Ethical Challenges of Distributing Limited Health Resources in Low-Income Countries

Authored by: Kjell Arne Johansson

The Routledge Companion to Bioethics

Print publication date:  December  2014
Online publication date:  December  2014

Print ISBN: 9780415896665
eBook ISBN: 9780203804971
Adobe ISBN: 9781136644849


 Download Chapter



Children born in low-income countries (LICs) can on average expect to live 20.1 life years less and are 16 times more likely to die before their fifth birthday than children born in high-income countries (see Table 7.1). Is this inequality in life prospects acceptable? Many people live in poverty; 74 percent of the people in LICs live on less than U.S.$2 per day. Low-income populations are growing due to high fertility rates and there is a high burden of disease; in addition, the majority of people in LICs live in rural regions and are hard to reach with health care services. Health care expenditures in LICs are on average 1/180th of high-income country expenditures. This scarcity of resources raises the justice issue: Whom should governments and charity organizations favor in allocating these limited resources? And what can theories of justice tell us about the moral grounds for making fair decisions? Policy decisions on access, availability, and quality of medical and public health services influence both the overall level of health in a population and the distribution of health between individuals. But access and quality of medical services do not solve the whole problem. Improving the position of the worst off in other, non-health domains of justice, such as liberty, income, education or capabilities, will have a substantial impact on population health. It is thus urgent to establish legitimate and practical procedures for making fair priority decisions and involving key stakeholders in an impartial and reasonable way. What should such legitimate priority setting procedures look like?

Search for more...
Back to top

Use of cookies on this website

We are using cookies to provide statistics that help us give you the best experience of our site. You can find out more in our Privacy Policy. By continuing to use the site you are agreeing to our use of cookies.