The domestic power structure - how power is exercised in the United States, for instance - greatly influences the structure of international institutions. So, for example, the Clinton administration was very influential in shaping the WTO treaty, and, because of the way the US domestic political system works, this meant that corporations could use the US government to wield a huge influence.

For the present system to work, poor people must be excluded from the innovation, because if they could get access at an affordable price, then affluent people would find ways to buy it cheaply as well - and then the innovator would be poorly rewarded and introductions of new medicines would decline.

Our Supreme Court has lifted the practice of buying legislation to the level of a constitutional principle by repeatedly protecting corporate spending for and against political candidates, as well as promises and threats of such spending to bribe and blackmail such candidates, by appeal to the free-speech clause of the First Amendment.

The bottom quarter of the human population has only three-quarters of one percent of global household income, about one thirty-second of the average income in the world, whereas the people in the top five percent have nine times the average income. So the ratio between the averages in the top five percent and the bottom quarter is somewhere around 300 to one - a huge inequality that also gives you a sense of how easily poverty could be avoided.

It is irrational to charge high prices for socially valuable innovations as this guarantees that they will be underutilized. It is much better to sell them at cost and then to reward the innovator in some other way. This is not always possible, because in some cases the value of an innovation is in the eye of the beholder; it's very difficult to value how much a new Madonna song is worth, for example. But in the case of medicines, green technologies and seeds in agriculture, such an alternative reward mechanism is fairly straightforward.

Dictatorial regimes often manage to keep themselves in power because they are recognized by foreigners as representing the state and its people, and therefore as entitled to sell the country's natural resources and to borrow money in its people's name. These privileges conferred by foreigners keep autocrats in power despite the fact that they were not elected and do not rule in the interest of the population.

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.