The authors argue that omitting the costs to scale up the system-wide components involved in programs to improve maternal, neonatal, and child health (MNCH)—such as the human resource cost necessary to allow programs to function effectively— is a serious oversight and risks raising false expectations about the funding needed for impact. They recommend that the US$30 billion "price tag" for improving MNCH be updated before the September 2010 Millennium Development Goals (MDG) Summit in New York. An updated price tag would give donor governments a more realistic picture of what is required to reduce maternal, newborn, and child deaths and successfully achieve MDG targets 4 & 5 (the child and maternal health targets).
The authors conclude that there are two things that they can say with certainty: "First, the current level of aid devoted to MNCH is inadequate, providing only a fraction of the total resources required to achieve the child and maternal health MDGs. Second, donors are not living up to their promises—in 2010, Africa will receive only about US$12 billion of the $25 billion pledged by the G8 at Gleneagles." The authors continue: "Scaling up to reach MDGs 4 and 5 means urgently fixing these shortfalls."