By Joseph Odoi
As Uganda rolls out vaccines in an effort to kick out coronavirus, Bioethicists from Makerere University have urged Government to involve all stakeholders in priority setting for COVID-19 vaccination.
This call follows a latest study which sought to establish ethical and social issues for COVID-19 vaccination in the country.
While disseminating preliminary findings of the study titled ‘Ethical And Social issues for COVID-19 vaccine priority setting and access in Uganda’, Associate Professor Joseph Ochieng from the Department of Anatomy, College of Health Sciences (CHS), Makerere University said one of the most effective ways for public buy-in for new interventions is effective stakeholder engagement using the down-up model so that all stakeholders feel they have a say and their input is valued.
“When people are adequately involved in the decision making, they tend to adequately accept the results and take them up because they feel they own them. So we set out to access the different stakeholders whether they’re aware of the ethical issues associated with priority setting and how they’re going to handle priority of vaccine access in Uganda,” he explained while at Anatomy Department Building on 19th March, 2021.
Prof. Ochieng further noted that there should a proactive, open (to the public) and evidence-based engagement of as many stakeholders as possible in these and related processes.
’This is important to build and sustain public support to and trust in health systems, all of which are critical in ensuring an equitable and efficient health system’’ he added
With regard to priorities, the Bioethicists state that since the quantities for the COVID-19 vaccine coming in are small, there should be a pre-determined evidence-based criterion for deciding who gets what first, and who should lose out or wait for the next opportunity
“Setting those priorities of who is vaccinated when has a number of ethical and social issues with questions.
We came up with this study to see how we can contribute to this issue of priority setting and vaccine access so that everyone feels it’s a fair process. If people believe it’s fair, then it’s ethical and acceptable and likely to be taken up,” Prof. Ochieng explained.
Findings
As Part of the preliminary findings, Dr. John Barugahare, Co-investigator and Senior Lecturer at Department of Philosophy, Makerere University said COVID-19 could be controlled by first attending to people who are likely to spread the disease like travelers; including truck drivers who have been associated with this disease whenever they traverse the country.
“We’ve heard from taxi drivers and conductors saying that they’re exposed to the risk of infections from passengers everyday by virtue of their work and they increase the risk of transmission to other passengers. However, they don’t understand why the elderly in rural areas are having priority over them,” he said.
Dr. Baruhagare further says that there is need to harmonize WHO immunization guidelines by setting priorities which fit into the local context as each country has its unique challenges.
Moving forward, the researchers recommend public engagement to create awareness on vaccination guidelines
“If the guidelines are developed, they should be freely available and well publicized. There should also be a continuous process of priority setting,” Prof. Ochieng noted.
“In future, such processes of setting priorities should be more open and transparent. There should be sufficient efforts to involve the public and seek opinions on what they think as opposed to having a few individuals to guide in the decision making process,” added Dr. Barugahare.
Funded by the World Health Organization (WHO), the study involved key informant interviews and in-depth interviews with a number of key stakeholders in COVID-19 intervention like bioethicists, clinicians, public health experts, policy makers, lawyers, human rights activists and scientists.
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