A new campaign aims to highlight and tackle the increasing globalisation of health problems.

As NHS staff struggle to keep pace with the medical fall-out of the typical British winter, they might be forgiven for dismissing the problems of malaria in Africa or polio in India as remote and irrelevant.

But a UK campaign, launched last month, wants to bring global health concerns right home to the NHS. It is urging healthcare managers not simply to pay lip service to worldwide health problems but actually to consider their impact in local health improvement plans.

The UK Partnership for Global Health has been forged from an alliance of organisations, including the Nuffield Trust and the Royal College of Physicians.

Launched at a conference hosted by the RCP in London last week, it won the blessing of Gisela Stuart, the junior health minister responsible for international issues. She pledged Department of Health support for the drive to improve access to health 'not just locally and domestically but globally'.

The partnership is the culmination of 12 months' research by the Nuffield Trust on the effects of globalisation - or the growing irrelevance of national borders - on health.

'Globalisation is determining the conditions for health beyond the reach of national governments, ' John Wyn Owen, secretary of the Nuffield Trust, told HSJ.

Making something happen involves uniting the NHS, the government, voluntary organisations, universities and business interests - including the pharmaceutical industry - in a combined effort to raise awareness of global health issues. The UK is ideally placed to take a global lead on the challenge, the partners argue, because the NHS offers a more relevant healthcare model than the US private system, while our royal colleges, medical schools and pharmaceutical companies are world leaders in their fields.

Plans include supporting trade and aid for global health and improving understanding of global health threats through more research, Internet-based information and an international award for contribution to world health.

The health threats are well outlined in the 16 papers resulting from the Nuffield Trust's research, which have been released as a report and placed on the charity's website.

As trade, finance, culture and technology ignore traditional borders and barriers, so infections are spreading faster, new multidrug resistant diseases have emerged and the divide between rich and poor is growing.

TB rates have doubled in some London boroughs, mainly due - researchers believe - to increased immigration from the Indian sub-continent.

British tourists, meanwhile, have brought infections ranging from cholera and lassa fever to typhoid and malaria back with their holiday souvenirs. And anyone with access to the Internet can discover in minutes how to manufacture biological weapons which could have devestating effects.

'The impact of globalisation on health is likely to be very longterm and it is often irreversible in terms of effects on future generations, ' Michael Adler, professor of sexually transmitted diseases at University College London, warned the conference.

It is the poorest people in the poorest countries who are most often the victims.

More than 70 per cent of disease in sub-Saharan Africa is due to infectious - mainly preventable - diseases, like TB, measles and HIV, he explained.

More than 23 million people in that part of the world, plus 6 million in Asia, are now living with HIV. It took only a few years after AIDS was first reported in the US for HIV to take hold worldwide.

But as Nigel Crisp, director of the NHS's London region, told the conference, today a bug can 'hop on a plane in Peru, enjoy a stop-over in the Caribbean and arrive in London tomorrow afternoon'.

Mr Crisp, who has helped lead the project, made it clear that the NHS should be driven to take account of globalisation by both altruism and self-interest.

Britain should be educating doctors and nurses from overseas to return to their native countries, rather than 'asset stripping' them from abroad, he urged.

The UK should use its influence and leverage to tackle global health concerns. But at the same time, health authorities should use HImPs both to outline how they could minimise global health problems and deal with their effects.

A pilot health impact assessment by London regional office, produced as one of the research papers, explores both how London's health is damaged by globalisation and how London contributes to the problem. The 50,000 travellers arriving at Heathrow each day bring in infections like TB and HIV, while the City's financial institutions contribute to the growing world income gap which exacerbates health problems in the poorest countries, it shows.

As Dr Sue Atkinson, London's public health director, pointed out: 'Globalisation is very much a two-way street.'

The same can clearly be said for the impact of Britain's pharmaceutical industry, which is second only to Germany in exporting medicine. The profit motive and the rules on patents put life-saving medicines like the antiAIDS drug AZT beyond the reach of people in the developing world, the research suggests.

But Dr Trevor Jones, director general of the Association of the British Pharmaceutical Industry which has pledged support to the partnership, was at pains to point out that drug companies were also helping the developing world fight disease with projects like Merck Sharp and Dohme's donation of free drugs to fight river blindness in developing countries.

'We need to get together on the project and stop throwing bricks at each other, ' he said.

Pharmaceutical companies were part of the problem, Mr Wyn Owen agreed. 'They are also part of the solution.'

Global health: a local issue. Nuffield Trust, 59 New Cavendish Street, London W1M 7RD and