Global health obligations of states and corporations: Utilitarian and liberal egalitarian perspectives

This essay surveys utilitarian, comprehensive liberal and political liberal approaches to global health in order to demonstrate convergence among them with respect to global health aid obligations for powerful countries and wealthy corporations. Despite significant funding increases in recent years the global total in health aid remains woefully inadequate: considerably less than 0.1% of the combined GDP of G8 countries. Millions of people—-mostly, but not only, in developing countries—-continue to suffer and die from easily preventable or treatable diseases. Classical libertarianism provides no satisfactory solution to this moral challenge. Our paper turns instead to utilitarianism and liberal egalitarianism to demonstrate a global moral duty to prevent unnecessary disease related suffering and death. Some of the natural obstacles to extending single-state versions of liberalism to global health are discussed. We argue that these obstacles are more formidable for political liberalism, yet still surmountable. We ultimately defend global universal access to basic health services and essential medicines, together with globally funded drug R&D for neglected diseases. We appeal to considerations of causal responsibility, ability to provide aid, economic ties, and the obligations of pharmaceutical companies in order to explain why special responsibility falls on wealthy and powerful world economic players—-both countries and corporations—-to support global funding regimes for achieving these goals.