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154 Fighting the Diseases of Povertythose who want to import brand name drugs, of whichgeneric copies are sold in Kenya. Importers of ‘essential’medicines on the WHO list do not want brand name drugsto be imported because importers are afraid of competition.They know there is a vibrant market for these drugs, whichposes a threat to their commercial interests.A more fundamental question must also be considered:Why even define some drugs as essential and not others? Alldrug products are essential to those people who need them.Each disease requires personalized treatment. Our goalshould be to provide doctors with enough options to useexactly the right drug to fit the needs of each patient.Instead, the drug list seems to be designed to suit the needsof various vested-interests and pressure groups. As a result,the EML does not correspond with the actual demand fordrugs on the ground.Inadequate health insuranceHealth insurance enables individuals to pool their financialresources and thereby protect themselves against the risk of unexpectedand expensive illness. In return for monetary payment, aninsurer agrees to compensate the individual in a specified wayshould defined, uncertain events actually happen.When health insurance systems function well, demand forhealthcare increases because larger numbers of people are coveredagainst the costs of ill health. Several studies have shown the linkbetween greater uptake of therapeutic medicines among poor andvulnerable populations, and the availability of health insurance inthe United States (Department of Health and Human Services, 2002;Poisal & Chulis, 2000). However, many low-income countries do nothave properly functioning health insurance schemes. In 1998 notone low-income country with a gross national product (GNP) percapita below US $761 had a social health insurance scheme (Carrin,