Global health is a continuously evolving field of study and practice, and learning materials replete with contemporary examples and a cosmopolitan view of health in all human populations are in high demand. Dr Armstrong-Mensah has broadly succeeded with this ambitious task in the form of her recent textbook, drawn from first-hand experience in both the developing and developed world, and from teaching students in graduate and undergraduate courses in global health. The book aims to distance itself from previous concepts of international health, a practice based on institutions based in wealthy countries attempting to deal with health issues in individual countries elsewhere, typically low- and middle-income countries. Instead, Armstrong-Mensah appeals to a concept of global health, which focuses on health problems that transcend national boundaries. This is broad in scope, taking in not only the infectious and maternal–neonatal health problems of international health but also including noncommunicable diseases and truly global epidemics such as HIV-AIDS, acknowledging that the burden of mortality and ill-health is still felt first and foremost in communities subject to poverty. Even in a highly unequal world, the ideal strategy is one of horizontal collaborations, involving all relevant actors and populations across a range of disciplines, cultures, and socioeconomic backgrounds. As such, the book gives a rich account of how globalization, food security, water, and sanitation play important roles in driving the global burden of disease, but also how gender, cultural practices, and ethical approaches such as human rights are increasingly recognized as important in global health. Even in the context of ambitious goals such as realizing the human right to health for all, factors such as discrimination on the basis of gender, age, nationality (especially in the context of forced migration), and disability create significant barriers. The chapter on global burden of disease measurement gives a solid background in current metrics for estimating population morbidity and mortality, with a focus not only on the significant burden of maternal, neonatal, and childhood disease but also on the growing fraction of noncommunicable disease. Here, as elsewhere, the book is informed by up-to-date data (eg, from the Global Burden of Disease study) and current World Health Organization priorities, with many of the figures drawn from World Health Organization resources and integrated with informative text and analysis. Similarly, the chapter on hunger, nutrition, and food security pays careful attention not only to relevant definitions and measuring strategies but also to current priorities for intervention, global action strategies, and challenges to their implementation. As Armstrong-Mensah emphasizes, although determinants such as nutrition play a crucial role in childhood development and long-term health outcomes, nutrition often gets less attention than it deserves, with high-profile single-disease categories often seen as a priority; even though cost-effective nutritional interventions are available that, if widely implemented, could have significant long-term benefits. Similar principles would apply to avoiding sedentary lifestyles within populations. This chapter also highlights other challenges, such as sudden changes in agricultural commodities in a globalized market, and how such macroeconomic factors have important downstream health effects, especially for vulnerable populations. Similarly, the chapter on water and sanitation gives a nuanced view on how these factors intertwine with gender roles (especially where women are primarily responsible for collecting water and/or washing clothes) as well as economic, social, and political drivers of ill health that ultimately culminate in endemic and epidemic disease. There has been some progress, although improvements in sanitation have been slower than the targets of the Millennium Development Goals, and improvements in access to clean water have brought significant benefits to many populations since the beginning of the 21st century. Armstrong-Mensah provides insight into the ground realities in countries such as Ghana, as well as significant background knowledge regarding the international political momentum required across many years from multiple stakeholders to achieve sustainable improvements in global public health, and how maintaining these improvements depends on ongoing motivation and financial support in the face of a growing global population. Interestingly, there was little mention of the growing body of evidence regarding links among climate change, water and food security, and disease, and this may be a consideration for future editions. Later chapters focus on health systems, financing, public–private partnerships, and governance and ethical issues, giving a picture of the complexities of current global health research and practice. Discussions of current global health partnerships illustrate the many currently ongoing partnerships among international agencies, private funding bodies, governments, and drug/vaccine developers that aim to reduce the incidence and disease burden of major pathogens such as HIV, tuberculosis, and malaria, as well as develop new interventions for emerging infectious diseases. Such partnerships have targeted important gaps in research, development, and implantation of interventions and, with support from funding bodies such as the Gates Foundation and the Global Fund, aim to ramp up disease control efforts. Armstrong-Mensah gives a balanced view, highlighting dramatic reductions in disease burden as well as the challenges of aligning the priorities of large global health partnerships with recipient country priorities in the long term. The critical tools of global health are but rarely turned on “Western” or Anglo-American culture. For instance, although it is mentioned that around US $750 billion dollars are wasted on unnecessary health care in the United States per year, there is little discussion of how this could be addressed, how this huge sum of money could be better spent (including on global health), or how cultural factors are largely responsible for the rising inequality, relatively poor health outcomes, and lack of universal health care in one of the richest countries in the world. If we are to take a truly global view of global health, we would do well to address health inequities and inefficiencies in the developed world as well as in developing countries, as is emphasized elsewhere in the book. That being said, Armstrong-Mensah gives an insightful treatment of global trends whereby noncommunicable diseases including those related to obesity are on the rise in all parts of the world, driven in part by social, cultural, and technological factors that have spread with modern globalization. Likewise, although the burden of infectious diseases is inequitably distributed and experienced most severely in disadvantaged communities, many infections—including drug-resistant tuberculosis, influenza, and other pathogens with pandemic potential—can spread anywhere with increasing international travel. The book rightly takes a view that future improvements in global health depend on solidarity, shared responsibility, and working together with those of other disciplines, backgrounds, and nationalities to preserve and promote public health. A consideration for future editions would be a chapter on surgery—essential treatment for one third of the global burden of disease. Global disparity is reflected in the fact that only 25% of patients with cancer worldwide actually get safe, affordable, or timely surgery. The inability to provide essential surgery, including cancer surgery, is estimated to result in 17% loss of gross domestic product—a catch-22 situation in developing nations that struggle to provide essential surgical services, let alone safe surgical services. Additionally, while improved safety in preventable anesthetic mortality has decreased by an order of magnitude from 1 in 10,000 cases to well under 1 in 100,000 cases, it stands in contrast to postoperative mortality, which remains common even in the developed world, with US national 30-day mortality among inpatients being about 2 in 100. In fact, if 30-day postoperative mortality were considered a distinct disease, it would be the third leading cause of death in the United States. In the context of increasing prevalence of cancer, 80% of cancer cases will need surgery. Furthermore, an estimated 1:4 people suffer major complications after surgery. By 2030, we estimate that annually 45 million surgical procedures will be needed worldwide. The commission on global cancer surgery, building on Global Surgery 2030, estimates that the failure to train more cancer surgeons and strengthen health care systems could result in as much as US $6.2 trillion in lost cumulative gross domestic product by 2030. Overall, Armstrong-Mensah should be congratulated for a textbook that provides a good introduction to the topic with contemporary examples that will be of interest to undergraduate and graduate students, as well as faculty members and practitioners in the important, expanding, field of global health. Euzebiusz Jamrozik, MBBS, FRACPDepartment of Anaesthesia, Perioperative and Pain MedicinePeter MacCallum Cancer CentreMelbourne, Victoria, AustraliaDepartment of General MedicineRoyal Melbourne HospitalMelbourne, Victoria, AustraliaMonash Bioethics CentreMonash UniversityMelbourne, Victoria, Australia Bernhard Riedel, MD, FANZCA, MBA, PhDDepartment of Anaesthesia, Perioperative and Pain MedicinePeter MacCallum Cancer CentreMelbourne, Victoria, AustraliaAnaesthetics, Pain, and Perioperative Medicine UnitUniversity of MelbourneMelbourne, Victoria, Australia[email protected]