investigators must be fully registered with the Medical Council of Malawi, and please send copies of registration to us. 24