McNabb BMC Public Health 2010, 10(Suppl 1):S3 http://www.biomedcentral.com/1471-2458/10/S1/S3 Page 6 of 7 Figure 3. Envisioned Architecture of Global Public Health Grid. individuals to have real-time access to public health information that might impact their lives. Data management requires much more than invest- ment in technology; it involves how data are created, stored, moved, used, and retired. As opposed to the 20th century replicated database model, a federated model of public health information sharing allows multiple partici- pants to share data without having to give up ownership, thus accommodating universal access to public health information [24]. A federated model is a type of meta- database management system that transparently inte- grates multiple autonomous database systems into a single one. The constituent databases are interconnected via a computer network, and may be geographically decentralized. Since the constituent database systems remain autonomous, a federated database (or virtual database) is the fully-integrated, logical composite of all constituent databases. One mechanism to achieve this federated model is through a global public health grid (http://cdc.confex. com/cdc/phin2009/webprogram/Paper21091.html) (Figure 3). The goal of the grid is to improve population health by facilitating timely and reliable global public health information exchange. The global grid has the core principles of long-term sustainability; low barrier to entry (technically, ﬁnancially and socially); and uses a standards-based approach that is reusable, collaborative, and open source. Recommendations The way forward that addresses the gaps and challenges to achieve the end-state paradigm described here for comprehensive, eﬀective and eﬃcient, multiple-hazard global public health surveillance lies through incorpora- tion of these key principles: 1. People are key and listening is important – true partnership takes this into account. 2. Transparency builds trust and is crucial to success. 3. Mutual respect and mutual beneﬁt are vital and necessary. This includes a full recognition of data ownership, national sovereignty, and the rights of individual patients. 4. Competence, relevance, and a common language in public health practice are required. 5. A culture of responsible stewardship and quality data is mandatory. 6. While one-size-does-not-ﬁt-all, a set of core capacities does exist [25]. Each Member State should proactively