Developing regions such as sub-Saharan Africa are a hotbed of diseases such as malaria and AIDS. Neither the people nor the government can afford the drugs to treat the sick, or the simple measures needed to prevent them. With much of the population chronically ill, hospitals and clinics are overcrowded with illnesses of all kinds. When citizens are ill they cannot contribute to GDP, they become a drain on resources, trapping their regions in poverty once again. Geography is not without fault. Most of Africa's poor nations and many other developing nations are “hampered by high transportation costs because they are landlocked; located in high mountain ranges; or there is a lack of navigable rivers, long coastlines or good natural ports” (Sachs page 59). Countries obviously cannot change their physical location, and are therefore becoming dependent on surrounding areas and governments to make transportation accessible and feasible, while avoiding imposing strict border laws and taxes. Many citizens of rich nations do not take into account how fortunate they are to simply live where they do, almost all of the richest nations in the world are rich due to their access to trade routes. Of course, governments in trapped countries play an important role and tend to be among the most corrupt on the planet, but even countries that want reforms often fail to achieve them. With the country's resources completely depleted, any kind of reform becomes almost impossible. You can't create tax-free medical, educational, or savings programs, and you can't tax those who live on less than $2 a day, and so, once again, the cycle