It is now frequently observed that millions around the world die from preventable diseases, and that millions more suffer from poor health as a result of extreme poverty. However ‘health’ is defined and however it is measured – and there is considerable controversy about both defining and measuring health – the citizens of developing countries fare significantly worse than citizens of developed countries: life expectancy ranges from 40 (in some sub-Saharan African countries) to over 80 (in many western, developed nations); the number of doctors ranges from fewer than 5 per 100,000 people to nearly 600 per 100,000 (in many sub-Saharan African countries, and in Cuba, respectively); health expenditure ranges from less than US$3 per person per year to over US$5,000 per year (in many sub-Saharan African countries, and in the USA, respectively); and the infant mortality rate ranges from 3/1,000 in Iceland to nearly 200/1,000 in Angola (World Health Organization 2007). These statistics, even if well-known, are startling, and reveal the depth of the differences in health outcomes for citizens around the world.
The causes of the appallingly poor health outcomes in developing nations are complex, to say the least, as are the difficulties we face in identifying who, if anybody, is responsible for them and who should take on the responsibility to remedy then. For many, among them several contributors to this volume, it is increasingly clear that poor health in the developing world is not only a local problem, but also a consequence of multiple global decisions, for example, to permit global patents on life-saving drugs and to permit morally egregious healthcare- worker recruiting policies in the developing world.