Background During the COVID-10 pandemic, governments worldwide were faced with priority setting challenges as the resource needs outpaced the available resources. Explicit criteria and ethical principles are recommended since they improve the consistency, transparency and the fairness of the priority setting and resource allocation processes.
Objectives To identify the criteria and the degree to which COVID-19 pandemic plans included explicit criteria, including equity considerations.
Methods We retrieved and reviewed COVID-19 pandemic plans from a sample of 86 countries from the six WHO regions. We abstracted information, on criteria and equity considerations, from each of the retrieved reports. We conducted comparative analysis of the criteria that were abstracted between regions and the priority setting criteria discussed in the literature.
Results Only 32% (n=28) of the sampled countries identified explicit criteria and guiding principles in their pandemic plans. The most common criteria identified included: disease burden, severity, health sector capacity (in low income countries) and justice or equity. Several plans explicitly identified equity as a criterion, while other plans identified varied groups of vulnerable populations which should be prioritized including: those at risk for severe disease, risk of infection or risk of spreading the disease; immigrants/refugees, sexual minorities.
Discussion and Conclusion The limited number of countries that included explicit PS criteria and equity considerations in their pandemic plans, highlight a need for PS researchers and policy makers to collaborate on how to meaningfully integrate these aspects into their pandemic plans. However, the documentation of the criteria is just an initial step. There is a need for studies that empirically examine the criteria which were actually implemented during the response phase of the pandemic.
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