Global Justice in Healthcare: Developing Drugs for the Developing World

TABLE OF CONTENTS INTRODUCTION ................................................................................... 583 I. REASONS................................................................................... 585 A. National Self-Interest......................................................... 588 B. Historical Equity ............................................................... 591 C. Social Utility ..................................................................... 602 1. The Basic Reasoning................................................... 604 2. Distribution of the Cost-Burden for Global R & D ... 606 3. Allocation of Global R & D Resources....................... 611 4. The Value of DALYs ................................................... 613 5. The Vulnerabilities of Utilitarianism ......................... 618 D. Distributive Justice in Healthcare....................................... 624 1. Deontological Theories .............................................. 624 2. Teleological Theories ................................................. 637 3. A “Right to Health” .................................................... 641 II. OBJECTIONS.............................................................................. 647 A. The Limits of Ethical Commitments ................................... 648 1. Obligations to the Needy............................................ 649 2. International Distributive Justice ............................... 653 3. Robust Cosmopolitanism ........................................... 663 B. Compromising the Patent System....................................... 667 C. Interfering with the Market in Pharmaceutical Products .... 674