Pacific Island Countries (PICs) are increasingly engaged in international health research, both regionally and internationally. However, the capacity to provide effective ethical oversight through national Ethics Review Committees (ERCs) varies widely across the region. While some countries have established ERCs and supporting governance mechanisms, many others are in early or developing stages, facing challenges such as limited institutional capacity, lack of trained committee members, under-resourced secretariats, and the absence of clear national policies and standard operating procedures. These disparities in research ethics governance create regional inequities, increase vulnerability to externally driven research agendas, and limit countries’ ability to safeguard the rights, interests, and well-being of research participants and communities. Strengthening research ethics capacity in the Pacific is critical to ensuring that health research is conducted in a manner that respects local contexts, upholds international ethical standards, and delivers meaningful benefits to local populations. In May 2025, a Member State workshop on Strengthening research ethics governance in Pacific island countries, convened by WHO in collaboration with the Pacific Academy of Sciences and the Pacific Community, brought together representatives from 13 PICs, experts and key stakeholders. Participants highlighted the urgent need for a comprehensive, context-sensitive mapping of ERC capacity across the 21 countries and areas in the South Pacific, as well as the importance of gathering qualitative insights to understand the nuanced governance, technical, and operational challenges facing countries at different stages of system development. This activity responds directly to those recommendations, combining a desktop review of all PICs with targeted qualitative interviews in three representative countries, capturing the diversity of governance maturity and geographic subregions (Melanesia, Micronesia, Polynesia). The results will guide future national and regional capacity-strengthening initiatives, including tailored technical support, training, and the development of regional frameworks and guidelines.