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As the rich get richer and the poor get poorer, advances in science and technology are securing better health and longer lives, but only for a small fraction of the world's population. This alternative world health report offers a comprehensive survey of the key areas that influence the health of poor and vulnerable groups in all countries. They range from climate change, water and nutrition to national health policies and services and the brain drain of health professionals from South to North. It is a call to action, including resource sections and recommendations for Health for All rather than for the privileged few. It challenges the major global bodies that influence health, including the World Bank, World Health Organization and Unicef. The real scandal, it argues, is that the world lacks neither funds nor expertise to solve most of these problems.