A/HRC/11/12 page 7 the burden of disease in developing countries, nearly ten times higher than in developed countries.9 There has been a resurgence of tuberculosis and malaria in the last decade:10 58 per cent of malaria cases occur in the poorest 20 per cent of the world population and each year there are nearly 529,000 maternal deaths.11 13. The state of health correlates significantly with poverty. Public health spending in both high and low income countries benefits the rich more than the poor. People with the most means and often with less need consume the most care, while those with the least means and most need consume the least care.12 Over 100 million people fall into poverty annually because they have to pay for health care.13 In developing countries, patients themselves pay for 50-90 per cent of essential medicines.14 A report from WHO and Health Action International on the results of surveys undertaken in 36 countries reported that in the public sector only one third of essential medicines needed were available and in the private sector only two thirds of such medicines were available.15 14. Nearly 2 billion people lack access to essential medicines.16 Improving access to medicines could save 10 million lives a year, 4 million in Africa and South East Asia.17 The inability of populations to access medicines is partly due to high costs.18 In the context of HIV, as of 2007, only 31 per cent of people living with HIV who needed treatment received it.19 Furthermore, it is 9 WHO, Public Health Innovation and Intellectual Property Rights, A Report of the Commission on Intellectual Property Rights, Innovation and Public Health (Geneva, 2006) p. 3. 10 Ibid., pages 2 to 3. 11 Ibid., page 4. 12 See footnote 8 above, p. xiv, box 1. 13 14 Ibid. A/61/338, para. 75. 15 A. Cameron et al., “Medicine prices, availability, and affordability in 36 developing and middle-income countries: a secondary analysis”, Lancet, vol. 373, issue 9659, (January 2009), p. 240. 16 WHO, “WHO Medicines Strategy: Countries at the Core, 2004-2007”, (2004). 17 A/61/338, para. 37. 18 E. t’Hoen, The Global Politics of Pharmaceutical Monopoly Power: Drug patents, Access, Innovation and the Application of the WTO Doha Declaration on TRIPS and Public Health, Diemen, AMB, 2009. 19 WHO, Towards Universal Access - Scaling up priority HIV/AIDS interventions in the health sector, Progress Report 2008, p. 7.