Being pragmatic about justice

Thomas Pogge at the Peace Palace
in The Hague, before his lecture started

How principled or how pragmatic should one be when it comes to matters of justice? This question was prominently on my mind yesterday. One of the leading philosophers in the area of global justice, Thomas Pogge, gave a public lecture in The Hague, organized by 3TU.Ethics. Preceding the lecture was a small seminar in which the Health Impact Fund (HIF) was an important topic of discussion. This HIF offers pharmaceutical companies an alternative for getting a patent on their new medicine. The HIF is designed to reward companies for the health impact that their medicines make, instead of for merely their success in sales. Pogge is one of the driving forces behind the HIF and it is a direct outcome of his more abstract ideas about how the global institutional order that we create and uphold is harming the poor in developing countries and that we therefore have a duty to reform these institutions.

One might think that any philosopher who has thought long and hard about principles of justice and our moral duties towards the poor is also quite rigorous when it comes to undertaking the right action. Yet Pogge, so I found out during the workshop, is a real pragmatist. My reason for saying this is not that the HIF is limited in scope, with a proposed budget of ‘only’ 6 billion dollar (less than 1% of current worldwide expenditures on pharmaceuticals) and being concerned with only a small part of the total global institutional order. Pogge himself fully recognized this. He called the HIF “exemplar of realistic moral leadership” and saw it as an advantage that it “benefits a strong, well-organized faction of the global elite”, as it offers “new profit opportunities and image improvement for the pharma industry”. Like it or not, the underlying message seemed to be: one needs powerful friends to make a difference.

Pragmatism also featured in his replies to some of the participants. Prof. Korthals from Wageningen University, for example, challenged the HIF by claiming that interventions in the area of sanitation and nutrition are much more effective when it comes to increasing health in developing countries. Pogge agreed, but said that he would not be able to raise 6 billion dollar for those things, while he was confident that he would be able to get together the money needed for establishing the HIF. Dr. Koepsel of TU Delft challenged the HIF by arguing that it leaves intact the “root causes of injustice” itself, namely the current patent system. Pogge agreed that there is much wrong with the whole idea of IP itself, but said that the “HIF is based on the assumption that the TRIPPS agreements are very hard to reverse.”

All this gave me food for thought – ought one to be principled or pragmatic? Or is this a meaningless dilemma, as one can be pragmatic on the short term and principled on the long term? Pogge, at least, assumed that in the long run his HIF would “kill the patent system from below”, as it could scale up in the future and lure more and more medicines away from the patent system.