There is persistent and growing concern that the benefits of the advances in health technology are not reaching the poor. The emphasis of the developed world is naturally on the solution of the problems that affect it predominantly. This is in spite of the evidence of the heavy burden of disease on the poor, which in addition to being one of the more egregious manifestations of inequity, could undoubtedly affect overall global stability. There is convincing evidence of the poor bearing a double burden of disease, but there is still no indication of adequate research and development to address the Type II and III diseases: Type I. diseases are incident in both rich and poor countries with large numbers of vulnerable populations in each - Type II. diseases are incident in both rich and poor countries but with a substantial proportion of the cases in poor countries - Type III diseases are those that are overwhelmingly or exclusively incident in developing countries. This growing focus on the diseases of the poor has led to examination of the relationship between intellectual property rights,2 innovation and public health, and the gap in the innovation cycle with the concern that the commercial incentives provided by intellectual property rights have not resulted in sufficient improvements in public health in developing countries or to access to the benefits of innovations that take place in the developed world. The Director-General of WHO established an expert working group to address some of these challenges in the context of the Global strategy and plan of action on public health, innovation and intellectual property. [Ed.]