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同一健康、疫苗与埃博拉:实现共同利益的机遇

One Health, Vaccines and Ebola: The Opportunities for Shared Benefits.

作者信息

Capps Benjamin, Lederman Zohar

机构信息

1Department of Bioethics, Faculty of Medicine, Dalhousie University, 5849 University Avenue, Room C-312, CRC Bldg, PO Box 15000, Halifax, NS B3H 4R2 Canada.

2Sourasky Medical Center, Tel Aviv, Israel.

出版信息

J Agric Environ Ethics. 2015;28(6):1011-1032. doi: 10.1007/s10806-015-9574-7. Epub 2015 Sep 16.

Abstract

The 2013 Ebola virus outbreak in West Africa, as of writing, is declining in reported human cases and mortalities. The resulting devastation caused highlights how health systems, in particular in West Africa, and in terms of global pandemic planning, are ill prepared to react to zoonotic pathogens. In this paper we propose One Health as a strategy to prevent zoonotic outbreaks as a shared goal: that human and Great Ape vaccine trials could benefit both species. Only recently have two phase 2/3 Ebola human vaccine trials been started in West Africa. This paper argues for a conceptual change in pandemic preparedness. We first discuss the ethics of One Health. Next, we focus on the current Ebola outbreak and defines its victims. Third, we present the notion of a 'shared benefit' approach, grounded in One Health, and argue for the vaccination of wild apes in order to protect both apes and humans. We believe that a creation of such inter-species immunity is an exemplar of One Health, and that it is worth pursuing as a coextensive public health approach.

摘要

截至撰写本文时,2013年西非埃博拉病毒疫情在报告的人类病例和死亡人数方面正在下降。由此造成的破坏凸显了卫生系统,特别是西非的卫生系统,以及在全球大流行规划方面,对人畜共患病原体的应对准备不足。在本文中,我们提出“同一健康”作为预防人畜共患疫情的一项战略,作为一个共同目标:即人类和大猩猩疫苗试验可以使两个物种都受益。直到最近,西非才启动了两项埃博拉病毒人类疫苗2/3期试验。本文主张在大流行防范方面进行观念转变。我们首先讨论“同一健康”的伦理问题。接下来,我们关注当前的埃博拉疫情并确定其受害者。第三,我们提出基于“同一健康”的“共享利益”方法的概念,并主张为野生大猩猩接种疫苗,以保护大猩猩和人类。我们认为,建立这种种间免疫是“同一健康”的一个典范,并且作为一种广泛的公共卫生方法值得追求。

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本文引用的文献

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The next epidemic--lessons from Ebola.下一场疫情——埃博拉带来的教训
N Engl J Med. 2015 Apr 9;372(15):1381-4. doi: 10.1056/NEJMp1502918. Epub 2015 Mar 18.
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3
Apes in the Anthropocene: flexibility and survival.人类世的猿类:灵活性与生存
Trends Ecol Evol. 2015 Apr;30(4):215-22. doi: 10.1016/j.tree.2015.02.002. Epub 2015 Mar 9.
10
Randomisation is essential in Ebola drug trials.随机化在埃博拉药物试验中至关重要。
Lancet. 2014 Nov 8;384(9955):1667. doi: 10.1016/S0140-6736(14)61735-9. Epub 2014 Oct 27.

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