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Global health priorities – priorities of the wealthy?

DOI: 10.1186/1744-8603-1-6

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The major actors in global health policy are changing. New actors are entering and old ones are losing power; the overall change has seen a shift from global nation-based health-policy-making structures towards more diversity that puts emphasis on private sector actors. In the 1980s and 1990s there was a shift in global health policy making from the UN agencies towards financial institutions. This shift has meant increasing attention being given to involving private actors in health policy [1-4]. Towards the end of the 20th century the UN increasingly collaborated with business, which subsequently increased the influence of private interests in the UN system. [5-8]. This development was partly due to the declining levels of development assistance of the OECD (Organisation for Economic Co-operation and Development) countries to the UN, which became particularly acute in the 1990s [9], and partly due to the fear that the UN would become marginalized if it did not increase its collaboration with the corporate sector, which had gained power in overall policy-making [10].In the UN forums, civil society has become recognized as an important body of actors in global policy-making, as seen at the UN Conference for Environment and Development in 1992, and at the International Conference on Population and Development in 1994, where women's organisations were instrumental in shaping the Programme of Action. Regarding health matters, the not-for-profit sectors of the civil society have played an important role for much longer, most notably in the debates concerning essential drugs, breast milk substitutes, and weaning foods in the 1970s and 1980s. [11]. More recently the public health NGOs have been important, for example, in shaping pharmaceutical policies and emphasising the needs and rights of HIV-infected people.The emergence of new global health policy actors – as a result of new global legally independent public-private entities such as the Global Alliance for Vaccines an


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