The persistence of tropical diseases in an era that could have seen these largely eradicated is inextricably linked to poverty, inequality and global injustice. The root causes of such disruptive forces, and how they are perpetuated need to be recognized, studied and debated more constructively in order to make progress towards eradicating preventable diseases. Rather than focusing exclusively on such ethical considerations as what is right and wrong at the micro-level of the physician–patient relationship, ethical inquiry should be extended to include considerations of right and wrong behaviour within institutions and between nations – at which levels political decisions have a major impact on the health of whole populations. In a globalizing world the ethical imperatives that should be addressed include the need to relieve hunger, alleviate poverty and improve living conditions; reduce military …