Global health status: two steps forward, one step back.

Impressive improvements have occurred in global health status in the past century. Unfortunately, these improvements have not been shared equally and health in equalities within and among countries are entrenched. The fragility of health gains has been seen in response to economic, political, and social changes changes, and civil disruption. The limitations of health-status measure hinder our ability to map health trends except in the simplest way. There is an urgent need for better regional and national health surveillance systems to underpin efforts to address the complex mixture of old and new health concerns.