Abstract

Can resource-poor countries bear any stringent obligations in the pursuit of equity in the distribution of global health opportunities between individuals globally? Distributive justice is primarily about resource transfer from those who have more than enough to those who are suffering severe scarcity. In the particular case of distributive justice in global health, given that most health opportunities cost money and given that the idea of ‘resource-poor countries’ entails that such countries lack sufficient resources in general and in particular health resources, the question of this work may seem a rhetorical one, seeking “no” as an obvious answer. On the contrary, however, despite the reality of severe resource scarcity among poor countries, the main thesis defended in this work is that poor countries ought to bear certain stringent obligations in the pursuit of global distributive justice in general. This obligation applies even in the specific case of the pursuit of justice in the global distribution of certain basic health opportunities among individuals globally. This work is based on a general claim that in efforts to ensure distributive justice it is not enough to look at what amounts of resources should flow from the global haves to the global have-nots. The work demonstrates that even though resource flow from the global rich to the global poor is a necessary condition for achieving distributive justice in the current global circumstances, there is evidence which suggests that this may not be a sufficient condition for the achievement of global distributive justice; or at least reducing the current global inequities. Bearing in mind that global injustice, in this case, means unjust distribution of global resources and opportunities rather than global inequality per se, this work suggests that potential beneficiaries of redistribution need to behave in ways which confirm that current inequalities in global distribution of life chances and all opportunities for survival and human well-being are unjust in a sense that the current global maldistribution of resources cannot be attributed to their moral fault. If the current global inequalities can be attributed to their moral fault, then they ought to bear morally binding obligations to their citizens and those whose resources are to be redistributed. Short of this proviso it will not be possible to achieve global distributive justice in the strict sense of the word. It is this proviso that leads to an enquiry into possible obligations of poor countries in ensuring global distributive justice. This reasoning about what it may necessarily take to achieve global distributive justice is motivated by an insight that ignoring the victims’ obligations may lead to further injustice especially if affluent countries are morally required to transfer their resources to cover deficits in victim countries, which deficits arise out of the moral fault of those governments. The insight also extends to the possibility that current efforts might fail to achieve the desired global threshold distribution of material and social well-being for poor country citizens especially if their governments behave like economic ‘black holes.’