Beyond crucial questions of fair access to scarce supplies of the experimental drug ZMapp and to other potentially effective drugs to treat Ebola, commentators from bioethics, public health, journalism, and other sectors are increasingly focused on “staff, stuff, and systems.” The consequences of chronically inadequate local and national public health infrastructures in developing countries are tragically revealed as systems in affected West African nations are overwhelmed by epidemic. In a recent interview Hastings Center Fellow George Annas described the Ebola epidemic as a “public health disaster that requires a heavy-duty public response,” including capital investments in clinics in addition to emergency measures needed to control the spread of the highly contagious virus, and to care for the sick. Annas also cautioned against reducing ethical questions to procedures for drug testing and allocation, important as these issues are.
Funding cutbacks and the loss of expert staff through attrition at global entities such as the World Health Organization (W.H.O.) are also problems with ethical dimensions, as uncertainty over who should be responsible for coordinating an effective response to the epidemic persists. Margaret Chan, director general of the W.H.O., told NPR that her financially strapped organization should play a primarily supportive role, a position characterized as unconvincing in a September 6 New York Times editorial. Commentators widely acknowledge severe, seemingly insoluble shortages of health care workers, plus supply-chain breakdowns, as air and sea deliveries of supplies and the movement of supplies on the ground are interrupted due to fear of transmission during unloading, and to roadblocks. The Times editorial concludes by suggesting that the United States may need to step in to coordinate the international response if the U.N.
The views, opinions and positions expressed by these authors and blogs are theirs and do not necessarily represent that of the Bioethics Research Library and Kennedy Institute of Ethics or Georgetown University.