title: Prioritising Healthcare Workers for Ebola Treatment: Treating Those at Greatest Risk to Confer Greatest Benefit.
abstract: The Ebola epidemic in Western Africa has highlighted issues related to weak health systems, the politics of drug and vaccine development and the need for transparent and ethical criteria for use of scarce local and global resources during public health emergency. In this paper we explore two key themes. First, we argue that independent of any use of experimental drugs or vaccine interventions, simultaneous implementation of proven public health principles, community engagement and culturally sensitive communication are critical as these measures represent the most cost-effective and fair utilization of available resources. Second, we attempt to clarify the ethical issues related to use of scarce experimental drugs or vaccines and explore in detail the most critical ethical question related to Ebola drug or vaccine distribution in the current outbreak: who among those infected or at risk should be prioritized to receive any new experimental drugs or vaccines? We conclude that healthcare workers should be prioritised for these experimental interventions, for a variety of reasons.
authors: Priya
authors: P
authors: Satalkar
authors: Bernice E
authors: BE
authors: Elger
authors: David M
authors: DM
authors: Shaw
mesh_terms: D000354:Africa, Western / Q000453:epidemiology; D000998:Antiviral Agents / Q000627:therapeutic use*; D003140:Communicable Disease Control / Q000379:methods* / Q000592:standards; D003466:Cultural Characteristics; D004196:Disease Outbreaks; D015507:Drugs, Investigational / Q000627:therapeutic use*; D046129:Ebola Vaccines / Q000008:administration & dosage*; D029043:Ebolavirus / Q000276:immunology; D006282:Health Personnel; D006292:Health Priorities / Q000941:ethics*; D006295:Health Resources / Q000706:statistics & numerical data; D019142:Hemorrhagic Fever, Ebola / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control*; D006801:Humans; D007116:Immunization, Passive / Q000379:methods; D011057:Politics; D011634:Public Health / Q000941:ethics* / Q000379:methods / Q000592:standards; D016032:Randomized Controlled Trials as Topic / Q000941:ethics; D012107:Research Design; D012306:Risk
chemical_list: D000998:Antiviral Agents; D015507:Drugs, Investigational; D046129:Ebola Vaccines
keywords: Africa; Disease surveillance; Ebola; bioethics; clinical trials; community engagement; resource allocation