Education and debate

Achieving the millennium development goals for health

Evaluation of current strategies and future priorities for improving health in developing countries

BMJ 2005; 331 doi: 10.1136/bmj.38658.675243.94 (Published 15 December 2005)
Cite this as: BMJ 2005;331:1457

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  1. David B Evans, director (evansd@who.int)1,
  2. Stephen S Lim, research fellow2,
  3. Taghreed Adam, health economist3,
  4. Tessa Tan-Torres Edejer, coordinator4

    WHO Choosing Interventions that are Cost Effective (CHOICE) Millennium Development Goals Team

  1. 1 Health Systems Financing, Evidence and Information for Policy, World Health Organization, Geneva, Switzerland
  2. 2 School of Population Health, University of Queensland, Australia
  3. 3 Health Systems Financing, Evidence and Information for Policy, World Health Organization
  4. 4 Costs, Effectiveness, Expenditure and Priority Setting, World Health Organization
  1. Correspondence to: David B Evans
  • Accepted 12 October 2005

This article is the last in a series examining the cost effectiveness of strategies to achieve the millennium development goals for health

More resources are needed to enable developing countries to fund just the health interventions that are highly cost effective. Evidence that existing money is being well spent may help this cause

Introduction

Five years after the Millennium Declaration was signed, few of the poorest countries in the world are on track to achieve the millennium development goals for health.1 2 In September 2005, heads of state renewed their commitment to these goals and to finding the resources to achieve them. The needs are substantial. An additional $73bn (£41bn; €60bn) in external aid will be needed in 2006 alone for all the millennium development goals, with about $18.5bn for health.3 In this series we have examined whether the strategies adopted for using the available resources, and those planned for future resources, are appropriate in view of the disappointing progress, changing circumstances, and new evidence.4–8 Here, we summarise the key findings for each of the health conditions targeted by the goals and then take the perspective of a policy maker trying to achieve all of them.

Analysis of simultaneous interventions

Our method of analysis used two innovations to ensure the results had more relevance to practical policy decisions than traditional cost effectiveness analysis.3 9–12 Firstly, the cost effectiveness of the existing use of resources could be evaluated at the same time as the cost effectiveness of possible future courses of action should new resources become available. Traditional cost effectiveness analysis has usually considered only future use of resources. Secondly, we incorporated interactions between costs and effects of interventions that are undertaken simultaneously, as they would …

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