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Global Health

Global health priorities
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Healthcare budget priorities in developing countries
By Yann A. Meunier, MD

Capacity is the main obstacle to adequate healthcare in developing countries. I have witnessed shocking and heart-breaking insufficiencies in developing tropical countries since my first work as general practitioner in Cameroon in the early 1980s. It is a sobering experience to see people, particularly children, die because medications and/or surgical operations mostly taken for granted in the developed world, are not available to them. Some slow progress in physician density and education standards has been made but it is patchy, uncoordinated and too often temporary.

Quantitatively, data are dismal. Quality wise, the gap is huge and increasing.

Unfortunately, the trend in various places is not toward improvement particularly in Sub-Saharan Africa. Questions have not been raised on the origin and utilisation of resources. For example, how many lives could be saved by buying vaccines instead of life-long, viral-suppressive treatments for HIV/AIDS? It takes courage and vision to make tough and right choices. Unfortunately, those are the ones that leaders must make in resource-limited environments. I believe that history will not be kind to deciders who fail their people in this regard. Guidelines should be given by international institutions (the World Bank, the IMF, WHO, PAHO, UNICEF, etc) on the establishment of healthcare budget priorities in developing countries.
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