Relevance of Medical Ethics in Public Health: Case Study of Polio Eradication

Abstract

Global Polio Eradication began in 1988, with a time target of 2000, but it remains unfinished in 2023. Since 2000, polio caused by vaccine-virus-turned wild-like has been paralyzing many children in several countries that still use the live attenuated oral polio vaccine (OPV), according to the policy of Global Polio Eradication Initiative (GPEI). We have detected a fundamental flaw in GPEI’s intervention tactics that began in 1988 with the exclusive use of OPV – which contravened the principles of medical ethics, namely beneficence, non-maleficence and justice – while a safe and highly efficacious alternative, the inactivated poliovirus vaccine (IPV), was already available. This flaw remained unrecognized as the common perception is that public health actions are ‘public good,’ hence outside the purview of medical ethics. We argue why medical ethics must apply to public health when a pharmaceutical substance is included in the intervention. Having identified unethical vaccine-choice as the root cause of both the failure to eradicate polio so far and causing widespread iatrogenic polio, it is imperative that the flawed policy is reversed at the earliest, for which we propose a way forward. We also advocate for financial compensation to be given to all individuals harmed by the unethical vaccine-policy of GPEI.