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Abstract
Globalisation is a defining economic and social trend of the past several decades. Globalisation affects health directly and indirectly and creates economic and health disparities within and across countries. The political response to address these disparities, exemplified by the Millennium Development Goals, has put pressure on the global community to redress massive inequities in health and other determinants of human capability across countries. This, in turn, has accelerated a transformation in the architecture of global health governance. The entrance of new actors, such as private foundations and multi-stakeholder initiatives, contributed to a doubling of funds for global health between 2000 and 2010. Today the governance of public health is in flux, with diminished leadership from multilateral institutions, such as the WHO, and poor coherence in policy and programming that undermines the potential for sustainable health gains. These trends pose new challenges and opportunities for global public health, which is centrally concerned with identifying and addressing threats to the health of vulnerable populations worldwide.
Acknowledgements
The author wishes to thank Drs. Linda Fried, Richard Parker, Marni Sommer, Alastair Ager, Wafaa el-Sadr, Lynn Freedman and Sandro Galea for their valuable comments on earlier drafts of this article as well as two anonymous reviewers for their suggestions. I am also grateful to Dr Julio Frenk and Prof. Gita Sen for their thoughtful commentaries at the Changing Landscape of Global Public Health meeting where this article was first presented.