The agreement was developed by a collaboration of eye banking organisations, led by the Global Alliance of Eye Bank Associations (GAEBA) – whose headquarters are based in Melbourne. It outlines the ethical use of donated human tissue for ocular transplantation, research, and future technologies. The agreement (known as ‘the Barcelona Principles’) was unveiled on Thursday 14 June 2018 at an event in Barcelona, Spain, hosted by Centro de Barraquer Ophthalmology Centre and Barcelona Tissue Bank.

Dr Graeme Pollock OAM heads the Lions Eye Donation Service at the Centre for Eye Research Australia (CERA) – and the GAEBA. “The Barcelona Principles evolved due to the need to improve tissue access to millions of waiting recipients, without compromising what are universal ethical principles and our own professional custodian responsibilities to the donor, recipient and the extended community.”

Dr Pollock and his colleagues at the Eye Bank Association of Australia and New Zealand developed the world’s first regional bioethical framework on eye banking in 2015, based on a recommendation from the World Health Organization and others. This framework was developed specifically for the Australian eye banking community, however the need for a similar global framework was clear.

“We are fortunate that in Australia, we don’t have a shortage of eye tissue and in most cases, anyone who needs a corneal transplant will receive one within a matter of weeks,” explained Dr Pollock. “Unfortunately, many lower-resourced countries do not have the same access to donor eye tissue, creating issues around equity and the risk of commercial trade in human tissues.”

It is not only developing countries that are grappling with the ethical issues surrounding donation, transplant and research using human tissue. “The global community is concerned about the emergence and development of a ‘market mentality’ around donations in some quarters. The Barcelona Principles include a clear statement – that it is our collective responsibility to protect and retain stewardship of altruistic donations as a public resource for the shared benefit of all,” says Dr Pollock.

About the Barcelona Principles

The agreement’s nine key strategies include:
1. Respect the autonomy of the donor and their next-of-kin in the consent process.
2. Protect the integrity of the altruistic and voluntary donation and its utility as a public resource for the shared benefit of all.
3. Support sight restoration and ocular health for recipients
4. Promote fair, equitable and transparent allocation mechanisms
5. Uphold the integrity of the custodian’s profession in all jurisdictions
6. Develop high-quality services that promote ethical Cell, Tissue and Organ (CTO) management, traceability, and utility
7. Develop local/national self-sufficient services
8. Recognise and address the potential ethical, legal and clinical implications of cross-border activities
9. Ensure ethical practice and governance of research (non-therapeutic) requiring cells, tissue and/or organs.

Note: The Barcelona Principles Adhere to the World Health Organization’s Guiding Principles on Human Cell, Tissue and Organ Transplantation.