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[23 April 2008] - Tanzania has been singled out as a country that handles incoming aid and investment in its healthcare systems well, and looks set to meet its Millennium Development Goals, or MDGs, on maternal and child health. The key, say experts, lies in investment in health systems — not just in specific health intervention projects. The analysis is being made under the 'Countdown to 2015' initiative — which tracks progress in reducing child and maternal deaths under the MDGs. It highlights a study published in a special issue of The Lancet showing that Tanzania looks likely to hit the fourth MDG — that of reducing mortality in children under five by two-thirds, in the period between 1990 and 2015. Annual death rates in children under five between 1990 and 2004 in Tanzania have fallen by 40 per cent, with the sharpest decrease of 24 per cent occurring between 2000 and 2004. Researchers say the heath service in Tanzania improved vastly between 1999 and 2004, after policy changes led to a doubling of government spending on health. Under the new scheme, donor and government funds were pooled to create a 'basket fund' for redistribution in individual districts, providing additional funds per person. Among the interventions to benefit were the provision of insecticide-treated bednets against malaria infection, vitamin A supplementation against blindness and oral rehydration therapy against diarrhoea. Currently, only a handful of countries request that donors give funds to their general budget rather than to specific projects, like immunisation programmes. Liz Mason, director of the Department of Child and Adolescent Health and Development at the WHO, said only two per cent of donor money to maternal and child health is given in this way, even though Tanzania's success showed that through this approach the authorities were able to secure a much more reliable source of support. Meanwhile, Ann Starrs, president of the U.S. non-profit organisation Family Care International, called for more balance in health investments, with some funds going into 'vertical interventions' like vaccination and immunisation, and some being used to strengthen health systems. But Starrs said it was not simply a question of diverting money away from projects; overall investment levels needed to rise among donors, and then to be matched by the countries receiving them. Currently, less than a quarter of priority countries — those that account for 97 per cent of all maternal and child deaths — look set to meet their MDGs.