Because present procedures by design favor the affluent, the poor are being increasingly marginalized. And because the poor are so marginalized, they can exert little influence on institutional design decisions. We need to break out of this vicious spiral and create momentum in the opposite direction.
Thomas PoggeThe domestic power structure - how power is exercised in the United States, for instance - greatly influences the structure of international institutions. So, for example, the Clinton administration was very influential in shaping the WTO treaty, and, because of the way the US domestic political system works, this meant that corporations could use the US government to wield a huge influence.
Thomas PoggeOur global institutional arrangements - the basic ground rules that govern our world economy - are human-made. They don't exist naturally, nor are they God-given. We make these rules, those of the WTO [World Trade Organization] Treaty for instance, which fill tens of thousands of pages. These words have been strung together by human beings and are also interpreted and enforced by human beings.
Thomas PoggeYou can think of the Health Impact Fund as a mechanism that would keep the benefits and burdens of pharmaceutical innovation for the affluent roughly as they are while massively reducing the burdens presently imposed upon the poor. This sounds like magic. But it really works because the current system is not Pareto efficient. It's a system that generates hundreds of billions of dollars in litigation costs and deadweight losses that HIF-registered medicines would sidestep. By avoiding these losses, the HIF reform can bring improvements all around - including for pharmaceutical innovators.
Thomas PoggeIn the domain of pharmaceuticals, we need a metric for health impact, and with this metric we can then assess the value of the introduction of a new product and pay its innovator accordingly, say on the basis of the product's measured health impact during its first ten years on the market. In exchange, innovators must of course renounce the usual rewards they are otherwise entitled to, namely the patent-protected markup on the price of their product.
Thomas PoggeThe World Bank is the monopoly provider of poverty data and, partly due to a leadership change there, the World Bank's reporting has been heavily on the rosy side since about 2000. The Bank's cultivation of an upbeat picture affords a very interesting lesson in statistics and how you can, depending on which numbers you present and how you present them, create a more positive or more negative impression of the evolution of poverty.
Thomas PoggeDomestic and supranational regulatory capture leads to two things: on the one hand, to an inequality spiral where the rich get richer because they can influence rulemaking and rule application in their favor; on the other hand, it also leads to instability. This is so because the relatively few organizations capable of influencing supranational rulemaking through the lobbying of major governments have diverse interests. This will, in some cases, lead to compromises. But it will also lead to spheres of influence.
Thomas Pogge