A global social contract to ensure access to essential medicines and health technologies

The COVID-19 pandemic illuminates the need to move away from the current social contract, which focuses on the nation-state’s responsibility for protecting the health of its own population, including by providing essential medicines and health technologies.

We argue for embracing a global social contract, which is a governance concept that lays the foundation for how states should act as members of the international community, as regulators of the private pharmaceutical industry and as guarantors of public goods benefiting people worldwide.

A global social contract should be based on a set of four principles: collective state stewardship of the pharmaceutical and health technology; equity and the protection of health as a human right; an effective global polity; and governmental transparency and democratic accountability.

This foundation can serve as a basis for a future pandemic treaty and as a model to address the much broader global crisis of inequitable access to medicines and health technologies for infectious and non-communicable diseases.