millennium project the millennium project: a plan for

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Millennium Project

This year marks a pivotal moment in internationalefforts to fight extreme poverty. During the UnitedNations (UN) Millennium Summit in 2000, 147 headsof state gathered and adopted the MillenniumDevelopment Goals (MDGs, panel 1) to addressextreme poverty in its many dimensions—incomepoverty, hunger, disease, lack of adequate shelter, andexclusion—while promoting education, genderequality, and environmental sustainability, withquantitative targets set for the year 2015. The UNcommitted to reviewing progress towards the goals in2005, recognising that by this time only a decade wouldbe left to fulfil the MDGs.

We are now at the 5-year juncture with a starkrealisation: many of the poorest regions of the world,most notably in sub-Saharan Africa, are far off-track toachieve the goals. Yet the MDGs are still achievable. Thelives of hundreds of millions of people could bedramatically improved and millions could be savedevery year, but only if the world takes bold steps in 2005.This essay is the first in a series summarising keyconclusions of the UN Millennium Project, a 3-yearindependent advisory effort initiated by UN Secretary-General Kofi Annan to identify practical steps to achievethe MDGs in every country, especially in those currentlyfar off-course in progress. The project was housed inand supported by the UN Development Programme.

The project established 10 task forces to identifystrategies and means of implementation to achieve eachMDG target, and each task force has produced adetailed report (panel 2). The task force coordinatorsalso worked together to synthesise their findings into anoverall integrated strategy.1 Additionally, the project hasworked in several countries with government,international agencies, and civil society, to supportdetailed on-the-ground analyses of strategies and

financing needs to achieve the MDGs. On Jan 17, theUN Millennium Project delivered its reports to the UNSecretary-General.

Practical approaches to achieve the MDGsThis series of essays provides an overview of thepractical approaches that UN Millennium Project hasidentified. The approaches are similar to, and in somecases built directly on, the series of five essays in TheLancet last year on child survival.2–6 The Lancet studiesdemonstrated a core truth: there are known packages ofeffective and generally low-cost interventions in the areaof public health that could make a decisive difference tochild survival, if access to those interventions could beextended to the poor. As Jones and colleagues3 wrote,“These findings show that the interventions needed toachieve the millennium development goal of reducingchild mortality by two-thirds by 2015 are available, butthat they are not being delivered to mothers and childrenwho need them.”

The UN Millennium Project, like the WHOCommission on Macroeconomics and Health during2000–01, determined that the scarcity of financialresources is a critical constraint to scaling up theseknown and proven interventions in the poorest countries.Increased financing, linked to effective governancestructures in low-income countries, can producedramatic results. Fortunately, what is crushinglyexpensive for the poorest of the poor is shockinglyinexpensive for the rich. Thus, increases in officialdevelopment assistance totalling only a few tenths of onepercent of donor-country income, if properly directed andintegrated into national poverty reduction strategies, canreduce child mortality substantially. The same effect istrue in other dimensions of poverty including hunger,lack of access to safe drinking water and sanitation, slum

Published online January 12, 2005http://image.thelancet.com/extras/04art12121web.pdf

The UN Millennium Project,314 Low Library (Prof J D Sachs PhD), and OneUN Plaza (J W McArthur MPhil),New York, NY, USA

Correspondence to: Prof Jeffrey D Sachs, The UN Millennium Project, 314 Low Library, 535 West116th Street, New York, NY10027, [email protected]

www.thelancet.com Published online January 12, 2005 http://image.thelancet.com/extras/04art12121web.pdf 1

The Millennium Project: a plan for meeting the MillenniumDevelopment GoalsJ D Sachs, J W McArthur

Panel 1: Millennium Development Goals

1 Reduce extreme poverty and hunger by half relative to1990

2 Achieve universal primary education3 Promote gender equality and empowerment of women4 Reduce child mortality by two-thirds relative to 19905 Improve maternal health, including reducing maternal

mortality by three-quarters relative to 19906 Prevent the spread of HIV/AIDS, malaria, and other

diseases7 Ensure environmental sustainability8 Develop a global partnership for development

Panel 2: UN Millennium Project task forces

1 Poverty and economic development 2 Hunger3 Education and gender equality 4 Child and maternal health5 HIV/AIDS, malaria, tuberculosis, and access to essential

medicines6 Environmental sustainability7 Water and sanitation8 Improving the lives of slum dwellers9 Trade10 Science, technology, and innovation


Millennium Project

conditions in urban areas, or lack of schooling.Importantly, interventions to reduce one dimension ofpoverty almost invariably assist in reducing otherdimensions.

The increased aid required to meet MDGs has beenpromised, though not yet delivered. In March, 2002,governments worldwide adopted the Monterreyconsensus at the International Conference on Financingfor Development, which strengthened the globalpartnership needed to achieve MDGs. In essence, theinternational community recognised the need for a newpartnership of rich and poor countries based on goodgovernance and expanded trade, aid, and debt relief,especially to help finance the infrastructure and humancapital needed to attract private investment. Donorcountries committed to providing the necessaryresources by reaffirming their pledge to reach 0·7% oftheir income in official development assistance,compared with the current developed world average ofabout 0·25% of gross national product (GNP). Withthe combined donor-country GNP at roughly US$30 trillion, 0·7% of GNP would be about $200 billionper year compared with present aid flow at about $70billion per year. The UN Millennium Project’s findingsshow that the additional $130 billion per year would bemore than enough to scale up the critical interventionsneeded to achieve the MDGs in well governed,developing countries.

The UN Millennium Project’s final report1 has fourmain parts. The first is a diagnosis of why the MDGs arenot being achieved in many regions (and almost

worldwide in the case of some goals). The secondidentifies the key investments and policies that couldmake the difference in achieving the MDGs. The thirdoutlines the international processes and policy changesthat could help scale up the needed investments atcountry level, if backed by the necessary increases indevelopment financing. The fourth estimates the costsand benefits, describing the tens of millions of lives thatcould be saved—and the hundreds of millionsimproved—at a cost clearly within the financial targetsagreed upon in the Monterrey Consensus.

Diagnosis of the shortfall in achieving MDGsSince the goals were set, the performance acrosscountries has been very mixed. Many parts of the worldare making very good progress. Improvementsthroughout east Asia and south Asia, home to more thanhalf the world’s population, have been especiallyremarkable. However, there are huge disparities. Sub-Saharan Africa is in pervasive crisis, with rising extremepoverty, shockingly high child and maternal mortality,and a trajectory that has many of the countries failing tomeet most of the MDGs. Additionally, Latin America,the Middle East, and north Africa have made littleheadway in reducing the rates of extreme poverty inrecent years. Even Asia remains home to hundreds ofmillions of people living in extreme poverty. Virtually allcountries are failing in the goal of achievingenvironmental sustainability, and most lag severely onthe goals for gender equality and maternal mortality(figure 1).

2 www.thelancet.com Published online January 12, 2005 http://image.thelancet.com/extras/04art12121web.pdf

<20

<500

No data

20–100100–200200–500

Figure 1: Maternal mortality ratio, 2000 (per 100 000 livebirths) Source: UN Development Programme (2004).


Millennium Project

The UN Millennium Project identified four broadcategories to explain why some regions are failing tomeet MDGs and why some goals are falling short almosteverywhere. First, not surprisingly, is the problem ofpoor governance. When governments in low-incomecountries fail to govern responsibly by abusing citizens,denying equal protection of the law, or victimisingsociety with corruption, mismanagement, or economicirrationality, the MDGs are bound to fall short. Yet poorgovernance also arises when governments are wellintentioned but lack the human resources managementsystems and infrastructure needed to run an efficientpublic administration. Throughout the developingworld, weak but willing governments are also fallingshort of achieving MDGs.

Second, therefore, is the pervasive problem of povertytraps, in which poor people are simply too poor to carryout the investments needed to overcome hunger,disease, and inadequate infrastructure, and as a resultare also unable to achieve sustained economic growth.These countries are caught in a vicious circle. Extremepoverty results in low saving rates (families are living atsubsistence and therefore unable to save), low taxrevenues (governments cannot provide the publicinvestments and administration prerequisite todevelopment and private-sector growth), low foreigninvestment (the lack of basic infrastructure makes thecost of running a business too high), high frequency ofviolent conflict (due to resource scarcity and otherstrains), brain drain (skilled workers emigrate in searchof higher wages), rapid population growth (poor peoplehave the highest fertility rates and less access toinformation and services to space or limit theirpregnancies in accordance with their preferences), andenvironmental degradation (people living in extremepoverty are often unable to invest in the environment orlimit damage to local resources). In turn, these factors allcontribute directly to low or even negative rates ofeconomic growth per person, and thereby to prolongedor worsened poverty over time.

Poverty traps are much more likely to occur whengeographical conditions are unfavourable, as isespecially true in sub-Saharan Africa. Adverse geograph-ical conditions include: high transport costs (eg,landlocked areas or mountainous regions), adversedisease ecology (eg, high burden of tropical diseasessuch as malaria), and adverse conditions for agriculture(eg, dependency on rain-fed agriculture in subhumid orarid regions). The key to ending the poverty trap is forhigh-income countries to help developing countriesmake the necessary investments in health, education,and basic infrastructure.7 Once extreme poverty isreduced with the support of external assistance, low-income countries can begin to achieve self-sustainingeconomic growth on their own.

Third, many countries are failing to achieve at leastsome of the MDGs because of persistent pockets of

poverty. This is especially characteristic of large middle-income countries with great regional and ethnicdiversity, such as Brazil, China, and Mexico. In theseinstances, governments must ensure that the criticalinvestments—in infrastructure, human capital, andimproved public administration—are channelled tolagging regions (including slums) and to social groupsexcluded from the political process and economicbenefits.

Fourth, some of the goals are falling short almosteverywhere because of policy neglect, where policy-makers are unaware of the challenges, unaware of whatto do, or neglectful of core public issues. Throughout thedeveloping world, neglect is especially common withrespect to the environment and deprivation of girls andwomen—especially with regard to schooling, maternalmortality, legal protection against violence, and access toinfrastructure.

Identifying key interventions and policiesIf governance is adequate, the key to achieving theMDGs is therefore a scaling up of investments intargeted sectors and regions. The key lesson from TheLancet series on child survival and from the UNMillennium Project task forces is that sound, proven,cost-effective interventions indeed exist that canameliorate, and often eliminate, the underlying causesof extreme poverty. Some real breakthroughs arepossible, if the existing technologies can be imple-mented, at scale, in the poorest parts of the world. Goodscience and practical experience have identified coretechnologies that can deliver increased food production,disease control, and access to basic infrastructure suchas safe drinking water. When these basic investmentsare in place, it becomes much easier for the country’s


Panel 3: Examples of quick wins in the health sector

● The training of large numbers of village workers inhealth, farming, and infrastructure (in 1-yearprogrammes) to ensure basic expertise and services inrural communities

● Distribution of free, long-lasting, insecticide-treatedbednets to all children in malaria-endemic zones todecisively cut the burden of malaria

● Elimination of user fees for basic health services in alldeveloping countries, financed by increased domesticand donor resources for health

● Expansion of access to sexual and reproductive health,including family planning and contraceptive informationand services, by closing existing funding gaps oncontraceptive supplies, family planning, and logistics

● Expansion of the use of proven effective drugcombinations for AIDS, tuberculosis, and malaria,especially in places where infrastructure already existsbut finance is lacking


Millennium Project

private sector to thrive, attract foreign investment, andimprove the country’s economy, thus creating jobs andraising incomes.

Of course, investments need to be accompanied bysound policies. Scaling up education systems forexample, requires significant investments in schools,teachers, and supplies, but it also needs managementsystems that allow greater transparency to trackbudgets, policies that encourage parental involvement

and oversight, and more decentralised school-basedmanagement. Similarly, investments for genderequality need to go hand-in-hand with legislation toguarantee property and inheritance rights for womenand girls and to protect them from violence.

The scale-up of interventions and policies required tomeet the MDGs will demand long-term investments inmanagement systems, training and retention of humanresources, and infrastructure. For instance, afunctioning district-level health system will be requiredto achieve and sustain many of the health goals.However, in some aspects of the MDGs, there arepotentially huge quick wins (panel 3), in which simpleinterventions can make a profound difference tosurvival and quality of life, even before breakthroughsin public management, major expansions ofprofessionals, or infrastructure. Soil nutrient replen-ishment, distribution of incesticide-treated bednets,expansion of locally produced school meals pro-grammes to improve school attendance and perform-ance, among others, can be accomplished rapidly andon a very large scale, similar to a bold immunisationcampaign. The project urges an especially rapid scaleup and financing of such quick wins in many differentsectors. In many instances, non-governmentalorganisations will be best placed to deliver rapid scale-up.

Creation of national-level processes for scalingupThe UN Millennium Project’s core operationalrecommendation is that every developing country withextreme poverty should adopt and implement anational development strategy that is ambitiousenough to achieve the MDGs. The country’sinternational development partners—includingbilateral donors, UN agencies, regional developmentbanks, and the Bretton Woods institutions—shouldgive all the technical and financial support needed toimplement the country’s strategy. In particular, officialdevelopment assistance should be adequate to pay forthe financing needs, assuming that governancelimitations are not the binding constraint, and that thereceiving countries are making their own reasonableefforts at domestic resource mobilisation. For manylow-income countries, such a mechanism already existsthat allows governments to work in collaboration withtheir development partners, as well as with civil societyand the private sector in the design of a nationalstrategy. The instrument is called a Poverty ReductionStrategy Paper (PRSP), which, albeit imperfectly, hashelped focus the development efforts of governmentsand is the main country-level framework used by theinternational development agencies.

However, as the central strategy document at thecountry level, the PRSP must be aligned with theMDGs. In countries where the goals are already withinreach, additional MDG-plus targets can be set. So far,most national strategies have not been ambitiousenough to meet the MDGs, especially in low-incomecountries, and have instead planned around modestincremental expansions of social services andinfrastructure on the basis of existing budgets andamounts of donor aid. Instead, MDG-based povertyreduction strategies should present a bold, 10-yearframework aimed at achieving the quantitative targetset in the MDGs. They should spell out a financial planfor making the necessary investments, then show whatdomestic resources can afford and how much will beneeded from the donors. Although poverty reduction ismainly the responsibility of developing countriesthemselves, achievement of the MDGs in the poorestcountries—those that genuinely aspire to the MDGtargets—will require substantial increases in officialdevelopment assistance to break the poverty trap.Importantly, we are not advocating new developmentprocesses or policy vehicles. We are simplyrecommending that the current processes be MDG-oriented.

The core challenge of the MDGs is in the financingand implementation of the interventions at scale—fortwo reasons. One is the sheer range of interventionsthat should be sequenced and integrated to reach thegoals. The second is the need for national scaling-up tobring essential MDG-based investments to most of the


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Millennium Project

population by 2015. Scale-up needs to be carefullyplanned and overseen to ensure successful andsustainable implementation. The amount of planningis much more complex than for any one project, andrequires a working partnership between government,the private sector, non-governmental organisations,and civil society. Previously, scaling up has beenimmensely successful when governments are com-mitted to doing it, communities are encouraged toparticipate in the process and implementation, andlong-term, predictable financing has been available.

Mobilisation of global scienceAdvances in science and technology allow society tomobilise new sources of energy and materials, fightdisease, produce crops, assemble and disseminateinformation, transport people and goods with greaterspeed and safety, restrict family size as desired, andmuch more. But these technologies are not free. Theyare the fruits of enormous social investments ineducation, scientific discovery, and targeted technolog-ical projects. Every successful high-income countrymakes special public investments to promote scientificand technological capacities.

The poor countries have largely been spectators, or atbest, users of the technological advances produced in thehigh-income world. Developing countries have tended tolack large scientific and technological communities.Their scientists and engineers, chronically underfunded,emigrate for satisfying employment in scientificresearch and development. Moreover, private companiesfocus their innovation activities on the problems andprojects of high-income countries, where the financialreturns are likely.

Any strategy to meet the goals requires a special globaleffort to build scientific and technological capacities inthe poorest countries. These efforts should focus onstrengthening institutions of higher education. Effortsare also needed to direct research and developmenttowards specific challenges facing the poor in disease,climate, agriculture, energy, and environmentaldegradation. Realistic prospects exist to develop newvaccines and medicines for malaria, HIV/AIDS,tuberculosis, and other killer diseases in developingcountries. Improved sexual and reproductive healthproducts—including microbicides, new female-con-trolled methods, and male contraceptives—could expandtheir use. Improved agricultural varieties and croppingsystems can increase food productivity of rain-fedagriculture. Accurate environmental monitoring andforecasting can help focus actions with the greatestpositive impact. Other examples abound.

The UN Millennium Project is therefore calling for amajor effort for targeted science and technologydevelopment in high-priority areas, reaching $7 billionevery year by 2015. $4 billion could be directed at publichealth, following the recommendations of the

Commission on Macroeconomics and Health. $1 billionwould go toward agriculture and improved naturalresource management by more than doubling thecurrent budget of the Consultative Group onInternational Agricultural Research (CGIAR). Roughlyanother $1 billion would go toward improved energytechnologies, and perhaps $1 billion is needed forgreater understanding of seasonal, interannual, long-term climate change.

Global costs and benefits How much will the goals cost to achieve? What share oftotal costs can be borne through increased domesticresources, and what must be provided by donors?These questions can be properly answered onlythrough detailed needs assessments that must beundertaken at the country level. As a first attempt, theUN Millennium Project collaborated with localresearch organisations to prepare MDG needsassessments for five countries to quantify infra-structure, human resource, and financial needs. Wefound that Ghana, for example, required annual publicinvestments for the MDGs totalling to $80 per personin 2006 (compared with $40 per person spent in 2002),scaling up to $124 in 2015. Needs assessments forother low-income countries show similar amounts ofinvestments required for the MDGs.


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Even assuming a major increase in domesticresource mobilisation, our results suggest that in atypical low-income African country with an averageincome of $300 per person in 2005, external financingof public interventions of about 10–20% of GNP will beneeded. For these countries, the costs of achieving theMDGs will need to be split evenly between domesticfinance and official development assistance. Mean-while, most middle-income countries will be able tofinance essentially all investments in the goals withoutresorting to external finance—unless excessive debtburdens constrain them or they require modest levelsof official development assistance to redress especiallydifficult pockets of poverty.

According to our estimates, the total donor cost ofsupporting the MDG financing gap for every low-income and middle-income country would be$73 billion in 2006, rising to $135 billion in 2015. Inaddition to these direct investments in the goals, thereare added national and international costs—inemergency and humanitarian assistance, outlays forscience and technology, enhanced debt relief, increasedtechnical capacity of bilateral and multilateral agencies,and other categories of official development assistance.Moreover, projections of official developmentassistance must take into account the fact that somecountries are unlikely to reach minimum thresholds ofgovernance required to qualify for increased aid andthat some existing funds can be reprogrammed tosupport the goals. If we take into account a substantialincrease in domestic resource mobilisation in alldeveloping countries, we project that overall officialdevelopment assistance required during the nextdecade will be $135 billion in 2006, rising to$195 billion in 2015 (table1). These figures areequivalent to 0·44% and 0·54% of donor GNP,respectively, well within the long-standing 0·7%commitment. Notably, additional funds will berequired to finance other needs such as measures todeal with climate change or to protect global

environmental goods, because of which reaching the0·7% commitment will still be important. The requireddoubling of annual official development assistancepales beside the wealth of high-income countries—andthe global military budget of $900 billion a year.

Reaching the MDGs will bring tremendous benefitsworldwide. If the goals are achieved, more than500 million people will be lifted out of poverty in 2015and tens of millions of lives will be saved, with a greatproportion of the improvements taking place in Africa.More than 300 million will no longer suffer fromhunger. With the MDGs, from now to 2015 roughly30 million fewer children will die before their fifthbirthdays, and about 20 million fewer will diecompared with the current declining trajectory of childmortality (figure 2). More than 2 million mothers will besaved. Achievement of the goals will also mean safedrinking water for another 350 million people, and thebenefits of basic sanitation to 650 million, allowing themto lead healthier and more dignified lives. Environ-mental degradation will be reversed and hundreds ofmillions more women and girls will be leading their


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If developing countries continueat current trend

20 million additionallives saved

If MDGs met in alldeveloping countries

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12

10

4

6

8

2

01990 1995 2000 2005 2010 2015

Year

Figure 2: Global mortality of children under 5 years of ageSource: UN Millennium Project (2005).

2002 2006 2010 2015

Baseline ODA for MDGs in 2002 28 28 28 28Incremental MDG investment needs n/a 94 115 161Adjustment for non-qualifying countries because of inadequate governance n/a –21 –23 –25Reprogramming of existing ODA n/a –6 –7 –9Emergency and distress relief 4 4 5 6Other ODA* 34 36 34 35Total indicative net ODA needs for the MDGs† 65 135 152 195As % of OECD-DAC countries’ GNI 0·23% 0·44% 0·46% 0·54%ODA to least developed countries (as % of OECD-DAC countries’ GNI) 0·06% 0·12% 0·15% 0·22%Absolute increase in net ODA required (compared with 2002) n/a 70 87 130Difference between total net ODA needs and existing commitments n/a 48 50 74

Data are in 2003 US$ billion. Data for 2002 are estimates, data for 2006–2015 are projections. ODA=official development assistance. OECD=Organisation for Economic Cooperation andDevelopment. DAC=Development Assistance Committee. GNI=gross national income. n/a=not applicable. *Includes ODA that does not contribute directly to MDGs and operatingexpenditures of donor agencies. †This estimate does not include several important ODA needs, such as: response to crises of geopolitical importance (ie, Afghanistan or Iraq), protectionof the impact of climate change, protection of biodiversity, and conservation of global fisheries, among others.

Table: Plausible ODA needs for achievement of MDGs


Millennium Project

lives in freedom with more security and moreopportunity. The achievement of MDGs could put theworld on a path to ending absolute poverty, and—asrecognised last month by the Secretary-General’s high-level panel on threats, challenges, and change—thisaccomplishment will be central to global security.

The importance of 2005If the MDGs are to be met, 2005 must bring a majorincrease in effort. Fortunately, two world leaders, theUK’s Tony Blair and France’s Jacques Chirac, buildingon a far-thinking plan of Gordon Brown, the BritishChancellor, have promised exactly that. They havepledged to make 2005 a breakthrough year, especially atthe G8 summit, to be hosted by the UK in Scotland inJuly. To lay the groundwork, President Chiraccommissioned Jean-Pierre Landau to report on thefinancing mechanisms for development. Prime MinisterBlair appointed a high-level commission for Africa,which will issue a report in the spring of 2005. TheCommission for Africa will probably concur that greatlyincreased donor assistance, well spent, is key to helpingAfrica break out of its poverty trap. Such agreementshould be followed by a successful G8 summit in July, inwhich developed countries commit to at least doublingofficial development assistance in 2005–15, reachingnothing less than 0·5% of GNP by 2010 before 0·7% by2015. This situation would provide the backdrop forworld leaders at the UN General Assembly inSeptember, 2005, to review progress on the MillenniumDeclaration. They would commit to a series of specificactions to lay the foundation for a decade of rapid growthand social improvements in the most impoverishedplaces on the planet.

To ensure success, in 2005 the world must startbuilding capacity, improving policies, and delivering theinvestments needed to meet the goals. This effort willneed to be sustained at the global, national, and locallevel over the next decade. And only with immediateaction can long-term environmental challenges, such as


climate change and fisheries depletion, be containedbefore they cause irreparable harm for the poorcountries least able to protect themselves.

Urgent action is needed if we are to usher in a decadeof high ambition to implement the goals. Developingcountries need to make every effort to mobilise aroundthe goals. Developed countries need to ask themselves ifthey should be more concerned with pointing the fingerat the responsibilities of poor countries than withmeeting their own commitments, as many of them aretoday. In 2005, the world needs desperately to followthrough on its commitments, taking quick, practicalsteps at scale before the goals become impossible toachieve. The credibility and functioning of theinternational system is at stake. Without a breakthroughin 2005, well-governed, poor countries will not beeffectively supported in pursuing an MDG-orientedstrategy, and the already dwindling faith in internationalcommitments to reduce poverty will probably vanish. Ifwe do not act now, the world will live without develop-ment goals, and it will be a very long way to the nextMillennium Summit in the year 3000.

Conflict of interest statementWe declare that we have no conflict of interest.

References1 UN Millennium Project. Investing in development: a practical

plan to achieve the Millennium Development Goals. New York:January, 2005.

2 Black RE, Morris SS, Bryce J. Where and why are 10 millionchildren dying every year? Lancet 2003; 361: 2226–34.

3 Jones G, Steketee RW, Black RE, Bhutta ZA, Morris SS, BellagioChild Survival Study Group. How many child deaths can weprevent this year? Lancet 2003; 362: 65–71.

4 Bryce J, el Arifeen S, Pariyo G, et al. Reducing child mortality: canpublic health deliver? Lancet 2003; 362: 159–64.

5 Victora CG, Wagstaff A, Schellenberg JA, Gwatkin D, Claeson M,Habicht J-P. Applying an equity lens to child health and mortality:more of the same is not enough. Lancet 2003; 362: 233–41.

6 Claeson M, Gillespie D, Mshinda H, Troedsson H, Victoria CG.Knowledge into action for child survival. Lancet 2003; 362:323–27.

7 Sachs JD, McArthur JW, Schmidt-Traub G, et al. Ending Africa’spoverty trap. In: Brainard WC, Perry GL, eds. Brookings paperson economic activity 1. Washington, DC: Brookings InstitutionPress, 2004: 117–240.

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