Revising global theories of justice to include public goods

Abstract

Our aim in this paper is to suggest that most current theories of global justice fail to adequately recognise the importance of global public goods. Broadly speaking, this failing can be attributed at least in part to the complexity of the global context, the individualistic focus of most theories of justice, and the localised nature of the theoretical foundations of most theories of global justice. We argue – using examples (particularly that of protecting antibiotic efficacy) – that any truly effective theory of global justice must recognise the importance of global public goods. Global public goods confer significant benefits to individuals yet can only be effectively promoted and preserved through collective action and the restriction of individual choice; something which most theories of justice are structurally unequipped to sufficiently promote.

Keywords:

• global justice
• public goods
• well-being
• choice
• antibiotic resistance
• antibiotic efficacy
• vaccination

Acknowledgements

We would like to thank Monique Deveaux and Kathryn Walker for their repeated comments on this paper. It may not be a good paper but it is a vastly improved paper. It also gave us the opportunity to wrestle with some of the key issues we had been working on with regard to global public goods – this was hard and our views are by no means resolved but we hope that nonetheless this is a useful contribution to the debate.

Notes

As will later be explored many theorists of justice are not global theorists, for instance, David Millar and Thomas Nagel, and most importantly for this paper John Rawls, who is not a global justice theorist, but nonetheless the inspiration for many global theorists. 

The claim is not that individuals and their goods are unimportant but rather that if we are to deliver global justice and actually make the lives of individuals better and maximise what they can ‘actually be and do’ (Sen 1999, 66), we must acknowledge that recognising and respecting public goods is essential.

As well as being personal mentors, fellow-travelers, idols and friends. This should be read as a reflection and a suggestion of ways to expand and develop and as homage rather than critique.

This is an argument which Widdows has developed elsewhere particularly with regard to health goods (Widdows 2013).

The similarity between regions and the ease of delivering justice in bounds is recognised in some debates. For instance, John Harris and Charles Erin argue for a centralised European purchaser of body parts (Erin and Harris 2003). They suggest this is limited to the EU precisely because they recognise that global disparities in wealth are such that globally there is no price which would not be exploitative. While we are critical (for many reasons of this proposal) it does demonstrate that it is far harder to move to the global sphere than is often recognised.

This seems to be still the case, even though in fact it may not be exceptionally demanding. For instance, as Pogge argues the cost of making up the difference between $1 per day to $2 per day for the approximately 950 million people currently living at or below the lower, ‘extreme poverty’, threshold would cost only $38 billion annually (2008, 105). Such an expenditure would only reduce the share of global GDP enjoyed by wealthy countries from 78.98% to 78.90% (2008, 105).

See, for example, Nagel (1991), Parfit (1997), and Temkin (2003).

One example which could be given of such self-interested reasons comes from public health. For example, in 1992 the public costs of treatment services in California for approximately 150,000 drug and alcohol addicts cost roughly $200 million, but resulted in savings of between $1000 million and $1500 million during treatment and in the year following treatment, largely as a result in reductions in crime (Inter-University Consortium for Political and Social Research 2004, x). This represents an economic benefit, in the form of lower public costs of prevention, prosecution and incarceration, as well as a ‘safety’ benefit caused by the reduction of crime. The self-interested reasons for contributions to the cost of public goods in bounded communities are more obvious than they are in the global context, although there are some instances, such as pandemics where arguments could be made for them.

While it should be the case that a self-interested argument could apply to the global health goods, as yet, this has not affected behaviour. But the truism that ‘infectious disease … knows no borders’ is particularly apt here (Battin et al. 2009, 34) when we consider pandemics, infectious disease and the problems of antibiotic resistance (Kunin 1993). It can also be argued that the provision of effective health care services to poor people is in the interests of the wealthy since doing so reduces the likelihood of the spread of pandemic disease, and impedes the development of drug resistance (Ormerod 2005; Faustini, Hall, and Perucci 2006). However, these arguments are tangential to our main focus.

Rawls is explicitly not a global justice theorist. Rawls considers that his principles of justice apply only in the domestic realm and within borders. For Rawls, international justice, which he addresses in The Law of Peoples (Rawls 1999b) does not consist of the application of his principles of justice directly to individuals and the basic structures of societies in the global realm. Rather it is about respect for a minimal set of human rights applied within the ‘society of peoples’.

For an example of the controversial nature of a duty to provide health care for all even within a domestic context we can consider the extremely contentious debate during the recent Presidential elections in the USA over the Patient Protection and Affordable Care Act (Rick Santorum for President 2011; Ron Paul Presidential Campaign Committee 2011; Romney For President, Inc. 2012).

For a discussion of this, see Widdows (2007).

It should however be noted that increasingly, human rights discourse is recognising the status of group rights which assert value in virtue of the ‘status of the group qua group’ (Widdows 2013, 157). See, for example, Peter Jones' discussion of state rights to self-determination, or rights to the preservation of heritage and culture (1999, 85–87). Importantly, these rights, while essential for individuals, are not merely the result of the collection of many individual rights, they are rights held by the community itself.

See, for example, Oloka-Onyango (1995), Liao (1996), Verdirame (1999), Guthrie and Quinlan (2005), and Hathaway (2005).

Earlier rights documents which are argued as pertinent here are the founding document of the French Republic, the Declaration of the Rights of Man and the Citizen (1793) (Anderson 1967, 160–170), and the American Declaration of Independence (Continental Congress of the United States of America 1776).

This claim is also implied by Sen in The Idea of Justice when he discusses the difficulty of applying ‘perfect’ theory to real world practice (Sen 2010, 15–18).

Arguably Caney's work in environmental ethics brings global public goods and individual wellbeing together in claims about access to a sustainable environment being a human right.

We might also note that this emphasis on choice could be said to apply to the ‘ethics-type’ of theory, since the goods which we might uncontroversially want, enjoy this status because they are wanted or chosen by individuals.

Please note that not all access to healthcare or treatment is considered to be a global public good.

Clearly there are reasons why it is easier to enforce public goods in the domestic arena as compliance, at least to some of these is required by law.

Further, even if we ignore the possibility for increased habitat ranges of vector organisms, increased temperatures also tend to increased transmission rates within areas where mosquitoes are already present (Koopman et al. 1991, 1168). That is, where diseases like dengue fever and malaria already exist, they are likely to affect more people if temperatures increase slightly.

Indeed elsewhere Peter West-Oram makes an argument for healthcare, rather than health, as a basic right and effectively a public good (West-Oram Forthcoming). His claim is that if we wish to analyse any human right to health(care) it could be argued that what we are entitled to is care for our health and not health itself, since such a guarantee is impossible. However, the focus on this paper is on primary goods of this type, hence the focus on global public health goods.

Additional reasons include the widespread use of antibiotics in agriculture, which has also accelerated the evolution of drug resistance (Khachatourians 1998).

Similar arguments apply to the environment, it is not yet a good which individuals choose to prioritise. In a review of tourist attitudes towards air travel and climate change McKercher et al. note that despite increased fuel prices, and increasing concern about the environment, global tourism is predicted to grow between 4% and 7% annually ‘for the foreseeable future’ (2010, 297–298). Therefore, while individual agents may be aware that the preservation of the environment is important this does not significantly change their choices. Indeed, McKercher et al. note that amongst those who were more informed about the issue of climate change, there was a diminished sense of responsibility for actually doing something about it (2010, 300).

Vaccination is in many ways a global public good – although it does not require the action of all, but rather the vast majority and clearly if all those who could were vaccinated this would be the best way of protecting this key good.

For the majority, vaccination is safe, cost effective, and effective (Expanded Programme on Immunization of the Department of Immunization, Vaccines and Biologicals 2006, 3).

See, for example, the rhetoric displayed on personal liberty and the Patient Protection and the Affordable Care Act in the USA during the recent Republican Presidential Primary Elections (Rick Santorum for President 2011; Ron Paul Presidential Campaign Committee 2011; Romney for President, Inc. 2012).