富裕國家有援助落後國家及其人民的義務嗎？

二、 全球正義的消極義務

承上，對於全球正義的道德因果關連性議題，有著兩個重要的前提命題。其 一乃係規範命題(normative premise)，就是所謂的消極義務(negative duties)論述，

消極義務簡單言之，就是不可傷害原則(rule of not to harm)，每個道德主體具有 避免不要要傷害他人的道德義務(T. Pogge, 2005; 2008b, pp. 19-25)。如果違反了消 極義務，就必須履行積極義務(positive duties)，也就是對於人道救助對於傷害的 彌補責任。另一前提命題乃是事實命題(factual premise)，這個事實呈現著已開發 國家及其人民事實上並沒有傷害開發中國家及其人民，並且這些全球制度規則的 國際制度設計與維護並沒有因此使貧困國家及其人民遭受到不平等與傷害。試圖 在事實命題上否認全球正義的因果關連性之牽連，而排除道德上的非難性。

而 Pogge 的全球正義觀在其內涵上，主要就是要去挑戰事實命題的可非難 性。Pogge 指出，關鍵的是，我們到底對這些貧困國家及其人民做了些什麼傷害。

因此，我們必須基於消極義務的違反，積極對 TRIPS 進行制度改革，並對開發 中國家及其人民所造成的傷害給予補償(T. Pogge, 2008b; Pogge, 2007; T. W.

Pogge, 2008c)。

三、 富裕國家有援助落後國家及其人民的義務嗎？

承上，假若已開發國家及其人民( 主要是國際大製藥廠)因違反消極義務，

一方面必須停止傷害的繼續，進行 TRIPS 協定的制度改革；另一方面必須要履

22

行積極義務，對開發中國家及其人民(尤其是病患)進行人道協助的補償。對於實 際上，國際大製藥廠一方面對於貧困國家人民常遭受的忽略性疾病，諸如 HIV/AIDS，國際大藥廠一方面提供昂貴的專利新藥，另一方面，卻提供即將專 利到期的藥品給予所謂人道救助。前者對於病患而言，是比較有療效的藥品，後 者則是較沒有療效且有許多副作用的舊專利藥品。對於國際大藥廠而言，這就是 所謂的補償嗎？

Pogge 對於長久以來富裕國家及其人民存在的既定人道援助觀點，提供挑戰 與質疑。Pogge 以為，我們必須停止以幫助窮人的角度來考慮全球不平等與世界 貧困的議題。並且，目前許多的人道援助計畫後來都流於失敗的下場。因為世界 貧困與不平等困境，是不可能藉由目前的「投入金錢援助」(throwing money at the problem )得到改善的。這些金錢投入的人道援助並沒有真正的切入爭議的核心，

也沒有真正的幫助到貧困國家與人民的迫切需求(Pogge, 2001b, 2007; T. W.

Pogge, 2008c)。

首先，貧困國家及其人民是的確需要人道援助的，這是無庸置疑的。但是，

Pogge 認為我們援助的理由並不是基於同情與憐憫，而是基於因為我們違反了道 德上的消極義務，導致貧困國家及其人民遭受更大的傷害與不平等，包含本文所 探討的諸多衛生不平等現象(Pogge, 2001b, 2007; T. W. Pogge, 2008c)。

所以，全球正義觀是要對我們所提供的人道援助計畫，提供道德反思。思考 我們應當如何透過 TRIPS 這項全球智財制的制度改革與專利藥品的可及性與可 負擔性的醫療救助，來保護這些貧困國家及人民免於受到 TRIPS 的繼續強迫與 傷害。

23

Reference

Achilladelis, B., & Antonakis, N. (2001). The Dynamics of Technological Innovation:

The Case of the Pharmaceutical Industry. Research Policy, 30, 535-588.

Aginam, O. (2005). Global Health Governance: International Law and Public Health in a Divided World Toronto: University of Toronto Press.

Angell, M. (2004). The Truth about The Drug Companies: How They Deceive Us and What to Do about It. New York: Random House.

Barnes, S. (2002/2003). Pharmaceutical Patents and TRIPS: A Comparison of India and South Africa. 91 Ky. L.J. 911.

Beitz, C. R. (1975). Justice and International Relations. Philosophy & Public Affairs, 4(4), 360-389.

Beitz, C. R. (1999). Political Theory and International Relations. Princeton, N.J:

Princeton University Press.

Beitz, C. R. (2005). Cosmopolitanism and Global Justice. The Journal of Ethics, 9, 11-27.

Birmingham, K. (2001). South Africa vs. Big Pharma. Nature Medicine, 7(4), 390-390.

Chien, C. (2003). Cheap Drugs at What Price to Innovation: Does the Compulsory Licensing of Pharmaceuticals Hurt Innovation? 18 Berkeley Tech. L.J. 853.

Collste, G. (2005). Globalisation and Global Justice. Studia Theologica, 59(1), 55-72.

Colonomos, A. (2008). Moralizing International Relations: Called to Account (C.

Turner, Trans.). New York: Palgrave Macmillan.

Dallmayr, F. R. (2002). Globalization and Inequality: A Plea for Global Justice.

International Studies Review, 4(2), 137-156.

Deere, C. (2009). The Implementation Game: The TRIPS Agreement and the Global Politics of Intellectual Property Reform in Developing Countries. Oxford:

New York ; Oxford University Press.

Dollar, D. (2001). Is Globalization Good for your Health? Bulletin of the World Health Organization, 79(9), 827-833.

Dollar, D. (2007). Globalization, Poverty and Inequality since 1980. In D. Held & A.

Kaya (Eds.), Global Inequality: Patterns and Explanations. Cambridge: Polity.

Dollar, D., & Kraay, A. (2002). Spreading the Weatlh. Foreign Affairs, 81(1), 120-133.

24

Dukes, G. (2005a). The Law and Ethics of the Pharmaceutical Industry. Amsterdam ; Boston: Elsevier Science.

Dukes, G. (2005b). Pharmaceutical Pricing and Profits. In G. Dukes (Ed.), The Law and Ethics of the Pharmaceutical Industry. Amsterdam ; Boston: Elsevier.

Feachem, R. G. A. (2001). Globalization is Good for your Health. British Medical Journal, 323(1), 504-506.

Fidler, D. P. (2007a). Health as Foreign Policy: Harnessing Globalization for Health.

Health Promotion International, 21(1), 51-58.

Fidler, D. P. (2007b). Reflections on the Revolution in Health and Foreign Policy.

World Health Organization. Bulletin of the World Health Organization, 85(3), 243-244.

Fidler, D. P., & Drager, N. (2006). Health and Foreign Policy. Bulletin of the World Health Organization, 84(9), 687.

Franceschet, A. (2009). The Ethics of Global Governance. Boulder: Lynne Rienner Publishers.

Gilpin, R. (2001). Global Political Economy: Understanding the International Economic Order Princeton, N.J.: Princeton University Press.

Gilpin, R. (2002). A Realist Perspective on International Governance. In D. Held & A.

McGrew (Eds.), Governing Globalization: Power, Authority, and Global Governance. Cambridge ; Malden, MA: Polity.

Gwatkin, D., & Guillot, M. (2000). The Burden of Disease among the Global Poor.

Washigton, D.C.: The World Bank.

Held, D., & McGrew, A. (2007a). Globalization/Anti-Globalization: Beyond the Great Divide (2nd ed.). Cambridge: Polity.

Held, D., & McGrew, A. (2007b). The Great Divergence? Global Inequality and Development. In D. Held & A. McGrew (Eds.),

Globalization/Anti-Globalization: Beyond the Great Divide. Cambridge:

Polity.

Henry, D., & Lexchin, J. (2002a). The Pharmaceutical Industry as a Medicines Provider. Lancet, 360, 1590-1595.

Henry, D., & Lexchin, J. (2002b). The Role of the Pharmaceutical Industry in Drug Development and Approval. Lancet, 360, 1590-1595.

Hurrell, A. (2001). Global Inequality and International Institutions. Metaphilosophy, 32(1-2), 34-57.

25

Kale, D., & Wield, D. (2007). The Indian Pharmaceutical Industry Before and After TRIPS. Technology Analysis & Strategic Management, 19(5), 559-563.

Keohane, R. O. (2005). After Hegemony: Cooperation and Discord in the World Political Economy (1st Princeton classic ed.). Princeton, N.J.: Princeton University Press.

Kiely, R. (2007). The New Political Economy of Development: Globalization, Imperialism, Hegemony 2007. Houndmills, Basingstoke, Hampshire ; New York: Palgrave Macmillan.

Kymlicka, W. (2002). Contemporary Political Philosophy: An Introduction (2nd ed.).

Oxford ; New York: Oxford University Press.

Lawrence, H. J. (2004). The High Cost of Prescription Drugs: The Price of Success? 4 Yale J. Health Pol'y L. & Ethics 165.

Lee, K. (2003). Globalization and Health: An Introduction. Houndmills, Basingstoke, Hampshire ; New York: Palgrave Macmillan.

Lee, K., & Zwi, A. (2003). A Global Political Economy Approach to AIDS: Ideology, Interests and Implications In K. Lee (Ed.), Health Impacts of Globalization:

Towards Global Governance. Houndsmills, Basingstoke, Hampshire ; New York, N.Y.: Palgrave Macmillan.

Lipkus, N. (2006). How to Understand Product Development: Public-Private Partnerships as Vehicles for Innovation in Combating Neglected Disease. 10 Mich. St. J. Med. & Law 385.

Malone, D. M., & Hagman, L. (2002). The North-south Divide at the United Nations:

Fading at Last? Security Dialogue, 33(4), 399-414.

Marc, P. (2001). Compulsory Licensing and the South African Medicine Act of 1997:

Violation or Compliance of Trade Related Aspects of Intellectual Property Rights Agreement? New York Law School Jiurnal of International and Comparative Law, 21, 109-125.

McGrew, A. (2008). Globalization and Global Politics. In J. Baylis, S. Smith & P.

Owens (Eds.), The Globalization of World Politics: An Introduction to International Relations. New York: Oxford University Press.

Mertens, T. (2005). International or Global Justice? Evaluating the Cosmopolitan Approach. In A. Follesdal & T. Pogge (Eds.), Real World Justice: Grounds, Principles, Human Rights, and Social Institutions. Dordrecht: Springer.

Nagel, T. (2005). The Problem of Global Justice. Philosophy & Public Affairs, 33(2),

26

113-147.

Nair, G. G. (2008). Impact of TRIPS on Indian Pharmaceutical Industry. Journal of Intellectual Property Rights, 13(5), 432-441.

Nwaka, S., & Ridley, R. G. (2003). Virtual Drug Discovery and Development for Neglected Diseases through Public--Private Partnerships. Nature Reviews Drug Discovery, 2, 919-928.

Patten, A. (2005). Should We Stop Thinking about Poverty in Terms of Helping the Poor? Ethics & International Affairs, 19(1), 19-27.

Pogge, T. (2005). Severe Poverty as a Violation of Negative Duties. Ethics &

International Affairs, 19(1), 55-83.

Pogge, T. (2008a). Achieving Democracy. In T. Pogge (Ed.), World Poverty and Human Rights: Cosmopolitan Responsibilities and Reforms. Cambridge:

Polity.

Pogge, T. (2008b). World Poverty and Human Rights: Cosmopolitan Responsibilities and Reforms (2nd ed.). Cambridge: Polity.

Pogge, T. W. (1989 ). Realizing Rawls. Ithaca: Cornell University Press.

Pogge, T. W. (2001a). Introduction: Global Justice. Metaphilosophy, 32(1/2), 1-5.

Pogge, T. W. (2001b). Priorities of Global Justice. Metaphilosophy, 32(1/2), 6-24.

Pogge, T. W. (2001c). Rawls on International Justice. Philosophical Quarterly, 51(203), 246.

Pogge, T. W. (2003). Priorities of Global Justice. In D. Held & A. McGrew (Eds.), The Global Transformations Reader: An Introduction to the Globalization Debate.

Oxford: Polity.

Pogge, T. W. (2005). Real World Justice. The Journal of Ethics, 9, 29-53.

Pogge, T. W. (2007). Reframing Global Economic Security and Justice. In D. Held &

A. McGrew (Eds.), Globalization Theory: Approaches and Controversies.

Cambridge ; Malden, Mass.: Polity.

Pogge, T. W. (2008a). Access to Medicines. Public Health Ethics, 1(2), 73-82.

Pogge, T. W. (2008b). Growth and Inequality. Dissent, 55(1), 66-75.

Pogge, T. W. (2008c). What Is Global Justice? Revista de Economia Institucional, 10(19), 99-114.

Pogge, T. W. (2008d). World Poverty and Human Rights: Cosmopolitan Responsibilities and Reforms (2nd ed.). Cambridge: Polity

Rai, R. K. (2008). Battling with TRIPS: Emerging firm Strategies of Indian

27

Pharmaceutical Industry Post-TRIPS. Journal of Intellectual Property Rights, 13(4), 301-317.

Rawls, J. (1971). A Theory of Justice. Cambridge, Mass: Belknap Press of Harvard University Press.

Rawls, J. (1999). The Law of Peoples: With "The Idea of Public Reason Revisited".

Cambridge, Mass.: Harvard University Press.

Shapcott, R. (2008). International Ethics. In J. Baylis, S. Smith & P. Owens (Eds.), The Globalization of World Politics: An Introduction to International Relations. New York: Oxford University Press.

Stiglitz, J. E. (2002). Globalization and Its Discontents. New York: W.W. Norton.

Trouiller, P., Olliaro, P., Torreele, E., Orbinski, J., Laing, R., & Ford, N. (2002). Drug Development for Neglected Diseases: A Deficient Market and a Public Health Policy Failure. Lancet, 359, 2188-2194.

Wade, R. H. (2004). Is Globalization Reducing Poverty and Inequality? World Development, 32(4), 567-589.

Wade, R. H., & Wolf, M. (2003). Are Glaobal Poverty and Inequality Getting Worse?

In D. Held & A. McGrew (Eds.), The Global Transformations Reader: An Introduction to the Globalization Debate. Oxford: Polity.

Waltz, K. N. (2001). Man, the State and War: A Theoretical Analysis New York:

Columbia University Press.

Wang, M.-L. (2009). Global Health Partnerships: The Pharmaceutical Industry and BRICA. Basingstoke [England] ; New York: Palgrave Macmillan.

WHO. (1995). The World Health Report 1995: Bridging the Gaps. Genava: WHO.