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"Worst-off countries should be prioritised in COVID-19 vaccine allocation"
In contrast to WHO´s and other experts´ advice, the worst-off countries should be extra prioritised when it comes to COVID-19 vaccine allocation, according to Professor Ole Frithjof Norheim at the University of Bergen.
Once effective COVID-19 vaccines are approved, they will be scarce. The World Health Organisation (WHO) and others have said that vaccines should be distributed fairly among countries, but no one has defined what fair distribution actually means.
“Fair allocation should aim to reduce premature deaths and social deprivations, with extra priority to the worst-off countries,” says Professor Ole Frithjof Norheim, at the Bergen Centre for Ethics and Priority Settings (BCEPS), University of Bergen.
This is in contrast to alternative models, discussed by the WHO and others, which either allocate a percentage of doses to each country or prioritise countries with high numbers of health personnel and people with a large number of risk factors.
“These models will clearly favour high-income countries, not the disadvantaged,” Norheim claims.
COVID-19 harms directly and indirectly
The professor has recently contributed to a paper in Science Magazine, proposing an ethical framework called The Fair Priority Model, for global COVID-19 vaccine allocation. The model is designed by a group of international researchers, ethicists and philosophers at Perelman School of Medicine, University of Pennsylvania, University of Bergen and others.
COVID-19 kills people and causes permanent organ damage, straining health care systems and raising mortality rates for common conditions.
The pandemic is also devastating the global economy causing unemployment, poverty and starvation.
“Economics and health interact. Worsening economic conditions harm health, and a worsening pandemic harms the economy”, Norheim explains.
Limiting harms, benefiting the disadvantaged
The authors of the Science-paper propose a model they deem to be the best embodiment of the ethical values of limiting harms, benefiting the disadvantaged, and recognizing equal concern when it comes to COVID-19 vaccine allocation.
The Fair Priority Model is new, but builds upon established models for fair allocation that the researchers have worked on for years. It contains ethical views and arguments about global justice and theories on fair distribution of scarce medical resources.
“By building on established principles for fair allocation, we adapted those to this very special situation that the coronavirus pandemic has created worldwide,” Norheim says.
According to Norheim the model gives the responsible parties a practical guide to fulfil their pledges to distribute vaccines fairly and equitably.
“The responsibility for implementing the model rests with countries, international organisations and vaccine producers,” says Ole Frithjof Norheim.
Emanuel, J Ezekiel et al, An ethical framework for global vaccine allocation, Science, September 2020
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