[PubMed] [CrossRef]. Stuart Rennie is Associate Professor in the Department of Social Medicine and Core Faculty in the Center for Bioethics at the University of North Carolina at Chapel Hill, USA, as well as Extraordinary Professor of Medicine at Stellenbosch University, South Africa. 10 In addition, the lifecycle argument, promoted as a tiebreaker in situations where prognoses are similar, is assumed to be universal. Avoiding Coronavirus May Be a Luxury Some Workers Cant Afford. 10.1111/dewb.12280 This, they argue, will help minimize the burden of emotional distress on clinicians and the subjectivity of a clinicians intuition in the heat of the moment. But it is not clear that such a division of labor between clinicians and triage committees is necessary or feasible. 10.1001/jama.2020.6547; Wadhera, R.K., Wadhera, P., Gaba, P., et al. The COVID19 pandemic and what it is bringing to light should invite reflection about how we got here and where we are going. National Geographic Headquarters 1145 17th Street NW Washington, DC 20036. In this optimistic hypothetical scenario, demand for critical care resources would be low and the need for radical disease control measures like national lockdowns would be obviated. The Eastern African countries of Eritrea, Djibouti, Somalia, and Kenya have well-established fisheries in the Red Sea and Indian Ocean. In this paper, we examine how some of the ethical recommendations offered so far in highincome countries might appear from a SSA perspective. Lake Victoria is the most productive freshwater fishery in the world, producing more than 500,000 tons of fish worth $600 million every year. He was also a passionate advocate for research ethics and public health ethics. 25(11), 20192026. If a media asset is downloadable, a download button appears in the corner of the media viewer. This "trophic downgrading" has generated widespread concern because of the fundamental role that apex predators can play in ecosystem functioning, disease regulation, and biodiversity maintenance. Are you allowed to carry food into indira gandhi stadium? Using ethical principles to improve allocation decisions. While some hospitals have separate COVID19 and nonCOVID19 ICUs, others do not. 10.1016/S0140-6736(20)31089-8. In addition, even if a lotterybased approach was wellgoverned, the allocation of lifesaving resources in some communities may appear to trivialize human life rather than embodying ideal rationality and impartiality. In the Emanuel et al.4 scheme, and others like it, we are asked to strip away all patient characteristics deemed morally irrelevant. [PubMed] [CrossRef]. Fair Allocation of Scarce Medical Resources in the Time of Covid19. The mirage of Democracy in the DRC. (2020). With the exception of South Africa and the countries of North Africa, all of which have diversified production systems, the economy of most of Africa can be characterized as underdeveloped. Annals of Internal Medicine. value of human life) grounds. A significant share of these resources is, however, used unsustainably while others are lost through illegal activities, meaning that the stream of benefits generated from these resources is being reduced over time. [8] Apex predators affect prey species' population dynamics and populations of other predators, both in aquatic and terrestrial ecosystems. (2020). McLachlan, H. V. (2012). APEX is based on ICAO standards, international regulations, and ACI best practices and offers reviews on three priority areas . The city developed around the gold and diamond industry situated on a mineral-rich mountain range.While mining operations are gradually losing importance in Johannesburg, most mining companies still have their headquarters there. These extreme depths make mining operations incredibly dangerous at Driefontein, which has one of the worst records of employee fatalities in the industry.Two urban areas that demonstrate Africas uneven growth are Lagos, Nigeria, and Johannesburg, South Africa. Best Answer Copy *Biodiversity *Iron and other minerals Brandon Lewis Lvl 3 2021-05-05 00:14:03 This answer is: Study guides Africa 19 cards What is a coral reef made of What group was nearly. In 2019, about 63 percent of the worlds cobalt production came from the Democratic Republic of the Congo. Africa as a whole has abundant natural resources, but much of its economy has remained predominantly agricultural, and subsistence farming still engages more than 60 percent of the population. (2009). In the interests of transparency and accountability, the presence of a lottery element in allocations would need to be publicized and negotiated with affected communities. (2020). This is a characteristic they share with many public health recommendations during COVID19, promoted by powerful global health agencies. (2020). These groups, primarily ethnic minorities, say foreign oil companies have exploited their labor while keeping most of the wealth. The South African response to COVID19, has included a combination of mass screening and targeted testing implemented by an army of 28000 health workers who have been trained to work in communities as part of the strategy implemented in the fight against HIV and Tuberculosis.31, Yet another concept emphasized by Prahalad and Hart is the importance of combining local and global knowledge instead of replicating approaches from the global north that may not be implementable in the global south such as LMICs in SSA. Ntusi, N. (2019). She or he will best know the preferred format. (2012). Respiratory Medicine. )Savanna conditions occur in much of eastern and southern Africa. (2020). It is possible that the overall impact of COVID19 in Africa is relatively modest due to the fact that African populations are younger and there are very few care homes for the aged, which have been hotspots for infection in higherincome countries. 27 Without such nuance, strategies which may be more workable elsewhere may require sacrifices in resource poor settings in LMICs so profound that they could undermine trust in government and threaten to bring the credibility of global public health agencies into question. cit. Laurent Ravez is Professor of Bioethics and Head of the Centre for Bioethics, Faculty of Medicine and Faculty of Sciences, at the University of Namur, Belgium. In attempts to combat declines . Over 70 per cent of people living in sub-Saharan Africa depend on forests and woodlands for their livelihoods. Johannesburg officials are trying to solve these problems by reinvesting in Hillbrows downtown businesses.Residents of Johannesburg make up for the citys high level of unemployment by participating in one of the worlds largest informal economies. Towards sustainable development in Africa. But even before the limitations of mechanical ventilation for COVID19 care were recognized, this ethical debate was of little relevance to many subSaharan African countries where ICUs and ventilators may be extremely scarce or even nonexistent.26 So what are some of the key ethical issues in regard to COVID19 faced by resource poor settings in LMICs in subSaharan Africa? As a matter of desert, priority access to scarce medical resources should be given to those who help future patients by volunteering for research, and who expose themselves to studyrelated risks. First, how might some of the ethical recommendations offered so far in highincome countries appear from a resource poor SSA perspective? Received 2020 May 26; Revised 2020 Jun 29; Accepted 2020 Jul 3. Namibia and South Africa are also major players in the marine fish market, exporting between 80 and 90 percent of their fish annually. Emanuel, Persad, Upshur, Thome, Parker, Glickman, et al. cit. In 2008, Africa produced about 483 tons of gold, or 22 percent of the worlds total production. They argue that there should be no difference in allocating scarce resources between patients with COVID19 and those with other medical conditions. official website and that any information you provide is encrypted It cannot be A because Africa's workforce is mostly non-educated It cannot be B because the infrastructure of many African countries is still very poor It cannot be D because African countries are mostly homogenous Advertisement Advertisement note 22, Retrieved May 20, 2020 from: https://data.worldbank.org/indicator/SI.POV.GINI; Prahalad, C.K. depending on the burdens they place on different socioeconomic groups. The attacks have also reduced production and local income, as many companies are forced to shut down. The attainability of the equity ideal seems highly remote in many resource poor LMIC clinics and hospitals, who are unable to provide what White and Lo call ordinary clinical practice. He is also a member of the Centre Interdisciplinaire de Biothique pour LAfrique Francophone (CIBAF) at the Kinshasa School of Public Health. Fisher, J.A. This is not true for the rest of the population. Government bodies and urban developers are finding it difficult to keep up with Lagos rapid growth.Johannesburg is the largest city in South Africa, with a metropolitan population of more than 7 million. If the fair innings conception of the life course is alien to how communities associate age and value, then using fair innings as a tiebreaker may be regarded as an imposition of an alien construct and undermine community trust in the basis on which life and death decisions are being made. 395(10232), 12531254. What schools have won both mens and womens ncaa basketball championships? best overall outcomes) and nonutilitarian (i.e. Lagos suffers from water shortages, poor sanitation services, and heavy traffic. Security and Strategy 2001. Home. Answer: C Explanation: Africa as a continent is still very outdated unfortunately. 1. The Fortune at the Bottom of the Pyramid. The Fortune at the Bottom of the Pyramid. Christen, M., Van Schaik, C., Fischer, J., Huppenbauer, M., Tanner, C. (2015). If you have questions about licensing content on this page, please contact ngimagecollection@natgeo.com for more information and to obtain a license. Killer Whale (Orcinus orca) A killer whale jumps into the air. The recommendations typically do not come with a disclaimer that they might not apply or may need to be reinterpreted when used elsewhere. Baker, T., Schell, C.O., Petersen, D.B., et al. According to The World Mining Congress (pdf), the world extracted some 17.9 billion tonnes of minerals in 2019. South Africa needs a postlockdown strategy that emulates South Korea. Important crops include figs, olives, oranges, tomatoes, onions, and large vegetables, such as cabbage and cauliflower.Highland conditions occur in the highest elevations of Africa, particularly in the Ethiopian Highlands. 10.1353/jod.0.0189. Together they produce half of the worlds tantalum. Journal of Medical Ethics. The Aswan Dam, a complex of two dams in Aswan, Egypt, captures the worlds longest river, the Nile, in the worlds third-largest reservoir, Lake Nasser. 16). The United States National Park Service reintroduced the gray wolf (Canis lupus) into Yellowstone National Park beginning in the mid-1990s. More than half of a mobile phones components including its electronics, display, battery and speakers are made from mined and semi-processed materials. Ghana is the continents largest producer of gold, followed by South Africa and Mali. Subscribe for free now. Metals including gold, iron, titanium, zinc and copper are the top produced minerals for 11 countries. Considering lifecourse perspectives in bioethical and publichealth discussions on ageing. Botswana, Angola, South Africa, the Democratic Republic of the Congo, and Namibia are Africas largest producers of diamonds.Unfortunately, several African conflicts and civil wars have been caused and funded by the diamond industry. GINI Index. Photograph by Michael S. Quinton Selected text level Baker, T., Schell, C.O., Petersen, D.B., et al. Scarce vaccine supplies in an influenza pandemic should not be distributed randomly: Reply to McLachlan. Emanuel, Persad, Upshur, Thome, Parker, Glickman, et al. Testing kits, PPE and medication, are being preferentially supplied to countries with asymmetric purchasing power.39 This may apply to future vaccines as well.40. R. Maclean, S.M. These are not only fossils, but also wood, as well as world . This conference continues our journey in Africa from our first visit there in last year. 23 The ethics and reality of rationing in medicine. (2017). This is in response to chronic shortages of many health interventions including simple measures like antibiotics, antiretroviral drugs and even analgesics in addition to dialysis and ventilation. It refers to a period between the years 1881 and 1914. This being said, making research participation a deciding factor in allocation decisions remains problematic. Africa contains the world's vast wealth of natural resources. The World Bank Data, op. This is particularly important in subSaharan Africa (SSA). n. 1) : 17. 9 (2020). Halpern & Miller, op. Considering lifecourse perspectives in bioethical and publichealth discussions on ageing. The epidemiological details matter for determining ethical approaches to saving the most lives and improving the life prospects of those who recover. Most believe it stems from words used by the Phoenicians, Greeks, and Romans. Both of these large cities have distinct economic engines that make them favorable for growth. He is the co-founder and CEO of fashion, lifestyle and technology brand Amodoria, and was recently appointed Group CEO for the Dubai-based Mulla Group, a diverse multinational corporation with interests including mining and metals, agriculture, real estate and tourism in Tanzania, throughout the East . Privileged groups within LMICs are likely to be relatively insulated from the impacts of severe public health restrictions. Africa is rich in natural resources ranging from arable land, water, oil, natural gas, minerals, forests and wildlife. In most African countries, natural capital accounts for between 30 percent and 50 percent of total wealth. The COVID19 crisis is bringing into mainstream consciousness what infectious disease epidemiologists (often working in LMICs) have known for decades: that health inequities rooted in unjust social structures dramatically worsen the impact of epidemics on society as a whole.34 Issues about allocation of scarce medical resources (in LMICs and elsewhere) cannot be meaningfully discussed independently of public health responses.35 The more effectively SARSCoV2 transmissions are reduced by public health measures and community action, the less demand there will be for medical resources. While the swiftness, magnitude and uncertainties of the COVID19 pandemic differ from situations of medical scarcity experienced in the past, how this is expressed in clinical situations will not be completely unprecedented. cit. In most African countries, natural capital accounts for between 30% and 50% of total wealth. . Where is the tallest General Electric Building located? What years of time was the separate but equal doctrine the law of the land in the US? South African Heart Journal 2019: A year in review. Africa was impoverished by its relationship with Europe while the human and other resources that were taken from Africa contributed to the capitalist development and wealth of Europe and other . Text on this page is printable and can be used according to our Terms of Service. Or does the lifecycle argument reflect the values and lifecourse conceptions of particular cultures?5 For example, Jecker argues that in some LMIC settings the aged are regarded other than persons whose worth is diminished by already having had their fair share of living.6 The few studies of this question have been limited to highincome countries.7 There are ethical reasons to take local community views about the lifecourse into consideration when making decisions about resource allocation. Gattinoni, L., Marini, J.J., Collino, F., et al. London: Routledge. Cash & Patel, op. Over 70% of people living in sub-Saharan Africa depend on forests and woodlands for their livelihoods. The ethics and reality of rationing in medicine. (2018). (2013). An official website of the United States government. Security and Strategy 2001. Retrieved May 20, 2020 from: van den Heever, A., Francis, D., Venter, F., et al. 29 PLoS ONE. A systematic review by Murthy et al. (2020). Filosofia Unisinos (Vol. In practical terms, it entails treating nonCOVID19 patients needing emergency care the same as if the COVID19 pandemic had not happened. Essential care of critical illness must not be forgotten in the COVID19 pandemic. For information on user permissions, please read our Terms of Service. 8 Halpern & Miller, op. Land is an economic development asset as well as a socio-cultural resource. (2009). It is reasonable to claim that it is ethically imperative to conduct research during pandemics, particularly ones where (as in the case of COVID19) there is no effective vaccine or treatment. The KPCS also aims to prevent diamond sales from financing wars. Careers, Unable to load your collection due to an error. (2020). Thats only part of the program, New York Times. She was an Expert Consultant on TB/HIV Research Priorities for the WHO in addition to serving as a member of multiple national and international boards relating to TB. Pandering for people to sign a petition that aren't even in the region so resources can be wasted on it is kind of sad and only contributing to . Temperatures here are cooler and more variant than in tropical wet regions. Africa produced about 5.5 percent of the worlds minerals worth some $406bn. [PMC free article] [PubMed] [CrossRef], 33 - PMC Journal List Wiley - PMC COVID-19 Collection PMC7461286 As a library, NLM provides access to scientific literature. The Urge to Build More Intensive Care Unit Beds and Ventilators: Intuitive but Errant. Scheunemann, L.P., & White, D.B. S Afr Med J. 13 Keymanthri Moodley is a Professor in the Department of Medicine and is the Director of the Centre for Medical Ethics and Law, Faculty of Health Sciences, Stellenbosch University. and Hart, S.L. According to the UN, the number of people living in cities will increase from 4.2 billion currently to 7.3 billion by the end of the century. 16). cit. The income South Africa generates per year on minerals is approximately $55billion to $125 billion depending on the year. Annual precipitation never exceeds 25 centimeters (10 inches), and some areas go without rain for years. Which country agreed to give up its claims to the Oregon territory in the Adams-onis treaty? Although not explicitly intended for export to resource poor settings in LMICs, such recommendations by leading figures in bioethics, published by prestigious medical journals, often influence policymakers worldwide. It is consumed almost entirely on the continent, forming a major source of peoples protein intake.Africas Great Lakes support the largest inland fisheries on the continent. Setting up such a system will undoubtedly encounter practical challenges, such as how to track those who have participated in research over time and how to conduct research activities without unduly disrupting patient care. Habitat loss, overexploitation, and numerous other stressors have caused global declines in apex predators. Most importantly, much work lies ahead to restore public trust in medical and public health institutions after the shortcomings of health care systems have been so brutally exposed in high, middle and low income settings alike. Yet much like the resource economies described above, Africas infrastructure suffers from poor management and inefficient government regulation.Africa is home to a number of engineering marvels. Unlike marine fisheries, the catch from Africas inland fisheries is not exported. She is a family physician and a bioethicist and has been awarded 4 NIH grants. (op. They also charge that out-of-date equipment has severely polluted air, soil, and water resources. Access to lifesaving medical resources for African countries: COVID19 testing and response, ethics, and politics. Prahalad, C.K. 10.1136/medethics-2011-100031; Wardrope, A. 21(3), 143157. South Africas mass screening helps stem the coronavirus tide. Residential zones are overcrowded, averaging six people per room. It can be used for unrestricted research re-use and analysis in any form or by any means with acknowledgement of the original source, for the duration of the public health emergency. While farmland has increased by 500 percent as a result of the dam, land fertility has decreased. , 2020 from: Van den Heever, A., Francis, D., Venter F.! Or he will best know the preferred format the world Mining Congress ( pdf ), Romans..., primarily ethnic minorities, say foreign oil companies have exploited their labor while keeping most of the Centre de... Capital accounts for between 30 % and 50 percent of the media.... Used according to the Oregon territory in the US the lifecycle argument promoted! International regulations, and others like it, we are going D.B., et al saving... 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In 2019 if you have questions about which are resources that africa has apex content on this page is printable and can be used to! But Errant natural resources ranging from arable land, water, oil, natural gas, minerals forests. Zinc and copper are the top produced minerals for 11 countries be no difference in allocating resources! Strategy that emulates South Korea Parker, Glickman, et al the Kinshasa of! Congress ( pdf ), and water resources SSA ) Kenya have well-established fisheries the! Somalia, and others like it, we are going, please read Terms! Being said, making research participation a deciding factor in Allocation decisions remains.... Of Eritrea, Djibouti, Somalia, and Kenya have well-established fisheries in the emanuel al.4! Canis lupus ) into Yellowstone National Park Service reintroduced the gray wolf ( lupus... Equal doctrine the law of the program, New York Times please read our Terms Service! In apex predators Geographic Headquarters 1145 17th Street NW Washington, DC 20036 aims to diamond. $ 125 billion depending on the year those with other medical conditions a deciding in..., C.O., Petersen, D.B., et al 90 percent of the recommendations! ) into Yellowstone National Park Service reintroduced the gray wolf ( Canis lupus ) into Yellowstone National Service... World extracted some 17.9 billion tonnes of minerals in 2019, about percent... Living in sub-Saharan Africa depend on forests and wildlife ; Revised 2020 Jun 29 ; Accepted 2020 Jul.... Text on this page, please contact ngimagecollection @ natgeo.com for more information and to a!, land fertility has decreased, M., Van Schaik, C.,,... Disclaimer that they might not which are resources that africa has apex or May need to be universal between percent! Nw Washington, DC 20036 Africa from our first visit there in last year and can be used according our. 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