Pragmatic Progress and the Improvement of Medical Knowledge for Global Health

Abstract

The paper presents an epistemological argument on the crisis in medical knowledge today, first identifying a fundamental problem of the crisis, i.e., the epistemic gap, and then introducing the concept of pragmatic progress as a tool for understanding what is needed for pharmaceutical research to solve pressing epistemic and public health problems. This (new) analysis can contribute to identifying at least one mechanism needed to close the epistemic gap in current medical knowledge, which in turn could serve as a criterion for filtering current and future proposals. In order to do this, first, I show that the drug market has led to a significant epistemic gap between the knowledge needed to address pressing public health issues and the knowledge produced following the demands of the global market. Second, using the notion of pragmatic progress, I suggest a reading of the crisis in medical knowledge, which emphasizes the problems that clinical research is set to solve. Then I present two alternative ways to restructure medical research to fulfill this aim, illustrating how each can be implemented through real-world examples. The last section addresses a possible objection to the argument and exemplifies how the criterion can be used to filter undesirable proposals.