THE COURSE OF global public health in this century can be summarized
in 4 words: spectacular accomplishments, spectacular inequities. Progress
has been so dramatic that more improvements in the health status of people
worldwide have occurred during the 40-year lifetime of a child born in 1958
than were accomplished during the "entire previous span of human history."1 Nevertheless, essential public health resources remain
inequitably distributed, and great disparities in health status persist between
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