Of the 4.8 billion people in developing countries, 2.7 billion live on less than US$2 a day while about 836 million (77% of population) in India earn less than Rs 20 (US$ 0.5) a day (1,2). The global disease burden is huge–about 14 million die due to infectious diseases and 10 million children due to vaccine-preventable diseases (3,4). Now chronic diseases–primarily cardiovascular diseases (32%) and cancers (13%)-account for 46 per cent of DALYs in poor countries (5). As poverty and health form a vicious circle, a major goal of the Millennium Development Project is to promote investment in health and health care (6). Over 1.7 billion mostly concentrated in Africa and India still do not have access to essential drugs (7). With the steady rise in number of poor needing health care and dwindling public sector spend, health care infrastructure in poor countries fast crumbling. The expenditure on health in India as % of GDP has actually decreased from 1.05 per cent (1985-86) to about 0.90 per cent (8). Currently, over 80 per cent of health care expenditure is borne by patients in India (9,10) through out-of-pocket expenditure with medicines accounting for 60-90 per cent for poor house-holds (11).