The document outlines collaborative efforts under the ACCESSAFRICA 2 project to support the adaptation of Uganda’s Joint Scientific and Ethical Review Guidelines in Ethiopia. Led by the Uganda National Council for Science and Technology (UNCST), the initiative engaged Jimma University and Ethiopian stakeholders to discuss integrating WHO-AVAREF-based joint review processes into Ethiopia’s clinical trial oversight. The guidelines aim to improve review quality, reduce approval timelines, and strengthen capacity through harmonized and collaborative ethical and regulatory assessments. Key discussions addressed differences between Ethiopian and Ugandan systems, stakeholder roles, and a roadmap for guideline development, validation, and rollout by June 2025. The document highlights ongoing efforts to foster cross-country regulatory alignment and enhance clinical trial governance in East Africa.