We've taken on the major health problems of the poorest - tuberculosis, maternal mortality, AIDS, malaria - in four countries. We've scored some victories in the sense that we've cured or treated thousands and changed the discourse about what is possible.

Equity is the only acceptable goal

Haiti was founderd by a righteous revolution in 1804 and became the first black republic. It was the first country to break the chains of slavery, the first to force Emperor Napoleon to retreat, and the only to aid Simón Bolívar in his struggle to liberate the indigenous people and slaves of Latin America from their colonial oppressors.

The poorest parts of the world are by and large the places in which one can best view the worst of medicine and not because doctors in these countries have different ideas about what constitutes modern medicine. It's the system and its limitations that are to blame.

The essence of global health equity is the idea that something so precious as health might be viewed as a right.

I've been impressed, over the last 15 years, with how often the somewhat conspiratorial comments of Haitian villagers have been proven to be correct when the historical record is probed carefully.

Anywhere you have extreme poverty and no national health insurance, no promise of health care regardless of social standing, that's where you see the sharp limitations of market-based health care.