Bcnet MEMBER APPLICATION FORM

BCNet MEMBER APPLICATION FORM

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Applicant Information
Name of Applying Institution: Click here to enter text.
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Current address: Click here to enter text.
City: Click here to enter text. / State: Click here to enter text. / Postal Code: Click here to enter text.
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Name of Director/Head of Institution
Last Name / First Name / Title
Contact information Director/Head of institution
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FAX / Area code / Number / Extension / Email
Institutions Primary Contact Person for BCNet
Last Name / First Name / Title
Contact Person’s information (Primary)
Phone / Area code / Number / Extension / Mobile / Area code / Number
FAX / Area code / Number / Extension / Email
Institutions Secondary Contact Person for BCNet
Last Name / First Name / Title
Contact Person’s information (Secondary)
Phone / Area code / Number / Extension / Mobile / Area code / Number
FAX / Area code / Number / Extension / Email
Biobank Activities
Disease-based biobank:
Population-based biobank:
Environmental Specimen Bank:
Academic/Research Institution:
Date of start of biobank:
Types of biospecimen: Click here to enter text.
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Method of storage:
Fridge
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Source of your financial support:
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Are you aware of other biobank activities in your country? ☐
If yes, give details
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If yes, do you collaborate with some of them?
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Do you participate in any Quality Assurance programs? Yes No
If not, are you willing to do so? Yes No
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Do you give permission for your institute/organization logo to be used on the BCNet Website and/or other BCNet material? Yes No
Please note that, the use of BCNet members’/partners’ logos by other members/partners requires written permission from the relevant institutions.
LEGAL INFORMATION ON BIOBANK
Public Entity: ☐ Private entity: ☐
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ACTIVITY OF INSTITUTION
Non-profit ☐ For profit ☐
Does your institution/organization have a policy not to accept any financial or other support from the tobacco industry or its subsidiaries in any of its activities?
Yes ☐ No ☐
If the answer is ”No”’, is the institution/organization currently in receipt of such support?
Yes ☐ No ☐
To the best of your knowledge, does the institution/organization engage in any activities that may be potentially in conflict with the goals and mission of IARC/WHO?
Yes ☐ (if “Yes”, please provide details No ☐
Under “Comments” below)
CommentS
Name of applicant (Director/Head) / Signature of applicant (Director/Head) / Date
Name of Primary Contact person / Signature of Primary Contact person / Date

Annex 1

Low and Middle Income Countries Biobank and Cohort Building Network (BCNet)

1.  Definition

The Low and Middle Income Countries Biobank and Cohort Building Network (BCNet) is a consortium of Biobank institutions from Low and Middle Income Countries (LMIC) that have decided to join their efforts to ensure the excellence of collection, annotation, storage and sharing of biological resources for scientific research and improving human health.

2.  Background

The BCNet initiative arose from the realization that despite improvements in developed countries, population cohorts and biobanking facilities are either underdeveloped or non-existent in LMIC. Thus, public health professionals and decision-makers lack the scientific evidence about disease causes, particularly cancer, and control measures that are needed to set up targeted and cost-effective action plans within their health-science systems. In addition, many LMIC have yet to develop standard guidelines and protocols regulating the sharing and use of biological samples and data for scientific research.

In this context, IARC set up BCNet as an opportunity for LMIC to work together in a coordinated and effective manner and jointly address the shortfalls in biobanking infrastructure and other shared challenges, including ethical, legal and social issues (ELSIs). In addition, the network will facilitate the sharing of resources (e.g. expertise, protocols) and the development of joint projects, strengthening the competitiveness of the LMIC biobanks in applying for international funding.

The first BCNet International Working Group meeting was held at IARC, Lyon, on 25th and 26th September 2013 and was attended by 23 participants representing 14 LMIC in all the WHO regions (Asia-Pacific, Africa, Europe, Middle East & Pan-American), nine international organizations and by IARC staff members. The participants discussed various topics including the feasibility and need for an LMIC network, short-term and long-term goals, the role of IARC and other potential partners, and training and funding opportunities. All participants endorsed the implementation of BCNet and recognized its instrumental role in improving significantly biobanking and biobank management in LMIC.

BCNet is initially formed by 16 representative countries from all the WHO regions. BCNet is not exclusive and is open to other LMIC biobank institutions that are willing and able to work together for common interest and agree with the principles and practice endorsed by the Network.

IARC is well placed to provide guidelines and protocols on the collection and management of high quality samples and data as well as support in education and training programs. As an independent organization, IARC will play a key role in providing guidelines for sample and data sharing which is important for scientific collaboration within and outside BCNet member countries.

3.  Objectives

·  Providing high standard protocols and guidelines for biological sample collection, storage, management and distribution in LMIC

·  Promoting and facilitating collaboration among BCNet members to combine their resources for common interests

·  Facilitating the distribution of high quality samples for scientific research

·  Searching for opportunities for training and funding

·  Developing capacity-building in LMIC biobanks

·  Promoting biobanking to the community and to decision-makers (governments)

·  Organising meetings relevant to BCNet activities

4.  Membership

·  Membership to BCNet is open to all LMIC biobank institutions committed to endorsing BCNet principles and regulations and contributing to reach its objectives

·  A biobank institution is a structure involved in the collection, storage, use and sharing of biological samples for scientific research to improve human

·  Except for the BCNet founder members, membership is based upon application and acceptance by the BCNet Advisory Committee

·  Members must participate in external Quality Assurance programmes

·  Accepted members will receive a membership certificate with BCNet logo

5.  The BCNet member

·  A BCNet member is the representative, or his/her nominated alternate, of a biobank institution based in LMIC

·  Members, or their alternate, are entitled to one vote on BCNet matters submitted to a vote at the general assembly

·  Although only one representative, or his nominated alternate, is entitled to attend the General Assembly, institutions may nominate up to four associate members who will be entitled to receive correspondence from and about BCNet, and participate in Working Groups when appropriate.

·  The BCNet member is committed to collaborate with other BCNet members with regard to his resources and BCNet objectives and to provide expertise for common interest

·  The BCNet member agrees to contribute to developing commonly agreed high standard protocols for sample collection, annotation, storage and sharing that fulfil the criteria for scientific research

·  The BCNet member agrees, if requested and appropriate, to host BCNet members and collaborators for training and sharing technology

·  Benefits of being a BCNet member include: access to high-standard international protocols, access to advice from leading experts in biobanking and medical research, invitation to BCNet meetings, exchange with BCNet members, training and help to identify funding opportunities, research projects

6.  Loss of membership of BCNet

Membership will be lost when the member does not comply with BCNet regulations and with consent of the BCNet general assembly. A warning letter giving three (3)-months’ notice will be sent by the Advisory Committee.

7.  General Assembly

BCNet general assembly includes IARC, members and partners and will meet at least once every two years alternatively in the location of a BCNet member that has the means to host the meeting. Assembly Members will receive an annual report on the activities of the BCNet from the Advisory Committee.

8.  Advisory Committee

The 14-member Advisory Committee was formed at the first BCNet International Working Group meeting held at IARC on 25th & 26th September.

9.  Meetings of Advisory Committee

The Advisory Committee is expected to hold at least one formal meeting annually, with follow-up through emails and telephone conference calls.

10.  BCNet Resources

The BCNet is entitled to coordinate applications from BCNet members for funding organization of meetings, workshops, training or research projects toward international funding agencies.

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