Fair domestic allocation of monkeypox virus countermeasures.

Autor:	Persad G; Sturm College of Law, University of Denver, Denver, CO, USA., Leland RJ; Department of Philosophy, University of Manitoba, Winnipeg, MB, Canada., Ottersen T; Division of Infection Control, Norwegian Institute of Public Health, Oslo, Norway., Richardson HS; Department of Philosophy and Kennedy Institute of Ethics, Georgetown University, Washington, DC, USA., Saenz C; Department of Evidence and Intelligence for Action in Health, Pan American Health Organization, Washington, DC, USA., Schaefer GO; Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore., Emanuel EJ; Department of Medical Ethics and Health Policy, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA. Electronic address: zemanuel@upenn.edu.
Jazyk:	angličtina
Zdroj:	The Lancet. Public health [Lancet Public Health] 2023 May; Vol. 8 (5), pp. e378-e382.
DOI:	10.1016/S2468-2667(23)00061-0
Abstrakt:	Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death or illness and unjust disparities; prioritising those who prevent harm or mitigate disparities; recognising contributions to combating an outbreak; and treating similar individuals similarly. Ethically and equitably marshalling available countermeasures requires articulating these fundamental objectives, identifying priority tiers, and recognising trade-offs between prioritising the people at the highest risk of infection and the people at the highest risk of harm if infected. These five values can provide guidance on preferable priority categories for a more ethically sound response and suggest methods for optimising allocation of countermeasures for mpox and other diseases for which countermeasures are in short supply. Properly marshalling available countermeasures will be crucial for future effective and equitable national responses to outbreaks. Competing Interests: Declaration of interests GP declares personal fees from WHO, ASCO Post, and WCG IRB, outside of the submitted work. EJE reports being a venture partner in Oak HC/FT and a partner in Embedded Healthcare and COVID-19 Recovery Partners; receiving travel reimbursement from the RAND Corporation, Goldman Sachs, The Atlantic, and the Center for Global Development; receiving speaking fees and travel reimbursement from Medical Home Network, Healthcare Financial Management, the Associação Nacional de Hospitais Privados, the National Alliance of Healthcare Purchaser Coalitions, Optum Labs, the Massachusetts Association of Health Plans, the District of Columbia Hospital Association, Washington University, Optum, Brown University, McKay Lab, the American Society for Surgery of the Hand, the Association of American Medical Colleges, America's Essential Hospitals, Johns Hopkins University, the National Resident Matching Program, Shore Memorial Health System, Tulane University, Oregon Health & Science University, United Health Group, and Blue Cross Blue Shield; receiving speaking fees from CBI–Informa, the Galien Foundation, RightWay, WellSky, Signature, and Healthcare Leaders of NY; and serving as an unpaid board member for VillageMD and Oncology Analytics outside of the submitted work. All other authors declare no competing interests. (Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze:	MEDLINE
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