Introduction 1
The global health challenge 1
Why genetics? 3
Influence of genetics on global health 8
Benefit sharing 10
The structure of the book 15
PART Ⅰ A THEORETICAL FRAMEWORK FOR DISTRIBUTION IN HEALTH 21
1 Global application of distributive justice: a cosmopolitan approach 21
Introduction 21
1.1 Distributive justice 22
1.1.1 What are the characteristics of a normative obligation of benefit sharing? 22
1.1.2 Global distributive justice 23
1.2 Cosmopolitanism: a way of envisioning global justice 24
1.2.1 Objections to cosmopolitanism 32
1.2.2 Reasons for envisioning distributive justice on a global scale: a response 37
Conclusion 46
2 An argument for global distribution in health 47
Introduction 47
2.1 Conception of health justice 47
2.1.1 Promoting health to avoid serious harm and allow normal functioning 51
2.1.2 Avoidance of harm and normal functioning: crucial aspects of equality of opportunities 56
2.1.3 Global perspective on health 60
2.2 Normative grounds to operate distribution and premises upon which to claim health equity and fairness 63
2.2.1 What can constrain distribution in health? What kinds of responsibilities do the affluent of the world have towards the global disadvantaged? 63
2.2.2 Rights (to equality in opportunities) 63
2.2.3 Obligations/duties (to redress distributive injustice) 68
Conclusion 81
PART Ⅱ SOME NORMATIVE TOOLS FOR DISTRIBUTION IN HEALTH 85
How does our normative theory of distribution translate into positive law now? The cases of intellectual property and international human rights law 85
3 International intellectual property law: a first tool? 87
Introduction 87
Introduction to intellectual property 87
3.1 The patent system 90
3.1.1 Human genetic material: patentable substance? 93
3.1.2 National and international patent rights 95
3.2 Some theoretical justification for the institution of patents 98
3.2.1 What purpose is this system (as it exists today) designed to achieve? 98
3.2.2 Locke's labour theory 100
3.2.3 The utilitarian justification of property 103
3.2.4 Drahos' economic power theory of IP 112
3.3 Global distribution, justice and the patent system: an assessment 116
3.3.1 Global access to genetic resources and international intellectual property rights 116
3.3.2 Patents and access in terms of availability and affordability 130
Conclusion 143
4 International human rights law: a second tool? 146
Do international human rights help or hinder the realisation of benefit sharing? 146
Introduction 146
4.1 The field of IHR law 147
4.1.1 Presentation 147
4.1.2 Theoretical and legal foundations of IHR 150
4.2 Distribution, access, justice and the IHR system: an assessment 157
4.2.1 The global/universal aspect of access to health in the context of the IHR system 157
4.2.2 Legal access to health, responsibility for distribution of health and human rights 168
4.3 The conceptualisation of human rights within the reality of the market 182
4.3.1 How is the institution of human rights shaped by the market and the powers in place? 182
Conclusion 190
Conclusion 194
Policy options to explore within the existing global structure 197
Broader long-term and inclusive options 202
Bibliography 207
Index 245