We are now experiencing the tragic consequences of failing to appreciate the need to invest more resources, expertise and support in developing countries, including those where the Ebola outbreak is happening. Such investments would have allowed for health systems in those parts of the world to be better equipped to respond to and minimize the unfolding crisis. For decades, fairly narrow global health programs targeting single diseases have received greater attention and financial support than broader efforts to strengthen health infrastructures in developing countries. Those choices have contributed to this situation growing into the global public health emergency it is now.
That is bioethicist Jason Schwartz (Princeton), in a brief interview here (via Ann Johnson). Meanwhile, Arthur Caplan (NYU) has a list of “10 Things America Needs to Do about Ebola,” which includes “bending” the “ethics of testing”:
Normally we wait for randomized trials to show safety and efficacy. With an infectious disease with a 70 percent death rate, treatments are going to be given if they are shown to be safe in animals and people and have some reasonable basis in science for being possibly efficacious, and we make every effort to follow patients who get them to see what happens. Some may be tried here as last-ditch therapies. Some may be tried in West Africa as first-line preventive agents. Science should not go out the window, but the ethics of testing needs to bend a bit in the context of a lethal epidemic.
Comments and pointers to other pieces by or featuring bioethicists on Ebola are welcome.