Governments and their hired negotiators are designing the supranational rules and pressing for their adoption and for compliance - and the US government first and foremost. These governments are elected by us, funded by us, acting on our behalf, sensitive to our will, and so, we are not mere bystanders observing the injustice.
Think of US slavery in 1850, or the subjection of women. Both of these injustices could have been - and were! - defended by pointing out, quite correctly, that this situation of slaves and women had been improving throughout the preceding century. Slaves, in particular, were worked less hard, beaten and raped less frequently, better fed, and less often ripped apart from their families. So would a celebration of moral progress have been appropriate in 1850? Surely not. Slavery could have been and should have been abolished - then, if not before.
It is perfectly consistent - and also true - to say that the world poverty problem today is smaller (relative to world population) than before and yet also a much graver injustice.
With the Health Impact Fund, the innovation is paid for separately, through publicly funded health impact rewards, and the product is sold at the cost of production to all. Here, the cruel injustice of preventing the poor from buying at cost - evidenced by today's suppression of the trade in generic versions of patented medicines - would no longer be needed.
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