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Pogge, Human Rights and Global Health

Pogge, Human Rights and Global Health - r Metaphilosophy...

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HUMAN RIGHTS AND GLOBAL HEALTH: A RESEARCH PROGRAM THOMAS W. POGGE Abstract: One-third of all human lives end in early death from poverty-related causes. Most of these premature deaths are avoidable through global institutional reforms that would eradicate extreme poverty. Many are also avoidable through global health-system reform that would make medical knowledge freely available as a global public good. The rules should be redesigned so that the development of any new drug is rewarded in proportion to its impact on the global disease burden (not through monopoly rents). This reform would bring drug prices down worldwide close to their marginal cost of production and would powerfully stimulate pharmaceutical research into currently neglected diseases concentrated among the poor. Its feasibility shows that the existing medical-patent regime (trade-related aspects of intellectual property rights F TRIPS F as supplemented by bilateral agreements) is severely unjust F and its imposition a human-rights violation on account of the avoidable mortality and morbidity it foreseeably produces. Keywords: diseases, drugs, health, human rights, incentives, justice, medicine, patents, pharmaceutical research, poverty, public goods, TRIPS. 1 Some eighteen million human beings die prematurely each year from medical conditions we can cure F this is equivalent to fifty thousand avoidable deaths per day, or one-third of all human deaths. 1 Hundreds of millions more suffer grievously from these conditions. 2 The lives of additional hundreds of millions are shattered by severe illnesses or 1 In 2002, there were fifty-seven million human deaths. Among the main avoidable causes of death were (with death tolls in thousands): respiratory infections (3,963 F mainly pneumonia), HIV/AIDS (2,777), perinatal conditions (2,462), diarrhea (1,798), tuberculosis (1,566), malaria (1,272), childhood diseases (1,124 F mainly measles), maternal conditions (510), malnutrition (485), sexually transmitted diseases (180), menengitis (173), hepatitis (157), and tropical diseases (129). See WHO 2004b, annex table 2; cf. also FAO 1999 and UNICEF 2002. 2 Such morbidity is due to the conditions listed in the preceding footnote as well as to a variety of other communicable diseases, including dengue fever, leprosy, trypanosomiasis r Metaphilosophy LLC and Blackwell Publishing Ltd. 2005. Published by Blackwell Publishing Ltd, 9600 Garsington Road, Oxford OX4 2DQ, UK, and 350 Main Street, Malden, MA 02148, USA METAPHILOSOPHY Vol. 36, Nos. 1/2, January 2005 0026-1068 r Metaphilosophy LLC and Blackwell Publishing Ltd. 2005
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premature deaths in their family. And these medical problems also put a great strain on the economies of many poor countries, thereby perpetu- ating their poverty, which in turn contributes to the ill health of their populations. This huge incidence of mortality and morbidity is not randomly distributed. For a variety of social reasons, females are significantly overrepresented among those suffering severe ill health (UNDP 2003, 310–30; UNIFEM 2001). Being especially vulnerable and helpless, children under the age of five are also overrepresented, accounting for about two-thirds of the death toll (USDA 1999, iii). But the most
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Pogge, Human Rights and Global Health - r Metaphilosophy...

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