“A mother of two, her left arm amputated, she refuses to ever go near a sewing machine again.” In April this year, the Rana Plaza factory in Bangladesh collapsed killing over a 1000 people and injuring many more. Among poignant accounts of despair that emerged from the incident, I felt this woman’s situation reflected the nation’s dilemma as a whole. With nearly 80% of exports fuelled by the garment industry, the Bangladeshi government has to choose between the economics of being a cheap labour platform for big Western retailers and ensuring worker safety. Likewise, millions of Bangladeshi women make the difficult choice everyday to work in dangerous conditions to provide for their families. Are these even justifiable choices?

In the aftermath of the disaster, compensations are being worked out for survivors and families of victims. However, these serve as short term cosmetic moves, unless the recurring hazard of perilous working conditions is addressed. A parallel movement to have global retail giants sign an Accord on Fire and Building Safety in Bangladesh is gaining ground. This would make them financially and legally accountable for safety and labour conditions in the factories they employ workers in. While some retailers such as Primark, Marks & Spencer, H & M, Zara, and Target have agreed to it, big US retailers Walmart and GAP are holding back.

This disaster is uncannily reminiscent of the Bhopal Gas Tragedy of 1984, a sordid tale of corporate negligence and greed, that claimed thousands of lives and affects people generations after. It throws up the same questions: What is the responsibility of corporations that employ workers in these regions at a pittance of what manufacturing and resources would have cost in their own countries? And what is the responsibility of governments that fail to regulate and ensure the safety of their people? How can safety standards vary across countries? Is human life cheap in one place, and more precious elsewhere?

As consumers purchase a pair of jeans for US$10 from Walmart, it is time we recognise who pays the real price for it. One may argue that labour is a commodity in largesse in countries like India, Bangladesh, and China, that comes cheap. However human life does not. For that one person or family, the loss of a limb or life is absolute. Speaking on sustainable development at Women Deliver 2013, Babatunde Osotimehin, executive director of UNFPA, highlighted that increasingly the problem is not one of population growth, rather of unrestrained consumption. To illustrate, he said that a homeless family in Denmark may consume more than a family of six in Tanzania. Quite controversially, Kavita Ramdas from the Ford Foundation made a point that on the basis of pure consumption, Americans should have a one child policy and not Bangladeshi women. As Bangladesh plays host to the Global Meet on Sustainable Development next week, it is important that human life is valued equally in the discourse and not weighted by market forces.

Anita Jain is the India editor, BMJ.