Health Care Ethics
McAnulty College and Graduate School of Liberal Arts
Henk ten Have
Developing Countries, Global Justice, Host Populations, Participants, Post-Trial Access
The pandemic nature of HIV/AIDS in developing countries engenders global health emergency which establishes the urgent need to address the issue of affordable access to anti-retroviral drugs in developing countries. The dissertation discusses an ethical justification for post-trial access to anti-retroviral drugs for participants and host populations in developing countries within the context of global justice, stressing the combination of national and global responsibilities in realizing this objective. Drawing on the strengths of Rawls's statist and Pogge's cosmopolitan theories and on the International Human Rights Law, the dissertation proposes a paradigm of Global Health Justice involving a sliding scale of national and global responsibilities for the realization of the right to health in general and access to drugs in particular.
Every nation has the primary responsibility for realizing the right to health, including affordable access to drugs for its citizens. However, when poor developing countries demonstrate their best efforts by spending at least 3% of their average Gross Domestic Product (GDP) on national health and still are not able to realize the right to health, including affordable access to drugs for its citizens, developed countries should intervene to exercise their global responsibilities in realizing this objective. The proposed paradigm emphasizes that global responsibility supplements rather than replaces national responsibility for health. Thus, health is considered a shared responsibility in the contemporary era.
International human rights law was argued as providing a theoretical framework for national and global responsibilities for realizing the core obligations that stem from socio-economic rights and for addressing global health inequalities. The obligation to provide international assistance in realizing the minimum essential level of the right to health which includes access to drugs was argued as imperative.
The dissertation proposes an international agency such as Global Health Fund for the distribution of health-related goods that would rectify the injustice stemming from the current global system. Expanding the mandate of the current Global Fund to fight AIDS, Tuberculosis and Malaria in order to include interventions for other diseases as well as addressing the weakness of the public health systems in developing countries was proposed as a good start for establishing the Global Health Fund. An effective Global Health Fund rooted in the concept of financial sustainability would significantly enhance the realization of the right to health and affordable access to drugs, including anti-retroviral drugs for participants and host populations in developing countries.
Obi, E. (2014). An Ethical Justification for Post-Trial Access to Anti-Retroviral Drugs for Participants and Host Populations in Developing Countries: A Global Justice Perspective (Doctoral dissertation, Duquesne University). Retrieved from https://dsc.duq.edu/etd/989