Allocating Scarce Unproven Interventions during Public Health Emergencies: Insights from the WHO MEURI Framework

MASTROLEO, IGNACIO; AHMAD, A.; DAGRON, S.; MOODLEY, K.; PASCOE, L.-A.; THOME, B.; VOO, T.-C.; SMITH, MAXWELL J.; MATHUR, R.; PIRARD, V.; UPSHUR, R.

AMERICAN JOURNAL OF BIOETHICS

ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD

Lugar: Londres; Año: 2020 vol. 20 p. 41 - 44

1526-5161

During the Ebola virus disease outbreak in West Africa, an advisory panel to the World Health Organization (WHO) argued that it can be ethically appropriate to offer individual patients experimental interventions on an emergency basis outside clinical trials provided that certain conditions are met (WHO 2014a). The panel referred to the use of experimental interventions under these circumstances as ?monitored emergency use of unregistered and experimental interventions? (MEURI) (WHO 2014b). In the ethical framework subsequently developed to guide policy and practice related to MEURI, it was acknowledged that compounds qualifying for MEURI may not be available in large quantities, and so choices would have to be made about who receives each intervention (WHO 2016). While the MEURI framework offered some general considerations for allocating scarce unproven interventions (WHO 2016), it was largely silent on the specifics of allocation. As the current WHO working group struck to evaluate the utility of MEURI in the context of the COVID-19 pandemic, we commend Webb et al. (2020) for advancing detailed thinking around the allocation of scarce unproven interventions for COVID-19. In the spirit of finding common ground in the area of using unproven interventions during public health emergencies, in what follows we will provide a brief introduction to MEURI, compare Webb et al.?s proposal to the existing MEURI framework, and outline key areas where the use and allocation of unproven interventions can be enhanced.