Who delivers public health?
Contemporary policies and players
When you board an international flight do you consider how many people are involved in your safe transportation from one place to another? First, there is the travel agent from whom you purchased your ticket, then the airport shuttle bus driver who gets you to the airport. At the airport are the check-in staff; the security, customs and immigration staff; the employees of foreign exchange and duty-free shops; and airport cleaners. To get the aircraft ready for departure requires the contribution of engineers, refuellers, baggage handlers, catering staff and cleaners. Then there are the pilots, other aircrew and cabin staff who ensure that your flight is safe, welcoming and provides for your many needs while flying. Before you even get onto the runway, staff members in the air traffic control towers ensure your aircraft can safely share air space with other aircraft and also land safely. A similar number of people are involved at your destination and any stopovers in between.
Public health is a similar story, in that the length and quality of our lives depend, in part, on numerous interactions between many different people and organisations with complementary roles to play. One can think of a catastrophe being a test of the design and capacity of a public health system, but so are the changing standards and patterns of health and illness in a society. Designation of roles of who can be expected to be responsible for what matters is a key concern in public health, ensuring that the various people and organisations work together as part of a system, and if those roles are changing for whatever reasons (for example, to increase efficiency or adapt to new technologies or social values), we need to be aware and ready