The eight Millennium Development Goals represent a unique global compact. Derives from the Millennium Declaration, which was signed by 189 countries, the MDGs benefit from international political support. As such, they reflect an unprecedented commitment by the world's leaders to tackle the most basic forms of injustice and inequality in our world: poverty, illiteracy and ill health. The health-related MDGs do not cover all the health issues that matter to poor people and poor countries, but they do serve as markers of the most basic challenges ahead: to stop women dying during pregnancy and child birth, to protect young children from ill-health and death, and to tackle the major communicable diseases, in particular HIV/AIDS. This report explains some of the reasons for the slow progress and suggests solutions. It looks beyond the statistics to discuss strategic and policy areas where change is needed and support should be provided. As such, it summarizes WHO's contribution to the debates on the MDGs in 2005, and to the United Nations' Millennium + 5 Summit.