Public Health Ethics Advance Access first published online on September 24, 2009
This version published online on October 14, 2009
Public Health Ethics, doi:10.1093/phe/php019
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Global Health Justice
Yale University
* Corresponding author: Jennifer Prah Ruger, Ph.D. Yale University, 60 College Street, P.O. Box 208034, New Haven, CT 06520, Email: jennifer.ruger{at}yale.edu
 |
Abstract |
|---|
What are the respective roles and responsibilities of global, national, and local communities as well as individuals themselves to address health deprivations and avert health threats? This article offers the beginnings of a theory of global health justice, arguing for universal ethical norms (general duty) with shared global and domestic responsibility (specific duties) for health. It offers a global minimalist view I call ‘provincial globalism’ as a mean between nationalism and cosmopolitanism, in which a provincial consensus must accompany a global consensus on health morality. This minimalist account asserts global and national duties to promote human flourishing and, more specifically, individuals’ central health capabilities. In this view, justice requires prioritizing responsibilities through shared health governance to reduce shortfall inequalities in central health capabilities—a general duty to reduce premature mortality and escapable morbidity. It examines the difficulties presented by the philosophical principles of connectedness, causality, remediation, partiality, and capacity in the allocation of responsibility for global health. It offers a theory of responsibility allocation based on a functional, health agency centered and homeostatic balanced understanding of the analytical components required to solve global health problems and parcels out roles and responsibilities at the global, national, local, and individual levels accordingly. Allocations of responsibility rest on the effectiveness and special obligations of different actors, respecting self-determination by groups and individuals and seeking voluntary commitments. This view understands that the remedy for global health problems must be sustainable to take nations and the global health community to a new global health equilibrium that remedies current problems and prepares for new health threats to come.