Extra priority should be given to worst-off countries in COVID-19 vaccine allocation, says expert

Reviewed by Emily Henderson, B.Sc.Sep 4 2020

In contrast to WHO´s and other expert´s advice, the worst-off countries should be extra prioritised when it comes to COVID-19 vaccine allocation, according to Professor Ole Frithjof Norheim at the University of Bergen.

Once effective COVID-19 vaccines are approved, they will be scarce. WHO and others have promised that vaccines should be distributed fairly among countries, but none have defined what fair distribution implies.

Fair allocation should aim to reduce premature deaths and social deprivations, with extra priority to the worst-off countries."

Ole Frithjof Norheim, Professor, Bergen Centre for Ethics and Priority Settings (BCEPS), University of Bergen

This is in contrast to alternative models, discussed by the World Health Organisation (WHO) and others, which either allocate a percentage of doses to each country or prioritise countries with high numbers of health personnel and people with a large number of risk factors.

"These models will clearly favour high-income countries, not the disadvantaged," Norheimpoints out.

Norheim has contributed toa paper in Science Magazine, proposing an ethical framework,the so-called The Fair Priority Model,for global COVID-19 vaccine allocation. The model is designed by a group of international researchers, ethicists and philosophers at Perelman School, University of Pennsylvania, University of Bergen and others.

Covid harms directly and indirectly

COVID-19 kills people and causes permanent organ damage, straining health care systems andraising mortality rates for common conditions.

The pandemic is also devastating the global economy causing unemployment, poverty and starvation.

"Economics and health interact. Worsening economic conditions harm health, and a worsening pandemic harms the economy", Norheim explains.

The Fair Priority Model

The authors of the Science-paper propose as the best embodiment of the ethical values of limiting harms, benefiting the disadvantaged, and recognizing equal concern when it comes to COVID-19 vaccine allocation.

The Fair Priority Model is new, but builds upon established models for fair allocation that the researchers have worked on for years. It contains ethical views and arguments about global justice and theories on fair distribution of scarce medical resources.

"By building on established principles for fair allocation, we adapted those to this very special situation that the COVID pandemic has created worldwide," Norheim explains.