groups, global case studies, and demonstration projects on public engagement, research enhances the esc expertise with respect to specific goals of the grand challenges. criticism as is the case with most health initiatives, the gcgh have been subject to a fair degree of criticism. a very widely circulated critique was published in 2005 in the lancet. in the column, anne-emanuelle birn, sc.d., an associate professor of public health sciences at the university of toronto, described the initiative's role as "weak" for focusing too narrowly on the power of science and neglecting the importance of economic, social, and political factors. she cites the 20th century cultural obsession with technological advancement as one that cannot ignore the need to redistribute economic and social resources within impoverished communities. she suggests that rather than trying to finance, develop and distribute new and existing vaccines, a more sustainable effort might focus on public support for a universal, accessible public health system. she references goal #4, which involves improved nutrition, as a specific challenge that is shortsighted and "overlooks key distributional questions". she explains that because malnutrition and famine are not the result of technical obstacles, but rather, political and economic ones, technology is not the answer. these issues are not about supply or the lack of nutritional value available in foods, but rather, poor income distribution and market shifts leading to populations unable to afford food. laurie garrett, in her article published in foreign affairs, says the main problem in global health was lack of resources but with the input of private players such as bill and melinda gates, there has been a major contribution to pressing health issues such as hiv, malaria, tb and others. although these contributions are useful, they also highlight specific diseases which are more high-profile or research that may fascinate the public. the bmgf initiative may have provided funds for improving health care but this is not enough to improve public health, as education and an all-disease health system are needed.