Distribute vaccines in an ethical manner
The world has a moral obligation to make COVID jabs available at affordable prices to all
As the United States, the United Kingdom and the European Union have formally approved the PfizerBioNTech and Moderna vaccines for COVID-19, which are 95 percent and 94.1 percent effective respectively, and the UK has given the green light to the Oxford/AstraZeneca vaccines for emergency use, it has paved the way for mass vaccination in many Western countries.
Indeed, this is good news, but it has raised ethical questions on the fair allocation and distribution of the vaccines across the world and within countries.
Given the limited supply of the vaccines in the initial phase and its critical role in containing the novel coronavirus, which has infected more than 86 million people and claimed 1.87 million lives globally, how to distribute vaccines fairly and equitably has become an important ethical issue, and therefore, must be guided by ethical principles.
Due to the vaccines’ limited supply and huge demand, countries are scrambling to procure them.
If the international community does not set ethical rules for vaccination, wealthy and developed countries could end up hoarding astronomical doses of the vaccines while most of the low- and middle-income countries will struggle to inoculate their citizens.
To contain the pandemic and mitigate its destructive effects on the international community and the global economy, some ethical principles must be followed. To begin with, the vaccines must be considered global public goods needed to bring global society and the world economy back to normal.
The allocation of the vaccines should also be based on the ethics of utilitarian and equitable approach.
Of course, countries that enjoy advantages in vaccinating the population, thanks to their strong medical systems, should get the vaccines too. But more importantly, the vaccines should be equitably allocated to low-income countries, so that global disparities can be reduced.
Also, multinational pharmaceutical companies making the vaccines should more vigorously fulfill their corporate social responsibilities in allocating vaccines globally.
It is understandable that these companies would seek profits. But if they only pursue profit and supply vaccines based purely on economic considerations, they would be acting unethically and unfairly, because very high prices would put the vaccines beyond the reach of many developing countries.
Therefore, it is the moral obligation of “Big Pharma” to make the vaccines available at affordable prices to all countries, particularly the low- and middle-income countries.
Also, major countries should never use multinational pharmaceutical enterprises, through global vaccine distribution, as an instrument to spread their geopolitical influence.
More important, no country should resort to vaccine nationalism by restricting vaccine exports, because such acts are detrimental to the global fight against the virus, not to mention morally reprehensible. And fair and equitable vaccine allocation will help even low- and middle-income countries to obtain enough doses of the vaccines to inoculate their citizens. Distributing the vaccines ethically within countries is as important as ensuring their fair and equitable distribution globally. Policymakers and health officials grappling with ethical issues in the allocation of limited vaccine volume available in the initial phase must be guided by ethical principles.
The vaccines must be distributed in a way that maximizes public health and the socioeconomic well-being of all and minimizes mortality, mitigates health inequities and reduces health disparities.
Finally, the principle of promoting justice and transparency — as recommended by the Advisory Committee on Immunization Practices affiliated to the US Centers for Disease Control and Prevention — is also crucial for fair vaccination. So the vaccines should be distributed transparently and with respect for people, promoting mutual responsibility and solidarity.
In the initial phase, since health workers are at a high risk of infection and transmission, they should be the first to be vaccinated. This is important to ensure no dearth of such professionals to care for COVID-19 and other patients.
People with certain medical conditions or co-morbidities, regardless of their age, and senior citizens are also at increased risk.
Priority groups include professionals such as teachers, police and customs officers, airport staff and food service workers who maintain the functions of society and, due to the nature of their work, are at higher risk. Early vaccine access is therefore critical to maintain the essential services they provide.
Ethical principles must guide vaccine distribution both globally and within countries.
The development of effective vaccines has brought hope after a horrendous year of fear, pain and despair. Yet the distribution of the vaccines will be a test of morality and human wisdom, which can be gained from global collaboration coordinated by the World Health Organization.