If these countries are to make meaningful progress on the strategy aims - the Millennium Development Goals - most will have to raise funds or be forced to reallocate monies from other programmes, argue the authors, all experts from the World Health Organisation.

The Millennium Development Goals were agreed between 189 of the world's major western nations and much of the developing world. Those specifically on health were designed to take action on five key fronts: reducing mother and infant deaths, tackling child poverty, preventing the spread of HIV/AIDS, and controlling malaria and tuberculosis.

Current approaches must change if the goals are to be achieved more quickly. In curbing the spread of HIV/AIDS, treatment with first-line antiretrovirals has now become at least as cost effective as some of the well known preventive interventions, such as voluntary counselling and testing, say the authors. Educating sex workers, mass media messages, and treating people for other sexually transmitted infections, should also be the focus of new campaigns.

Mothers and newborns must have both basic and emergency medical services as a priority, and all children should get measles immunisation and micronutrients as a matter of course, say the authors.

The fight against malaria demands a much larger injection of resources than currently available, and substantial investment is also needed to meet targets on reducing tuberculosis, they argue.

The papers, which examine the cost-effectiveness of health policies in Africa and South-East Asia, preview a two-day Paris summit next week (14-15 November 2005) to look at why the Millennium Development Goals have not been met.

Both Africa and South-East Asia have such a huge degree of need
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Contact: Teresa Hagan
thagan@bma.org.uk
020-738-36174
BMJ-British Medical Journal
10-Nov-2005