It is a Small World: Global Medical Education for the Twenty-first Century

• Main Author: Stephen J. Atwood
• Other Authors: The Pennsylvania State University CiteSeerX Archives
• Format: Text
• Language: English
• Subjects: Avian flu
• Online Access: http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.597.4242; http://www.einstein.yu.edu/uploadedfiles/ejbm/21atwood38.pdf

Last year’s epidemic of the Severe Acute RespiratorySyndrome (SARS) virus in Asia and the presentworld-wide concern about the spread of the H5N1 avian flu virus has brought international health concerns to the front pages of national and international news-papers, newsmagazines, and health journals around the world. Add to this the global Human Immunodeficiency Virus (HIV) epidemic, the global resurgence of tuberculo-sis (TB), and the disturbing increases in antibiotic-resistant bacteria, and it becomes difficult to imagine the com-partmentalized world of even 30 years ago when dis-eases of different continents stayed in their place. Today, more than one million people cross international borders each day (not including refugees and displaced persons). Air transport guarantees a rapid transit of both person and pathogen well within the incubation period of many diseases. Body-heat detectors used recently at immigra-tion points (e.g., Singapore and Hanoi) to detect febrile passengers are symbolic of the coarse screening attempts being used to control the movement of contagious diseases. As the mobility and transportability of diseases have changed, so has the idea of international health, from the arcane study of rare communicable and usually trop-ical diseases to a concept of global health for the global public good. Global public goods are defined by 3 gen-eral criteria: nondivisibility, nonexcludability, and nonri-valry in consumption. Nondivisibility indicates that all members of society will benefit from the good; nonex-cludability means that it is not possible to exclude any group or individual from the benefits; nonrivalry in con-sumption means that the ability of one person to bene-fit from the good does not interfere in any way with another person’s ability to do the same (Kaul et al., 1999;