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The delivery of health care is a major international issue. Not only is the cost of the provision of this service increasingly burdensome, the way in which it is apportioned has become the subject of both ethical and practical consideration. Currently, this matter is dealt with by governments, professional associations, individual pharmaceutical manufacturers, private insurance companies and charitable foundations but there has not been an overarching or underpinning set of principles that are accepted as the guidance for the promulgation of this aspect of social welfare. In particular, the ethical principles which guide the well meaning activities of these organizations rarely, if ever, openly discuss the issue of fairness in the provision of aid and support to those in greatest need.