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WHO R&D Blueprint COVID-19 WHO Ethics & COVID-19 Working Group Achievements February 2020 – May 2021 WHO reference number © World Health Organization 2021. All rights reserved. This is a draft. The content of this document is not final, and the text may be subject to revisions before publication. The document may not be reviewed, abstracted, quoted, reproduced, transmitted, distributed, translated or adapted, in part or in whole, in any form or by any means without the permission of the World Health Organization. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by WHO in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letter
WHO Ethics & COVID-19 Working Group - Achievements
Table of Contents
1. Introduction ............................................................................................................... 3
2. Research priorities and questions........................................................................... 4
3. Publications – Overview ........................................................................................... 5
4. Events and Outreach ................................................................................................ 7
5. Advisory Roles ........................................................................................................ 10
6. Sub-Working Groups Established ......................................................................... 11
7. Funded Projects ...................................................................................................... 12
Annex 1. Members of the WHO Ethics & COVID-19 Working Group ...................... 19
Annex 2. Sub-Working Groups Established ............................................................. 20
Annex 3. Publications - Full List ................................................................................ 24
2WHO Ethics & COVID-19 Working Group - Achievements
1. Introduction
The promotion of ethical values such as equity, fairness, and solidarity must be central to COVID-
19 R&D and the broader response to the pandemic. These ideas are ubiquitous in the language
used to describe global commitments in research, resource allocation, and measures taken in
response to the pandemic, and so it is crucial that meaningful effort is made to examine the ethical
commitments entailed by these values and understand what this requires in practice, whether it
is in the design and implementation of global clinical trials for COVID-19 therapeutics or the global
distribution of vaccines.
The Ethics & COVID-19 Working Group aims to examine and produce guidance with respect to
the ethical considerations and dimensions associated with COVID-19 R&D and the pandemic
response. In particular, the objectives for the Ethics & COVID-19 Working Group are:
Objective 1: Build on pre-existing ethics guidance to develop guidance materials fit for
purpose in COVID-19
Objective 2: Identify principles for research and their application (SOPs, Solidarity trials,
human challenge studies)
Objective 3: Develop allocation principles for clinical management, vaccines, diagnostics, &
therapeutics
Objective 4: Build ethical preparedness for the subsequent waves and future infectious
disease threats
In order to effectively guide action, the Ethics & COVID-19 Working Group recognizes that it must
be responsive to the needs of other R&D Blueprint working groups and technical units at WHO
and its regional and country offices. However, ethics plays a critical function in identifying issues
of moral concern, and so the Ethics & COVID-19 Working Group must also play a role in setting
agendas and highlighting important ethical issues that might otherwise be overlooked.
Attention to ethics (and prominent ethical values like equity, fairness, and solidarity) is a shared
responsibility across the R&D Blueprint and broader pandemic response. The Ethics & COVID-
19 Working Group is aware that it is not able to provide guidance on every issue of ethical
significance. However, by articulating ethical commitments and frameworks, and by establishing
guidance applicable to a plurality of issues, the Working Group has aimed to have an expanding
sphere of influence that may be applicable to a multitude of areas and issues. The Ethics &
COVID-19 Working Group has also frequently revisited its roadmap so as to set priorities in
anticipation of evolving needs for ethical guidance.
3WHO Ethics & COVID-19 Working Group - Achievements
Moreover, WHO and Epidemic Ethics (a WHO-led global community of bioethicists providing
support to communities, policy makers, researchers, and responders in relation to the ethical
issues arising out of global health emergencies, with a current focus on the COVID-19 pandemic)
has initiated highly successful calls for proposals to leverage a broader, global network of
expertise to research significant ethical issues related to COVID-19, covering topics from
surveillance and monitoring to research prioritization and political responsibility. In addition, a
successful seminar series hosted by Epidemic Ethics has stimulated a global conversation,
fostered cross-disciplinary collaboration, and engaged the ethics, health, and broader scientific
community on pressing ethical issues raised by COVID-19. Epidemic Ethics has evolved to
become a trusted source for global discussion on ethics and COVID-19.
An enduring priority for the Ethics & COVID-19 Working Group is to ensure commitments to key
values like equity, fairness, and solidarity are meaningfully reflected in policy and practice. Stated
commitments to these values are meaningless if not reflected in practice and the outcomes of
R&D and the pandemic response. Similarly, ethical guidance is irrelevant if it does not
meaningfully inform and impact the decisions that are made in R&D and pandemic response. This
extends far beyond the ethical review of research to the ethical decision-making involved in the
prioritization and design of research, the allocation of medical resources, the implementation of
public health and social measures, and the ways in which global leaders and communities treat
one another as we collectively take steps to end this pandemic.
2. Research priorities and questions
Research priorities for 2021
• Unequal access to COVID-19 vaccines: the need for global solidarity and justice
• Ethics of vaccination certification/adjusting public health and social measures in light of
increasing rates of vaccination
• Monitored emergency use of unregistered and investigational interventions (MEURI) /
emergency use of unproven interventions outside of research contexts / expanded
access (“compassionate use”) / off-label use
• Input into ACT Accelerator Ethics & COVID-19 Working Group: vaccine allocation,
diagnostics, therapeutics, health system strengthening
• Research design and prioritization, and ethical oversight
• Ethics and migrant / refugee health
• Ethics and the opportunity costs of focusing on COVID-19
• Ethical aspects of managing COVID-19 mutations
• Ethical implications of post-COVID-19 conditions (i.e., ‘long COVID’)
• Knowledge translation and outreach of Epidemic Ethics research findings
4WHO Ethics & COVID-19 Working Group - Achievements
3. Publications – Overview
The WHO Ethics & COVID-19 Working group has produced a number of publications as WHO
guidance documents, in scholarly journals, and in popular media. The following provides a high-
level overview of key publications. A full list of over 100 publications produced by the Working
Group and its members, organized thematically, can be found in Annex 2.
WHO Guidance Documents
Title Brief description
1. Ethical Standards for Research during Public Summarizes key universal ethical
Health Emergencies: Distilling Existing Guidance standards that should be adhered to
to Support COVID-19 R&D (WHO/RFH/20.1) by researchers, review bodies,
funders, publishers, and
manufacturers during the COVID-19
pandemic.
2. Guidance for Research Ethics Committees for Provides guidance for research ethics
Rapid Review of Research During Public Health committees regarding the rapid
Emergencies (ISBN 978-92-4-000621-8) review of research during public
health emergencies.
3. Key Criteria for the Ethical Acceptability of Provides guidance to scientists,
COVID-19 Human Challenge Studies research ethics committees, funders,
(WHO-2019-nCoV Ethics_criteria 2020.1) policy-makers, and regulators in
deliberations regarding SARS-CoV-2
challenge studies by outlining key
criteria that would need to be satisfied
in order for such studies to be
ethically acceptable.
4. Ethical Considerations to Guide the Use of Digital Provides policy-makers and other
Proximity Tracking Technologies for COVID-19 stakeholders with guidance as to the
Contact Tracing (WHO/2019- ethical and appropriate use of digital
nCoV/Ethics_Contact_tracing_apps/2020.1) proximity tracking technologies for
COVID-19.
5WHO Ethics & COVID-19 Working Group - Achievements
5. Ethics, Resource Allocation and Priority Setting Provides a high-level ethical
(WHO/RFH/20.2) framework that can be used to guide
decision-making regarding the
allocation and priority setting of
scarce resources during the
pandemic.
6. COVID-19 and Mandatory Vaccination: Ethical Identifies important ethical
Considerations and Caveats (WHO/2019- considerations and caveats that
nCoV/Policy_brief/Mandatory_vaccination/2021.1) should be explicitly evaluated and
discussed through ethical analysis by
governments and/or institutional
policy-makers who may be
considering mandates for COVID-19
vaccination.
Selected External Publications by the Working Group
Title Publisher
1. Fair Allocation of Scarce Medical Resources in the New England Journal of Medicine
Time of Covid-19
2. Publication Ethics During Public Health American Journal of Public Health
Emergencies Such as the COVID-19 Pandemic
3. Ethics & SARS-CoV-2 – Restrictive Measures and Epidemic Ethics
Physical Distancing
4. Key Ethical Concepts and their Application to Public Health Ethics
COVID-19 Research
5. Allocating Scarce Unproven Interventions during American Journal of Bioethics
Public Health Emergencies: Insights from the WHO
MEURI Framework
6. Ethical Considerations for Accelerating COVID-19 Wellcome Open Research
Vaccine Research
7. Top Five Ethical Lessons of COVID-19 that the Wellcome Open Research
World Must Learn
6WHO Ethics & COVID-19 Working Group - Achievements
4. Events and Outreach
19 webinars have been organised and delivered through the Epidemic Ethics Platform. A number
of additional presentations have been given across multiples platforms, including at Asia Pacific
Network of Ethics Committess (APNEC) regional meetings and Regional and Global Summits of
National Ethics Committees.
Epidemic Ethics Webinars
Title Panelists
Why Should Ethics be Front and Centre to the • Katherine Littler (World Health
Response to COVID-19. Is it? (April 20, 2020) Organization)
• Emily Chan (Chinese University of Hong
Kong)
• Jerome Singh (University of KwaZulu-
Natal)
• Ross Upshur (University of Toronto)
• Michael Parker (chair) (University of
Oxford)
COVID-19 Immunity Passports: Inevitable? • Sylvie Briand (World Health Organization)
Ethical? (May 4, 2020) • Samia Hurst (University of Geneva)
• Voo Teck Chuan (National University of
Singapore)
• Jeffrey Kahn (chair) (Johns Hopkins
University)
COVID-19 Human Challenge Studies: Is it OK • Euzebiusz Jamrozik (Monash University)
for Research Participants to Volunteer to be • Joshua Morrison (1Day Sooner)
Infected? (May 18, 2020) • Seema K. Shah (Northwestern University)
• Claudia Emerson (chair) (McMaster
University)
Digital Technologies and their Ethical • Joseph Ali (Johns Hopkins University)
Application during the COVID-19 Pandemic • Effy Vayena (ETH Zürich)
(June 1, 2020) • Yi Zeng (Beijing Academy of Artificial
Intelligence)
• Michael Parker (chair) (University of
Oxford)
7WHO Ethics & COVID-19 Working Group - Achievements
Ethics Beyond ‘Good Enough’: How to Engage • John Marshall (University of Toronto)
Communities with COVID-19 Research • Noni Mumba (KEMRI-Wellcome Trust
Quickly and Effectively (June 15, 2020) Research Programme)
• Phaikyeong Cheah (University of Oxford)
• Alun Davies (KEMRI-Wellcome Trust
Research Program)
• Lisa Schwartz (chair) (McMaster
University)
An Epidemic of Research: Publication Ethics • Ezekiel J. Emanuel (University of
during a Public Health Emergency (June 29, Pennsylvania)
2020) • Laragh Gollogly (International Committee
of Medical Journal Ethics)
• Ross Upshur (chair) (University of
Toronto)
Ethicists Advising Public Health Authorities: • Alena Buyx (Technical University Munich)
Opportunities and Challenges (July 27, 2020) • Florencia Luna (Facultad Latinoamericana
de Ciencias Sociales (FLACSO))
• Maxwell J. Smith (Western University)
• Michael Parker (chair) (University of
Oxford)
COVID: A Case for Research Exceptionalism? • Clement Adebamowo (University of
(August 10, 2020) Maryland)
• Alex John London (Carnegie Mellon
University)
• Katharine Wright (Nuffield Council on
Bioethics)
• Ross Upshur (chair) (University of
Toronto)
Setting Priorities for COVID-19 Vaccine • Anant Bhan (Yenepoya University)
Allocation (September 21, 2020) • Ruth Faden (Johns Hopkins University)
• Sophie Mathewson (GAVI)
• Michael Parker (chair) (University of
Oxford)
COVID-19 Vaccination in an Era of Vaccine • Maya Goldenberg (University of Guelph)
Hesitancy (August 10, 2020) • Heidi Larson (London School of Hygiene
and Tropical Medicine)
• Charles Shey Wiysonge (South African
Medical Research Council)
• Katherine Littler (chair) (World Health
Organization)
8WHO Ethics & COVID-19 Working Group - Achievements
Ethics of Data Sharing in Health Research • Phaik Yeong Cheah (University of Oxford)
(November 2, 2020, hosted jointly with the • Gloria Mason (National Research Ethics
Global Forum for Bioethics in Research) Board, Liberia)
• Oommen John (The George Institute for
Global Health)
• Robert Terry (chair) (World Health
Organization)
Ethics of Adaptive Trial Designs (November • Srinivas Murthy (University of British
16, 2020, hosted jointly with the Global Forum Columbia)
for Bioethics in Research) • Fyezah Jehan (Aga Khan University)
• Jerome Singh (University of KwaZulu-
Natal)
• Ross Upshur (chair) (University of
Toronto)
Ethics of Research in Pregnancy (November • Marian Knight (University of Oxford)
30, 2020, hosted jointly with the Global Forum • Loulou Kobeissi (World Health
for Bioethics in Research) Organization)
• Sonali Kochhar (University of Washington)
• Maggie Little (chair) (Georgetown
University)
Effective COVID-19 Vaccine(s)? Ethical • Beatriz Thomé (Federal University of São
Implications for Vaccine Research in 2021 Paulo)
(December 14, 2020) • Joseph Millum (National Institutes of
Health)
• Dorcas Kamuya (KEMRI-Wellcome Trust
Research Programme)
• Ross Upshur (chair) (University of
Toronto)
Mandates and Special Privileges for COVID- • Effy Vayena (ETH Zürich)
19 Vaccination (March 15, 2021) • Jonathan Montgomery (University College
London)
• Maya Peled-Raz (University of Haifa)
• Maxwell J. Smith (chair) (Western
University)
A Grand Experiment: Ethical Responsibilities • Marc Lipsitch (Harvard University)
in the Global Rollout of COVID-19 Vaccines • Dirceu Greco (Federal University of Minas
(March 29, 2021) Gerais)
• Pearson Nkhoma (Malawi-Liverpool-
Wellcome Trust Clinical Research Unit)
• Gagandeep Kang (chair) (Christian
Medical College)
9WHO Ethics & COVID-19 Working Group - Achievements
Vaccine Diplomacy during the COVID-19 • Annelien Bredenoord (University Medical
Pandemic (April 12, 2021) Center Utrecht)
• Keymanthri Moodley (Stellenbosch
University)
• Françoise Baylis (Dalhousie University)
• Michael Parker (chair) (University of
Oxford)
Ethical Considerations in Alternative COVID- • Raji Tajudeen (Africa Centres for Disease
19 Vaccination Strategies: Delayed Second Control and Prevention)
Doses, Mixing Vaccines and Partial Doses • Jonathan Wolff (University of Oxford)
(April 26, 2021) • Cassandra J. Opikokew Wajuntah (First
Nations University of Canada)
• Ross Upshur (chair) (University of
Toronto)
Adapting Ethics Review to the COVID-19 • Maureen Kelley (University of Oxford)
Pandemic (May 10, 2021) • Roli Mathur (Indian Council of Medical
Research)
• Raffaella Ravinetto (Institute of Tropical
Medicine)
• Carla Saenz (chair) (Pan American Health
Organization)
5. Advisory Roles
The role of ethics is not simply about knowledge production, where that knowledge is then
expected to be applied in various contexts or to different issues. As such, in addition to the
guidance provided by the WHO Ethics & COVID-19 Working Group itself, the sphere of influence
of its members, in their role as experts in ethics, has extended to numerous governments and
other organizations, including:
• Asia Pacific Network of Ethics Committees (APNEC)
• Australian Health Ethics Committee
• Australia’s National COVID-19 Health and Research Advisory Committee
• Australian Technical Advisory Group on Immunisation (ATAGI) COVID-19 Vaccine
Prioritisation and Implementation sub-committee
• Central Ethics Committee on Human Research (CECHR), Indian Council of Medical
Research (ICMR)
• Central Medical Ethics Committee of Latvia
10WHO Ethics & COVID-19 Working Group - Achievements
• Clinical Ethics Malaysia’s online clinical ethics consultation service for COVID-19
• Council for International Organisations of Medical Sciences
• Data Sharing Working Group, COVID-19 Clinical Research Coalition
• Ethics Advisory Council, International COVID-19 Data Research Alliance (ICODA)
• FLASCO Argentina
• France’s COVID-19 Scientific Council
• France’s National Consultative Ethics Committee
• Indian COVID-19 National Ethics Committee (CoNEC)
• Indian Department of Health Research National Registry of Ethics Committees
• National Accreditation board for hospitals and Healthcare Providers Committee
for Accreditation of Ethics Committees in India
• Nepal’s National Ethics Review Board, Nepal Health Research Council, Ministry of Health
& Population
• UNESCO International Bioethics Committee
• Working Group for the development of national recommendations on prioritization of
intensive care patients during Covid-19 pandemic in Latvia
• Ontario’s COVID-19 Bioethics Table
• Ontario’s COVID-19 Vaccine Distribution Task Force
• Public Health Agency of Canada Public Health Ethics Consultative Group
• South Africa’s COVID-19 Ethics Consultation and Review for the Mediclinic Hospital
Group and Tygerberg Hospital
• Sydney Clinical Ethics Network
• United Kingdom’s Scientific Advisory Group on Emergencies (SAGE)
• University of Sydney Faculty of Medicine and Health’s COVID Management Committee
• WHO ACT Accelerator Ethics & Governance Working Group
• WHO Ethics and Governance of Use of Artificial Intelligence in Health
• WHO Western Pacific Regional Office (WPRO) Futures Foresight Think Tank on Ethics
and Human Rights viz. COVID- 19 Non-Pharmaceutical Interventions
• WHO Working Group to Establish Technical Specifications for a Digital Vaccination
Certificate to Support COVID-19 Vaccination
6. Sub-Working Groups Established
A number of sub-working groups of the WHO Ethics & COVID-19 Working Group have been
established to address particular issues. These working groups and their members are listed in
the Annex.
11WHO Ethics & COVID-19 Working Group - Achievements
7. Funded Projects
Epidemic Ethics Projects1
In October 2020, the WHO Health Ethics & Governance Unit issued an international call for
research proposals addressing the ethics of COVID-19 public health preparedness and response
to support both the work of the Unit and the Epidemic Ethics Network (formerly the Public Health
Emegrency Preparedness and Response Ethics Network). Themes of interest mentioned in the
call included:
• Vulnerabilities & inequalities
• Resource allocation
• Political responsibilities
• Containment approaches
• Surveillance & monitoring
• Engagement & communication
• Health systems
• Data & sample sharing
• Research prioritisation & oversight
Project title Institution
Ethics recommendations for data and biological sample University of Kwazulu-Natal
use and sharing
Casebook of ethical issues in epidemic health research Ethox Centre and Wellcome
Centre for Ethics and Humanities,
University of Oxford
Exploring ethical challenges faced during the COVID-19 Asia School of Business in
pandemic in Malaysia collaboration with MIT Sloan
Management
Why we need public health-focused end-to-end Els Torreele (Individual)
governance for epidemic preparedness and response
R&D: an ethics and access perspective
1 The Epidemic Eithics initiative is supported by FCDO/Wellcome Grant 214711/Z/18/Z
12WHO Ethics & COVID-19 Working Group - Achievements
Project title Institution
Global health justice and equitable vaccine allocation Binghamton University
A Review of COVID-19 Regulation: Research Ethics Ana Palmero (Individual)
Review and Oversight in Latin America
An Investigation of ethical issues in long-term care (LTC) Ethics Quality Improvement Lab,
during COVID-19: A Survey of stakeholders in low, middle, William Osler Health System
and high income countries
Solidarity Model: Community’s Ethical Response for Reach Out Mbuya Community
Managing COVID-19 epidemic in Kampala Uganda Health Initiative (ROM)
Palliative care in poor resource settings – the ethical Monash University Malaysia
questions and challenges faced during a global pandemic
COVID-19 and the International Health Regulations: Ethical University of Toronto
and Legal Considerations for Travel Restrictions in 2021
and Beyond
From Theory to Practice: Integrating Ethics into Scarce Kaiser Foundation Health Plan,
Resource Allocation for COVID-19. Inc (Kaiser Permanente),
Exploratory Discourse Analysis of Herd-Immunity as a The University of Alberta
COVID-19 Management Strategy in Eight Countries:
Communication Networks, Misinformation, and Health
Literacy
‘The Ethics of Public Health Emergency Preparedness and Australasian College for
Response: Experiences and lessons learnt from Emergency Medicine (ACEM)
frontline clinicians in low- and middle-income countries in
the Indo-Pacific region during the COVID-19 pandemic’
Racing to respond: Race and resource allocation in the University of Oxford
COVID-19 pandemic
Fostering global conversations around COVID-19 clinical Western University
research with ethics committees: exploring the utility of the
Nuffield Council’s Ethical Compass in supporting ethics
review (GUINEA project)
13WHO Ethics & COVID-19 Working Group - Achievements
Project title Institution
Responsibility for Public Health in the Lusophone World: University of Coimbra Institute for
Doing Justice in and beyond the COVID Emergency Legal Research
The Lived Experience of Participants in COVID-19 Clinical The Botswana Harvard AIDS
Studies in Gabarone, Botswana Institute Partnership
Developing Recommendations for Ethics Committees and Astana Medical University, Nur-
Policy Guidance for Eastern European / Central Asian Sultan, Kazakhstan
Countries to Support Public Health Emergency
Preparedness and Response
Ethical challenges and considerations in the rationing of Jimma University
health commodities and provision of high-risk clinical
services in resource-limited settings: Adjusting
conventional pillars of medical ethics to guide services
during COVID-19 pandemic
Strengthening the ethics review capacities in the University of Kinshasa, Kinshasa;
Democratic Republic of Congo, with a focus on Institute of Tropical Medicine
preparedness for research conducted in the context of (ITM), Antwerp; & National Ethics
outbreaks and other public health emergencies Committee, Kinshasa
Community Appraisal for COVID-19 Vaccine Allocation Uganda National Academy of
Ethical Principles in Uganda and Kenya (CACVAEP) Sciences.
Who Gets the Last Ventilator? Disability, Discrimination Miami University
and Distributing Resources
Pandinference: How do values and evidence interact with Dalla Lana School of Public
policy discourse in the SARS-CoV-2/ COVID-19 pandemic Health, University of Toronto
Decolonizing COVID-19 vaccine distribution through a SeeChange Initiative
CommunityFirst approach: prioritizing vulnerable and
isolated communities
Development of Clinical Ethics Framework (CEF): A Global Institute for
participatory approach to deliver evidence based ethical Interdisciplinary Studies (GIIS)
guideline for COVID19 care
14WHO Ethics & COVID-19 Working Group - Achievements
Project title Institution
Assessing health system readiness/preparedness and The University of Zambia
ethical concerns in implementation of COVID-19
interventions in Zambia
Citizens’ perceptions on moral issues in the COVID-19 Vrije Universiteit Amsterdam
crisis in The Netherlands and Indonesia
Clinical use of unproven interventions outside of research NYU Grossman School of
during a public health emergency: Ethical issues and policy Medicine
guidance
Situating Communities at the Centre of Shaping a Mary Kasule (Individual)
Sustainable Ethical Response to COVID-19: a Case of
Botswana
International migrants in quarantine facilities in Chile during Instituto de Ciencias e Innovación
the COVID-19 pandemic: towards an ethical response to en Medicina, Facultad de
deeply rooted challenges Medicina, Clínica Alemana –
Universidad del Desarrollo
Challenges to Global Equitable COVID-19 Vaccine Access University of Zurich
through the COVAX Facility
Community Responses to COVID-19 restrictions and Amref International University
Containment Measures in Kenya
To strengthen the utility of ethical guidance for Marc DuBois (Individual)
humanitarian aid agencies responding to public health
outbreak emergencies such as COVID-19
Comparative Analysis of the Digitalization of Public Health Faculty of Law, The University of
Interventions in India and China Hong Kong
Strengthening research ethics governance and regulatory Julio Canario (individual)
oversight in Central America and the Dominican Republic
in response to the COVID-19 pandemic
The Ethics of Public Health Emergency Preparedness and University of Augsburg
Response: Migrant Workers’ Health and Covid-19
15WHO Ethics & COVID-19 Working Group - Achievements
Project title Institution
Do No Harm Framework for Future Quarantine or Fordham University Institute for
Lockdown Consideration in Public Health Emergencies International Humanitarian Affairs
Ethical, social, cultural, and human rights (ESCHR) Pawfect Nation and University of
implications of subjecting individuals to mandatory KwaZulu-Natal, Durban
vaccination with COVID-19 candidate vaccines issued
under WHO or local Emergency Use Listing (EUL)
regulatory mechanisms
Other funded Projects2
Project Title Institution
Public perception of surveillance and certification strategies National University of Singapore
for safe movement and travel during COVID-19
COVID-19 and digital contact tracing: moving the ethical ETH Zurich
debate forward
The ethical dimensions of collecting and using geolocation Johns Hopkins Berman Institute
data during infectious disease outbreaks: Learning from of Bioethics
COVID-19
An Ethical Framework for COVID-19 Vaccine Allocation in Western University
Canada
Ethics of emergency use of unproven intervention outside BioThera Research Institute for
research (MEURI) Philosophy of Translational
Medicine
How have South African Research Ethics Committees Stellenbosch University
coped with reviewing health research during the COVID-19
pandemic?
2 These projects were funded by the German Federal Ministry of Health (BMG) through the COVID-19 Research and
development funding. https://www.who.int/news-room/articles-detail/call-for-proposals-ethics-support-for-COVID-19
16WHO Ethics & COVID-19 Working Group - Achievements
Project Title Institution
Experiences of Malawian REC members in reviewing Malawi University of Science and
research protocols during the COVID 19 pandemic Technology
Assessment of the effects of COVID-19 Pandemic on Kenya Medical Research
Research Regulation: The Case of the Scientific and Ethics Institute
Review Unit, Kenya Medical Research Institute CERC.
Health System Responses and Ethical Challenges to the University of Zambia
Health Needs of Refugees: The Case of COVID-19
pandemic in Zambia
Ethical and social issues for COVID-19 vaccine access in Makerere University
Uganda
Ethics and uncertainties in accelerated COVID-19 vaccine University of Oxford
pathways
Adapting national research review process during Covid- Shifa Tameer-e-Millat University
19: Reviewers’ perspectives from Pakistan
Clinical Ethics Consultations in Covid-19. Current and University of Erlangen-
future Challenges Nuremberg
PubliCo – an experimental online platform for COVID-19 University of Zurich
related public perception
Ethics review mutual recognition and multinational Vasiliki Rahimzadeh (Individual)
research collaboration in pandemic response settings
COVID-19: Ethics, Computing, and Resource Allocation University of Miami
and A Global Capacity-Building Project
Strengthening health data access for health systems University of Oxford, Mahidol
resilience and evidence informed policy for COVID-19 Oxford Tropical Medicine
response (SHARE) Research Unit (MORU)
Data sharing practices in the context of COVID-19 The George Institute for Global
Health, UNSW, India
17WHO Ethics & COVID-19 Working Group - Achievements
Project Title Institution
Towards harmonization of data sharing information Infectious Disease Data
requirements in ICTRP registries. An analysis of trials for Observatory, University of
diseases with the potential for public health epidemics Oxford &
including Covid-19 trials. South African Medical Research
Council.
What capacity is needed for researchers to share and Mahidol Oxford Tropical
reuse data? A training needs assessment through online Medicine Research Unit,
workshops to determine existing gaps in knowledge and University of Oxford
skills among researchers in LMICs, to effectively share
and use COVID-19 research data
Rapid systematic reviews to explore broad consent in Heidelberg University
relation to sharing of clinical data in the context of the
Covid-19 pandemic
Examining the role of evolving evidence in pandemic University of Washington
decision-making
Ethical issues arising from vaccine development and Eric Meslin & Jim Lavery
evaluation (Individuals)
18WHO Ethics & COVID-19 Working Group - Achievements
Annex 1. Members of the WHO Ethics & COVID-19 Working
Group
Beatriz Thomé (co-chair) Federal University of São Paulo PAHO
Ross Upshur (co-chair) University of Toronto PAHO
Aasim Ahmad The Kidney Centre, Karachi EMRO
Thalia Arawi American University of Beirut EMRO
Oumou Bah Sow Comité National d’Ethique pour la AFRO
Recherche en Santé (CNERS)
Angus Dawson University of Sydney WPRO
Jean-François Delfraissy French National Bioethics Committee EURO
Ezekiel J. Emanuel University of Pennsylvania PAHO
Tina Garanis-Papadatos University of West Attica EURO
Prakash Ghimire National Ethics Review Board, Kathmandu SEARO
Zubairu Iliyasu National Health Research Ethics AFRO
Committee, Abuja
Sharon Kaur University of Malaya WPRO
Ruipeng Lei Huazhong University of Science and WPRO
Technology
Ignacio Mastroleo Facultad Latinoamericana de Ciencias PAHO
Sociales (FLACSO)
Roli Mathur Indian Council of Medical Research SEARO
Signe Mezinska University of Latvia EURO
Keymanthri Moodley Stellenbosch University AFRO
Kaori Muto University of Tokyo WPRO
Michael Parker University of Oxford EURO
Maxwell J. Smith (rapporteur) Western University PAHO
Teck Chuan Voo National University of Singapore WPRO
Xiaomei Zhai Peking Union Medical College WPRO
19WHO Ethics & COVID-19 Working Group - Achievements
Annex 2. Sub-Working Groups Established
Digital Health and COVID-19
Ross Upshur University of Toronto
Beatriz Thomé Universidade Federal de Sao Paulo
Jerome Singh University of KwaZulu-Natal
Tze-Yun Leong National University of Singapore
Yi Zeng Chinese Academy of Sciences
Najeeb Al-Shorbaji eHealth Development Association
Effy Vayena, (chair) ETH Zürich
Maxwell J. Smith Western University
Timo Minssen University of Copenhagen
Michael Parker University of Oxford
Rasha Abdul Rahim Amnesty International
Maria Paz Canales Derechos Digitales
Jeroen van den Hoven Delft University of Technology
Ezekeil J. Emanuel University of Pennsylvania
Partha Majumder National Institute of Biomedical Genomics
Public Health and Migration
Talia Arawi American University of Beirut
Ann Burton UNHCR
Lisa Eckenwiler George Mason University
Deborah Zion Victoria University
Kristine Onarheim University of Bergen
Gabrielle Berman UNICEF
Kol Wickramage IOM Philippines
Miriam Orcutt Lancet Migrant Health Commission
20WHO Ethics & COVID-19 Working Group - Achievements
WHO regional observers:
Carla Saenz PAHO
Camilla Plinori
Tasnim Azim SEARO
Lin Aung
Pem Namgyal
Joseph Okeibunor AFRO
Ernest Dabire
Jozef Bartovic EURO
Darryl Barret WPRO
Kira Fortune
Isabel Espinosa
WHO
Katherine Littler Health Ethics & Governance Unit
Liz Mumford
Rifat Hossain People’s Health Movement
Human Challenge Studies
Susan Bull University of Oxford
Claudia Emerson McMaster University
Euzebiusz Jamrozik Monash University
Gagandeep Kang Christian Medical College
Melissa Kapulu KEMRI-Wellcome Trust Research Programme
Elena Ray Universidad Icesi
Michael Selgelid Monash University
Seema Shah Northwestern University
Peter G. Smith London School of Hygiene and Tropical Medicine
Ross Upshur University of Toronto
Charles Weijer Western University
21WHO Ethics & COVID-19 Working Group - Achievements
Katherine Littler WHO
Lee-Anne Pascoe
Carla Saenz PAHO
Immunity Certificates
Juan P. Beca Universidad del Desarrollo
Ezekiel J. Emanuel University of Pennsylvania
Nina Gobat University of Oxford
Calvin W.L. Ho University of Hong Kong
Samia Hurst University of Geneva
Nancy Kass Johns Hopkins University
Cassandra Kelly-Cirino Foundation for Innovative New Diagnostics
Ruipeng Lei Huazhong University of Science and Technology
Sody Munsaka University of Zambia
Michael Parker University of Oxford
Maxwell J. Smith Western University
Clarence C. Tam National University of Singapore
Beatriz Thomé Federal University of São Paulo
Ross Upshur University of Toronto
Voo Teck Chuan National University of Singapore
Katherine Littler WHO
Andreas Reis WHO
22WHO Ethics & COVID-19 Working Group - Achievements
Monitored Emergency Use of Unregistered and Investigational Interventions (MEURI)
Ross Upshur University of Toronto
Beatriz Thomé Federal University of São Paulo
Ignacio Mastroleo Facultad Latinoamericana de Ciencias Sociales (FLACSO), National
Scientific and Technical Research Council (CONICET), Argentina
Voo Teck Chuan National University of Singapore
Tina Garani-Papadatos University of West Attica
Roli Mathur Indian Council of Medical Research
Aasim Ahmad The Kidney Centre, Karachi
Maxwell J. Smith Western University
Keymanthri Moodley Stellenbosch University
Stéphanie Dagron University of Geneva
Arthur Caplan New York University
Lembit Rägo Council for International Organizations of Medical Sciences (CIOMS)
Agnes Sagfors Imperial College London
Phiippe Calain (observer) Médecins Sans Frontières
Yaseen Arabi King Abdullah International Medical Research Center
John Marshall University of Toronto
Dereck Angus University of Pittsburgh
Neill Adhikari University of Toronto
Le Van Tan Hospital for Tropical Diseases, Vietnam
Srinivas Murthy University of British Columbia
Steve Webb Monash University
Virginie Pirard Institut Pasteur
Marie Valentin WHO
Katherine Littler
Andreas Reis
Carla Saenz PAHO
23WHO Ethics & COVID-19 Working Group - Achievements
Annex 3. Publications - Full List
Research Ethics (general)
Carracedo, S., Palmero, A., Neil, M., Hasan-Granier, A., Saenz, C., & Reveiz, L. (2020). The
landscape of COVID-19 clinical trials in Latin America and the Caribbean: assessment
and challenges. Revista Panamericana de Salud Pública, 44, 1.
https://doi.org/10.26633/RPSP.2020.177
Dal-Ré, R., LG Bekker, Gluud, C., Holm, S., Jha, V., Poland, G., et al. (forthcoming). Ongoing
and Future Covid-19 Vaccine Clinical Trials: Challenges and Opportunities. The Lancet
Infectious Diseases.
Dawson, A., Emanuel, E. J., Parker, M., Smith, M. J., & Voo, T. C. (2020). Key Ethical Concepts
and Their Application to COVID-19 Research. Public Health Ethics, 13(2), 127–132.
https://doi.org/10.1093/phe/phaa017
Emanuel, E. J., & Boyle, C. W. (2021). Assessment of Length and Readability of Informed
Consent Documents for COVID-19 Vaccine Trials. JAMA Network Open, 4(4),
e2110843. https://doi.org/10.1001/jamanetworkopen.2021.10843
Indian Council of Medical Research. (2020a). National Guidelines for Ethics Committees
Reviewing Biomedical & Health Research During COVID-19 Pandemic.
https://ethics.ncdirindia.org/asset/pdf/EC_Guidance_COVID19.pdf
Indian Council of Medical Research. (2020b). SOP Template for Ethics Review of Biomedical
and Health Research During COVID-19 Pandemic.
https://ethics.ncdirindia.org/asset/pdf/EC_Guidance_COVID19.pdf
Ghimire, N., Hamal, P. K., Panthee, A., Vaidya, A., Khadka, M., Mahato, N. K., et al. (2021).
Ethical Characteristics of Research Proposals Related to COVID-19 Pandemic in Nepal:
A Retrospective Review. Journal of Nepal Health Research Council, 19(1), 148–153.
https://doi.org/10.33314/jnhrc.v19i1.3373
Kaur, S. (in progress). Issues and challenges associated with data sharing in COVID-19
research: exploring the experiences of Malaysian researchers.
Mathur, R. (2020a). Ethics preparedness for infectious disease outbreaks research in India: A
case for novel coronavirus disease 2019. The Indian Journal of Medical Research,
151(2–3), 124–131. https://doi.org/10.4103/ijmr.IJMR_463_20
Moodley, K., Allwood, B. W., & Rossouw, T. M. (2020). Consent for critical care research after
death from COVID-19: Arguments for a waiver. South African Medical Journal, 110(7),
629–634. https://doi.org/10.7196/SAMJ.2020.v110i7.14918
Pan American Health Organization. (2020a). Considerations for Regulatory Oversight of Clinical
Trials in the COVID-19 Pandemic. https://iris.paho.org/handle/10665.2/52266
Pan American Health Organization. (2020c). Guidance and strategies to streamline ethics
review and oversight of COVID-19-related research.
https://iris.paho.org/handle/10665.2/52089
24WHO Ethics & COVID-19 Working Group - Achievements
Pan American Health Organization. (2020d). Guidance for Ethics Oversight of COVID-19
Research in Response to Emerging Evidence.
https://iris.paho.org/handle/10665.2/53021
Pan American Health Organization. (2020e). How Can Research Transparency Be Promoted?
Actions for National Health Authorities During the COVID-19 Pandemic.
https://iris.paho.org/handle/10665.2/52768
Pan American Health Organization. (2020f). Template and operational guidance for the ethics
review and oversight of COVID-19-related research.
https://iris.paho.org/handle/10665.2/52086
Moodley, K. (2020). Research imperialism resurfaces in South Africa in the midst of the COVID-
19 pandemic - this time, via a digital portal. South African Medical Journal = Suid-
Afrikaanse Tydskrif Vir Geneeskunde, 110(11), 1068–1069.
Moodley, K., & Rossouw, T. South African COVID-19 vaccine trials hold key lessons for future
partnerships. The Conversation. http://theconversation.com/south-african-covid-19-
vaccine-trials-hold-key-lessons-for-future-partnerships-154676. Accessed 5 May 2021
Schveitzer, M. C., & Thome, B. da C. (2021). Research ethics and resource allocation in times
of covid-19. Revista Bioética, 29(1).
https://revistabioetica.cfm.org.br/index.php/revista_bioetica/article/view/2761. Accessed
5 May 2021
Smith, M. J. (2020a). A COVID-19 vaccine is needed as soon as possible – how can this be
accomplished in the most ethical way possible? Epidemic Ethics.
https://epidemicethics.tghn.org/community/blogs/post/258785/2020/09/a-covid-19-
vaccine-is-needed-as-soon-as-possib/. Accessed 4 May 2021
Smith, M. J., Emanuel, E. J., Thomé, B., & Upshur, R. E. G. (2020). Ethical conditions for
accelerating COVID-19 vaccine research. Wellcome Open Research, 5, 249.
https://doi.org/10.12688/wellcomeopenres.16361.1
World Health Organization. (2020b). Ethical standards for research during public health
emergencies: distilling existing guidance to support COVID-19 R&D.
https://apps.who.int/iris/handle/10665/331507. Accessed 4 May 2021
World Health Organization. (2020c). Guidance for research ethics committees for rapid review
of research during public health emergencies.
https://www.who.int/publications/i/item/9789240006218. Accessed 4 May 2021
Wright, K., & Parker, M. (2020). In emergencies, health research must go beyond public
engagement toward a true partnership with those affected. Nature Medicine, 26(3), 308–
309. https://doi.org/10.1038/s41591-020-0758-y
Human Challenge Studies
Jamrozik, E., Littler, K., Bull, S., Emerson, C., Kang, G., Kapulu, M., et al. (2021). Key criteria for
the ethical acceptability of COVID-19 human challenge studies: Report of a WHO
Working Group. Vaccine, 39(4), 633–640. https://doi.org/10.1016/j.vaccine.2020.10.075
25WHO Ethics & COVID-19 Working Group - Achievements
Moodley, K., Maasdorp, E., & Rennie, S. (2021). Could human challenge studies for COVID-19
vaccines be justified in South Africa? South African Medical Journal, Online first.
http://www.samj.org.za/index.php/samj/article/view/13241. Accessed 5 May 2021
Schaefer, G. O., Tam, C. C., Savulescu, J., & Voo, T. C. (2020). COVID-19 vaccine
development: Time to consider SARS-CoV-2 challenge studies? Vaccine, 38(33), 5085–
5088. https://doi.org/10.1016/j.vaccine.2020.06.007
World Health Organization, Working Group for Guidance on Human Challenge Studies in
COVID-19. (2020). Key criteria for the ethical acceptability of COVID-19 human
challenge studies. Geneva, Switzerland: World Health Organization.
https://apps.who.int/iris/bitstream/handle/10665/331976/WHO-2019-nCoV-
Ethics_criteria-2020.1-eng.pdf
Vaccine Trial Unblinding and Placebo Controls
Ahmad, A., & Dhrolia, M. F. (2021). “No” to placebo-controlled trials of Covid-19 vaccines.
Indian Journal of Medical Ethics, 6(2), 100–102. https://doi.org/10.20529/IJME.2021.019
Singh, J. A., Kochhar, S., Wolff, J., & WHO ACT-Accelerator Ethics & Governance Working
Group. (2021). Placebo use and unblinding in COVID-19 vaccine trials:
recommendations of a WHO Expert Working Group. Nature Medicine, 27(4), 569–570.
https://doi.org/10.1038/s41591-021-01299-5
Singh, J. A., & Upshur, R. E. G. (2021). The granting of emergency use designation to COVID-
19 candidate vaccines: implications for COVID-19 vaccine trials. The Lancet. Infectious
Diseases, 21(4), e103–e109. https://doi.org/10.1016/S1473-3099(20)30923-3
World Health Organization, ACT Accelerator Ethics & Governance Working Group. Emergency
use designation of COVID-19 candidate vaccines: ethical considerations for current and
future COVID-19 placebo-controlled vaccine trials and trial unblinding. Geneva,
Switzerland. https://www.who.int/publications-detail-redirect/emergency-use-designation-
of-covid-19-candidate-vaccines-ethical-considerations-for-current-and-future-covid-19-
placebo-controlled-vaccine-trials-and-trial-unblinding. Accessed 4 May 2021
Public Health and Social Measures
Moodley, K., Obasa, A. E., & London, L. (2020). Isolation and quarantine in South Africa during
COVID-19: Draconian measures or proportional response? South African Medical
Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde, 110(6), 456–457.
https://doi.org/10.7196/SAMJ.2020v110i6.14842
Obasa, A. E., Singh, S., Chivunze, E., Burgess, T., Masiye, F., Mtande, T., et al. (2020).
Comparative strategic approaches to COVID-19 in Africa: Balancing public interest with
civil liberties. South African Medical Journal, 110(9), 858–863.
https://doi.org/10.7196/SAMJ.2020.v110i9.14934
26WHO Ethics & COVID-19 Working Group - Achievements
Silva, D. S., & Smith, M. J. (2020). Social distancing, social justice, and risk during the COVID-
19 pandemic. Canadian Journal of Public Health, 111(4), 459–461.
https://doi.org/10.17269/s41997-020-00354-x
Smith, M. J. (2020c). Failure to combat COVID-19 can have economic consequences, too.
Impact Ethics. https://impactethics.ca/2020/12/08/failure-to-combat-covid-19-can-have-
economic-consequences-too/. Accessed 4 May 2021
Thomé, B. C., Matta, G. C., & Rego, S. T. A. (2020). Ethical Considerations for Restrictive and
Physical Distancing Measures in Brazil During COVID-19: Facilitators and Barriers.
Journal of Bioethical Inquiry, 17(4), 627–631. https://doi.org/10.1007/s11673-020-10023-
w
Voo, T. C., Ballantyne, A., Jenn, N. C., Cowling, B. J., Xiao, J., Chang, P. K., et al. (2021).
Public perception of ethical issues related to COVID-19 control measures in Singapore,
Hong Kong, and Malaysia: A cross-sectional survey. medRxiv, 2021.03.01.21252710.
https://doi.org/10.1101/2021.03.01.21252710
World Emergency COVID19 Pandemic Ethics (WeCope) Committee. (2020d). Statement on
individual autonomy and social responsibility within a public health emergency.
https://www.eubios.info/yahoo_site_admin/assets/docs/WeCopeStatementAutonomyand
Responsibility.199134724.pdf
World Emergency COVID19 Pandemic Ethics (WeCope) Committee. (2020e). Wearing Masks
and Face Covers as Social Responsibility during COVID-19 pandemic.
https://www.eubios.info/yahoo_site_admin/assets/docs/WECOPEStatement_on_Public_
Use_of_Masks.151164039.pdf
Voo, T. C., & Kaur, S. (2020). Understanding public perception of digital contact tracing,
monitoring devices and vaccination measures for international travel: An online survey
(Funded Research Project). WHO Rapid Funding to support the work of the WHO Global
Health Ethics & Governance Unit on Ethics & COVID-19.
World Health Organization. (2020a). Ethical considerations to guide the use of digital proximity
tracking technologies for COVID-19 contact tracing. https://www.who.int/publications-
detail-redirect/WHO-2019-nCoV-Ethics_Contact_tracing_apps-2020.1. Accessed 4 May
2021
World Health Organization Working Group on Ethics & SARS-CoV-2. (2020). Ethics & SARS-
CoV-2 - Restrictive Measures and Physical Distancing. Geneva, Switzerland: World
Health Organization. https://media.tghn.org/articles/Ethics__COVID-
19__Restrictive_Measures_-_Apr_14.pdf
Allocation of Scarce Clinical Resources
Antiel, R. M., Curlin, F. A., Persad, G., White, D. B., Zhang, C., Glickman, A., et al. (2020).
Should Pediatric Patients Be Prioritized When Rationing Life-Saving Treatments During
COVID-19 Pandemic. Pediatrics, 146(3). https://doi.org/10.1542/peds.2020-012542
27WHO Ethics & COVID-19 Working Group - Achievements
Emanuel, E. J., Persad, G., Upshur, R., Thome, B., Parker, M., Glickman, A., et al. (2020). Fair
Allocation of Scarce Medical Resources in the Time of Covid-19. The New England
Journal of Medicine, 382(21), 2049–2055. https://doi.org/10.1056/NEJMsb2005114
Hassan, B., & Arawi, T. (2020). The Care for Non-COVID-19 Patients: A Matter of Choice or
Moral Obligation? Frontiers in Medicine, 7, 564038.
https://doi.org/10.3389/fmed.2020.564038
López, E. R., Abal, F., Rekers, R., Holzer, F., Melamed, I., Salmún, D., et al. (2020). Propuesta
para la elaboración de un protocolo de triaje en el contexto de la pandemia de COVID-
19. Revista de Bioética y Derecho, 0(50), 37–61.
https://doi.org/10.1344/rbd2020.50.31816
Moodley, K. Tough choices about who gets ICU access: the ethical principles guiding South
Africa. The Conversation. http://theconversation.com/tough-choices-about-who-gets-icu-
access-the-ethical-principles-guiding-south-africa-135227. Accessed 5 May 2021
Moodley, K., Ravez, L., Obasa, A. E., Mwinga, A., Jaoko, W., Makindu, D., et al. (2020). What
Could “Fair Allocation” during the Covid-19 Crisis Possibly Mean in Sub-Saharan Africa?
Hastings Center Report, 50(3), 33–35. https://doi.org/10.1002/hast.1129
Moodley, K., Rennie, S., Behets, F., Obasa, A. E., Yemesi, R., Ravez, L., et al. (2021).
Allocation of scarce resources in Africa during COVID-19: Utility and justice for the
bottom of the pyramid? Developing World Bioethics, 21(1), 36–43.
https://doi.org/10.1111/dewb.12280
Organización Panamericana de la Salud. Orientación ética para el uso de recursos limitados en
los servicios críticos de salud durante la pandemia de COVID-19.
https://iris.paho.org/handle/10665.2/52092
Satomi, E., Souza, P. M. R. de, Thomé, B. da C., Reingenheim, C., Werebe, E., Troster, E. J.,
et al. (2020). Fair allocation of scarce medical resources during COVID-19 pandemic:
ethical considerations. Einstein (Sao Paulo)., 18.
https://doi.org/10.31744/einstein_journal/2020AE5775
Singh, J. A., & Moodley, K. (2020). Critical care triaging in the shadow of COVID-19: Ethics
considerations. South African Medical Journal, 110(5), 355–359.
https://doi.org/10.7196/SAMJ.2020.v110i5.14778
World Emergency COVID19 Pandemic Ethics (WeCope) Committee. (2020c). Statement on
Ethical Triage Guidelines for COVID-19.
https://www.eubios.info/yahoo_site_admin/assets/docs/WECOPETriage_Statement_for_
COVID.151172039.pdf
World Health Organization, Working Group on Ethics and COVID-19. (2020a). Coronavirus
disease (COVID-19): Ethics, resource allocation and priority setting.
https://www.who.int/emergencies/diseases/novel-coronavirus-2019/question-and-
answers-hub/coronavirus-disease-covid-19-ethics-resource-allocation-and-priority-
setting. Accessed 4 May 2021
28WHO Ethics & COVID-19 Working Group - Achievements
Monitored emergency use of unregistered & investigational interventions (MEURI) /
emergency use of unproven internvetions outside research context / expanded access
(“compassionate use”) / off-label use
Caplan, A. L., & Upshur, R. (2020). Panic prescribing has become omnipresent during the
COVID-19 pandemic. The Journal of Clinical Investigation, 130(6), 2752–2753.
https://doi.org/10.1172/JCI139562
Goyal, P. K., Mathur, R., & Medhi, B. (2020). Understanding the challenges and ethical aspects
of compassionate use of drugs in emergency situations. Indian Journal of Pharmacology,
52(3), 163–171. https://doi.org/10.4103/ijp.IJP_665_20
Mastroleo, I. (2021a). Cómo defenderse cuando un médico ofrece un fármaco no probado
contra el COVID-19. /salud/2021/01/31/como-defenderse-cuando-un-medico-ofrece-un-
farmaco-no-probado-contra-el-covid-19/. Accessed 5 May 2021
Mastroleo, I. (2021b). Final report on ethics of emergency use of unproven intervention outside
research (MEURI) during COVID-19 pandemic: literature review & a case study of
inhalable ibuprofen from Argentina. WHO Health Ethics & Governance Unit on Ethics &
COVID-19.
Mastroleo, I. (2021c). The Role of ethics committees in emergency use of unproven
interventions outside research. In E. Valdes & J. A. Lecaros (Eds.), Handbook of
Bioethical Decisions (Vol. 2). New York: Springer.
Mastroleo, I., & Holzer, F. (2020). New non-validated practice: an enhanced definition of
innovative practice for medicine. Law, Innovation and Technology, 12(2), 318–346.
https://doi.org/10.1080/17579961.2020.1815405
Mastroleo, I., Smith, M. J., & The WHO MEURI Working Group (2020). Allocating Scarce
Unproven Interventions during Public Health Emergencies: Insights from the WHO
MEURI Framework. The American Journal of Bioethics, 20(9), 41–44.
https://doi.org/10.1080/15265161.2020.1795539
Pan American Health Organization (PAHO). (2020a). Emergency use of unproven interventions
outside of research: ethics guidance for the COVID-19 pandemic. https://covid19-
evidence.paho.org/handle/20.500.12663/1189
Pan American Health Organization (PAHO). (2020b). PAHO Does Not Recommend Taking
Products that Contain Chlorine Dioxide, Sodium Chlorite, Sodium Hypochlorite, or
Derivatives, 16 July 2020. Pan American Health Organization.
https://iris.paho.org/handle/10665.2/52515
Saenz, C. (2021). Broadening the Scope of Moral Responsibility of Clinicians: What Medical
Ethics Can Learn from Public Health Ethics. The American Journal of Bioethics, 21(1),
17–19. https://doi.org/10.1080/15265161.2020.1845871
World Health Organization, MEURI Working Group. (in progress). Emergency use of unproven
clinical interventions outside research: ethical considerations. Policy document.
29WHO Ethics & COVID-19 Working Group - Achievements
World Health Organization (WHO). (2020a, March 31). Off-label use of medicines for COVID-19.
https://www.who.int/news-room/commentaries/detail/off-label-use-of-medicines-for-
covid-19. WHO reference number: WHO/2019-nCoV/Sci_Brief/Off-label_use/2020.1
World Health Organization (WHO). (2020b). Bacille Calmette-Guérin (BCG) vaccination and
COVID-19. World Health Organization. https://www.who.int/news-
room/commentaries/detail/bacille-calmette-guérin-(bcg)-vaccination-and-covid-19
World Health Organization (WHO). (2020c). Guidance on maintaining a safe and adequate
blood supply during the coronavirus disease 2019 (COVID-19) pandemic and on the
collection of COVID-19 convalescent plasma: Interim guidance, 10 July 2020.
https://apps.who.int/iris/handle/10665/333182
Migrant Health
Arawi, T. (2020c, March 21). Forgetting “refugees” during COVID-19. Beirut Today.
https://beirut-today.com/2020/03/21/forgetting-refugees-during-covid19/. Accessed 4
May 2021
Arawi, T., Hatab, T., & Mikati, D. (2020). COVID-19 and Refugees’ Status of Permanent “Out-of-
Placeness”: A Necropolitical Neoliberal Construct. In I. Laher (Ed.), Handbook of
Healthcare in the Arab World (pp. 1–22). Cham: Springer International Publishing.
https://doi.org/10.1007/978-3-319-74365-3_222-1
Clinical Care
Bekelman, J. E., Emanuel, E. J., & Navathe, A. S. (2020). Outpatient Treatment at Home for
Medicare Beneficiaries During and After the COVID-19 Pandemic. JAMA, 324(1), 21–22.
https://doi.org/10.1001/jama.2020.9017
GE2P2 Global Foundation. COVID Vaccine. The Informed Choice/Consent/Right-to-Refuse
Imperative. http://www.ge2p2.org/the-informed-choice/consent/right-to-refuse-imperative.
Accessed 4 May 2021
Kaur, S. (in progress). Ethical Challenges in Clinical Practice during the COVID-19 pandemic in
Malaysia.
Mathur, R. (2020b). ICMR Consensus Guidelines on “Do Not Attempt Resuscitation.” The
National Medical Journal of India, 33(2), 107–112. https://doi.org/10.4103/0970-
258X.284970
Voo, T. C., Lederman, Z., & Kaur, S. (2020). Patient Isolation during Infectious Disease
Outbreaks: Arguments for Physical Family Presence. Public Health Ethics, 13(2), 133–
142. https://doi.org/10.1093/phe/phaa024
Voo, T. C., Senguttuvan, M., & Tam, C. C. (2020). Family Presence for Patients and Separated
Relatives During COVID-19: Physical, Virtual, and Surrogate. Journal of Bioethical
Inquiry, 17(4), 767–772. https://doi.org/10.1007/s11673-020-10009-8
Vaccine Distribution, Prioritization, and Access
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