Hi all, this has been a fascinating discussion. My brief comment is that even when local site-level CABs may not have been involved in protocol development, it is worth noting that much of the protocol is formulated at quite an abstract level, which leaves much room for site-level CABs to be impactful about how broad standards are implemented in a real setting.
I am not arguing against the need to get local review as far as possible, but merely observing that the broad formulations used in protocols often leave much room for impact of local actors in the local setting.
As has been mentioned here, local community actors need to know what inputs have preceded & how these were seriously reflected on.
