The world could initiate a partnership between rich and poor of unrivalled significance

Commission on Macroeconomics and Health

The report shows that just a few health conditions are responsible for a high proportion of the avoidable deaths in the poor countries and that well-targeted measures, using existing technologies, could save the lives of around 8m people per year.

It calculates that increasing medical spending by US $66 bn (�44bn) a year by 2015-2020 would generate at least US $360bn (�240bn) annually.

About half of this will be as a result of direct economic benefits: the world's poorest people will live longer, have many more days of good health and, as a result, will be able to earn more.

The other half will be as a consequence of the indirect economic benefits from this greater individual productivity.

Partnership required

The report proposes a new "health pact" between donor and developing countries.

Major killers

HIV/AIDS tuberculosis malaria childhood diseases unsafe pregnancy infant illness at the time of delivery tobacco-related illnesses

Half the extra cash would come from international development assistance, with Third World countries providing the other half by changing their budgets.

Spending would target the main illnesses of poverty, such as malaria, tuberculosis, Aids and childhood diseases.

The report said: "With bold decisions in 2002, the world could initiate a partnership between rich and poor of unrivalled significance, offering the gift of life itself to millions of the world's dispossessed and proving to all doubters that globalisation can indeed work to the benefit of all humankind."

It said that instead of health improving as a result of economic growth, as is widely accepted, improved health was, in fact, a requirement for economic development in poor countries.

Dr Gro Harlem Brundtland said the report was a turning point

WHO Director-General Dr Gro Harlem Brundtland described the report as a "turning point".

She said: "It will influence how development assistance is prioritised and coordinated in the years to come.

"It is important to see the report not as just another plea for more resources for health.

"The Commission is arguing for a comprehensive, global approach to development assistance, which underlines the need for investments towards concrete goals within specific time-frames."

Spending plan

The current level of official development assistance (ODA) for health stands at around US $6bn per year.

The report says this should rise to US $27bn per year by 2007.

The increase would enable vastly greater health care for the poor, and more research and development into new ways to fight disease.

Much of the aid would be directed towards sub-Saharan Africa, where the health emergency is most severe.

Developing countries would aim to raise domestic budgetary spending on health by an additional 1% of GNP as of 2007, rising to 2% in 2015.

According to 1998 data, almost a third of deaths in low and middle-income countries are due to communicable diseases, maternal and perinatal (around birth) conditions and nutritional deficiencies. These can both be prevented and treated.