The Health Impact Fund as Philosophy

What does a practical political idea like the Health Impact Fund have to do with academic philosophy? Or, as the question is often posed, why is the Health Impact Fund being run by Thomas Pogge, a philosopher? I’m a (marginal) member of the HIF project, and I find myself confronted by this question on a regular basis. As a follow-up to our episode with Pogge, I’ll try to sketch out some answers.

I can see at least three ways of answering this question. The first is to say that the HIF doesn’t in fact have anything to do with philosophy, at least not any more, and that the project just happens to be in the hands of a philosopher. First, the caveat needs to be added that the HIF is not truly “run” by Pogge. Although he’s certainly the public face of the project, a great number of people work on it as well. Pogge is less of a manager and more of an organizer. He also happens to be the hardest worker and most prominent supporter. But other individuals work quite hard on the project as well, notably the economist Aidan Hollis.

But with that qualification acknowledged, one might still claim that the intellectual work of the project required a philosopher. An excellent illustration of this point is Pogge’s 2005 Metaphilosophy article that set out the intellectual contours of the project, “Human Rights and Global Health: A Research Program.” There, Pogge establishes the justification for program, then called Track2, as lying in certain flaws in the global intellectual property scheme. The writing of that article clearly involved a great deal of working out of the various problems involved (what’s wrong with the patent system as it relates to medicines, what principles would guide an alternative, and so on), and this is work that is straightforwardly within the domain of political philosophy. Pogge began that work during a visiting fellowship at the National Institutes for Health, and this more or less fully formed proposal project is the result. The process of identifying the moral issues involved is now largely finished; the remaining work is more properly within the domain of economists and public health experts, not to mention lobbyists.

The second answer to is to say that although the project is not (or no longer is) within the intellectual domain of philosophy, it’s related to philosophy. Pogge’s views on global poverty explain and motivate projects like the Health Impact Fund. The argument he sets out in World Poverty and Human Rights is that the global institutional order, consisting of the system of state sovereignty, the rules governing international trade, and various institutions like the World Bank, IMF, and UN, foreseeably and avoidably produces a stable pattern of appalling global poverty. This order was designed and instituted by wealthy, reasonably democratic countries, whose citizens are thus implicated in the deaths of some 18 million of the global poor every year. From Pogge’s perspective, the vast extent of human rights violations makes stringent demands on individuals, as did other periods of terrible injustice during the twentieth century. Although the relationship of affluent Westerns to the sufferers of severe poverty is not as direct or intentional as that of genocidaire to victim, individuals nonetheless have clear moral duties to rectify the injustice they—through the global institutional order their governments enforce—have contributed to. The Health Impact Fund is, then, an attempt to ameliorate one aspect of this contribution to global injustice.

The third answer relies on taking a rather expansive view of what philosophy consists of. On this view, as Pogge describes it,  at least part of the role of the philosopher is to induce people to think about what is important. As I mentioned above, Pogge believes that the world we live in is characterized by an astonishingly high levels of underfulfillment of human rights. Regardless of one’s views on the particular question of  culpability, it’s not a stretch to say that global institutions are worthy of moral contemplation. The time Pogge has put into making the Health Impact Fund a political reality has paid off immensely in terms of getting people to think—some of them quite a bit—about public health, poverty, and intellectual property rights. So by promoting this idea, even if it never bears political fruit, he clearly meets the goal of the third answer as well as the second.

I should say that I agree entirely with Pogge’s conception of philosophy and the role of its practitioners. Philosophers can be very well placed to assess existing institutions and to offer alternatives. And I see no reason to say that moral philosophers should write only at a high level of abstraction. If philosophers are indeed to engage with what’s important, then doing so will require a great deal of interaction with fields like law, economics, and medicine. One of the main motivations of Public Ethics Radio is to bring out those interactions that philosophers have with other disciplines and with the world as it actually is. Philosophers have a great deal more to say about the world than they can publish in peer-reviewed journals, and I hope we can give them a place to say it. And, of course, plenty of people who are not philosophers have something to add to the conversation about what’s important, and we will have some of them as guests on the show as well in the coming months. Stay tuned.

3 Comments

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3 responses to “The Health Impact Fund as Philosophy

  1. Crucial blog site. Your links with this are wonderful. I went through all this and I very thanks for your guidance.

  2. Hi, do you have a site feed I can add to my reader? I looked around but couldn’t find it, thanks a ton in advance.

  3. Michael Glover

    This is a marvelous site. Will spread the word, to be sure. (Recently read your and Overland’s response to Singer’s ‘Life You can Save'; so good to see that the Poggean school,so to speak, has such talent.) Greatly enthused.

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