A global social contract to ensure access to essential medicines and health technologies (Peer-reviewed)

This paper published in BMJ Global Health, emphasizes the urgent need for a global social contract to guarantee access to essential medicines and health technologies. The COVID-19 pandemic has accentuated the disparities in international health, revealing the inadequacies of the current social contract that primarily focuses on individual nation-states' responsibilities. This model struggles to address the global distribution of pharmaceutical products, especially during international health crises.

The authors argue that the pandemic is a wake-up call, highlighting global inequities that have been evident since the HIV/AIDS epidemic of the 2000s. Addressing these disparities necessitates a shift towards a global model of the social contract, emphasizing global cooperation. The current social contract, rooted in the nation-state's responsibility, often fails to regulate the transnational pharmaceutical industry effectively. This industry plays a crucial role in helping states fulfill their obligations to provide essential medicines and health technologies.

The proposed global social contract should be based on four principles:

Collective State Stewardship: States should collectively oversee the pharmaceutical and health technology industry, ensuring that research and development are in the public interest.

Equity and Health as a Human Right: The distribution of medicines and health technologies should be based on public health needs and state capacity.

Effective Global Polity: A robust global governance system is required to enforce the global social contract.

Governmental Transparency and Democratic Accountability: The state's interactions with the pharmaceutical industry should be transparent, and there should be mechanisms for public oversight.