Propuestas bioéticas frente a los problemas sociales y éticos que generan las enfermedades infecciosas desatendidas
DOI:
https://doi.org/10.5294/pebi.2019.23.1.6Palabras clave:
Enfermedades infecciosas, enfermedades transmisibles, enfermedades desatendidas, bioética, determinantes sociales de la saludResumen
Bioethical Proposals to Face Social and Ethical Problems Generated by Neglected Infectious Diseases
Propostas bioéticas ante os problemas sociais e éticos que geram as doenças infecciosas desatendidas
Este artículo de revisión se centra en el tema de las enfermedades infecciosas desatendidas (EID), grupo de 18 patologías de carácter incapacitante, a veces mortales y frecuentemente deformantes, que prevalecen en poblaciones de Asia, África y en las zonas tropicales de Sur América. Mediante una revisión bibliográfica se plantean los elementos que se relacionan con estas enfermedades, se categorizan y se analizan a la luz de la Declaración Universal sobre Bioética y Derechos Humanos de 2005, en cuanto a igualdad, justicia y equidad, el enfoque de no discriminación y estigmatización, responsabilidad social y salud. A lo largo de la revisión se concluye que la problemática alrededor de las EID es multifactorial y se presentan propuestas, desde una mirada de la bioética centrada en el respeto por la dignidad de la persona y de las poblaciones afectadas, para mitigar y solucionar la atención a partir de estrategias posibles que aborden determinantes sociales. Se propone incluir la bioética en el debate sobre la atención de las EID para analizar los problemas y examinar soluciones por medio de proyectos de investigación transdisciplinaria que impliquen un trabajo colaborativo y formativo entre las comunidades afectadas, entidades gubernamentales y profesionales de la salud y de las ciencias veterinarias.
Para citar este artículo / To reference this article / Para citar este artigo
Sáenz V, Mazzanti di Ruggiero MA. Propuestas bioéticas frente a los problemas sociales y éticos que generan las enfermedades infecciosas desatendidas. Pers Bioet. 2019; 23(1): 84-110. DOI: https://doi.org/10.5294/pebi.2019.23.1.6
Recepción: 27/09/2018
Aceptación: 06/02/2019
Descargas
Citas
Hotez PJ, Fenwick A, Savioli L, Molyneux DH, Rochon P, Bundy D. Rescuing the bottom billion through control of neglected tropical diseases. Lancet. 2009;373(9674):1570-5. DOI: http://dx.doi.org/10.1016/S0140-6736(09)60233-6
WHO. First WHO report on neglected tropical diseases: Working to overcome the global impact of neglected tropical diseases. World Health Organization. 2010 [citado 2017 abr 10]. Disponible en: http://apps.who.int/iris/bitstream/10665/44440/1/9789241564090_eng.pdf
The Lancet. Editorial . Neglected tropical diseases: Becoming less neglected. Lancet. 2014;383(9925):1269. DOI: https://doi.org/10.1016/S0140-6736(14)60629-2
Keating C, Warren K, The Rockefeller Foundation’s. Great Neglected Diseases Network, 1978-1988. Mol Med. 2014;20:S24-30.
World Health Organization (WHO). Neglected tropical diseases. 2016 [citado 2017 abr 12]. Disponible en: http://www.who.int/neglected_diseases/diseases/en/
Donaldson K. Calculating Cost-Effectiveness of Brilliance [blog] [citado 2017 abr 12]. Disponible en: http://d-rev.org/2014/04/dalys-cost-effectiveness-analysis-brilliance/
Hotez P, Ottesen E, Fenwick A, Molyneux D. The neglected tropical diseases: The ancient afflictions of stigma and poverty and the prospects for their control and elimination. In: Advances in Experimental Medicine and Biology; 2006. p. 23-33.
Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: A systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016;388(10053):1545-602. DOI: https://doi.org/10.1016/S0140-6736(16)31678-6
Mitra A, Mawson A. Neglected tropical diseases: Epidemiology and global burden. Trop Med Infect Dis. 2017;2(3):1-15. DOI: https://doi.org/10.3390/tropicalmed2030036
Hotez PJ. The worlds great religions and their neglected tropical diseases. PLoS Negl Trop Dis. 2016;10(7):1-5. DOI: https://doi.org/10.1371/journal.pntd.0004544
Hotez PJ. The neglected tropical diseases and their devastating health and economic impact on the member nations of the Organisation of the Islamic Conference. PLoS Negl Trop Dis. Public Library of Science; 2009;3(10):e539. DOI: https://doi.org/10.1371/journal.pntd.0000539
Hotez PJ. Neglected tropical diseases in the Catholic world. PLoS Negl Trop Dis. Public Library of Science; 2011;5(4):e1132. DOI: https://doi.org/10.1371/journal.pntd.0001132
Lobo DA, Velayudhan R, Chatterjee P, Kohli H, Hotez PJ. The neglected tropical diseases of India and South Asia: Review of their prevalence, distribution, and control or elimination. PLoS Negl Trop Dis. 2011;5(10):e1222. DOI: https://doi.org/10.1371/journal.pntd.0001222
Al-Salem W, Herricks JR, Hotez PJ. A review of visceral leishmaniasis during the conflict in South Sudan and the consequences for East African countries. Parasit Vectors. Parasites & Vectors; 2016;9(1):460. DOI: https://doi.org/10.1186/s13071-016-1743-7
Choffnes ER, Relman DA. The causes and impacts of neglected tropical and zoonotic diseases: Opportunities for Integrated intervention strategies. Workshop Summary. 2011. Disponible en: http://www.nap.edu/catalog.php?record_id=13087
Naciones Unidas/Cepal. Agenda 2030 y los Objetivos de Desarrollo Sostenible: una oportunidad para América Latina y el Caribe. Nueva York: Naciones Unidas; 2016.
Samuels F, Rodríguez Pose R. Why neglected tropical diseases matter in reducing poverty. Dev Prog Work Pap London Overseas Dev Inst. 2013. Disponible en: http://www.developmentprogress.org/sites/developmentprogress.org/files/resource-document/why_neglected_tropical_diseases_matter_in_reducing_poverty.pdf%5Cnhttp://unitingtocombatntds.org/sites/default/files/resource_file/Why neglected tropical diseases mat.
Rijal S, Koirala S, van der Stuyft P, Boelaert M. The economic burden of visceral leishmaniasis for households in Nepal. Trans R Soc Trop Med Hyg. EDCD/BPKIHS/WHO, Kathmandu; 2006 Sep;100(9):838-841. DOI: https://doi.org/10.1016/j.trstmh.2005.09.017
Pullan RL, Freeman MC, Gething PW, Brooker SJ. Geographical inequalities in use of improved drinking water supply and sanitation across Sub-Saharan Africa: Mapping and Spatial analysis of cross-sectional survey data. PLoS Med. 2014;11(4):1-17. DOI: https://doi.org/10.1371/journal.pmed.1001626
Grimes JET, Croll D, Harrison WE, Utzinger J, Freeman MC, Templeton MR. The relationship between water, sanitation and schistosomiasis: A systematic review and meta-analysis. PLoS Negl Trop Dis. 2014;8(12):e3296. DOI: https://doi.org/10.1371/journal.pntd.0003296
Hotez P, Whitham M. Helminth infections: A new global women´s health agenda. Obstet Gynecol. 2014;123(1):155-60. Disponible en: https://insights.ovid.com/pubmed?pmid=24463676
Yamey G, Hotez P. Neglected tropical diseases: Woman and girls in focus. Summary report of meeting held on July 27-28, 2016 in London, UK. 2016. Disponible en: https://www.jstor.org/stable/2568994
Frew SE, Liu VY, Singer PA. A business plan to help the ‘global south’ in its fight against neglected diseases. Health Aff. 2009;28(6):1760-73. DOI: https://doi.org/10.1377/hlthaff.28.6.1760
Pedrique B, Strub-Wourgaft N, Some C, Olliaro P, Trouiller P, Ford N, et al. The drug and vaccine landscape for neglected diseases (2000-11): A systematic assessment. Lancet Glob Heal. 2013 [consultado 2017 jun 26]. Disponible en: www.thelancet.com/lancetgh
Blake RM, Adams J. Global research report - Neglected tropical diseases. Thomson Reuters Global Research Report; 2012.
Shringarpure KS, Isaakidis P, Sagili KD, Baxi RK, Das M, Daftary A. ‘When treatment is more challenging than the disease’: A qualitative study of MDR-TB patient retention. PLoS One. 2016;11(3):1-12. DOI: https://doi.org/10.1371/journal.pone.0150849
Hofstraat K, van Brakel WH. Social stigma towards neglected tropical diseases: A systematic review. Int Health. 2016;(8):53-70. DOI: https://doi.org/10.1093/inthealth/ihv071
Weiss MG, Ramakrishna J, Somma D. Health-related stigma: Rethinking concepts and interventions [consultado 2017 jun 26]. Disponible en: http://mysite.science.uottawa.ca/rsmith43/mat4996/weissramakrishna.pdf.
Moya L, Alvar J. Stigmatizing neglected tropical diseases: a systematic review. Soc Med. 2010;5(4):218-27. Disponible en: http://www.socialmedicine.info/index.php/socialmedicine/article/view/519/1033
Deribe K, Tomczyk S, Mousley E, Tamiru A, Davey G. Stigma towards a neglected tropical disease: Felt and enacted stigma scores among podoconiosis patients in Northern Ethiopia. BMC Public Health. 2013;(13):1-8. DOI: https://doi.org/10.1186/1471-2458-13-1178
Webb JC, Mergler D, Parkes MW, Saint-Charles J, Spiegel J, Waltner-Toews D, et al. Tools for thoughtful action: The role of ecosystem approaches to health in enhancing public health. Can J Public Health. 2010 [consultado 2017 Jul 7];101(6):439-41. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/21370776
Rice University. James A Barker Institute for public Policy. Houston; 2013.
Unesco. Declaración Universal sobre Bioética y Derechos Humanos. Unesco. 2005 [consultado 2017 Jun 26]. Disponible en: http://portal.unesco.org/es/ev.php-URL_ID=31058&URL_DO=DO_TOPIC&URL_SECTION=201.html
Gamboa-Bernal G. Libertad y dignidad. En: El ser humano y su dimensión bioética. Chía: Universidad de La Sabana; 2014. p. 181-98.
Sgreccia E. Manual de Bioética. México: Diana; 1996.
Andorno R. Bioética y dignidad de la persona. Madrid: Tecnos; 1998.
United Nations. Social Justice in an Open World. 2006 [consultado 2017 jul 7]. Disponible en: http://www.un.org/esa/socdev/documents/ifsd/SocialJustice.pdf.
Pérez N, López O. La equidad en salud: propuestas conceptuales, aspectos críticos y perspectivas desde el campo de la salud colectiva. Med Soc. 2008;3(3):247-59. Disponible en: http://www.medicinasocial.info/index.php/medicinasocial/article/view/226/484
Weiss MG. Stigma and the social burden of neglected tropical diseases. PLoS Negl Trop Dis. 2008;2(5):1-6. DOI: https://doi.org/10.1371/journal.pntd.0000237
Mantilla B. Plagas y voces invisibles: un análisis crítico del discurso de las enfermedades tropicales desatendidas. Med Soc. 2011;134-45. Disponible en: http://www.medicinasocial.info/index.php/medicinasocial/article/view/557/1112
WHO. Ethics Guidance for the Implementation of the End TB Strategy. 2017 [consultado 2017 jul 7]. Disponible en: https://www.who.int/tb/publications/2017/ethics-guidance/en/
OPS/OMS. Promoción de la Salud. s.f. [consultado 2017 jul 7]. Disponible en: http://www.paho.org/hq/index.php?option=com_topics&view=article&id=144&Itemid=40829&lang=es
WHO. Sixty-Sixth World Health Assembly - Neglected tropical diseases. 2013 [consultado 2017 Jul 7]. Disponible en: http://www.who.int/neglected_diseases/mediacentre/WHA_66.12_Eng.pdf
Bill and Melinda Gates. Private and Public Partners Unite to Combat 10 Neglected Tropical Diseases by 2020 [consultado 2017 jul 7]. Disponible en: https://www.gatesfoundation.org/media-center/press-releases/2012/01/private-and-public-partners-unite-to-combat-10-neglected-tropical-diseases-by-2020
Pécoul B. New drugs for neglected diseases: From pipeline to patients. PLoS Med. 2004;1(1):019-22. DOI: https://doi.org/10.1371/journal.pmed.0010006
Trouiller P, Olliaro P, Torreele E, Orbinski J, Laing R, Ford N. Drug development for neglected diseases: A deficient market and a public-health policy failure. Lancet. 2002;359(9324):2188-94. DOI: https://doi.org/10.1016/S0140-6736(02)09096-7
WHO. London 2012 Declaration. Washington: WHO; 2012.
Directory HP. Sanofi and WHO Partnership - IFPMA. 2012 [consultado 2017 jul 7]. Disponible en: http://partnerships.ifpma.org/partnership/sanofi-and-who-partnership
Maurya A. Executive summary Medicine Index 2014. 2016 [consultado 2017 jul 7]. Disponible en: http://apps.who.int/medicinedocs/documents/s21637en/s21637en.pdf
Freeman MC, Ogden S, Jacobson J, Abbott D, Addiss DG, Amnie AG, et al. Integration of water, sanitation, and hygiene for the prevention and control of neglected tropical diseases: A rationale for inter-sectoral collaboration. PLoS Negl Trop Dis. 2013;7(9): e2439. DOI: https://doi.org/10.1371/journal.pntd.0002439
Unicef and World Health Organization. 2015 Update and MDG Assessment WHO Library Cataloguing-in-Publication Data. World Health Organization; 2015.
WHO. Global costs and benefits of drinking-water supply and sanitation interventions to reach the MDG target and universal coverage. Washington: WHO; 2012.
FAO. The State of Food Insecurity in the World. [consultado 2017 jul 7]. disponible en: http://www.fao.org/3/a-i4646e.pdf
Chaves LF, Cohen JM, Pascual M, Wilson ML. Social exclusion modifies climate and deforestation impacts on a vector-borne disease. PLoS Negl Trop Dis. Public Library of Science. 2008;2(1):e176. DOI: https://doi.org/10.1371/journal.pntd.0000176
Tong MX, Hansen A, Hanson-Easey S, Cameron S, Xiang J, Liu Q, et al. Infectious diseases, urbanization and climate change: Challenges in future China. Int J Environ Res Public Health. 2015;12(9):11025-36. DOI: https://doi.org/10.3390/ijerph120911025
Utzinger J, Keiser J. Urbanization and tropical health — Then and now. Ann Trop Med Parasitol. 2006;100(5):517-33. DOI: https://doi.org/10.1179/136485906X97372
Mackey TK, Liang BA, Cuomo R, Hafen R, Brouwer KC, Lee DE. Emerging and reemerging neglected tropical diseases: A review of key characteristics, risk factors, and the policy and innovation environment. Clin Microbiol Rev. 2014;27(4):949-79. DOI: https://doi.org/10.1128/CMR.00045-14
León Correa FJ. Pobreza, vulnerabilidad y calidad de vida en América Latina. Retos para la bioética. Acta Bioeth. 2011;17(1):19-29. DOI: http://dx.doi.org/10.4067/S1726-569X2011000100003
Herrera Llamas JA, Herrera Aguilar K, Herrera Aguilar Y et al. Eufemismos bioéticos de la pobreza: clase vulnerable colombiana entre las estadísticas y la realidad. Rev Latinoam Bioética. 2017;17(32):80-101. DOI: https://doi.org/10.18359/rlbi.2203
Cortina A. Estamos bajo mínimos de humanidad y justicia. La Provincia - Diario de Las Palmas. 2008 [consultado 2017 jul 7]. Disponible en: http://www.laprovincia.es/sociedad/2008/03/08/adela-cortina-minimos-humanidad-justicia/135720.html
Aagaard-Hansen J, Chaignat CL. Neglected tropical diseases: Equity and social determinants. s.f. [consultado 2017 jun 26]. Disponible en: http://www.who.int/neglected_diseases/Social_determinants_NTD.pdf
Bishwajit G, Ide S, Ghosh S. Social determinants of infectious diseases in South Asia. Int Sch Res Not. Hindawi; 2014;1-10. DOI: http://dx.doi.org/10.1155/2014/135243
WHO. Eradicating dracunculiasis: Ethiopia’s Gambela region announces new measures to stop transmission. En: Neglected tropical diseases; 2019 [consultado 2019 feb 4]. Disponible en: https://www.who.int/neglected_diseases/en/
Conference series. Tropical and Infectious Diseases. 2019 [consultado 2017 jun 26]. Disponible en: https://tropicaldiseases.infectiousconferences.com
Freitas-Junior LH, Chatelain E, Kim HA, Siqueira-Neto JL. Visceral leishmaniasis treatment: What do we have, what do we need and how to deliver it? Int J Parasitol Drugs Drug Resist. 2012;2:11-9. DOI: https://doi.org/10.1016/j.ijpddr.2012.01.003
OMS. La OMS publica la lista de las bacterias para las que se necesitan urgentemente nuevos antibióticos. 2017 [consultado 2017 jul 6]. Disponible en: http://www.who.int/mediacentre/news/releases/2017/bacteria-antibiotics-needed/es/
Medicines for Malaria Venture (MMV). Supported projects. s.f. [consultado 2017 jul 9]. Disponible en: https://www.mmv.org/research-development/mmv-supported-projects
Croft SL. Neglected tropical diseases in the genomics era: Re-evaluating the impact of new drugs and mass drug administration. Genome Biol. 2016;14(17):46-57. DOI: https://doi.org/10.1186/s13059-016-0916-1
Manns MP, von Hahn T. Novel therapies for hepatitis C – One pill fits all? Nat Rev Drug Discov. 2013;12(8):595-610. DOI: https://doi.org/10.1038/nrd4050
WHO. A human rights-based approach to neglected tropical diseases. s.f. [consultado 2017 jul 9]. Disponible en: https://www.who.int/neglected_diseases/Human_rights_approach_to_NTD_Eng_ok.pdf
Errea RA, Vasquez-Rios G, Machicado JD, Gallardo MS, Cornejo M, Urquiaga JF, et al. Medical Student knowledge of neglected tropical diseases in Peru: A cross-sectional study. PLoS Negl Trop Dis. 2015;9(11):e0004197. DOI: https://doi.org/10.1371/journal.pntd.0004197
Naciones Unidas. Fortalecer la alianza mundial para el desarrollo en una época de crisis. 2009 [consultado 2017 jul 9]. Disponible en: http://apps.who.int/medicinedocs/documents/s17082s/s17082s.pdf
Chowdhury AMR, Bhuiya A, Chowdhury ME, Rasheed S, Hussain Z, Chen LC. The Bangladesh paradox: Exceptional health achievement despite economic poverty. Lancet. 2013;382(9906):1734-45. DOI: https://doi.org/10.1016/S0140-6736(13)62148-0
Boccia D, Hargreaves J, Lönnroth K, Jaramillo E, Weiss J, Uplekar M, et al. Cash transfer and microfinance interventions for tuberculosis control: Review of the impact evidence and policy implications. Int J Tuberc Lung Dis. 2011;15:(Suppl 2):S37-S49. DOI: https://doi.org/10.5588/ijtld.10.0438
Alves de Andrade BL, Rocha DG. Enfermedades desatendidas y bioética: Diálogo de un viejo problema con una nueva área de conocimiento. Rev Bioét. 2015;23(1):106-14. DOI: http://dx.doi.org/10.1590/1983-80422015231051
Iltis AS, Matthews KRW. NTD policy priorities: Science, values, and agenda setting. PLoS Negl Trop Dis. 2017;11(5):2-5. DOI: https://doi.org/10.1371/journal.pntd.0005431
London AJ, Omotade OO, Mello MM, Keusch GT. Ethics of randomized trials in a public health emergency. PLoS Negl Trop Dis. 2018;12(5):e0006313. DOI: https://doi.org/10.1371/journal.pntd.0006313