The World Health Organization (WHO) is surprised by the statements made by Médecins sans Frontières (MSF) over the past two days in relation to the Massive Effort advocacy forum being held in Winterthur.

Massive Effort is primarily concerned with changing the lives of poor people through concerted action to tackle three critical communicable diseases.

To do this effectively requires action at several levels. First, it is essential to make sure that people have better access to existing services, commodities and information – as close to their homes as possible. Programmes for HIV, malaria or TB cannot be allowed to fail through a lack of basic supplies.

It is equally clear that action at country level alone is insufficient. Massive Effort must necessarily include work on global enabling actions which will make existing drugs and vaccines more widely available to poor people and development of new drugs and vaccines.

These enabling actions include: work to drastically reduce prices of existing essential drugs, and to create incentives for research and development on new products needed to combat the diseases which cause and perpetuate poverty.

There has already been substantial movement internationally on all these issues – most recently in the recent statements of the European Commission. Work on affordability and research and development (R&D) is also a central part of WHO's on-going agenda.

We are working on a broad and long term agenda. The problems to be tackled are complex and deep-seated. A step increase in the resources needed from governments and agencies is required. Policy messages need to reflect these realities and not create unrealistic expectations.