Globalization is a term often used in describing contemporary society, but it is frequently ill defined and misunderstood, and its definition is subject to argument. Indeed, its very conceptualization is “contested” (Buse and Walt, 2002, p. 42). It is frequently taken to mean the process of increasing global interdependency, but this is only part of the process of globalization as understood by contemporary social scientists. In the various descriptions and analyses of the effects of globalization that are found in the health sciences, interdependency, as manifested by increasing international transportation, is seen as the most salient feature that can affect the redistribution and movement of infectious disease. There is a fundamental tension that pervades both the popular and scholarly literature on globalization: globalization as a factor that promotes well-being and economic opportunity versus globalization as an alienating social force that marginalizes those at the periphery of societies.
What, then, is globalization? First, it is important to note that the health sciences could benefit from the explicit understanding of globalization as developed in international relations, political economy, political geography, and other disciplines. As noted in a recent article on the implications of the globalization of cholera for global governance: “an understanding of global health issues at the turn of the twenty-first century could benefit substantially from the voluminous literature on globalization from international relations, including the subfields of social and political theory and international political economy. This is a rich and voluminous literature. It documents what structural changes are occurring toward a global political economy, how power relationships are embedded within this process of change, what varying impacts this may have on individuals and groups…” (Lee and Dodson, 2000, p. 213). Clearly, then, globalization is something that is more profound than merely an increase in international interdependency and international connectivity. Moreover, changes in disease patterns that are the result of globalization are as old as globalization itself: many decades and perhaps centuries old, and the result of long-established historical transformations.
Globalization certainly contains elements of increasing global interdependency, the decline of international boundaries as deterministic social constructs, and the erosion of distance as an inhibitor of human interaction for some but not all segments of societies—though the effects of distance are highly variable, and some societies remain locally constrained. In addition, the term refers not only to increasing movement of goods and people or, as transportation geographers and regional scientists refer to such movement more generally, “spatial interaction,” but also to the movement of capital. What is the movement of capital, and why is it relevant here? The