At the International ABR Seminar on UHC (Singapore, 28-29 January 2019), Dr Valerie Luyckx from the Institute for Biomedical Ethics and History of Medicine at the University of Zurich in Switzerland, will discuss the ethical issues that arise in the context of sustainable renal care in sub-Saharan Africa.
Ethical Issues Relating to the Provision of Sustainable Renal Care
Non-communicable diseases (NCDs) are the leading causes of global deaths and most premature deaths occur in low and middle income countries (LMICs). NCDs require long-term access to healthcare, and as they progress, access to high-cost life-saving therapies. In LMICs, access to such therapies is at times provided by the state (often without parallel development of prevention programmes) or at other time may require unsustainable out of pocket expenditure. Decisions around the provision of high-cost NCD care in LMICs under universal health coverage are complex. When there is scarcity of resources for health there will be a need for priority setting. Priority setting dilemmas arise when trade-offs must be made about what kind of services to provide to whom, thereby withholding some services from individuals who could benefit. Using the examples of dialysis and transplantation, we discuss approaches to fair priority setting, which involve balancing the weight of technical evidence (such as costs, disease burden and effectiveness) with social values, which may conflict.
Dr Valerie Luyckx
obtained her MBBCh from the University of the Witwatersrand, South Africa. She trained in Internal Medicine at University of Miami and in Nephrology at Harvard University. She has an MSc in Public Heath from the London School of Hygiene and Tropical Medicine and is completing a PhD in Biomedical Ethics at the Institute for Biomedical Ethics and History of Medicine, University of Zurich on Ethical issues relating to provision of sustainable renal care in sub-Saharan Africa. She is a consultant to the WHO for the Global Health Ethics Team.