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International co-operation in health
  1. André den Exter,
  2. Herbert Hermans
  1. Erasmus University Rotterdam, Netherlands

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    Edited by M McKee, P Garner, R Stott. (Pp 217; price not stated). Oxford University Press, 2001. ISBN 0-192-63198-5.

    International co-operation in health focuses on transboundary public health issues and examines the influence of global factors on human health. Historically, the earliest examples arose from changes in the natural environment such as climate changes during the last ice age. Other global events are less obvious but also had important implications (positive and negative) for human health, such as the widespread migration of populations, the enormous effects of international trade, war and civil disorder, or even genetic modified food on human health.

    Discussing these global influences, authors of several chapters describe the formal organisations and alliances that are developing to fill the gap between the globalised world and national governments. Suggestions for collaboration predominantly focus on UN structures, for instance, the WHO’s efforts in tobacco control, multidisciplinary groups working on global changes coordinated through the UN Environmental programme, and the work of the WTO. Other suggestions focus more on regional (EU) surveillance and prevention networks, responding to challenges posed by infectious diseases.

    We may question where the analysis takes us? Discussing these global factors, it becomes clear that globalisation is an extremely complex phenomenon. Although the effects on people may be clear, we still face many challenges when trying to quantify these consequences. The concluding chapter revisits some of the threats that are posed to the public health by globalisation and explores some of the opportunities it offers, in particular, how health professionals can come together to promote global public health. It looks at what health professionals can do to tackle these threats, highlighting principles for actions that encourage collective thinking, mitigating against isolationism and nationalism in confronting problems of society and environment. Finding an answer as to what health professionals can do, the editors advocate that health professionals need to be interested in the changes happening around them; need to look beyond their own national interest as public health problems and solutions have to be considered a global context. More concrete, they propose several valuable suggestions to find common solutions including undertaking research, communicating the information to the public in a clear and comprehensible way, and, most importantly, using this information to lobby for change.