The extremely low respect Congress enjoys among the population indicates that the citizens understand broadly what's going on. But the lack of a realistic political reform path leads to apathy and the kind of mindless frustration that manifests itself in the Tea Party-style hatred of any and all government.

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.

To improve global health, it's not enough just to have a really good new product and to obtain marketing approval. You still need to market the product and bring it to patients, follow up, create the infrastructure, and so on - the whole pipeline, the network. That's something that companies are extremely good at: organizing a whole pipeline in a cost-effective way.

The bottom half of humanity is living in severe poverty; not all of them are malnourished or severely deprived now, but they are extremely vulnerable to even small upsets in their income or in the prices they face of basic necessities, and when something like this happens, they can be thrown off kilter in terms of a disease of a family member or a change in food prices; anything like that can throw them into destitution.

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.

Ordinary people like you and me can achieve very little on their own. We need to build support. Even if you are a thought leader and have some good ideas on how to make the world better, and even if you write five or ten books - that won't have much effect unless you have people who are willing to support your ideas.

I see a violation of human rights not in the mere fact that people don't have enough to eat and that they are very vulnerable, but I see it in the fact that the economic institutional order of the world is associated with this very persistent poverty and that different institutional arrangements at the supranational level could stop and even reverse the slide towards ever-greater income disparities.