112 Global Ethics for Leadership
I will defend the need to consider a plurality of responsible agents to
ameliorate global health. Finally, I will analyse a real case and show
how this proposal based on multiple strategies and various responsible
agents is feasible and the best response.
8.1 Why is Global Health a Moving Target?
Basic and fundamental public health policies can solve part of the
problem of global health. However, these are structural modifications
like sanitation, drinkable water, or a working electric system. Most of
the developing countries are indebted to their inhabitants owing to the
absence of such infrastructure. In addition to this public health infra-
structure that is lacking in most developing countries, specific illnesses
still present particular challenges (for example malaria, river blindness,
Chagas, or dengue), some of which, the so-called neglected diseases, are
infectious and strongly related to poverty, climate, and living conditions.
In what follows I will focus on those diseases. Let me enumerate some
of the challenges these diseases present and why their control or cure
can be considered so complex.
A first challenge is the lack of an available cure for many of these
illnesses and the ineffectiveness of existing treatments; many drugs also
have side-effects or patients have built up a resistance to those drugs,
making them less effective. Research is crucial. However, as these are
the illnesses of the poorest, pharmaceutical companies show little inter-
est in conducting research. This lack of interest is an enormous obstacle.
Some solutions may come from a theoretical and innovative framework
like the Health Impact Fund (HIF) proposed by Pogge and Hollis to in-
centivize pharmaceutical firms.^76 It seeks to promote research in relevant
76
A. Hollis and T. Pogge, The Health Impact Fund: Making New Medicines
Accessible for All (Incentives for Global Health, 2008).