Kampala: The UN Summit on the Millennium Development Goals concluded with the adoption of a global action plan to achieve the eight anti-poverty goals by their 2015 target date and the announcement of major new commitments for women's and children's health and other initiatives against poverty, hunger and disease. Charles Abugre writes how far Africa has gone in trying to fulfil the MDGs.

A mother cradles her newborn baby girl, with joy where there might have been grief. During labour, the baby was in a dangerous breech position, putting both mother and child at risk of death. But a skilled birth attendant turned the baby, saving their lives. Thanks to the UN Millennium Development Goals, standards world leaders agreed on in 2000 to lift the poor, the sick and the hungry by 2015, professionally-attended births are at an all-time high in Africa.

Benin is most improved, and even war-scarred DRC and Angola have risen to the challenge, with Angola halving maternal deaths. Thanks to the impetus of the MDGs, the expectant mother and this baby received free prenatal care, and free medical visits will continue through the breastfeeding period, strengthening the child's body and mind - a low-cost policy Ghana, Malawi, Ethiopia, Tanzania and Rwanda all began.

Thanks to the MDGs challenge, she is likely to escape Africa's child-killing diseases, because cadres of health workers have been hired and trained to distribute essentials, such as bed nets and improved malaria medicines. Africa-wide, malaria deaths have fallen by half. Meanwhile, vaccinations including measles and tuberculosis have skyrocketed, saving six million lives.

The world leaders who are gathering for an MDGs Review Summit at the UN this week must study these victories-and remember, if they wonder whether the goals are realistic, that maternal and child health, hunger, poverty and disease, have improved in some of sub-Saharan Africa's poorest countries.

Before the global financial crisis, hunger plummeted by 75 per cent in Ghana, and by a smaller degree in Djibouti, Mozambique, Chad, Benin, Mali, Gambia, Uganda, Burkina Faso and Togo. Populous Ethiopia, Egypt, and Angola halved their poverty rates. And although the goals were inked in 2000, change really began in 2004. So it's all happened very, very fast.

Today, with five critical years to go, we know what works. There's a set of solutions that are proven, and cheap.

Solutions include...

Increasing health budgets, so maternal and prenatal care are free (And so more birth attendants can be trained). Publicly-funded discounts on fertiliser, to lessen hunger. Low-cost childhood preventive care, which could save six million of the 11 million children who die each year. That includes breastfeeding for six months, nutritional supplementation up to two years, vaccines, bed nets, antibiotics for respiratory infections and oral rehydration for diarrhea.

Cash grants to the most destitute, like teenage orphans, the elderly, and families without a breadwinner, to reduce poverty. But more of the same will not be enough. World leaders in New York must re-energise their MDG efforts, with stronger action plans to accelerate through 2015, because despite the many stunning successes, progress has been uneven. Too many donor, and African, governments have failed to make the plans, to fund the programmes, and to deliver on their promises. Meanwhile, the food and financial crises have devastated the poorest, though final numbers on the impact mostly are not available. But even before the global economic crisis, amid progress elsewhere, poverty was up in Nigeria and Zimbabwe.

While the mother and newborn above were saved, one in seven women die in childbirth in sub-Saharan Africa. (In Ireland, it's one in 48,000.) One in three infants in Africa is undernourished, causing irreversible stunting. Rural areas are worse off than cities almost everywhere.

Access to piped water and sanitation has seen little progress; two-thirds of those in sub-Saharan Africa lack basic sanitation. And though education is spreading, 38 million children here still do not attend school.

Africa has three-quarters of all new HIV infections. Most medical workforces are inadequate-in some nations, a single ob-gyn serves an entire state or province of millions. And with measles vaccine funding down, measles deaths could rebound by as much as 1.7 million.

This week's summit must refocus the world leaders' attention on the policy failures behind these tragic shortfalls, and end with a commitment to redouble efforts.

To turn away now would be, as Secretary General Ban Ki-Moon has said, morally and practically unacceptable and would multiply the world's dangers: instability, violence, epidemic diseases, overpopulation, and environmental degradation.

And progress must happen on multiple fronts at once. Extreme poverty kills through the cumulative effects of malnutrition, poor infrastructure, gaps in health care delivery, and more.

Here is what commitment looks like. Take the baby girl, when she reaches school age. Education will be free if she is in Burundi or Tanzania, where school fees were abolished in pursuit of the MDGs. Now enrollment is nearly universal. Once she is in a clean school, she may be immunised there, and get a nutritious free meal, kicking off a virtuous circle: Being healthier, she will be absent less often. Attending regularly, she will likely finish.

Being better educated, she will make healthier decisions when she grows up. And so on. If her government school purchases the free meals from an area farmer or community garden, local income rises. More community children can eat. They are healthier and miss less school.

Getting decent job

Commitment will allow these children, upon graduating, to find decent employment, thanks to fair, efficient economic and tax policies. With jobs, they will pay taxes. That will fund more schools and clinics. And so on.

Leaders at the summit must also be heartened because the backdrop in Africa now is in many ways better than in 2000. Economies are bouncing back. Our abundant natural resources are in demand. There is less inflation, less debt, and more scope to borrow and raise taxes (and stop tax evasion and fraud).

Broad popular awareness of the goals has fostered new coalitions now working together. The public institutions responsible for social services to the poorest are in better shape. And the trend towards decentralisation, that is shifting funds and power to provincial localities, makes citizens better able to monitor their leaders' governing and spending.

The political landscape is more conducive, too, with fewer military conflicts and military dictatorships. And we Africans seeking justice are backed by a global movement, pressure from which helped lessen Africa's debt burden, leaving governments more money to spend on MDGs.

Here is what needs to happen next.

Donor nations should fulfil your side of the bargain and deliver on your promises. Stop tying humanitarian aid to political and macroeconomic conditions that do not favour growth and pro-poor human development.

African leaders in countries falling short must find a stronger will to improve the condition of your poorest citizens, as you promised when you signed the MDGs in 2000. The Goals make it mandatory that you provide health, clean water, sanitation and education for your citizens.

Citizens: Recognise your responsibility and in your own powerful voice, demand that political leaders and public servants deliver. You can force those responsible to solve our societies' problems.

Our fates, north and south, urban and rural, rich and poor, are entwined.

Our common future depends on more powerful commitment to end the suffering of extreme poverty, to make sure every newborn, like the baby girl asleep in her mother's arms, has the basic necessities we know how to provide. For now, tiny but alive with possibility, she waits for our action.

* Mr CharlesAbugre is the Regional Director - Africa, United Nations Millennium Campaign.

Keywords: MDGs, social policy, donor aid, civil society