BACKGROUND: In the pandemic time, many low- and middle-income countries are experiencing restricted access to COVID-19 vaccines. An access to imported vaccines or ways to produce them locally becomes the principal source of hope. But developing a strategy for success in obtaining and allocating vaccines is not easy task. The governments in those countries have faced difficult decision whether to accept or reject offers of vaccine diplomacy, weighing price and availability of COVID-19 vaccines against concerns over their efficacy and safety. Our aim was to analyze public opinion regarding the governmental strategies to obtain COVID-19 vaccines in three Central Asian countries, focusing particularly on possible ethical issues. METHODS: We searched opinions expressed either in Russian or in the respective national languages. We provided data of the debate within three countries, drawn from social media postings and other sources. The opinion data was not restricted by source and time. This allowed to collect a wide range of possible opinions that could be expressed regarding COVID-19 vaccine supply and public's participation in vaccine trials. We recognized ethical issues and possible questions concerning different ethical frameworks. We also considered additional information or scientific data, in the process of reasoning. RESULTS: As a result, public views on their respective government policies on COVID-19 vaccine supply ranged from strongly negative to slightly positive. We extracted most important issues from public debates, for our analysis. The first issue involved trade-offs between quantity, speed, price, freedom, efficacy and safety in the vaccines. The second set of issues arouse in connection with the request to site a randomized trial in one of countries (Uzbekistan). After considering additional evidences, we weighed individual with public risks and benefits to make specffic judgements concerning every issue. CONCLUSIONS: We believe that our analysis would be a helpful example of solving ethical ...
BACKGROUND: In the pandemic time, many low- and middle-income countries are experiencing restricted access to COVID-19 vaccines. Access to imported vaccines or ways to produce them locally became the principal source of hope for these countries. But developing a strategy for success in obtaining and allocating vaccines was not easy task. The governments in those countries have faced the difficult decision whether to accept or reject offers of vaccine diplomacy, weighing the price and availability of COVID-19 vaccines against the concerns over their efficacy and safety. We aimed to analyze public opinion regarding the governmental strategies to obtain COVID-19 vaccines in three Central Asian countries, focusing particularly on possible ethical issues. METHODS: We searched for opinions expressed either in Russian or in the respective national languages. We provided data on the debate within three countries, drawn from social media postings and other sources. The opinion data was not restricted by source and time. This allowed collecting a wide range of possible opinions that could be expressed regarding COVID-19 vaccine supply and human participation in the vaccine trial. We recognized ethical issues and possible questions concerning different ethical frameworks. We also considered scientific data and other information, in the process of reasoning. RESULTS: As a result, public views on their respective government policies on COVID-19 vaccine supply ranged from strongly negative to slightly positive. We extracted the most important issues from public debates, for our analysis. The first issue involved trade-offs between quantity, speed, price, freedom, efficacy, and safety in the vaccines. The second set of issues arose in connection with the request to site a randomized trial in one of the countries (Uzbekistan). After considering additional evidence, we weighed individual and public risks against the benefits to make specific judgements concerning every issue. CONCLUSIONS: We believe that our analysis would be a ...
BACKGROUND: The burden of ischemic heart disease (IHD) is high. There is limited information on the burden of IHD in identified high risk areas like Central Asia (CA) which is comprised of Armenia, Azerbaijan, Georgia, Kazakhstan, Kyrgyzstan, Turkmenistan, Mongolia, Uzbekistan and Tajikistan. This study addresses the burden of IHD in CA at the regional and country levels. METHODS: Using data from the latest iteration of the Global Burden of Disease Study (GBD), this study provides age-adjusted mortality, prevalence, and Disability Adjusted Life Years (DALYs) of IHD by sex in the CA region, and national levels for countries in this region from 1990 to 2017. RESULTS: The CA region has a higher IHD burden than the rest of the world over the studied period. Amongst the countries within this region, age-standardized mortality and DALY rates in Uzbekistan are the highest not only in CA but worldwide, while Armenia consistently has the lowest IHD burden in CA. Unhealthy diet, high systolic blood pressure and LDL-cholesterol are the risk factors with the highest attributable IHD DALYs. CONCLUSION: Increasing burden of IHD over time in CA can be partially explained by the economic crisis in the 1990s. There is considerable variation in IHD DALY rates among countries in the CA region. The reasons for such differences are likely multifactorial such as differences in risk factors distribution, health care effectiveness, political, social and economic factors.
Background The rapid spread of COVID-19 renewed the focus on how health systems across the globe are financed, especially during public health emergencies. Development assistance is an important source of health financing in many low-income countries, yet little is known about how much of this funding was disbursed for COVID-19. We aimed to put development assistance for health for COVID-19 in the context of broader trends in global health financing, and to estimate total health spending from 1995 to 2050 and development assistance for COVID-19 in 2020.