Public health in the Arab world at a crossroad

The Arab world has been undergoing transformative changes since early 2011. Yet, the profound implications for public health are yet to be seriously debated. I first review socioeconomic and political characteristics that define the context and determinants of public health, and recent research and data on population health, disease burden, and health systems to draw a picture of public health today. I show that Arab countries have made important progress in health and development but important gaps remain. The current moment raises new challenges, for example related to destruction of public health infrastructure, but also opportunities, for example related to mobilization of health professionals as part of street struggle or newly-empowered political elites, revisions of the social contract, and proposals and plans for reforming or rebuilding social services. I argue that it cannot be assumed that public health gains would flow automatically from political and social change. This requires deliberate action by a new public health aligned with, or as part of, rising social forces. I suggest that public health is at a crossroad that touches on its ethos and purpose. While it is dominated today by an apolitical, technical, sectoral, professional and biomedical outlook and aligned with ruling classes, the public health that can respond to the current historical moment would need to be political, comprehensive, multisectoral, grassroots-based and multidisciplinary and aligned with the cause of justice. How we now develop the public health workforce and organize public health action need to be radically changed.