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Why is "prioritization" important for global health? Demystify the process!
In today's global health environment, priority setting has become a key process for countries to formulate health policies. This process not only involves the allocation of resources, but also affects the lives and health of countless people. Whether governments, nonprofits, or private donors, they must make choices about which health interventions to prioritize.
Priority setting is the act of deciding which health interventions to pursue, and this process can occur at multiple levels.
Levels of priority setting
Priority setting is multi-level, including:
- Health budget level: determines the amount of overall health spending.
- Overall strategic level: selective primary care, primary care and more general health system strengthening.
- Disease Hierarchy: Identify diseases that need to be mitigated.
- Intervention tiers per disease: Prioritize interventions within specific disease categories.
- Drug hierarchy.
- Research level: Determines what health research needs to be conducted.
Who sets priorities?
In the priority-setting process, various roles play different roles. Among them, include:
- Governments: Governments lead health spending in most countries, making them the main health priority setters.
- Nonprofit organizations and companies that assist governments.
- International organizations and foundations.
- Private donors, including high net worth individuals: Their priorities often combine certain domestic needs with technical, political and economic considerations dominated by donor interests.
According to Devi Sridhar, a global health expert at the University of Edinburgh: "The priorities of funding agencies largely determine the health problems and diseases studied."
The challenge of prioritization
Although this process is intended to reflect population needs, in practice policymakers often face challenges when setting priorities. These include:
- Information asymmetry: Health organizations may overestimate the priorities expected by beneficiaries.
- Socioeconomic and health inequalities: Priorities need to consider not only socioeconomic status but also inequalities such as gender, race and religion.
- Length of Policy Development: Due to the complexity of a particular policy, the decision-making process may take considerable time to reach consensus.
History of priority setting
Priority setting at the global level has been taking place since at least the 1980s, but these efforts have focused on only a few aspects. While many organizations and programs have been working on priority setting for years, the results are often confusing.
Some studies have pointed out that priority setting efforts often rely on consensus reached by expert groups, and the results are not systematically displayed, resulting in unreasonable and fair presentation to the external public.
Policy acceptance
Many advocates, researchers, and policymakers may label almost any disease, condition, or intervention a "health priority," creating much confusion. Priority setting is influenced by multiple factors, including the reliability of data, value judgments and equality considerations.
How do current health policy challenges and priority-setting processes impact our future health path?
