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Domestic power structures are shaped in good part by global arrangements.
Large companies are very good at solving extremely complex problems in a globally optimal way.
Income inequality matters more on a day-to-day basis. Wealth matters more for political influence.
We have the ability now to arrange global economic institutions so that poverty declines to a fraction of what it is now.
Severe poverty is getting better by some measures, but it's also becoming ever more scandalous because it is now so easily avoidable.
Economics is like a church, and it fulfills the same function the church had fulfilled for centuries: the justification of the status quo.
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.
We live in a world where economic positions - income and wealth - are very unevenly distributed, and this leads to the widespread persistence of poverty.
Whatever we, as prospective participants unaware of our specific features, would desire society to be like is what, morally speaking, we ought to institute.
It seems far-fetched, even preposterous, to blame the global economic order for the persistence of severe poverty in countries that are ruled by obvious thugs and crooks.
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].
It is perfectly consistent - and also true - to say that the world poverty problem today is smaller (relative to world population) than before and yet also a much graver injustice.
The collective income of all these people - the bottom half - is less than three percent of global household income, and so there is a grotesque maldistribution of income and wealth.
It is for the poor people's sake, above all, that we urgently need more unity and better organization and need to concentrate our reform efforts in order to really to achieve reforms, one by one.
Poverty persists, essentially, because the people at the bottom - the bottom quarter and also the bottom half - see the gains from the rising global average income wiped out by severe declines in their relative share.
If I were surrounded by angels who were purely rational and had no inclinations at all, I couldn't do anything for them. I couldn't make them happy; I couldn't make them sad, I would be entirely useless as a moral agent.
Countries compete in offering easy working conditions to their banks. In many jurisdictions, you can deposit money anonymously with no questions asked, even if the accepting bank knows that it derives from criminal activities.
We should not think of poverty eradication as a matter of collecting money and giving it to the poor so much as of reforming the global rules that are disadvantaging the poor and making it impossible for them to fend for themselves.
We citizens of the affluent countries tend to discuss our obligations toward the distant needy mainly in terms of donations and transfers, assistance and redistribution: How much of our wealth, if any, should we give away to the hungry abroad?
What we should do is require or at least permit innovators to license their green innovations free of charge in exchange for public payments based on the impact this innovation has on the environment - emissions averted or something of this sort.
Given the total income and wealth available in the world today, we could easily overcome poverty, which would require raising the share of the bottom half from three to roughly five percent. Unfortunately, the trend is going in the opposite direction.
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.
By seeing the problem of poverty merely in terms of assistance, we overlook that our enormous economic advantage is deeply tainted by how it accumulated over the course of one historical process that has devastated the societies and cultures of four continents.
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.
There exist better models of decisionmaking, for the governance of states, corporations and other large organizations, for example in Germany. We need to study such models and promising pathways on which our existing decisionmaking procedures can be gradually reformed.
The stunning thing about the world as it is, is that we have a tremendously large problem in it: namely, one-third of all human deaths, 80-million every year from poverty-related causes, trivial diseases and so on, and stunningly, nobody is really paying attention to it.
Drafts of domestic legislation must be published, debated and publicly voted on, which gives ample opportunities to civil society organizations and ordinary citizens to at least understand what's being proposed and to voice and to organize opposition before the decision is made.
Our international banking system allows banks to accept funds gained from tax evasion and other crimes and thereby facilitates and encourages embezzlement by public officials, especially in developing countries, as well as tax evasion and tax avoidance by multinational corporations.
Medicines are unusual commodities. Important drugs can save the lives and protect the health of millions. Their consumption can bring huge benefits, by helping patients to avoid infection and preventing serious damage to the economies of families, nations and even humanity at large.
I think one big improvement would be if we somehow made it cheaper and easier for developing countries to learn from the sad experience of some of the developed countries, and also from some of the positive experiences we have of building good transportation systems, like high-speed rail.
Large multinational corporations, often acting through their industry lobbies, exert a powerful influence on the formulation of domestic rules and on their application - but their influence on supranational institutional design is even larger because it faces practically no opposition there.
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.
Because present procedures by design favor the affluent, the poor are being increasingly marginalized. And because the poor are so marginalized, they can exert little influence on institutional design decisions. We need to break out of this vicious spiral and create momentum in the opposite direction.
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.
The collective shortfall of the 3.08 billion people (47 percent of world population) who, in 2005, lived below $2.50 per day was $507 billion per annum, which indeed comes to about two-thirds of the present US military budget. This gives us a rough sense of how much the eradication of poverty would cost.
The cost of research, development and testing of a new drug is vastly greater than the cost of each dose produced. How should we pay for new medicines? Innovators should be rewarded according to the impact of their medicine, and people should contribute to these rewards according to their ability to pay.
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.
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.
The fact that oppressive and corrupt regimes can borrow money in the name of the whole country means that the country's future generations will be weighed down by interest and repayment burdens, even if the money has been frittered away in some frivolous way, embezzled or used for weapons to suppress the country's population.
Governments and their hired negotiators are designing the supranational rules and pressing for their adoption and for compliance - and the US government first and foremost. These governments are elected by us, funded by us, acting on our behalf, sensitive to our will, and so, we are not mere bystanders observing the injustice.
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.
Competing companies evolve toward efficiency as the more efficient ones profit and expand while those who fall behind fail. And companies being efficient and profiting under the Health Impact Fund, this is exactly what we want, because the company's profit is directly driven by the health impact its registered products achieve.
One citizen, or a few, may be powerless if all the rest are determined to benefit from the imposition of unjust supranational rules. But this excuse cannot work for large numbers. Just imagine 10 million US citizens saying in unison: "I am just one powerless citizen. There is nothing I can do to change my government's policies!"
It's easy to complain that pharmaceutical companies place profits over people and apparently care more about hair loss than TB. However, many in the pharmaceutical industry would be glad for the opportunity to reorient their research toward medicines that are truly needed, provided only that such research is financially sustainable.
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.
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.
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.
There is at the global level a very small number of actors who can meaningfully weigh in on global institutional design, who are able - through powerful governments and most effectively through the government of the United States - to exert substantial influence on international negotiations, which are routinely conducted behind closed doors.
You can get an ice-cold Coke for around fifty cents in most developing countries, not just in the major population centers, but at the most remote and surprising places. The logistical challenges to resupplying all these outlets are enormous - and yet, the entire system works with incredible efficiency as is confirmed by the price of the product.
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.