For criticism and helpful comments, I am grateful to Avi Astor, Christian Barry, Dan Brock, Zeke Emanuel, Slim Haddad, Reidar Lie, Maria Merritt, Thomas Pogge, and Anthony So. Earlier versions of this paper were presented at the workshop, “Public Health and International Justice” organized by the Carnegie Council on Ethics and International Affairs, and at the Second International Conference of the International Society for Equity in Health. I am especially indebted to Alan Patten, who was my commentator at the Carnegie Council workshop. The views expressed are the author's own. They do not represent the position or policy of the National Institutes of Health, the Public Health Service, or the Department of Health and Human Services.
International Justice and Health: A Proposal
Article first published online: 30 AUG 2006
Ethics & International Affairs
Volume 16, Issue 2, pages 81–90, September 2002
How to Cite
Sreenivasan, G. (2002), International Justice and Health: A Proposal. Ethics & International Affairs, 16: 81–90. doi: 10.1111/j.1747-7093.2002.tb00399.x
- Issue published online: 30 AUG 2006
- Article first published online: 30 AUG 2006
This paper discusses obligations of international distributive justice-specifically, obligations rich countries have to transfer resources to poor countries. It argues that the major seven OECD countries each have an obligation to transfer at least one percent of their GDP to developing countries.
The strategy of the paper is to defend this position without having to resolve the many debates that attend questions of international distributive justice. In this respect, it belongs to the neglected category of nonideal theory. The key to the strategy is to show that a significant amount of good would be accomplished by a one percent transfer, despite the fact that one percent is quite a small amount.
To make this showing, the paper takes health as a fundamental measure of individual well-being and examines the improvement in life expectancy that would likely result from devoting the one percent transfer to the major determinants of health. It adduces data indicating that substantial progress towards raising life expectancy in developing countries to the global average of 64.5 years can be expected from expenditures of $125 per capita, divided between health care, education, and basic nutrition and income support. A one percent transfer from the major seven is enough to cover expenditures on that scale for the poorest fifth of the world's population.