Caesar Atuire: Making health more ethical for all

My name is Caesar Atuire, I'm a Philosopher and a Health Ethicist, originally from Ghana, which is my home. I've worked in Europe, Latin America, the Middle East, and now I'm the Ethics Lead in the MSc IHTM programme.

My area of research is ethics, and as you know ethics is all about trying to see how we can do what we want to do, in a way that is fair, that is equitable. And especially in the health space, we're trying to do good, but doing good and doing it well is important, and that is my area of work.

One of the research projects I'm working on is an investigation into solidarity. You'll remember that during the COVID-19 pandemic, there were many slogans like ‘No one is safe until we are all safe’, ‘Let us not leave anyone behind’ and ‘We’re all in this together’. These sorts of appeals are appeals to solidarity, and yet at the same time we noticed that while all these slogans were being repeated on television, everywhere, there was also the fact that some people were receiving booster vaccines, third, fourth doses, whilst other people in parts of the world did not even have access to their first vaccine. So, what does solidarity mean, and what does it mean to different people? How can we create tools to ensure that when we are talking about solidarity, we know what we're talking about, and be able to measure whether we are really living up to our solidaristic ideals?

The questions are many. I can just think of four perhaps that I would like to mention. One inequality, and that is especially in the health space, just think of the fact that if you're born maybe in Burundi, or the Republic of Central Africa, you have a life expectancy around 60 years, whereas if you're born in some parts of the Global North, your life expectancy is well into the 80s. Why? Is it just because people are born that way or there are other factors, and what are these drivers and what can we do about them? So, we've got inequality.

We have radical disagreements. In many countries, many societies, we've gotten to the point, especially with the advent of social media in the political space, whereby when we have a moral difficulty, the opinions are so divided that we simply talk past each other, and we actually shout at each other without trying to create a moral frameworks that can bring us to consensus.

We also have other issues, for example emerging issues like AI. We're beginning to use AI in healthcare a lot, and artificial intelligence does have a greater cognitive capacity. But what is the relationship between having a greater cognitive capacity, that means you know more and you can do more, and having moral responsibility? Because AI is beginning to act, but can we hold AI responsible, like we hold humans?

And the fourth big challenge is a problem we've inherited which is structural injustice. The world in which we live today is based on a history that hasn't been fair to all people. And are we going to continue that way and even pass this unfairness to future generations? So, these are some of the ethical questions.

If you think about COVID, as I mentioned, ethics is important or was necessary to be able to design allocation frameworks, to ensure that those who actually need the vaccine can get it. Two malaria vaccines have just been produced. How do we ensure that those who need it get it and they get it on time? We carry out research, we treat patients in hospitals, how can we assure that they are not abused? There are just so many questions, and remember, health is not only about pathogens and about diseases, it is about livelihoods, and we look at how our health interventions can have a human character, a humane face. We talk about caring, we talk about justice, we talk about solidarity, we talk about fairness.

I think this line of research matters, it is important because we look at the equity, the fairness and the justice of health interventions. Science is doing great things, we're inventing new interventions, new solutions, but how can we ensure that these interventions reach those who actually need them, and they reach them in an adequate way and in a timely manner? Our work, I think, ensures that we do good, and not only do good but do it well, and this I think is important

This interview was recorded in July 2024.