ABSTRACT
Although Charles Dickens’s A Tale of Two Cities1 was published in 1859 and is set during the French Revolution in the late eighteenth century, the paradoxical and eloquent opening paragraph could easily apply to the beginning years of the twenty-fi rst century:
With two world wars, countless confl icts, terrorism, pandemics, severe recessions, poverty and socio-economic disparities, throughout the twentieth century people certainly experienced ‘the worst of times’. But, unlike in Dickens’s era, the twentieth century also witnessed major improvements in the standard of living, life expectancy, transport and communication, science, nutrition, education and, of course, medicine generally. Regrettably, however, the majority of people worldwide (well over 5 billion of an estimated world population of 7 billion) have not yet had the opportunity to benefi t from many of these achievements, and they continue to face many hard ‘winters of despair’.
