TP: Yes, indeed, these two are closely connected in both directions. See all articles by Thomas Pogge Thomas Pogge. 0000003062 00000 n What is really nice about the Health Impact Fund is that it is a win-win, something that without much cost to anyone makes a lot of people better off. Politics as Usual: What Lies behind the Pro-Poor Rhetoric. But what consolation is this? So you can think of the HIF as a mechanism that would keep the benefits and burdens of pharmaceutical innovation for the affluent roughly as they are while massively reducing the burdens presently imposed upon the poor. They don't exist naturally, nor are they God-given. TP: That's right, the massive corruption common in so many developing countries would be quite impossible if Western countries did not provide convenient opportunities to ship ill-gotten funds out of the country. 6. Pogge (2010) believes that institutions producing foreseeable and avoidable harms are unjust and result in extreme poverty. Economics is like a church, and it fulfills the same function the church had fulfilled for centuries: the justification of the status quo. The two sides of the problem are closely interdependent: because present procedures by design favor the affluent, the poor are being increasingly marginalized. It has to do with the fact that most foodstuffs are tradable commodities: basic foodstuffs, such as rice, flour and beans, can easily be conveyed across national borders and their prices will therefore roughly mirror the exchange rates among currencies. TP: Yes, some of the developing-country governments and populations are tired of having things rammed down their throats, but we're not yet at the stage we want to get to, namely where the developing countries join forces with one another on behalf of creative alternative ideas about how to take things forward. Book Review: Thomas Pogge, World Poverty and Human Rights: Cosmopolitan Responsibilities and Reforms (Cambridge: Polity Press, 2002, 284 pp., $27.95 … This was highlighted in the Organization of African Unity report on the behavior of the various countries and who did what in the Rwanda episode, "Rwanda: The Preventable Genocide," especially sections 17.30 and 17.33. The aim of the organization is to encourage people to commit to long-term donations to those charities that provide the most cost-effective good. KB: Up until the economic crisis that took place a couple of years back, many people did not look to institutional moral analysis to explain a wide range of phenomena, like why someone might not have a job, for example. True. For the present system to work, poor people must be excluded from the innovation, because if they could get access at an affordable price, then affluent people would find ways to buy it cheaply as well—and then the innovator would be poorly rewarded and introductions of new medicines would decline. Adjusting for inflation, this means that a household located in the United States would count as poor in 2010 only if its entire spending in that year had been below $510 per household member. There is at the global level a very small number of actors who can meaningfully weigh in on global institutional design, who are able—through powerful governments and most effectively (for reasons just discussed) through the government of the United States—to exert substantial influence on international negotiations, which are routinely conducted behind closed doors. These large multinational corporations, often acting through their industry lobbies, also exert a powerful influence on the formulation of domestic rules and on their application—but their influence on supranational institutional design is even larger because it faces practically no opposition there. Such additional support depends on being able to show that, and how, the HIF would actually work in the real world. TP: Governments and their hired negotiators are designing these supranational rules and pressing for their adoption and for compliance—and the US government first and foremost. As an example, let me mention Coca-Cola's distribution network. We now condemn feudalism. Surely not. KB: You're the architect of this initiative and have assembled some of the greatest minds in economics, public health, bioethics and government to support you. This is not always possible, because in some cases the value of an innovation is in the eye of the beholder; it's very difficult to value how much a new Madonna song is worth, for example. TP: Yes, social rules are susceptible to moral analysis. As it happens, the Bank has actually applied its methodology with such a higher poverty line of $2.50 per person per day, in 2005 US dollars converted at PPPs, and found that the number of poor has increased in the 1990 to 2005 period. Thomas Pogge (涛慕思•博格) Yale Philosophy Department P.O. His 2002 book, World Poverty and Human Rights, offers proposals on how to achieve global economic equality. Cambridge, Polity Press, 2002. vii + 284 pp. This is what we must work for. For more information about the Program, people working in and affiliated with the Program, and the Projects that our members and affiliates are engaged in, use the above links. Competing companies evolve toward efficiency as the more efficient ones profit and expand while those who fall behind fail. Will we be able to overcome this, that and the other last-mile problem?" 0000001573 00000 n People are fighting quite hard over these rules—different countries and corporations are trying to influence this rulemaking process. But the alternative is to continue losing politically—which means continued failure to protect the world's poor, who are really bearing the brunt of our disorganization. By using general consumption PPPs, the World Bank is, in effect, saying to the poor: "Sure, you cannot buy as much food as the dollar value we attribute to your income would buy in the United States. Here, the cruel injustice of preventing the poor from buying at cost—evidenced by today's suppression of the trade in generic versions of patented medicines—would no longer be needed. In the domain of pharmaceuticals, we need a metric for health impact, and with this metric we can then assess the value of the introduction of a new product and pay its innovator accordingly, say on the basis of the product's measured health impact during its first ten years on the market. And this is what I say about severe poverty. You, however, say our duty to the poor is to stop actively harming them, which strikes most people as bizarre or counterintuitive. First, the alternative proposal is not politically realistic in the United States and most other affluent countries with a substantial pharmaceutical industry. But the World Bank's own data show that, if they had chosen a more adequate poverty line, perhaps one twice as high at $2.50 per person per day, US dollars of the year 2005 converted at purchasing power parities, then they would have found a slight increase in the number of poor people between 1990 and 2005, the last year for which full data are now available. That's something that companies are extremely good at: organizing a whole pipeline in a cost-effective way. Ordinary people like you and me can achieve very little on their own. And because the poor are so marginalized, they can exert little influence on institutional design decisions. 0000006810 00000 n The justice of dealings between, say, a country and a corporation would be evaluated in terms of the sanctity of legal contracts. Drafts of domestic legislation must be published, debated and publicly voted on, which gives ample opportunities to civil society organizations and ordinary citizens to at least understand what's being proposed and to voice and to organize opposition before the decision is made. But I would stress that we should not think of poverty eradication as a matter of collecting money and giving it to the poor so much as of reforming the global rules that are disadvantaging the poor and making it impossible for them to fend for themselves. UPS is another example where they are able to get the parcels to the most remote locations at an incredibly low price. But if you bring up Pareto efficiency, why not advocate strongly increasing the $30 billion already spent by the government through the National Institutes of Health and directing it toward drug research and development [R&D] to provide medicine at cost? In order to achieve something like this, in competition with the powerful and smartly wielded influence of corporations, we need to join forces and be as well-organized as they are. Thomas Pogge (涛慕思•博格) Yale Philosophy Department P.O. TP: My analysis is not really a conspiracy theory, but it is certainly an analysis that is supporting what you report as a widespread perception in the US: that the country is run by the rich and powerful in their own interest. KB: Are there any other examples of perverse incentives that arise out of this legal and economic framework? Thomas Winfried Menko Pogge (/ˈpɒɡi/; born 13 August 1953) is a German philosopher and is the Director of the Global Justice Program and Leitner Professor of Philosophy and International Affairs at Yale University. Launched in 2008 by Thomas Pogge, the Global Justice Program unites an interdisciplinary group of scholars with the aim of taking morality seriously in shaping foreign policy and in negotiating transnational institutional arrangements. 15 0 obj << /Linearized 1 /O 17 /H [ 820 209 ] /L 103452 /E 91849 /N 4 /T 103034 >> endobj xref 15 19 0000000016 00000 n , such an alternative reward mechanism is fairly straightforward I should also mention our international system... Realizing the Health Impact Fund idea, which I think that many citizens understand our. Should also mention our international banking system litigation costs and deadweight losses HIF-registered... Pretty staggering, as you see them. you could buy with this PPP equivalent in the opposite direction,... 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