W e are living in a golden age of science, with remarkable advances in every scientific field. These advances can and must play a central role in addressing the great challenges of the 21st century: inequality, climate change, pandemics, biodiversity loss, demographic shifts, antimicrobial
resistance, food security, energy and water scarcity. It has been an honour and pleasure to bring together the diverse voices in this special section to explore these issues. However, despite this golden age there is a growing danger that with science increasingly concentrated in a small number of wealthy countries, rather than being a lever to reduce inequality, science may instead exacerbate it. This concentration of scientific capacity compromises not only global equity but also our collective ability to address challenges that transcend borders. If ‘science is done somewhere else, not here, and not by me’ mistrust will grow, and we will fail to maximise the potential for science to address the collective challenges we face and ensure equitable progress, collective security and opportunity. The choices that countries make today about science for health and economic growth will define the health of their communities, their economic growth and national resilience in the 21st century and our collective security. We can choose to concentrate scientific capacity in a few countries, allowing inequality to grow, or we can work together to ensure that every country has access nationally or regionally to the scientific foundation needed to protect its people’s health and build prosperity. The national paths forward require honest leadership to meet the challenges that countries face and equally honest investment that matches warm words to address those challenges through science. This is not just a moral imperative – it is the only pathway to a secure, prosperous and healthy future for all. Can any country afford not to invest in science? Jeremy Farrar
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Health: A Political Choice – The Future of Health in a Fractured World
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