It is for the poor people's sake, above all, that we urgently need more unity and better organization and need to concentrate our reform efforts in order to really to achieve reforms, one by one.

Large multinational corporations, often acting through their industry lobbies, exert a powerful influence on the formulation of domestic rules and on their application - but their influence on supranational institutional design is even larger because it faces practically no opposition there.

If we offer a prize, so to speak, to anyone who manages to bring a country under his physical control - namely, that they can then sell the country's resources and borrow in its name - then it's not surprising that generals or guerrilla movements will want to compete for this prize. But that the prize is there is really not the fault of the insiders. It is the fault of the dominant states and of the system of international law they maintain.

With the Health Impact Fund, the innovation is paid for separately, through publicly funded health impact rewards, and the product is sold at the cost of production to all. Here, the cruel injustice of preventing the poor from buying at cost - evidenced by today's suppression of the trade in generic versions of patented medicines - would no longer be needed.

It seems far-fetched, even preposterous, to blame the global economic order for the persistence of severe poverty in countries that are ruled by obvious thugs and crooks.

We live in a world where economic positions - income and wealth - are very unevenly distributed, and this leads to the widespread persistence of poverty.

Companies are actually much better than governments and other bureaucracies at organizing in a holistically efficient way the extremely complex path from the examination of molecules all the way to the delivery of medicines to patients. Already in the conception and selection of research projects, companies would anticipate all the challenges down the line that they will need to overcome in order to achieve actual health impact. Bureaucratic organizations, by contrast, are notoriously bad at this sort of optimizing.