Ethical approval in developing countries is not optional

When conducting health and medical research it is not only important to do the research ethically, but also to apply for prior ethical approval from the relevant authorities. The latter requirement is true for developed countries as well as developing countries. We argue that simply applying for research ethics approval from an institutional review board at a university based in a developed country is not enough to start a health research project in a developing country. The paper also suggests a number of reasons why researchers may fail to seek local research ethics permission in developing countries. We use a recent paper reporting research conducted in Nepal and published in an international journal as a case study to highlight the importance of being sensitive to local requirements regarding applying for and registering health and medical research