Tourism, the world's largest industry, is expected to grow to 1.6 billion arrivals by 2020. Public health officials are only beginning to understand the challenges such growth will entail. This article argues that there is a unique and growing public health crisis associated with global tourism. The threat is not only to the tourists but also host societies and the tourists' home nations. Demographics, deforestation, deregulation, decentralization, privatization, and the fragmentation of power pose a dreadful urgency to dealing with this issue. Studies of warning and advisory mechanisms, authority and political will of international bodies, and the overall importance of tourism to most nations illustrate that regulation and coordination are eroding as the need for international collaboration grows. The study concludes with an action agenda for attempting to deal with this crisis.

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Rebuilding tourism requires more than a technical process of repairing facilities, negotiating investments, and marketing. The nature of the political unrest and what if any role tourism played in it must be understood. This article uses the experiences of the Philippines, Sri Lanka, and Pakistan to demonstrate the complexity of the issues involved. With each case the factors that exacerbated the problem for tourism development are noted and suggestions are made as to what steps need to be taken to provide a better foundation for future tourism.

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