Prologue: Affording access to essential medicines in a global economy represents a twofold challenge. Pharmaceutical therapies have played a rapidly increasing role in health care generally in the past generation. Even in prosperous countries, public and private financing systems have struggled to keep pace with the growth in spending driven by biomedical innovation. At the same time, the pharmaceutical industry has become ever more visible as the epitome of global enterprise-at times wildly successful but also jolted by price transparency, scrambling to adapt to evolving trade and aid arrangements, and goaded by a flow of information on the Internet and in the media that makes it impossible to ignore the consequences of inadequate access to medicine in poor countries.
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