scholarly journals Multivalue ethical framework for fair global allocation of a COVID-19 vaccine

2020 ◽  
Vol 46 (8) ◽  
pp. 499-501 ◽  
Author(s):  
Yangzi Liu ◽  
Sanjana Salwi ◽  
Brian C Drolet
Keyword(s):  
Low Income ◽  
Vaccine Development ◽  
Ethical Framework ◽  
Low Income Countries ◽  
Ethical Considerations ◽  
Allocation Model ◽  
Public And Private ◽  
Successful Vaccine ◽  
Global Access ◽  
Pandemic Vaccine

The urgent drive for vaccine development in the midst of the current COVID-19 pandemic has prompted public and private organisations to invest heavily in research and development of a COVID-19 vaccine. Organisations globally have affirmed the commitment of fair global access, but the means by which a successful vaccine can be mass produced and equitably distributed remains notably unanswered. Barriers for low-income countries include the inability to afford vaccines as well as inadequate resources to vaccinate, barriers that are exacerbated during a pandemic. Fair distribution of a pandemic vaccine is unlikely without a solid ethical framework for allocation. This piece analyses four allocation paradigms: ability to develop or purchase; reciprocity; ability to implement; and distributive justice, and synthesises their ethical considerations to develop an allocation model to fit the COVID-19 pandemic.

scholarly journals Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries

2020 ◽  
Vol 128 (5) ◽  
pp. 057005 ◽  
Author(s):  
Michael Brauer ◽  
Jeff T. Zhao ◽  
Fiona B. Bennitt ◽  
Jeffrey D. Stanaway
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Global Access

scholarly journals Pharmacovigilance quality system for vaccine monitoring (COVID-19) using quality indicators: a scoping review

2021 ◽  
Author(s):  
Mayra M. Moura de Oliveira ◽  
Gabriela Arantes Wagner ◽  
Vera L. Gattás ◽  
Larissa de Souza Arruda ◽  
Monica Taminato
Keyword(s):  
Signal Detection ◽  
Active Surveillance ◽  
Scoping Review ◽  
Low Income ◽  
Scientific Evidence ◽  
World Health ◽  
Low Income Countries ◽  
Public And Private ◽  
Health Organization ◽  
Detection Of Signals

This scoping review responds to the appeal of the scientific community for collaboration between different entities for pharmacovigilance and active surveillance of coronavirus disease 2019 (COVID-19) vaccines. The objective is to identify, systematically evaluate, and synthesize the best scientific evidence available on the indicators used in pharmacovigilance systems. Our results demonstrate that approximately 50% of the 25 studies used in this review have been carried out in the past 5 years. Of these, only four used the pharmacovigilance indicators proposed by the World Health Organization (WHO). Eighty-seven pharmacovigilance indicators were identified, of which seven (8.0%) related to signal detection. While the WHO advocates signal detection as routine pharmacovigilance, in special situations – such as accelerated clinical studies where adverse events are not yet well known – other indicators related to signal detection appear to be good options for maintaining quality pharmacovigilance and active surveillance in the development of the COVID-19 vaccine. However, the less robust pharmacovigilance systems in low-income countries will necessitate greater involvement of health professionals from public and private sectors, pharmaceutical companies, academic institutions, and the general public, to ensure information security and detection of signals for the COVID-19 vaccine.

scholarly journals Professionally responsible advocacy for women and children first during the COVID-19 pandemic: guidance from World Association of Perinatal Medicine and International Academy of Perinatal Medicine

2020 ◽  
Vol 48 (9) ◽  
pp. 867-873
Author(s):  
Frank A. Chervenak ◽  
Laurence B. McCullough ◽  
Amos Grünebaum ◽  
Eran Bornstein ◽  
Cihat Sen ◽  
...  
Keyword(s):  
New York ◽  
Low Income ◽  
Ethical Framework ◽  
Low Income Countries ◽  
Ethical Challenges ◽  
Perinatal Medicine ◽  
World Association ◽  
Women And Children ◽  
Children First ◽  
International Academy

AbstractThe goal of perinatal medicine is to provide professionally responsible clinical management of the conditions and diagnoses of pregnant, fetal, and neonatal patients. The New York Declaration of the International Academy of Perinatal Medicine, “Women and children First – or Last?” was directed toward the ethical challenges of perinatal medicine in middle-income and low-income countries. The global COVID-19 pandemic presents common ethical challenges in all countries, independent of their national wealth. In this paper the World Association of Perinatal Medicine provides ethics-based guidance for professionally responsible advocacy for women and children first during the COVID-19 pandemic. We first present an ethical framework that explains ethical reasoning, clinically relevant ethical principles and professional virtues, and decision making with pregnant patients and parents. We then apply this ethical framework to evidence-based treatment and its improvement, planned home birth, ring-fencing obstetric services, attendance of spouse or partner at birth, and the responsible management of organizational resources. Perinatal physicians should focus on the mission of perinatal medicine to put women and children first and frame-shifting when necessary to put the lives and health of the population of patients served by a hospital first.

scholarly journals Climate Adaptation Finance in World Bank Economic Development Programs: The Challenges of Systemic Transformation via “Scaling Up”

2021 ◽  
Vol 13 (19) ◽  
pp. 10553
Author(s):  
Todd A. Eisenstadt ◽  
Ifeoluwa Olawole ◽  
Michael A. Toman
Keyword(s):  
Climate Change ◽  
World Bank ◽  
Low Income ◽  
Climate Adaptation ◽  
Climate Change Policy ◽  
Greenhouse Gas Mitigation ◽  
Low Income Countries ◽  
Public And Private ◽  
State Fragility ◽  
Recent Emergence

Worldwide only about four percent of the estimated $500 billion-plus in public and private climate finance in 2017 was destined for adaptation. However, institutions like the World Bank are positioning themselves for a transformation in adaptation finance, seeking to provide substantially more adaptation finance as distinct from financial support for greenhouse gas mitigation. This article explores the recent emergence of adaptation as a higher priority and how a longer-term time horizon is necessary if a transformation in climate change governance is to occur which places greater emphasis on sustainable development goals relating to improvement of circumstances of citizens in the most climate-vulnerable nations, mostly in the Global South. The article also considers the important debate in the climate change policy literature over the extent to which funds supporting adaptation are going to lower-income nations or people, as might be anticipated given the view that the poor are more vulnerable to the adverse impacts of climate change. Data linking World Bank project funding to climate change adaptation and mitigation, derived from a keyword-matching approach, show that from 2010 to 2018, the share of climate-change-related finance devoted to adaptation in World Bank projects increased considerably. The data indicate that adaptation funding tends to be directed more to more climate-vulnerable nations and those with greater state fragility, but not to low-income countries versus high-income countries. Implications are considered for how this change might be “scaled up” to achieve a transformational status.

scholarly journals Current Status of HIV-1 Vaccines

Vaccines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1026
Author(s):  
Anna Hargrave ◽  
Abu Salim Mustafa ◽  
Asma Hanif ◽  
Javed H. Tunio ◽  
Shumaila Nida M. Hanif
Keyword(s):  
Clinical Trial ◽  
Clinical Trials ◽  
Global Health ◽  
Low Income ◽  
Vaccine Development ◽  
Low Income Countries ◽  
Current Status ◽  
Health Challenge ◽  
Hiv 1 ◽  
Global Health Challenge

HIV-1 infection and its progression to AIDS remains a significant global health challenge, particularly for low-income countries. Developing a vaccine to prevent HIV-1 infections has proven to be immensely challenging with complex biological acquisition and infection, unforeseen clinical trial disappointments, and funding issues. This paper discusses important landmarks of progress in HIV-1 vaccine development, various vaccine strategies, and clinical trials.

scholarly journals A framework for Controlled Human Infection Model (CHIM) studies in Malawi: Report of a Wellcome Trust workshop on CHIM in Low Income Countries held in Blantyre, Malawi

2017 ◽  
Vol 2 ◽  
pp. 70 ◽  
Author(s):  
Stephen B Gordon ◽  
Jamie Rylance ◽  
Amy Luck ◽  
Kondwani Jambo ◽  
Daniela M Ferreira ◽  
...  
Keyword(s):  
Low Income ◽  
Vaccine Development ◽  
Clinical Laboratory ◽  
Human Infection ◽  
Low Income Countries ◽  
Infection Model ◽  
Proof Of Concept ◽  
Middle Income ◽  
Regulatory Issues ◽  
Middle Income Countries

Controlled human infection model (CHIM) studies have pivotal importance in vaccine development, being useful for proof of concept, pathogenesis, down-selection and immunogenicity studies.  To date, however, they have seldom been carried out in low and middle income countries (LMIC), which is where the greatest burden of vaccine preventable illness is found.  This workshop discussed the benefits and barriers to CHIM studies in Malawi.  Benefits include improved vaccine effectiveness and host country capacity development in clinical, laboratory and governance domains.  Barriers include acceptability, safety and regulatory issues. The report suggests a framework by which ethical, laboratory, scientific and governance issues may be addressed by investigators considering or planning CHIM in LMIC.

scholarly journals Erratum: Global Access to Handwashing: Implications for COVID-19 Control in Low-Income Countries

2020 ◽  
Vol 128 (6) ◽  
pp. 069001
Author(s):  
Michael Brauer ◽  
Jeff T. Zhao ◽  
Fiona B. Bennitt ◽  
Jeffrey D. Stanaway
Keyword(s):  
Low Income ◽  
Low Income Countries ◽  
Global Access

scholarly journals Overview of the Development, Impacts, and Challenges of Live-Attenuated Oral Rotavirus Vaccines

Vaccines ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 341 ◽  
Author(s):  
Olufemi Samuel Folorunso ◽  
Olihile M. Sebolai
Keyword(s):  
Low Income ◽  
Vaccine Development ◽  
Cost Effective ◽  
Low Income Countries ◽  
Effective Vaccine ◽  
Middle Income ◽  
Middle Income Countries ◽  
Rotavirus Vaccines ◽  
The Impact ◽  
Infants And Young Children

Safety, efficacy, and cost-effectiveness are paramount to vaccine development. Following the isolation of rotavirus particles in 1969 and its evidence as an aetiology of severe dehydrating diarrhoea in infants and young children worldwide, the quest to find not only an acceptable and reliable but cost-effective vaccine has continued until now. Four live-attenuated oral rotavirus vaccines (LAORoVs) (Rotarix®, RotaTeq®, Rotavac®, and RotaSIIL®) have been developed and licensed to be used against all forms of rotavirus-associated infection. The efficacy of these vaccines is more obvious in the high-income countries (HIC) compared with the low- to middle-income countries (LMICs); however, the impact is far exceeding in the low-income countries (LICs). Despite the rotavirus vaccine efficacy and effectiveness, more than 90 countries (mostly Asia, America, and Europe) are yet to implement any of these vaccines. Implementation of these vaccines has continued to suffer a setback in these countries due to the vaccine cost, policy, discharging of strategic preventive measures, and infrastructures. This review reappraises the impacts and effectiveness of the current live-attenuated oral rotavirus vaccines from many representative countries of the globe. It examines the problems associated with the low efficacy of these vaccines and the way forward. Lastly, forefront efforts put forward to develop initial procedures for oral rotavirus vaccines were examined and re-connected to today vaccines.

scholarly journals Participation of psychiatric nurses in public and private mental healthcare in Kenya

2015 ◽  
Vol 12 (01) ◽  
pp. 19-21 ◽  
Author(s):  
Victoria Pattison de Menil ◽  
Martin Knapp
Keyword(s):  
Mental Health ◽  
Low Income ◽  
Mental Healthcare ◽  
Psychiatric Nursing ◽  
Psychiatric Nurses ◽  
Low Income Countries ◽  
Public And Private ◽  
Mental Health Patients ◽  
Salaried Employment ◽  
The Brain

We studied the rate of participation of psychiatric nurses in mental healthcare in Kenya. A simple questionnaire was delivered to 50 nurses attending a mental health meeting of the National Nursing Alliance of Kenya in April 2012. Of the 40 nurses with psychiatric nursing qualifications, 19 worked specifically as psychiatric nurses; among those employed as general nurses, half their case-loads were mental health patients. Ten per cent of psychiatric nurses had run a private clinic (75% of them general clinics) and 15% were doing private locum work alongside salaried employment. Kenya would need to increase the number of psychiatric nurses 20-fold in order to achieve an internationally recommended ratio (for low-income countries) of 12 psychiatric nurses per 100 000. It appears psychiatric nurses are migrating internally to nursing positions in other areas of healthcare, aggravating the ‘brain drain’ in mental health.

scholarly journals Cell, Time and Knowledge: Some Conjectures

2021 ◽  
Vol 2 (5) ◽  
pp. 408-411
Author(s):  
Diosey Ramon Lugo-Morin
Keyword(s):  
Low Income ◽  
Vaccine Development ◽  
Low Income Countries ◽  
Poor Countries ◽  
Global Institutions ◽  
Health Measures ◽  
The World ◽  
The Impact ◽  
Single Path ◽  
Over Time

The impact that the COVID-19 pandemic has had on global institutions and populations has been unprecedented. The health measures (e.g., confinement and social distancing) recommended by WHO and adopted by most nations in the world have not contained the spread of COVID-19. Vaccine development is expected to be a decisive element in controlling the pandemic, however, poor countries do not have immediate access to developed vaccines, which means that the COVID-19 pandemic will be present for some time among low-income countries. Against this daunting backdrop, it is necessary to explore more universal and inclusive ways of combating the COVID-19 pandemic and all future pandemics. Three conjectures are proposed that lead to a single path, unlocking the knowledge that cells have been able to accumulate over time. Although it may seem impossible in practice, the theory shows that knowledge exists to reach the frontiers of DNA.

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