The Pluralism of Coherent Approaches to Global Health

Stakeholders in global health, including governments, international and nongovernmental organizations, and corporations, face complex decisions about how to help improve the lives of those most burdened by sickness and disease while upholding their rights and facilitating the transition to a more just social and political order. In "The Case for Resource-Sensitivity: Why It Is Ethical to Provide Cheaper, Less Effective Treatments in Global Health," Govind Persad and Ezekiel Emanuel argue that "[t]he provision of health care in developing countries should reflect what best balances utility, equality, and priority to the least advantaged in those countries." This positive proposal faces several difficulties. For one thing, it is not clear that these are the only relevant values, and moreover, even if we assume that they are, we do not know what global health policies these values rule out because conflict between the values is pervasive.