Pharmaceutical companies developed Covid-19 vaccines in record time. However, it soon became apparent that global access to the vaccines was inequitable. Through a qualitative inquiry as the pandemic unfolded (to mid-2021), we provide an in-depth analysis of why companies engaged with the Covid-19 Vaccines Global Access Facility (COVAX), identifying the internal (to the company) and external factors that facilitated or impeded engagement. While all producers of the World Health Organization (WHO)-approved vaccines engaged with COVAX, our analysis highlights the differential levels (...) of COVAX engagement and identifies contractual obligations, opportunities and company strategy, and reputational pressures as key explanatory factors. We discuss our empirical findings relative to the literature on political corporate social responsibility (PCSR). Accordingly, we question whether pharmaceutical companies lived up to their responsibilities as corporate citizens and conclude that they failed to fulfill the implied responsibility of combating inequitable vaccine distribution. We conclude with implications of our research for practice, in relation to the challenges of global access to Covid-19 vaccines and for access to medicines more generally. (shrink)

This article assesses some of the implications of globalization for the scholarly debate on business ethics, CSR and related concepts. The argument is based, among other things, on the declining capacity of nation state institutions to regulate socially desirable corporate behavior as well as the growing corporate exposure to heterogeneous social, cultural and political values in societies globally. It is argued that these changes are shifting the corporate role towards a sphere of societal governance hitherto dominated by traditional political actors. (...) This leads to a discussion of the ambivalent results of such a process for a responsible corporate role in a globalized world. While assessing the current reception these changes have received in the management literature, the contributions of the four articles in this Special Issue are framed and evaluated. The argument closes by highlighting avenues of future research on this new challenge. (shrink)

ABSTRACT:This article examines the presuppositions and theoretical frameworks of the “new-wave” “Post-Westphalian” approach to international business ethics and compares it to the more philosophically oriented moral theory approach that has predominated in the field. I contrast one author’s Post-Westphalian political approach to the human rights responsibilities of transnational corporations (TNCs) with my own “Fair Share” theory of moral responsibility for human rights. I suggest how the debate about the meaning of corporate human rights “complicity” might be informed by the fair (...) share theory. While I point out that Post-Westphalians and moral philosophers may have fundamental disagreements about basic concepts such as legitimacy, justice, and democratic deliberation, I conclude that the Post-Westphalians have made a major contribution to the expansion of the field by presenting business ethicists with an opportunity to inform and guide debates about the potential future course of transnational governance. (shrink)

With over 2 billion people lacking medicines for treatable diseases and 14 million people dying annually from infectious disease, there is undeniable need for increased access to medicines. There has been an increasing trend to benchmark the pharmaceutical industry on their corporate social responsibility (CSR) performance in access to medicines. Benchmarking creates a competitive inter-business environment and acts as incentive for improving CSR. This article investigates the corporate feedback discourses pharmaceutical companies make in response to criticisms from benchmarking reports. It (...) determines whether these responses are part of a healthy process in increasing access to medicines or a barrier to improvement. A qualitative analysis on the feedback the industry provided was performed, and the responses seen in these statements were grouped by analysing the language used, the ideas portrayed and atti- tudes of the companies. Increasing transparency through benchmarking is a powerful tool which reveals the industry’s shortfalls to the public, affects the decisions of socially responsible investors, and is a risk to their financial bottom line. This article demonstrates the importance of benchmarking and transparency in creating inter-business competition and the translation of these responses to actual access to medicine practices. (shrink)

Moral purism is a commonly held view on moral worthiness and how to identify it in concrete cases. Moral purists long for a moral world in which (business) people—at least sometimes—act morally worthy, but in concrete cases they systematically discount good deeds as grounded in self-interest. Moral purism evokes moral cynicism. Moral cynicism is a problem, both in society at large and the business world. Moral cynicism can be fought by refuting moral purism. This article takes issue with moral purism. (...) The common strategy to tackle moral purism is to reject the exclusion thesis which states that self-interest and the ‘pure’ moral motive (and thus moral worthiness) exclude each other. We develop a different strategy. We argue that moral purists are mistaken in the way they judge moral worthiness in concrete cases. They employ the wrongprocedureand the wrongcriteria.We develop a proper procedure and proper criteria. We build on Kant, who we argue is unfairly regarded as the champion of moral purism. In order to see how Kant can develop a consistent (non-purist) philosophy, the exclusion thesis must be embedded in Kant’s transcendental philosophy. Properly embedded, Kant turns out to be both anti-purist and anti-cynical. (shrink)

Considering the urgency of addressing grand challenges that affect human health and achieving the ambitious health targets set by the United Nations’ Sustainable Development Goals, the role of business in improving health has become critical. Yet, our systematic review of the business–health literature reveals that business research focuses primarily on occupational health and safety, health care organizations, and health regulations. To embrace the health externalities generated by business activities, we propose that future research should investigate the conditions under which business (...) articulates and participates in health challenges, engages in multilevel actions toward tackling health challenges, and improves health outcomes and its impact on the health of external stakeholders, including customers and local communities. We also urge business scholars to engage with the public health research community to increase impact. (shrink)

This paper discusses the need to focus on the dignity of human participants as a legal and ethical basis for providing post-trial access to healthcare. Debate about post-trial benefits has mostly focused on access to products or interventions proven to be effective in clinical trials. However, such access may be modelled on a broad fair benefits framework that emphasises both collateral benefits and interventional products of research, instead of prescribed post-trial access alone. The wording of the current version of the (...) Declaration of Helsinki could in fact be interpreted to broaden the scope to include other collateral benefits by applying such a broad fair benefits framework. We argue that this possibility should be utilised by low and middle income countries’ health research ethics committees in order to ensure that research participants who enrol in clinical trials so as to receive medical care continue to access care after the trial is concluded, as befits their dignity. Although each LMIC has unique concerns, nonetheless there are common challenges based especially on emerging issues, such as post-trial access to healthcare. Accordingly, the South African perspective is used to draw lessons that can benefit other LMICs. (shrink)

Any system for the protection of intellectual property rights (IPRs) has three main kinds of distributive effects. It will determine or influence: (a) the types of objects that will be developed and for which IPRs will be sought; (b) the differential access various people will have to these objects; and (c) the distribution of the IPRs themselves among various actors. What this means to the area of pharmaceutical research is that many urgently needed medicines will not be developed at all, (...) that the existing medicines will not be suitable for countries with a precarious health infrastructure or not target the disease variety that is prevalent in poorer regions. Such effects are commonly captured under the rubric of the “10/90 gap” in biomedical research. High prices will also restrict access to medicines as well endanger compliance to treatment schemes. IPRs are mainly held by multinational corporations situated in the developed world, which not only raises egalitarian concerns, but also severely limits the possibilities of companies in poorer countries to realize improvements on existing inventions, as they cannot financially afford to secure freedom to operate, which systematically shrinks the number of potential innovators. Those inequities lead to an enormous burden for the global poor and since no institution is willing to assume the responsibility to fulfil the right to health and the corresponding right of access to essential medicines, we have to analyse alternatives or additions to the actual intellectual property regimes in order to create new incentives to fill this gap. (shrink)