medigraphic.com

2022, Number 1

Next >>

Revista Colombiana de Bioética 2022; 17 (1)

Ethics and negotiations for access to vaccines: methodological and ethical excepcionalism

Vidal SM

Language: Spanish
References: 45
Page:
PDF size: 206.76 Kb.


ABSTRACT

Purpose/Context. This article discusses the various factors that have affected access to vaccines for the prevention of SARS-CoV-2 infection, with particular attention to the interests involved in the negotiations. An analysis of the processes of vaccine research, production, procurement, distribution, and marketing is detailed, as well as the international ethical standards that guide these practices.
Methodology/Approach. Similarly, a framework of scientific, methodological, ethical and legal exceptions for research, production and commercialization of vaccines is identified, while the rules imposed by the global market system regarding intellectual property protection (TRIPS), negotiations and contracts, defense of private and corporate interests have been maintained and deepened without exceptions. It also highlights the role played by the richest countries, accumulating more doses than necessary, which seriously impacted the access of low-income countries.
Results/Findings. The international ethical norms and agreements made by governments that should limit conducts such as these, avoid their consequences and that have not been complied with, are analyzed.
Discussion/Conclusions/Contributions. It concludes with a concrete proposal that could alleviate the current situation and includes a reflection on the impact on the life and health of the most vulnerable countries and groups, if the international order continues to be governed by the global market system instead of a new and fairer global agreement.


REFERENCES

  1. Agarwal, Ruchir y Gita Gopinath. 2021. A Proposal to End the COVID-19 Pandemic.https://doi.org/10.5089/9781513577609.006

  2. Amnesty International. 2021. Dosis doble de desigualdad. Las empresas farmacéuticas yla crisis de las vacunas contra la covid-19. Resumen ejecutivo y recomendaciones. https://doc.es.amnesty.org/ms-opac/doc?q=*%3A*&start=0&rows=1&sort=fecha%20desc&fq=norm&fv=*&fo=and&fq=mssearch_fld13&fv=POL40470421&-fo=and&fq=mssearch_mlt98&fv=gseg01&fo=and

  3. Asamblea General de las Naciones Unidas. 1948. "Declaración Universal de losDDHH, Resolución 217 A (III), París, 10 de diciembre de 1948". https://www.un.org/es/about-us/universal-declaration-of-human-rights#:~:text=Toda%20persona%20tiene%20todos%20los,nacimiento%20o%20cualquier%20otra%20condici%C3%B3n.

  4. Asociación Médica Mundial. 2013. "Declaración de Helsinki. Principios éticospara las investigaciones médicas en seres humanos". 64ª Asamblea General,Fortaleza, Brasil, octubre 2013.

  5. Baral, Stefan, Jean Twahirwa y Nancy Phaswana-Mafuya. 2021. COVID-19 Passportswill harm sustainable development. https://blogs.bmj.com/bmj/2021/03/30/COVID-19-vaccine-passports-will-harm-sustainable-development

  6. Bertomeu, María Julia. 2021. Solidaridad, pandemia y barbarie. https://accesojustomedicamento.org/solidaridad-pandemia-y-barbarie/

  7. Boseley, Sarah. 2020. Belgian minister tweets EU’s Covid vaccine price list to anger ofmanufacturers. https://www.theguardian.com/world/2020/dec/18/belgian-minister-accidentally-tweets-eus-covid-vaccine-price-list

  8. Callaway, Ewen. 2021. “COVID vaccine boosters: the most important questions.”Nature 596: 178-180. https://doi.org/10.1038/d41586-021-02158-6

  9. Comissão Nacional de Ética em Pesquisa (CONEP). 2021. Oficio Circular No.5/2021/CONEP/SECNS/MS. Brasília, 30 de maio de 2021.

  10. Davies, Madlen, Ivan Ruiz, Jill Langlois y Rosa Furneaux. 2021. ‘Held to ransom’:Pfizer plays hardball in Covid-19 vaccine negotiations with Latin American countries.https://www.statnews.com/2021/02/23/pfizer-plays-hardball-in-covid19-vaccine-negotiations-in-latin-america/?utm_campaign=rss

  11. Davies, Madlen, Rosa Furneaux, Ivan Ruiz y Jill Langlois. 2021. Pfizer demands governmentsgamble with state assets to secure vaccine deal. https://science.thewire.in/health/pfizer-demands-governments-gamble-with-state-assets-to-secure-vaccine-deal/

  12. Deming, Meagan, Nelson Michael, Merlin Robb, Myron Cohen y Kathleen Neuzil.2020. “Accelerating development of SARS-CoV-2 vaccines—the role for controlledhuman infection models.” The New England Journal of Medicine 383: e63.https://doi.org/10.1056/NEJMp2020076

  13. González, Guillermo. 2021. MSF España. MSF pide que se analicen de forma crítica lasdeficiencias de COVAX. https://reliefweb.int/report/world/msf-pide-que-se-analicen-de-forma-cr-tica-las-deficiencias-de-covax

  14. Hellmann, Fernando, Silvia Cardoso, Fabíola Stolf, Mirelle Finkler, Marta Verdi ySandra Caponi. 2020. COVID-19: Think First, Act Better Later. http://www.bioethics.net/2020/05/covid-19-think-first-act-better-later/

  15. Holder, Josh. 2021. Tracking Coronavirus Vaccinations around the World. https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker.html

  16. Hooker, Lucy y Daniele Palumbo. 2020. Vacunas contra el coronavirus, cuánto dineropuede ganar realmente las farmacéuticas con la inmunización. https://www.bbc.com/mundo/noticias-55293057

  17. John Hopkings Coronavirus Resource Center. 2021. International Vaccination Effort.Understanding Vaccination Progress by Country. https://coronavirus.jhu.edu/vaccines/international

  18. Johns Hopkins University. 2021. Coronavirus Resource Center. https://coronavirus.jhu.edu/map.html

  19. Keren, Arnon y Ori Lev. 2020. Uncertainty, error and informed consent to challengetrials of COVID-19 vaccines: response to Steel et al.” Journal of Medical Ethics46, no. 12: 813-814. https://doi.org/10.1136/medethics-2020-106793

  20. London, Alex y Jonathan Kimmelman. 2020. “Against pandemic research exceptionalism.”Science 368: 476-477. https://doi.org/10.1126/science.abc1731

  21. Los Ángeles Times. 2020. Argentina: exigencias de Pfizer para vacuna son inaceptables.https://www.latimes.com/espanol/internacional/articulo/2020-12-15/argentina-exigencias-de-pfizer-para-vacuna-son-inaceptables

  22. Médicos sin Fronteras. 2021. Los países del G7 deben compartir inmediatamente todaslas dosis posibles con los países de ingresos bajos y medios. https://www.msf.es/actualidad/los-paises-del-g7-deben-compartir-inmediatamente-todas-las-dosis-posibles-los-paises

  23. Médicos Sin Fronteras. 2021. Los países opositores deben dejar de obstruir las negociacionessobre la exención de los ADPIC en la OMC. https://www.msf.es/actualidad/los-paises-opositores-deben-dejar-obstruir-las-negociaciones-la-exencion-losadpic-la-omc

  24. Nature. 2021. “The WHO is right to call a temporary halt to COVID vaccine boosters.”Nature 593: 317. https://doi.org/10.1038/d41586-021-02219-w

  25. Nussbaum, Martha. 2006. El ocultamiento de lo humano, repugnancia, vergüenza y ley.Buenos Aires: Katz Editorial.

  26. OMS. 2021. Consideraciones para aplicar y ajustar medidas de salud pública y socialesen el contexto de la COVID-19. https://apps.who.int/iris/handle/10665/343055

  27. ONU. 2005. Objetivos de Desarrollo Sostenible. https://www.un.org/sustainabledevelopment/es/

  28. ONU. 2021. Diez países han acaparado el 75 % de las vacunas COVID-19 administradas,denuncia Gutiérrez al Consejo de Seguridad. https://news.un.org/es/story/2021/02/1488202

  29. Our World in Date. 2021. Coronavirus (COVID-19) Vaccinations. Share of people vaccinatedagainst COVID-19. https://ourworldindata.org/covid-vaccinations

  30. Oxfam Internacional. 2020. ¿Quién paga la cuenta? Gravar la riqueza para enfrentarla crisis de la COVID 19 en América Latina y el Caribe. https://oxfamilibrary.openrepository.com/bitstream/handle/10546/621033/bp-quien-paga-la-cuenta-covid-19-270720-es.pdf p.5

  31. Oxfam Internacional. 2021. Los mega ricos han recuperado las pérdidas ocasionadas porla pandemia en un tiempo récord, mientras que miles de millones de personas vivirán ensituación de pobreza al menos una década. https://www.oxfam.org/es/notas-prensa/los-mega-ricos-han-recuperado-las-perdidas-ocasionadas-por-la-pandemia-en-un-tiempo

  32. Parsons, Lucy. 2021. “Pfizer/BioNTech reach vaccine supply agreement with COVAX.”PMLive. https://www.pmlive.com/pharma_news/pfizerbiontech_reach_vaccine_supply_agreement_with_covax_1361849

  33. Parsons, Lucy. 2021. “WHO’s director-general deems vaccine nationalism a “catastrophicmoral failure.” PMLive. http://www.pmlive.com/pharma_news/whos_director-general_deems_vaccine_nationalism_a_catastrophic_moral_failure_1361533

  34. PNUD. 2019. Informe Anual 2019. https://reliefweb.int/sites/reliefweb.int/files/resources/UNDP-Annual-Report-2019-es-compressed.pdf

  35. Public Citizen. 2021. "Pfizer Power. Access to Medicine Programe." Report byZain Rizvi. https://www.citizen.org/wp-content/uploads/Pfizer-power-Oct-19-final-web.pdf

  36. Sociedade Brasileira de Bioética (SBB). 2021. Recomendaçao Placebo & AcessoMed&Vac 1-2021, Covid 27Jan21. https://www.sbbioetica.org.br/

  37. Solbakk, Jan Helge y Susana Vidal. 2014. “Clinical research in resource-poor settings.”Handbook of Global Bioethics: 527-550. https://doi.org/10.1007/978-94-007-2512-6_102

  38. Solbakk, Jan Helge, Shereen Cox, Rosemarie Bernabe y Susana Vidal. 2021. Covid-19,Comedy and Crimes against humanity. Uniforum. https://www.uniforum.uio.no/leserbrev/2021/debate-covid-19-comedy-and-crimes-against-humanity.html

  39. Stoeklé, Henri-Corto y Christian Hervé. 2020. “COVID-19: Act First, Think Later.”The American Journal of Bioethics 20: 7. https://doi.org/10.1080/15265161.2020.1761199

  40. UN Asamblea General. 2020. Respuesta integral y coordinada a la pandemia de enfermedadpor coronavirus. https://www.un.org/es/pga/75/events/specialsession/covid-19

  41. Vidal, Susana. 2021. Ética y repugnacia: negociaciones sobre vacunas para los paísespobres. https://redbioetica.com.ar/etica-y-repugnacia-negociaciones-sobre-vacunas-para-los-paises-pobres/

  42. WHO. 2016. Expert Committee on Biological Standardization. Human ChallengeTrials for Vaccine Development: regulatory considerations. https://www.who.int/biologicals/expert_committee/Human_challenge_Trials_IK_final.pdf

  43. WHO. 2020. Working Group for Guidance on Human Challenge Studies in COVID-19Key criteria for the ethical acceptability of COVID-19 human challenge studies. https://www.who.int/publications/i/item/WHO-2019-nCoV-Ethics_criteria-2020.1

  44. WHO. 2021. WHO Director-General’s opening remarks at 148th session of the ExecutiveBoard. https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-148th-session-of-the-executive-board

  45. WTO. 1994. Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS).https://www.wto.org/english/thewto_e/whatis_e/tif_e/agrm7_e.htm




2020     |     www.medigraphic.com