[ad_1]
The National Vaccination Plan against COVID-19 of Colombia, therefore, builds a solid bioethical framework, but also a scientific one, through a careful review of the scientific evidence on who should go first.
The world today faces an enormous common challenge, exacerbated even more in the non-high-income countries. It is about distributing a scarce good among a population of millions, who await it with anxiety and determination. Vaccines against COVID-19, which were an uncertain possibility a few months ago, will probably be recognized in a few years, especially the new platforms, as the main scientific development of the century. A good, of great health and economic value, but also a deep symbolic value.
Vaccines represent a hope, still early to be completely conclusive, but with a high probability of success of beginning to defeat the virus, or at least to mitigate its greater profound social, human and economic effects. To get us out of this postponement of our common aspirations that the virus has imposed on us as a society, and that, however, has allowed solidarity and technological innovation on a scale and speed of development, without historical precedent.
Given the availability of biologics that starts out low, and that after the hoarding by high-income countries, will only grow gradually, there is a mathematical and operational need to decide who will receive the benefit first. It is not easy at all. The National Vaccination Plan against COVID-19 of Colombia, therefore, builds a solid bioethical framework, but also scientific, through a careful review of the scientific evidence on who should go first than others to respond to its objectives, a process that was strengthened by an extensive participation of social, government, scientific and citizen organizations, which is rare in the world for this type of plan, and that will lead to a decree with political, legal and scientific legitimacy to especially shield the prioritization process.
Read: This is how vaccination will be for the prioritized population in the first phase
Contrary to the interpretation of a part of the population, the Plan does not place in order those for whom this represents a greater individual or particular good, but rather places the general good as the fundamental imperative, in accordance with the Constitution and Statutory Law in health. In this way, for example, the protection of the elderly is not only beneficial for themselves as individuals, and their families, but also for the entire society. In other words, prioritizing the selected groups efficiently maximizes the benefits for all the inhabitants of Colombia, by reducing, for example, the burden on health systems, and consequently making more restrictive future measures that produce large social impacts less likely in the future. All society.
Grounded in equity as a principle, the prioritized groups do not respond to judgments of the social value of any particular group over another, given that doing this would imply a delicate ethical debate where absolute consensus is impossible, which is why Colombia’s vaccination plan avoided talking about “essential personnel” as in other countries and was governed mainly by an epidemiological reading based on criteria bioethics of Public Health such as solidarity, beneficence, progressiveness, justice and the primacy of the common interest.
The prioritization of each of the groups obeys to clear objectives explicitly defined in the new decree, and to the scientific evidence about which groups there is more evidence by including them earlier, the faster it is possible to achieve said objectives, as is the case of those with a higher mortality or incidence of serious cases, such as the elderly and people with morbidities, or in a second phase, those groups with a higher incidence or probability of contagion, such as those who must be in battalions or prisons. Additionally, it explicitly recognizes the vital role, and not only the greater exposure of health personnel, to sustain the response against the pandemic, including its logistical support personnel, without whom the impact of the pandemic would be worseAnd that is why they also go first, although for different reasons, along with older adults.
Read: PAHO says that the vaccine would arrive in Colombia the first week of February
The plan also aims to protect those they protect, such as caregivers of older adults, children and adolescents. In the case of teachers, their protection allows children, whose rights are paramount as a constitutional mandate, to benefit indirectly from vaccination, since it favors the return to school that has affected millions of children, especially poor, in scenarios where virtual education is not very effective or even does not arrive. In this way, not only the impact of the virus is reduced, but also the most critical measures such as the closure of schools and colleges, whose future impacts are immense, and which would deepen existing social inequalitiesWe are still in time to reverse this trend, so the plan also has as a priority to contribute to the return of boys and girls to receive their education.
As a result of the participation process, the discussion was opened on the need to make the inclusion of indigenous people, Afro-Colombians, Palenqueros, Raizales and all the diverse ethnic groups more explicit, that is why the new decree, and the new version to come out of the plan It will explicitly mention the need to adapt to diverse geographic and socio-cultural contexts. In this way, in addition to their inclusion in the same phases and stages as all, in which they were always numbered, affirmative actions must be taken to guarantee their inclusion. Additionally, and as a historical landmark, the ancestral knowers, own health managers and indigenous traditional doctors will be included in stage 2 along with the rest of health personnel, vindicating how the sanitary practices of these peoples should be, and thus also, with the same spirit, the indigenous and maroon guard that is prioritized in stage 3.
Many groups have felt excluded from the Plan. They are not! Nobody is! The entire society will benefit from prioritization. We must protect this process together, to accelerate the social impacts of vaccination, which allow us to advance with equity to a new scenario that in something allows us to recover the life that this virus has painfully taken from us, but that we hope to begin to expire in 2021.
* Julián Alfredo Fernández Child. Director of Epidemiology and Demography. Ministry of Health and Social Protection.
