The article critically examines domestic political concerns about the competitive disadvantages and possible carbon leakage arising from the introduction of domestic emission trading legislation and the fairness of applying carbon equalization measures at the border as a response to these concerns. I argue that the border adjustment measures proposed in the emissions trading bills that have been presented to Congress amount to an evasion of the U.S.'s leadership responsibilities under the United Nations Framework Convention on Climate Change (UNFCCC). I also show how the “level commercial playing field” justification for border measures that has dominated U.S. domestic debates is narrow and lopsided because it focuses only on the competitive disadvantages and direct carbon leakage that may flow from climate regulation while ignoring general shifts in the production and consumption of emissions in the global economy, which have enabled the outsourcing of emission to developing countries. The UNFCC production-based method of emissions accounting enables Northern consumers to enjoy the benefit of cheaper imports from Southern producers and to attribute the emissions associated with this consumption to the South. I argue that it is possible to design fair border measures that address carbon leakage, are consistent with the leadership responsibilities of developed countries, do not penalize developing countries, and ensure that consumers take some responsibility for the emissions outsourced to developing countries.

In order to achieve more ethical global health outcomes, health policies must be driven by health priorities and should take into account broader health policy requirements, including the needs of specific national health systems. It is thus important to recognize that the division of interests in key policy areas are not necessarily between the priorities of rich and poor countries, but between (1) pharmaceutical industry interests and health policy interests, and (2) national industrial and trade policy interests and public health policies. In this article I will focus on two broad common interests for health policy officials. Both have become important in the context of current global negotiations relating to access to medicines; pandemic influenza; and public health, innovation, and intellectual property rights. These are (1) ensuring access, availability, and the safety of pharmaceuticals, and (2) ensuring that research-and-development efforts respond to public health needs. I argue that these issues are not solely the concern of developing countries because the diminishing national policy space for health in pharmaceutical policies presents a challenge to all governments, including rich ones.