The purpose of my paper is to
tackle the issue of basic human health needs under the heading of global
justice. Although my approach is philosophical and pertains to the specific
field of international ethics, there is no doubt, in my view, that current
ethical debates in biomedical and public health research may take great
interest in this fundamental question: can international obligations of
distributive justice in the field of basic human health care be justified?
I will argue following three
distinct lines of thought expounding one proposal: inequities (those
inequalities considered unjust) in the field of health care at the
international level call for the implementation of global institutions in order
to fulfill basic human health needs in accordance to fundamental principles of
global justice.
First, a strong case in favour of
global justice can be defended in the context of globalization, depicting a
world order characterized by structural interdependency linking all states,
peoples and individuals in a common fate towards global risks and goods.
Furthermore, I argue that recent theories expounding the notion of global public good (cf. L. Chen, I. Kaul & al.), in spite of warranted critical
objections, help us better understand why it is in the best interest of the
international community to respond efficiently to transnational issues related
to health care such as the HIV/AIDS pandemic in sub-Saharan Africa.
Secondly, drawing from Sen’s work
on deprivations and capabilities,
Daniels’ reading of Rawls’ equal opportunity principle implying equal
access to health care, Shue’s theory of basic rights as subsistence rights, I
argue that numerous philosophical approaches justify the need to incorporate
health care issues into a substantial theory of global justice.
Finally, I suggest that Held’s
work on cosmopolitan democracy and differentiated sovereignty offers a promising
conceptual framework to design institutional model proposals of global
governance without world government. Although this last point will be briefly
summarized in my paper, I believe that this theoretical framework may lead us
to plausible institutional reforms within the UN model in order to foster
greater international cooperation in the field of health care treatment.
In conclusion, a normative theory
of global justice, warranted by an accurate understanding of globalization,
requires indeed fair distribution of resources at the international level in
order to fulfill basic health care needs.