Public Health Crisis: the Need for Primary Prevention in Failed and Fragile States.

OBJECTIVE: A new 'normal' in global affairs may be erupting from large global powers to that of non-state actors and proxies committing violence through scaled conflict in a post-Westphalian world generating significant global health policy challenges. Health security of populations are multifactorial and indirectly proportional to war, conflict and disaster. Preventing conflict and avoiding the health vacuum that occurs in war and violence may be best practices for policy makers. This paper considers an approach of applying clinical primary prevention principles to global health policy. METHODS: Brief policy review of current standards and practices in health security in fragile and failed states and prevention; and definitions discussion. A short case study series are presented with best practices, with risk and outcome review. RESULTS: The global balance of power and order may be shifting through geopolitical transference and inadequate action by major global power brokers. Health security in at risk nation-states may be decreasing as a result. CONCLUSION: Small scale conflict with large-scale violence threatens health security and may experience increased incidence and prevalence in fragile and failed states. Preventative policy to resuscitate fragile and failed states and prevent further external and internal shocks may support health and promote a positive feedback loop of further state stability and increased health security. Public health policy shift to mitigate state failure and public health crisis in war and conflict through the basis of primary prevention may provide best practices and maximize health security for at risk populations

Proglomena: Globalisation, cultural identity and diversity

Globalisation and the mass communication revolution of the last 40 years has made the world a much smaller place. It has brought diverse cultures, traditions and languages in far greater contact than was previously possible. The expansion of the free market economy and the growth of transnational corporations has also brought both East and West, as well as North and South in closer contact. While the potential for mutual understanding is great, so is the potential for conflict. The forces which shape cultural identity are varied and the challenge is to appreciate the influences that shape our values and beliefs so that we can understand ourselves. In doing so, we are in a better position to value diverse cultures, religions, languages and traditions and recognise their preciousness. This is important if globalisation is not to result in the growth of a monoculture that destroys the rich diversity of culture as well as our individual cultural identities