In an influential series of works (1986, 1990, 2013), David Gauthier has propounded a conception of morality on which its requirements are necessary if individuals are to take the most effective route to the satisfaction of their interests. This is a seductive claim, amounting to the contention that we can see that moral norms are justified if we have a clear view of our non-moral purposes. Recently, Gauthier’s work has been applied in the context of global health. It has been argued that a certain minimal redistribution of healthcare resources (from wealthier to poorer countries) is morally required, because it is in the interests of wealthier nations when those are considered across generations. In the following paper I discuss this argument. I suggest that while there is a moral duty for more developed nations to ensure a more equitable distribution of healthcare resources, a Gauthier-style argument for this conclusion fails to carry conviction. Such an argument shares the flaw common to all attempts to ground moral requirements on self-interest; namely, that our confidence in any empirical hypothesis about the congruence of morality and self-interest is less certain than, and is in fact derivative upon, our confidence in the moral requirements which that hypothesis is supposed to justify. I will attempt to demonstrate this in the case of global healthcare, and, in so doing, will provide an alternative conception of the nature of collective responsibility and its relation to self-interest.