The renaissance in global health.

This decade is witnessing a renaissance in the research, development and control of infectious diseases of global importance. Starting with the availability of some existing tools (such as drugs for mass drug administration to treat communities for helminths) and fueled by the potential application of science to develop novel tools (such as vaccines for malaria and hookworm), the possibilities of what can be done across the research, development and implementation spectrum to achieve a global health impact is beginning to be realized. Crucial factors for this dramatic shift in attention and the potential for impact include the following:(i) Cross sector partnerships. Originally labeled ‘public–private partnerships’ to signify the synergy from engaging industry, research institutes and not-for-profit sectors in product development, in reality, the concept reflects engagement of resources and knowledge across industry, research communities, governments, non-profit organizations and disease-endemic countries. At the disease control phase, such partnerships include pharmaceutical commitments that enable governments to make the marginal investments required to deliver interventions.(ii) Impact and other data for decision making. From research to national priorities, the emphasis on data for appropriate investment and policy setting can help to focus resources for maximum impact. Evidence on the best way to use drugs in national programs is crucial to the credibility that such programs can be launched rapidly, and will be generated to support the scaling-up efforts needed to take successes from a single community to national-level impact. Proving that programs are scalable and cost-efficient will be essential to their ultimate sustainability.(iii) Leadership and champions. As reflected in the articles in this special issue of Trends in Parasitology and in a recent analysis by the Center for Global Development, both experienced and emerging leaders are essential elements in the process of leading to the potential success of global health programs.(iv) Industrial sector engagement. This renaissance is not owned by the public sector alone, and this perhaps signals the important transitions from ‘public health’ to ‘global health’. Industry is itself exploring a variety of engagement models, from the classical drug donation so vital to the onchocerciasis program, to the active participation in product development for malaria drugs and vaccines.(v) Increasing resources. A vital ‘necessary but not sufficient’ factor, the money that drives the global health renaissance comes from an impressive array of sources. Philanthropy has been important in starting and driving the product development partnerships. Commitments from the private sector have been crucial to that greatest of the global health challenges for this decade – the eradication of polio, a cause to which Rotary International, for example, is fully committed. Government resources are the most important driver of the biggest investments being made in the implementation of control and treatment of HIV, tuberculosis and malaria globally. Obviously, these resources include the donor community (the Global Fund for AIDS, Tuberculosis and Malaria, and national commitments such as the President's Emergency Plan for AIDS Relief) but also include endemic government as the principal funder of country-specific health systems and implementation programs. However, innovative financing mechanisms are still needed to generate additional monies to meet the promises of global health.This is an auspicious beginning, and one that we are incredibly fortunate to be able to participate in. The goals of global health – driven by the commitment to equity and the vision of what is possible given these aforementioned essential elements – will not be met if we do not rise to meet that challenge as a world community. The causal pathway between a healthy family and national development is certainly more than a hypothesis, although the evidence linking these is often based on macroeconomic projections. However, there is little doubt of the opposite: that individuals and communities weakened by the impact of disease find it difficult to reach their promise. Thus, the progress documented in this special issue on global health is important not only for what researchers are achieving, but also for what they tell us is possible in the decade to come. These are worthy goals indeed and ones that are absolutely reachable.