There is a long tradition of global collaboration in biomedicine and public health. Examples range from medical outposts in rural communities run by foreign missionaries (Good 1991 ) to the early infectious disease programs of the Rockefeller Foundation (Fosdick 1989 ) and from medical services and training programs for indigenous populations set up by colonial authorities (Marks 1997 ) to the Pan American Health Organization (PAHO) established by a collective of sovereign governments (Cueto 2007 ).Two complementary sets of factors provide context for understanding collaboration in global public health : fi rst, the factors that inform globalization generally and global health specifi cally; second, the factors that shape ethical standards for global health programs generally and global health research specifi cally. Good examples of both factors are refl ected in this chapter's case studies.