WEIGHT CHECKINGEveryone checks their body to some extent, but many people with eating disorders repeatedly check their body and often in a way that's unusual.

Sometimes body and weight checking becomes second nature and many individuals with eating disorders don't even realize they're doing it," said Dena Cabrera, PsyD, psychologist at Remuda Programs for Eating and Anxiety Disorders. "Commonly, they check to feel for fatness, bones and any physical change in their body to subconsciously or consciously motivate their eating disorder behavior."

Many individuals with eating disorders weigh themselves at frequent intervals, sometimes many times a day. As a result they become obsessed with the daily weight fluctuations that are a normal part of the body and would otherwise pass unnoticed. The movements on the scale then determine their mood and eating patterns.

A few things must be kept in mind before we put ourselves on that scale:

For starters, always check your weight first thing in the morning with an empty stomach. Weight tends to fluctuate in the course of the day. With all our various activities such as eating, sweating, water retention in the body and sometimes even constipation, the fluctuation can be as much as a kilo or two.

What we wear also contributes to our weight. For instance, a pair of jeans for women can weigh up to 700 gms, a shirt about 250 gms, so on and so forth. So if you have a weighing scale at home in your privacy, its best to try and weigh oneself in the nude! That way you have no extra kilos…

Some people have the tendency to retain water in their bodies; this includes both men and women. Due to this, their weight might be different during various times of the time. In some cases, even food stays longer in the body and digestion is slow. For example. if you eat extra salt or Chinese food, the next day your weight will be more than a kilo extra. To figure out if you fit into the category of people who retain food and water, you could have apples only for dinner and check your weight next morning. Incase the weight drops more than 600gms than normal, then you automatically come into that category.

To watch out for certain foods that can cause water/food retention, its best to avoid white flour, corn flour and all their products. All things sweet (especially Indian sweets), fruit juices, coconut water, soups, rice and heavy pulses should be avoided at night.

Something for women to watch out is checking your weight during their menstrual period, as it can go up by close to one and half kilos. Although it would automatically come down by the end of the period.

Anyone with a sedentary lifestyle will find that their weight fluctuates during travel or even when they are exposed to high levels of heat and cold.

Another interesting fact is that stress has the side effects of weight gain.

Last but not the least, being on any sort of medication (antibiotics) can sometimes cause a bit of water retention, so during the course it’s best to avoid checking your weight.

There are many reasons as to why are weight varies through our lives. The only way to be healthy is to eat right and exercise, there are no short cuts!

Read more: http://www.lifemojo.com/lifestyle/are-you-checking-your-weight-correctly-42836#ixzz0tqtB4WKh

BMI Categories:

Underweight = <18.5 Normal weight = 18.5–24.9 Overweight = 25–29.9 Obesity = BMI of 30 or greater

Check Up on Your Weight and Waistline Almost 59% of Canadian adults are overweight (37%) or obese (22%). This proportion is on the rise and increasingly younger individuals are facing the problem. Excess weight significantly increases the risk of cardiovascular disease, high blood pressure, high cholesterol, diabetes and other illnesses. Fortunately, changes to the level of physical activity and to nutrition can make a difference. You don’t need “miracle diets” or weight-loss products – which are often bad for you – to control your weight.

Several factors can explain weight gain, but it’s not always easy to recognize, or even understand them. Here are a few tips to help you identify them:

too many calories too little exercise family history unhealthy eating habits stopping smoking taking certain medications “couch potato” environments

How to Check

The Canadian body weight classification system uses two indicators to evaluate the possible risk of health problems associated with either an excess or insufficiency of

weight: body mass index (BMI) and waist circumference. This system is for use with adults age 18 years and over with the exception of pregnant and lactating women

What is the BMI?

The body mass index (BMI) allows us to evaluate if a person’s weight represents a health risk. To calculate your BMI, click here, or simply ask your physician.

The BMI only applies to people 18 years or older. In addition, if you’re over 65 years or if your muscles are very developed, your BMI can be slightly higher than 25 without increasing the risks to your health.

BMI Weight Category Risk of Health Problems

Less than 18.5

Underweight Increased

18.5 – 24.9 Normal Weight Least

25.0 – 29.9 Overweight Increased

30.0 and over

Obese High to very high

Source: Health Canada. Canadian Guidelines for Body Weight Classification in Adults, 2003.

Waistline: A Weighty Measurement

The risk of disease increases when the excess weight is localized around the waist rather than elsewhere on the body.

Where do you find yourself?With the help of a tape measure, measure your waist circumference halfway between the top of your hipbone and the bottom of your ribcage, without sucking in your stomach.

  Waist Circumference Measurement

Risk of Suffering from CVD and Diabetes

Normal Range of Waistline

Men: less than 94 cm (37 in)

Women: less than 80 cm (32 in)

Least

Abdominal Heaviness

Men: between 94 and 102 cm (37 and 40 in)

Women: between 80 and 88 cm (32 and 35 in)

Increased

Abdominal Obesity

Men: more than or equal to 102 cm (40 in)

Women: more than or equal to 88 cm (35 in)

High

So What is the right weight for my height?

How much should you weigh according to your height? This height to weight chart is a guideline to an Adults ideal bodyweight:

Female Height to Weight Ratio

   Male Height to Weight Ratio

Height Low Target High Height Low Target High

4' 10" 100 115 131 5' 1" 123 134 145

4' 11" 101 117 134 5' 2" 125 137 148

  

  

5' 0" 103 120 137 5' 3" 127 139 151

5' 1" 105 122 140 5' 4" 129 142 155

5' 2" 108 125 144 5' 5" 131 145 159

5' 3" 111 128 148 5' 6" 133 148 163

5' 4" 114 133 152 5" 7" 135 151 167

5' 5" 117 136 156 5' 8" 137 154 171

5' 6" 120 140 160 5' 9" 139 157 175

5' 7" 123 143 164 5' 10" 141 160 179

5 '8" 126 146 167 5' 11" 144 164 183

5' 9" 129 150 170 6' 0" 147 167 187

5' 10" 132 153 173 6' 1" 150 171 192

5' 11" 135 156 176 6' 2" 153 175 197

6' 0" 138 159 179 6' 3" 157 179 202

 

Height to weight chart you can print:

Right click the chart below and save it to your computer. You can then print the height to weight chart for future reference.

Weighing scales comes in more different types and they suits for wide different application and provides standard and unique features. They weighing scales comes in a wide variety and in styles, sizes, prices and capacities. The popular known weighing scale or equipment listed in the market for sale are floor scales, Bench scales, platform scales, digital indicator scales, rail scales, digital scales, pocket scales, software, jewelry scales, industrial scales, laboratory scales, truck scales and bathroom scales comes under different or common types of weighing scales. These weighing scales are specially designed for business people and different users who seek weighing scale applications.

Weighing scales are said to be the most important and essential scales required for all kinds of people. Weighing scales are used for most of the applications and they satisfy the requirement and demands of the customer around the world. When weighing scales are designed and produced, they are produced only after knowing the demands of the customer and to weigh the weight of the objects accurately and with correct measurement. Weighing scales can be used for commercial and domestic purposes. When weighing scales are produced, it is produced to meet the demands from the basic to the higher levels. The uses of different weighing scales are

    Weighing scales can be used to measure the weigh of the object accurately.     Weighing scales are largely useful manufacturers, retailers, sellers, business entrepreneurs, shop owners and for some users.

    Weighing scales applications are in large numbers and they have more standard features and in different models, prices, capacities.     weighing scales such as floor scales, platform scales, digital scales, bench scales, indicators fetches more demand and they provides more benefits to the users.     Weighing scales measures the weight of the object without any mistake.    The measurement procured from weighing scales will come up with the counting measurement and numbers for the objects.     Weighing scales suits for wide applications and it ensures guaranteed measurement for the object whether placed with load or unload.     Weighing scales measures weigh of any objects such as trucks, machines, tools, raw materials, vehicles, vegetables, crane and so on.

A weighing scale (usually just "scales" in UK and Australian English, or "scale" in US English) is a measuring instrument for determining the weight or mass of an object. A spring scale measures weight by the distance a spring deflects under its load. A balance compares the torque on the arm due to the sample weight to the torque on the arm due to a standard reference weight using a horizontal lever. Balances are different from scales, in that a balance measures mass (or more specifically gravitational mass), whereas a scale measures weight (or more specifically, either the tension or compression force of constraint provided by the scale). Weighing scales are used in many industrial and commercial applications, and products from feathers to loaded tractor-trailers are sold by weight. Specialized medical scales and bathroom scales are used to measure the body weight of human beings.

HEALTH PROMOTION

Health promotion has been defined by the World Health Organization's 2005 Bangkok Charter for Health Promotion in a Globalized World as "the process of enabling people to increase control over their health and its determinants, and thereby improve their health"[1]. The primary means of health promotion occur through developing healthy public policy that addresses the prerequisites of health such as income, housing, food security, employment, and quality working conditions. There is a tendency among public health officials and governments—and this is especially the case in liberal nations such as Canada and the USA—to reduce health promotion to health education and social marketing focused on changing behavioral risk factors[2].

Recent work in the UK (Delphi consultation exercise due to be published late 2009 by Royal Society of Public Health and the National Social Marketing Centre) on relationship between health promotion and social marketing has highlighted and reinforce the potential integrative nature of the approaches. While an independent review (NCC 'It's Our Health!' 2006) identified that some social marketing has in past adopted a narrow or limited approach, the UK has increasingly taken a lead in the discussion and developed of much more integrative and strategic approach (see Strategic Social Marketing in 'Social Marketing and Public Health' 2009 Oxford Press) which adopts a whole-system and holistic approach, integrating the learning from effective health promotion approaches with relevant learning from social marketing and other disciplines. A key finding from

the Delphi consultation was the need to avoid unnecessary and arbitrary 'methods wars' and instead focus on the issue of 'utility' and harnessing the potential of learning from multiple disciplines and sources. Such an approach is arguably how health promotion has developed over the years pulling in learning from different sectors and disciplines to enhance and develop.

Contents[hide]

1 History 2 Worksite health promotion 3 Health promotion entities and projects by country

o 3.1 International and multinational o 3.2 Australia o 3.3 Canada o 3.4 New Zealand o 3.5 United Kingdom o 3.6 United States

4 See also 5 References 6 Further reading

7 External links

[edit] HistoryThe "first and best known" definition of health promotion, promulgated by the American Journal of Health Promotion since at least 1986, is "the science and art of helping people change their lifestyle to move toward a state of optimal health"[3][4]. This definition was derived from the 1974 Lalonde report from the Government of Canada[3], which contained a health promotion strategy "aimed at informing, influencing and assisting both individuals and organizations so that they will accept more responsibility and be more active in matters affecting mental and physical health"[5]. Another predecessor of the definition was the 1979 Healthy People report of the Surgeon General of the United States [3] , which noted that health promotion "seeks the development of community and individual measures which can help... [people] to develop lifestyles that can maintain and enhance the state of well-being"[6].

At least two publications led to a "broad empowerment/environmental" definition of health promotion in the mid-1980s[3]:

In 1984 the World Health Organization (WHO) Regional Office for Europe defined health promotion as "the process of enabling people to increase control over, and to improve, their health"[7]. In addition to methods to change lifestyles, the WHO Regional Office advocated "legislation, fiscal measures, organisational

change, community development and spontaneous local activities against health hazards" as health promotion methods[7].

In 1986, Jake Epp, Canadian Minister of National Health and Welfare, released Achieving health for all: a framework for health promotion which also came to be known as the "Epp report"[3][8]. This report defined the three "mechanisms" of health promotion as "self-care"; "mutual aid, or the actions people take to help each other cope"; and "healthy environments"[8].

The WHO, in collaboration with other organizations, has subsequently co-sponsored international conferences on health promotion as follows:

1st International Conference on Health Promotion, Ottawa, 1986, which resulted in the "Ottawa Charter for Health Promotion"[9]. According to the Ottawa Charter, health promotion[9]:

o "is not just the responsibility of the health sector, but goes beyond healthy life-styles to well-being"

o "aims at making... [political, economic, social, cultural, environmental, behavioural and biological factors] favourable through advocacy for health"

o "focuses on achieving equity in health"o "demands coordinated action by all concerned: by governments, by health

and other social and economic sectors, by nongovernmental and voluntary organization, by local authorities, by industry and by the media"

o "should be adapted to the local needs and possibilities of individual countries and regions to take into account differing social, cultural and economic systems"

In addition, the Ottawa Charter conceptualized "health promotion action" as "Build Healthy Public Policy," "Create Supportive Environments," "Strengthen Community Actions," "Develop Personal Skills," "Reorient Health Services" (i.e., "beyond its responsibility for providing clinical and curative services"), and "Moving into the Future."

2nd International Conference on Health Promotion, Adelaide, 1988, which resulted in the "Adelaide Recommendations on Healthy Public Policy"[10].

3rd International Conference on Health Promotion, Sundsvall, 1991, which resulted in the "Sundsvall Statement on Supportive Environments for Health"[11].

4th International Conference on Health Promotion, Jakarta, 1997, which resulted in the "Jakarta Declaration on Leading Health Promotion into the 21st Century"[12].

5th Global Conference on Health Promotion, Mexico City, 2000, which resulted in the "Mexico Ministerial Statement for the Promotion of Health"[13].

6th Global Conference on Health Promotion, Bangkok, 2005, which resulted in the "Bangkok Charter for Health Promotion in a Globalized World"[14].

Altogether, the documents produced by conference attendees emphasized "investing in health promotion beyond an individual, disease-oriented, behaviour-change model"[15]

Worksite health promotionHealth promotion can be performed in various locations. Among the settings that have received special attention are the community, health care facilities, schools, and worksites[16]. Worksite health promotion, also known by terms such as "workplace health promotion," has been defined as "the combined efforts of employers, employees and society to improve the health and well-being of people at work" [17][18]. WHO states that the workplace "has been established as one of the priority settings for health promotion into the 21st century" because it influences "physical, mental, economic and social well-being" and "offers an ideal setting and infrastructure to support the promotion of health of a large audience"[19].

Worksite health promotion programs (also called "workplace health promotion programs," "worksite wellness programs," or "workplace wellness programs") include exercise, nutrition, smoking cessation and stress management. Reviews and meta-analyses published between 2005 and 2008 that examined the scientific literature on worksite health promotion programs include the following:

A review of 13 studies published through January 2004 showed "strong evidence... for an effect on dietary intake, inconclusive evidence for an effect on physical activity, and no evidence for an effect on health risk indicators"[20].

In the most recent of a series of updates to a review of "comprehensive health promotion and disease management programs at the worksite," Pelletier (2005) noted "positive clinical and cost outcomes" but also found declines in the number of relevant studies and their quality[21].

A "meta-evaluation" of 56 studies published 1982-2005 found that worksite health promotion produced on average a decrease of 26.8% in sick leave absenteeism, a decrease of 26.1% in health costs, a decrease of 32% in workers’ compensation costs and disability management claims costs, and a cost-benefit ratio of 5.81[22].

A meta-analysis of 46 studies published 1970-2005 found moderate, statistically significant effects of work health promotion, especially exercise, on "work ability" and "overall well-being"; furthermore, "sickness absences seem to be reduced by activities promoting healthy lifestyle"[23].

A meta-analysis of 22 studies published 1997-2007 determined that workplace health promotion interventions led to "small" reductions in depression and anxiety[24].

A review of 119 studies suggested that successful work site health-promotion programs have attributes such as: assessing employees' health needs and tailoring programs to meet those needs; attaining high participation rates; promoting self-care; targeting several health issues simultaneously; and offering different types of activities (e.g., group sessions as well as print materials)[25].

The global burden of disease (GBD) is a comprehensive regional and global assessment of mortality and disability from 107 diseases and injuries and ten risk factors. The GBD is assessed using the GBD study by the World Health Organization, and is an example of

an evidence-based input to public health policy debate. The aim of the study was to provide information and projections about disease burden on a global scale.

The GBD project was initiated in 1992 and is a collaborative effort between the Harvard School of Public Health, the Institute for Health Metrics and Evaluation, the World Health Organization (WHO) and the World Bank. The original project estimated health gaps using disability-adjusted life years (DALYs) for eight regions of the world in 1990. It is a worldwide collaboration of over 100 researchers based at the Harvard School of Public Health. It provides a standardised approach to epidemiological assessment and uses a standard unit, the disability-adjusted life year (DALY), to aid comparisons.

The GBD has three specific aims:

1. To systematically incorporate information on non-fatal outcomes into the assessment of health status (using a time-based measure of healthy years of life lost due either to premature mortality or to years lived with a disability, weighted by the severity of that disability)

2. To ensure that all estimates and projections were derived on the basis of objective epidemiological and demographic methods, which were not influenced by advocates.

3. To measure the burden of disease using a metric that could also be used to assess the cost-effectiveness of interventions. The metric chosen was Disability-Adjusted Life Years, or DALYs

The burden of disease can be viewed as the gap between current health status and an ideal situation in which everyone lives into old age free of disease and disability. Causes of the gap are premature mortality, disability and exposure to certain risk factors that contribute to illness.

The GBD is now in its fifth round. The series quantifies the burdens of 483 sequelae of 109 major causes of death and disability disaggregated by eight geographic regions and ten age-sex groups. Risk factors are evaluated and projections to the year 2020 are made.

[edit] References Global burden of disease at WHO website GBD Publications from Harvard School of Public Health Global Burden of Disease Mental Disorders and Illicit Drug Use Expert Group at

National Drug and Alcohol Research Centre (University of New South Wales, Australia)

The global burden of disease: what does it mean and what use is it?.

Williams A; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 1997; 13: 66.

Centre for Health Economics, University of York, England.

When calculating the global burden of disease in its World Development Report for 1993, the World Bank employed two sets of explicit weights, and a rather special assumption about people's life expectancy. The first set of weights was concerned with the impact of disease on people's health-related quality-of-life (in terms of "disability"). Together with the impact of disease upon life expectacy, this constitutes the natural meaning of "burden of disease." A second set of weights was also introduced to reflect the fact that society values people more likely in young adulthood than at earlier and later stages in their lives. These "age-weights," being based on a broad notion of social productivity, reflect a supposed efficiency for health care. When estimating years of life lost, some assumption has to be made about people's life expectancy. The World Bank takes this to be the longest life expectancy so far attained by any major group of people on the face of the earth. This is then applied to everybody uniformly, on grounds of fairness, for otherwise a given reduction (say) in an already low level of infant mortality in a rich country (where subsequent life expectancy is high), would appear to be more beneficial than the same absolute reduction to a high rate in a poor country (where subsequent life expectancy is low). My presentation will challenge the World Bank's approach on two grounds. Firstly, that it is dangerous at a policy-making level because it presents aspirations as facts. Secondly, that it imports into the analysis strong ethical judgements the general acceptability of which needs to be empirically tested. An alternative approach will be outlined which avoids these problems.

Global Health ProgramWhat We DoOur Global Health Program harnesses advances in science and technology to save lives in poor countries.  We focus on the health problems that have a major impact in developing countries but get too little attention and funding. Where proven tools exist, we support sustainable ways to improve their delivery.  Where they don’t, we invest in research and development of new interventions, such as vaccines, drugs, and diagnostics.

 

How We Work

Most of our work is done through grants to partners in our priority areas of focus.  Along the way, we seek extensive input from external experts and from our Global Health advisory panel.

In China and India, we have established offices to help manage large programs there. Many of our health efforts are integrated with those in our Global Development program, which focuses on reducing poverty and hunger. 

Priority Areas of FocusOur work in infectious diseases focuses on developing ways to fight and prevent enteric and diarrheal diseases, HIV/AIDS, malaria, pneumonia, tuberculosis, and neglected and other infectious diseases.

We also work on integrated health solutions for family planning, nutrition, maternal, neonatal and child health, tobacco control  and vaccine-preventable diseases.  

Three cross-cutting programs help us successfully address our areas of focus.  These include:

Discovery – Closing gaps in knowledge and science and creating critical platform technologies in areas where current tools are lacking.

Delivery – implementing and scaling up proven approaches by identifying and proactively addressing the obstacles that typically lie in the path of adoption and uptake

Policy & Advocacy– Promoting more and better resources, effective policies, and greater visibility of global health so that we may effectively address the foundation’s priority health targets

Global health priorities

Global health priorities – priorities of the wealthy?Eeva Ollila 1

1Globalism and Social Policy Programme (GASPP), Welfare Research Group, National Research and Development Centre for Welfare and Health (Stakes), Helsinki, FinlandCorresponding author.

Eeva Ollila: eeva.ollila@stakes.fi Received December 1, 2004; Accepted April 22, 2005.This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.This article has been cited by other articles in PMC.

  Other Sections▼ o Abstract o Global health policy actors o Global health priorities

o Approaches for improved global health o Conclusion o References

AbstractHealth has gained importance on the global agenda. It has become recognized in forums where it was once not addressed. In this article three issues are considered: global health policy actors, global health priorities and the means of addressing the identified health priorities. I argue that the arenas for global health policy-making have shifted from the public spheres towards arenas that include the transnational for-profit sector. Global health policy has become increasingly fragmented and verticalized. Infectious diseases have gained ground as global health priorities, while non-communicable diseases and the broader issues of health systems development have been neglected. Approaches to tackling the health problems are increasingly influenced by trade and industrial interests with the emphasis on technological solutions.

  Other Sections▼ o Abstract o Global health policy actors o Global health priorities o Approaches for improved global health o Conclusion o References

Global health policy actorsThe 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 and Immunizations (GAVI), the Global Fund to Fight AIDS, Malaria and Tuberculosis (GFATM) and the Global Alliance for Improved Nutrition (GAIN) – to address selected health issues at the turn of the century has further diversified the global health policy scene. Furthermore, new challenges in health research have been defined under the public-private partnership umbrella of the Global Forum for Health Research.Development aid to health has continued to grow substantially since 1992 despite the fall in total official development assistance (ODA) since that time. The USA provides about one third of the total bilateral aid to health. Other bilateral donors are substantially smaller. The multilateral agencies provide one third of the total official development assistance to health and of that assistance 80% comes from the International Development Association (IDA) [12]. As a new funding source, the Global Health programme of the Bill and Melinda Gates Foundation (BMGF) has become not only significant in size, but also in setting health policy. The funding from the USA, IDA and the BMGF are of about the same order.The US role in global health policy setting has increased in the 1990s. [13] Traditionally the US AID emphases have been on fostering goals such as privatization and economic liberation, and on ties to US exports and technical assistance [14]. During the past decade, the USA has been active in lifting global health issues in new forums, such as the G8. The USA was also instrumental in the creation of the GFATM, towards which the EU, for instance, was initially more critical. According to Kagan [15], the US foreign policy is less inclined to act through international institutions such as the UN and less inclined to work co-operatively with other nations to pursue common goals, while the European foreign policy emphasis is on multilateralism over unilateralism.

  Other Sections▼ o Abstract o Global health policy actors o Global health priorities o Approaches for improved global health o Conclusion o References

Global health prioritiesGlobal health priorities have in recent years been defined through several processes and by several actors and at various forums. In 2000 and 2001, HIV/AIDS, tuberculosis and malaria came to be discussed in a variety of forums at the UN as well as outside the UN, and commitments to address the three diseases were made, for example, by the G8, the World Bank, the World Economic Forum and the European Commission [16,17].Millennium Development Goals (MDGs) [18] are a product of consultations between international agencies, but were also adopted by the United Nations (UN) General Assembly in September 2001 as part of the road map for implementing the substantially broader Millennium Declaration, which it had adopted in September 2000 [19]. The MDGs have eight goals, three of which are health-focussed, namely those on child mortality, maternal health, and HIV/AIDS, malaria and other diseases.

The UN-led Millennium Project, directed by the economist Jeffrey Sachs, has the objective of ensuring that all developing countries meet the MDGs. The whole UN system has since been requested to adapt to addressing the MDGs, and to report to the Secretary General on their achievements in that direction. For health policies, this has meant, for example, pressures from some of the member states, such as the UK, for the WHO to refocus its work on the MDGs, most notably to the goal concerning HIV/AIDS, malaria and tuberculosis, while its wider mandate as the normative health organisation that sets norms and standards and promotes the building up a wider health systems would not be so emphasised [20]. The MDGs have become an important tool to steer both the UN system towards a narrower agenda with more emphasis on selected interventions and country presences, but more recently increased attention has been placed on the need for addressing development – including health policy issues and systems – more comprehensively [21-23].Largely the same priorities for health emerged from the report of the Commission of Macroeconomics and Health (CMH) in December 2001 [24], which concluded that public health resources should be directed to the following priorities: communicable diseases; malnutrition, which exacerbates childhood infections; and maternal and perinatal mortality.Development aid for health is also largely steered towards tackling communicable infectious [25]. USAID has financed population programmes, including family planning, for three decades, while its emphasis on health issues is more recent. In 2002, the USAID population, health, and nutrition funding covered HIV/AIDS, family planning/reproductive health, child survival/maternal health, and infectious diseases [26]. The BMGF has provided strategic funding for the founding of new structures for global health policy making – such as GAVI and GAIN – and for the implementation of the recommendations derived from the CMH. Its Global Health programme focuses on infectious disease prevention, vaccine research and development, and reproductive and child health, with emphasis on the development and implementation of technologies, though recurrent costs or chronic conditions are not financed [28]. In GAVI, the substantial BMGF funding is targeted at new vaccines. Efforts have also been made to tackle health challenges through new health technology research and development funding under the Bill and Melinda Gates Foundation funded Grand Challenges in Global Health initiative [29].According to global mortality and burden-of-disease calculations, the above-set priorities indeed represent the majority of deaths and ill-health in sub-Saharan Africa [27], but do not represent the majority of ill-health in any other region. They cover less that a third of the global ill-health [24,27]. Today, non-communicable diseases are a cause of the majority of ill-health in developing countries, and their importance is increasing rapidly. They affect all socioeconomic groups and in many cases the risks are biggest in the poorest sections of the populations [25].Kickbusch [13] argues that global unilateralism has linked the global health agenda to the US national interests, as well as created a systematic effort to respond to the challenge of the present US administration to show effectiveness. As a result, the four Es – economics, effectiveness, efficiency, and evidence – are now the new battle cries for the development community. Selected interventions to eradicate infectious diseases fit well with these premises.

The lists of the current global health priorities can be seen as reflecting health-related problems in the developing countries that are perceived to threaten the vital interests of industrialised countries. Linking national interests to development aid is by no means new. In the 1970s, such concerns were central in, for example, the argumentation for population programme implementation [30,31]. Nevertheless, it is noteworthy that since the mid-1990s the arguments for a greater US engagement in global health have been expressed increasingly in terms of national interests or enlightened self-interest [13,16].The joint strategic plan of the US Department of State and the US Agency for International Development (USAID) for the fiscal years 2004–2009 states that US foreign policy and development policy are fully aligned to advance the National Security Strategy. The strategy sets out its mission as being to create a more secure, democratic and prosperous world for the benefit of the American people and the international community. The purpose of the Strategy is to help American business succeed in foreign markets and help developing countries create conditions for investment and trade [32].Added emphasis on the trade and industrial policies has been part of global development policies. The eighth MDG is to develop global partnerships for development, which includes developing an open trading and financial system that is rule-based and non-discriminatory in co-operation with both the pharmaceutical sector, for the purpose of providing access to affordable medicines, and in co-operation with the private sector in order to make available the benefits of new technologies. The CMH also argues for increased partnerships with business [24].

  Other Sections▼ o Abstract o Global health policy actors o Global health priorities o Approaches for improved global health o Conclusion o References

Approaches for improved global healthHealth policy-making has become increasingly fragmented and verticalized, with the increasing emphases on selected interventions, the increasing number of partnerships and especially because of the founding of new entities for various health issues. Little emphasis has been put on comprehensive infrastructure building. These trends are in contrast to the stated aims of integrating health policy making with the broader development agenda or with comprehensive health sector planning.An emphasis on innovations and innovative approaches encourages the use of new technologies and the building of new structures. Problems of unsustainability and inequity have arisen with the high levels of funding required, an emphasis on fast results, and the construction of new structures both at global and national levels [2,33-35]. In the initial faces of GAVI serious concerns were raised that those children that had been without basic vaccine coverage before GAVI funding would remain so and also be out of the reach of the new vaccines [33,36]. The GAVI emphasis on new and more expensive vaccines have raised the costs of the immunizations programmes at country level making the future financing of the programmes highly vulnerable [37].

National priorities often differ from the global priorities, and the thinking around global public goods recognizes this as a starting point. Yamey [34] has argued that the increased emphasis on global programmes and global priority setting is problematic from the point of view of national sovereignty and empowerment. He furthermore states that partnerships rarely synchronise their activities with emerging processes within countries aimed at developing their national health systems. This observation has also been made in relation to GAVI country level action [38].Partnerships are commonly defined as voluntary and collaborative relationships between state and non-state participants who agree to work together to achieve a common purpose or undertake a specific task, and to share risks, responsibilities, resources, competencies and benefits [39]. According to Richter [7] one of the most substantive losses resulting from the shift towards the partnership paradigm is the loss of distinction between different actors in the global health arena. UN agencies, governments, transnational corporations, their business associations and public interest NGOs are all called 'partner'. The realisation that these actors have different and possibly conflicting mandates, goals and roles has been lost.The inclusion of business as an integral part of public policy making may weaken the vital role of the public sector in norm- and standard setting and monitoring, as the public sector has been made an equal partner with business, sharing a common purpose and tasks. The WHO collaboration with business has caused harm to the credibility of the WHO's normative functions [7,40-43]. The legally independent global PPPs are structured so that public bodies with normative functions hold seats in the policy-making bodies together with business representatives both at global and national levels. This 'forced marriage' within the legally independent PPPs may harm not only the credibility of the normative functions of the regulators, but also the normative functions as such. In GAIN and in the UNFPA private sector initiative, the normative bodies are directly requested for 'supportive environments' as regards regulation, taxes and tariffs [6].GAVI, GFATM and GAIN deal with essential health issues. Selected UN agencies (in the case of GAIN only one UN or other multilateral agency) that have mandates to deal with these health matters are invited to join their boards either as voting (GAVI and GAIN) or non-voting (GFATM) members, while industry and other private sector actors are included as full members at all levels of their structures [2,6]. The marginalisation of the UN in the structures of the legally independent global PPPs did not happen accidentally. The cautious approach of the WHO to integrating private industry into its activities has been reported as one of the main reasons for GAVI's construction as an independent legal body. Problems were encountered, for example, when issues of intellectual property rights and profits arose [44]. According to Phillips [45], the USA opposed the running of GFATM by either the UN or the World Bank. The US also demanded that the fund set up a world-wide aid-delivery system instead of relying on established agencies, such as the UN and the World Bank.According to Stansfield et al. [46] many public sector leaders have raised the concern that in its eagerness to address market failures and pursue international public goods, PPPs are often structured so that the public sector absorbs the lion's share of the risks and costs, while the private sector absorbs a disproportionate share of the profit. On a more general note, a report by the International Monetary Fund has raised concerns over the inadequate risk-sharing in public-private partnerships [47]. This tendency can be demonstrated, for

example, by the UNFPA private-sector initiative, which aimed at increasing access to reproductive health commodities. According to the initiative, governments were to give preferential tax and duty conditions and ease manufacturing and import regulations, as well as undertake and support market-related research, the donors were to provide support for marketing, advertising and marketing research, while the selected transnational contraceptive producers were requested to sell their products at affordable prices, and handle distribution and implement market-building activities. The initiative also suggested that the governments and the donors could improve the policy environment for private sector investment and security, and facilitate the building of an extensive distribution system so as to reduce the costs for the private sector. Transnational contraceptive producers were instrumental in the selection of the target developing countries, many of which had significant domestic contraceptive production [48].

  Other Sections▼ o Abstract o Global health policy actors o Global health priorities o Approaches for improved global health o Conclusion o References

ConclusionWhile globalisation increases the risk that infectious diseases travel from South to North, it has also increased the risk that major risk factors for non-communicable diseases travel from North to South. Currently, global public health policies are concentrated on selected conditions around infectious diseases and on the technological solutions for them. Addressing infectious diseases in the South is important. However, other health matters are increasingly being left for private actors to deal with. Addressing the most important risk factors of non-communicable diseases, namely tobacco, alcohol and unhealthy foods, would benefit from normative actions, including restrictions on trade and marketing [25]. Simultaneously, global health policy making is increasingly aligned with industrial and trade policies, and is being done hand in hand with business, thus weakening the firewalls necessary for effective regulation and normative actions both at global and national levels.