This paper offers a new perspective on historical understandings of the relationship between alcohol, climate and the body, by studying the way that British explorers of tropical Africa drank alcohol and wrote about drink between c.1850 and c.1910. We demonstrate that alcohol was simultaneously classified as a medicinal, a preventative and a pleasurable drink, shaped by competing medical theories, but that distinctions between these different roles were highly blurred. We also show how many explorers thought certain drinks helped to (...) protect white bodies from the effects of tropical diseases. While popular amongst travellers, these views came under growing scrutiny in the latter part of the nineteenth century, reflecting both changing scientific views about the relationship between alcohol, climate and the body and the development of a much larger European presence in tropical Africa. However, even those who opposed tropical drinking often supported the use of other stimulants and viewed the tropics as uniquely dangerous. As such, the paper challenges the idea that the late nineteenth century marked a paradigm shift in scientific attitudes towards tropical environments, as much previous scholarship has suggested. At the same time, our examinations of explorers’ descriptions of drinking by African people demonstrates how ideas about racial difference played an important role within medical understandings of alcohol. Overall, this paper examines the heterogeny of attitudes to alcohol to be found within tropical medicine and documents the continuities in approach shown between the nineteenth and twentieth centuries. (shrink)

This paper reassesses Robert Koch’s work on tropical infections of humans and cattle as being inspired by an underlying interest in epidemiology. Such an interest was developed from the early 1890s when it became clear that an exclusive focus on pathogens was insufficient as an approach to explain the genesis and dynamics of epidemics. Koch, who had failed to do so before, now highlighted differences between infection and disease and described the role of various sub-clinical states of disease in (...) the propagation and—consequently—in the control of epidemics. Studying pathologies of men and cattle in tropical countries eventually facilitated the application of such measures in Europe through the screening of healthy carriers of typhoid, which was carried out in 1902. The concept of the carrier state can be understood as a spin-off from tropical medicine into the study and control of infectious disease in Europe. With it travelled assumptions that were typical for colonial and veterinary medicine where the health of indigenous individuals or cattle would be a secondary objective compared to the control of diseases in populations. (shrink)

Recruiting minorities into research studies requires special attention, particularly when studies involve “extra-vulnerable” participants with multiple vulnerabilities, e.g., pregnant women, the fetuses/neonates of ethnic minorities, children in refugee camps, or cross-border migrants. This study retrospectively analyzed submissions to the Ethics Committee of the Faculty of Tropical Medicine (FTM-EC) in Thailand. Issues related to the process and outcomes of proposal review, and the main issues for which clarification/revision were requested on studies, are discussed extensively.

From the earliest photographic attempts to represent tropical hybrid races to depictions of disease in new tropical medicines, Picturing Tropical Nature offers ...

Scholars and environmentalists in the industrialized nations have repeatedly deplored the destruction of tropical forests as a byproduct of economic development. Their position is based upon scientific, economic, and ethical arguments. Proponents of economic development from the tropical nations recognize that its immediate benefits are enjoyed by their own relatively poor populations while the benefits of habitat preservation are enjoyed by the world as a whole. So far, few institutional mechanisms have been developed that can reconcile the competing (...) perspectives. In addition to reviewing the arguments in favor of and against habitat preservation, this paper proposes some innovative institutions that can both satisfy developmental aspirations and account for the global benefits of habitat preservation. (shrink)

Scholars and environmentalists in the industrialized nations have repeatedly deplored the destruction of tropical forests as a byproduct of economic development. Their position is based upon scientific, economic, and ethical arguments. Proponents of economic development from the tropical nations recognize that its immediate benefits are enjoyed by their own relatively poor populations while the benefits of habitat preservation are enjoyed by the world as a whole. So far, few institutional mechanisms have been developed that can reconcile the competing (...) perspectives. In addition to reviewing the arguments in favor of and against habitat preservation, this paper proposes some innovative institutions that can both satisfy developmental aspirations and account for the global benefits of habitat preservation. (shrink)

"The largest Ebola outbreak to date—first detected in December 2013 and still ongoing as of April 2015—has cast new light on the shortfalls of international public health systems.1 As in previous health crises, scrutiny has reemerged over the pharmaceutical industry’s ability and willingness to innovate new medicines for underserved disease areas. The public debate has intensified following revelations that promising drug candidates to treat Ebola had gone undeveloped despite compelling preclinical results.2 This lack of development is especially troubling because it (...) occurred after a recently implemented U.S. incentive scheme—the Food and Drug Administration’s (FDA) tropical disease priority review voucher program—designed to counteract exactly this problem. Taking Ebola as a case in point, it is useful to examine the short history and ongoing refinement of this voucher program, since it represents one of the most significant legislative efforts to systematically address the relative absence of com- mercial rewards for drugs targeting tropical diseases. This analysis evaluates the voucher program’s effectiveness for both stimulating private sector innovation and achieving positive health impacts among populations most severely burdened by tropical diseases. It then proposes specific recommendations for how law- makers can improve the program’s legislation to better achieve these objectives. ". (shrink)

The article addresses the role of scarcity in negotiating the relationship between intellectual property, particularly from a legal-economic perspective, and property rights, as understood by transaction cost economics, to shed light on the deadlock faced by those suffering from neglected tropical diseases (NTDs). The consistency of the law and economics fundamentals that support the trade on knowledge goods, namely patents on essential medicines, is put under check by Scott Veitch’s scholarship on legal irresponsibility. The damages that emerge from the (...) operations of the intellectual property system are registered in the novel concept of negative public domain, and are due mainly to the lack of access to treatments that end up being unaffordable, or to innovation that leads to new drugs that is not sufficiently incentivised though price signals. The accountability for such damages is taken into consideration by arguing that the disavowal of responsibility is made possible by the negative public domain, which is balanced by the construction of a positive response through the language of rights. As such, responsibility per se is preserved, evading one instantiation of Teubner’s legal paradoxes, but rendered ineffective by design. In other words, even if the harms endured by those affected by the NTDs can be traced back to the operations of the intellectual property system, there is no one to hold accountable. The main goal pursued through the article is to make such an arrangement explicit, by giving centrality to the notion of scarcity and its interplay between legal and economic theory, alongside the novel concept of negative public domain as a site where the actual consequences of irresponsibility lie, to hopefully inform further critique in subsequent works. (shrink)

This essay critically examines the emerging view among some ethnologists that replicable models of sustainable management of tropical forests may be found within the knowledge systems of contemporary indigenous peoples. As idealized epistemological types, several characteristics distinguishing “indigenous” from “modern” knowledge systems are described. Two culturally distinctive land use systems in Latin America are compared, one developed by an indigenous group, the Huastec Maya, and the other characteristic of colonist farms in Rondonia, Brazil. While each of these systems reflects (...) a different cultural-historical tradition, I argue that the process of knowledge formation and cultural adaptation is coevolutionary and continuous in both cases. The very concept of “indigenous” as a discrete analytic category is questioned; indigenicity alone cannot explain local adaptation of farming systems. Rather than dichotomize indigenous and colonist knowledge as inherently different categories, differences in land use patterns between such social groups may be more accurately viewed as reflecting different points on a single epistemological continuum. (shrink)

My concern here is with the way a new American medical discourse in the Philippines fabricated and rationalized images of the bodies of the colonized and the subordinate colonizers. I am interested in reading the reports of biological experiments as discursive constructions of the American colonial project, as attempts to naturalize the power of foreign bodies to appropriate and command the Islands. The origin of the American colonial enterprise at a time when science lent novel force and legitimacy to public (...) policy gave scientists and doctors an opportunity to construct a new physiology and pathology of colonialism. The medical laboratory thus became an important site for the construction of the social space of interaction between American and Filipino bodies.5 The Filipino emerged in this period as a potentially dangerous part of the zoological realm, while the American colonizer became a resilient racial type, no longer inevitably susceptible to the tropical climate but vulnerable to the crowd of invisible, alien parasites newly associated with native bodies. This new medical discourse in the tropics accorded with a broad shift in the language and practices of medical science that occurred at the end of the nineteenth century. Generally, the medical concern with constitutions and climate gave way to a greater interest in the specific microbial causation of individual disease. At the same time, the colonial doctor’s anecdotes and clinical impressions seemed less convincing, and increasingly the laboratory was called on to authenticate knowledge. Warwick Anderson is a medical doctor who is completing his doctorate in the history and sociology of science at the University of Pennsylvania. His current project is the politics of disease theory in southeastern Asia. (shrink)

This essay originated from a re-reading of Umberto Eco's Six Walks in the Fictional Woods (1994) and from discussions of Charles Darwin's illnesses. The question of historical truth arises whenever we seek to validate a scientific analysis of a fictional incident. Whereas Darwin may actually have suffered from several health conditions, Robinson Crusoe's illness is the product of Daniel Defoe's imagination. But the search for a medical diagnosis must follow the same methods in both cases. After eight months as sole (...) inhabitant of his island, Crusoe is taken ill. A detailed description of the symptoms is duly registered in his diary, along with his attempts at finding its possible nature and origin. The island, according to Crusoe, lies in the tropical waters of the Caribbean Sea, not far from the coast of Venezuela. From the standpoint of medical geography, his illness is a tropical disease that was prevalent in South and Central America in the seventeenth century. Five possible diseases are suggested and discussed. (shrink)

Patrick Manson, the so-called father of tropical medicine, played a pivotal role in making that discipline into a specialty. During his early career in China he discovered that the mosquito was the intermediate host of the filarial parasite and he somewhat peculiarly called the mosquito the " nurse " of the filarial worm. The discovery contributed greatly to the intellectual foundation of modern parasitology. In this paper I situate Manson's nomenclature in the context of nineteenth-century biological research on (...) reproductive mechanisms and argue that Manson's concept of the " nurse " was derived from nineteenth-century theories of sexual division of labor in nature's economy. The way he framed the relation between the mosquito and the parasite, moreover, can be understood in the terms of the domestic arrangement of the colonial European household. Manson's research demonstrates the significant exchange between medical concerns over European women's procreative role in the tropics and biological studies of parasitic reproduction. (shrink)

Society has historically not taken a benign view of genetic disease. The laws permitting sterilization of the mentally re tarded~ and those proscribing consanguineous marriages are but two examples. Indeed as far back as the 5th-10th centuries, B.C.E., consanguineous unions were outlawed (Leviticus XVIII, 6). Case law has traditionally tended toward the conservative. It is reactive rather than directive, exerting its influence only after an individual or group has sustained injury and brought suit. In contrast, state legislatures have not been (...) inhibited in enacting statutes. Many of their products can be characterized as hasty, unnecessary, ill-conceived, and based on the heart rather than the head. Moreover the lack of expert consultation sought has also been remarkable. One state legislature, for example, has advocated immunization for sickle cell anemia! Many others have enacted laws for the screening of inborn errors of metabolism, e.g., phenylketon uria, but have poorly defined the lines of responsibility to secure compliance. A spate of specific disease-related bills has emerged in the u.S. Congress, each seeking recognition and appropriations. Sickle cell anemia, hemophilia, Cooley's anemia and Tay-Sachs disease have been among the front-runners for support. Finally, in 1975, Congress has begun to examine an omnibus bill concerning all forms of genetic disease. The bill, termed the National Genetic Diseases Act is, however, still far from being enacted. (shrink)

Malaria is a disease of developing countries whose local health services do not have the time, resources or personnel to mount studies of drugs or vaccines without the collaboration and technology of western investigators. This investigative collaboration requires a unique bridging of cultural differences with respect to human investigation. The following debate, sponsored by The Institute of Medicine and The American Society of Tropical Medicine and Hygiene, raises questions concerning the conduct of trans-cultural clinical malaria research. Specific (...) questions are raised about the difficulties of informed consent in different cultural settings and whether there is any role for community involvement. Discussants debate whether drug and vaccine trials not approved in an industrialised country are ever defensible if performed in a third-world setting. Potential conflicting priorities between investigators are discussed and ideas regarding conflict resolution are offered. (shrink)

During the cold war, Frank Fenner and Francis Ratcliffe studied mathematically the coevolution of host resistance and parasite virulence when myxomatosis was unleashed on Australia’s rabbit population. Later, Robert May called Fenner the “real hero” of disease ecology for his mathematical modeling of the epidemic. While Ratcliffe came from a tradition of animal ecology, Fenner developed an ecological orientation in World War II through his work on malaria control —that is, through studies of tropical medicine. This makes Fenner (...) at least a partial exception to other senior disease ecologists in the region, most of whom learned their ecology from examining responses to agricultural challenges and animal husbandry problems in settler colonial society. Here I consider the local ecologies of knowledge in southeastern Australia during this period, and describe the particular cold-war intellectual niche that Fenner and Ratcliffe inhabited. (shrink)

The informed-consent process should be one of meaningful information exchange between researchers and study participants. One of the responsibilities of research ethics committees is to oversee appropriate informed consent. The committee must consider various matters before deciding whether the process is appropriate, including the adequacy and completeness of the written information provided to study participants, and the process of obtaining informed consent. This study aimed to identify, quantitatively and qualitatively, consent-related issues in different types of malaria proposals submitted to the (...) Faculty of Tropical Medicine, Ethics Committee. This study reviewed proposal documentation submitted to two panels of the Ethics Committee of the Faculty of Tropical Medicine, Mahidol University, from 2011 to 2015. The documentation included proposals, notifications to researchers of review outcomes and ethical issues of concern to committee members. Each element of the informed-consent process was identified and analyzed by study classification, design, and specimen use, including whether the study involved a vulnerable population. Summative content analysis was used to analyze patterns of common issues raised in reviews. Of the 112 proposals reviewed, 63 required an informed consent process. All researchers proposed communicating with their study participants; however, about two-thirds needed to improve their explanations of study procedures to participants. About 40% of the proposals attracted comments on informed-consent process elements--risk and discomfort, vulnerable status, and compensation. Studies that planned to collect or use new/linked specimens raised more issues around informed consent than studies using linked data/records. Studies that involved vulnerable populations raised more issues than those that did not. The committee usually asked researchers to clarify, elaborate, revise, or paraphrase the consent process elements that were considered to involve inadequate information exchange between researcher and study participant. This study aimed to describe lessons for malaria researchers about common informed-consent process issues in different types of malaria proposals. The information and analysis of informed-consent elements should assist the preparation of malaria-research proposals. (shrink)

Research funders, regulatory agencies, and journals are increasingly expecting that individual-level data from health research will be shared. Broad consent to such sharing is considered appropriate, feasible and acceptable in low- and middle-income settings, but to date limited empirical research has been conducted to inform the design of such processes. We examined stakeholder perspectives about how best to seek broad consent to sharing data from the Mahidol Oxford Tropical Medicine Research Unit, which implemented a data sharing policy and (...) broad consent to data sharing in January 2016. Between February and August 2017 qualitative data were collected at two sites, Bangkok and the Thai-Myanmar border town of Mae Sot. We conducted eighteen semi-structured interviews. We also conducted four focus group discussions with a total of nineteen people. Descriptive and thematic coding informed analysis of aspects of data sharing that are considered most important to inform participants about, and the best ways to explain complex and abstract topics relating to data sharing. The findings demonstrated that clinical trial participants prioritise information about the potential benefits and harms of data sharing. Stakeholders made multiple suggestions for clarifying information provided about data sharing on such topics. There was significant variation amongst stakeholders’ perspectives about how much information should be provided about data sharing, and it was clear that effective information provision should be responsive to the study, the study population, the individual research participant and the research context. Effectively communicating about data sharing with research participants is challenging in practice, highlighting the importance of robust and effective data sharing governance in this context. Broad consent should incorporate effective and efficient explanations of data sharing to promote informed decision-making, without impeding research participants’ understandings of key aspects of the research from which data will be shared. Further work is required to refine both the development of core information about data sharing to be provided to all research participants, and appropriate solutions for context specific-challenges arising when explaining data sharing. (shrink)

'Trade in Health is a timely reflection on the interface of economics with the ethics and public policy facets of the international movement of patients. Health issues such as these are at the forefront of modern political economy."National" health is increasingly less so. Reisman's previous scholarship in this area is brought to bear in an insightful and eminently readable and engaging fashion. In an area where uncovering the facts is more difficult than "decyphering the Dead Sea Scrolls", such a reflective (...) work on the critical aspects of political economy helps to fill a void in considering whether such trade is likely to be in the interests of patients, nations and the global community. In addition to the rosy picture of healthy and wealthy tourists having a sojourn for medical care during a vacation, Reisman is not afraid to tackle the thorny issues concerning trade in organs, eggs and even death, in this sobering and comprehensive volume. It is a rare skill to bring the luminaries of Smith, Marshall, Mill and Confucius to bear on such a contemporary tale! International travel by patients is at the nexus of a revolution in global health. It is driving and affecting aspects of foreign investment, health worker migration and e-health provision. Reisman skilfully links these foundations of health care, and as such provides critical text for consideration by those seeking to build and strengthen future health systems. Trade in Health is an excellent overview. It provides critical insights for those new to the area as well as new information and challenges for those of us involved for a number of years.' - Richard Smith, Professor of Health Ssytem Economics and Dean of Faculty of Public Health and Policy, London School of Hygiene & Tropical Medicine, UK. Once exports and imports meant agriculture and industry. In the global economy and the electronic age, trade is also expanding into the service sector. This timely book closely examines trade in health. It documents the growth of a cross-national service that in the past was mainly consumed at home. Following from his highly successful book Health Tourism, Professor David Reisman offers a comprehensive and searching multidisciplinary account of the way in which medical services, patients, capital and professionals are making up a global healthcare economy that crosses borders. He reflects on their pursuit of lower prices, better quality and a differentiated product, and suggests that public policy is essential if the ethical capital of interdependent societies is not to be eroded by the international market in health and care. Written in a concise and lucid form, this original book will be of great interest to all people interested in the internationalization of health care. Combining theory and empirical evidence from economics, tourism and medical care, scholars involved in health policy and social administration will find much of significance in this authoritative study. (shrink)

Since January 2016, the Mahidol Oxford Tropical Medicine Research Unit has trialled a data-sharing policy where requests to access research datasets are processed through a Data Access Committee. In this paper, we share our experiences establishing data management systems and data-sharing infrastructure including a data-sharing policy, data access committee and related procedures. We identified a number of practical and ethical challenges including requests for datasets collected without specific or broad consent to data sharing and requests from pharmaceutical companies (...) for data to support drug registration applications. We also encountered significant resource constraints which required the development of appropriate human resources and infrastructure. We suggest a research agenda to promote responsible and equitable data sharing while safeguarding the rights and interests of research participants and researchers. (shrink)

Some claim that “global health is public health” but most regard global health as a new field, rapidly emerging mostly at North American academic institutions . The term was first incorporated into University of California, San Francisco’s Institute for Global Health in 1999 and UCSF also inaugurated the first North American master of science in global health in 2009. Global health is commonly acknowledged to have historical precedents in tropical medicine and international health. All three fields are regarded (...) as having some overlapping and some distinctive features . One overlapping feature of all three is retaining traces of European and/or North American conquest, imperialism, and colonialism that create a legacy of ongoing ethical challenges for global health . One touted distinctive feature of global health is its .. (shrink)

A distinct British approach to disease in the tropics has been identified in the recent historiography of colonial medicine: Mansonian tropical medicine, named after Sir Patrick Manson (1844–1922), the founder of the London School of Tropical Medicine. This essay examines Manson's study of filariasis (infection with the filarial nematode worm) and argues that his conceptual tools and research framework were derived from contemporary natural history. It investigates Manson's training in natural history at the University of (...) Aberdeen, where some of his teachers were closely associated with transcendental biology. The concepts of perfect adaptation and the harmony of nature were crucial to the formulation of his research problematic. This essay demonstrates that biogeographical concepts played an important part in Manson's research methodology. It also investigates how Manson's natural historical approach contributed to the making of so‐called Mansonian tropical medicine. (shrink)

This paper attempts to show how leading contemporary disciplines influenced the discovery of Chagas' disease and the formation of the early disease concept. Chagas was among the first generation of Brazilian trained scientists who incorporated modern principles of tropical medicine in its research. Thus, Chagas was familiar with characteristics of vector borne tropical diseases such as malaria and yellow fever. The detection of a hitherto unknown trypanosome in the gut of a reduviid bug prompted him to search (...) for a related vector borne disease. Among the disciplines that were influential on Chagas' discovery and early disease description were pathology, entomology and parasitology. Parasitology as a new discipline was of crucial importance to tropical medicine and had a political dimension in the context of colonial medicine. Hence, leading scientists in tropical medicine were located in European countries and in the United States of America. One of these was the German Schaudinn School of Protozoology. The early description of American Trypanosomiasis can also be seen as a reflection of the Schaudinn School of Protozoology which dominated Chagas' scientific orientation towards parasitology with regard to the interpretation of the observed phenomena of the life cycle and the morphology and biology of T. cruzi. The first Chagas' disease concept was based on research of the biology and entomology of the trypanosome and its vector as well as on pathological studies of fatal cases. This concept was characterized by a confusion of some of the chronic forms of the disease, as iodine deficiency and goitre were endemic in some rural regions in Brazil. Therefore, early concepts of the disease faced strong opposition and even raised doubts about its existence. (shrink)

George Ohsawa's account of his 1955 visit to Dr. Albert Schweitzer's hospital in Africa and how he discovers a cure for deadly tropical ulcers followed by his teachings on the physical and mental aspects of disease, the traditional approach to healing versus the symptomatic medicine of today, and the priniciple of the unifying principle of yin and yang--the foundation of macrobiotics.

Neglected diseases are severe conditions that mainly affect the world's poorest people. Those suffering from neglected diseases are mostly suffering from tropical infections that have failed to receive priority in pharmaceutical research and development programs, as well as in public health policies aimed at improving availability and access to preventive, diagnostic and curative medicine. The World Health Organization has issued a number of documents directing attention to the plight affecting one third of the world's population, assisted by active (...) support from private organizations, notably the Bill and Melissa Gates Foundation, but the overall situation remains dismal. In the wake of major socioeconomic processes including globalization, steadily growing economic disparity, healthcare inequality, the instability created by rogue states and terrorism, as well as massive migration, and epidemic outbreaks, the features of neglected diseases have been changing. Neglected populations affected by tropical diseases are suffering increasingly from non-infectious degenerative conditions and disabilities due to untreated chronic maladies. Pockets of poverty and neglect can also be detected in high-income countries, contributing to the emergence of new diseases and the reemergence of infections believed to be disappearing such as tuberculosis and the measles. Included in the issues of neglect are rare diseases, mostly of genetic origin, affecting a small number of patients that suffer from multiple life-shortening functional impairment and organ defects. Effective medicines are extremely expensive, allegedly because research and development of appropriate drugs is resources and time consuming, requiring exorbitant prices to recoup investment from a small number of consumers. Bioethics has been tardy in addressing the suffering and destitution of neglected and rare diseases. Convinced that permanently repeated denunciations blunt the sensitivity towards suffering, whereas statistics are bloodless and unable to elicit commitment, this book attempts to explore a different strategy. In an upstream approach, bioethics needs to engage in ethnographic fieldwork that confronts and shares the context in which people suffer, vividly presenting what epidemiological research has blunted into statistical data. Additionally, a downstream approach is suggested, requiring bioethics to vigorously and openly denounce unethical biomedical and pharmaceutical research, misdeeds in registration and marketing of drugs, and misalignment of policies with the unmet healthcare needs of the destitute. More than being critical observers, bioethicists ought to shed lurking conflicts of interests and seek active participation in planning research and public healthcare practices aimed at improving the lives of medically neglected populations. (shrink)

In fields such as medicine, geography, and mechanics, spatial reasoning involves reasoning about entities that may coincide without overlapping. Some examples are: cavities and invading particles, passageways and valves, geographic regions and tropical storms. The purpose of this paper is to develop a formal theory of spatial relations for domains that include coincident entities. The core of the theory is a clear distinction between mereotopological relations, such as parthood and connection, and relative location relations, such as coincidence. To (...) guide the development of the formal theory, I construct mathematical models in which nontrivial relative location relations are defined. (shrink)

This essay examines the sanitary policies for the protection of overseas communities that Italian fascism employed during the empire. From 1935–1936, the vast scale of the Ethiopian campaign, as well as intensive colonisation programmes, gave new political visibility to the issue of safeguarding Italian settlers from the risks of the tropical climate. In this period, the problem of how Italians could adapt to overseas environments moved beyond the boundaries of scientific discussion to become a major concern of colonial rule. (...) Analysing both the medical literature and archival sources, this essay examines the concepts and practices that underpinned the fascist project for the “reclamation” of the empire: from the intensification of hygienic propaganda, to the redefinition of the medical-geographical boundaries of tropical risk, and to the expansion of social security benefits, which were extended to harms caused by tropical diseases. Finally, it investigates how the notion of acclimatisation was transformed within the context of the regime's imperial ideology, showing how the conception of the tropics as a pathogenic space remained widespread, fuelled by the regime's organicistic vision and its concerns for upholding the racial prestige of Italians in the colony. (shrink)

Rather than making another attempt at proposing a single and unifying theory of global health justice, this timely collection brings together, instead, scholars from a range of traditions to frame the issue more broadly, highlighting not only different perspectives but also key topics and debates. -/- The volume features chapters that offer both new theoretical approaches to global health justice, as well as fresh takes on existing frameworks. Others adopt a bottom-up approach to tackle specific problems, including the sexual rights (...) of children and adolescents, artificial intelligence (AI) in medicine, framing of neglected tropical diseases, securitization of health, and trademarks in global health. Brought together within one volume, the breadth of these chapters provides a unique and enlightening contribution to the wider Global Health field. -/- This important volume will be a fascinating read for students and researchers across Global Health, Bioethics, Political Philosophy, and Global Development. (shrink)

In the last decade, the organization of pharmaceutical research on neglected tropical diseases has undergone transformative change. In a context of perceived “market failure,” the development of new medicines is increasingly handled by public-private partnerships. This shift toward hybrid organizational models depends on a particular form of exchange: the sharing of proprietary assets in general and of intellectual property rights in particular. This article explores the paradoxical role of private property in this new configuration of global health research and (...) development. Rather than a tool to block potential competitors, proprietary assets function as a lever to attract others into risky collaborative ventures; instead of demarcating public and private domains, the sharing of property rights is used to increase the porosity of that boundary. This reimagination of the value of property is connected to the peculiar timescape of global health drug development, a promissory orientation to the future that takes its clearest form in the centrality of “virtual” business models and the proliferation of strategies of deferral. Drawing on the anthropological literature on inalienable possessions, we reconsider property’s traditional exclusionary role and discuss the possibility that the new pharmaceutical “commons” proclaimed by contemporary global health partnerships might be the precursor of future enclosures. (shrink)

ABSTRACTMore than a third of the world's population has no access to essential drugs. More than half of this group of people live in the poorest regions of Africa and Asia. Several factors determine the accessibility of drugs in developing countries. Hardly any medicines for tropical diseases are being developed, but even existing drugs are often not available to the patients who need them.One of the important determinants of access to drugs is the working of the patent system. This (...) paper first maps out some facts about the global patent regime that has emerged as a consequence of the conclusion of the WTO‐TRIPs Agreement in 1994. Attempts to construct a moral justification of the patent system have been based on three grounds: natural rights, distributive justice, and utilitarian arguments. This paper examines to what extent and on which grounds drug patents can be justified. The final section looks at the so‐called ‘Doha Declaration on the TRIPs Agreement and Public Health’, which was adopted by the WTO Ministerial Conference two years ago, recognising the primacy of public health over the interests of patent proprietors. (shrink)

More than a third of the world's population has no access to essential drugs. More than half of this group of people live in the poorest regions of Africa and Asia. Several factors determine the accessibility of drugs in developing countries. Hardly any medicines for tropical diseases are being developed, but even existing drugs are often not available to the patients who need them.One of the important determinants of access to drugs is the working of the patent system. This (...) paper first maps out some facts about the global patent regime that has emerged as a consequence of the conclusion of the WTO‐TRIPs Agreement in 1994. Attempts to construct a moral justification of the patent system have been based on three grounds: natural rights, distributive justice, and utilitarian arguments. This paper examines to what extent and on which grounds drug patents can be justified. The final section looks at the so‐called ‘Doha Declaration on the TRIPs Agreement and Public Health’, which was adopted by the WTO Ministerial Conference two years ago, recognising the primacy of public health over the interests of patent proprietors. (shrink)