The Millennium Development Goals are just goals.

When the heads of governments of 186 countries signed the Millennium Declaration in 2000, they articulated comprehensively, at the highest political level, the priority areas of economic, social and environmental development that need to be pursued in order to reduce poverty and enable sustainable development.

The goals represent an important step in the underlining of the interconnectedness of the problems that the world is facing and they formulate, in one document, the breadth of development efforts needed to create a more just world. It is now more explicit that development is not just about economic growth; the goals have given us a vision of development where health and education is a cornerstone.

With goal number eight, the MDGs underline the global responsibility of the international community. All the other goals' completion depends heavily on the formation of this new global partnership. It is clear that everyone's effort, including IFMSA's, is needed for the achievement of the Millennium Development Goals.

The goals, however, are not perfect. By definition, goals are not about processes or best practises -nor do they involve explaining the means to achieve them. They are simply targets that set out the roadmap of development until their achievement.

The Governments of the world are committed to the end result, but are they willing to provide the means also?

850 million people are starving and over a billion people are living in extreme poverty -their lives are in a constant state of emergency, but the whole development world moves at a somewhat easier pace. Now the problems have been identified and prioritized, we know what to do. What, then, are we waiting for?

At the time of writing, the dying economies of Sub-Saharan countries are, taken together, are not on track for meeting a single target. There is no progress, rather worsening, on the status of poverty, hunger, infant mortality or immunisation against measles; on maternal mortality; on malaria; secondary-school enrolment for girls, on forests, drinking water and sanitation.

Where is the money? In 1970, the rich countries of the world agreed to reach

0.7 % of GNI as foreign aid at the latest in 1980. Twenty-five years later, only 5 countries have reached that target, four are EU member states. The high-income countries must scale up and reach the 0.7% target.

It is widely acknowledged that spending on prevention and treatment of AIDS is needed as a key-aim. It is also regarded as one of the most cost-effective ways to spend money in developing countries. While nearly 5 million people were HIV infected last year, spending on its prevention is very far from satisfactory.

Is money the only thing we need? Money is of course essential, but other basic factors include the type of governance adopted nationally and internationally; compliance with international commitments, human rights and gender equality, fair trade, reversing the spread of non-communicable diseases, information sharing, security and other global common goods.

I think it is worth reiterating that development and achievement of the MDGs is also the responsibility of the developing countries themselves. It is the developing countries that make, or do not make, progress towards the MDGs, not the donors. As future physicians and community leaders, we have to act as advocates for global health and we must speak out louder and clearer. We must ask ourselves and others very simple questions 'Why should people go hungry amid plenty?' 'Why should children die of diseases that a simple bednet could prevent?' We must actively hold our governments accountable for their promises' so act! Go out and tell everybody the story that this publication is telling you.

Andreas Rudkjøbing (Denmark) President, IFMSA 2004-2005