There can be few politicians who remain unaware of how international issues can affect the health of their populations. The international dimension to health is also apparent through our television screens, as a global communications system can allow us to watch in real time the death of a child from hunger or violence thousands of miles away. In an increasingly integrated world, where the actions of one government can easily impact on the health of people living far beyond its borders, it is essential to have a means to tackle common challenges that is based on evidence rather than ideology. The global public health community must not remain silent in the face of the threat posed by the neoconservatives in Washington to international law and the institutions that are charged with upholding it. Unless things change, it will be much more difficult to make the world a safer and healthier place.