Josh Ruxin, Joan E Paluzzi, Paul A Wilson, Yes.im Tozan, Margaret Kruk, Awash Teklehaimanot
With 2015 only a decade away, the poorest countries face enormous hurdles to achieving the Millennium Development Goals (MDGs) for health, let alone the broader goal of health for all their citizens. The MDGs all relate to health to some degree; virtually any intervention that reduces poverty and inequality will also decrease the disproportionate vulnerability to disease and injury borne by impoverished people. The UN Millennium Project established a task force concerned with the sixth goal, to “combat HIV/AIDS, malaria and other diseases” and improving access to essential medicines. Its work emphasises broad health challenges while recognising the specific threats posed by the worsening epidemics of HIV/AIDS, tuberculosis, and malaria, which together caused an estimated 6 million deaths in 2004.
The world has the financial and technological resources to bring essential health services to all. In particular, the task force has concluded that existing approaches to combating AIDS, tuberculosis, and malaria, although imperfect, are adequate to greatly reduce the effect of these three diseases. However, the woeful state of health systems in most developing countries prevents these effective interventions from reaching those in greatest need, even where resources are available. Until systems are in place to deliver essential health services on a large scale, attempts to address individual diseases will founder and progress against one will be bought at the price of neglecting others. Although global political and financial commitment for disease control has grown, far more attention and a greater share of resources must be invested in building and strengthening health systems as a whole.
Although the UN Millennium Project Task Force on AIDS, Malaria, TB, Other Major Diseases, and Access to
Essential Medicines is publishing four separate reports, we are united in the conviction that the these concerns must be addressed together through stronger health systems. In this article, we present some of our major recommendations.