Achieving the Millennium Development Goals--the case of malaria.

Malaria currently kills up to 3 million people per year worldwide, most of them children in sub-Sa-haran Africa. 1 Yet the disease is utterly treatable and highly preventable. Now, the international community has vowed as part of its Millennium Development Goals to make appropriate investments and interventions to bring this scourge under control. These goals, adopted by world leaders at the United Nations Millennium Assembly in September 2000, represent a commitment to reducing extreme poverty and diseases such as malaria sharply by 2015. Among other objectives, the eight development goals call for reducing by half the rates of extreme poverty and hunger by 2015 and reducing childhood mortality by two thirds and maternal mortality by three fourths relative to their 1990 levels. The goals also target the control of the great pandemic diseases — human immunodeficiency virus (HIV) and AIDS, tuberculosis, and malaria. In 2002, the high-income countries, including the United States, made a commitment to substantially increasing their aid to poor countries in order to meet these ambitious but achievable targets, though the actual flow of aid has not yet increased markedly. Three years ago, I was asked by U.N. Secretary-General Kofi Annan to direct a worldwide effort to identify practical means for achieving the Millennium Development Goals in all countries that sought to do so. The U.N. Millennium Project recruited a global network of experts and leading practitioners from many key disciplines to identify a practical course of action. Our final report, Investing in Development: A Practical Plan to Achieve the Millennium Development Goals , as well as final reports of 10 task forces, were presented to Secretary-General Annan on January 17, 2005. Our central conclusion is that the goals can indeed be met through well-designed and concerted actions, but they will not be met in large areas of the world if we continue with business as usual. The current international system of development assistance is not functioning properly. There is too little aid, and it is too poorly directed to enable the world's poorest countries to invest ambitiously in disease control and poverty reduction. The situation is most dire in sub-Saharan Africa. More specifically, we found that poverty reduction and disease control are amenable to targeted investments using proven and effective technologies. Extreme poverty can be cut sharply in a decade's time by scaling up investments in key infrastructure (such as roads, power, water, and sanitation) and …