Time to reassess strategies for improving health in developing countries

摘要: A girl born today in Malawi is 35 times more likely to die before reaching the age of 5 years than a United Kingdom. If she reaches her fifth birthday, can look forward life which has 37 greater chance contracting tuberculosis British counterpart and 180 during pregnancy or childbirth.1 Malawian girls expect span only 42 years, 39 less that girls.1 These differences are typical health gaps between rich poor countries. Contributing factors numerous complex include poverty, low levels education (particularly for women), environmental hazards, limited access services, volumes, unpredictability, volatility aid flows. In recognition, after decade discussion, 189 countries committed accelerate development by endorsing an interrelated set goals, outlined Millennium Declaration September 2000.2 Improving received considerable prominence millennium goals. Three eight goals focused on reducing key causes mortality countries: maternal perinatal conditions, diseases affecting children infants, major communicable (box 1). remain priorities, although non-communicable injuries increasingly important even (table 1). View this table: Table 1 Leading death developing developed countries, 20004 Targets indicators each goal were help monitor evaluate progress 2). Tuberculosis disease other HIV AIDS malaria specifically mentioned last goal. View 2 Targets goals3 The have been criticised several fronts: they too ambitious therefore …