Buying and distributing a COVID-19 vaccine will involve hard ethical and practical choices

http://www.shutterstock.com’

Barbara Allen, Te Herenga Waka — Victoria University of Wellington and Michael Macaulay, Te Herenga Waka — Victoria University of Wellington

The world was ablaze with hope following the announcement last week that a vaccine developed by Pfiser and BioNTech may be more than 90% effective in preventing COVID-19.

New Zealand politicians were quick to point out 1.5 million doses had already been pre-purchased through a legally binding agreement signed in late September to buy any vaccine to emerge from the multilateral COVAX facility.

Within the week, a second potentially effective vaccine emerged from US biotech firm Moderna. Health Minister Chris Hipkins would not say if New Zealand had negotiated for this option.

But assuming an approved vaccine is coming, attention then turns to logistics. Funding, procurement, storage and distribution all raise significant questions about values, decision-making and ethics.

We know there are multiple candidates for a COVID-19 vaccine, but there will be few “winners”, as many countries have already pre-contracted substantial amounts based on calculated risk assessments of which will emerge first. Even then, the challenges will be immense.

For example, assuming the Pfizer vaccine does become available as a safe option, it must be held in “ultra-cold storage” at -70 degrees Celsius. As has been observed already, “Distributing an effective COVID-19 vaccine to the global population will likely be the greatest logistical challenge since World War II.”

Who gets a vaccine first?

For New Zealand, as with all countries, the questions raised are complex: do we now spend a large amount of money to scale up a logistics, distribution and storage system for the Pfizer drug? Or should we wait for an alternative that is more effective, easier to transport and store, and possibly cheaper?

After all, the first available vaccine might not achieve the outcomes we want. But would it be fair (or feasible) to make the country wait?

---

Read more:
Moderna follows Pfizer with exciting vaccine news – how to read these dramatic developments

---

Furthermore, because enough doses to treat everyone will not be available immediately, it will be necessary to prioritise recipients. What are the country’s obligations here? Do we offer the vaccination first to the oldest, or the youngest, or the most vulnerable?

National health systems will have some idea about how to go about this, but wealthy countries have never faced an immediate requirement on this scale.

An ethical framework

Answering these questions means calling simultaneously on a number of different ethical perspectives:

• an ethic of justice to assess the fairness of a decision

• an ethic of consequentialism to look at outcomes

• the ethics of obligations to see who we may have made commitments to

• an ethic of care to look at individual cases, rather than relying on abstract logic.

Only when we combine these perspectives can we begin to make sense of priorities.

The vaccine marketplace is a kind of oligopoly, with a few extremely large firms deciding which vaccines get made, when and at what price. Pharmaceutical companies are reluctant to invest in producing new vaccines for the developing world because they have little prospect of earning an attractive return.

While global organisations such as vaccine alliance GAVI have been instrumental in getting vaccines to developing countries, given the geopolitics of procurement it could be a long time before an effective COVID-19 option reaches the poorest populations.

The moral dimension

All this points to the deeper ethical issue of inequality. Many agencies, including the World Health Organisation (WHO), have demonstrated that health outcomes are related to socio-economic, ethnic and gender inequalities. COVID-19 has only made these inequalities worse.

Only last week, for example, a UK study showed 57.7 more people per 100,000 have died in the poorest areas of northern England than in the rest of the country.

---

Read more:
COVID-19 vaccines could go to children first to protect the elderly

---

This matches other research showing how the pandemic has disproportionately affected poorer families, including their being less likely to be able to work from home or adapt to home-schooling.

Limited or selective availability of a vaccine could exacerbate these problems. And while New Zealand may be in a relatively privileged position, this doesn’t mean there won’t be negative consequences for other countries.

This adds an international dimension to our national dilemma: we have a duty to protect our own citizens, but is there a way we can minimise harm to others at the same time?

Barbara Allen, Senior Lecturer in Public Management, Te Herenga Waka — Victoria University of Wellington and Michael Macaulay, Professor of Public Administration, Te Herenga Waka — Victoria University of Wellington

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Taliban in Pakistan warns Christian leaders to convert to Islam

International Christian Concern (ICC) has learned that on October 6, members of the Taliban sent threatening letters in Sargodha, Pakistan warning Christian leaders to convert to Islam or face dire consequences, reports Dan Wooding, founder of ASSIST Ministries.

A copy of the letter obtained by ICC warns Christians to convert to Islam, pay Jizya tax (an Islamic tax imposed on religious minorities) or leave the country. If Christians refuse to accept the choices given to them, the letter explains that they “would be killed, their property and homes would be burnt to ashes and their women would be treated as sex slaves. And they themselves would be responsible for this.”

Rev. Zaheer Khan, pastor of Maghoo Memorial Church, Rev. Aamir Azeem, pastor of United Christians Church and Rev. Zafar Akhter, pastor of United Presbyterian Church each received a copy of threatening letter.

“The Islamists sent the letters to the following Christian institutions: St Peter’s Middle School, Sargodha Institute of Technology, Sargodha Catholic High School, St John’s Primary School and Fatima Hospital,” said an ICC spokesperson.

“Besides the Christian institutions, the letter was also sent to the main Immam-Bar-Gha (Shiite Muslim’s gathering hall). Shiites are a minority Muslim group in Pakistan where the majority of the population is Sunni Muslim.”

ICC’s Jonathan Racho said, “Christians in Pakistan are soft targets for attacks by Islamic extremists. Over the past four months alone, 12 Christians have been killed by Muslims due to their faith. We are alarmed by the increase in attacks against Christians in Pakistan. We urge Pakistani officials to take the threatening letters seriously and take measures to protect the Christians and their institutions from attacks.”

Note: ICC is a Washington-DC based human rights organization that exists to help persecuted Christians worldwide. ICC provides Awareness, Advocacy, and Assistance to the worldwide persecuted Church.

Report from the Christian Telegraph 

Decline of traditional media

Should the threat to traditional media from the internet really be a cause for concern?

The new social media — blogging, Facebook, MySpace, Twitter, and YouTube are current faves — revolutionising the publishing world, for better and worse. Let’s look at both the better and the worse in perspective.

The current tsunami of personal choices in communication is slowly draining the profit from mainstream media. These media traditionally depend on huge audiences who all live in one region and mostly want the same things (the football scores, the crossword, the TV Guide, etc.). But that is all available now on the Internet, all around the world, all the time.

One outcome is a death watch on many newspapers, including famous ones like the Boston Globe. As journalist Paul Gillin noted recently: “The newspaper model scales up very well, but it scales down very badly. It costs a newspaper nearly as much to deliver 25,000 copies as it does to deliver 50,000 copies. Readership has been in decline for 30 years and the decline shows no signs of abating. Meanwhile, new competition has sprung up online with a vastly superior cost structure and an interactive format that appeals to the new generation of readers.”

Traditional electronic media are not doing any better. As James Lewin observes in “Television audience plummeting as viewers move online” (May 19, 2008), mainstream broadcasters “will have to come to terms with YouTube, video podcasts and other Internet media or they’ll face the same fate as newspapers.”

Radio audiences have likewise tanked. Overall, the recent decline of traditional media is remarkable.

Some conservative writers insist that mainstream media’s failure is due to its liberal bias. But conservatives have charged that for decades — to no effect. Another charge is that TV is declining because it is increasingly gross or trivial. True enough, but TV’s popularity was unaffected for decades by its experiments with edgy taste.

Let’s look more closely at the structure of the system to better understand current steep declines. Due to the low cost of modern media technology, no clear distinction now exists between a mainstream medium and a non-mainstream one, based on either number of viewers or production cost. Today, anyone can put up a video at YouTube at virtually no cost. Popular videos get hundreds of thousands of views. Podcasting and videocasting are also cheap. A blog can be started for free, within minutes, at Blogger. It may get 10 viewers or 10,000, depending on the level of popular interest. But the viewers control that, not the providers.

The key change is that the traditional media professional is no longer a gatekeeper who can systematically admit or deny information. Consumers program their own print, TV, or radio, and download what they want to their personal devices. They are their own editors, their own filmmakers, their own disc jockeys.

Does that mean more bias or less? It’s hard to say, given that consumers now manage their own level of bias. So they can hear much more biased news — or much less. And, as Podcasting News observes, “Social media is a global phenomenon happening in all markets regardless of wider economic, social and cultural development.”

Understandably, traditional media professionals, alarmed by these developments, have constructed a doctrine of “localism” and, in some cases, called for government to bail them out. That probably won’t help, just as it wouldn’t have helped if the media professionals had called for a government “bailed out” of newspapers when they were threatened by radio, or of radio when it was threatened by TV. Video really did (sort of) kill the radio star, but the radio star certainly won’t be revived by government grants.

Still, the news is not all bad. Yes, new media do sometimes kill old media. For example, no one seriously uses pigeon post to send messages today. But few ever thought birdmail was a great system, just the only one available at the time. However, radio did not kill print, and TV did not kill radio. Nor will the Internet kill older media; it will simply change news delivery. Sometimes in a minor way, but sometimes radically.

Media that work, whether radio, TV, newspapers, books, blogs, or any other, thrive when there is a true need. Today’s challenge is to persuade the consumer to look at alternatives to their own programming decisions.

Denyse O’Leary is co-author of The Spiritual Brain.

The original news article can be viewed at:
http://www.mercatornet.com/articles/view/decline_of_traditional_media/

Article from MercatorNet.com

TENSIONS RISE IN INDIA AS THE ELECTION SEASON BEGINS

India’s election season begins today and will stretch across four weeks, reports MNN.

The incumbent Congress Party is secular and more friendly to freedom of religion, but they’re on the defensive. The Hindu extremist Bharatiya Janata Party (BJP) has also lost ground. Neither of these two main national parties is seen as capable of securing an absolute majority in the five-stage polls.

That leaves the election open to a power grab from one of the other political parties. Stravers explains it makes sense that the smaller political parties will grab up many of the 543 parliamentary seats. No one will have a clear majority, so the final result will kick off a mad scramble to form a working coalition.

No one knows which result will benefit ministries more. Dave Stravers with Grand Rapids, Michigan-based Mission India says, “We need to pray that the people who do vote will also value the freedom of religion that is enshrined in the Constitution of India. Also pray that voters will call their leaders to account to enforce laws that protect people who convert from one religion to another.”

In order to ensure voter safety, more than two million security personnel will be rotated around the country over the five phases of balloting that end on May 13.

More than 700 million registered voters are expected to make their choices along religious and caste lines. Stravers notes that there is some tension. “Pray that there will be a peaceful election and that whatever political environment emerges from these elections will be friendly to the Gospel. People in India are very responsive to the Gospel; the church is growing fast.”

Report from the Christian Telegraph

EGYPT: JUDGE EJECTS LAWYER FOR CHRISTIAN FROM COURT

Dispute over evidence stalls bid by convert from Islam to change official ID.

ISTANBUL, January 13 (Compass Direct News) – An attempt by an Egyptian convert from Islam to legally change the religion listed on his identification card to “Christian” hit a setback on Jan. 6 when a judge ordered security personnel to remove his lawyer from court.

Attorney Nabil Ghobreyal was expelled from the courtroom at Cairo’s Administrative Court following a heated argument with Judge Mohammad Ahmad Atyia.

The dispute arose after Atyia refused to acknowledge the existence of legal documents detailing the successful attempt of a Muslim man to convert to the Baha’i faith. Ghobreyal had planned to submit the court records of the decision in support of his case.

The convert from Islam who is trying to legally convert to Christianity, Maher Ahmad El-Mo’otahssem Bellah El-Gohary, first submitted his request to alter the religious status stated on his ID in August 2008. He follows Muhammad Hegazy as only the second Egyptian Christian convert raised as a Muslim to request such a change.

El-Gohary received Christ in his early 20s. Now 56, he decided to legally change his religious affiliation out of concern over the effects that his “unofficial Christianity” has on his family. He said he was particularly concerned about his daughter, Dina Maher Ahmad Mo’otahssem, 14; though raised as a Christian, when she reaches age 16 she will be issued an identification card stating her religion as Muslim unless her father’s appeal is successful.

At school, she has been refused the right to attend Christian religious classes offered to Egypt’s Christian minorities and has been forced to attend Muslim classes. Religion is a mandatory part of the Egyptian curriculum.

El-Gohary also has charged that his nephew was denied a position in state security agencies because of his uncle’s religious “double life.”

“Why should my family pay for my choices?” said El-Gohary in a report by The Free Copts.

No date has been set for resumption of court proceedings, which, due to the dispute, will reconvene under a different judge.

Ghobreyal said he plans to submit a complaint to the High Administrative Court requesting an investigation of Atyia and the expulsion from court. “I am willing to continue the fight,” Ghobreyal told Compass through a translator, saying he remains hopeful of a positive outcome.

Despite a constitution that grants religious freedom, legal conversion from Islam to another faith remains unprecedented. Hegazy, who filed his case on Aug. 2, 2007, was denied the right to officially convert in a Jan. 29 court ruling that declared it was against Islamic law for a Muslim to leave Islam.

The judge based his decision on Article II of the Egyptian constitution, which enshrines Islamic law, or sharia, as the source of Egyptian law. The judge said that, according to sharia, Islam is the final and most complete religion and therefore Muslims already practice full freedom of religion and cannot return to an older belief (Christianity or Judaism).

The seminal nature of the El-Gohary and Hegazy cases is part of what makes them so controversial, according to Gamal Eid, director of the Arabic Network for Human Rights Information.

“First, there is no experience – this is a very new question, it has made judges and lawyers confused,” he said. “The second thing is that many judges are very religious, for many of them it is based on their religion, their thoughts; the law itself allows for people to convert, so that’s what we’re trying to do, have a decision based on law not on sharia.”

Eid attributed much of the reluctance to grant conversion to this religious bias.

“If the Minister of the Interior respected the law, we would not need to go to court,” he said. “The law says clearly that people can change their address, their career, their religion, they only have to sign an application and then they can have a new ID; the law allows people to convert from any religion to another.”

Egyptian President Anwar Sadat amended the constitution in 1980 to make sharia the main source of legislation in order to bolster support from Islamists against his secular and leftist rivals. Legal experts say there are two views of how sharia is to influence Egyptian law: That it is to be enforced directly in all government spheres, or that it is only to influence shaping of law by legislators and is not to be literally enforced by courts or other bodies.  

Report from Compass Direct News

IRAQ: CHURCH LEADERS PLEAD FOR HELP IN MOSUL

Christians meet with Al-Maliki, ask for troops and provincial voting rights.

ISTANBUL, October 19 (Compass Direct News) – Amid escalating violence against Christians, Iraqi church leaders have appealed directly to Prime Minister Nuri al-Maliki for increased efforts to curb the continuing attacks In Mosul.

In a meeting with Al-Maliki, 10 heads of Iraqi churches urged the prime minister on Thursday (Oct. 16) to send the army to Mosul to help the approximately 1,000 police that were dispatched this past week to keep watch over Christians in the city.

Church leaders said police efforts to curb violence were insufficient and more needed to be done to stabilize the city, from which an estimated 1,500 families have fled following recent killings of Christians.

Al-Maliki assured the church heads that he would do whatever was in his power in cooperation with them and that he hoped to send soldiers to Mosul “immediately,” said Shlemon Warduni, an auxiliary bishop of the Chaldean Church in Bagdad present at the meeting.

“He is upset and he’s sorry for what is happening,” said Warduni. “He is going to do whatever he can in cooperation with those who work with him.”

Members of the Christian communities believe that the police already sent to the city have made little difference and more forces are needed to ensure peace.

“I hope they will follow it up with more action; that they will continue as they said themselves until there is peace,” said Warduni. “We firmly ask for the army to be sent in the hopes that peace will come back and people will return to their homes.”

Father Basher Warda of St. Peter’s Seminary, spoke by phone to Compass with similar urgency. Government officials have visited Mosul and the victims promising to help, “but there is nothing,” said Fr. Warda. “A few initiatives here and there, but they cannot correspond to the whole crisis.”

He pointed out how no military spokesman has said Mosul is now secure, leaving only the government’s promises.

“The whole system needs to be reconsidered,” Fr. Warda said. “In a crisis the government should not take any holiday or rest, but they said, ‘We will see what to do in the coming days.’ But it’s not a matter of coming days; it’s a matter of families who have left everything behind.”

Families are still fleeing as threats, bombings and deaths persist in Mosul, according to Fr. Warda. He said 20 percent of the displaced people he has spoken to said they had been directly threatened before they fled Mosul. Others described how they witnessed threats against their neighbors, “the killing of a man, or a father and his son,” in their streets.

“These [accounts] … show there is something planned to evacuate Christians form Mosul,” he said. “They say: ‘We cannot risk it.’”

 

Change in Parliament

It is not clear who is behind the attacks on Christians in Mosul, where U.S. and Iraqi forces have been conducting operations against the Sunni militant group al-Qaeda.

The displacement of Christians follows comes on the heels of an Iraqi parliamentary vote to drop a clause in its new provincial election law, Article 50, that protected rights of minorities by guaranteeing their representation on provincial councils.

The change earlier this month sparked protests from Christians in Mosul, which some believe have fueled the attacks on the Christian community.

In their meeting with Al-Maliki, church community leaders also pleaded for the re-instatement of Article 50. Al-Maliki assured them he would bring it to the attention of Parliament in the next session, Warduni said.

Although unwilling to draw direct links to the demonstrations, Fr. Warda did tell Compass that he thought the attacks were coordinated.

“Maybe it’s a coincidence, and maybe it’s an occasion for violence,” said Fr. Warda. “But whatever the reason was, it looks like there was a plan [for the violence]. We cannot say it’s just a coincidence, it happened in such a quick way.”

He called the effort to clear Christians out of Mosul, a “massive task.”

“We are talking about 1,700 families who have fled in nine days,” he said.

In the wake of attacks on churches and individuals, Iraqi Christians have fled to surrounding villages leaving homes and businesses.

Some of Mosul’s refugees have sought shelter across the border in either Turkey or Syria. It is the small and unprepared villages surrounding the city, however, that have borne the brunt of the displacement, according to Fr. Warda.

For now, the primary concern of church leaders is the safe return of those who have fled.

“[Mosul is] their history, their heritage, memories are there. Every beautiful memory is there. We have to do something,” said Fr. Warda. He said those he spoke to were too afraid to go back to their homes and did not know if they could trust the government for their security.

Asked whether he thought Mosul would lose its entire Christian population, Fr. Warda said, “I don’t care to think about it, because it would be a tragedy for all people. The choices are so limited. My concern now is for Christians who are leaving.”

Although “hopeful” about the situation of Mosul’s Christian community, Warduni did not hesitate to criticize what he calls the “silence” of the international community on the human rights of Iraq’s Christian community.

“I want to tell the developed world that from the outset no one has said anything,” he said. “No one is talking about the rights of Christians and minorities in Iraq. We are waiting for support from the outside, at least as human beings not only as Christians.”

Report from Compass Direct News