Large companies are very good at solving extremely complex problems in a globally optimal way.

Purchasing power parities are not a reasonable method for comparing households across countries or currencies. The reason for this is simply that PPPs are sensitive to the prices of all the commodities, goods and services, that households are consuming worldwide, with each commodity weighted in the calculations according to its share in international household consumption expenditure.

Each powerful player, or coalition of players, will make concessions in areas where it has relatively less at stake in exchange for other such players making reciprocal concessions in other areas where it has relatively more at stake. Such trades are collectively rational insofar as they get each of the powerful players more of what it wants. But such trades are also dangerous because the whole international rule-system will become incoherent and therefore vulnerable to crises that will continue to become increasingly severe.

Feudalism is an economic system where a few people own all the land and the others have no option but to be serfs on such a feudal estate. We now condemn feudalism. We condemn not merely the feudal lords but we condemn the whole structure of rules that sustained feudalism. I am asking people to think similarly about the world economy.

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.

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.

In order to prepare for meaningful change, we have to look at both sides of the problem. We need to examine the output of our political system, which is often very hostile to the poor abroad and hostile also to the poor and middle class domestically. And we must also look at the procedures through which this output is produced.