Introduction

Several issues have to be kept in mind when reading this chapter. First, there are vast differences between the economically disadvantaged countries (Sartorius, 2001). In most of them, however, the gap between the richest and poorest parts of the population has grown over the past few decades and continues to grow. The health care for the poorest groups in the population has also become weaker and of poorer quality. In relation to pharmacotherapy this means that even when low-cost medications are made available the poor do not benefit from this, because the weakness of the health system makes it impossible for them to get to health care staff who could advise them and guide them in taking these medications.

Second, there are poor population groups in many of the rich countries, and at first glance they seem to be in a position similar to that of the poor in the Third World. This, however, is not so. The poor in the highly developed countries have access to some of the amenities that are considered exceptional and most desirable but rarely available in the Third World – such as the abundance of drinkable water and the minimal risk of contracting one of the many communicable diseases that kill people in the Third World, such as malaria. Not infrequently the poor in the industrialized countries have access to shelter and clothing provided by the often numerous humanitarian and religious organizations, such as the Salvation Army or the Emmaus organization.