New figures on global child mortality show a continuing inequality between rich and poor countries.
In 2007, 9.2 million children died below the age of five, according to UNICEF. A full report appears in this week’s edition of the Lancet.
In a commentary, experts from UNICEF say it is the 30th anniversary of the Alma-Ata declaration, which called for urgent action by the world community towards the goal of "Health for All".
This anniversary "provides a tremendous opportunity to galvanise the increasing political commitment and global momentum behind meeting the health-related Millennium Development Goals (MDG)", say the experts.
Goal 4 calls for a two-thirds reduction in mortality of children aged less than five years between 1990 and 2015. "Accurate and timely estimates of childhood mortality are needed," they add.
The latest figures show that generally, high-income countries are on target to meet this goal but poor countries are not.
Latin America and the Caribbean, Central and Eastern Europe and Commonwealth of Independent States and East Asia and Pacific are all on target for 2015. However, Western and Central Africa, sub-Saharan Africa, and Eastern and southern Africa are not.
The experts say more interventions must be directed to "the most underserved", and stronger links must be made between health, sanitation, nutrition and HIV programmes. They conclude: "We call upon others to join us in redoubling our efforts to meet these goals."
Dr Simon Lewin, of the Medical Research Council of South Africa, and colleagues add that there are several promising implementation strategies for strengthening primary health care, however "the evidence base needs urgently to be strengthened".
Loaiza, E., Wardlaw, T. and Salama, P. Child mortality 30 years after the Alma-Ata Declaration. The Lancet, Vol. 372, September 13, 2008, pp. 874-76.
Lewin, S. et al. Supporting the delivery of cost-effective interventions in primary health-care systems in low-income and middle-income countries: an overview of systematic reviews. The Lancet, Vol. 372, September 13, 2008, pp. 828-39.
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