Strengthening public health education and training to improve global health.

Public health training and education have existed for over a century,1 yet there is little systematic evidence on whether current approaches prepare graduates to improve health by developing, evaluating and implementing effective and equityoriented public health programmes. There are three reasons to document and debate this topic worldwide and disproportionately focus on lowand middle-income countries. The first is that the global health workforce is in a state of crisis. The World health report 2006 describes this situation as a “major mismatch” between population needs and the available public health workforce in terms of overall numbers, relevant training, practical competencies and sufficient diversity to serve all individuals and communities.2 In many countries, public health programmes led by clinicians with little or no public health training are plagued by poor management and ineffective resource allocation. This cannot be overcome by simply building on current policies: government oversight must ensure proper recruitment for public health jobs, and new models are needed for pre-service and in-service training. What information is available to guide reforms and ensure goals are met? The second is that there is increasing demand for well-trained public health professionals that can address the changing context of global health challenges, including complex and persistent health problems, increasing health inequities, new and emerging diseases, necessity for greater collaboration, and incorporation of social models and determinants of health.3 What advances equip graduates to anticipate and respond to these and other challenges? Thirdly, such debate allows networking among schools, public health agencies, policy-makers, student groups, professionals, United Nations agencies and other organizations. These groups include the World Federation of Public