Worsening economic injustice has become a fact of life in our current world and has a profound effect on health and health care in many countries. Dysfunctional health systems exist in most areas of the world. Many impoverished countries, especially those in Sub-Saharan Africa, spend so little on health care that it is impossible to provide even the most basic services for their populations. Many middle-income countries have complicated insurance systems or cover only salaried workers, leaving the majority of the population with very poor access to care.