Domestic power structures are shaped in good part by global arrangements.

The collective shortfall of the 3.08 billion people (47 percent of world population) who, in 2005, lived below $2.50 per day was $507 billion per annum, which indeed comes to about two-thirds of the present US military budget. This gives us a rough sense of how much the eradication of poverty would cost.

What is really nice about the Health Impact Fund is that it is a win-win, something that without much cost to anyone makes a lot of people better off.

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.

Though people could, in principle, cross national borders to reach places where their work is more highly rewarded, they are in fact prevented from doing so. As a result, huge differences also persist in the price of labor, as you can see when you get a haircut in rural India or hire a driver or babysitter in Bolivia. You can easily buy such services at one-fiftieth the price you would pay in London, Hamburg or Manhattan.

One citizen, or a few, may be powerless if all the rest are determined to benefit from the imposition of unjust supranational rules. But this excuse cannot work for large numbers. Just imagine 10 million US citizens saying in unison: "I am just one powerless citizen. There is nothing I can do to change my government's policies!"

This splendid book discusses how, in the last two hundred fifty years, large numbers of people have achieved levels of well-being that were previously available only to a few individuals, and how this achievement has given rise to equally unprecedented inequalities. Unique in its focus and scope, exceptional knowledge and coherence, and careful argumentation, The Great Escape is highly illuminating and a delight to read.