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Poorer countries will not meet health targets, warns WHO
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     Many of the world's poorer countries will not meet the health millennium development goals without concerted effort. This was the warning of a report published last week by the World Health Organization, just ahead of the G8 summit (a meeting of the leaders of the world's most industrialised nations).

    The report, Health and the Millennium Development Goals, concluded that most poor countries would not meet the goals if the trends seen during the 1990s continued. The goals, agreed in the 1990s by 189 countries, include reducing child mortality, improving maternal health, and combating infectious disease.

    No region of the developing world was currently on track to meet the child mortality target of cutting death rates in children younger than 5 years by two thirds by 2015. The data showed that countries with high child mortality had not improved and death rates had even worsened in some. Sub-Saharan Africa achieved only a 3% reduction, for example.

    The report predicted that if current trends continued, death rates among children younger than 5 would fall by only 25% by 2015—far short of the goal.

    But the proportion of women with a skilled medical person in attendance during labour had increased rapidly in some regions, particularly in Asia. Overall, this figure had risen from 42% in 1990 to 53% in 2000. But in sub-Saharan Africa, the figure had remained static at about 40% over the decade.

    Use of effective tuberculosis treatment and case finding had expanded, but too slowly to meet the target of 70% case detection.

    The establishment of fully functioning and equitable health systems is a prerequisite for reaching the health goals, the report found, but "in too many countries, the health systems either do not exist or are on the point of collapse," it says.

    Andrew Cassels, director of health and development policy at WHO, said, "The real priority is to encourage countries to develop better health systems, with the right skill mix, staff numbers and in service training—particularly in... southern Africa." Countries needed to put political muscle behind health improvement measures, he added.

    Africa and measures to improve retention of healthcare professionals and reduce "poaching" by wealthier countries are key topics that will be discussed at the G8 summit.(Susan Mayor)