There is at the global level a very small number of actors who can meaningfully weigh in on global institutional design, who are able - through powerful governments and most effectively through the government of the United States - to exert substantial influence on international negotiations, which are routinely conducted behind closed doors.

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.

For the present system to work, poor people must be excluded from the innovation, because if they could get access at an affordable price, then affluent people would find ways to buy it cheaply as well - and then the innovator would be poorly rewarded and introductions of new medicines would decline.

Think of US slavery in 1850, or the subjection of women. Both of these injustices could have been - and were! - defended by pointing out, quite correctly, that this situation of slaves and women had been improving throughout the preceding century. Slaves, in particular, were worked less hard, beaten and raped less frequently, better fed, and less often ripped apart from their families. So would a celebration of moral progress have been appropriate in 1850? Surely not. Slavery could have been and should have been abolished - then, if not before.

The bottom quarter of the human population has only three-quarters of one percent of global household income, about one thirty-second of the average income in the world, whereas the people in the top five percent have nine times the average income. So the ratio between the averages in the top five percent and the bottom quarter is somewhere around 300 to one - a huge inequality that also gives you a sense of how easily poverty could be avoided.

We have the ability now to arrange global economic institutions so that poverty declines to a fraction of what it is now.

Domestic and supranational regulatory capture leads to two things: on the one hand, to an inequality spiral where the rich get richer because they can influence rulemaking and rule application in their favor; on the other hand, it also leads to instability. This is so because the relatively few organizations capable of influencing supranational rulemaking through the lobbying of major governments have diverse interests. This will, in some cases, lead to compromises. But it will also lead to spheres of influence.