The COVID-19 pandemic has highlighted the fundamental role public health has in protecting populations and mitigating the impact of major threats to global health. We suggest that the COVID-19 pandemic response has raised important issues about the effectiveness and equity implications of current public health practice. We argue that we need to learn from that experience as we prepare for other infectious disease pandemics we could face this century. Furthermore, we argue that threats to global health in the 21st century extend beyond future infectious disease pandemics to include both the growing burden of non-communicable diseases – such as diabetes – that are linked to the pandemic of childhood obesity and the health impacts of climate change. Increased concerns about future infectious disease pandemics – along with the recognition of chronic disease and climate change as global threats to health – highlight the importance of developing a strategy to guide effective 21st-century public health practice. In this paper, we argue that the key principles of population health, largely drawn from seminal Canadian work that explicitly incorporates concepts of health inequities, complex causation and coordinated upstream intervention, can guide the development of effective public health practice for the 21st century.

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