Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
Nufflield Department of Medicine, University of Oxford, Oxford, UK; Department of Philosophy and Classics, University of Ghana, Accra, Ghana.
Lancet Infect Dis. 2023 Nov;23(11):e489-e496. doi: 10.1016/S1473-3099(23)00364-X. Epub 2023 Jul 5.
The COVID-19 pandemic revealed numerous weaknesses in pandemic preparedness and response, including underfunding, inadequate surveillance, and inequitable distribution of countermeasures. To overcome these weaknesses for future pandemics, WHO released a zero draft of a pandemic treaty in February, 2023, and subsequently a revised bureau's text in May, 2023. COVID-19 made clear that pandemic prevention, preparedness, and response reflect choices and value judgements. These decisions are therefore not a purely scientific or technical exercise, but are fundamentally grounded in ethics. The latest treaty draft reflects these ethical considerations by including a section entitled Guiding Principles and Approaches. Most of these principles are ethical-they establish core values that undergird the treaty. Unfortunately, the treaty draft's set of principles are numerous, overlapping, and show inadequate coherence and consistency. We propose two improvements to this section of the draft pandemic treaty. First, key guiding ethical principles should be clearer and more precise than they currently are. Second, the link between ethical principles and policy implementation should be clearly established and define boundaries on acceptable interpretation, ensuring that signatories abide by these principles.
新冠疫情暴露出大流行防范和应对工作中的诸多弱点，包括资金不足、监测不力以及应对措施分配不均等。为了克服这些弱点，以应对未来的大流行，世卫组织于 2023 年 2 月发布了一份大流行条约的零草案，并随后于 2023 年 5 月发布了经修订的局内案文。新冠疫情表明，大流行的预防、防范和应对反映了各种选择和价值判断。因此，这些决策不仅仅是纯粹的科学或技术问题，而是从根本上基于伦理考量。最新的条约草案通过纳入一个题为“指导原则和方法”的章节来反映这些伦理考虑。这些原则中的大多数都是伦理原则——它们确立了支撑条约的核心价值观。不幸的是，该条约草案的原则众多、相互重叠，且一致性和连贯性不足。我们对该大流行条约草案的这一部分提出了两点改进建议。首先，关键的指导伦理原则应比目前更加清晰和精确。其次，应明确确立伦理原则与政策执行之间的联系，并为可接受的解释划定界限，以确保签署方遵守这些原则。
