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The United States secured 1 billion doses of Covid-19 vaccines. Medical ethicists say it needs to be shared with other countries



But it’s a drop in the bucket.

The United States has purchased or agreed to purchase more than 1 billion doses of coronavirus vaccines. That’s enough to vaccinate the American people at least twice, with plenty left.

Medical ethicists told CNN that the United States has a moral obligation to share these doses with other countries. This is especially true, they said, now that the pandemic is relatively under control in the United States, while countries like India have been overwhelmed by the virus.

“I think the United States is committed to sharing vaccines with other countries,” said Keisha Ray, an assistant professor and bioethicist at UTHealth McGovern Medical School in Houston, “especially the countries we may consider poorer countries or what we call. underdeveloped countries. ”

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Arthur Caplan, director of the Division of Medical Ethics at NYU’s Grossman School of Medicine, agreed. He said the United States was “ethically committed” to sharing vaccines, pointing to the “horrific death toll and tsunami of hospitalization taking place in many countries.”

“Morally,” he said, “we have to help.”

It’s a question of when – not if

From an ethical perspective, everyone should have access to protection from Covid-19, Kathy Kinlaw, associate director of Emory University’s Center for Ethics, told CNN.

She said many countries lack access to vaccine because of the “reduced purchasing power of healthcare in general, but also of Covid-19 treatments and vaccines.”

“I think the United States is definitely in a position where we absolutely have to share,” she said. “It’s a matter of timing – I think that’s a real problem here.”

The United States is not just obligated to share vaccines by virtue of its resources, Ray said. Richer countries like the United States have historically benefited from hindering other countries, she said, whether through governance or colonialism.

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“We have gone to other poorer countries, taken their resources, and we have built our wealth on the backs of their resources,” she said. “And we have left them in a position that they can now not take care of themselves.”

“Now we are able to give back, we are able to go there and help these countries,” she said like “to pay our debts.”

All three agreed that it was right for the United States to control its virus outbreaks before sharing vaccines. The pandemic is still a problem in the United States, Ray said, but conditions have greatly improved.

“When looking at the United States and global distribution of vaccines, one must first ask whether the United States is capable of helping other people? That means it will not be to the detriment of its own people, in this case Americans,” she said. said. “So we have the resources to share with other countries that are really struggling with the Covid pandemic? And simply put, right now the answer is yes.”

Caplan compared it to the rule about the plane’s oxygen masks, which flight attendants describe before takeoff: “Put on your own mask before helping others.”

“You have to stabilize your own nation before you help others,” he said. “And I think we’re there. I think we’re getting there now.”

US supply exceeds demand

One factor in the decision to release additional vaccines is the issue of supply and demand – specifically that the former will soon surpass the latter in the US, Kinlaw said. And that may mean it’s time to start sending extra doses abroad, she said.

A recent report from the Kaiser Family Foundation said the country as a whole “is likely to reach a turning point for vaccine enthusiasm in the next 2 to 4 weeks.”

“When this happens,” the report said, “efforts to encourage vaccination will be much more difficult and pose a challenge to reach the levels of herd immunity that are expected to be needed.”

Health experts have already warned of declining demand.
An Ohio State Mercer County official told CNN this month that officials are struggling to complete vaccine appointments. And earlier this week, Georgia officials announced they would close the state’s eight remaining mass vaccination sites on May 21.

The United States needs to continue to tackle vaccine hesitation at home and be responsive to people’s concerns, Kinlaw said. “But certainly there could be a point where there are people who do not take the vaccine and we have extra vaccine in this country, in which case it should be used and shared.”

The United States is taking a big step towards resuming normal life

Data from the U.S. Centers for Disease Control and Prevention show that 30% of the U.S. population is fully vaccinated. Experts such as Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, has estimated that the United States needs between 70% and 85% of the country to be immune – either through vaccination or prior infection – to achieve herd immunity.

But even without reaching the crucial threshold, the United States has enough vaccines to share with other countries, experts said.

The United States could have estimated 300 million excess doses by the end of July, according to a recent report from Duke University.

“The world’s richest nations have unlocked much of the short-term supply,” wrote Dr. Krishna Udayakumar and Dr. Mark McClellan, health expert at Duke. “At the current rate, vaccines are being administered, 92 of the world’s poorest countries will not vaccinate 60% of their population until 2023 or later.”

Ray told CNN that the main problem in the United States is not a supply chain. It is vaccine access for poor communities, rural areas and color communities – especially those who are black and Latino – and prolonged hesitation, largely among white and conservative populations.

“It’s an education, a public outreach and an access problem,” she said. “We have other obstacles that are not delivery barriers. So we have the supply to help other countries.”

Global herd immunity will benefit everyone

It’s not just the right thing to do.

The United States and the world have benefits, especially if they want to prevent further spread of coronavirus and the emergence of new variants, ethicists said.

“If you do not get these hotspots under control outside the United States, they will come back, probably with new, dangerous strains that could undermine our vaccines,” Caplan said. “It is both wise to do so and ethical to do so.”

Kinlaw also stressed the importance of herd immunity not only in the United States but globally.

“Epidemiologically, we need to work on suppressing the virus and reducing transmission and reducing the continued development of the virus and its variants,” she said. “It will be beneficial for every single person.”

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But vaccinations everywhere could also bring economic benefits, Kinlaw said, allowing people to travel more freely and do business around the world.

“Beyond just doing what’s fair, we can look at it practically,” Ray said, “and we can not have a country as big as India and as important to the global economy as India that does not produce the goods for which we have come to trust. ”

There are lots of issues that also need to be addressed when the United States shares vaccines, Caplan said as “Who goes first? What do you do within the country? Is it too late and better to send medicine rather than vaccine?”

He pointed out the need to ensure that a country receiving doses from the United States distributes them fairly and to vulnerable individuals.

“One of the ethical challenges is, will we insist on a fair distribution within these countries? Or will we just give them vaccine and let them give it to the military and the elite?” he said.

“It sounds nice to say we want to help others, but it’s simplified because some governments are corrupt,” he said. “Some governments have no distribution plan other than to give it first to their own leaders rather than to those in need.”

CNN’s Maggie Fox contributed to this report.


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