Looking to the Future: A Cooperative Approach to Equality in Global Health, by Michael Zhou

Looking to the Future: A Cooperative Approach to Equality in Global Health, by Michael Zhou

Nowadays, many are concerned with the unequal distribution of global health care standards in the developing world due to the actions of drug manufacturers. Historically, the problems associated with global health have been exacerbated by globalization of the pharmaceutical industry, which had often sacrificed drug efficacy and safety for quick profits even through economic and social exploitation. As demonstrated by studies like that of Michael Kremer (2002), the high prices of many essential pharmaceutical drugs developed by multinational firms often restrict access of lifesaving medication to poor communities, presenting an ethical dilemma of access versus profits. There is also the constant lack of attention in terms of research toward endemic diseases in poor countries (Kremer, 2002) and investments in local health care infrastructure, as many of these companies have catered to the demands of consumers in the developed world. As a result, much of the developed world has paid the price for corporate greed, while governments have been powerless to stop corporations as they use their incredible legal power to get what they desire. On many levels, the situation may appear bleak as these corporations tighten their grip on the global markets at the expense of the poor.

Yet, there is still hope for a brighter future in global health. With the rise of corporate social responsibility (CSR) practices, mutual partnerships between the world of business and politics are becoming commonplace. From NGOs and nonprofit organizations to governments and corporations, various players seek to benefit if the momentum of CSR in the global pharmaceutical industry continues at its current pace. Though it is uncertain if CSR practices are sustainable, there is optimism for what the increased prevalence of CSR may bring in terms of advancing equitable global health care. As social pressures for better treatment of poor communities in need of reliable health care mount, pharmaceutical firms have been compelled toward adopting responsible policies that increase the well being of communities in impoverished nations. There has even been a growing shift toward accountability in corporate culture in recent years, as pharmaceutical firms are incentivized with the chance to cultivate a positive brand image as they expand into new markets beyond the developed world to provide for the welfare of the people they sell medicine to.

Despite the rise of this global transparency movement, certain steps must be taken to ensure such trends continue into the far future. One of the most effective options is the enactment of legislation designed to protect consumers by holding drug manufacturers accountable. Such is the case in the United States, where the Sunshine Act forces drug companies to disclose their payments to third party providers such as physicians and teaching hospitals along with reports about any conflicting interests and research costs. Other countries have followed suit, adopting the use of reporting, disclosure, and inspections to keep drug manufacturers in line. This has subsequently become a key step to organizing global transparency in a defined, transnational structure that helps regulate the pharmaceutical industry through independent commissions sponsored by coalitions of governments and NGOs.

Of course, such a strategy may also hinder further progress in self-regulatory measures of transparency in the pharmaceutical industry as laws become more stringent. As companies are set against ever more concrete and specific regulations, the risk of decreasing incentives that can undermine the entire system of voluntary transparency grows. In the bid to comply with more and more regulations, smaller pharmaceutical firms may be driven to bankruptcy as they are drained of their financial resources and competitive advantage. Subsequently only the largest firms can remain competitive, giving them unfair economic advantages. This is especially the case if regulations are not standardized across borders, with each country having their own independent set of policies dealing with the pharmaceutical industry. By breeding confusion and inconsistencies across national lines for multinational companies, complex regulatory systems can actually do more harm than good if enacted without considering the effects of globalization.

Intellectual property rights (iPRs) serve as the biggest roadblock to genuine reform in health care for developing nations. Viewed as a barrier to cheap medicine, iPRs in the form of patent rights have been proven to slow the spread of scientific knowledge and prevent generic drugs from reaching developing markets (Chang, 2001). Combined with their influence on foreign governments in drug policy, these patents could dissuade others from improving on drugs, slowing down medical progress as poor communities suffer, as well as unjustly allow developed nations to claim medical knowledge in the TRIPS agreement (Chang, 2001). Another significant issue that complicates the spread of CSR practices is the internal R&D costs of developing drugs. Often major drugs take years to undergo testing and reach market before they make back money for the manufacturers, driving their mindsets over what drugs to invest in and what to ignore.

Keeping this in mind, an incentive system encouraging alternative investments in areas of development vital to improving health care in poor communities may be our best option. Certain governments can provide limited benefits to firms that comply with CSR protocols, such as tax breaks and trade privileges, to stimulate an atmosphere of corporate cooperation. Nonprofit organizations and other activist groups can also do their part through community-based programs that promote the spread of vital medicines and vaccines in underdeveloped countries. Corporations would have some degree of autonomy in terms of how much they invest in global health initiatives while these other organizations serve as a system of checks and balances. As public health is pushed into the spotlight, there is much to hope for in a new age of public health.


Chang, H. J. (2001). Intellectual Property Rights and Economic Development: historical lessons and emerging issues. Journal of Human Development,2(2), 287-309.

Kremer, M. (2002). Pharmaceuticals and the developing world. The Journal of Economic Perspectives16(4), 67-90.


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