Public health is the organized eVorts made by society action to protect and promote health in this era of globalization. to prevent and control disease and promote health at the population level. Unfortunately, the practice of Globalization interacts with other important and inter-related determinants of population health status: public health has yet to ful® l its potential to improve the health of poor and disadvantaged populations demographic changes, especially population growth and the ageing of populations; global environmental (1, 2). Worldwide, there is a tremendous burden of preventable premature death and disability that is way changes; the new and old epidemics of infectious diseases; and the emerging epidemics of nonbeyond the ability of individualized health services, in even the wealthiest countries, to deal with. Many councommunicable diseases. Although there were impressive and unrivalled gains in health status worldwide in tries are overwhelmed by indebtedness, and one longterm eVect of structural readjustment processes has the twentieth century, many populations in both poor and wealthy countries still have life expectancies and been the restriction of publicly supported health services. In the long term, the only eVective and equitable disease burdens typical of European countries a century ago. The relative disparity between countries in response to the global disease burden is to emphasize and strengthen preventive programmes. For this to life expectancy has improved only a little over the last half-century and health inequalities within countries occur a strong public health capacity is required in all countries, especially the poorest; a priority is the estabare increasing (4). The fragility of recent health gains has become apparent in the face of social disruption lishment of the surveillance mechanisms that underpin all public health eVorts. as a result of economic and political disarray, as in the former Soviet Union (5), civil war, as in the former The challenges facing public health practitioners have always been great. Today, they are even more Yugoslavia, or in the face of the ravages of HIV/AIDS. A major item on the un® nished population health daunting (3). Globalization, one of the key challenges facing public health practitioners and health policy agenda is the more than one billion people whose life experiences have improved only slowly over the last makers, refers to the increasing interconnectedness of countries through cross-border ows of ideas, comhalf-century. Infectious disease epidemics, most of which are, in theory, preventable with existing knowmerce and people; the increasing openness of countries to such ows; and the development of international ledge, are of special relevance to the poorest 20% of the world’s population that lives in Sub-Saharan Africa rules and institutions dealing with these ows. The current phase of globalization, dating from the late and Asia. HIV/AIDS, for example, has the potential to reduce life expectancy at birth by 30 years in 1970s, is marked by a more rapid increase in interconnectedness and more radical changes in the internaSub-Saharan Africa (4) and has already substantially eroded life expectancy in several eastern African tional institutional framework than previous phases. A priority for public health is to strengthen national countries.
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