Setting health priorities

The disease distribution of our world is as diverse as the population distribution itself. It can be considered as a normal part of our ecology affecting every corner of the planet with its characteristic of interaction with the living species. To deal with this abundant pathology,  global, national and local bodies have set their priorities in the pursuit to make this world disease free. That is what we call the Global Health agenda, which according to Shiffman is as much a political as it is a medical or technical challenge where success depends not only on appropriate technical interventions but also effective political strategies.

So why some health issues gain priority in achieving global focus while others remain suppressed? Shiffman explains it to as the presence of sufficient credible evidence to proves the severity of an issue backed up by leadership having effective global champions for the issue. The objective is to achieve a reasonable degree to which political leaders actively pay attention to an issue, the way political systems lead to programs that address the problem, and their support by financial, technical, and human resources.1

In general, the way an issue is presented, opportune moments within political contexts, and characteristics of the issue play vital role in setting of agenda. The process is proposed to start with framing the issue in the light of shared values and framing the problem and the solution as in line with existing policy principles. Shiffman has used maternal mortality reduction study in 5 developing countries to offer guidance on how political priority can be generated in other health issues. Presence of a global norm for a problem should exist or needs to be developed along with international collaboration for the support of the issue and inputs that articulate with national policies. The important aspect is the presence of  a strong political will and the sense of responsibility for the protection of the health of the citizens at the national level and endeavors like organization of attention generating events that creates national visibility for the issue.2

On practical grounds generating political priority is a slow paced process and in fact too heavily dependent on the social, economic and political construction of the region. Shiffman explains that the lack of consensus on intervention strategies  and weak health systems promote difficulty in generating national political support for particular health goals. Policymakers, especially in the developing nations are burdened with thousands of issues and have limited resources to deal with them, as well as conflicting political imperatives. In these circumstances targeting and prioritizing certain health issues can be difficult and challenging.


1-Review Generation of political priority for global health initiatives: Shiffman et al Lancet. 2007 Oct 13; 370(9595):1370-9.

2- Shiffman-Am J Public Health. 2007 May; 97(5): 796–803.


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