spread democracy-and how to ensure the improvements continue. Never before have so many people, in so many developing countries, made so much progress. Most people believe the opposite: that with a few exceptions like China and India, the majority of developing countries are hopelessly mired in deep poverty, led by inept dictators, and living with pervasive famine, widespread disease, constant violence, and little hope for change. But a major transformation is underway-and has been for two decades now. Since the early 1990s more than 700 million people have been lifted out of extreme poverty, six million fewer children die every year from disease, tens of millions more girls are in school, millions more people have access to clean water, and democracy-often fragile and imperfect-has become the norm in developing countries around the world. The Great Surgethe remarkable story of this unprecedented economic, social, and political transformation. It shows how the end of the Cold War, the development of new technologies, globalization, courageous local leadership, and in some cases, good fortune, have combined to dramatically improve the fate of hundreds of millions of people in poor countries around the world. Most importantly, it reveals how we can fight the changing tides of climate change, resource demand, economic and political mismanagement, and demographic pressures to accelerate the political, economic, and social development that has been helping the poorest of the poor around the world.

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