ACP releases policy on ethics of global COVID-19 vaccine distribution

Keith A. Reynolds

The policy says physicians have an ethical obligation to advocate for the health and wellbeing of patients globally.

The American College of Physicians (ACP) has released a policy statement identifying physicians’ ethical obligation to advocate for the health and wellbeing of patients and communities, both locally and globally.

According to a news release, the policy paper is titled ACP Statement on Global COVID-19 Vaccine Distribution and Allocation: On being Ethical and Practical and it supports finding innovative and practical solutions to distributing COVID-19 vaccines among and within countries in need.

“The ethical, equitable and efficient distribution of vaccines is critical to ending the global pandemic,” George M. Abraham, MD, MPH, FACP, president of ACP, says in the release. “As a society, we must do all we can to ensure that that equity is paramount in a coordinated effort to allocate vaccines in a practical and ethical way.”

The ACP recommends a coordinated global response including a rapid scale up of vaccines, support for infrastructure development, and cooperation among regulatory authorities and vaccine manufacturers globally. To ensure equitable distribution, the ACP also supports:

  • Vaccine distribution plans within countries that are based on medical criteria (i.e., risk of morbidity/mortality and risk of COVID-19 transmission). Plans should be developed through transparent and inclusive processes.
  • Vaccine allocation based in principles of nonmaleficence, beneficence, and justice. Allocations should first, maximize benefit to individuals: save the most lives, care for those most in need and then, maximize benefit to public health: prevent infection and transmission to others.
  • Special efforts that may be necessary to promote equity and to deliver vaccines to marginalized and underserved populations (recognizing that how these populations are defined is local context-specific).
  • Goals that should be to maximize lives saved, using a science-based data-driven approach. ACP cautions against approaches that systematically disadvantage certain groups of patients (e.g., the “life years” approach, which is biased against older individuals or those living with disabilities, or approaches based on perceived social worth or economic value).

The policy was released a day before President Joe R. Biden’s administration announced a plan to buy 500 million doses of the Pfizer COVID-19 vaccine and donate them among about 100 countries over the next year, as reported by The New York Times.