News flash: the cards are stacked against the little people, and it’s bad for the world’s health.

That’s what a commission convened by the prominent medical journal The Lancet and the University of Oslo has found after two years of study. In a report titled “The Political Origins of Health Inequity,” the group concluded that the system of post–World War II “global governance”—for instance, the treaties and trade agreements that govern our increasingly globalized world—heavily favors corporations and powerful countries. And as a result, health has taken a hit.

One example: the issue of drug patents. Thanks to massive pressure from the United States and pharmaceutical companies, World Trade Organization rules now require all countries, save for the absolute poorest, to offer twenty-year patent protection on new drugs. The result: higher prices for medicine. Or consider the austerity measures imposed by the European Union and the IMF on Greece, which required slashing the country’s health budget by 40 percent, causing a public health crisis. Says the commission’s chair, Ole Petter Ottersen: “Health inequities…are exacerbated by the current system of global governance that places wealth creation over human health.”

This conclusion, endorsed by a journal best known for its measured, peer-reviewed articles, is radical, although its steps for action are not. To correct today’s global health imbalance, the commission has proposed the creation of two international bodies: one, under the auspices of the UN, for ensuring that health is considered in all global decisions, and another to monitor progress.

But the commission does offer one powerful piece of advice: in designing the post–Millennium Development Goal agenda, governments and donors should abandon their obsession with technical interventions. The MDGs are a series of ambitious global health and development targets, which have relied heavily on just such interventions. Ottersen warns that today’s “unacceptable health inequities” cannot be addressed “by technical measures…alone.”

With the 2015 deadline fast approaching and most targets still out of reach, governments and donors would do well to heed the commission’s warning: to fix health, we need to fix inequality.