Columbia University, Department of Epidemiology, New York, USA.
We are heartened by the vigorous responses to our call for epidemiologists to debate the implications of September 11 and its aftermath.1 The letter from Lopman and Tam2 is a good example, sharp and critical but constructive. We would underscore one of their points. More than ever, public health is a global endeavour, whereas the most powerful political structures are not; their base and interest is invariably national. As a result, even when in any particular instance public health and political objectives converge, there remains an inherent tension between the two.
To be true to the international mission of achieving health for all, our discipline must maintain a global and multilateral perspective, and cannot accept any narrowing of its focus to state-centred biodefence. Nonetheless, epidemiologists need to blend idealism with realism. While always eschewing crude opportunism, we are compelled to seek opportunities for improving public health. Our hand is strengthened when we can acquire political backing without losing sight of our distinct public health purpose.
References
1 Susser E, Susser M. The aftermath of September 11: whats an epidemiologist to do? Int J Epidemiol 2002;31:71921.
2 Lopman BA, Tam CC. Epidemiologists: clinging to coat-tails or donning them? Int J Epidemiol 2003;32:88081.