Alaka Singh

Ceylon Medical Journal (CMJ) is a peer-reviewed, open access journal published quarterly by the Sri Lanka Medical Association in the last week of March, June, September and December each year. The mission of the CMJ is to promote the science and art of medicine and betterment of public health. The Journal publishes original papers and commentaries which have relevance to medicine and allied sciences. The CMJ is committed to maintaining and conforming to the editorial and ethical standards recommended by the International Committee of Medical Journal Editors.

The UNDP report on the Millennium Development Goals, or MDGs (UNDP 2005), cautions that the Goals will not be met by 2015 in the most needy countries, and, in fact, warns that the situation in Africa may actually worsen. What can be done to secure some measure of success in the health-MDGs effort? Should strengthening health systems be regarded a ‘first-order’ goal within ‘higher-order’ MDGs to secure at least the institutional and system prerequisites of better health for all in the future, perhaps after 2015 – a ‘second-best’ result in the absence of a ‘first best’ MDG outcome?