Canada has no accreditation or inspection system for research ethics boards for clinical drug trials, and no oversight mechanism for the way that they undertake reviews.

The absence of any standards and regulations is becoming increasingly problematic. At least 70 per cent of clinical trials are now being done in the community, outside of health-care institutions and their in-house REBs.

In response to the movement of trials into the community where they aren’t covered by institutional REBs, it’s reasonable to assume that the number of for-profit REBs has grown, although there are no definite estimates of their number. Drug companies pay these for-profit REBs a fee to review their trials.