The UK government's Department for International Development has launched a new policy document outlining its strategy to tackle health problems in developing countries. The paper is one of a set that collectively aims to define what needs to be done to achieve the ambitious international development targets agreed by the United Nations and recently endorsed by the G8 countries in Okinawa, Japan.
The first of eight targets is to halve the proportion of people living in extreme poverty, by 2015. In an acknowledgement that tackling this target requires international action in many areas, the department has published separate strategy papers on the environment, education, good government, and economic policies in addition to the current paper on health.
The link between poverty and ill health is well recognised, and at a recent meeting in London, Clare Short, the secretary of state for international development, emphasised that improving the health of poor people in developing countries is vital to promoting development.
She also said, “It is essential to raise the profile of the targets to generate more momentum, both nationally and internationally, to achieve them.”
The advantage of setting clear targets is that progress—or lack of it—can be measured, and the G8 has asked for annual reports to be drawn up.
Four responses are seen as “crucial” to achieving the targets that relate to health. Firstly, the main health problems of poor populations need to be addressed. Raising international awareness of the importance of maternal health and determining (and tackling) the environmental factors that influence child health are singled out. So is improving access to health care, appropriate treatments, communicable disease control programmes, and high quality reproductive and sexual health services.
Secondly, investment in efficient, effective health systems is needed in developing countries. Strong primary healthcare services are particularly important, said Ms Short, because “increased support and investment by the international community will achieve little if the basic delivery mechanisms are not there.”
Thirdly, action should be taken to develop a more effective and better coordinated global response to the HIV and AIDS epidemic that is threatening development in many African countries. Among the action points that the department outlines is support for the international AIDS vaccine initiative and the development of microbicides.
Fourthly, access to clean water and sanitation should be promoted because these are major determinants for improving child survival. Educational initiatives should also promote good hygiene.
Ms Short put the chances of achieving the targets at 50:50.
• Gordon Brown, the Chancellor of the Exchequer, announced last week that Britain would stop taking debt repayments from 41 of the world's poorest countries. The repayments, amounting to £1.6bn ($2.24), will instead be used to fight poverty in the debtor countries.
Better Health for Poor People: Strategies for Achieving the International Development Targets is available from the Department for International Development, 94 Victoria Street, London SW1 5JL, or from www.dfid.gov.uk 
International development targets endorsed by the G8 group in August 2000
A 50% reduction in the proportion of people living in extreme poverty by 2015
Demonstrated progress towards equality of the sexes and the empowerment of women by eliminating disparity between the sexes in education by 2005
A reduction by two thirds in mortality among children aged under 5 by 2015
A reduction by three quarters in maternal mortality by 2015
Universal access to reproductive health services no later than 2015
Implementation of national strategies for sustainable development in all countries by 2005
A 24% reduction in HIV infection rates among 15-24 year olds in the worst affected countries by 2005 and globally by 2015
A 50% reduction in mortality from tuberculosis and malaria by 2010