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Introduction1

The global health challenge1

Why genetics?3

Influence of genetics on global health8

Benefit sharing10

The structure of the book15

PART Ⅰ A THEORETICAL FRAMEWORK FOR DISTRIBUTION IN HEALTH21

1 Global application of distributive justice: a cosmopolitan approach21

Introduction21

1.1 Distributive justice22

1.1.1 What are the characteristics of a normative obligation of benefit sharing?22

1.1.2 Global distributive justice23

1.2 Cosmopolitanism: a way of envisioning global justice24

1.2.1 Objections to cosmopolitanism32

1.2.2 Reasons for envisioning distributive justice on a global scale: a response37

Conclusion46

2 An argument for global distribution in health47

Introduction47

2.1 Conception of health justice47

2.1.1 Promoting health to avoid serious harm and allow normal functioning51

2.1.2 Avoidance of harm and normal functioning: crucial aspects of equality of opportunities56

2.1.3 Global perspective on health60

2.2 Normative grounds to operate distribution and premises upon which to claim health equity and fairness63

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

Conclusion81

PART Ⅱ SOME NORMATIVE TOOLS FOR DISTRIBUTION IN HEALTH85

How does our normative theory of distribution translate into positive law now? The cases of intellectual property and international human rights law85

3 International intellectual property law: a first tool?87

Introduction87

Introduction to intellectual property87

3.1 The patent system90

3.1.1 Human genetic material: patentable substance?93

3.1.2 National and international patent rights95

3.2 Some theoretical justification for the institution of patents98

3.2.1 What purpose is this system (as it exists today) designed to achieve?98

3.2.2 Locke's labour theory100

3.2.3 The utilitarian justification of property103

3.2.4 Drahos' economic power theory of IP112

3.3 Global distribution, justice and the patent system: an assessment116

3.3.1 Global access to genetic resources and international intellectual property rights116

3.3.2 Patents and access in terms of availability and affordability130

Conclusion143

4 International human rights law: a second tool?146

Do international human rights help or hinder the realisation of benefit sharing?146

Introduction146

4.1 The field of IHR law147

4.1.1 Presentation147

4.1.2 Theoretical and legal foundations of IHR150

4.2 Distribution, access, justice and the IHR system: an assessment157

4.2.1 The global/universal aspect of access to health in the context of the IHR system157

4.2.2 Legal access to health, responsibility for distribution of health and human rights168

4.3 The conceptualisation of human rights within the reality of the market182

4.3.1 How is the institution of human rights shaped by the market and the powers in place?182

Conclusion190

Conclusion194

Policy options to explore within the existing global structure197

Broader long-term and inclusive options202

Bibliography207

Index245