  One striking feature of the state of global health is that there are large inequalities in health outcomes and opportunities for health. Consider that life expectancy can vary a great deal. A person born in Sierra Leone can expect to live about 40 years whereas one born in Japan can expect to live for 80 years.  Malaria has been almost entirely eradicated in high-income countries, but it still kills about a million people in developing countries (United Nations 2009). A woman in the Niger has a 1 in 7 chance of dying in childbirth, whereas this is 1 in 11 000 for women in Canada (Benatar and Brock 2011). The global burden of disease is by no means evenly spread nor does workforce capability correspond with areas of highest need. In fact many of the countries that suffer from the greatest burdens of disease have the fewest skilled healthcare workers. In addition, pharmaceutical companies do not spend their research and development budgets in ways that match where the needs are greatest. Rather, seeking the most profitable ventures, they are much more likely to spend resources developing drugs for lucrative markets where the payoffs are greatest, even when the marginal benefits to consumers are small. One example is the research and development resources pharmaceutical companies frequently spend on developing drugs that are similar to others already available, rather than developing treatments for diseases for which there are no cures. It is estimated that drug companies spend approximately 90% of their research and development resources in seeking treatment for about 10% of diseases (Drugs for Neglected Diseases Working Group 2001).