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2.10 Medicine quality, physicians, and patients 124 ESSENTIALS Poor-​quality medicines negate the enormous advantages of modern pharmaceuticals and lead to avoidable morbidity and mortality; loss of confidence in medicines and healthcare systems; economic loss...

2.11 Preventive medicine 127 ESSENTIALS Causes of death Most deaths before age 80  years are preventable but preventive medicine cannot offer immortality. Childhood and early adult life Deaths from infectious diseases and trauma usually reflect poverty and pol...

2.12 Medical screening 137 ESSENTIALS Medical screening is the systematic application of a test or inquiry to identify individuals at sufficient risk of a specific disorder to benefit from further investigation or direct preventive action (these individ- uals ...

2.13 Health promotion 152 ESSENTIALS The ‘Ottawa Charter for Health Promotion’ (1986) remains a bench- mark for the global health promotion community, but the context for health promotion has changed with increasing recognition of the significance of inequitie...

2.14 Deprivation and health 157 ESSENTIALS The health of an individual is influenced by the circumstances in which he or she lives. Individuals who live in poverty are more likely to be unhealthy and die younger than individuals who are wealthy. The mechanism ...

2.15 How much should rich countries’ governments spend on healthcare? 161 ESSENTIALS The argument commonly made by politicians in richer countries is that a universal health system is unaffordable because of the enor- mous gains in life expectancy leading to a...

2.16 Financing healthcare in low- income developing countries: A challenge for equity in health 168 ESSENTIALS Low-​income developing countries remain challenged by the increasing demand for essential healthcare combined with gov- ernments’ inability to mobili...

2.17 Research in the developed world 177 ESSENTIALS The entire health system seeks to prevent disease, or diagnose and intervene effectively to limit its impact. The goal of most funders of medically related research in the developed world is to support re- se...

2.18 Fostering medical and health research in resource- constrained countries 181 ESSENTIALS Access to quality healthcare and education for all are essential elem- ents underpinning national development as well as prerequisites for personal well-​being. This m...

2.19 Regulation versus innovation in medicine 185 ESSENTIALS Two tragedies created drug regulatory authorities in the form they exist today. The marketing in 1937 of an elixir of sulphanilamide using diethyl alcohol as the solvent led to over 100 children dyin...

2.2 Evolution: Medicine’s most basic science 39 ESSENTIALS The role of evolutionary biology as a basic science for medicine is expanding rapidly. Some evolutionary methods are already widely applied in medicine, such as population genetics and methods for anal...

2.20 Human disasters 188 ESSENTIALS Human disasters, as massive misfortunes long recorded over history, have great importance for medicine, rightly prompting the call for prevention, relief, and practical intervention by medical personnel. But why do human dis...

2.21 Humanitarian medicine 193 ESSENTIALS Humanitarian medicine addresses the human consequence of crises such as conflict, disaster, or displacement, and serves to assist those whose lives and health are impacted by such events. It is practised in challenging...

2.22 Complementary and alternative medicine 201 ESSENTIALS Complementary and alternative medicine can be defined as diagnosis, treatment, and/​or prevention which complements mainstream medi- cine by contributing to a common whole, by satisfying a demand not m...

2.3 The Global Burden of Disease: Measuring the health of populations 43 ESSENTIALS To make the best decisions to improve health, policymakers need reliable, up-​to-​date information on the major challenges facing their country. The Global Burden of Disease st...

2.4 Large- scale randomized evidence: Trials and meta- analyses of trials 51 ESSENTIALS Reliable detection or refutation of realistically moderate effects on major outcomes often requires large-​scale randomized evidence As long as doctors start with a healthy...

2.5 Bioinformatics 67 ESSENTIALS Bioinformatics may be defined as ‘conceptualizing biology in terms of molecules and applying “informatics techniques” (e.g. applied mathematics, computer science and statistics) to understand and organize the information associ...

2.6 Principles of clinical pharmacology and drug therapy 71 ESSENTIALS In its widest sense a drug is any chemical entity that can perturb a biological system. For the purposes of drug therapy the biological system is the human body and the perturbation is expl...