Because present procedures by design favor the affluent, the poor are being increasingly marginalized. And because the poor are so marginalized, they can exert little influence on institutional design decisions. We need to break out of this vicious spiral and create momentum in the opposite direction.

If you ask yourself who is paying for pharmaceutical innovation today, the answer is that it's the more affluent populations paying for still-patented advanced medicines at the pharmacy, for comprehensive insurance coverage or for a national health system.

Some of the developing-country governments and populations are tired of having things rammed down their throats, but we're not yet at the stage we want to get to, namely where the developing countries join forces with one another on behalf of creative alternative ideas about how to take things forward.

Over the period from 1988 to 2005, the income share of the top five percent has grown by about 3.5 percent of global household income, and the shares of all the other groups have diminished. The greatest relative reduction was in the bottom quarter, which lost about one third of its share of global household income, declining from 1.155 to 0.775 percent, and now is even more marginalized.

The collective income of all these people - the bottom half - is less than three percent of global household income, and so there is a grotesque maldistribution of income and wealth.

Critical journalism has gone out of fashion, or rather, it has been bought out. And so, we have much less of it than we did during the Vietnam era, where there was very critical reporting on the Vietnam War and a lot of disagreement among the media. Now you find that the media are much more homogenous, converging because they all must cater to the same community of advertisers. It's sad to see.

Car prices play a large role in calculating PPPs even while they play no role whatsoever in the consumption or consumption needs of the poor. And the prices of rice, bread and beans play a small role in calculating PPPs even though they play a huge role in meeting the consumption needs of the poor. So the World Bank's method of comparing and converting everything at general purchasing power parities into US dollars is highly distorting within an exercise whose purpose it is to determine whether households are or are not capable of meeting their basic consumption needs.