Throughout this topic we have discussed the concept of beneit sharing: its origin,
its development and its application. Particular instances of benefit sharing usually
take place in the context of very specific research endeavours. Possible benefit-
sharing arrangements with research participants are determined by the provisions
of the Convention on Biological Diversity (CBD 1992 ) or the Declaration of
Helsinki's post-study obligations (WMA 2008 ).
Providing health care is a feasible benefit-sharing mechanism for highly vulner-
able populations involved in minimal-risk research (see Chap. 8 ), as in the case of
the Majengo sex workers, who can access life-saving medicines in return for con-
tributing to medical research.
However, while much may be hoped for from medical research (e.g. a vaccine
against HIV), benefit sharing is no more than a tool to guard against the specific
exploitation of the small number of participants who contribute to that research
or resolve deep-seated problems of global distributive justice (see also Schroeder
and Pogge 2009 ). To address those issues, much more ambitious and visionary
plans need to be promoted.
'Faced with what is right, to leave it undone shows a lack of courage.' These
words are attributed to Chinese thinker and philosopher Confucius (551-479 BC)
Yet knowing that a state of affairs is wrong does not make the best way forward
obvious. For instance, there is broad agreement that the premature, avoidable
death of children is a catastrophe. 1 In Sub-Saharan Africa, one in every eight chil-
dren dies before the age of five, often due to avoidable causes such as pneumonia,
malaria, diarrhoeal diseases or birth complications. By comparison, in industrial-
ized countries one in 167 children dies before turning five.2 2 Likewise, the death of
10 million people each year because they do not have access to existing life-saving
drugs is entirely unacceptable and one of the ethical challenges of the twenty-first
century (Grover 2009 ). But how can these problems best be addressed?
The right to health 3 was incorporated into international law in 1948 when the
governments of the world came together and asserted in the Universal Declaration
of Human Rights that each and every human being
has the right to a standard of living adequate for the health and well-being of himself and
of his family, including food, clothing, housing and medical care and necessary social ser-
vices, and the right to security in the event of unemployment, sickness, disability, widow-
hood, old age or other lack of livelihood in circumstances beyond his control [emphasis
added] (UN 1948 : article 25(1)).
1 For a philosophical discussion of obligations towards the poor, see Pogge ( 2008 ).
3 This chapter uses 'the human right to health' to mean 'the right of everyone to the enjoyment
of the highest attainable standard of physical and mental health' (ICESCR 1966 : article 12).