Sergio Spinaci and David Heymann argue that there are cost-effective interventions against the diseases which are causing 50 percent of preventable death among the poor. These interventions have been insufficiently prioritized within existing health systems, therefore their coverage and impact is still low. There are no technical reasons for such low coverage; the main reasons are insufficient human and financial resources and lack of ownership by communities. They suggest that we can build on successful examples of scaling-up interventions and apply them generally, but only if there is the political commitment by those in power able to shift resources to investing in health priorities for the poor. © 2001 The Society for International Development.
