Ethics, human rights & medico-legal issues regarding the COVID-19 pandemic: African cross-national perspectives
The ethical issues of COVID-19 range from depriving people of their personal liberty, their right of movement, as well as putting measures that limit access to healthcare, stressed panellist Prof Felix Nzube Chukwuneke, Chair, UNESCO Bioethics Unit; Chair - College of Medicine Research Ethics Committee (COMREC), Chair - Eastern Nigeria Research Ethics Forum.
He said: “In Nigeria, for instance, some people who were really unwell were not able to see their doctors because they couldn’t go out during lockdown. The law enforcement agencies were also brutal in their approach in some instances which raised serious ethical issues.”
Another example, he shared, was of women who couldn’t continue the vaccination of their children. The governments were concentrating on CVOID-19, but leaders were not thinking of the routine immunisation of children that needed to be done and it was completely stopped.
Panellist Prof Julius Kipkemboi, Member, National Bioethics Committee; Associate Professor of Aquatic Sciences, Department of Biological sciences - Egerton University, said that COVID-19 has presented several ethical dilemmas such as balancing between the interest of the society and that of the individual. These include issues of quarantine for people coming from abroad, the matter of lockdown versus livelihoods, issues of contract tracing and surveillance versus privacy and rights of individuals.
“In Kenya, we are just finalising ethical guidelines for public health emergencies in response to COVID-19. If there are any clinical trials, this will provide guidelines on how we can participate and comes with ethical principles such as sharing of benefits,” he explained.
Transforming health through AI - challenges and opportunities?
Omnia Health Live Africa concluded with a session looking at AI’s role in healthcare. Speakers from IBM Research, Africa; Facebook; Novartis Foundation; Moxit; and Pan African Women in Health (PAWH) discussed what low- and middle income countries have to gain from the radical potential of AI to transform health systems and they have to lose.
The panelilsts were invited by moderator Lucy Setian, Digital & AI Stakeholder Engagement Lead at Novartis Foundation, to share updates how on their organisations were leveraging AI, before and during the pandemic.
Charles Wachira, Software Developer at IBM Research, commented on a similar system powered by AI. IBM Research is building a system to support intervention planning in Africa. Machine intelligence was originally used to explore more effective malaria policy interventions. The primary goal of the system was to allow insights to be generated: decision-makers use AI to interrogate a high-dimensional model. It's powered by AI, he explained, because it's "hard to determine what to do" otherwise.
Laura McGorman, Policy Lead, Data for Good at Facebook commented that the Data for Good team sits within data and privacy policy at Facebook, and that there was a deliberate decision to generate social impact through a "privacy by design" framework. Three pillars of trust are followed:
- user consent, with surveys (they’re doing global symptom survey in 200 countries, for example) and location history requiring opt in;
- the second pillar concerns access control, through open source data sets and making them publicly available; and
- techniques are deployed to preserve user privacy - Facebook uses a technique called "differential privacy" to add noise to make re-identification impossible.
She revealed that it was important to prioritise in that one product is built well that may be used by a wide variety of non-profits and academics. Good products must cure a migraine (in the decision-making process), rather than fix a headache.
McGorman offered an example of such a solution from Facebook, which were population density maps, resulting in more detailed census data (where are there people/not people, which would inform spraying or vaccination decisions). While this may not sound "Facebooky", she explained, it was one of the tech giant's most impactful projects.
Ramatoulie Jallow, Public Health Consultant and Health Communications Specialist; Stigma Index Researcher - Global Network for People living with HIV (GNP+), provided a different perspective, in that it was important to keep community in mind.
She highlighted that sometimes in tech or AI "we don't see women" for instance, and that it was important to bring everyone to the table. In this regard, neighbouring countries can also learn from one another - Ethiopia and Gambia for example.