This chapter presents a variety of arguments against factory farming and explores arguments that question the status quo notion that animals belong in the category of edible beings.

This chapter introduces human exceptionalism, explores various attempts to distinguish humans from other animals, and reviews a variety of ethical positions about human relations with other animals.

In this chapter, human-caused extinction is discussed and the philosophical challenges of identifying whether there is value in collectives over and above the individuals that make up that collective are explored. Though humans are doing a great deal of harm to other species, the history of intervention is also discussed as a problem. Moral arguments about whether humans should intervene or not are explored.

This chapter develops an argument about what is wrong with captivity beyond its impact on animal well-being. It proposes a discussion of the harms that denying liberty and dignity creates. Zoos, companion animals, and sanctuaries are discussed as sites of captivity.

This chapter explores the variety of strategies and ideologies that have been used in campaigning to eliminate the harms that humans do to other animals.

This chapter examines a number of concepts that are used in arguments against taking animals seriously. The chapter explores how difficult it is to say what behaviors are natural and looks at the multiple meanings of "species" and "human" and "person." The chapter also discusses the problems with familiar hierarchies of worth and explores some of the tensions that have developed between animal liberation and disability activists.

We are in the midst of a gender reckoning in the fields of science, medicine, and global health (Clark et al., 2017). Four contemporary social movements have helped shape the global gender and health landscape: online movements against violence, including #MeToo and #NiUnaMenos; intersectional feminism; the evolving recognition of men and masculinities; and the global trans rights movement. These movements are transforming the health sciences, forcing us to grapple with “questions of agency, vulnerability, and the dynamic and changing realities of gendered power relations” (Hilhorst et al., 2018: online). We are living through transformative and challenging times.

Imagine a world where people everywhere have access to the lifesaving drugs they need to fight diseases such as tuberculosis, malaria, and HIV/AIDS. To help extend access to essential medicines, we have to understand the problem. Understanding the impact of key technologies on the global burden of disease is essential for policymakers to extend access to important medicines, to achieve Sustainable Development Goal (SDG) 3, and to fulfill everyone’s human right to health. The Global Health Impact (GHI) Index opens the door to positive change by considering how essential medicines for some of the world’s worst diseases are affecting global health. It provides new models measuring the effect of key HIV/AIDS, malaria, tuberculosis (TB), and neglected tropical diseases (NTDs) medicines on death and disability over time.

Some 500 million people, including 260 million children under the age of five, have died from hunger and remediable diseases in peacetime in the 30 years since the end of the cold war. This is vastly more than have perished from wars, civil wars, and government repression over the entire twentieth century. And poverty continues unabated, as the official statistics amply confirm: of the 7.6 billion people alive today, 821 million are officially counted as undernourished, 150 million are homeless and about 1.6 billion lack adequate shelter, 2.1 billion have no safe drinking water at home, and 4.5 billion lack safe sanitation, 1.2 billion lack electricity, 2 billion are lacking access to essential medicines, 750 million adults are illiterate, and 152 million children (aged 5–17) are victims of child labor – often under slavery-like and hazardous conditions as soldiers, prostitutes, or domestic servants or in agriculture, construction, or textile or carpet production.

When people talk about global health and the ethics thereof, they almost invariably mean global human health. This is not because it is impossible to have more expansive notions of global health that include other species. Instead, it is because most people who are concerned about global health, like most of those who are concerned about local health, are either not concerned at all or are much less concerned with the health of other species. Thus, global health ethics, although expanding the reach of health ethics geographically, has not extended moral concern to other species within that global space.

To provide an answer to the question of whether we need global health ethics, we set ourselves three goals in this chapter. First, we explore a number of different ways that we might understand the term global health ethics. Second, we consider the arguments that could be used either to support or dismiss what we call substantive accounts of global health ethics. Finally, we make some suggestions in relation to what (if any) global obligations may bind us. Our discussions will use public health as an example throughout to illustrate our points. The reason for this focus is that, in our view, we ought to think of public health as providing systematic structural support for population health, with the key aim of fulfilling the basic requirements to protect health and prevent illness. This is not to suggest that other forms of healthcare are unimportant, just that public health will fulfill a primary role in any attempt to address questions of global justice in relation to existing health inequalities.

The dominant bioethical paradigm that provides the context for research ethics discourse has evolved within Western philosophy’s powerful normative framework and is built on a relationship model that explains and underpins the obligations doctors have to their patients. In this one-to-one relationship, the doctor is claimed to have primary duties to do no harm to patients and to respect patients’ rights. Employing the values of liberal individualism currently dominant in Western civilization, this model provides the starting point for understanding ethical research practice. Hence, researchers, like doctors, have obligations to do no harm to subjects and to respect their rights within the dominant conception of what these rights are or should be.

War, armed conflict, and other forms of collective violence are incompatible with health, especially when we use the World Health Organization’s (WHO, 2006) conceptualization of health as a state of complete physical, mental, and social well-being, a fundamental human right, and the responsibility of the state. In addition to their obvious direct physical and psychological effects, wars, conflict, and collective violence damage health through a variety of indirect channels, including: the destruction of healthcare and undermining of the broader determinants of health by, for example, disrupting food, water, and sanitation systems; displacing large numbers of people; polluting and degrading the environment; and damaging the economy (Weinberg & Simmonds, 1995). There is an enormous opportunity cost.

As many of the chapters in this volume document, we continue to bear witness to – and often create and perpetuate – wide disparities in global health outcomes. These inequalities extend to the health and well-being of children worldwide. Globally, more than 25,000 children under five years of age die every day, the vast majority of them in low-income countries (LICs). Under-five mortality is, on average, 14 times higher (69 versus 9 per 1,000 live births) in the world’s LICs than in the industrialized world. Of note, however, under-five mortality decreased by 58% globally between 1990 and 2017, with a goal for all countries to reach a level below 25 per 1,000 live births by 2030 (Global Health Observatory [GHO], 2019).