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This lecture first inquires why governments should care about serious health threats outside their borders, and explores the alternative rationales. Second, I examine the compelling issue of global health equity, and ask whether it is fair that people in poor countries and regions suffer such a disproportionate burden of disease, disability, and premature death. Third, I describe how the international community focuses on a few high profile, heart-rending, issues while largely ignoring deeper, systemic problems in global health. By focusing on basic survival needs, the international community could dramatically improve prospects for the world’s population. Finally, I explore the value of international law itself, and propose an innovative mechanism for global health reform—a Framework Convention on Global Health.