Ethics Issues in Outbreak Containment in Low and Middle Income Countries

Though the need for a traditional public health response of may not be contested, how to best implement these measures is often far from clear, especially in contexts of scarcity, recent or current civil conflict, and with an influx of international responders from around the world. Misunderstanding among the public of the meaning and purpose of public health measures, fear of the disease, and/or longstanding distrust of government or Western aid organizations may fuel counterproductive but understandable reactions on the part of the public. Yet, public health countermeasures rely in large part on public cooperation. Contact tracing is useless if affected individuals refuse to provide names of their contacts. Isolation is meaningless if individuals do not cooperate, and quarantine will not work if those affected are not provided with what they need in terms of food, water, and care for loved ones.  How can such measures be implemented fairly, respectfully, and effectively?  What can responders do to enhance the acceptability of public health containment measures and uphold commitments to ethics at the same time?

This project aims to understand the key reasons why public health measures sometime fail or met with resistance or distrust, and develop guidance that can enhance the fairness and respectfulness of outbreak containment in LMIC settings.

Systematic review of existing literature reporting the challenges and lessons learned from previous outbreaks of Ebola and other infectious outbreaks in LMICs. This review summarizes previous experiences of implementing containment measures at the community level with the aim of understanding what is known about how the way containment measures are implemented influences the ways they are perceived, followed, and understood by local communities. While there is a rapidly increasing literature on lessons learned during the 2014-2015 outbreak of Ebola, the review includes experiences from previous outbreaks of Ebola, Lassa fever, Marburg virus, polio, and smallpox. The review establishes a baseline from which to understand the challenges and strategies that other outbreak responses have encountered to understand how an ethics lens can contribute to more respectful, fair, and ultimately effective approaches to containment of infectious disease.

Systematic review of existing literature reporting the challenges and lessons learned from previous outbreaks of Ebola and other infectious outbreaks in LMICs. This review summarizes previous experiences of implementing containment measures at the community level with the aim of understanding what is known about how the way containment measures are implemented influences the ways they are perceived, followed, and understood by local communities. While there is a rapidly increasing literature on lessons learned during the 2014-2015 outbreak of Ebola, the review includes experiences from previous outbreaks of Ebola, Lassa fever, Marburg virus, polio, and smallpox. The review establishes a baseline from which to understand the challenges and strategies that other outbreak responses have encountered to understand how an ethics lens can contribute to more respectful, fair, and ultimately effective approaches to containment of infectious disease.

Systematic review of existing literature reporting the challenges and lessons learned from previous outbreaks of Ebola and other infectious outbreaks in LMICs. This review summarizes previous experiences of implementing containment measures at the community level with the aim of understanding what is known about how the way containment measures are implemented influences the ways they are perceived, followed, and understood by local communities. While there is a rapidly increasing literature on lessons learned during the 2014-2015 outbreak of Ebola, the review includes experiences from previous outbreaks of Ebola, Lassa fever, Marburg virus, polio, and smallpox. The review establishes a baseline from which to understand the challenges and strategies that other outbreak responses have encountered to understand how an ethics lens can contribute to more respectful, fair, and ultimately effective approaches to containment of infectious disease.

Systematic review of existing literature reporting the challenges and lessons learned from previous outbreaks of Ebola and other infectious outbreaks in LMICs. This review summarizes previous experiences of implementing containment measures at the community level with the aim of understanding what is known about how the way containment measures are implemented influences the ways they are perceived, followed, and understood by local communities. While there is a rapidly increasing literature on lessons learned during the 2014-2015 outbreak of Ebola, the review includes experiences from previous outbreaks of Ebola, Lassa fever, Marburg virus, polio, and smallpox. The review establishes a baseline from which to understand the challenges and strategies that other outbreak responses have encountered to understand how an ethics lens can contribute to more respectful, fair, and ultimately effective approaches to containment of infectious disease.