9. Millennium Development Goals for Health: What Will It Take to Accelerate Progress?


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Richard Lord, www.rlordphoto.com

In response to the burden of mortality and suffering concentrated in the world's poorest countries, the United Nations endorsed the Millennium Development Goals (MDGs) to focus resources on addressing critical health issues, including eradicating extreme poverty and hunger; reducing child mortality; improving maternal health; and combating HIV/AIDS, malaria, and other diseases. Halfway through the interval for achieving MDGs, the score is mixed; for example, the poorest 20 percent of the population within countries have seen improvements in nutrition, but child mortality has been failing more slowly among the poor than among the better–off.

Whether countries can scale up health interventions by 2015 depends in part on sound governmental policies and expanded funding. Countries can improve the effectiveness of health care interventions by focusing on the regions furthest behind, reallocating spending across all levels of care toward more cost–effective interventions, targeting specific populations, lowering financial barriers, providing information about good health practices, improving transportation and sanitation systems, providing access to adequate water supplies, and making provider organizations accountable to the public.

While governments in developing countries generally recognize that public health functions such as regulations and infrastructure are important, they often lack the capacity and financial resources to implement them. By employing public health professionals with core health competencies, governments can not only develop and implement standards, they can also monitor the health of communities and promote health education and prevention. Development agencies can help countries accelerate progress toward health goals by providing financial assistance until governments mobilize more domestic resources for health care.