A new report by the World Health Organization finds the majority of poor countries will not sufficiently improve the health of their people by 2015, the target date set by the United Nations Millennium Development Goals. This first WHO assessment comes less than a month before world leaders meet in New York to review progress made toward meeting those goals. The report shows progress is particularly slow in sub-Saharan Africa.

The World Health Organization says building stronger health systems is key to reaching the Health Millennium Development goals. Without rapid progress on developing health systems, it warns large numbers of people will continue to die every year from mostly preventable diseases.

These include almost 11 million children under five, about one million people from malaria, and more than 500,000 women in pregnancy and childbirth. In addition, the report notes the HIV/AIDS pandemic takes three million lives each year.

Carla Abou-Zahr, Head of WHO's Health Network System, said the underlying cause of many of these deaths is malnutrition. "We have seen some parts of the world have made impressive gains in terms of reducing the numbers of people suffering from malnutrition," she said, "But, again, in sub-Saharan Africa, we are tending to see an increase in the people suffering from malnutrition. And people who suffer from malnutrition ... are more vulnerable to communicable diseases. They are more vulnerable to dying from malaria and to rapidly declining when they have HIV infection."

World leaders from 189 countries agreed to the Millennium Development Goals in 2000. Three out of eight goals relate to health. The others include reducing poverty and hunger, increasing access to clean water and tackling gender inequality by 2015.

Director of WHO's MDG Program, Andrew Cassels, said if the present rate of decline continues, it will take 150 years, not 10 years, to achieve these goals. He said effective health systems capable of delivering drugs, dealing with emergencies and a whole range of diseases at the same time are essential for improving health. He said many countries face a human resource crisis.

"Africa particularly is desperately short of health workers," noted Mr. Cassels. "People are leaving because the conditions under which they have to work are rotten and getting worse. They are looking for jobs in the private sector. They are leaving the country both within Africa and to the North. Stemming this flow, getting people in place to deliver health care is not just a technical issue of one of training and manuals and so forth. It is the political issue that affects the way governments set priorities for their public servants between north and south when it comes to migration."

Despite the setbacks, the report notes a number of success stories. For example, in South Asia, it finds India has made huge progress in reproductive and child health and improvements in treating tuberculosis. The report cites Sri Lanka, Thailand and Malaysia as other success stories.

WHO says it will take an estimated $135 billion of official development assistance, rising to $195 billion by 2015, to meet all the Millennium Development Goals.