Reducing the health gap: A global plan for justice

A child born in sub-Saharan Africa is twenty-five times more likely to die in the first five years of life than one born in the United States. If she lives to child-bearing age, she is a two hundred times more likely to die in labor. Overall, she will die thirty years earlier than the American child. If this health gap is unfair and unacceptable, then how can the international community be galvanized to make a genuine difference?

To answer this question, Lawrence O. Gostin, Faculty Director of the O’Neill Institute at Georgetown University Law Center, proposes an international call to action through the adoption of a Global Plan for Justice (GPJ), a voluntary compact among states and their partners in business, philanthropy, and civil society to redress health inequalities. Under the GPJ, states would devote resources to a Global Health Fund based on their ability to pay — for example, 0.25% of Gross National Income (GNI) per annum — in addition to maintaining current development assistance devoted to programs and activities of their choice. Global Health Fund resources would be allocated based on the health needs of developing countries measured by poverty, morbidity, and premature mortality.

For an explanation of how the GPJ fits into other innovative Global Health Governance strategies, see and (explaining the progression from a Joint Learning Initiative for National and Global Responsibilities for Health, to a Global Plan for Justice, through to a Framework Convention on Global Health). See also, Lawrence O. Gostin, Meeting Basic Survival Needs of the World’s Least Healthy People: Toward a Framework Convention on Global Health, 96 Geo. L.J. 331 (2008),,