One Health, Vaccines and Ebola: The Opportunities for Shared Benefits

Abstract

The 2013 Ebola virus outbreak in West Africa, as of writing, is declining in reported human cases and mortalities. The resulting devastation caused highlights how health systems, in particular in West Africa, and in terms of global pandemic planning, are ill prepared to react to zoonotic pathogens. In this paper we propose One Health as a strategy to prevent zoonotic outbreaks as a shared goal: that human and Great Ape vaccine trials could benefit both species. Only recently have two phase 2/3 Ebola human vaccine trials been started in West Africa. This paper argues for a conceptual change in pandemic preparedness. We first discuss the ethics of One Health. Next, we focus on the current Ebola outbreak and defines its victims. Third, we present the notion of a 'shared benefit' approach, grounded in One Health, and argue for the vaccination of wild apes in order to protect both apes and humans. We believe that a creation of such inter-species immunity is an exemplar of One Health, and that it is worth pursuing as a coextensive public health approach.

Responding to a Public Health Objection to Vaccinating the Great Apes

“…The principle should be reserved for cases whereby the potential risks are grave, and/or their likelihood is potentially high. Again, based on current data, vaccination of apes does not seem to fulfill either of the two (Capps and Lederman 2015).…”

“…In a paper that appeared in this Journal, we argued that, in respect to Emerging Infectious Diseases (EIDs) emanating from animals-or zoonoses (zEIDs)-the ethical debate was being dominated by their threat to humans, while other considerations about the environment from which they come were being overlooked (Capps and Lederman 2015). At the time, it was the height of the Ebola virus disease (EVD) outbreak in West Africa; and our point was that too little was being done to understand the ecological determinants that led to the pathogen spillover, and therefore opportunities were being lost.…”

Culling and the Common Good: Re-evaluating Harms and Benefits under the One Health Paradigm

“…There are significant differences between OH policies and practices that remain wedded to only protecting public goods and those that also seek to promote, rather than withhold, benefit for non-humans. To be both ethical and effective, OH approaches might require us to understand health as a universal good that is necessarily shared between species (Capps and Lederman, 2015). Inconsistencies and ambiguities in the values underpinning stated OH objectives and currently accepted infection control practices invite a reconsideration of how we use and interact with other species-and any obligations that should follow from our actions.…”

“…Under these conditions, infection control measures applied to animals are arguably unethical if they are motivated by short-term, partisan (human) gains rather than being directed towards the long-term overall reduction of harm by configuring food and agricultural practices around multispecies collectives that sustain effective infectious disease management. Further work on the relevance and ethical significance of 'shared benefit' approaches Degeling, 2012, Capps andLederman, 2015) and other putative public health principles and values such as solidarity, reciprocity and transparency to OH is needed (Rock and Degeling, 2015). As the case of HPAI illustrates, applying these principles may require a fundamental reconfiguration of how we understand and approach the promotion of interspecies health.…”

Does One Health require a novel ethical framework?

“…Beyond addressing problems that arise from the interdisciplinary nature of OH, philosophy has more to contribute. As there is no agreed on OH ethics (though Capps and Lederman16 have sketched out key features they argue should form part of any OH ethics), there is work for philosophers to do in clarifying the conceptual terrain and making explicit the assumptions which underpin OH, as well as developing principles and strategies to help resolve the inevitable conflicts that will arise in the implementation of a OH approach. OH commands philosophical consideration on these and other matters, not least because of the importance of the problems it deals with (eg, the complexity of issues surrounding disease management at the human–animal–environment interface, the burden of global disease and so on) and the growing significance to—and traction it has within—allied disciplines such as global and public health 17…”