Background
For over 35 years, Africa has continued to host HIV vaccine trials geared towards overturning the HIV/AIDs pandemic in the continent. However, the methods of sharing the vaccines, when available remain less certain. Therefore, the study aims to explore stakeholders’ perspectives in the global South, in this case, Tanzania, on how HIV vaccines ought to be fairly shared.
Methods
The study deployed a qualitative case study design. Data were collected through in-depth interviews and focus group discussions with a total of 37 purposively selected participants. This included researchers, institutional review board members, a policymaker, HIV/AIDS advocates, and community advisory board members. The data obtained were inductively and deductively analyzed.
Results
Findings indicate that HIV vaccines can be shared fairly under the principles of distributive justice (contribution, need and equality). Thus, contribution-based sharing ought to be utilized upon the necessity to prioritize vaccine access or subsidized trial benefits to host communities. Need-based sharing ought to be considered for non-host communities that are at an increased risk of HIV infection. Lastly, equal-based sharing would be useful at later stages of vaccine distribution or when the aforementioned principles are deemed morally inappropriate. However, none of the benefit-sharing approaches is free of limitations and a counterbalancing sense of unfairness.
Conclusion
Fair sharing of HIV vaccines, when available, ought to be informed by the contribution, need and equality principles of distributive justice. Countries in the global south including Tanzania are likely to be prioritized during the distribution of the HIV vaccines due to their participation in HIV vaccine trials and due to the disproportionate HIV burden evident in the region.
Disparity in economic development between high-income countries (HICs) and low-and medium-income countries (LMICs) has necessitated collaborations, some in health-related activities. Globalisation frameworks indicate that, in fair collaborations, the ultimate aim should be to improve the situation in LMICs. In this paper we present the findings of a research study in which we used Aristotle's concept of friendship among unequal parties as an analytic framework to engage with the issue of inequality in an existing international partnership in health, the Indiana University-Kenya Partnership (IU-Kenya Partnership). This is a collaborative health programme involving a consortium of North American universities and schools of the Moi University College of Health Sciences in Kenya. We carried out in-depth oral interviews and focus group discussions with a sample of 41 partners of various IU-Kenya Partnership programmes. We did a comparison of obtained themes to the Aristotelian pointers of aspects of friendship among unequal parties. We eventually identified good and bad aspects of North-South partnerships as perceived in the IU-Kenya Partnership restricted to the Aristotelian model.
Informed by evidence from past studies and experiences with epidemics, an intervention combining quarantine, lockdowns, curfews, social distancing, and washing of hands has been adopted as "international best practice" in COVID-19 response. With massive total lockdowns complemented by electronic surveillance, China successfully controlled the pandemic in country within a few months. But would this work for Africa and other communalistic resource-poor settings where social togetherness translates to effective sharing of basic needs? What ethical and practical challenges would this pose? How would communalism be translated in special contexts to be useful in contributing to the ultimate common good? This paper uses examples from the current situation of COVID-19 in Kenya to address these questions.
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