ABSTRACT
The emergence in recent years of the “Global Health Sciences” field (or various versions thereof) in lieu of “International Public Health” has entailed a concomitant shift in focus of health interventions that potentially diminishes the strength and visibility of national public health programs. Although some have argued that this change in nomenclature reflects no more than old wine in new bottles (Brown et al. 2006), globalization itself (reflected in this redefinition of the field) has spurred at least three structural changes in health delivery systems that marginalize, or minimally overlook, national public health programs (Adams et al. 2008; Novotny 2007). One of these trends is the globalization of pharmaceutical and biomedical research, which augments local participation in clinical trials research but diverts resources from national public health programs (and, in the worst case, enrollment in clinical trials becomes the only way for the poorest to gain access to health resources) (Petryna 2006). Another trend is the growth of small-and large-scale NGO-based health and development organizations, which cumulatively pose a risk to the role played by large multilateral and bilateral aid organizations in helping countries design and deploy effective policy and practice through public health measures (McNeil 2008). A third trend is the rise of biosecurity programs in the guise of health interventions, which run the risk of undermining integrated health development programs by diverting resources to proposed (or imagined) biological threats response preparedness (King 2002; Lakoff 2008).
