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Dealing with terrorism: a public health agenda
  1. School of Public Health, The University of North Carolina at Chapel Hill, School of Nursing, Carrington Hall 7460, Chapel Hill, NC 27599, USA (milio{at}

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    For the public health community, the terrorism wreaked on the United States is stunning, but not necessarily surprising. It was a shrieking reminder to us all that desperate and hopeless peoples will follow extremist minorities, that poverty and insecurity, compounded by smoldering pockets of war and the cautious engagement, if any, by the rich world breeds the destruction of 11 September. That horror spread its message in nanoseconds across the world, evoking cries of alarm and sorrow, life sacrificing rescues, and loud calls for vengeance and a “crusade” to counter the “jihad”, expending more material and human resources for more death, disability, and damage to the lives and futures of thousands, perhaps millions.

    Our commitment to the promotion of health and prevention of human and environmental damage calls us to join those whose voices are muffled in the mass media, those who claim another way, those who call for serious peace work and the conditions that can bring it about.

    Clearly, the immediate priority in the terror for the public health community was and is to attend to survivors and their families and the protection of environments to avoid further injury and illness to rescuers, securing the necessary infrastructure—air, water, sewage and sanitation, transportation and communication.

    Secondly, we must now—if we ever had doubts after decades of research and experience—work with renewed energy to prevent the anger and hopelessness that fosters extremism and finds solace in its crimes. But not, as many would lead the world, with terrorists' tactics. Rather let us use our own tested tools: working for policies and with organisations that will bring basic humane and healthful living conditions to communities—secure housing, safe environments, food security, education and health care—to those in our own rich countries who are deprived; let us lead, encourage, and sup-port the same efforts in poor countries.

    To reallocate national budgets in both rich and poor states, as we are doing, to wage a vaguely targeted war on terrorism will only confirm the claims of the “Great Satan” myth. A shift toward war in the US will mean further reductions in already meagre funds for social concerns (because the new money is not likely to be drawn from a repeal of recent tax cuts), diminishing the already threadbare hopes of 37 million Americans living in poverty, including one in five children, the one in three families facing housing hardship, the 44 million without health insurance. These are the grounds of anger and hopelessness.

    Thirdly on a public health agenda to eradicate the allure of terrorism is to use 21st century information technology to join the globalising net of organisations that seek to humanise state policies and world markets, to end the rush to commodify everything from genes to environments. Locally and globally, we must raise the message persistently to publics, the media, and policy makers: that there can be no peace without social justice, the fair sharing of the goods and goodness that we have. Let us give leaders in communities and those in intergovernmental forums the political courage to dissent from a war regime and support social justice and criminal justice under law. Every move we can make, everywhere, toward a just society nourishes hope, calms rage, helps ensure a peaceable future for us all.