The Millennium Development Goals (MDGs), ratified by most nations in 2000, set specific targets for poverty reduction, eradication of hunger, education, gender equality, health and environmental sustainability. MDG 4 aims to reduce child mortality with a target of reducing under-five mortality rates by two thirds over the period 1990-2015. Over the last year, Live Aid, Make Poverty History, the G8 summits and prominent entertainers have directed unprecedented attention towards development and health. Africa particularly has been in the spotlight. Reports are published and commitments are made, but is there real progress? Are poor people being reached with essential health care? Who will hold leaders to account: celebrities, activists or health professionals?