GLOBAL HEALTH EQUITY: A CRITICAL EXAMINATION OF RIGHTS-BASED VERSUS SOLIDARITY-DRIVEN MODELS FOR INTERNATIONAL JUSTICE

• Dr. Elara N. Jesmond

  Department of Global Health Policy, University of Cape Town, South Africa

  Author

The profound disparities in health outcomes and access to healthcare between affluent and low-income nations represent one of the most pressing ethical challenges of our time. The international community has grappled with establishing a robust and universally accepted ethical framework to guide the redistribution of healthcare resources. This debate is largely polarized between two dominant paradigms: a model grounded in the language of human rights and entitlements, and a model centered on the value of solidarity. This article provides a comprehensive philosophical analysis of these competing frameworks. We begin by deconstructing the rights-based model, which posits a universal entitlement to a minimum standard of healthcare, often derived from a more fundamental right to a minimally good life {2}. While this approach offers the allure of legal clarity and individual empowerment, it is fraught with conceptual paradoxes and practical difficulties, including the challenge of defining a "minimum," the statistical nature of public health interventions, and the potential for a "redistributive minimalism" that contradicts the generous intent of aid {1}. Subsequently, we explore the critique of the rights-based model, particularly through the lens of imperfect duties, which characterizes obligations as indirect and institutionally mediated without strict enforcement {1, 3}. As an alternative, this article champions a framework rooted in solidarity, understood not as mere sympathy but as a proactive commitment to collective action based on recognizing a shared human condition {4, 5}. By synthesizing prominent theories of solidarity in public health ethics, we argue that this concept fosters a more flexible, pragmatic, and respectful mode of international cooperation. We further contend that the normative force of solidarity is significantly amplified when integrated with the principles of sustainable development. This synthesis transforms the discourse from one of aid and charity to one of partnership, mutual trust, and shared responsibility for creating a resilient global health system. The proposed solidarity-sustainability model moves beyond the simplistic opposition of self-interest and altruism, offering a politically astute and ethically sound pathway toward achieving genuine international justice in healthcare.

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4. Dawson A, Jennings B. The Place of Solidarity in Public Health Ethics. Public Health Reviews. 2012;34(1):65–79.

5. West-Oram PGN, Buyx A. Global Health Solidarity. Public Health Ethics. 2017;10(2):212–224.

6. WHO COVID-19 Solidarity Therapeutics Trial. Accessed June 5, 2022, https://www.who.int/emergencies/diseases/novel-coronavirus-2019/global-research-on-novel-coronavirus-2019-ncov/solidarity-clinical-trial-for-covid-19-treatments.

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