Inter Press Service - November 11, 2004
Stefania Bianchi

The report 'Rising to the Challenges: The Millennium Development Goals For Health' released Thursday says more than 11 million children died in 2002 before reaching their fifth birthday from preventable illness, while some 500,000 women died during pregnancy or childbirth.

The Bank says that this situation is particularly distressing as many of the "technologies" needed to improve health are available and affordable.

It adds that even in countries with little money, "sensible and systematic efforts" to improve health can work.

The set of eight Millennium Development Goals (MDGs) aim to improve the well-being of hundreds of millions of people in the developing world by 2015.

Four of these goals relate directly to health - to reduce maternal mortality by three-quarters and child mortality by two-thirds, to halve the proportion of people who suffer from hunger, to combat HIV/AIDS, malaria and other diseases, and to improve access to safe drinking water and essential drugs.

With just ten years left before the MDGs are meant to be achieved, the Bank says "more help is needed to fix inadequate health care delivery systems, to train more health care workers, and to supply more predictable aid to those developing countries in dire need of support."

The Bank is particularly concerned that "even with general economic growth and faster progress on the non-health MDGs" many regions will still miss many of the health MDG targets.

The report finds that progress against child mortality has been so slow that no sub-Saharan country in Africa is on target to reach that goal. It adds that at the current pace, only 16 percent of countries in the developing world are on track to meet this goal.

Similarly, only 17 percent of developing countries are likely to meet the maternal mortality goal. Latin American and Caribbean countries are faring worst, the report says.

Although effective treatments and interventions already exist for many illnesses, the Bank says they are used too infrequently by people who need them most. This is particularly true of illnesses such as diarrhoea, pneumonia and malaria which account for 52 percent of child deaths worldwide.

"The scale of death and illness in the world today is simply staggering, but it doesn't have to be this way, given what governments now know about what works, and what doesn't in helping poor people live healthier, longer lives," says Jacques Baudouy, director of the Bank's health, nutrition, and population team which produced the report.

The Bank identifies steps that both developing and donor countries can take to speed up progress towards meeting the goals.

For developing countries, the Bank says that increasing health spending is part of the answer to getting poor people the effective treatments they need. It stresses however, that this is not the whole story.

It adds that unless money and services are targeted at people who need them the most, increased spending will have little impact.

Instead, health systems need to be strengthened to better distribute life-saving drugs and treatments, and more medical staff needs to be trained to offset the steady loss of doctors, nurses and other medical staff to more affluent countries in developed countries, the report says.

The Bank also warns donor countries that the foreign aid they give for health is often "too unpredictable", and that the transaction costs are too high. It is urging these countries to work together to raise more money for aid and to ensure that advice given to poor countries is consistent.

"Better coordination, pooling foreign aid to secure the biggest impact for the money, and putting countries in the driver seat to steer towards their own priorities, would all help greatly in getting care and treatment to people who need it the most in developing countries," the report says.

World Bank president James D. Wolfensohn says in the report that new and innovative steps need to be taken to ensure that the track record improves. "We need to look at measures such as committing increased resources to meeting the health-related MDGs, and using those resources more effectively in countries," he says.

The strengthening of human resources in the health care system, improvements in the monitoring and evaluation of the goals, and donor harmonisation are particularly important, he says.

***** +World Bank (www.worldbank.org)

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