Although empirical evidence may provide a much desired sense of certainty amidst a pandemic characterised by uncertainty, the vast gamut of available COVID-19 data, including misinformation, has instead increased confusion and distrust in authorities’ decisions. One key lesson we have been gradually learning from the COVID-19 pandemic is that the availability of empirical data and scientific evidence alone do not automatically lead to good decisions. Good decision-making in public health policy, this paper argues, does depend on the availability of reliable data and rigorous analyses, but depends above all on sound ethical reasoning that ascribes value and normative judgement to empirical facts.

Global justice theorists have widely discussed how the international intellectual property rights regime (i.e., the TRIPs regime of the World Trade Organization) makes it more difficult to achieve the goal of universal access to generic (and more affordable) vital COVID-19 treatments (including potential COVID-19 vaccines). This article argues that while patents can impose certain barriers to universal access to generic COVID-19 treatments, the TRIPs regime itself is an integral part of an equitable global solution to the pandemic. More specifically, it argues that article 31bis of the TRIPs, in allowing for a cooperation strategy predicated on complementary importing and exporting of vital COVID-19 generic treatments, is key for successful pandemic suppression. By providing a normative interpretative analysis of article 31bis in light of the ethical requirements of global justice, and by responding to possible objections to its core argument, this article substantiates the ideal of multilateral solidarity among nations. In times of crisis—not only a crisis of global public health, but also a crisis of multilateralism—this complementary cooperation strategy that article 31bis allows for shows a way forward in upholding the global common good that the international legal order seeks to safeguard.

This commentary defines what shared yet differentiated ethical responsibilities to tackle antimicrobial resistance (AMR) mean, by introducing a threefold principled account of AMR global governance. It argues that the principles of solidarity, subsidiarity, and stewardship can be especially helpful for further justifying some of the universal, differentiated, and individual responsibilities that Van Katwyk et al propose. The upshot of my threefold principled account of AMR global governance is a less ambitious AMR treaty, one that can only justify (i) universal duties of global coordination (as per the principle of solidarity); (ii) differentiated duties to local communities, which bear the primary AMR responsibilities (as per the principle of subsidiarity); and (iii) individualized duties for ensuring truthful, evidence-based, consistent, and timely shared accountable communication (as per the principle of stewardship).

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Global health governance (GHG) scholars have conventionally advocated for a stronger World Health Organization, able to better centralize power and authority in decision-making processes addressing global health challenges. What we call “the centralization approach to GHG reform” has not led to the best outcomes. In challenging the centralization approach and showing where it fails, this article argues for a decentralized GHG reform, predicated on the principle of subsidiarity, as an alternative. We offer an applied ethics analysis of the principle of subsidiarity, which contradicts the conventional wisdom of the centralization approach. This normative article not only opens up a new way in the global health literature of theorizing the long-standing debate on GHG reform, but it also offers a new lens for responding to the current backlash against multilateralism by substantiating the complementarity and cooperation among global health stakeholders in times of pandemics and beyond.

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This study argues against the expansive approach to the WHO reform, according to which to be a better global health leader, WHO should do more, be given more power and financial resources, have more operational capacities, and have more teeth by introducing more coercive monitoring and compliance mechanisms to its IHR. The expansive approach is a political problem, whose root cause lies in ethics: WHO’s political overambition is grounded on WHO’s lack of conceptual clarity on what good leadership means and what health (as a human right) means. This study presents this ethical analysis by putting forth an alternative: the humble approach to the WHO reform. It argues that to be a better leader, WHO should do much less and have a much narrower mandate. More specifically, WHO should focus exclusively on coordination efforts, by ensuring truthful, evidence-based, consistent, and timely shared communications regarding PHEIC among WHO member-states and other global health stakeholders, if the organization desires to be a real global health leader whose authority the international community respects and whose guidance people trust.