The Barcelona Principles: An Agreement on the Use of Human Donated Tissue for Ocular Transplantation, Research, and Future Technologies©.

PREAMBLE: The Barcelona Principles: An Agreement on the use of human donated tissue for ocular transplantation, research, and future technologies (Agreement) is a global bioethical framework (GBF), developed by the eye bank and ophthalmic communities, to inform on the management of altruistic and voluntary donations; their subsequent utility within ophthalmology and research; their retention as a public resource for the shared benefit of all; and their accessibility by waiting recipients.The Agreement is the result of global sector engagement over a 12-month period-led by the Global Alliance of Eye Bank Associations. Its aim is to provide leadership, guidance and recommendations that inform and support sound policy, and sector wide strategic planning and implementation at local, national, regional, and international levels.Inspired by the Declaration of Istanbul on Organ Trafficking and Transplant Tourism, this Agreement affirms the importance of the missions of the United Nations Sustainable Development Goals (Transforming our World: the 2030 Agenda for Sustainable Development); Universal Declaration of Human Rights; World Medical Association's Declaration of Helsinki-Ethical Principles for Medical Research Involving Human Subjects, and their Statement on Organ and Tissue Donation; The Council for International Organizations of Medical Science's International Ethical Guidelines for Health-related Research Involving Humans 2016; and accords with the World Health Organization's 2010 Guiding principles on human cell, tissue, and organ transplantation-WHA63.22.With millions waiting for a corneal transplant at any given moment-and the majority residing in lower resource locations, a significant component of this Agreement promotes equitable allocation systems for waiting recipients, and the development of self-sufficient services. It recognises important instruments, such as the International Council of Ophthalmology 2017 Position Statement: Donation, Processing, Allocation, Advocacy, and Legislation Supporting Human Corneal Tissue for Ocular Transplant; the World Health Organization's Universal Eye Health-Global Action Plan 2014 to 2019, and the mission of the International Agency for the Prevention of Blindness.Future biological innovations/technologies are also addressed within the Agreement, promoting research and development that seek to improve donation utility, reduce burden, and improve therapeutic options for recipients, without ethical compromise.The Agreement has been developed by the Global Alliance of Eye Bank Associations in conjunction with the International Council of Ophthalmology, International Agency for the Prevention of Blindness, The Corneal Society, Asian Eye Bank Association, European Eye Bank Association, Eye Bank Association of America, Eye Bank Association of Australia and New Zealand, Eye Bank Association of India, the Pan American Association of Eye Banks, and in countries and regions without eye bank organizations, their ophthalmic societies-such as the Ophthalmological Society of the West Indies, and the Pacific Eye Care Society.Finally, we endorse the current international consensus that prohibits trafficking and transplant tourism.