There is a sentence that I still remember from one of myFrench geography textbooks in high-school: ‘‘Asia does notexist, has never existed, has never wanted to exist.’’Arguably, the first two clauses of this statement can beapplied to the Arab world. While we Arabs have wanted toexist as a single nation—this is what twentieth-centurypan-Arabism amounts to—we have never succeeded indoing so, our efforts having mostly spawned authoritarianregimes. Furthermore, only some us, mostly urban elites inCairo, Damascus and Baghdad, appear to have wanted thisunity. Maziak (2009) draws a list of health problemsplaguing our part of the world and rightly bemoans the lackof democratic practices and adequate social and institu-tional responses to these problems. He points astutely tosome underlying dynamics—women’s inferior social statusas a cause of honour crimes and poor physical and mentalhealth; authoritarian structures of government leading toflawed data collection with detrimental effects on healthmonitoring and so on. However, his diagnosis could havegone further had it not been based on a less convincingpremise, one that Maziak himself has brought to the fore:‘‘Understanding the complexity of generalizing to such avast and diverse region, there is a striking sense of unityand destiny among Arabs, and an ironic commonality ofproblems facing them nowadays.’’I see no evidence of such a sense of unity. Rather, whatis ironic is the lack of commonality in health problems,despite the shared language and culture. There is noescaping the fact that Yemen, Saudi Arabia, the UnitedArab Emirates, Lebanon, Iraq, Palestine and Libya—topick a few countries almost randomly—appear to havevery different health problems, which partly reflect the vastdifferences in their respective social, historical and geo-graphical settings. A central determinant of Palestinian andSouth Lebanese health over the last few decades has beenIsraeli occupations and military incursions (Batniji et al.2009; Giacaman et al. 2009). Women in Saudi Arabia areconstrained by patriarchal structures which are deeplyentrenched, give rise to severe restrictions on freedom andcan easily turn into abuse (Human Rights Watch 2008),while youth in Lebanon are subject to relentless tobaccoadvertising (Saade et al. 2008) and high levels of traffic-related trauma (Gerbaka et al. 1999). Islamist and secularpolitical organizations have moved to fill in a gap in theprovision of primary health care in countries where thestate is relatively weak but not in others (Jabbour et al.2007). Wars in Iraq, Sudan and Somalia over the lastdecade have led to the death and injury of hundreds ofthousands of civilians. Occupational injury and violenceappear to be significant health problems for foreignworkers in the Arab Gulf, Lebanon and Jordan, althoughpeer-reviewed research on this topic remains scarce(UNDP 2005). Palestinian refugees in some Arab countriessuffer from systematic institutional and legal discrimi-nation with significant health implications. Cairo, amegalopolis of over 15 millions, may have more in com-mon with Sao Paolo, Casablanca or Calcutta, than Sanaa,Ryadh or Baghdad. Indeed, many health and socio-eco-nomic indicators at the end of the Arab DevelopmentReport 2005 do reflect this wide variability (UNDP 2005).The premise of ‘commonality of problems’ alas blightsMaziak’s otherwise powerful and brave article.Many health dynamics are probably shared by a largenumber of Arab countries, without being mere reflectionsof broader globalization trends relevant to Asia, Africa and