What triggered Lie’s change of mind? His reaction was informed by an excellent paper in the US journal Hastings Center Report.2 Alex London and Kevin J.S. Zollman tried to put the fair benefits approach into action. Amongst their most significant findings was that the approach would likely result into a race to the bottom, whereby pharmaceutical companies would use their bargaining power to search across the globe for the cheapest possible deal to undertake their research. London and Zollman rightly concluded that the approach would produce results that would not even meet standards of fairness endorsed by its own proponents. Other aspects of the procedural approach to fair benefits have been sharply criticized by other bioethicists.3
It is time to move beyond this approach to fair benefits in international health research, and it is time to stop propagating it in developing countries under the guise of capacity building efforts. Alternative concepts aimed at addressing the normative problem at hand have been proposed. I am looking forward to how this debate will unfold.