Coordination among levels of governments is almost non-existent.

There has not been an era in history when the importance of public health has been more critical than it is today. Hugh Tilson and Bobbie Berkowitz lay out the challenges.

Here's Challenge 1: the public health infrastructure, basically rests with governments at the national, state, provincial and local levels. Why is it not surprising that coordination among these levels is almost non-existent and certainly insufficient for a collaborative plan to emerge easily in the event of an incident of "national significance"? In neither country has the national government been able to take the lead in driving solutions to public health initiatives.