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.

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.

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.

The Bank and the media continue to propagate the story that the global elite wishes to be told: that the number of poor has declined by 24 percent in those 15 years [1990-2005].

We should condemn as unjust a global economic order that leads to ever-increasing economic disparities - provided this effect is foreseeable and provided it is also avoidable through some alternative institutional design that would foreseeably lead to much less poverty and inequality. Those involved in designing or imposing the existing rules are collectively responsible for the resulting excess deprivations and human rights deficits.

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.

Often vastly more important, international agreements are not routinely published in draft form or publicly debated, and civil society organizations and ordinary citizens often learn of important global institutional design decisions only after they have already been finalized and adopted. The only reliable way to be kept informed and to exert timely influence is by lobbying and paying the politicians and their negotiators.