You can get an ice-cold Coke for around fifty cents in most developing countries, not just in the major population centers, but at the most remote and surprising places. The logistical challenges to resupplying all these outlets are enormous - and yet, the entire system works with incredible efficiency as is confirmed by the price of the product.

A few hundred years ago, perhaps 85 or even 90 percent of humanity lived below a standard of living that today only 40 or 45 percent fail to reach. But at that earlier time only part of this poverty could have been eradicated, and this at substantial cost not only to the pleasures of the affluent, but also to their well-being and to human culture. In our time, nearly all severe poverty could be eradicated at a cost to the affluent that is truly trivial.

You can think of the Health Impact Fund as a mechanism that would keep the benefits and burdens of pharmaceutical innovation for the affluent roughly as they are while massively reducing the burdens presently imposed upon the poor. This sounds like magic. But it really works because the current system is not Pareto efficient. It's a system that generates hundreds of billions of dollars in litigation costs and deadweight losses that HIF-registered medicines would sidestep. By avoiding these losses, the HIF reform can bring improvements all around - including for pharmaceutical innovators.

Given the total income and wealth available in the world today, we could easily overcome poverty, which would require raising the share of the bottom half from three to roughly five percent. Unfortunately, the trend is going in the opposite direction.

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.

In order to achieve something, in competition with the powerful and smartly wielded influence of corporations, we need to join forces and be as well-organized as they are. This does not come natural to us more intellectual types, as we tend to be averse to hierarchy and groupthink; we don't like to be part of anything like a disciplined and well-organized team or movement. But the alternative is to continue losing politically - which means continued failure to protect the world's poor, who are really bearing the brunt of our disorganization.

To make a proper moral appraisal of the prevalence of severe poverty today, we should focus not on comparisons with times past, when the global average income was much lower, but on a comparison with what would be possible in our time, given the current global average income and level of technological and administrative development.