More Carrots, Less Sticks: Encouraging Good Stewardship in the Global Antimicrobial Commons.

Time-tested commons characterize by having instituted sanctioning mechanisms that are sensitive to the circumstances and motivations of non-compliers. As a proposed Global Antimicrobial Commons cannot cost-effectively develop sanctioning mechanisms that are consistently sensitive to the circumstances of the global poor, I suggest concentrating on establishing a wider set of incentives that encourages both compliance and participation.

What, if anything at all, do African societies themselves owe to their own citizens in terms of health?

The debate about global justice and health has focused so far on what developed countries owe to developing countries to advance global public health. Less attention has however been paid to the health obligations of developing countries, especially in Sub-Saharan Africa, towards their own people and how this may affect considerations about justice and health in a globalized world. This paper challenges the implicit presumption in global justice theories that African societies, because they are poor, have weaker health obligations toward their own peoples. It makes two main claims. First, despite their economic shortcomings, African governments should have the primary responsibility to protect the domestic side of the human right to health of their own citizens and dumping their own health obligations on rich countries is a disservice to the overall goal of global justice in health. Second, the health obligations of African societies towards their own people should be assessed and grounded also on their potential abilities, and not exclusively on their current abilities. Global justice in health cannot be reduced to what rich countries should do. It must include also what developing countries from Sub-Saharan Africa should do beyond accepting or managing any health assistance.

Open access publishing - noble intention, flawed reality.

For two decades, the international scholarly publishing community has been embroiled in a divisive debate about the best model for funding the dissemination of scientific research. Some may assume that this debate has been thoroughly resolved in favour of the Open Access (OA) model of scientific publishing. Recent commentaries reveal a less settled reality. This narrative review aims to lay out the nature of these deep divisions among the sector's stakeholders, reflects on their systemic drivers and considers the future prospects for actualising OA's intended benefits and surmounting its risks and costs. In the process, we highlight some of inequities OA presents for junior or unfunded researchers, and academics from resource-poor environments, for whom an increasing body of evidence shows clear evidence of discrimination and injustice caused by Article Processing Charges. The authors are university-appointed researchers working the UK and South Africa, trained in disciplines ranging from medicine and epidemiology to social science and digital science. We have no vested interest in any particular model of scientific publication, and no conflicts of interest to declare. We believe the issues we identify are pertinent to almost all research disciplines.

Shared Responsibility and Labor Rights in Global Supply Chains.

The article presents a novel normative model of shared responsibility for remedying unjust labor conditions and protecting workers' rights in global supply chains. While existing literature on labor governance in the globalized economy tends to focus on empirical and conceptual investigations, the article contributes to the emerging scholarship by proposing moral justifications for labor governance schemes that go beyond voluntary private regulations and include public enforcement mechanisms. Drawing on normative theories of justice and on empirical-legal research, our Labor Model of Shared Responsibility introduces three main claims: First, that responsibility for protecting and promoting labor standards in global supply chains should be shared by all private and institutional actors involved (whether directly or indirectly) in the production and distribution processes. Second, we offer a normative model for allocating responsibility among the various actors, based on five principles: connectedness, contribution, benefit, capacity, and power. Last, we demonstrate how the normative model could be implemented through various national and international institutional mechanisms.

Global justice and the opportunity costs of conservation.

Opportunity costs can represent a significant portion of the costs associated with conservation projects and frequently outstrip other kinds of cost. They are typically understood to refer to the benefits someone would have obtained if conservation projects had not required them to give up current activities, such as farming or hunting or if the land had been available for uses other than conservation. This familiar way of identifying opportunity costs is flawed, however, because it threatens to condone, or take advantage of, the injustices that many people face that affect their opportunities. I integrated ideas from the political theory of global justice to examine how the analysis of opportunity costs illustrates the importance of considering conservation and issues of global justice together, rather than thinking about them in isolation. I distinguish four baselines for defining opportunity costs. A status quo baseline defines opportunity costs by asking what people would have earned had a conservation project not happened. A willingness to accept baseline defines them by asking people what it would take to make them indifferent to whether a conservation project takes place or not. An antipoverty baseline suggests that opportunity costs have been met when people affected by a project are not left in poverty. An egalitarian baseline suggests opportunity costs have been met when people are not left in relative disadvantage, with worse than average opportunities. I argue that the egalitarian baseline is the most acceptable from the point of view of justice. Such a baseline would suggest that, in practice, many of the world's poor are being unjustly treated, or even exploited, as a result of conservation activities.

Los costos de oportunidad pueden representar una porción significativa de los costos asociados con los proyectos de conservación y con frecuencia superan otros tipos de costos. Comúnmente se entiende que estos costos se refieren a los beneficios que alguien habría obtenido si los proyectos de conservación no los hubieran requerido para renunciar a ciertas actividades, como la agricultura o la cacería, o si la tierra hubiera estado disponible para otros usos además de la conservación. Sin embargo, esta manera familiar de identificar los costos de oportunidad es defectuosa ya que amenaza con perdonar, o aprovechar, las injusticias que muchas personas enfrentan y que afectan sus oportunidades. Integré ideas de la teoría política de la justicia global para examinar cómo el análisis de los costos de oportunidad ilustra la importancia de considerar en conjunto la conservación y los temas de justicia global, en lugar de considerarlos de manera aislada. Distingo cuatro líneas base para definir los costos de oportunidad. Una línea base de orden establecido define los costos de oportunidad al preguntar a las personas lo que habrían obtenido de no haberse realizado un proyecto de conservación. Una línea base de la voluntad de aceptación las define al preguntar a las personas qué necesitarían para volverse indiferentes a si se realiza o no un proyecto de conservación. Una línea base de antipobreza sugiere que los costos de oportunidad se han cumplido cuando las personas afectadas por un proyecto no quedan en la pobreza. Una línea base igualitaria sugiere que los costos de oportunidad se han cumplido cuando las personas no quedan en una desventaja relativa, con peores oportunidades al promedio. Argumento que la línea base igualitaria es la más aceptable desde el punto de vista de la justicia. Dicha línea base sugeriría que, en la práctica, muchas de las personas que viven en pobreza son tratadas injustamente, o incluso explotadas, como resultado de las actividades de conservación.

Global justice in the context of transnational surrogacy: an African bioethical perspective.

The ongoing debate on how best to regulate international commercial surrogacy defies consensus, as the most cogent normative and jurisprudential grounds for and against non-altruistic surrogacy remain controversial. This paper contributes to the debate by focusing on social justice issues arising from transnational, moneymaking surrogacy, with a focus on the Global South. It argues that existing theoretical perspectives on balancing interests, rights, privileges, and resources in the context of cross-border surrogacy-such as cosmopolitanism, communitarianism, liberal feminism, radical feminism, and neorealism-are not sufficient to treat the question of justice underpinning transnational surrogacy in the Global South. An Afro-communal theory of social justice is proposed as an alternative model for addressing the shortcomings in existing global justice theories. Building on Thaddeus Metz's construction of Afro-communal social theory and a bioethic of communion, this article reveals the fundamental nature of injustices in the Global South surrogacy foray. This approach provides prima facie grounds for making commercial surrogacy more just in the evolving global order.

Modelo de negocios en la salud e investigación clínica: la cuestión de las patentes en la ciencia

Propósito/Contexto. En este artículo se exponen las tendencias y las características de un modelo de negocio que la industria farmacéutica ha venido imponiendo con la ayuda del desarrollo de nuevos medicamentos a los que se les cuestiona su "altura inventiva" y que, a pesar de ello, les son otorgadas las patentes de segunda generación, considerándose esta una práctica abusiva y que favorece el incremento de los precios de estas innovaciones en el mercado. Metodología/Enfoque. Mediante la presentación de un caso: "la declaración de interés público del medicamento imatinib en Colombia" se identifican las estrategias y las maniobras anticompetitivas que dejan pocas oportunidades a los Estados para distribuir de manera equitativa los beneficios de las invenciones de medicamentos. En el análisis bioético del caso se caracteriza el dilema como tipo práctico, esto es, aquel en el que persisten requerimientos morales en tensión con un interés privado, en esta ocasión, entre la salud pública, por un lado, y la propiedad intelectual como política internacional, por el otro. Resultados/Hallazgos. La tesis es que este es un problema transfronterizo sintomático de la falta de justicia global en razón a la suplantación del sentido de "bien común" que ha acallado los vínculos sociales, solidarios y colaborativos. Discusión/Conclusiones/Contribuciones. Se insta a un consenso sobre las bases sociales y el respeto de la dignidad de las personas, un mandato de solidaridad superior en beneficio del bien común y el "florecimiento de la humanidad".

Objetivo/Contexto. Este artigo expõe as tendências e características de um modelo de negócio que a indústria farmacêutica tem vindo a impor com a ajuda do desenvolvimento de novos medicamentos cujo nível de inventividade é questionado. Como resultado, é-lhes concedidas patentes de segunda geração, o que é considerado uma prática abusiva e favorece o aumento dos preços destes inovações no mercado. Metodologia/Abordagem. Através da apresentação de um caso "A Declaração de Interesse Público da droga Imatinib na Colômbia", são identificadas estratégias e manobras anticompetitivas, que deixam poucas oportunidades para os Estados distribuírem os benefícios das invenções de drogas de forma equitativa. Na análise bioética do caso, o dilema é especificado como sendo prático, ou seja, um dilema em que os requisitos morais persistem em tensão com um interesse privado, neste caso, entre a saúde pública, por um lado, e a propriedade intelectual como uma política internacional, por outro. Resultados/Descobertas. A tese é que se trata de um problema transfronteiriço sintomático de falta de justiça global devido à suplência de um senso o bem comum que silenciou os laços sociais de solidariedade e colaboração. Discussão/Conclusões/Contribuições. Apela a um consenso sobre os fundamentos sociais e o respeito pela dignidade das pessoas, um mandato de maior solidariedade em benefício do bem comum, o florescimento da humanidade.

Purpose/Background. This article exposes the tendencies and characteristics of a business model that the pharmaceutical industry has been imposing with the help of the development of new drugs whose degree of inventiveness is questioned. As a result, they are granted second generation patents, which is considered an abusive practice that favors the increase of the prices of these innovations in the market. Methodology/Approach. Through the presentation of a case "The Declaration of Public Interest of the Drug Imatinib in Colombia", anti-competitive stra-tegies and maneuvers are identified, which leave few opportunities for the States to distribute the benefits of drug inventions in an equitable manner. In the bioethical analysis of the case, the dilemma is specified as a practical one, that is, one in which moral requirements persist in tension with a private interest, in this case, between public health on the one hand, and intellectual property as an international policy, on the other. Results/Findings. The thesis is that this is a cross-border problem symptomatic of a lack of global justice due to the supplanting of the sense of the common good that has silenced social bonds of solidarity and collaboration. Discussion/Conclusions/Contributions. It calls for a consensus on social foundations and respect for the dignity of persons, a higher mandate of solidarity for the benefit of the common good, and the flourishing of humanity.

Tax Justice Beyond National Borders-International or Interpersonal?

Recent times have seen growing calls for considerations of justice to be given a greater role in international taxation. The main driver of these calls are distributive concerns, although agreement is still missing as to what this means both in principle and in practice. This article asks whether it is the task of international tax law at all to implement principles of distributive justice beyond the national context and gives an overview of how the 'global justice debate' in contemporary political philosophy bears on this question. When it comes to distributive duties with respect to taxing rights, it is crucial to differentiate between the collective and the individual level. Absent a robust assumption of a benevolent and capable government on the recipient side, the reallocation of taxing rights from state to state does not necessarily help when it comes to fulfilling duties of justice towards individuals.

Pluralist internationalism, global justice and international student recruitment in the UK.

The number of international students in the UK has risen considerably in recent years. These students, now constituting around one-fifth of the student body in the UK universities, are viewed primarily in terms of the economic benefits they bring to the host country, and there has been little explicit discussion around equity principles that might inform international student recruitment. Responding to calls for further consideration of the ethics of this situation, this article offers a novel perspective by drawing on a 'pluralist internationalist' theory of global justice. This theory grants unique normative relevance to the state whilst at the same time embedding the state within multiple other grounds of justice that are global in scope, thereby contributing to the disentanglement of some of the normative disagreements that characterise debates about global justice. The suggestions that result from applying this theory offer a substantive alternative both to the nationally oriented assumptions of current policy and to other contributions to the debate within academia which have drawn on the cosmopolitan tradition of global justice.

On the morality of vaccination tourism.

Vaccination tourism (whereby citizens of one nation travel to a different, usually more developed nation to receive a vaccine unavailable or with little availability at home) during the COVID pandemic raises a host of moral issues and is usually met with criticism. From the perspective of the society of origin, the criticism is that those who use their socio-economic privileges to go abroad and receive the vaccine ahead of other citizens instead of 'making the line' act objectionably because in doing so they use their purchasing power to obtain a benefit that should not be distributed like any other product in the market. From the perspective of the society of destination, the criticism is that citizens and residents should receive the vaccines first; after all, their government purchased vaccines (with their taxes) to immunize the local population. The paper calls into question both objections to vaccination tourism. There might be other reasons to oppose it, but this pair of objections cannot ground a moral criticism of the practice.

Brief communication International cooperation in a non-ideal world: the example of COVAX.

The world witnessed one of the fasted responses in history to a new disease in terms of drug and vaccine development. However, despite the fact that safe and effective vaccines for COVID-19 were developed at a remarkable pace, international cooperation seems to have failed regarding the global equitable allocation of vaccines. This article explores challenges to international cooperation in global health and specifically to the fair allocation of vaccines at a global scale. We will present major obstacles to cooperative efforts and an interesting answer such as the COVAX facility, a cooperative redistribution scheme that has recently been launched by WHO, CEPI and Gavi. Considering COVAX a laudable and necessary first step to improve international cooperation in health, we nevertheless argue that the facility needs to identify key areas of potential improvement.

O mundo foi testemunha de uma das respostas mais rápidas da história a uma nova doença em termos de desenvolvimento de medicamentos e vacinas. No entanto, apesar do facto de que as vacinas seguras e eficazes para COVID-19 foram desenvolvidas a um ritmo notável, a cooperação internacional parece ter falhado no que diz respeito à distribuição global equitativa de vacinas. Este artigo explora os desafios para a cooperação internacional em matéria de saúde global e, especificamente, para a distribuição justa de vacinas à escala global. Apresentaremos os principais obstáculos aos esforços cooperativos e uma resposta interessante, como o mecanismo COVAX, um esquema de redistribuição cooperativa que foi lançado recentemente pela OMS, CEPI e Gavi. Considerando o COVAX como um primeiro passo louvável e necessário para melhorar a cooperação internacional em saúde, argumentamos que o mecanismo precisa de identificar as áreas de potencial melhoria.

El mundo ha sido testigo de una de las respuestas más rápidas a una nueva enfermedad, en términos de desarrollo de drogas y vacunas. Sin embargo, pese al hecho de que se han desarrollado vacunas seguras y efectivas para el COVID-19 a un paso impresionante; la cooperación internacional en relación al acceso equitativo a las vacunas parece haber fallado. Este artículo explora los desafíos a la cooperación internacional que se plantean en relación a la salud global y, específicamente, a la distribución justa de vacunas a escala global. Presentaremos algunos obstáculos a los esfuerzos cooperativos, así como también una respuesta interesante como lo es la del mecanismo COVAX, un sistema cooperativo de redistribución que ha sido recientemente introducido por la OMS, CEPI y GAVI. Aunque consideramos a COVAX un primer paso meritorio y necesario para mejorar la cooperación internacional en salud; argumentamos que el mecanismo necesita identificar áreas de mejora.

The Inefficient and Unjust Global Distribution of COVID-19 Vaccines: From a Perspective of Critical Global Justice.

The coronavirus disease 2019 (COVID-19) pandemic has caused huge losses and massive damage to socio-economic development around the globe, which might even potentially evolve into a humanitarian crisis as it continues to spread. In response to the further resulting public threats, collaborative research, rapid production, and efficient and just distribution of vaccines have been given a top priority. However, there exists a serious inefficiency and injustice in the distribution of COVID-19 vaccines among different countries, regions, and social classes currently. Richer countries and regions have acquired far more vaccines than needed, further exacerbating the severity of the epidemic in underdeveloped and marginalized countries and regions. From a perspective of critical global justice, we explore the causes of the inefficient and unjust global distribution of vaccines and comprehensively examine the shortcomings of the current distribution frameworks, such as COVID-19 Vaccines Global Access Facility (COVAX). Then, under the framework of critical global justice, we propose a multi-phase fair priority model that improves the existing proportional distribution mechanism. This solution to the global injustice reoptimizes the cross-border and domestic vaccine distribution and aims to resolve the pandemic more efficiently. The proposed framework and methodology of vaccine distribution could be taken as an opportunity to consistently promote the development of the global socio-economic structure towards global justice more broadly and systematically.

International cooperation in a non-ideal world: the example of COVAX / Cooperação internacional num mundo não ideal: o exemplo do COVAX / Cooperación internacional en un mundo no ideal: el ejemplo de COVAX

The world witnessed one of the fasted responses in history to a new disease in terms of drug and vaccine development. However, despite the fact that safe and effective vaccines for COVID-19 were developed at a remarkable pace, international cooperation seems to have failed regarding the global equitable allocation of vaccines. This article explores challenges to international cooperation in global health and specifically to the fair allocation of vaccines at a global scale. We will present major obstacles to cooperative efforts and an interesting answer such as the COVAX facility, a cooperative redistribution scheme that has recently been launched by WHO, CEPI and Gavi. Considering COVAX a laudable and necessary first step to improve international cooperation in health, we nevertheless argue that the facility needs to identify key areas of potential improvement.

O mundo foi testemunha de uma das respostas mais rápidas da história a uma nova doença em termos de desenvolvimento de medicamentos e vacinas. No entanto, apesar do facto de que as vacinas seguras e eficazes para COVID-19 foram desenvolvidas a um ritmo notável, a cooperação internacional parece ter falhado no que diz respeito à distribuição global equitativa de vacinas. Este artigo explora os desafios para a cooperação internacional em matéria de saúde global e, especificamente, para a distribuição justa de vacinas à escala global. Apresentaremos os principais obstáculos aos esforços cooperativos e uma resposta interessante, como o mecanismo COVAX, um esquema de redistribuição cooperativa que foi lançado recentemente pela OMS, CEPI e Gavi. Considerando o COVAX como um primeiro passo louvável e necessário para melhorar a cooperação internacional em saúde, argumentamos que o mecanismo precisa de identificar as áreas de potencial melhoria

El mundo ha sido testigo de una de las respuestas más rápidas a una nueva enfermedad, en términos de desarrollo de drogas y vacunas. Sin embargo, pese al hecho de que se han desarrollado vacunas seguras y efectivas para el COVID-19 a un pasoimpresionante; la cooperación internacional en relación alacceso equitativo a las vacunas parece haber fallado. Este artículo explora los desafíos a la cooperación internacional que se plantean en relación ala salud global y, específicamente, a la distribución justa de vacunas a escala global. Presentaremos algunos obstáculos a los esfuerzos cooperativos,así como también una respuesta interesante como lo es la del mecanismo COVAX, un sistema cooperativo de redistribución que ha sido recientemente introducido por la OMS, CEPI y GAVI. Aunque consideramos a COVAX un primer paso meritorio y necesario para mejorar la cooperación internacional en salud; argumentamos que el mecanismo necesita identificar áreas de mejora.

Individual Responsibility, Large-Scale Harms, and Radical Uncertainty.

Some consequentialists argue that ordinary individuals are obligated to act in specific, concrete ways to address large-scale harms. For example, they argue that we should each refrain from meat-eating and avoid buying sweatshop-made clothing. The case they advance for such prescriptions can seem intuitive and compelling: by acting in those ways, a person might help prevent serious harms from being produced at little or no personal cost, and so one should act in those ways. But I argue that such reasoning often relies on an overly simplistic assessment of the costs and benefits of those prescriptions, one that misconstrues or neglects important issues. Indeed, a closer look at those costs and benefits reveals just how little we often know about a number of real-world matters that bear on the expected consequences of the prescribed individual actions. Our predicament is one of radical uncertainty: we currently lack a sound basis for concluding that the relevant actions are more likely to do good than to backfire. I distinguish this empirically grounded objection from others, which are not convincing-including one based on the mere conceivability of the actions in question backfiring and another based on the supposition that such actions cannot make a difference in addressing the massive problems at issue. The upshot is that, at least for now, consequentialist arguments for many specific individual actions aimed at addressing large-scale harms are inconclusive.

The critical intersection of environmental and social justice: a commentary.

The global crises of ecological degradation and social injustice are mutually reinforcing products of the same flawed systems. Dominant human culture is morally obliged to challenge and reconstruct these systems in order to mitigate future planetary harm. In this commentary, we argue that doing so requires a critical examination of the values and narratives which underlie systems of oppression and power. We argue for the moral necessity of a socially just approach to the ecological crisis.

Crisis Nationalism: To What Degree Is National Partiality Justifiable during a Global Pandemic?

Are countries especially entitled, if not obliged, to prioritize the interests or well-being of their own citizens during a global crisis, such as a global pandemic? We call this partiality for compatriots in times of crisis "crisis nationalism". Vaccine nationalism is one vivid example of crisis nationalism during the COVID-19 pandemic; so is the case of the US government's purchasing a 3-month supply of the global stock of the antiviral Remdesivir for domestic use. Is crisis nationalism justifiable at all, and, if it is, what are its limits? We examine some plausible arguments for national partiality, and conclude that these arguments support crisis nationalism only within strict limits. The different arguments for partiality, as we will note, arrive at these limits for different reasons. But more generally, so we argue, any defensible crisis nationalism must not entail the violation of human rights or the worsening of people's deprivation. Moreover, we propose that good faith crisis nationalism ought to be sensitive to the potential moral costs of national partiality during a global crisis and must take extra care to control or offset these costs. Thus, crisis nationalism in the form of vaccine nationalism or the hoarding of global supplies of therapeutics during a global pandemic exceeds the bounds of acceptable partiality.

A Global Ecological Ethic for Human Health Resources.

COVID 19 has highlighted with lethal force the need to re-imagine and re-design the provisioning of human resources for health, starting from the reality of our radical interdependence and concern for global health and justice. Starting from the structured health injustice suffered by migrant workers during the pandemic and its impact on the health of others in both destination and source countries, I argue here for re-structuring the system for educating and distributing care workers around what I call a global ecological ethic. Rather than rely on a system that privileges nationalism, that is unjust, and that sustains and even worsens injustice, including health injustice, and that has profound consequences for global health, a global ecological ethic would have us see health as interdependent and aim at "ethical place-making" across health ecosystems to enable people everywhere to have the capability to be healthy.

From self-interest to solidarity: One path towards delivering refugee health.

The recent and ongoing refugee crisis in Europe highlights conflicting attitudes about the rights of migrants and refugees to health care in transition and destination countries. Some European and Scandinavian states, such as Germany and Sweden, have welcomed large numbers of migrants, while others, such as the U.K., have been significantly less open. In part, this is because of reluctance by certain national governments to incur what are seen as the high costs of delivering aid and care to migrants. In response to these assumptions, some theorists have argued that the appropriate way to view the health needs of migrants is not in terms of rights, but in terms of the interests of destination and transition countries-and have argued that providing care to migrants and refugees will generate benefits for their host countries. However, self-interest alone is less effective at motivating the provision of care for health deprivations that do not pose a threat to third parties, or to migrants and refugees in poor or distant countries. In this paper, I argue that while self-interest is unlikely in itself to motivate the provision of all necessary health care to all migrants and refugees, and may risk stigmatizing already vulnerable persons, it can provide the foundation upon which such motivations can be built. My goal is therefore to show how and why a more just approach to the provision of health care to migrants can and should be derived from narrower, self-interested commitments to preserving citizen health.

Can Theories of Global Justice Be Useful in Humanitarian Response?

Why is it that humanitarianism and theories of global justice seem to have relatively little engagement with each other? This article discusses some of the reasons for this being the case, and argues that instead of seeing these two fields as separate or adversarial they should be viewed as complementary. The article begins with a brief overview of humanitarianism, in order to argue for the relevance of justice in humanitarianism. The second section focuses on analyzing selected theories of justice- those of Peter Singer, John Kekes, and Thomas Pogge-through a particular lens, that of the question of responsibility for global well-being. The article concludes by arguing that theories of global justice can be beneficial for humanitarian causes, not in a comprehensive and consistent "all-or-nothing" manner, but rather on a case-by-case basis and through selective application of particular arguments.

Medical Tourism, Medical Migration, and Global Justice: Implications for Biosecurity in a Globalized World.

We live in the age of globalization. In medicine, that globalization has brought many benefits such as the diffusion of technology and the spread of health care training, but it has also brought threats to biosecurity. This article examines how medical tourism and medical migration pose risks to biosecurity. It also argues that designing legal responses to these risks requires not only technical competence but also a theory of global justice to guide that design.