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2012, RePEc: Research Papers in Economics
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25 pages
1 file
Interventions that improve childhood health directly improve the quality of life and, in addition, have multiplier effects, producing sustained population and economic gains in poor countries. We suggest how contemporary global institutions shaping the development, pricing and distribution of vaccines and drugs may be modified to deliver large improvements in health. To support a justice argument for such modification, we show how the current global economic order may contribute to perpetuating poverty and poor health in less-developed countries.
Vaccine, 2003
The dawn of the 21st century ushered in spectacular advances in vaccine production technology. However, the benefits of these developments have been largely confined to the world's most affluent and least afflicted. Of the 14 million deaths that occur worldwide in children aged less than 5 years, over 95% of these occur in developing countries and at least 70% are caused by infections for which vaccines are already available in other countries. While impoverished countries do not have a right to be assisted with the provision of funds or vaccines by affluent developed countries, an initiative for the global eradication of a vaccine preventable disease, requires a global effort. Assisting developing countries to achieve such goals should be a high priority for wealthy nations, even if only to protect their own populations. With improved international travel, not only can newly emerging diseases spread across the globe, but pathogens eliminated from one population can be re-imported by travellers or immigrants. In contrast, the recent decline in acceptance of immunisation programmes in developed countries are secondary to strong anti-vaccine movements attributing unproven adverse reactions to vaccines, placing these life-saving vaccines into disrepute. A fertile ground for propagation of these ideologies is created by parents who in their lifetime may not have seen a child killed or maimed from bacterial meningitis or measles and therefore have little understanding of the risk-benefit of vaccination. The development and deployment of vaccines must be a global effort as are the treaties for global disarmament for weapons of mass destruction.
BMJ, 2021
Early in the pandemic, Pfizer announced an intention to profit from its covid-19 vaccine. 1 In the first three months of 2021, Pfizer's vaccine brought in $3.5bn (£2.5bn; €3bn) in revenue and hundreds of millions in profit. 2 Other companies are also making exceptional profits from covid-19. Moderna, which received public funding to develop its covid-19 vaccine, will earn several billion dollars from vaccine sales. 3 Even Astra Zeneca, with its acclaimed "non-profit" model, will receive billions in revenue and is free to raise the price once itconsiders the pandemic to be over. 4 5 But the rich world is refusing to share vaccines with poorer countries speedily or equitably. Whereas 60% of the population in the UK is fully vaccinated, in Uganda it is only 1%. 6 The 50 least wealthy nations, home to 20% of the world's population, have received just 2% of all vaccine doses. 8 The rich world should
Health affairs (Project Hope), 2018
With social policies increasingly directed toward enhancing equity through health programs, it is important that methods for estimating the health and economic benefits of these programs by subpopulation be developed, to assess both equity concerns and the programs' total impact. We estimated the differential health impact (measured as the number of deaths averted) and household economic impact (measured as the number of cases of medical impoverishment averted) of ten antigens and their corresponding vaccines across income quintiles for forty-one low- and middle-income countries. Our analysis indicated that benefits across these vaccines would accrue predominantly in the lowest income quintiles. Policy makers should be informed about the large health and economic distributional impact that vaccines could have, and they should view vaccination policies as potentially important channels for improving health equity. Our results provide insight into the distribution of vaccine-preve...
Global Public Health
As vaccines for COVID-19 were first being approved for use, there were widespread calls for it to be assigned a 'global public good'. However, allocating the COVID-19 vaccine globally poses a novel challenge of redistribution, one that cannot be effectively undertaken using current mechanisms for the dispensation of aid. An examination of the origins and implicit logic of global public goods theory shows that it would not be effective as a framework in this context. I argue that while it is a useful rhetorical tool to underscore the need for global access, it fails to account for concerns arising out of structural inequities between countries in the Global South and North. In addition to being illdefined, the phrase encodes a neoliberal logicone that prioritises the protection of private capital over democratic claims of redistribution and social justice. To ensure global access, our attention must be focussed instead on explicitly accounting for inequities, securing access for countries in the Global South and addressing the norm-setting powers of pharmaceutical companies.
Wellcome Open Research, 2021
COVID-19 vaccination of children has begun in various high-income countries with regulatory approval and general public support, but largely without careful ethical consideration. This trend is expected to extend to other COVID-19 vaccines and lower ages as clinical trials progress. This paper provides an ethical analysis of COVID-19 vaccination of healthy children. Specifically, we argue that it is currently unclear whether routine COVID-19 vaccination of healthy children is ethically justified in most contexts, given the minimal direct benefit that COVID-19 vaccination provides to children, the potential for rare risks to outweigh these benefits and undermine vaccine confidence, and substantial evidence that COVID-19 vaccination confers adequate protection to risk groups, such as older adults, without the need to vaccinate healthy children. We conclude that child COVID-19 vaccination in wealthy communities before adults in poor communities worldwide is ethically unacceptable and consider how policy deliberations might evolve in light of future developments.
INQUIRY: The Journal of Health Care Organization, Provision, and Financing
The coronavirus disease 2019 (COVID-19) pandemic has caused huge losses and massive damage to socio-economic development around the globe, which might even potentially evolve into a humanitarian crisis as it continues to spread. In response to the further resulting public threats, collaborative research, rapid production, and efficient and just distribution of vaccines have been given a top priority. However, there exists a serious inefficiency and injustice in the distribution of COVID-19 vaccines among different countries, regions, and social classes currently. Richer countries and regions have acquired far more vaccines than needed, further exacerbating the severity of the epidemic in underdeveloped and marginalized countries and regions. From a perspective of critical global justice, we explore the causes of the inefficient and unjust global distribution of vaccines and comprehensively examine the shortcomings of the current distribution frameworks, such as COVID-19 Vaccines Glo...
Wellcome Open Research
COVID-19 vaccination of children over 12 has begun in various high-income countries with regulatory approval and general public support, but largely without careful ethical consideration. This trend is expected to extend to other COVID-19 vaccines and lower ages as clinical trials progress. This paper provides an ethical analysis of COVID-19 vaccination of healthy children. Specifically, we argue that it is currently unclear whether routine COVID-19 vaccination of healthy children is ethically justified in most contexts, given the minimal direct benefit that COVID-19 vaccination provides to children, the potential for rare risks to outweigh these benefits and undermine vaccine confidence, and substantial evidence that COVID-19 vaccination confers adequate protection to risk groups, such as older adults, without the need to vaccinate children. We conclude that child COVID-19 vaccination in wealthy communities before adults in poor communities worldwide is ethically unacceptable and c...
The universal access to Covid-19 vaccines is a global issue. By universal access, we mean the need to equalize rather than optimize the distribution of the vaccines. We argue that such is a matter that concerns social justice. Medical ethics presupposes the justice principle, but we need to understand other ethical questions. We will present the concept of entitlement and human rights with respect to the public good in which the vaccines are a part of. Liberalism puts as a matter of priority the equal respect for the moral worth of persons. The duty of the state, in this way, is to protect the well-being of everyone. But given the uneven structures in the world, the challenge is to ensure that the global poor will not be left behind when it comes to the vaccines.
Indian Pediatrics, 2007
Direct-to-consumer vaccine advertisements are a recent phenomenon. In India a newborn can make up to 27 visits to the doctor for immunizations before his fifth birthday(1) (Table I). The vaccines cost approximately Rs 11,000. There is a built-in incentive for doctors to prescribe the vaccines. After a market presence is established, in the next stage the equity argument is brought up. Pressure is brought to bear on Government, to bring the vaccine under the Universal Immunization Program (UIP) saying that the well-to-do are protected and it is not equitable that the poor go unprotected(2). The Government of India recently had to take out advertisements in leading newspapers cautioning the public to 'evaluate carefully the commercial claims' of various vaccines beyond the 6 UIP vaccines(3). Pressure is also put by international organizations like the World Health Organization (WHO) and Global Alliance for Vaccines and Immunization (GAVI). Resolution 45.17 of the World Health Assembly mandates that member countries integrate cost effective 'newer vaccines' into the national immunization programs. Regardless of costeffectiveness, organizations like GAVI persuade developing countries to use new vaccines by providing donor-grants (effectively driving costs to zero in the initial stages). The full cost implications are only realized once funding is withdrawn, after the vaccine has been included in the UIP.
Journal of Medical Ethics, 2022
While Covid-19 vaccines provide a light at the end of the tunnel in a difficult time, they also bring forth the complex ethical issue of global vaccine distribution. The current unequal global distribution of vaccines is unjust towards the vulnerable living in lowincome countries. A vaccine tax should be introduced to remedy this. Under such a scheme, a small fraction of the money spent by a country on vaccines for its own population would go into a fund, such as COVAX, dedicated to buying vaccines and distributing them to the world's poorest. A vaccine tax would provide a much-needed injection of funds to remedy the unequal distribution of vaccines. The tax allows for a distribution that, to a lesser degree, reflects the ability to pay and is superior to a donation-based model because it minimizes the opportunity for freeriding.
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