GLOBAL HEALTH PRIORITIES AND PROGRAMS

INTRODUCTION
“Investing in global health is one of the smartest investments we can make. Saving and
improving millions of lives will be one of the greatest things humanity has ever done.” —
Melinda Gates
Global health is the health of populations in the global context; it has been defined as "the area
of study, research and practice that places a priority on improving health and achieving equity
in health for all people worldwide". Problems that transcend national borders or have a global
political and economic impact are often emphasized. Thus, global health is about worldwide
health improvement (including mental health), reduction of disparities, and protection against
global threats that disregard national borders. Global health is not to be confused
with international health, which is defined as the branch of public health focusing on developing
nations and foreign aid efforts by industrialized countries. Global health can be measured as a
function of various global diseases and their prevalence in the world and threat to decrease life in
the present day.
GLOBAL HEALTH DEFINITION
Global health is an area for study, research, and practice that places a priority on improving
health and achieving equity in health for all people worldwide. Global health emphasizes
transnational health issues, determinants, and solutions; involves many disciplines within and
beyond the health sciences and promotes interdisciplinary collaboration; and is a synthesis of
population-based prevention with individual-level clinical care. (Jeffrey Koplan)
EMERGING ISSUES IN GLOBAL HEALTH
Globally, the rate of deaths from noncommunicable causes, such as heart disease, stroke, and
injuries, is growing. At the same time, the number of deaths from infectious diseases, such as
malaria, tuberculosis, and vaccine-preventable diseases, is decreasing. Many developing
countries must now deal with a “dual burden” of disease: they must continue to prevent and
control infectious diseases, while also addressing the health threats from noncommunicable
diseases and environmental health risks.
As social and economic conditions in developing countries change and their health systems and
surveillance improve, more focus will be needed to address noncommunicable diseases, mental
health, substance abuse disorders, and, especially, injuries (both intentional and unintentional).
Some countries are beginning to establish programs to address these issues.
TRIPLE BILLION TARGET
The world is facing multiple health challenges. These range from outbreaks of vaccine-
preventable diseases like measles and diphtheria, increasing reports of drug-resistant pathogens,

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growing rates of obesity and physical inactivity to the health impacts of environmental pollution
and climate change and multiple humanitarian crises.   

To address these and other threats, 2019 sees the start of the World Health Organization’s new
5-year strategic plan – the 13th General Programme of Work. This plan focuses on a triple
billion target: ensuring -
1 billion more people benefit from access to universal health coverage,
1 billion more people are protected from health emergencies and
1 billion more people enjoy better health and well-being. Reaching this goal will require
addressing the threats to health from a variety of angles. 
GLOBAL HEALTH PRIORITIES
Here are 10 of the many issues that will demand attention from WHO and health partners in
2019.
1. Air pollution and climate change
Nine out of ten people breathe polluted air every day. In 2019, air pollution is considered by
WHO as the greatest environmental risk to health. Microscopic pollutants in the air can
penetrate respiratory and circulatory systems, damaging the lungs, heart and brain, killing 7
million people prematurely every year from diseases such as cancer, stroke, heart and lung
disease. Around 90% of these deaths are in low- and middle-income countries, with high
volumes of emissions from industry, transport and agriculture, as well as dirty cookstoves and
fuels in homes.  

The primary cause of air pollution (burning fossil fuels) is also a major contributor to climate
change, which impacts people’s health in different ways. Between 2030 and 2050, climate
change is expected to cause 250 000 additional deaths per year, from malnutrition, malaria,
diarrhea and heat stress. 

In October 2018, WHO held its first ever Global Conference on Air Pollution and Health in
Geneva. Countries and organizations made more than 70 commitments to improve air quality.
This year(2019), the United Nations Climate Summit in September will aim to strengthen
climate action and ambition worldwide.
2. Non-communicable diseases
Noncommunicable diseases, such as diabetes, cancer and heart disease, are collectively
responsible for over 70% of all deaths worldwide, or 41 million people. This includes 15 million
people dying prematurely, aged between 30 and 69. 

Over 85% of these premature deaths are in low- and middle-income countries. The rise of these

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diseases has been driven by five major risk factors: tobacco use, physical inactivity, the harmful
use of alcohol, unhealthy diets and air pollution. These risk factors also exacerbate mental
health issues, that may originate from an early age: half of all mental illness begins by the age of
14, but most cases go undetected and untreated – suicide is the second leading cause of death
among 15-19 year-olds.

Among many things, this year WHO will work with governments to help them meet the global
target of reducing physical inactivity by 15% by 2030.
3. Global influenza pandemic
The world will face another influenza pandemic – the only thing we don’t know is when it will
hit and how severe it will be. Global defenses are only as effective as the weakest link in any
country’s health emergency preparedness and response system. 

WHO is constantly monitoring the circulation of influenza viruses to detect potential pandemic
strains: 153 institutions in 114 countries are involved in global surveillance and response. 

Every year, WHO recommends which strains should be included in the flu vaccine to protect
people from seasonal flu. In the event that a new flu strain develops pandemic potential, WHO
has set up a unique partnership with all the major players to ensure effective and equitable access
to diagnostics, vaccines and antivirals (treatments), especially in developing countries.
4. Fragile and vulnerable setting
More than 1.6 billion people (22% of the global population) live in places where protracted
crises (through a combination of challenges such as drought, famine, conflict, and population
displacement) and weak health services leave them without access to basic care. 

Fragile settings exist in almost all regions of the world, and these are where half of the key
targets in the sustainable development goals, including on child and maternal health, remains
unmet. 

WHO will continue to work in these countries to strengthen health systems so that they are better
prepared to detect and respond to outbreaks, as well as able to deliver high quality health
services, including immunization.
5. Antimicrobial resistance
The development of antibiotics, antivirals and antimalarials are some of modern medicine’s
greatest successes. Now, time with these drugs is running out. Antimicrobial resistance – the
ability of bacteria, parasites, viruses and fungi to resist these medicines – threatens to send us
back to a time when we were unable to easily treat infections such as pneumonia, tuberculosis,
gonorrhea, and salmonellosis. The inability to prevent infections could seriously compromise

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surgery and procedures such as chemotherapy. 

Resistance to tuberculosis drugs is a formidable obstacle to fighting a disease that causes around

10 million people to fall ill, and 1.6 million to die, every year. In 2017, around 600 000 cases of
tuberculosis were resistant to rifampicin – the most effective first-line drug – and 82% of these
people had multidrug-resistant tuberculosis.

WHO is working with these sectors to implement a global action plan to tackle antimicrobial
resistance by increasing awareness and knowledge, reducing infection, and encouraging prudent
use of antimicrobials.
6. Ebola and other high-threat pathogens
In 2018, the Democratic Republic of the Congo saw two separate Ebola outbreaks, both of which
spread to cities of more than 1 million people.
This shows that the context in which an epidemic of a high-threat pathogen like Ebola erupts is
critical – what happened in rural outbreaks in the past doesn’t always apply to densely populated
urban areas or conflict-affected areas. 

At a conference on Preparedness for Public Health Emergencies held last December, participants
from the public health, animal health, transport and tourism sectors focused on the
growing challenges of tackling outbreaks and health emergencies in urban areas. They called for
WHO and partners to designate 2019 as a “Year of action on preparedness for health
emergencies”.
7. Weak primary health care
Primary health care is usually the first point of contact people have with their health care system,
and ideally should provide comprehensive, affordable, community-based care throughout life. 

Primary health care can meet the majority of a person’s health needs of the course of their life.
Health systems with strong primary health care are needed to achieve universal health coverage. 

Yet many countries do not have adequate primary health care facilities. This neglect may be a
lack of resources in low- or middle-income countries, but possibly also a focus in the past few
decades on single disease programmes.
In 2019, WHO will work with partners to revitalize and strengthen primary health care in
countries.
8. Vaccine hesitancy
Vaccine hesitancy – the reluctance or refusal to vaccinate despite the availability of vaccines –
threatens to reverse progress made in tackling vaccine-preventable diseases. Vaccination is one

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of the most cost-effective ways of avoiding disease – it currently prevents 2-3 million deaths a
year, and a further 1.5 million could be avoided if global coverage of vaccinations improved. 

The reasons why people choose not to vaccinate are complex; a vaccines advisory group to
WHO identified complacency, inconvenience in accessing vaccines, and lack of confidence are
key reasons underlying hesitancy. Health workers, especially those in communities, remain the
most trusted advisor and influencer of vaccination decisions, and they must be supported to
provide trusted, credible information on vaccines. 

In 2019, WHO will ramp up work to eliminate cervical cancer worldwide by increasing coverage

of the HPV vaccine, among other interventions.
9. Dengue
Dengue, a mosquito-borne disease that causes flu-like symptoms and can be lethal and kill up to
20% of those with severe dengue, has been a growing threat for decades. 

A high number of cases occur in the rainy seasons of countries such as Bangladesh and India.
Now, its season in these countries is lengthening significantly (in 2018, Bangladesh saw the
highest number of deaths in almost two decades), and the disease is spreading to less tropical and
more temperate countries such as Nepal, that have not traditionally seen the disease. 

An estimated 40% of the world is at risk of dengue fever, and there are around 390 million
infections a year. WHO’s Dengue control strategy aims to reduce deaths by 50% by 2020. 
10. HIV-AIDS
The progress made against HIV has been enormous in terms of getting people tested, providing
them with antiretrovirals (22 million are on treatment), and providing access to preventive
measures such as a pre-exposure prophylaxis (PrEP, which is when people at risk of HIV take
antiretrovirals to prevent infection). 

However, the epidemic continues to rage with nearly a million people every year dying of
HIV/AIDS. Since the beginning of the epidemic, more than 70 million people have acquired the
infection, and about 35 million people have died. Today, around 37 million worldwide live with
HIV. Reaching people like sex workers, people in prison, men who have sex with men, or
transgender people is hugely challenging. Often these groups are excluded from health services.
A group increasingly affected by HIV are young girls and women (aged 15–24), who are
particularly at high risk and account for 1 in 4 HIV infections in sub-Saharan Africa despite
being only 10% of the population. 

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This year, WHO will work with countries to support the introduction of self-testing so that more
people living with HIV know their status and can receive treatment (or preventive measures in
the case of a negative test result). One activity will be to act on new guidance announced In
December 2018, by WHO and the International Labour Organization to support companies and
organizations to offer HIV self-tests in the workplace.
WHO PRIORITIES
Health for all
Ensuring universal health coverage without impoverishment is the foundation for
achieving the health objectives of the Sustainable Development Goals – because when
people are healthy, their families, communities and countries benefit. Our top priority
must be to support national health authorities’ efforts to strengthen all the building blocks
of health systems and to enact policies aimed at ensuring health care is equitable and
affordable for all.
Health emergencies
In today’s interconnected world, public health emergencies can affect anyone, anywhere.
The development of resilient and robust global and local health systems capable of
preventing, monitoring, detecting and responding to public health emergencies must
therefore be a key priority, closely linked to our efforts to achieve universal health
coverage.
Women, children and adolescents
The ambitious health and development targets in the Sustainable Development Goals
cannot be achieved unless the health, dignity and rights of women, children and
adolescents are secured. Yet, in too many places, gender gaps, harmful cultural and social
practices and gender-based violence are negatively impacting these individuals. Because
of this, the well-being of women, children and adolescents must be put at the center of
global health and development.
The health impacts of climate and environmental change
Climate and environmental change impact many aspects of life that are inextricably
linked to health – food security, economic livelihoods, air safety and water and sanitation
systems – and WHO estimates that 12.6 million people die each year as a result of living
or working in an unhealthy environment. To address this, WHO has a key role to play
advancing both mitigation and adaptation strategies for climate and environmental
change, working in close partnership with other UN agencies and stakeholders.
A transformed WHO

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 Building WHO into a more effective, transparent and accountable agency will require
striking a balance between bold reform and stability of the organization. To meet the
evolving needs and challenges of the 21st century and deliver game-changing, sustainable
results, WHO will need to focus its work where it has the most value, broaden and
intensify its engagement across stakeholders, attract more predictable, flexible financing,
and work to identify and retain the best global talent.
GLOBAL HEALTH PROGRAMS
The global health strategy focuses on diseases and health conditions that account for a significant
share of illness and death in developing countries. Attempt is made to address historically
neglected or underfunded health problems and apply the resources in places where they could
lead to major health advances. The focus is made on the following areas;
Infectious diseases – includes the Diarrheal Diseases, HIV/AIDS, Malaria, Pneumonia, Polio
and Other Vaccine-Preventable Diseases and Tuberculosis
Family health – includes the leading causes of illness and death for mothers and newborns
during and immediately after childbirth; nutrition, especially during the first two years of life;
and family planning.
ENTERIC AND DIARRHEAL DISEASES
The global situation: Each year, diarrhea causes more than 1.7 million deaths in children
under 5 - nearly all of whom live in the lowest-income areas. Those who survive diarrheal
infections often have other health problems and reduced cognitive development, potentially
causing lifelong impairment.
Strategy: Aim to save and improve millions of lives through the development and delivery of
low-cost interventions that prevent diarrheal diseases (through hygiene, breastfeeding, and
vaccines) and treat them (through oral-rehydration and zinc therapies).
In the long term, to protect children in developing countries from diarrhea and effectively treat
them at the same rate as children in developed countries.
Key elements of strategy include:
 Developing and introducing safe, effective, affordable vaccines to prevent major causes
of diarrhea in developing countries, including rotavirus, cholera, typhoid, Escherichia
coli, and Shigella
 Improving understanding of diarrhea and its links to nutrition and poor immunity, to
speed development of new vaccines and therapeutics
 Assessing the role of diagnostics and the biology of infections, to guide the development
of improved therapies

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  Promoting access to and delivery of existing therapies, such as oral-rehydration salts
(ORS) and zinc, and developing improved therapies to counter diarrhea-related
dehydration and promote better outcomes
 Promoting effective practices, such as breastfeeding, improved nutrition, and improved
sanitation and hygiene.
FAMILY PLANNING
The global situation: In recent years the reproductive health of men and women in the
developing world has improved tremendously, and family-planning services have been greatly
expanded for those who want them. Family planning is a cost-effective way to save and improve
the lives of women and children and empower families to determine the optimal timing and
spacing of births.
Strategy: Aim to improve health by increasing access to high-quality, voluntary family-planning
services and contraceptives in developing countries.
Key elements of strategy include:
 Advocating for increased resources and effective policies, including better procurement
systems and increased supply of and access to contraceptives
 Demonstrating the impact of family-planning programs that promote contraceptive
awareness and use in poor urban areas of the developing world
 Developing new contraceptive methods that are easy to use, cost-effective, and
appropriate for women and men in poor countries
HIV
Global situation: As the world makes significant progress in treating people living with
HIV/AIDS, it is also critical that we accelerate progress in preventing new infections. For every
two people who receive HIV treatment today, another five become newly infected with the virus.
There is tremendous opportunity to reduce HIV infections with existing tools. Making use of all
currently available prevention strategies—such as condoms, education, and harm-reduction
programs—could prevent more than half of the infections projected to occur over the next
decade. The successful development of drugs, vaccines, and other new preventive measures
could reduce infections even more.
Strategy: Aims to reduce new HIV infections significantly in developing countries by delivering
proven prevention tools and strategies, as well as advancing research and development on new
prevention technologies.
Key elements of strategy include:
 Overcoming key scientific challenges to developing safe and effective HIV vaccines and
advancing promising vaccines to clinical trials

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  Accelerating research on drugs and other interventions that can help prevent HIV, and
enhancing the safety and effectiveness of male circumcision for HIV prevention
 Demonstrating what works in HIV prevention by supporting programs that deliver
services to groups at the greatest risk
 Advocating for continued resources to fight HIV/AIDS, and helping ensure that resources
are used as effectively and efficiently as possible.
MALARIA
The global situation: Through malaria control, the malaria burden since 2000 has declined by at
least half in 25 countries around the world. Progress is also being made on the scientific front;
new tools for controlling the disease, including a potential vaccine to prevent malaria in children,
are now being tested
Strategy: Aims to maximize the impact of existing ways to reduce cases of malaria in the short
term, such as long-lasting insecticide-treated bed nets and treatment with artemisinin-based
combination drugs.
Key elements of strategy include:
 Discovering and testing malaria vaccines that prevent infection and reduce the risk of
serious disease and death
 Developing more effective and affordable diagnostics and drugs, including drugs that can
be used safely during pregnancy
 Developing new ways to manage resistance and stop mosquitoes from transmitting
malaria
 Advocating for increased funding, as well as bold and effective public policies to control
malaria in the developing world
MATERNAL, NEONATAL, AND CHILD HEALTH
The global situation: Maternal, neonatal, and child health are gaining prominence as a global
health priority. There is clear evidence that providing mothers and their newborns proper care
during and immediately after birth can significantly reduce deaths and improve the long-term
health of both mother and child.
A key challenge is that the mothers and newborns in greatest need are often the world’s poorest
—and live in the most remote areas, where women typically give birth at home and have limited
access to medical facilities. It is critical to develop and introduce practical, affordable
interventions for improving maternal, newborn, and child health.
Strategy: Aim to reduce the number of mothers and newborns who die during and immediately
after birth by developing and introducing low-cost, easy-to-use tools, technologies, and
treatments for the major causes of these deaths.

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Key elements of strategy include:
 Developing and field-testing new interventions that mothers and frontline workers can
potentially use at home, including misoprostol for maternal hemorrhage, topical
emollients, simplified antibiotic treatment, umbilical cord cleansing, and vitamin A for
newborns
 Creating and testing tools to help health workers who lack formal training identify and
manage the major causes of maternal and newborn deaths, such as maternal hemorrhage,
birth asphyxia, and newborn infections
 Developing and implementing ways to overcome barriers to practices that can save the
lives of women and their newborns
 Raising the visibility of the health of mothers and their young children and building
greater political support in donor and developing countries.
NUTRITION
The global situation: More young children in developing countries are receiving proper
nutrition than ever before, but much more needs to be done. It is especially critical that pregnant
and lactating women and children under age 2 receive proper nutrition, since this period has the
greatest impact on birth outcomes and children’s long-term health and cognitive development. In
addition, vitamins and minerals such as iron, vitamin A, and zinc are essential for the
development of healthy children worldwide.
Strategy: Aims to prevent malnutrition in children during the first two years of their lives and
reduce vitamin and mineral deficiencies.
Key elements of strategy include:
 Closing critical knowledge gaps to address malnutrition during pregnancy and the first
two years of life
 Developing effective approaches to promoting proper breastfeeding and other proper
infant-feeding practices, and improving nutrition during pregnancy
 Supporting public-private partnerships to develop and deliver low-cost staple foods and
condiments—such as flour, rice, salt with enhanced essential vitamins and minerals
PNEUMONIA
Global situation: Recent scientific advances have created enormous opportunities to reduce the
impact of pneumonia, which is the leading cause of child deaths in the developing world. There
are now proven vaccines available to mitigate the major causes of pneumonia, including
pneumococcus, Hemophilus influenzae type b, and measles. Additional innovation is needed,
however. Current vaccines have various shortcomings—most can only reduce the occurrence of
some forms of pneumonia, and some vaccines are relatively expensive.

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Strategy: Aim to reduce the number of children in the developing world who become sick or die
from pneumonia and respiratory infections that can cause pneumonia, such as influenza and
measles. Our approach emphasizes the prevention of pneumonia through affordable vaccines that
prevent the major causes of the disease. In addition, we aim to close gaps in the world’s
scientific understanding of pneumonia, to inform the development of new diagnostic and
treatment options.
Key elements of strategy include:
 Expanding access to existing vaccines through partnerships such as the GAVI Alliance
 Developing new vaccines that protect against a broader range of disease types and are
more affordable than current vaccines
 Improving scientific understanding of the origins and causes of pneumonia, to guide the
development of vaccines as well as new tools to diagnose and treat the disease
 Working for greater attention and resources to fight pneumonia, and encouraging private
industry to research and develop new vaccines in addition to these priorities, we also
make targeted investments to help developing countries address the threat of pandemic
influenza.
POLIO
The global situation: The world has made dramatic progress toward eradicating polio, a disease
that once paralyzed and killed children in nearly every country.
Strategy: Aim to contribute to global polio eradication by working with partners in the Global
Polio Eradication Initiative (GPEI). Explore all possible means of increasing the chances of
stopping poliovirus transmission as quickly as possible.
Key elements of strategy include:
 Supporting polio vaccination campaigns in countries that remain at risk, and preventing
and responding to outbreaks
 Advocating for resources and commitment from donor and polio-affected countries
 Ensuring that polio programs can serve as a platform for delivering other vaccines and
improving overall health systems
 Introducing improved surveillance systems that enable quick and accurate polio
detection, which can prevent outbreaks or allow them to be addressed as soon as possible
 Investing in new tools such as improved vaccines and antiviral drugs to achieve and
maintain eradication.
TOBACCO
Global situation: Tobacco-associated illness and death is one of the most serious global health
problems. Fortunately, there are multiple cost-effective ways to reduce tobacco consumption and

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prevent onset of tobacco use in nonsmokers. Many of these interventions are widely
implemented in the developed world but not yet commonly used in developing countries.
Strategy: Fund projects that implement proven policy interventions such as increased taxation
and smoke free bans aimed at reducing the burden of tobacco use in India, China, and Southeast
Asia.
Key elements of strategy include:
 Deploying the most effective tobacco-control measures for Africa, where tobacco use is
growing rapidly
 Supporting intensive efforts in India and China to substantially reduce widespread
tobacco use
 Collecting and distributing evidence related to tobacco control strategies—such as the
economic impact of tobacco taxation—to guide policymaking.
TUBERCULOSIS
Global situation: Although TB deaths are declining, the disease continues to pose one of the
world’s most urgent health challenges. While TB is curable and preventable, nearly one-third of
the world is currently infected with the TB bacterium, and the active form of the disease kills 1.8
million people annually. Standard TB vaccines, diagnostic tests, and drugs have serious
shortcomings, making TB difficult and costly to control.
Strategy: Aim to greatly improve global TB control by developing and introducing new and
improved ways to prevent, diagnose, and treat the disease.
Key elements of strategy include:
 Developing TB vaccines that are more effective than the current vaccine
 Developing more accurate diagnostics and effective and faster-acting drug regimens to
fight TB and MDR-TB
 Demonstrating the impact of new TB tools in national control programs, including
simplified TB drug regimens and drug-resistance testing
 Supporting scientific research to improve our understanding of the basic biology of TB
and MDR-TB
 Advocating for funding and commitment to implement the Global Plan to Stop TB and
for increased involvement by private industry in fighting the disease.
GLOBAL HEALTH POLICY AND ADVOCACY
The global situation: there is increasing recognition that improving global health is not only the
right investment but a smart investment as well. To continue improving the health of the world’s
poor and saving lives, the world must sustain and increase investments over the long term. It is

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also important that we target resources to programs that can have the greatest long-term impact
for the most people.
strategy: policy and advocacy strategy aim to improve global health by strengthening resources,
political commitment, and public policies.
Key elements of strategy include:
 Encouraging donor governments to maintain their global health funding commitments
and convincing developing countries to invest more of their own resources in health
 Creating innovative partnerships to finance global health and encouraging greater
involvement by private industry
 Collecting and analyzing data on global health needs, funding levels, and evidence of
impacts to help guide health policy decisions
 Increasing awareness and understanding of the results that global health investments have
already achieved.
OTHER PROGRAMS
GAVI - Global Alliance for Vaccines and Immunization
Introducing Underused Children’s Vaccines, The GAVI Alliance was launched in 2000 with
support from the foundation and other donors to expand access to childhood vaccines. It is a
public-private partnership of governments, UNICEF, the World Health Organization (WHO), the
World Bank, the Bill & Melinda Gates Foundation, civil-society organizations, vaccine
manufacturers, and public health and research organizations. Its unique approach involves
ensuring long-term, predictable funding for vaccines. GAVI helps countries negotiate multi-year
purchase agreements with vaccine manufacturers. This provides companies with necessary
assurances that countries will purchase their products at a fair price and enables countries to plan
ahead and optimize their resources.
GAVI has achieved dramatic results to date. Since 2000, GAVI-supported vaccines have reached
more than 200 million children and averted an estimated 5.4 million deaths, according to the
WHO.
GAVI’s initial focus has been on underused vaccines for hepatitis B, H. influenzae type b, and
yellow fever. GAVI is expanding its efforts in order to introduce new vaccines against
pneumococcal disease and rotavirus disease—the major infectious-disease killers of children
under the age of 5. This is the first time in history that vaccines will be available in the
developing world at nearly the same time as in industrialized countries. With additional new
vaccines expected to become available in the coming years, GAVI will continue to play an
essential role in reducing child mortality and improving health in the world’s poorest countries.
GLOBAL FUND TO FIGHT AGAINST AIDS, TB AND MALARIA

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The global fund to fight against ALDS, TB and MALARIA was established in2002 in Geneva,
Switzerland.
The driving force behind the establishment of the fund was increasing global concern about HIV
and a growing recognition among partners that measures to address the AIDS epidemic had been
insufficient. Interest in establishing the fund was also heightened by the growing attention to
global health discussed hereafter and a special concern for the exceptional burden of HIV, TB
and MALARIA especially in Africa.
The global fund is the partnership of the public and private sectors and WHO, UNAIDS and the
World Bank are also key partners. The fund is governed by grants that come from developed
country governments, but which also come from the private and foundation sector, including the
Bill and Melinda Gates Foundation.
The global fund is primarily a financing agency but it also engages in advocacy for global health
and the three diseases on which it focuses. The main ai of the fund is to finance proposed
investments in the se diseases, with an emphasis on AIDS and Africa. It has a particular interest
in helping to scale up the programs for anti-retroviral therapy against HIV. The fund has taken
innovative approaches to a number of aspects of development assistance for health, including the
following;
 It is strictly financing mechanism and not a technical or implementing agency.
 It seeks to raise funds for the investments that will be additional to other funding already
available.
 It tries to work on the basis of a national plan that is developed by a group of representing
diverse national interests, for the use of global fund financing. It evaluates proposals
through an independent review process.
 It tries to operate in performance-based manner by supporting investments that are
meeting their targets and reducing or eliminating support for programs that are not
meeting their aims.
INTERNATIONAL AIDS VACCINE INITIATIVE (IAVI)
Actions of IAVI:
Discover - new approaches to developing vaccines and other means of preventing HIV.
Accelerate - translational and clinical research through our laboratories in the U.S., India, and
the U.K.
Build Capacity - in-country for researching vaccine candidates while strengthening local public
health and scientific expertise.
Partner - with industry and enlist biopharma product development skills to develop innovative
products tailored to target populations.

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Share - IAVI’s resources with other innovators to help the HIV community as a whole succeed.
Extend - IAVI’s core capabilities to solving disease prevention and treatment challenges.
GLOBAL ACTION PLAN FOR PREVENTION AND CONTROL OF
NON-COMMUNICABLE DISEASES 2013-2020
WHO’s global monitoring framework on NCDs will start tracking implementation of the Global
Action Plan through monitoring and reporting on the attainment of the 9 global targets for NCDs,
by 2015, against a baseline in 2010. Accordingly, governments are urged to
(i) Set national NCD targets for 2025 based on national circumstances.
(ii) Develop multisectoral national NCD plans to reduce exposure to risk factors and enable
health systems to respond in order to reach these national targets in 2025
(iii) Measure results, taking into account the Global Action Plan.
Vision
A world free of the avoidable burden of noncommunicable diseases.
Goal
To reduce the preventable and avoidable burden of morbidity, mortality and disability due to
noncommunicable diseases by means of multisectoral collaboration and cooperation at national,
regional and global levels, so that populations reach the highest attainable standards of health
and productivity at every age and those diseases are no longer a barrier to well-being or
socioeconomic development.
Overarching principles
> Life-course approach
> Empowerment of people and communities
> Evidence-based strategies
> Universal health coverage
> Management of real, perceived or potential conflicts of interest
> Human rights approach
> Equity-based approach
> National action and international cooperation and solidarity
> Multisectoral action

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Objectives
1. To raise the priority accorded to the prevention and control of noncommunicable
diseases in global, regional and national agendas and internationally agreed development
goals, through strengthened international cooperation and advocacy.
2. To strengthen national capacity, leadership, governance, multisectoral action and
partnerships to accelerate country response for the prevention and control of
noncommunicable diseases.
3. To reduce modifiable risk factors for noncommunicable diseases and underlying social
determinants through creation of health-promoting environments.
4. To strengthen and orient health systems to address the prevention and control of
noncommunicable diseases and the underlying social determinants through people-
centered primary health care and universal health coverage.
5. To promote and support national capacity for high-quality research and development
for the prevention and control of noncommunicable diseases.
6. To monitor the trends and determinants of noncommunicable diseases and evaluate
progress in their prevention and control.
Targets
1. A 25% relative reduction in risk of premature mortality from cardiovascular diseases,
cancer, diabetes, or chronic respiratory diseases.
2. At least 10% relative reduction in the harmful use of alcohol, as appropriate, within the
national context.
3. A 10% relative reduction in prevalence of insufficient physical activity.
4. A 30% relative reduction in mean population intake of salt/sodium.
5. A 30% relative reduction in prevalence of current tobacco use in persons aged 15+ years.
6. A 25% relative reduction in the prevalence of raised blood pressure or contain the
prevalence of raised blood pressure, according to national circumstances.
7. Halt the rise in diabetes and obesity.
8. At least 50% of eligible people receive drug therapy and counselling (including glycemic
control) to prevent heart attacks and strokes.
9. An 80% availability of the affordable basic technologies and essential medicines,
including generics, required to treat major noncommunicable diseases in both public and
private

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 facilities.

Targets and indicators

ELEMENTS TARGET OUTCOME 2020 2025

MORTALITY AND MORBIDITY 1. Relative reduction on overall 10% 25
Premature mortality from mortality found CVD, DM, Cancer or
noncommunicable disease. COPD

BEHAVIORAL RISK FACTOR5S 2. Relative deduction in alcohol use 5% 10%

Harmful use of alcohol.

Physical inactivity 3. A relative reduction in prevalence of 5% 10%

insufficient physical inactivity

Salt/sodium intake 4. A relative reduction in mean 20% 30%

population intake of salt/sodium.
recommended level of less than 5gm
per day
Tobacco use 5. A relative reduction in prevalence of 15% 30%
current tobacco use in persons aged
15+ years

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 BIOLOGICAL RISK FACTORS
Raised blood pressure
Diabetes and obesity
6. A relative reduction in the 10% 25%
prevalence of raised blood pressure or
contain the prevalence of raised blood
pressure, according to national
circumstances
7. Halt the rise in diabetes & obesity No midterm target is
set

NATIONAL SYSTEM 8. At least 50% of eligible people 30% 50%

RESPONSE receive drug therapy and counselling
Drug therapy to prevent heart attacks (including glycemic control) to prevent
and strokes heart attacks and strokes

Essential noncommunicable disease 9. An 80% availability of the affordable 60% 80%

medicines and basic technologies to basic technologies and essential
treat major noncommunicable medicines, including generics, required
diseases to treat major noncommunicable
diseases in both public and private
facilities

COMPREHENSIVE MENTAL HEALTH ACTION PLAN 2013–2020

Introduction
WHO’s comprehensive mental health action plan 2013-2020 was adopted by the 66th World
Health Assembly.
Dr Margaret Chan, the WHO Director-General, described the new Comprehensive Mental
Health Action Plan 2013–2020 as a landmark achievement: it focuses international attention on a
long-neglected problem and is firmly rooted in the principles of human rights. The action plan
calls for changes. It calls for a change in the attitudes that perpetuate stigma and discrimination
that have isolated people since ancient times, and it calls for an expansion of services in order to
promote greater efficiency in the use of resources.
Vision of the action plan is a world in which mental health is valued, promoted and protected,
mental disorders are prevented and persons affected by these disorders are able to exercise the
full range of human rights and to access high quality, culturally-appropriate health and social

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care in a timely way to promote recovery, all in order to attain the highest possible level of health
and participate fully in society and at work free from stigmatization and discrimination.
Overall goal is to promote mental well-being, prevent mental disorders, provide care, enhance
recovery, promote human rights and reduce the mortality, morbidity and disability for persons
with mental disorders.
Objectives:
(1) to strengthen effective leadership and governance for mental health;
(2) to provide comprehensive, integrated and responsive mental health and social care services in
community-based settings;
(3) to implement strategies for promotion and prevention in mental health;
(4) to strengthen information systems, evidence and research for mental health.
SELECTED ORGANIZATINAL ACTORS IN GLOBAL HEALTH – By type organization
United Nations Agencies
1. UNAIDS - United Nations Programme on HIV and AIDS. This joint is the main
advocate for accelerated, comprehensive and coordinated global action on the HIV/AIDS
pandemic
2. UNDP - United Nations Development Programme. It is the United Nations' global
development network. Headquartered in New York City, UNDP advocates for change
and connects countries to knowledge, experience and resources to help people build a
better life for themselves.
3. UNFPA - United Nations Population Fund formerly the United Nations Fund for
Population Activities (UNFPA). It "is the lead UN agency for delivering a world where
every pregnancy is wanted, every childbirth is safe and every young person's potential is
fulfilled".
4. UNICEF - United Nations Children Education Fund. established on 11 December
1946 by the United Nations to meet the emergency needs of children in post-war Europe
and China. Its full name was the United Nations International Children's, Emergency
Fund.
5. WHO – World Health Organization. It is a specialized agency of the United Nations
that is concerned with international public health. It was established on 22 July
1946 headquartered in Geneva, Switzerland.
WHO Partnerships
1. Global Alliance for The Elimination of Leprosy
2. Roll Back Malaria,
3. Stop TB,

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Multilateral development banks:
1. African Development Bank,
2. Asian Development Bank,
3. Inter-American Development Bank,
4. World Bank.
5. Bilateral Development Assistance Agencies
6. Australian Agency for International Development
7. Canadian International Development Agency
8. Danish International Development Agency
9. Department of International Development of the U.K.
10. Dutch Agency for Development Cooperation
11. United States Agency for International Development
Foundations
1. The Bill and Melinda Gates Foundation
2. Rock Feller Foundation
Non-governmental organizations
1. CARE - Cooperative for Assistance and Relief Everywhere, formerly Cooperative for
American Remittances to Europe. It is a major international humanitarian agency
delivering emergency relief and long-term international development projects. Founded
in 1945, CARE is nonsectarian, impartial, and non-governmental.
2. Catholic Relief Services
3. Doctors Without Borders
4. Oxfam - Oxfam International was formed in 1995 by a group of independent non-
governmental organizations. Their aim was to work together for greater impact on the
international stage to reduce poverty and injustice. The name “Oxfam” comes from
the Oxford Committee for Famine Relief, founded in Britain in 1942.
5. Save The Children
Other special programs
1. Global Alliance for Vaccines and Immunization
2. Global Fund to Fight Against AIDS, TB And MALARIA
Public-private partnerships for health
1. Global Alliance for TB Drug Development
2. International AIDS Vaccine Initiative
3. Malaria Vaccine Initiative
CONCLUSION

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To achieve better health outcomes at the societal and the global level, it is important to
emphasize quality across the spectrum of health systems from the sub-national to the national
and across primary, secondary and tertiary levels of care.
Practical experiences and lessons from the sub-national level, when well-documented and shared
nationally and globally, play a critical role in informing national policy and strategy formulation
on improving the quality of health services. Implementation at the frontline must inform and be
informed by national direction on quality – defining what quality means at the national level and
seeks to create an enabling environment for delivering high quality services.

JOURNAL REFERENCE
Title: International consultation on long-term global health research priorities, research capacity
and research uptake in developing countries
Authors: Conalogue DM, Kinn S, Mulligan JA, McNeil M
Background
In recognition of the need for long-term planning for global health research, and to inform future
global health research priorities, the United Kingdom Department for International Development
(DfID) carried out a public consultation between May and June 2015. The consultation aimed to
elicit views on the (1) the long-term future global health research priorities; (2) areas likely to be
less important over time; (3) how to improve research uptake in low-income countries; and (4)
how to build research capacity in low-income countries.
Methods
An online consultation was used to survey a wide range of participants on global health research
priorities. The qualitative data was analyzed using a thematic analysis, with frequency of codes
in responses tabulated to approximate relative importance of themes and sub-themes.
Results
The public consultation yielded 421 responses. The survey responses confirmed the growing
importance of non-communicable disease as a global health research priority, being placed above
infectious diseases. Participants felt that the key area for reducing funding prioritization was
infectious diseases. The involvement of policymakers and other key stakeholders was seen as
critical to drive research uptake, as was collaboration and partnership. Several methods to build
research capacity in low-income countries were described, including capacity building
educational programs, mentorship programs and research institution collaboration and
partnership.

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