Approximately two decades ago world health authorities met in Alma-Ata to discuss the unequal distribution of health and other global questions. The meeting produced a declaration that emphasized the role of primary care in the provision of health services. Furthermore, adequate socioeconomic support, such as availability of food security, clean water, appropriate housing, and education, were all considered integral parts of health development. After the meeting, the World Health Organization developed a programme called 'Health for All by 2000', outlining strategies towards maximal health improvements all over the world. Thereafter, individual countries have developed national modifications from this agenda, and global development of health has on average been favourable. In the economically least developed countries, however, progress has been significantly slower than elsewhere. This editorial discusses the problem of inadequate socioeconomic development and increasing global health disparity through an example from Lungwena, a rural area in Sub-Saharan Africa. In the 21st century, poverty reduction is the key strategy towards health improvement in the least developed countries.