On 20 May 2025, the World Health Organization (WHO) adopted the Pandemic Agreement at the World Health Assembly in Geneva. After nearly three years of negotiations and after failing to adopt it in 2024, this is a decisive step towards more combined efforts to address future pandemics. The final text of the treaty highlights the need for equitable access to pandemic-related health products and aims to improve the ability of international health regulators to guide countries during future pandemics. There is hope that by learning from mistakes made during the COVID-19 pandemic, the Agreement can be used to address global inequities and make globally equitable resource sharing the norm, preventing harmful practices, such as vaccine hoarding and barriers to data sharing. However, while the current Pandemic Agreement puts equitable access to surveillance, therapeutics, vaccines, and other pandemic-related products at the forefront, many important questions are yet to be answered. The authors of this paper draw attention to ethics preparedness efforts. The piece considers the importance of building the necessary infrastructure for the provision of ethical advice on health-related matters as part of the implementation phases of the WHO Pandemic Agreement to ensure that we learn from the mistakes made during the COVID-19 pandemic.

ABSTRACT Climate change, ecological degradation and global inequalities are symptoms of an eco-social polycrisis that threatens global health and health equity. This polycrisis is deeply rooted in Western value systems. These can be described as anthropocentric and individualistic and support the prevailing neoliberal economic model. Bioethics is now called to respond to the urgent health-related ethical challenges of the polycrisis and has recently begun to engage with Planetary Health and One Health in this regard. Both have mainly emerged in the Western scientific community and understand human health to be inextricably linked to the state of environmental and structural societal determinants. We argue that bioethics should indeed embrace holistic or integrated understandings of health but also carefully revisit the foundational Western value systems at the root of the polycrisis. If Planetary Health and One Health stay grounded in Western value systems, an extensive conceptual engagement might be problematic for bioethics. Instead of turning to Western concepts of health, bioethics should engage deeply with Indigenous and non-Western ways of knowing and critically reflect on its own role in inadvertently maintaining the status quo.

ABSTRACT This paper explores the application of the One Health approach through an analysis of the response to the 2007 crisis in Chile's salmon aquaculture industry. To evaluate the extent to which the case aligns with a “minimal” One Health framework, we draw on four key dimensions of this framework (methodological, epistemic, ontological, and ethical) and contrast the case with the response to the 2009 Q fever outbreak in the Netherlands. We conclude that the Dutch response to Q fever, characterized by limited institutional collaboration, a narrow disciplinary focus, and an anthropocentric ethical stance, fell short of even a minimal One Health approach. In contrast, the response by the Aquaculture Health Management Program (PGSA) to Chile's salmon aquaculture crisis represents a more integrated approach, involving multisectoral collaboration, interdisciplinary dialogue, and concern for animal and environmental health. While the Chilean case does not fully achieve a strong One Health model, it demonstrates the practical benefits of adopting a minimal One Health perspective, including reduced antibiotic use and improved disease control. The paper concludes that One Health should be understood as a flexible, problem-solving framework, and that clarity regarding its core dimensions is essential for strengthening One Health approaches.

ABSTRACT One of the ways that environmental inequalities manifest is through the market economy. Research increasingly shows how the weight of capitalist interests cause disequilibria in nature: these imbalances spread to the welfare of animals and back to humans through socio-economic interactions. One Health recognises this connection as generative of unhealthy environments, but little has so far been said about the morality of balancing conflicting interests between animals and humans for resources and space. This paper focusses on One Health’s interdisciplinarity; and provides an alternative research methodology, based on concordance of the “right to science,” to analyse ethical collaborations between markets and ecological economies. The argument is illustrated by the financing of space exploration and its cost to the environment. My modest ambition is to enhance the ethical debate of a planetary “eco-” [Greek: oikos “house, dwelling place, habitation”] by connecting health, economies [oikonomia “household management”], and ecology [logia “study of”] to a sense of normative environmentalism.

ABSTRACT The equitable distribution of vaccines has emerged as a major issue in pandemic treaty negotiations following the COVID-19 pandemic. Failures in global procurement and distribution have been attributed to ineffective allocation mechanisms and a general lack of cooperation. More than four years after the onset of the pandemic, this article presents a perspective on how to achieve a more equitable global allocation of medical supplies for future pandemics, drawing on the distinction between “ideal” and “non-ideal” schemes of cooperation. We will consider two perspectives: first, improving solutions under current, non-ideal circumstances where non-cooperation dominates in the short and medium term, given the challenges of an uncooperative international landscape; and second, implementing long-term policies that aim at ideal proposals, assuming an increased level of cooperation in the future. This evaluation will address the past successes and shortcomings of the COVAX facility, and also the negotiations on a pandemic treaty led by the World Health Organizations, to better address future pandemics. We will discuss key issues that ought to be of central concern when moving towards more cooperative solutions in the future.

ABSTRACTBioethics provides various models of fair allocation of scarce health resources like COVID-19 vaccines. Even though these models are grounded in some ethical principles like justice and beneficence, there were severe inequalities in global access to COVID-19 vaccines. In Ghana, about 21.5 million COVID-19-doses have been administered but comprise mainly members of the adult population. As a result, ethical issues related to vaccinating children have been largely ignored in the country. This paper explores some of the ethical implications related to children’s exclusion in the initial COVID-19 vaccination programs in Ghana. It provides a general overview of the COVID-19 pandemic in Ghana and how it related to children and discusses the risks to which Ghanaian children were exposed by delaying their COVID-19 vaccination. A guide to facilitating the full rollout of COVID-19 vaccination in Ghana for children has been proposed that indicates that a fair vaccine distribution for children should prioritize children on admission at health facilities, those diagnosed with severe underlying health conditions, and children who could play an instrumental role in promoting vaccine uptake. It concludes that children must not be placed at the peripheries of the COVID-19 vaccination program in Ghana.

ABSTRACT Genetic results are usually not returned to research participants in Uganda despite their increased demand. We report on researchers’ perceptions and experiences of return of individual genetic research results. The study involved 15 in-depth interviews of investigators involved in genetics and/or genomic research. A thematic approach was used to interpret the results. The four themes that emerged from the data were the need for return of individual results including incidental findings, community engagement and the consenting process, implications and challenges to return of individual results. While researchers are willing to return clinically significant genetic results to research participants, they remain unsure of how this should be implemented. Suggestions to aid implementation of return of results included reconsenting of participants before receiving individual genetic results and increasing access to genetic counseling services. Community engagement to determine community perceptions and individual preferences for the return of results, and also prepare participants to safely receive results emerged as another way to support return of results. Researchers have a positive attitude toward the return of clinically significant genetic results to research participants. There is need to develop national guidance on genetic research and also build capacity for clinical genetics and genetic counseling.

ABSTRACT In many settings, and perhaps especially in low-middle income countries, training institutions do not adequately prepare their students for the ethical challenges that confront them in professional life. We conducted a survey to assess the training needs in research ethics among the faculty at the University of Zambia, School of Medicine (UNZASoM) using a structured questionnaire distributed to faculty members in January 2015. The study was approved by the University of Zambia Biomedical Research Ethics Committee. Seventy-five faculty members of various ranks completed the questionnaire. It was found that 31% of the faculty had not received any research ethics training. Of those who had received training, most of them had received it through short workshops of five days or less (57.4%, n = 31), while only 27.7% received ethics training as a component of an academic degree and 22.2% obtained it through electronic web-based courses. While most faculty (70.7%) reported being well-prepared to guide their students in developing a research methods section of a research protocol, only 25.3% felt they were well-prepared to guide on ethical considerations. This study has demonstrated gaps in research ethics training among faculty members at UNZASoM. Mandatory instruction in research ethics among faculty and students is recommended.

Genomic research offers the potential of significant improvements in diagnosis, treatment, and in health care more broadly. The achievement of these benefits against a background of well-founded pu...