global health governance • fall 2010 451 H ealth plays a fundamental role in our lives as individuals and as members of society. At the individual level, health is critical to a person’s well-being and can afect his or her opportunities in the world. Health is also important to public welfare because a basic level of human functioning is a nec- essary condition for the development and stability of economic, social, and political structures within a soci- ety. International norms reinforce the special value of human health ranging from the constitutional mission of World Health Organization (WHO), to the human right to health, through the Millennium Development Goals (MDGs) — all of which oblige states to act in concert for the protection and promotion of health. Social justice, which compels the fair disbursement of common advantages and sharing of common bur- dens, 1 “captures the twin moral impulses that ani- mate global health: to advance human well being by improving health and to do so particularly by focusing on the needs of the most disadvantaged.” 2 At present, the world’s poor bear a vastly disproportionate burden of disease and injury. As life expectancy has steadily increased in the developed world, the least developed countries and transitional states have seen a decrease. 3 Health disparities between the rich and poor, however, cannot be simpliied to a division between rich and poor countries. Rather, health disparities also exist within countries whereby diferent levels of health are linked to socio-economic conditions of life. 4 Many of the poor living in Europe and North America, for example, have life expectancies equal to those in the least developed countries. 5 In addition, many of the health problems of poor countries can threaten more wealthy countries as diseases have the ability to migrate rapidly across the globe. Hence, the concept of global social justice (or global health equity) promotes the attainment of health for the world’s population. The glaring health disparities between the world’s rich and poor can be attributed to social and economic factors. 6 Addressing these factors, which are com- monly referred to as the social determinants of health, can dramatically improve the patterns of systematic disadvantage that profoundly and persuasively under- mine prospects for well-being of the poor. For exam- ple, a lower socioeconomic status (as determined by education, occupation, and income) is strongly cor- related to poor health outcomes due to conditions of material disadvantage, diminished control of life cir- cumstances, and lack of social acceptance. 7 In addi- tion, factors such as daily living conditions, the built and natural environment, and equitable distribution of power and resources can have an impact on health. Despite the international community’s awareness of deep and persistent health inequities, 8 foreign aid often is not aligned with local priorities and does not address the principal determinants of health. Instead, international development assistance for health tends to be framed by donor countries in terms of their geo- strategic and philanthropic interests. Donors often foreword Innovative Solutions to Closing the Health Gap Between Rich and Poor: A Special Symposium on Global Health Governance Lawrence O. Gostin and Emily A. Mok Lawrence O. Gostin, J.D., LL.D. (Hon.), is the Linda D. and Timothy J. O’Neill Professor of Global Health Law, the Fac- ulty Director of the O’Neill Institute for National and Global Health Law, and Professor of Public Health at the Johns Hop- kins University. Professor Gostin is a Research Fellow and Visiting Professor at Oxford University and directs the WHO Collaborating Center on Human Rights and Public Health Legislation. Emily A. Mok, M.G.A., M.B.E., D.Phil. Candi- date, is a fellow of the O’Neill Institute for National and Global Health Law and an Adjunct Professor of Law at Georgetown University Law Center. She received dual Master degrees in Government Administration and Bioethics from the Univer- sity of Pennsylvania, Philadelphia, PA, and is completing her D.Phil. in Law at the University of Oxford in Oxford, U.K.