Pandemic lottery preparedness: Preparing to ethically, fairly, and systematically allocate scarce resources in response to future infectious disease outbreaks
Gerard Vong1, Emory University Center For Ethics Atlanta 1Emory University Center For Ethics, Atlanta, Georgia, USA
Abstract
Using the public health response to the recent COVID-19 and MPox international outbreaks as examples, I argue that one ethically important step in preparing for future disease outbreaks is setting up lottery systems for the allocation of scarce healthcare resources. Firstly, I concisely summarize the philosophical, historical, and public support for fairly and ethically allocating scarce healthcare resources by lottery in paradigmatic cases where we are unable to provide those resources to all equally-worthy potential beneficiaries. Secondly, I argue that future outbreaks are foreseeable to result in such paradigmatic cases due to current public health resource planning and stockpile policy, lack of research and data for new or unprioritized infectious agents, and logistical challenges in outbreak response. Finally, I argue that there are ethical reasons to incorporate three features into the design of such lotteries: (i) they should be designed such that information about them can be transparently shared in different languages with patients with varied heath literacy, (ii) that they should be able to respond to changes in the demand and supply of the resource over time, and (iii) should be able to exclude specific earlier lottery entrants from later lottery allocations in order to promote population-level equity.
Biography
Gerard Vong (DPhil) is Associate Professor at Emory University’s Center for Ethics. Prior to Emory, Dr. Vong worked at Harvard and Fordham universities. His research focuses on the ethical distribution of benefits and risks, including scarce healthcare resource allocation. Dr. Vong is also active in pandemic response policy.