It is that time of the year again when the big-wigs from around the world converge on mid-town Manhattan with such a force that even my husband, with all of his status after staying thousands of nights in luxury hotels between east 40th-60th streets, is told he must prematurely vacate his room to make way for the incoming guests. New York is crawling with dignitaries and their attachés. Secret security details are getting their workouts chasing VIPs around central park. A highlight of this fall’s meeting, at least from my perspective, is a midpoint check-in on progress towards achieving the Millennium Development Goals.

I think the consensus that will emerge from these meetings will be no surprise to anyone following these things: we are not currently on track to achieve the MDGs, and unless something extraordinary occurs, these commitments, like so many before them, will go down in history as yet another well-intentioned failure.

But might be this something extraordinary? While achieving the MDGs is a goal for the whole world, the real issue is how are we going to achieve the MDGs in Africa, where to date there has been little overall progress towards the MDGs, at least on the health measures. To many people, the MDGs have been synonymous with Africa. We are now mid way into the MDG commitment period, and not only will these goals not likely be met, I feel we don’t even yet have a good sense of how these goals can be achieved. As Paul Collier states in an op-ed in the NYTimes earlier this week:

A further weakness with the Millennium Development Goals is that they are devoid of strategy; their only remedy is more aid.

What then can we do instead? Collier argues that while he believes aid can be effective, he thinks that more structural changes will need needed, which potentially could be more effective in promoting development in Africa. Changes like that, however, are going to take forever so are there more concrete things that can be done in the interim?

I think the newly announced Global Road Map for Malaria looks promising, at least on paper. I like the focus on a global strategy for control, elimination, and research, rather than uncoordinated national strategies. How this will actually play in our real world settings, however, remains to be seen. Clearly a lot of thought and effort went into this, likely by a team of eager management consultants, but it is still not clear to me how you translate even the most effective global strategies into real world actions in communities.

Here is to hoping to the second half of the MDGs is more productive than the first.

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