The Lancet  |  May 2, 2015

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Although you may never have studied the law formally, you can hardly be concerned about health without being conscious of the importance of the word “justice”. I don’t mean the physical signs of a legal system—lawyers, courts, prisons. I mean the idea of fair treatment of people—the quality of being fair or reasonable. Living a life within a health system invites you to consider many cruel injustices. Social gradients that ferment disease. Barriers to the highest standards of care. Powerful forces that create toxic conditions for ill-health. The idea of justice—a phrase used by Amartya Sen to sum up a life’s work in pursuit of human betterment—is central to the international community’s vision of health and wellbeing. From the Universal Declaration of Human Rights to the Sustainable Development Goals (SDGs), nation-states have, in often spectacularly non-linear, stumbling, and sometimes even incompetent ways, sought to eliminate some of the deepest injustices confronting humanity. But two challenges should encourage even the most idealistic among us to be sceptical of these grand narratives of global health.

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