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Allocation of scarce resources in Africa during Covid‐19

Utility and justice for the bottom of the pyramid

Bibliographic Data

ID19516490
AuthorsKeymanthri Moodley (0000-0003-3404-4901, Western Cape Department of Health, corresponding author), Rennie (0000-0003-3844-972X, Western Cape Department of Health), Stuart Rennie, Frieda Behets (Western Cape Department of Health), Adetayo E Obasa (0000-0003-0934-9586, Western Cape Department of Health), Robert Yemesi (Western Cape Department of Health), Laurent Ravez (0000-0003-2123-0617, Western Cape Department of Health), Patrick Kayembe (0000-0002-5693-2144, Western Cape Department of Health), Darius Makindu (Western Cape Department of Health), Alwyn Mwinga (0000-0003-3723-0064, Western Cape Department of Health), Walter Jaoko (0000-0002-7134-6581, Western Cape Department of Health)
Year2021
Volume21
Issue1
Pages36-43
Publication date2021-03-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueDeveloping World Bioethics (JOURNAL)
Journal identifiersISSN: 1471-8731 • E-ISSN: 1471-8847
PublisherWiley (PUBLISHER • GB)
DOI10.1111/dewb.12280
PMID32845575
OpenAlexW3080953901
LanguageEN
Citations received6
References cited5

The COVID‐19 pandemic has raised important universal public health challenges. Conceiving ethical responses to these challenges is a public health imperative but must take context into account. This is particularly important in sub‐Saharan Africa (SSA). In this paper, we examine how some of the ethical recommendations offered so far in high‐income countries might appear from a SSA perspective. We also reflect on some of the key ethical challenges raised by the COVID‐19 pandemic in low‐income countries suffering from chronic shortages in health care resources, and chronic high morbidity and mortality from non‐COVID‐19 causes. A parallel is drawn between the distribution of severity of COVID‐19 disease and the classic “Fortune at the bottom of the pyramid” model that is relevant in SSA. Focusing allocation of resources during COVID‐19 on the ‘thick’ part of the pyramid in Low‐to‐Middle Income Countries (LMICs) could be ethically justified on utilitarian and social justice grounds, since it prioritizes a large number of persons who have been economically and socially marginalized. During the pandemic, importing allocation frameworks focused on the apex of the pyramid from the global north may therefore not always be appropriate. In a post‐COVID‐19 world, we need to think strategically about how health care systems can be financed and structured to ensure broad access to adequate health care for all who need it. The root problems underlying health inequity, exposed by COVID‐19, must be addressed, not just to prepare for the next pandemic, but to care for people in resource poor settings in non‐pandemic times

Business · Developing country · Development economics · Disease · Economic growth · Economic Justice · Economics · Geography · Health care · Pandemic · Political science · Public health · Disaster Response and Management · Health and Conflict Studies · Law · Medicine · Nursing · Viral Infections and Outbreaks Research

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Unique citing works6
Citations per year1,2
Citation span2021 - 2024 (4)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 6
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