A selective commitment: pharmaceutical actors, conflict visibility, and the fulfilment of the right to health

Abstract

This thesis examines the role of pharmaceutical companies in fulfilling the right to health in conflict settings, where the destruction of health systems severely disrupts access to essential medicines. It evaluates the voluntary and mandatory legal frameworks governing pharmaceutical engagement in armed conflict and assesses their implications for the realisation of the right to health. A comparative case study of the ongoing war in Ukraine and the civil war in Sudan is used to explore how pharmaceutical actors respond across conflicts with severe humanitarian consequences. The findings of this research indicate that pharmaceutical mobilisation is more closely associated with conflict visibility than with humanitarian need. A systematic review of twenty major pharmaceutical companies identified eighteen public statements supporting Ukraine, but zero addressing Sudan, despite both conflicts experiencing catastrophic health system collapse. This disparity suggests that pharmaceutical engagement is shaped by visibility, and existing legal frameworks remain insufficient to promote equitable corporate responses across conflict settings. The thesis then further explores structural factors that may contribute to these asymmetries, including the influence of colonial legacies and Global North–South divides within humanitarian, global health and business governance.