Introduction: Worldwide mass vaccination against SARS-CoV-2, while having been the most critical action in combating further waves of COVID-19, was initially fraught with multiple infrastructural and socio-cultural challenges. Vaccine hesitancy, a phenomenon of doubt over the vaccines’ claimed efficacy and/or safety amidst access to vaccination, emerged as a major challenge for global health, despite approval and regular post-marketing surveillance by major regulatory bodies. Methods: We reviewed the literature related to vaccine hesitancy in India published until November 14, 2021 using relevant keywords in various databases and examined it from a bioethical perspective. Results: Factors driving hesitancy either intensified skepticism towards vaccination in general or exacerbated reluctance towards specific vaccines. In India, hesitancy towards indigenously developed vaccines was aggravated by the lack of peer-reviewed phase III trial data before the start of vaccination, lack of public transparency of regulatory bodies, and presence of public perception of inappropriately expedited processes. This perspective piece discusses the state of mass immunization in India as a case of how vaccination and its hesitancy thereof gave rise to unique bioethical challenges in global health. In early 2021, vaccination in India was subject to difficulties in adhering to the principles of equity and justice, while a compromise of the principles of informed consent, beneficence, and non-maleficence also perhaps did occur. Conclusions: Post-pandemic debriefing on the subversion of bioethical principles will be needed, and an appropriate response may be required to rebuild and enhance the public faith in future mass vaccination movements.

The COVID-19 pandemic significantly impacted medical education worldwide. While healthcare professionals labored to ensure proper care for COVID-19 patients, medical students suffered from high rates of anxiety, uncertainty, burnout, and depressive symptoms. Whilst students in the pre-clinical phase of education faced disruption of didactic lectures and laboratory training, senior medical students faced uncertainty regarding their clinical rotations and internships, which are vital for practical exposure to healthcare. Several studies across the world demonstrated that clinical learning was significantly affected, with students in many countries completely cut off from in-person rotations. The disruption of the clinical curriculum coupled with a sense of failure to contribute at a time of significant need often led to despair. Reforms proposed and/or implemented by governments, medical advisory boards, medical schools, and other administrative bodies were felt to be insufficient by the medical student fraternity at large. Consequently, these students continue to face high rates of anxiety, depression, and a general sense of cynicism. In this student-authored perspective, we highlight the challenges faced by and the psychological impact on medical students directly or indirectly from the pandemic.

The WHO World Malaria Report 2020 states that 94% of malaria cases and 95% of its mortality globally are from Africa. However, in Africa, these rates are expected to be higher due to under detection and asymptomatic cases. In the Central African Republic (CAR), malaria is known to be holoendemic and is transmitted throughout the year. Every year, malaria turns out to be more deadly and destructive in September during the rainy season than any other time. It is the main cause of death for children under five in the country. During periods when malaria transmission is high, eight out of ten pediatric patients are diagnosed with malaria; which results into subsequent complications such as dehydration and anemia. The natural disasters like floods, conflict and violence in CAR are further inflating the epidemiology of this infectious disease resulting in the inability of the people to access care or preventive measures. Consequently, given the limited health care facilities, 57% of its population is in need of humanitarian aid. This situation is expected to further worsen as COVID-19 strikes the country. As of May 22, 2021, there were a total of 7, 010 confirmed cases of COVID-19 in the Central African Republic in which 96 deaths were recorded. This pandemic further adds burden to a country that is already facing long years of fight against malaria on top of being decimated by decades of violent conflict and poverty. Furthermore, this paper aims to discuss the impact of COVID-19 on malaria in the Central African Republic.

The global response to the COVID-19 pandemic varied greatly, with significant regional variations in the frequency and intensity of the public health measures taken to combat it. India was one of the worst affected nations worldwide, with 420,000 reported deaths having occurred due to SARS-CoV-2 infection by the end of July 2021. Given that merely 6.8% of the population had been fully vaccinated by then, restrictive measures continue to play a critical role in late 2021. Adherence to World Health Organization’s (WHO’s) and national COVID-19 guidelines was extremely heteregenous throughout the country. Social and behavioural impact of the measures employed by administrative authorities in India to control the spread of COVID-19 on different strata of the population were widely varying. Personal beliefs, influenced by religious and cultural factors, exarcebated the challenges faced by the administration in enforcing public health measures. The dispersal of information by government bodies and its acceptance by the public was severely impacted by the deep mistrust that had accrued in the general populace owing to agitations against the state’s policies about citizenship and agriculture. This opinion piece explores the interplay between the public health mitigative measures enforced by administrative institutions in India and the socio-economic and behavioral obstacles that challenged federal and state efforts.