Time to reassess strategies for improving health in developing countries

doi:10.1136/bmj.331.7525.1133

BMJ 2005;331:1133-1136 (12 November), doi:10.1136/bmj.331.7525.1133

Education and debate

Achieving the millennium development goals for health

Time to reassess strategies for improving health in developing countries

David B Evans, director¹, Taghreed Adam, health economist¹, Tessa Tan-Torres Edejer, coordinator², Stephen S Lim, research fellow³, Andrew Cassels, director⁴, Timothy G Evans, assistant director general⁵, for the the WHO Choosing Interventions that are Cost Effective (CHOICE) Millennium Development Goals Team

¹ Health Systems Financing, Evidence and Information for Policy, World Health Organization, Geneva, Switzerland, ² Costs, Effectiveness, Expenditure and Priority Setting, World Health Organization, ³ School of Population Health, University of Queensland, Australia, ⁴ Department of Millennium Development Goals, Health and Development Policy, World Health Organization, ⁵ Evidence and Information for Policy, World Health Organization

Correspondence to: D B Evans evansd@who.int

The first 150 words of the full text of this article appear below.

Introduction

A girl born today in Malawi is 35 times more likely to die beforereaching the age of 5 years than a girl born in the United Kingdom.If she reaches her fifth birthday, she can look forward to alife in which she has a 37 times greater chance of contractingtuberculosis than her British counterpart and is 180 times morelikely to die during pregnancy or childbirth.¹ Malawian girlscan expect a life span of only 42 years, 39 years less thanthat of British girls.¹ These differences are typical of thehealth gaps between rich and poor countries. Contributing factorsare numerous and complex and include poverty, low levels ofeducation (particularly for women), environmental hazards, limitedaccess to health services, and the low volumes, unpredictability,and volatility of aid flows. In recognition, after a decadeof discussion, 189 countries committed to accelerate developmentin poor countries . . . [Full text of this article]

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