Public health challenges in a globalizing world (original) (raw)

2005, The European Journal of Public Health

Public health challenges in a globalizing world p Public health challenges are no longer just local, national or regional. They are global. They are no longer just within the domain of public health specialists. They are among the key challenges to our societies. They are political and crosssectoral. They are intimately linked to environment and development. They are key to national, regional and global security. Historically, disease in other places was seen as an impediment to exploration, and a challenge to winning a war. Cholera and other diseases killed at least three times more soldiers in the Crimean War than the actual conflict. Malaria, measles, mumps, smallpox and typhoid felled more combatants than did bullets in the American civil war. And the Panama Canal went over-schedule because of "tropical" diseases-then unknown, untreatable and often fatal. Today on that front, there are very few unknowns. Globalization has connected Bujumbura to Bombay, and Bangkok to Boston. In an interconnected and interdependent world, bacteria and viruses travel almost as fast as e-mail messages and money flows. There are no health sanctuaries. No impregnable walls between the world that is healthy, well fed, and well off, and another world, which is sick, malnourished and impoverished. Globalization has shrunk distances, broken down old barriers, and linked people together. It has also made problems half way around the world everyone's problem. And we know that, like a stone thrown on the waters, a difficult social or economic situation in one community can ripple and resonate around the world. Now, there are solutions for those diseases, which plagued the explorers, soldiers and colonialists of historical times. We know how to prevent and treat malaria. There are vaccines for yellow fever. There are treatments for TB. The striking feature is: while we diligently take antimalarials and top up our vaccinations when we travel to developing countries-the people living there, those threatened most by these diseases-don't have this access. 3,000 Children in Africa die each day from malaria. They die of vaccine preventable diseases-like measles, by the hundreds of thousands. And, people are dying, by the millions every year, of HIV/AIDS.