The world has witnessed enormous changes in population health in recent years. The main sources of disease burden are now non-communicable diseases, and death and injury from external causes such as accidents, homicide, and suicide.1 This shift has demanded entirely new organisational structures and expertise within the health sector at a time of great increase in technology and, consequently, in health costs. These changes have been especially difficult to assimilate in developing countries, which must also continue to deal with a large burden of communicable diseases such as AIDS. To overcome these challenges, the World Health Report 2003 recommends strengthening health systems by centring action on primary health care and by integrating health promotion and disease prevention across all levels of care on behalf of the entire population.2

The campaign to revitalise academic medicine offers an excellent opportunity to question how academics can respond to these challenges.3 4 The case …