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Migration of population has always been a public health issue. Historically, in Europe, it was a phenomenon of the Irish, of the Scandinavians, and of other groups who moved around to escape epidemics, or in search of a better life. Push and pull factors have operated for 200 years between the rural and urban areas, accelerated by technological change, war, and colonial enterprise. Today, the movement that begins in the villages of the southern hemisphere and ends in the cities in the North has become a global challenge to world development. Refugees and asylum seekers are at the top of the public health agenda, but as Levin says, they’re coming here to get away from us—to get away from our failures to support sustainable development in the third world. Unless we do much better, we are faced with fortress continents in the decades ahead.