Epidemiology and health policy in the Americas: meeting the neoliberal challenge

This paper analyses the anti-health policies and programs that are being pursued by neoliberal governments on a global scale, and that are being sold to the public by labeling them as "health reforms." The role of epidemiologists in this situation is to strengthen opposition to these anti-health reforms by documenting their effects on preventive and therapeutic health services and on the health status of the population. Major difficulties in this regard are discussed. There is a great need for epidemiologists to move boldly forward to attack the major diseases that afflict the Americas today. Two examples of high-priority programs are discussed: the achievement of safe water supplies by newly developed, low-cost community-based initiatives, and the long over-due organization of effective campaigns against cardiovascular disease. The establishment of specific, concrete Health Objectives at all levels of government--national, state/provincial, and local--must become the central focus of public health policy and action throughout the Americas. Epidemiologists are urged to take leadership in advocating and achieving this fundamentally epidemiologic approach.