ETHICAL DILEMA OF RESEARCH AND PUBLIC HEALTH INTERVENTIONS IN EMERGING EPIDEMICS: THE CASE OF COVID-19

Abstract

Emerging epidemics, including Covid-19, SARs, Ebola, MERS, have posed a dilema on decisions taken in health research and public health interventions. It has been difficult to draw a line between research and public health interventions, paticularly vaccination. Ideally, the development and administration of safe and effective diagnostic, therapeutic and vaccine products depend on clinical research. Clinical research should be rigorous, of scientific and societal value, and executed with the highest standards of scientific validity. In this case, validity includes blind treatment assignment, randomization and controls. During development of vaccines, considerations have to be made on the safety and health of the public, patients, essential workers, and healthcare professionals. However, in emerging epidemics (such as the Covid-19 pandemic), implementation programes for public health are hybrids of research and interventions. This raises questions of validity and ethical obligations in the research processes, and in the implementation of public health programmes. Since it is difficult to ascertain the techniques or combination of tools and approaches that will guarantee that epidemics would neither resurge nor spread in the future, it is important to evaluate ethical issues for future control of epidemics and public health. Key among the issues is whether our current conventions of research such as regulations, guidelines and institutional ethical reviews adequately address ethical issues in emerging epidemics and what we need to change to address uncertainities faced in epidemics now and in future. As the Covid-19 pandemic recedes, there may be need for a global health treaty for emergencies.