9. Global Public Goods for Health: Use and Limitations
Richard D Smith, David Woodward
GPGH, human rightsand equity
- GPGH concept concerned with efficiency and is ‘neutral’ with respect to equity
- BUT 3 possible implications for equity:
- ‘GPG agenda’ may be set by rich, perpetuating existing imbalance of power
- Poor nations may face costs in GPGH production, making them unable or unwilling to cooperate
- Possible conflict with other ‘rights’ framework
The GPG concept is fundamentally concerned with improving efficiency, and is in principle 'neutral' with respect to equity: whether something is or is not a GPG provides no indication as to whether its benefits are, or should be, distributed equitably. However, there are 3 possible implications for equity:
- If the 'GPG agenda' is set by the rich without regard for the priorities of the poor, the existing imbalance of power between rich and poor nations may be perpetuated, and the poor may actually be made worse off.
- Poor nations may incur significant opportunity costs in the pursuit of the GPG agenda, also potentially making them unable or unwilling to cooperate in the provision of the GPG.
- There may be a conflict with other frameworks, such as human rights.
The public goods approach and the rights approach are different in nature: the rights approach is fundamentally normative, asserting what should be the case, while the concept of public goods is a positive one, describing the nature of goods. However, while there is no inherent conflict between the rights approach and the public goods approach, there are major differences in their scope. While it would not be untenable to argue that people have a right to public goods, this would extend rights to some unconventional areas. Equally, the right to health clearly implies ensuring access to goods and services necessary to health irrespective of whether they constitute public goods, or even whether they have positive externalities. This is clearly a significant and extensive area, and it is not possible to address the relevant issues comprehensively here.