Correcting globalisation in health: transnational entitlements versus the ethical imperative of reducting aid-dependency

There is growing tension between arguments for increasing foreign assistance to achieve the Millennium Development Goals and arguments for reducing foreign assistance so as to avoid a new form of colonisation. This essay argues that the impact of the global economy on access to healthcare in developing countries requires global corrective measures. It acknowledges the risk of foreign assistance being used for illegitimate purposes, but argues that if foreign assistance were provided within a human rights framework of rights-holders and duty-bearers, this risk can be mitigated. It analyses the current development aid paradigm, and how the fight against AIDS has begun to change it. It also examines why access to essential healthcare is a human right creating national and transnational entitlements and argues that foreign assistance responding to these entitlements is not a matter of discretionary spending; it is a matter of meeting legal obligations. It explores the legal implications of the core content of the right to health and its relationship with the obligation to provide assistance. It concludes with a review of two different but complementary proposals to create a global approach to the realisation of the right to health: the Global Health Fund and the Health Impact Fund Initiative.