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Summary

Health-care systems within most countries are resource-limited – budgets are ﬁnite and not every service one would like to provide can be funded. In publicly funded health systems, those responsible for procuring health-care need to be able to explain how taxpayers’ money has been spent. Decisions are made at both individual patient and population levels. At an individual level, the decision might be: which statin should this patient get a prescription for to lower her blood cholesterol? At a population level, the decision might be: will a health and social care commissioning organization purchase a heart-failure specialist nurse or an additional sexual health clinic?

This chapter focuses on how such decisions are made and considers a framework for priority setting, a discussion of what factors should be taken into account when comparing options, a consideration of basic health economic concepts, and an overview of ethical principles which influence decisions.

In November 2020, the world received the good news that some vaccine candidates were highly effective at preventing COVID-19. Yet, the demand for COVID-19 vaccines within the global free market has led wealthy nations to procure most of the vaccine supply, leaving low- and middle-income countries in dire circumstances. This article considers the morality of our global procurement strategies and argues that, although what we are witnessing may be adhering to the parameters set out in global business and global politics, it nonetheless has moral deficiencies.

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5 - Decision-Making and Priority Setting

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The Moral Failings of Vaccine Procurement

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5 - Decision-Making and Priority Setting

Summary

The Moral Failings of Vaccine Procurement