Pogge argues for a GBD patent such that pharmaceutical companies are compensated in direct proportion to the social impact they have on preserving human life. This is an attractive model, and Pogge claims that it is politically viable, economically efficient and morally fair. I have a couple issues with Pogge's arguments, some of which he briefly expresses but does not explain how he overcomes them. Others, he fails to even address.
First off, as Pogge admits, the plan requires a definition of what constitutes 'essential medicine' such that it would qualify for GBD patents. Though Pogge addresses this concern, he never explains how to overcome the challenge of finding an adequate definition of what diseases are significant enough to warrant a GBD patent. Moreover, Pogge's model is such that companies are rewarded for the lives they save. However, in the process of saving lives they can cause a lot of damage. Many medications have extremely harmful side effects. If a medication can help treat a deadly disease in a poor country, but leads to damaged limbs or organs or impaired physical or mental ability, it can cause just as much harm as it does benefit. The drug approval process is different in many countries and so without universalizing the approval and testing standards, it seems that this challenge cannot be overcome. Even if standards were universalized, some drugs still make it to the market with extremely harmful side-effects as a result of regulations that are not stringent enough. On the other hand, strict regulation can disincentive drug companies as the risk of failure is greater.
My second concern regards the external factors that companies must take into account when creating a treatment for a disease. Pogge claims that 'GBD patent holders are held responsible, as it were, for causes beyond their control - the weather, for instance, which may affect the prevalence of disease-carrying mosquitoes.' (27) Though it may seem unfair, this a natural risk of industry and so one that pharmaceutical companies must endure. However, I feel that it could narrow the interests of pharmaceutical companies such that they only invest in areas they believe that they can make the most profit. Suppose for example, suppose an inventor creates a cure for a disease extremely prevalent in India and in extremely poor African nations. The inventor can greatly profit as a result of GBD patents if he makes his drug accessible to India and these African nations. However, if we assume that India is a developing nation and therefore they have greater means of distributing medicine and greater access to doctors and nurses and hospitals - as opposed to an African nation without access to qualified doctors and quality hospitals and inefficient distribution - it seems in the companies' best interest to invest more in India than to invest at all in African nations whereby external factors would inhibit profitability.
Finally, Pogge stresses the importance of harmonizing interests in his plan. He shows that the interests of pharmaceutical companies and governments (both poor and rich) align. However, he doesn't address the likes of 'Nigeria's military dictator Sani Abacha, Myanmar's SLORC junta (...) Indonesia's kleptocrat Suharto, Zimbabwe's Robert Mugabe,' (12) and many other oppressive dictators. These dictators have a vested interest in maintaining autonomy and thus have an interest in keeping their people weak. Many nations such as those in the Middle East also greatly oppose western intervention and so are likely not to participate in the program. It seems that Pogge overestimates the cooperation such a program would receive from poor nations with corrupt leadership. Also, though I would never argue such a thing, it could be said that it is in humanities' best interest that deadly diseases survive. The Earth's population is almost 7.5 billion and rising. The planet is not growing and resources (food, water, energy, land) are depleting. Arguably, it is in humanities' best interest to limit population growth so that these resources are preserved and more generations have greater ability to survive.
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