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Published in: International Journal for Equity in Health 1/2020

Open Access 01-12-2020 | Coronavirus | Review

Ethics, pandemic and environment; looking at the future of low middle income countries

Authors: Faouzia Tanveer, Ali Talha Khalil, Muhammad Ali, Zabta Khan Shinwari

Published in: International Journal for Equity in Health | Issue 1/2020

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Abstract

COVID-19 which started in Wuhan, China and swiftly expanded geographically worldwide, including to Low to Middle Income Countries (LMICs). This in turn raised numerous ethical concerns in preparedness, knowledge sharing, intellectual property rights, environmental health together with the serious constraints regarding readiness of health care systems in LMICs to respond to this enormous public health crisis. From the restrictions on public freedom and burgeoning socio-economic impacts to the rationing of scarce medical resources, the spread of COVID-19 is an extraordinary ethical dilemma for resource constrained nations with less developed health and research systems. In the current crisis, scientific knowledge and technology has an important role to play in effective response. Emergency preparedness is a shared responsibility of all countries with a moral obligation to support each other. This review discusses the ethical concerns regarding the national capacities and response strategies in LMICs to deal with the COVID-19 pandemic as well as the deep link between the environment and the increasing risk of pandemics.
Literature
1.
go back to reference El Zowalaty ME, Järhult JD. From SARS to COVID-19: a previously unknown SARS-CoV-2 virus of pandemic potential infecting humans–call for a one health approach. One Health. 2020;1:100124.CrossRef El Zowalaty ME, Järhult JD. From SARS to COVID-19: a previously unknown SARS-CoV-2 virus of pandemic potential infecting humans–call for a one health approach. One Health. 2020;1:100124.CrossRef
4.
go back to reference Ye Z-W, Yuan S, Yuen K-S, Fung S-Y, Chan C-P, Jin D-Y. Zoonotic origins of human coronaviruses. Int J Biol Sci. 2020;16:1686–97.CrossRef Ye Z-W, Yuan S, Yuen K-S, Fung S-Y, Chan C-P, Jin D-Y. Zoonotic origins of human coronaviruses. Int J Biol Sci. 2020;16:1686–97.CrossRef
5.
go back to reference Hui DS, Zumla A. Severe acute respiratory syndrome: historical, epidemiologic, and clinical features. Infect Dis Clin. 2019;33:869–89.CrossRef Hui DS, Zumla A. Severe acute respiratory syndrome: historical, epidemiologic, and clinical features. Infect Dis Clin. 2019;33:869–89.CrossRef
6.
go back to reference Danielle A, Lucas S, Glenn C, Carmel S, Rajiv S, Glen W, et al. Securing justice, health, and democracy against the COVID-19 threat. Center for Ethics, Harvard University; 2020. Danielle A, Lucas S, Glenn C, Carmel S, Rajiv S, Glen W, et al. Securing justice, health, and democracy against the COVID-19 threat. Center for Ethics, Harvard University; 2020.
7.
go back to reference Khalil AT, Ali M, Tanveer F, Ovais M, Idrees M, Shinwari ZK, et al. Emerging viral infections in Pakistan: issues, concerns, and future prospects. Health Sec. 2017;15:268–81.CrossRef Khalil AT, Ali M, Tanveer F, Ovais M, Idrees M, Shinwari ZK, et al. Emerging viral infections in Pakistan: issues, concerns, and future prospects. Health Sec. 2017;15:268–81.CrossRef
8.
go back to reference Shinwari ZK, Khalil AT, Nasim A. Natural or deliberate outbreak in Pakistan: how to prevent or detect and trace its origin: biosecurity, surveillance, forensics. Arch Immunol Ther Exp. 2014;62:263–75.CrossRef Shinwari ZK, Khalil AT, Nasim A. Natural or deliberate outbreak in Pakistan: how to prevent or detect and trace its origin: biosecurity, surveillance, forensics. Arch Immunol Ther Exp. 2014;62:263–75.CrossRef
9.
go back to reference Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020;12:1–5.CrossRef Xu H, Zhong L, Deng J, Peng J, Dan H, Zeng X, et al. High expression of ACE2 receptor of 2019-nCoV on the epithelial cells of oral mucosa. Int J Oral Sci. 2020;12:1–5.CrossRef
10.
go back to reference Zhang W, Du R-H, Li B, Zheng X-S, Yang X-L, Hu B, et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect. 2020;9:386–9.CrossRef Zhang W, Du R-H, Li B, Zheng X-S, Yang X-L, Hu B, et al. Molecular and serological investigation of 2019-nCoV infected patients: implication of multiple shedding routes. Emerg Microbes Infect. 2020;9:386–9.CrossRef
13.
go back to reference WHO. Ethical considerations in developing a public health response to pandemic influenza. Geneva: World Health Organization; 2007. WHO. Ethical considerations in developing a public health response to pandemic influenza. Geneva: World Health Organization; 2007.
14.
go back to reference Gostin LO, Hodge JG. US emergency legal responses to novel coronavirus: balancing public health and civil liberties. Jama. 2020;323(12):1131.CrossRef Gostin LO, Hodge JG. US emergency legal responses to novel coronavirus: balancing public health and civil liberties. Jama. 2020;323(12):1131.CrossRef
15.
go back to reference Gostin LO, Friedman EA, Wetter SA. Responding to COVID-19: how to navigate a public health emergency legally and ethically. Hast Cent Rep. 2020;50(2):8.CrossRef Gostin LO, Friedman EA, Wetter SA. Responding to COVID-19: how to navigate a public health emergency legally and ethically. Hast Cent Rep. 2020;50(2):8.CrossRef
18.
go back to reference Saxena A, Horby P, Amuasi J, Aagaard N, Köhler J, Gooshki ES, et al. Ethics preparedness: facilitating ethics review during outbreaks-recommendations from an expert panel. BMC Med Ethics. 2019;20:29.CrossRef Saxena A, Horby P, Amuasi J, Aagaard N, Köhler J, Gooshki ES, et al. Ethics preparedness: facilitating ethics review during outbreaks-recommendations from an expert panel. BMC Med Ethics. 2019;20:29.CrossRef
19.
go back to reference Zhang H, Shao F, Gu J, Li L, Wang Y. Ethics committee reviews of applications for research studies at 1 Hospital in China during the 2019 novel coronavirus epidemic. JAMA. 2020;323(18):1844.PubMedPubMedCentral Zhang H, Shao F, Gu J, Li L, Wang Y. Ethics committee reviews of applications for research studies at 1 Hospital in China during the 2019 novel coronavirus epidemic. JAMA. 2020;323(18):1844.PubMedPubMedCentral
20.
go back to reference Djalante R, Shaw R, DeWit A. Building resilience against biological hazards and pandemics: COVID-19 and its implications for the Sendai framework. Prog Disaster Sci. 2020;1:100080.CrossRef Djalante R, Shaw R, DeWit A. Building resilience against biological hazards and pandemics: COVID-19 and its implications for the Sendai framework. Prog Disaster Sci. 2020;1:100080.CrossRef
21.
go back to reference Rivers C, Chretien J-P, Riley S, Pavlin JA, Woodward A, Brett-Major D, et al. Using “outbreak science” to strengthen the use of models during epidemics. Nat Commun. 2019;10:1–3.CrossRef Rivers C, Chretien J-P, Riley S, Pavlin JA, Woodward A, Brett-Major D, et al. Using “outbreak science” to strengthen the use of models during epidemics. Nat Commun. 2019;10:1–3.CrossRef
22.
go back to reference Alexander GC, Wynia MK. Ready and willing? Physicians’ sense of preparedness for bioterrorism. Health Aff. 2003;22:189–97.CrossRef Alexander GC, Wynia MK. Ready and willing? Physicians’ sense of preparedness for bioterrorism. Health Aff. 2003;22:189–97.CrossRef
27.
go back to reference Bonilla-Aldana D, Dhama K, Rodriguez-Morales A. Revisiting the one health approach in the context of COVID-19: a look into the ecology of this emerging disease. Adv Anim Vet Sci. 2020;8:234–7.CrossRef Bonilla-Aldana D, Dhama K, Rodriguez-Morales A. Revisiting the one health approach in the context of COVID-19: a look into the ecology of this emerging disease. Adv Anim Vet Sci. 2020;8:234–7.CrossRef
28.
go back to reference Ellwanger JH, Chies JAB. Zoonotic spillover and emerging viral diseases–time to intensify zoonoses surveillance in Brazil. Braz J Infect Dis. 2018;22:76–8.CrossRef Ellwanger JH, Chies JAB. Zoonotic spillover and emerging viral diseases–time to intensify zoonoses surveillance in Brazil. Braz J Infect Dis. 2018;22:76–8.CrossRef
29.
go back to reference Trilla A. One world, one health: the novel coronavirus COVID-19 epidemic. Med Clin. 2020;154:175–7.CrossRef Trilla A. One world, one health: the novel coronavirus COVID-19 epidemic. Med Clin. 2020;154:175–7.CrossRef
30.
go back to reference Hemida MG, Abduallah MMB. The SARS-CoV-2 outbreak from a one health perspective. One Health. 2020;10:100127.CrossRef Hemida MG, Abduallah MMB. The SARS-CoV-2 outbreak from a one health perspective. One Health. 2020;10:100127.CrossRef
31.
go back to reference Lam TT-Y, Shum MH-H, Zhu H-C, Tong Y-G, Ni X-B, Liao Y-S, et al. Identification of 2019-nCoV related coronaviruses in Malayan pangolins in southern China. BioRxiv. 2020;583(7815):282. Lam TT-Y, Shum MH-H, Zhu H-C, Tong Y-G, Ni X-B, Liao Y-S, et al. Identification of 2019-nCoV related coronaviruses in Malayan pangolins in southern China. BioRxiv. 2020;583(7815):282.
32.
go back to reference Carrington D. The Anthropocene epoch: scientists declare dawn of human-influenced age. Guardian. 2016;29:2016. Carrington D. The Anthropocene epoch: scientists declare dawn of human-influenced age. Guardian. 2016;29:2016.
33.
go back to reference Kass N, Kahn J, Buckland A, Paul A, Group EW. Ethics guidance for the public health containment of serious infectious disease outbreaks in low-income settings: lessons from Ebola. Baltimore: Johns Hopkins Berman Institute of Bioethics; 2019. Kass N, Kahn J, Buckland A, Paul A, Group EW. Ethics guidance for the public health containment of serious infectious disease outbreaks in low-income settings: lessons from Ebola. Baltimore: Johns Hopkins Berman Institute of Bioethics; 2019.
34.
go back to reference JCT AL, Barrett DH, Ortmann LW, DJH G. Key ethical issues discussed at CDC-sponsored international, regional meetings to explore cultural perspectives and contexts on pandemic influenza preparedness and response. Int J Health Policy Manag. 2016;5:653.CrossRef JCT AL, Barrett DH, Ortmann LW, DJH G. Key ethical issues discussed at CDC-sponsored international, regional meetings to explore cultural perspectives and contexts on pandemic influenza preparedness and response. Int J Health Policy Manag. 2016;5:653.CrossRef
36.
go back to reference Ghebreyesus TA, Swaminathan S. Scientists are sprinting to outpace the novel coronavirus. Lancet. 2020;395:762–4.CrossRef Ghebreyesus TA, Swaminathan S. Scientists are sprinting to outpace the novel coronavirus. Lancet. 2020;395:762–4.CrossRef
37.
go back to reference Gupta M, Wahl B, Adhikari B, Bar-Zeev N, Bhandari S, Coria A, et al. The need for COVID-19 research in low-and middle-income countries. Glob Health Res Policy. 2020;5:1–4.CrossRef Gupta M, Wahl B, Adhikari B, Bar-Zeev N, Bhandari S, Coria A, et al. The need for COVID-19 research in low-and middle-income countries. Glob Health Res Policy. 2020;5:1–4.CrossRef
38.
go back to reference Whitworth J. COVID-19: a fast evolving pandemic. Trans R Soc Trop Med Hyg. 2020;114(4):241. Whitworth J. COVID-19: a fast evolving pandemic. Trans R Soc Trop Med Hyg. 2020;114(4):241.
43.
go back to reference Jaffer Shah SK, Al-Ahdal TMA, Mousavi SH, Zahid SU, Huy NT. COVID-19: the current situation in Afghanistan. Lancet. 2020;8(6):e771.PubMed Jaffer Shah SK, Al-Ahdal TMA, Mousavi SH, Zahid SU, Huy NT. COVID-19: the current situation in Afghanistan. Lancet. 2020;8(6):e771.PubMed
45.
go back to reference Takian A, Raoofi A, Kazempour-Ardebili S. COVID-19 battle during the toughest sanctions against Iran. Lancet. 2020;395(10229):1035.CrossRef Takian A, Raoofi A, Kazempour-Ardebili S. COVID-19 battle during the toughest sanctions against Iran. Lancet. 2020;395(10229):1035.CrossRef
46.
go back to reference Quadri SA. COVID-19 and religious congregations: Implications for spread of novel pathogens. Int. J. Infect. Dis. 2020;96:219–21. Quadri SA. COVID-19 and religious congregations: Implications for spread of novel pathogens. Int. J. Infect. Dis. 2020;96:219–21.
50.
go back to reference Paintsil E. COVID-19 threatens health systems in sub-Saharan Africa: the eye of the crocodile. J. Clin. Invest. 2020;130(6):2741–4. Paintsil E. COVID-19 threatens health systems in sub-Saharan Africa: the eye of the crocodile. J. Clin. Invest. 2020;130(6):2741–4.
51.
go back to reference Wang CJ, Ng CY, Brook RH. Response to COVID-19 in Taiwan: big data analytics, new technology, and proactive testing. JAMA. 2020;323(14):1341.CrossRef Wang CJ, Ng CY, Brook RH. Response to COVID-19 in Taiwan: big data analytics, new technology, and proactive testing. JAMA. 2020;323(14):1341.CrossRef
53.
go back to reference Ahmed F, Ahmed NE, Pissarides C, Stiglitz J. Why inequality could spread COVID-19. Lancet. 2020;5(5):e240.PubMed Ahmed F, Ahmed NE, Pissarides C, Stiglitz J. Why inequality could spread COVID-19. Lancet. 2020;5(5):e240.PubMed
54.
go back to reference Cavallo JJ, Donoho DA, Forman HP. Hospital capacity and operations in the coronavirus disease 2019 (COVID-19) pandemic-planning for the nth patient. In JAMA health forum. Am Med Assoc. 2020;1:e200345. Cavallo JJ, Donoho DA, Forman HP. Hospital capacity and operations in the coronavirus disease 2019 (COVID-19) pandemic-planning for the nth patient. In JAMA health forum. Am Med Assoc. 2020;1:e200345.
56.
go back to reference Laventhal N, Basak R, Dell ML, Diekema D, Elster N, Geis G, et al. The ethics of creating a resource allocation strategy during the COVID-19 pandemic. Pediatrics. 2020;146:1.CrossRef Laventhal N, Basak R, Dell ML, Diekema D, Elster N, Geis G, et al. The ethics of creating a resource allocation strategy during the COVID-19 pandemic. Pediatrics. 2020;146:1.CrossRef
57.
58.
go back to reference Holm S. A general approach to compensation for losses incurred due to public health interventions in the infectious disease context. Monash Bioethics Rev. 2020;1:1–15. Holm S. A general approach to compensation for losses incurred due to public health interventions in the infectious disease context. Monash Bioethics Rev. 2020;1:1–15.
60.
go back to reference Rimmer M. The race to patent the SARS virus: the TRIPS agreement and access to essential medicines. Melb J Int’l L. 2004;5:335. Rimmer M. The race to patent the SARS virus: the TRIPS agreement and access to essential medicines. Melb J Int’l L. 2004;5:335.
63.
go back to reference Moorthy V, Restrepo AMH, Preziosi M-P, Swaminathan S. Data sharing for novel coronavirus (COVID-19). Bull World Health Organ. 2020;98:150.CrossRef Moorthy V, Restrepo AMH, Preziosi M-P, Swaminathan S. Data sharing for novel coronavirus (COVID-19). Bull World Health Organ. 2020;98:150.CrossRef
67.
go back to reference Wong H. The case for compulsory licensing during COVID-19. J Glob Health. 2020;10:010358.CrossRef Wong H. The case for compulsory licensing during COVID-19. J Glob Health. 2020;10:010358.CrossRef
Metadata
Title
Ethics, pandemic and environment; looking at the future of low middle income countries
Authors
Faouzia Tanveer
Ali Talha Khalil
Muhammad Ali
Zabta Khan Shinwari
Publication date
01-12-2020
Publisher
BioMed Central
Published in
International Journal for Equity in Health / Issue 1/2020
Electronic ISSN: 1475-9276
DOI
https://doi.org/10.1186/s12939-020-01296-z

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