Global Health Priorities for Developing Countries: Some Equity and Ethical considerations

Abstract

Although the need to make health priorities equitable in addressing health disparities among populations of the world is widely acknowledged, there are presently no clearcut mechanisms for achieving this goal at the global level. This paper highlights some of the limitations associated with priority setting based exclusively on the interplay of burden of disease and cost-effectiveness analysis, and identifies occasions when equity considerations may favor conditions lacking immediate evidence on cost-effectiveness but associated with substantial burden in individuals and the society and for which optimal interventions are time bound. It also highlights the implications of overlooking conditions and issues that are deserving of high-priority status by global health actors and are in the longer-term interest of donor recipients. It concludes by exploring how representative mechanisms for societal preferences such as the periodic resolutions of the World Health Assembly backed by commitments of national governments provide a framework for making global health priorities more equitable.