Why do some global health issues, such as HIV/AIDS, receive priority from international and national political leaders whereas others also representing high burden – such as pneumonia and injuries – receive little attention? To analyse this question I propose a framework consisting of four categories: the strength of the actors involved in the initiative, the power of the ideas they use to portray the issue, the nature of the political contexts in which they operate, and characteristics of the issue itself. I illustrate this framework by applying it to the case of a global initiative to reduce maternal mortality, launched in 1987. I then draw out implications for the issue of injury prevention. I conclude by suggesting areas for future research on the determinants of political priority for global health issues, a subject that has attracted much speculation but little scholarship.
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