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Infectious diseases have become less prominent as causes of death and disability in regions of improved sanitation and adequate supplies of antibiotics.

Some very poor countries run great vaccination systems, and some richer ones run terrible programs.

People are beginning to understand there is nothing in the world so remote that it can't impact you as a person. It's not just diseases. Economists are now beginning to say if we are going to have good markets in Africa, we're going to have to have healthy people in Africa.

Most problems in poor countries are locally generated even though international factors do play a role.

A health system that lacks commodities for managing high-mortality infectious diseases and the main killers of mothers and young children will not have an adequate impact. By the same token, even the best-stocked delivery system will have an inadequate impact if it fails to reach the poor.

I have seen this happen in recent years with regard to pharmaceuticals and vaccines, where, working together, we are improving access to medicines and vaccines for infectious diseases in the poorest countries.

In low-income countries, getting to a health post is hard. It's very expensive.

The biggest public health challenge is rebuilding health systems. In other words, if you look at cholera or maternal mortality or tuberculosis in Haiti, they're major problems in Haiti, but the biggest problem is rebuilding systems.

There are environmental threats to health; there are internal threats to health - genetic conditions, viral threats, diseases like cancer and Parkinson's. And then there are societal and global ones, like poverty and lack of nutrition. And unknown viral threats - everything from a new kind of influenza to hemorrhagic fever.

The 1 to 2 billion poorest in the world, who don't have food for the day, suffer from the worst disease: globalization deficiency. The way globalization is occurring could be much better, but the worst thing is not being part of it. For those people, we need to support good civil societies and governments.