Trade, foreign policy, diplomacy and health

9. Global Public Goods for Health: Use and Limitations

Richard D Smith, David Woodward

2. Knowledge

  • Many GPGH rely on generation and transmission of knowledge
  • Although non-rival and non-excludable in principle, in practice myriad ways knowledge is excludable
  • GPG concept of value in two ways:
    • Highlights tension between ensuring knowledge production, dissemination and use
    • Highlights importance of access goods - especially health systems

Many GPGH rely heavily, for example, on the generation and transmission of knowledge about the incidence of disease and the means of its control. Although in principle knowledge is totally non-rival and non-excludable, in practice there are myriad ways in which knowledge may be excludable. ’Knowledge' encompasses 3 different and distinct processes: the production of knowledge, its dissemination and its use. Exclusion may occur in each of these processes. For example, due to 'artificial' legislative exclusion, physical inability to 'access' the knowledge, or the inability to 'consume' a product which is the final embodiment of that knowledge. Nonetheless, these goods may be necessary to produce GPGH, just as private goods are needed for the production of national public goods. It will therefore be necessary to ensure access to them in order for many GPGH to be produced. In highlighting this distinction, the GPG concept is therefore seen to be of value in two ways.

  • It highlights the tension that exists between ensuring that knowledge is produced in the first place and the subsequent distribution and use of that knowledge. The GPG concept thus indicates the need for current IP to be redesigned, to optimise this balance. Eg a stronger focus on the use of pre-purchase agreements, and less reliance on 'monopolies' for patent holders.
  • In considering how and why some elements of knowledge production, dissemination and use may be excludable, the GPG concept highlights once more the importance of access goods - that the ability to use knowledge depends on national public/private/club goods. Eg surveillance requires countries to produce information and to act on it, and thus requires an effective health infrastructure and appropriate technical expertise at the national level.