Ética e negociações para o acesso às vacinas: excepcionalidades metodológicas e éticas
DOI:
https://doi.org/10.18270/rcb.v17i1.3935Palavras-chave:
COVID-19, bioética, pandemia, ética da investigação, vacinas, indústria farmacêutica, nacionalismo vacinal, normas éticas, direitos humanos, investigação biomédica, propriedade intelectualResumo
Finalidade/Contexto. Este artigo analisa os vários factores que afectaram o acesso às vacinas para a prevenção da infecção pela SRA-COV2, com especial atenção para os interesses envolvidos nas negociações. Detalha uma análise dos processos de investigação, produção, aquisição, distribuição e comercialização de vacinas, bem como as normas éticas internacionais que orientam estas práticas.
Metodologia/Aproximação. Do mesmo modo, é identificado um quadro de excepções científicas, metodológicas, éticas e legais para a investigação, produção e comercialização de vacinas, enquanto que as regras impostas pelo sistema de mercado global em termos de protecção da propriedade intelectual (TRIPS), negociações e contratos, defesa de interesses privados e empresariais foram mantidas e aprofundadas sem excepções. Salienta também o papel desempenhado pelos países mais ricos, acumulando mais doses do que as necessárias, o que teve um sério impacto no acesso dos países de baixos rendimentos.
Resultados/Findings. Normas e acordos éticos internacionais feitos pelos governos que deveriam limitar comportamentos como este e evitar as suas consequências são analisados e não têm sido cumpridos.
Discussão/Conclusões/Contribuições. Conclui com uma proposta concreta que poderia aliviar a situação actual e inclui uma reflexão sobre o impacto na vida e saúde dos países e grupos mais vulneráveis, se a ordem internacional continuar a ser regida pelo sistema de mercado global em vez de um novo pacto global, mais justo.
Downloads
Referências
Johns Hopkins University. Coronavirus Resource Center. 2021. Ver: https://coronavirus.jhu.edu/map.html
OMS. 2021. Consideraciones para aplicar y ajustar medidas de salud pública y sociales en el contexto de la COVID-19 . Orientaciones provisionales 14 de junio de 2021. Disponible en: WHO-2019-nCoV-Adjusting-PH-measures-2021.1-spa.pdf
Solbakk J. H., Cox S., Bernabe R., Vidal Suarez S. M.. 2021. Covid-19, Comedy and Crimes against humanity. EACME Newsletter European Association of Centres of Medical Ethics, Nederland, Nr57, April.
WHO. 2021. WHO Director-General's opening remarks at 148th session of the Executive Board.
January 2021. Disponible en: https://www.who.int/director-general/speeches /
detail/who-director-general-s-opening-remarks-at-148th-session-of the-executive-board
Parsons Lucy. 2021. Pfizer/BioNTech reach vaccine supply agreement with COVAX. PMLive. January 25th, 2021 Accessible: https://www.pmlive.com/pharma_news/pfizerbiontech_reach_vaccine_supply_agreement_with_covax_1361849
Parsons, Lucy. 2021. WHO's director-general deems vaccine nationalism a "catastrophic moral failure". PMLive. January 19th 2021. Accesible: http://www.pmlive.com/pharma_news/whos_director-general_deems_vaccine_nationalism_a_catastrophic_moral_failure_1361533
UN Asamblea General. 2020. Respuesta integral y coordinada a la pandemia de enfermedad por coronavirus. 10 de septiembre de 2020 (COVID-19). Disponible en : A_74_L.92-ES.pdf
John Hopkings Coronavirus Resource Center. International Vaccination Effort. Understanding Vaccination Progress by Country. Accesible en: https://coronavirus.jhu.edu/vaccines/international
ONU. 2021. Diez países han acaparado el 75% de las vacunas COVID-19 administradas, denuncia Guterres al Consejo de Seguridad. Noticias ONU. Accesible en: https://news.un.org/es/story/2021/02/1488202
Holder Josh. 2021. Tracking Coronavirus Vaccinations around the World. Updated July 3, 2021. NYT https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker.html
Our World in Date. 2021. Coronavirus (COVID-19) Vaccinations. Share of people vaccinated against COVID-19, Sep 7, 2021. Accesible en: https://ourworldindata.org/covid-vaccinations . Accesible en: https://ourworldindata.org/covid-vaccinations
Médicos sin Fronteras. 2021. Los países del G7 deben compartir inmediatamente todas las dosis posibles con los países de ingresos bajos y medios, Accesible en: https://www.msf.es/actualidad/los-paises-del-g7-deben-compartir-inmediatamente-todas-las-dosis-posibles-los-paises
Holder Josh 2021. Tracking Coronavirus Vaccinations Around the World, Updated Sept. 8, 2021, accessible en : https://www.nytimes.com/interactive/2021/world/covid-vaccinations-tracker.html
WTO. Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS). Disponible en: WTO | Intellectual property (TRIPS) - gateway
Hooker L, Palumbo D. 2020. Vacunas contra el coronoavirus, cuánto dinero puede ganar realmente las farmacéuticas con la inmunización. BBC News, 15.12.20. Accesible: https://www.bbc.com/mundo/noticias-55293057
Hooker L, Palumbo D. 2020. Op Cit
Stoeklé Henri-Corto & Hervé Christian. 2020. COVID-19: Act First, Think Later, The American Journal of Bioethics, 20:7, W1. https://doi.org/10.1080/15265161.2020.1761199
Hellmann F., Cardoso Bittencourt S., Stolf Brzozowski F.,Finkler M., Verdi M., Caponi, S. 2020. COVID-19: Think First, Act Better Later. Bioethics.net. Posted on May 25 at 12:57 PM. Accesible: http://www.bioethics.net/2020/05/covid-19-think-first-act-better-later/
London AJ, Kimmelman J. Science, 2020 Against pandemic research exceptionalism. SCIENCE, 368: 476-477.
https://doi.org/10.1126/science.abc1731
WHO. 2016. Expert Committee on Biological Standardization. Human Challenge Trials for Vaccine Development: regulatory considerations. Geneva, Accesible en:https://www.who.int/biologicals/expert_committee/Human_challenge_Trials_IK_final.pdf
WHO. 2020. Working Group for Guidance on Human Challenge Studies in COVID-19 Key criteria for the ethical acceptability of COVID-19 human challenge studies. Accesible en: https://www.who.int/publications/i/item/WHO-2019-nCoV-Ethics_criteria-2020.1
Keren A, Lev O. 2020. Uncertainty, error and informed consent to challenge trials of COVID-19 vaccines: response to Steel et al, J Med Ethics, 46 (12): 813-814. https://doi.org/10.1136/medethics-2020-106793
Deming, M. E.; Michael, N. L.; Robb, M.; Cohen, M. S.; Neuzil, K. M. 2020. Accelerating development of SARS-CoV-2 vaccines-the role for controlled human infection models. N. Engl. J. Med. 383, e63. https://doi.org/10.1056/NEJMp2020076
Solbakk JH, Vidal SM. 2014. Clinical research in resource-poor settings, En : H.A.M.J. ten Have, B. Gordijn (eds.), Handbook of Global Bioethics, Springer Science+Business Media Dordrecht: pp. 527-550. https://doi.org/10.1007/978-94-007-2512-6_102
Solbakk J. H., Cox S., Bernabe R., Vidal S. M. 2021. Covid-19, Comedy and Crimes against humanity. Op Cit. p15. Disponible en: EACMENewsletterApril2021.pdf
London A, Kimmelman J. Science, 2020, Op Cit
Médicos sin Fronteras. 2021 Los países opositores deben dejar de obstruir las negociaciones sobre la exención de los ADPIC en la OMC. Accesible en https://www.msf.es/actualidad/los-paises-opositores-deben-dejar-obstruir-las-negociaciones-la-exencion-los-adpic-la-omc
Agarwal R, Gopinath G. 2021. A Proposal to End the COVID-19 Pandemic, en International Monetary Fund webpage.
https://doi.org/10.5089/9781513577609.006
Baral, S.D. et.al. 2021. COVID_19 Passports will harm sustainable development. BMJ Opinion, March 2021: https://blogs.bmj.com/bmj/2021/03/30/COVID-19-vaccine-passports-will-harm-sustainable-development
Boseley Sarah. 2020. Belgian minister tweets EU's Covid vaccine price list to anger of manufacturers. The Guardian . Fri 18 Dec 2020. Accesible en: https://www.theguardian.com/world/2020/dec/18/belgian-minister-accidentally-tweets-eus-covid-vaccine-price-list
Vidal Susana M. 2021. Ética y repugnacia: negociaciones sobre vacunas para los países pobres. Artículo de opinión. Redbioetica UNESCO. Accesible: https://redbioetica.com.ar/etica-y-repugnacia-negociaciones-sobre-vacunas-para-los-paises-pobres/
Los Angeles Times. 2020. Argentina: exigencias de Pfizer para vacuna son inaceptables. DIC. 15, 2020 2:22 PM PT Accesible en: https://www.latimes.com/espanol/internacional/articulo/2020-12-15/argentina-exigencias-de-pfizer-para-vacuna-son-inaceptables . Véase también: https://blackysburrow.com/2021/08/24/how-pfizer-tried-to-bully-argentina-and-brazil-in-exchange-for-vaccines/
Davies M, Ruiz I, Langlois J and Furneaux R . 2021. 'Held to ransom': Pfizer plays hardball in Covid-19 vaccine negotiations with Latin American countries. The Bureau of Investigative Journalism Feb. 23, Accesible en: https://www.statnews.com/2021/02/23/pfizer-plays-hardball-in-covid19-vaccine-negotiations-in-latin-america/?utm_campaign=rss.
https://www.keionline.org/misc-docs/Pfizer-DominicanRepublic-Vaccine-Term-Sheet-19Jan2021.pdf (Publicado por la misma Fuente: Davies M, Ruiz I, Langlois J, et al 2021, Op Cit)
Davies M, Furneaux R, Ruiz I and Langlois J. 2021. Pfizer demands governments gamble with state assets to secure vaccine deal. Science the wire, February 24. Accesible en: https://science.thewire.in/health/pfizer-demands-governments-gamble-with-state-assets-to-secure-vaccine-deal/
González GA. 2021. MSF España. MSF pide que se analicen de forma crítica las deficiencias de COVAX 22 jun, Accesible en: https://reliefweb.int/report/world/msf-pide-que-se-analicen-de-forma-cr-tica-las-deficiencias-de-covax
Amnesty International. 2021. Dosis doble de desigualdad. Las empresas farmacéuticas y la crisis de las vacunas contra la covid-19. Amnesty International Ltd, London, 15p. Accesible en: https://doc.es.amnesty.org/ms-opac/doc?q=*%3A*&start=0&rows=1&sort=fecha%20desc&fq=norm&fv=*&fo=and&fq=mssearch_fld13&fv=POL40470421&fo=and&fq=mssearch_mlt98&fv=gseg01&fo=and
González GA. 2021, MSF España. Op Cit
Callaway, Ewen. 2021. COVID vaccine boosters: the most important questions. Nature. 05 August. Accesible en: https://www.nature.com/articles/d41586-021-02158-6
Nature. 2021. The WHO is right to call a temporary halt to COVID vaccine boosters. Editorial. 17 August, Accesible en: https://www.nature.com/articles/d41586-021-02219-w
PNUD. Informe Anual 2019 p19. Accesible: https://reliefweb.int/sites/reliefweb.int/files/resources/UNDP-Annual-Report-2019-es-compressed.pdf
Oxfam Internacional. 2020 ¿Quién paga la cuenta? Gravar la riqueza para enfrentar la crisis de la COVID 19 en América Latina y el Caribe. Oxfam Internacional, Julio. Accesible: https://oxfamilibrary.openrepository.com/bitstream/handle/10546/621033/bp-quien-paga-la-cuenta-covid-19-270720-es.pdf p.5
Oxfam Internacional, 2020 ¿Quién paga la cuenta?, Op Cit.
Oxfam Internacional. 2021. Los mega ricos han recuperado las pérdidas ocasionadas por la pandemia en un tiempo récord, mientras que miles de millones de personas vivirán en situación de pobreza al menos una década
Accesible en: https://www.oxfam.org/es/notas-prensa/los-mega-ricos-han-recuperado-las-perdidas-ocasionadas-por-la-pandemia-en-un-tiempo
ONU ODS. https://www.un.org/sustainabledevelopment/es/
ONU ODS. Objetivo 17: Revitalizar la Alianza Mundial para el Desarrollo Sostenible
Accesible en: https://www.un.org/sustainabledevelopment/es/globalpartnerships/
MSF. 2021. Los países del G7 deben compartir inmediatamente todas las dosis posibles con los países de ingresos bajos y medios. Accesible en: https://www.msf.es/actualidad/los-paises-del-g7-deben-compartir-inmediatamente-todas-las-dosis-posibles-los-paises
Bertomeu, María Julia. 2021. Solidaridad, pandemia y barbarie. Editorial. Asociación de Acceso Justo a Medicamentos, 3, Accesible en https://accesojustomedicamento.org/solidaridad-pandemia-y-barbarie/ Véase también el artículo de referencia de Britton-Purdy Jedediah. 2020. Solidarity and Crisis. Dissent Magazine. Accesible: https://www.dissentmagazine.org/article/solidarity-and-crisis.
Nussbaum, Martha. 2006. El ocultamiento de lo humano, repugnancia, vergüenza y ley. Katz Ed. Bs As. https://doi.org/10.2307/j.ctvm7bdp8
Downloads
Publicado
Como Citar
Edição
Seção
Licença
Este trabalho está licenciado sob uma licença Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Esta obra está bajo licencia internacional Creative Commons Reconocimiento-NoComercial-SinObrasDerivadas 4.0.