Emanuel, E., et al.
The Lancet
Originally published 5 August 21
Here is an excerpt:
Principles governing the response to COVID-19
An ethical approach to COVID-19 vaccine production and distribution should satisfy four uncontroversial principles: optimising vaccine production, including development, testing, and manufacturing; fair distribution; sustainability; and accountability.
These four principles should be taken as a coherent whole, for all companies and applied globally. For instance, ensuring accountability should not undermine optimising production. There are multiple ways to balance these principles. Any decision to give greater weight to some principles rather than others is inherently controversial. Optimising production is obviously necessary to end vaccine scarcity. Fair distribution requires that no segment of the world's population should be unvaccinated because of inability to afford vaccination.5 Importantly, any practical approach should ensure sustainability and companies' continued engagement in addressing COVID-19 and their focus on future infectious diseases and health emergencies.
Additionally, all parties' obligations should be coordinated and mutually consistent. For instance, companies should not be obligated to provide host countries with additional booster shots at the expense of fulfilling bilateral contracts with countries in which there are surges.
Finally, any satisfactory approach should include mechanisms for assurance that all parties are honouring their obligations. This assurance enables countries, pharmaceutical companies, global organisations, and others to verify compliance with the chosen approach and protect ethically compliant stakeholders from being unfairly exploited by unethical behaviour of others.
