Global Health Priorities

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INTRODUCTION
The World Health Organisation has defined health as "a state of complete physical, social, and mental well being and not merely the absence of disease or infirmity".(1) Health has long been the subject of diplomacy and cooperation across many countries.(2) No single country, regardless of capability or wealth can protect itself from the public health burden, without the co-operation of others, thus making health a global issue. Global health is ill defined, often referred to as any health problem that has many impact in many countries and encompasses all the important health threats.(3)

HOW PRIORITIES ARE SET
The global health priorities means different thing to different people. Epidemiologist described it based on pathology with infectious and non infectious diseases in mind.(4) Social scientists associated it with the systems that are unable to provide basic health care services for their community.(5) Others argued that socio-political and environmental issues would dominate the global health in future.(6) Indeed, it could be argued that, improving the quality of life through tackling issues like education, employment, good housing and sanitation should be the priority of the global health. Yet others believed that the burden of diseases predominates among the underprivileged. hence, inequality and poverty could be considered the main health priority globally.(5)

GLOBAL HEALTH PRIORITIES
Global health priorities have in recent years been defined through several processes, by several actors and at various forums. Millennium Development Goals (MDGs) was the result of these forums. The MDGs have eight goals, three of which are health focussed; child mortality, maternal health, and HIV/AIDS, malaria and other diseases while three are the social determinant of health; Poverty, education, gender equality and environmental sustainability.(2) Though, MDGs have become an important priority, more recently attention has shifted to the growing needs for addressing development of health policy issues and systems.(7) Similarly, in 2001 a policy emerged which concluded that resources of the public health should be channelled to infectious diseases, malnutrition, maternal and perinatal mortality which are recognised as global priorities.(8) Other UN agencies and NGOs have also set similar priorities for global health. According to global mortality and burden-of-disease indices, these priorities represent the majority cause of deaths and diseases, but not a true representation of the majority of ill-health in any other nation.(7)

HEALTH PRIORITIES IN NIGERIA
With a population of about 140 million(9) and a land mass of 932, 768km2,(10) Nigeria is the most populous country in Africa often tagged "Giant of Africa".(11) It is made of 6 geopolitical zones.(9) The south is covered by tropical rainforest and varying Sahel savannah and Sahara desert in the North.(10) It is the eight largest exporter of oil(12) which account for greater than 80% of the Nigerian government revenue.(13) Despite the oil wealth, health status of the citizen remains poor. It has the potential to be the engine for economic growth in the sub region but highly distorted and inefficient. The country is badly affected by widespread corruption, political monopoly and economic mismanagement which translate into overall failure of the health care system. Though, Nigeria has existing non functioning National health policies, the country has no stated priorities. National priorities are determined by the impact of existing public health problems. These priorities will be discussed as follows;

MILLENIUM DEVELOPMENT GOALS
MDG has been designed to improve the global health and to achieve specific goals by 2015.(14) Half way to the end of the period showed that progress has been very slow and is unlikely if the global target would be met by 2015. With little progress, many of the goals remained unmet. The under five mortality has reduced by 27%...
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