Global Health

Edited by Kyle Ferguson (Hunter College (CUNY), New York University)
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  1. Discounting future health.Hilary Greaves - forthcoming - In Norheim Emanuel Jamison Johansson Millum Otterson Ruger and Verguet (ed.), Global health priority-setting: Cost-effectiveness and beyond. Oxford University Press.
    In carrying out cost-benefit or cost-effective analysis, a discount rate should be applied to some kinds of future benefits and costs. It is controversial, though, whether future health is in this class. I argue that one of the standard arguments for discounting (from diminishing marginal returns) is inapplicable to the case of health, while another (favouring a pure rate of time preference) is unsound in any case. However, there are two other reasons that might support a positive discount rate for (...)
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  2. Response strategies of Filipino nursing organizations in the US and UK under the VUCA conditions of the COVID-19 pandemic.Patricia Eunice Miraflores - forthcoming - Migration and Diasporas: An Interdisciplinary Journal:82-120.
    The COVID-19 pandemic put immense pressure on healthcare systems globally, including those of highly developed countries like the United States and United Kingdom. During the pandemic, professional nursing organizations were the first to call attention to the disproportionate pandemic-related deaths among Filipino nurses. These organizations played a central role in addressing the various crises Filipino nurses faced due to their vulnerabilities as frontliners, ethnic minorities, and migrants in their host countries. Using the Volatile, Uncertain, Complexity, and Ambiguous (VUCA) framework, this (...)
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  3. Xenotransplantation: A historical–ethical account of viewpoints.Daniel Rodger, Daniel J. Hurst & David K. C. Cooper - forthcoming - Xenotransplantation.
    Formal clinical trials of pig-to-human organ transplant—known as xenotransplantation—may begin this decade, with the first trials likely to consist of either adult renal transplants or pediatric cardiac transplant patients. Xenotransplantation as a systematic scientific study only reaches back to the latter half of the 20th century, with episodic xenotransplantation events occurring prior to that. As the science of xenotransplantation has progressed in the 20th and 21st centuries, the public's knowledge of the potential therapy has also increased. With this, there have (...)
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  4. The Role of Museums in Planetary Health Bioethics: A Review.Teng Wai Lao & Jan Gresil Kahambing - 2023 - In Alexander Waller & Darryl Macer (eds.), Planetary Health Bioethics. pp. 434-451.
    This chapter delves into the museological side of ‘the way forward’ to conservation for planetary health bioethics. Specifically, it highlights the crucial role that museums play – their curatorial or exhibition interventions, conservation operations, development policies, or practices – which present or represent the vital relationship between human and planetary health. While it is not new to stress the significance of museums’ link to the environment and environmental education, it is necessary to re-examine recent cases in light of the rapid (...)
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  5. Fair domestic allocation of monkeypox virus countermeasures.Govind Persad, R. J. Leland, Trygve Ottersen, Henry Richardson, Carla Saenz, G. Owen Schaefer & Ezekiel J. Emanuel - 2023 - Lancet Public Health 8 (5):e378–e382.
    Countermeasures for mpox (formerly known as monkeypox), primarily vaccines, have been in limited supply in many countries during outbreaks. Equitable allocation of scarce resources during public health emergencies is a complex challenge. Identifying the objectives and core values for the allocation of mpox countermeasures, using those values to provide guidance for priority groups and prioritisation tiers, and optimising allocation implementation are important. The fundamental values for the allocation of mpox countermeasures are: preventing death and illness; reducing the association between death (...)
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  6. More Carrots, Less Sticks: Encouraging Good Stewardship in the Global Antimicrobial Commons.Cristian Timmermann - 2023 - Health Care Analysis 31 (1):53-57.
    Time-tested commons characterize by having instituted sanctioning mechanisms that are sensitive to the circumstances and motivations of non-compliers. As a proposed Global Antimicrobial Commons cannot cost-effectively develop sanctioning mechanisms that are consistently sensitive to the circumstances of the global poor, I suggest concentrating on establishing a wider set of incentives that encourages both compliance and participation.
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  7. Voluntariness or legal obligation? An ethical analysis of two instruments for fairer global access to COVID-19 vaccines.Katja Voit, Cristian Timmermann, Marcin Orzechowski & Florian Steger - 2023 - Frontiers in Public Health 11:995683.
    Introduction: There is currently no binding, internationally accepted and successful approach to ensure global equitable access to healthcare during a pandemic. The aim of this ethical analysis is to bring into the discussion a legally regulated vaccine allocation as a possible strategy for equitable global access to vaccines. We focus our analysis on COVAX (COVID-19 Vaccines Global Access) and an existing EU regulation that, after adjustment, could promote global vaccine allocation. -/- Methods: The main documents discussing the two strategies are (...)
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  8. Reconciling Regulation with Scientific Autonomy in Dual-Use Research.Nicholas G. Evans, Michael J. Selgelid & Robert Mark Simpson - 2022 - Journal of Medicine and Philosophy 47 (1):72-94.
    In debates over the regulation of communication related to dual-use research, the risks that such communication creates must be weighed against against the value of scientific autonomy. The censorship of such communication seems justifiable in certain cases, given the potentially catastrophic applications of some dual-use research. This conclusion however, gives rise to another kind of danger: that regulators will use overly simplistic cost-benefit analysis to rationalize excessive regulation of scientific research. In response to this, we show how institutional design principles (...)
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  9. Editorial: Coronavirus Disease (COVID-19): Socio-Economic Systems in the Post-Pandemic World: Design Thinking, Strategic Planning, Management, and Public Policy.Andrzej Klimczuk, Eva Berde, Delali Dovie, Magdalena Klimczuk-Kochańska & Gabriella Spinelli - 2022 - Frontiers in Communication 7:1–5.
    The declaration of the COVID-19 pandemic by the World Health Organization on March 11, 2020, led to unprecedented events. All regions of the world participated in implementing preventive health measures such as physical distancing, travel restrictions, self-isolation, quarantines, and facility closures. The pandemic started global disruption of socio-economic systems, covering the postponement or cancellation of public events, supply shortages, schools and universities’ closure, evacuation of foreign citizens, a rise in unemployment and inflation, misinformation, the anti-vaccine movement, and incidents of discrimination (...)
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  10. Editorial: Social, Technological and Health Innovation: Opportunities and Limitations for Social Policy, Health Policy, and Environmental Policy.Andrzej Klimczuk, Magdalena Klimczuk-Kochańska & Jorge Felix - 2022 - Frontiers in Political Science 4:1–4.
    Innovation is progressively needed in responding to global challenges. Moreover, the increasing complexity of challenges implies demand for the usage of multisectoral and policy mix approaches. Wicked problems can be tackled by "integrated innovation" that combines the coordinated implementation of social, technological, and health innovation co-created by entities of the public sector, the private sector, the non-governmental sector, and the informal sector. This Research Topic focuses on filling the knowledge gaps about the selected types of innovation. First, regarding social innovation (...)
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  11. Climate Change, Pollution, Deforestation, and Mental Health: Research Trends, Gaps, and Ethical Considerations.Moritz E. Wigand, Cristian Timmermann, Ansgar Scherp, Thomas Becker & Florian Steger - 2022 - GeoHealth 6 (11):e2022GH000632.
    Climate change, pollution, and deforestation have a negative impact on global mental health. There is an environmental justice dimension to this challenge as wealthy people and high-income countries are major contributors to climate change and pollution, while poor people and low-income countries are heavily affected by the consequences. Using state-of-the art data mining, we analyzed and visualized the global research landscape on mental health, climate change, pollution and deforestation over a 15-year period. Metadata of papers were exported from PubMed®, and (...)
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  12. Following the Science: Pandemic Policy Making and Reasonable Worst-Case Scenarios.Richard Bradley & Joe Roussos - 2021 - LSE Public Policy Review 1 (4):6.
    The UK has been ‘following the science’ in response to the COVID-19 pandemic in line with the national framework for the use of scientific advice in assessment of risk. We argue that the way in which it does so is unsatisfactory in two important respects. Firstly, pandemic policy making is not based on a comprehensive assessment of policy impacts. And secondly, the focus on reasonable worst-case scenarios as a way of managing uncertainty results in a loss of decision-relevant information and (...)
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  13. Phantom premise and a shape-shifting ism: reply to Hassoun.Kyle Ferguson & Arthur Caplan - 2021 - Journal of Medical Ethics 47 (11).
    In ‘Against vaccine nationalism’, Nicole Hassoun misrepresents our argument, distorts our position and ignores crucial distinctions we present in our article, ‘Love thy neighbor? Allocating vaccines in a world of competing obligations’. She has created a strawman that does not resemble our position. In this reply, we address two features of ‘Against vaccine nationalism’. First, we address a phantom premise. Hassoun misattributes to us a thesis, according to which citizen-directed duties are stronger than noncitizen-directed duties. This thesis is a figment (...)
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  14. Love thy neighbour? Allocating vaccines in a world of competing obligations.Kyle Ferguson & Arthur Caplan - 2021 - Journal of Medical Ethics 47 (12):e20-e20.
    Although a safe, effective, and licensed coronavirus vaccine does not yet exist, there is already controversy over how it ought to be allocated. Justice is clearly at stake, but it is unclear what justice requires in the international distribution of a scarce vaccine during a pandemic. Many are condemning ‘vaccine nationalism’ as an obstacle to equitable global distribution. We argue that limited national partiality in allocating vaccines will be a component of justice rather than an obstacle to it. For there (...)
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  15. Should we delay covid-19 vaccination in children?Lisa Forsberg & Anthony Skelton - 2021 - British Medical Journal 374 (8300):96-97.
    The net benefit of vaccinating children is unclear, and vulnerable people worldwide should be prioritised instead, say Dominic Wilkinson, Ilora Finlay, and Andrew J Pollard. But Lisa Forsberg and Anthony Skelton argue that covid-19 vaccines have been approved for some children and that children should not be disadvantaged because of policy choices that impede global vaccination.
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  16. Eating Meat and Not Vaccinating: In Defense of the Analogy.Ben Jones - 2021 - Bioethics 35 (2):135-142.
    The devastating impact of the COVID‐19 (coronavirus disease 2019) pandemic is prompting renewed scrutiny of practices that heighten the risk of infectious disease. One such practice is refusing available vaccines known to be effective at preventing dangerous communicable diseases. For reasons of preventing individual harm, avoiding complicity in collective harm, and fairness, there is a growing consensus among ethicists that individuals have a duty to get vaccinated. I argue that these same grounds establish an analogous duty to avoid buying and (...)
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  17. Strategie boje s epidemií: vítězové a poražení?Daniel D. Novotný - 2021 - Časopis Zdravotnického Práva a Bioetiky 11 (2):1–19.
    The ongoing covid-19 epidemic has affected the entire world. Somewhat surprisingly, it is not the case that the most successful countries are the richest one, with the best health care. Nor is there a clear link between success and geographical location. Above all, much of the rich Western world has failed so far to protect public health effectively, and so it is appropriate to consider the question why. In this article, I focus mainly on the choice of the basic epidemiological (...)
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  18. An ethical framework for global vaccine allocation.Ezekiel J. Emanuel, Govind Persad, Adam Kern, Allen E. Buchanan, Cecile Fabre, Daniel Halliday, Joseph Heath, Lisa M. Herzog, R. J. Leland, Ephrem T. Lemango, Florencia Luna, Matthew McCoy, Ole F. Norheim, Trygve Ottersen, G. Owen Schaefer, Kok-Chor Tan, Christopher Heath Wellman, Jonathan Wolff & Henry S. Richardson - 2020 - Science 1:DOI: 10.1126/science.abe2803.
    In this article, we propose the Fair Priority Model for COVID-19 vaccine distribution, and emphasize three fundamental values we believe should be considered when distributing a COVID-19 vaccine among countries: Benefiting people and limiting harm, prioritizing the disadvantaged, and equal moral concern for all individuals. The Priority Model addresses these values by focusing on mitigating three types of harms caused by COVID-19: death and permanent organ damage, indirect health consequences, such as health care system strain and stress, as well as (...)
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  19. Covid-19 katastrofa: Nad knihou Richarda Hortona.Daniel D. Novotný - 2020 - Filosofie Dnes 12 (2):88-127.
    In this review study, I reflect on Richard Horton’s book and his thesis that Western countries failed in their response to the current epidemic in the first half of 2020, with a few exceptions. In the five sections of the paper, after an initial modification of Horton’s thesis (A), I discuss briefly: the suppression approach in China (B), the mitigation approach in the West (C), the SARS epidemic as the key global public health event (D), the causes of Western failure (...)
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  20. Antimicrobial Footprints, Fairness, and Collective Harm.Anne Schwenkenbecher - 2020 - In Euzebiusz Jamrozik & Michael Selgelid (eds.), Ethics and Drug Resistance: Collective Responsibility for Global Public Health. Springer. pp. 379-389.
    This chapter explores the question of whether or not individual agents are under a moral obligation to reduce their ‘antimicrobial footprint’. An agent’s antimicrobial footprint measures the extent to which her actions are causally linked to the use of antibiotics. As such, it is not necessarily a measure of her contribution to antimicrobial resistance. Talking about people’s antimicrobial footprint in a way we talk about our carbon footprint may be helpful for drawing attention to the global effects of individual behaviour (...)
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  21. Asbestos Neglect: Why Asbestos Exposure Deserves Greater Policy Attention.Thomas Douglas & Laura Van den Borre - 2019 - Health Policy 123 (5):516-519.
    While many public health threats are now widely appreciated by the public, the risks from asbestos exposure remain poorly understood, even in high-risk groups. This article makes the case that asbestos exposure is an important, ongoing global health threat, and argues for greater policy efforts to raise awareness of this threat. It also proposes the extension of asbestos bans to developing countries and increased public subsidies for asbestos testing and abatement.
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  22. Putting a number on the harm of death.Joseph Millum - 2019 - In Espen Gamlund & Carl Tollef Solberg (eds.), Saving People from the Harm of Death. New York: Oxford University Press. pp. 61-75.
    Donors to global health programs and policymakers within national health systems have to make difficult decisions about how to allocate scarce health care resources. Principled ways to make these decisions all make some use of summary measures of health, which provide a common measure of the value (or disvalue) of morbidity and mortality. They thereby allow comparisons between health interventions with different effects on the patterns of death and ill health within a population. The construction of a summary measure of (...)
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  23. Emergency care research ethics in low- and middle-income countries.Joseph Millum, Blythe Beecroft, Timothy C. Hardcastle, Jon Mark Hirshon, Adnan A. Hyder, Jennifer A. Newberry & Carla Saenz - 2019 - BMJ Global Health 4:e001260.
    A large proportion of the total global burden of disease is caused by emergency medical conditions. Emergency care research is essential to improving emergency medicine but this research can raise some distinctive ethical challenges, especially with regard to (1) standard of care and risk–benefit assessment; (2) blurring of the roles of clinician and researcher; (3) enrolment of populations with intersecting vulnerabilities; (4) fair participant selection; (5) quality of consent; and (6) community engagement. Despite the importance of research to improve emergency (...)
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  24. The Case for Valuing Non-Health and Indirect Benefits.Govind Persad & Jessica du Toit - 2019 - In Ole F. Norheim, Ezekiel J. Emanuel & Joseph Millum (eds.), Global Health Priority-Setting: Beyond Cost-Effectiveness. Oxford University Press. pp. 207-222.
    Health policy is only one part of social policy. Although spending administered by the health sector constitutes a sizeable fraction of total state spending in most countries, other sectors such as education and transportation also represent major portions of national budgets. Additionally, though health is one important aspect of economic and social activity, people pursue many other goals in their social and economic lives. Similarly, direct benefits—those that are immediate results of health policy choices—are only a small portion of the (...)
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  25. Why Health-Related Inequalities Matter and Which Ones Do.Alex Voorhoeve - 2019 - In Ole F. Norheim, Ezekiel J. Emanuel & Joseph Millum (eds.), Global Health Priority-Setting: Beyond Cost-Effectiveness. Oxford University Press. pp. 145-62.
    I outline and defend two egalitarian theories, which yield distinctive and, I argue, complementary answers to why health-related inequalities matter: a brute luck egalitarian view, according to which inequalities due to unchosen, differential luck are bad because unfair, and a social egalitarian view, according to which inequalities are bad when and because they undermine people’s status as equal citizens. These views identify different objects of egalitarian concern: the brute luck egalitarian view directs attention to health-related well-being, while social egalitarianism focuses (...)
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  26. Health Research Priority Setting: The Duties of Individual Funders.Leah Pierson & Joseph Millum - 2018 - American Journal of Bioethics 18 (11):6-17.
    The vast majority of health research resources are used to study conditions that affect a small, advantaged portion of the global population. This distribution has been widely criticized as inequitable and threatens to exacerbate health disparities. However, there has been little systematic work on what individual health research funders ought to do in response. In this article, we analyze the general and special duties of research funders to the different populations that might benefit from health research. We assess how these (...)
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  27. Prioritarianism for Global Health Investments: Identifying the Worst Off.Daniel Sharp & Joseph Millum - 2018 - Journal of Applied Philosophy:112-132.
    The available resources for global health assistance are far outstripped by need. In the face of such scarcity, many people endorse a principle according to which highest priority should be given to the worst off. However, in order for this prioritarian principle to be useful for allocation decisions, policy-makers need to know what it means to be badly off. In this article, we outline a conception of disadvantage suitable for identifying the worst off for the purpose of making health resource (...)
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  28. The Social Value of Health Research and the Worst Off.Nicola Barsdorf & Joseph Millum - 2017 - Bioethics 31 (2):105-115.
    In this article we argue that the social value of health research should be conceptualized as a function of both the expected benefits of the research and the priority that the beneficiaries deserve. People deserve greater priority the worse off they are. This conception of social value can be applied for at least two important purposes: in health research priority setting when research funders, policy-makers, or researchers decide between alternative research projects; and in evaluating the ethics of proposed research proposals (...)
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  29. Dilemmas in access to medicines: a humanitarian perspective – Authors' reply.Ezekiel J. Emanuel & Govind Persad - 2017 - Lancet 387 (10073):1008-1009.
    Our Viewpoint argues that expanding access to less effective or more toxic treatments is supported not only by utilitarian ethical reasoning but also by two other ethical frameworks: those that emphasise equality and those that emphasise giving priority to the patients who are worst off. The inadequate resources available for global health reflect not only natural constraints but also unwise social and political choices. However, pitting efforts to reduce inequality and better fund global health against efforts to put available resources (...)
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  30. The Case for Resource Sensitivity: Why It Is Ethical to Provide Cheaper, Less Effective Treatments in Global Health.Govind C. Persad & Ezekiel J. Emanuel - 2017 - Hastings Center Report 47 (5):17-24.
    We consider an ethical dilemma in global health: is it ethically acceptable to provide some patients cheaper treatments that are less effective or more toxic than the treatments other patients receive? We argue that it is ethical to consider local resource constraints when deciding what interventions to provide. The provision of cheaper, less effective health care is frequently the most effective way of promoting health and realizing the ethical values of utility, equality, and priority to the worst off.
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  31. Transmitting Cholera to Haiti.J. Millum - 2016 - In Drue H. Barrett, Gail Bolan, Angus Dawson, Leonard Ortmann, Andreas Reis & Carla Saenz (eds.), Public Health Ethics: Cases Spanning the Globe. Springer. pp. 270-74.
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  32. The ethics of expanding access to cheaper, less effective treatments.Govind C. Persad & Ezekiel J. Emanuel - 2016 - The Lancet (10047):S0140-6736(15)01025-9.
    This article examines a fundamental question of justice in global health. Is it ethically preferable to provide a larger number of people with cheaper treatments that are less effective (or more toxic), or to restrict treatments to a smaller group to provide a more expensive but more effective or less toxic alternative? We argue that choosing to provide less effective or more toxic interventions to a larger number of people is favored by the principles of utility, equality, and priority for (...)
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  33. A Silenced Cry: Should stillbirth be given greater priority on the global health agenda?Z. U. Qureshi - 2015 - British Medical Journal 351 (h4620).
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  34. Stillbirth should be given greater priority on the global health agenda.Zeshan U. Qureshi, Joseph Millum, Hannah Blencowe, Maureen Kelley, Joy E. Lawn, Anthony Costello & Tim Colbourn - 2015 - British Medical Journal 351:h4620.
    Stillbirths are largely excluded from international measures of mortality and morbidity. Zeshan Qureshi and colleagues argue that stillbirth should be higher on the global health agenda.
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  35. Responsibility for Global Health: Is There a Case for 'Duty Dumping'?Kristin Voigt - 2015 - Jurisprudence 6 (1):144-150.
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  36. Valuing Stillbirths.John Phillips & Joseph Millum - 2014 - Bioethics 29 (6):413-423.
    Estimates of the burden of disease assess the mortality and morbidity that affect a population by producing summary measures of health such as quality-adjusted life years and disability-adjusted life years. These measures typically do not include stillbirths among the negative health outcomes they count. Priority-setting decisions that rely on these measures are therefore likely to place little value on preventing the more than three million stillbirths that occur annually worldwide. In contrast, neonatal deaths, which occur in comparable numbers, have a (...)
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  37. Maternal Mortality Interventions: A Systematic Review.Gina Marie Piane - 2014 - Open Journal of Preventive Medicine 4 (9):699-707.
    In order to achieve the World Health Organization’s Millennium Development Goal of reducing maternal mortality by three quarters by 2015, a strong global commitment is needed to address this issue in low-income nations where the risk to women is greatest. A comprehensive international effort must include provision of obstetric and general medical care as well as community-based interventions, with an emphasis on the latter in nations where the majority of women deliver babies at home without a trained attendant. Methods: This (...)
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  38. Mothers and Children: Designing research toward integrated care for both.Meg Stalcup & Stéphane Verguet - 2012 - Health, Culture and Society 3 (1):160-171.
    The Millennium Development Goals (MDG) set time-bound targets that are powerful shapers of how and for whom health is pursued. In this paper we examine some ramifications of both the temporal limitation, and maternal-child health targeting of MDG 4 and 5. The 2015 end date may encourage increasing the number of mass campaigns to meet the specific MDG objectives, potentially to the detriment of a more comprehensive approach to health. We discuss some ethical, political, and pragmatic ramifications of this tendency, (...)
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  39. The Health Impact Fund and the Right to Participate in the Advancement of Science.Cristian Timmermann - 2012 - European Journal of Applied Ethics 1 (1).
    Taking into consideration the extremely harsh public health conditions faced by the majority of the world population, the Health Impact Fund (HIF) proposal seeks to make the intellectual property regimes more in line with human rights obligations. While prioritizing access to medicines and research on neglected diseases, the HIF makes many compromises in order to be conceived as politically feasible and to retain a compensation character that makes its implementation justified solely on basis of negative duties. Despite that current global (...)
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  40. Global Health and the Demands of the Day.Meg Stalcup & Stéphane Verguet - 2011 - Health, Culture and Society 1 (1):28-44.
    We have two goals in this paper: first, to provide a diagnosis of global health and underline some of its blockages; second, to offer an alternative interpretation of what the demands for those in global health may be. The assumption that health is a good that requires no further explanation, and that per se it can serve as an actual modus operandi, lays the foundations of the problem. Related blockages ensue and are described using HIV prevention with a focus on (...)
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  41. Intellectual Property and the Pharmaceutical Industry: A Moral Crossroads Between Health and Property.Rivka Amado & Nevin M. Gewertz - 2004 - Journal of Business Ethics 55 (3):295-308.
    The moral justification of intellectual property is often called into question when placed in the context of pharmaceutical patents and global health concerns. The theoretical accounts of both John Rawls and Robert Nozick provide an excellent ethical framework from which such questions can be clarified. While Nozick upholds an individuals right to intellectual property, based upon its conformation with Lockean notions of property and Nozicks ideas of just acquisition and transfer, Rawls emphasizes the importance of basic liberties, such as an (...)
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