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].

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.

America is run by the rich and powerful in their own interest. To an extent that I think is hard to exaggerate, the intellectuals - academics, journalists and so on - are bought off. And that's a big change that happened in the United States in the last 30 or 40 years.

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.

Critical journalism has gone out of fashion, or rather, it has been bought out. And so, we have much less of it than we did during the Vietnam era, where there was very critical reporting on the Vietnam War and a lot of disagreement among the media. Now you find that the media are much more homogenous, converging because they all must cater to the same community of advertisers. It's sad to see.

If the Health Impact Fund were to be instituted, a single company would be in charge of a medical product all the way from its conception to the health improvements realized by actual patients. The company would be paid for health impact, and it would have to arrange the entire pipeline in between - all the steps of invention, of clinical testing, of getting marketing approval in many different countries, of wholesalers and retailers and prescriptions and so on - in a holistically optimal way.

Some of the developing-country governments and populations are tired of having things rammed down their throats, but we're not yet at the stage we want to get to, namely where the developing countries join forces with one another on behalf of creative alternative ideas about how to take things forward.