Addressing the persistent inequities in immunization coverage
In: Bulletin of the World Health Organization: the international journal of public health = Bulletin de l'Organisation Mondiale de la Santé, Band 98, Heft 2, S. 146-148
ISSN: 1564-0604
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In: Bulletin of the World Health Organization: the international journal of public health = Bulletin de l'Organisation Mondiale de la Santé, Band 98, Heft 2, S. 146-148
ISSN: 1564-0604
Once effective coronavirus disease 2019 (COVID-19) vaccines are developed, they will be scarce. This presents the question of how to distribute them fairly across countries. Vaccine allocation among countries raises complex and controversial issues involving public opinion, diplomacy, economics, public health, and other considerations. Nevertheless, many national leaders, international organizations, and vaccine producers recognize that one central factor in this decision-making is ethics (1, 2). Yet little progress has been made toward delineating what constitutes fair international distribution of vaccine. Many have endorsed ?equitable distribution of COVID-19?vaccine? without describing a framework or recommendations (3, 4). Two substantive proposals for the international allocation of a COVID-19 vaccine have been advanced, but are seriously flawed. We offer a more ethically defensible and practical proposal for the fair distribution of COVID-19 vaccine: the Fair Priority Model.The Fair Priority Model is primarily addressed to three groups. One is the COVAX facility?led by Gavi, the World Health Organization (WHO), and the Coalition for Epidemic Preparedness Innovations (CEPI)?which intends to purchase vaccines for fair distribution across countries (5). A second group is vaccine producers. Thankfully, many producers have publicly committed to a ?broad and equitable? international distribution of vaccine (2). The last group is national governments, some of whom have also publicly committed to a fair distribution (1).These groups need a clear framework for reconciling competing values, one that they and others will rightly accept as ethical and not just as an assertion of power. The Fair Priority Model specifies what a fair distribution of vaccines entails, giving content to their commitments. Moreover, acceptance of this common ethical framework will reduce duplication and waste, easing efforts at a fair distribution. That, in turn, will enhance producers' confidence that vaccines will be fairly allocated to benefit people, thereby motivating an increase in vaccine supply for international distribution. ; Fil: Emanuel, Ezekiel J. University of Pennsylvania; Estados Unidos ; Fil: Persad, Govind. University of Denver.; Estados Unidos ; Fil: Kern, Adam. University of Princeton; Estados Unidos ; Fil: Buchanan, Allen. University of Arizona; Estados Unidos ; Fil: Fabre, Cécile. All Souls College; Reino Unido ; Fil: Halliday, Daniel. University of Melbourne; Australia ; Fil: Heath, Joseph. University of Toronto; Canadá ; Fil: Herzog, Lisa. University of Groningen; Países Bajos ; Fil: Leland, R. J. University of Manitoba; Canadá ; Fil: Lemango, Ephrem T. No especifíca; ; Fil: Luna, Florencia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Facultad Latinoamericana de Ciencias Sociales; Argentina ; Fil: McCoy, Matthew S. University of Pennsylvania; Estados Unidos ; Fil: Norheim, Ole F. University of Bergen; Noruega ; Fil: Ottersen, Trygve. Norwegian Institute Of Public Health; Noruega ; Fil: Schaefer, G. Owen. Yong Loo Lin School Of Medicine; Singapur ; Fil: Tan, Kok-Chor. University of Pennsylvania; Estados Unidos ; Fil: Wellman, Christopher Heath. Washington University in St. Louis; Estados Unidos ; Fil: Wolff, Jonathan. University of Oxford; Reino Unido ; Fil: Richardson, Henry S. Kennedy Institute Of Ethics; Estados Unidos
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