Global Health Policy Making Is A Complex And Often,...

Introduction The prioritisation of specific issues in global health policy-making is a complex and often, unpredictable, process. Need, discourse, funding, and a number of other factors influence the prominence an issue takes in the policy arena. Here, it is proposed that funding is the main driver of global health policy priorities coupled with the interests of key donors and constraints on their actions. It is further argued that the control funding bodies hold over policy priorities can be detrimental when their interests do not reflect global health needs. To demonstrate this, the prioritisation of Health Systems Strengthening (HSS) in global health policy-making will be considered using the Kingdon model of agenda-setting (1). HSS,†¦show more content†¦While traditionally a national policy domain, the financial and technical assistance of global health players can be crucial to facilitating HSS efforts particularly in the fragile health systems in some developing countries (7). Over the last decade and a half, the global health community have increasingly focussed their attention to HSS. WHO, the World Bank, the G8, a number of global health initiatives (GHIs) and private foundations have participated in discourse on HSS and, in some cases, have committed substantial financial resources specifically to its cause (2). Despite this, the proportion of donor funding to HSS out of total funding for health and population decreased dramatically from 64% to 28% between 1998 and 2009 while single-disease or disease group initiatives received greater commitments (2). HSS has not attained the large-scale dedication that HIV/AIDs, and infectious disease in general have through GHIs such as PEPFAR, The Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM) and The Global Alliance for Vaccine and Immunization (GAVI); most funding directed towards HSS is restricted to the particular, usually disease-specific priorities of the donors (8). Here, the main drivers behind global