The College now has a significant global reach with members in 91 countries and since its inception has been involved in addressing social and public health issues. The global nature of communicable disease challenges have been highlighted by the increasing number of Ebola cases in West Africa, anticipated to worsen in the short-term, and its transmission to nurses in Spain and the US.

Contagion is an old problem, and it illustrates the essential links between public health and clinical practice, and the need for robust infrastructure to treat, prevent and control such a serious infection.

For clinicians in every country, while the likelihood of cases remains low, preparedness is everything and the safety of staff depends upon detailed planning in advance of possible cases occurring, rapid identification of cases, and meticulous use of full personal protective equipment.

For the countries most affected, with poor infrastructure, low levels of education and high levels of poverty, basic public health measures such as contact tracing and safe funeral practices are as important as international efforts to increase capacity in treatment centres and urgently develop vaccines.

Once Ebola subsides, re-building the health infrastructure in West Africa should continue to be a priority. This would prevent future outbreaks becoming so widespread and also address the many other prevalent preventable causes of death. An international challenge indeed.