President Barack Obama told a U.N. conference that the United States is changing its approach to development to focus less on spending money and more on really helping countries develop.
That means using diplomacy, trade, investment policies and other resources to help them prosper.
The changed approach is spelled out in the administration's new global development policy, which the president announced in a speech Wednesday at the United Nations in New York.
Obama said the administration will demand accountability from the U.S. and the countries it is trying to help. But, he said, make no mistake, the U.S. will remain a world leader in providing assistance.
"We will keep our promises and honor our commitments," Obama told world leaders.
"President Obama gave the first of three speeches at U.N. Headquarters, announcing a dramatic new approach U.S. foreign aid -- one that will hold recipients accountable and focuses on development not dependence -- an approach that appears aimed at convincing the American public to send billions of dollars overseas," said CBS News Foreign Affairs Analyst Pamela Falk from the U.N.
The world's nations pledged more than $40 billion to battle needless deaths among poor mothers and their children. But the struggling world economy, particularly in the United States, raises deep concerns that the cash won't be forthcoming. Leaders exhorted financial donors to fulfill their aid commitments.
"The crisis is no excuse for letting up our efforts, but underscores the need for actions," U.N. Secretary-General Ban Ki-moon said as he wrapped up the three-day Millennium Development Goals summit.
With many countries still hurting from the global economic crisis, the secretary-general has repeatedly urged governments not to abandon the world's 1 billion people living on less than $1.25 a day. The United States and Britain said they will continue to do their part to help the global poor.
"I suspect that wealthier countries may ask -- with our economies struggling, so many people out of work, and so many families barely getting by, why a summit on development?" Obama said. "The answer is simple. In our global economy, progress in even the poorest countries can advance the prosperity and security of people far beyond their borders, including my fellow Americans."
Britain's Deputy Prime Minister Nick Clegg urged other countries to join Britain in meeting aid commitments.
The goals, "are not simply charity, nor are they pure altruism," Clegg said. "They are also the key to lasting safety and future prosperity."
The issues of maternal and child mortality have been a particular focus of the summit, which reviewed efforts to implement anti-poverty goals adopted in 2000 -- and found them lacking. Worldwide every year, an estimated 8 million children still die before reaching their 5th birthday, and about 350,000 women die during pregnancy or childbirth.
Along with easing maternal and child mortality, the goals included cutting extreme poverty by half, ensuring universal primary education, halting and reversing the HIV/AIDS pandemic.
"In many parts of the world, women have yet to benefit from advances that made childbirth much safer nearly 100 years ago," Ban said at the afternoon launch of his pet project, the Global Strategy for Women's and Children's Health.
"Millions of children die from malnutrition and disease which we have known how to treat for decades. These realities are simply unacceptable," he said. "The 21st century must be and will be different."
More than $40 billion in financial commitments by governments and nonprofit agencies were announced for the global strategy, which aims to save the lives of 16 million mothers and children over the next five years.
"You can count on the United States and the Obama administration for the success of this initiative," U.S. Secretary of State Hillary Rodham Clinton told Ban at the "Every Woman, Every Child" event.
Speakers including Chinese Premier Wen Jiabao, Rwandan President Paul Kagame and the prime ministers of Ethiopia and Tanzania spoke of ways to tackle maternal and mortality: training midwives and other health workers to assist in births, inexpensive vaccines for common diseases such as measles which are responsible for needless deaths of small children.
Earlier Wednesday, former Chilean President Michelle Bachelet said she would make "women's issues a human rights issue" as head of the new U.N. agency promoting women's equality, and that reducing deaths of women in pregnancy and childbirth would be a priority.
"I expect ... we will take from this summit a huge, huge commitment to work harder on all the developing goals, especially on maternal mortality (which) not made any big advances in 20 years."
The international aid organization Oxfam expressed skepticism about how much money was being pledged for the new campaign for women's and children's health.
"That kind of money would go a long way toward reaching the child and maternal health goals, but we have a big concern," said Oxfam spokeswoman Emma Seery.
"Half of the donors cut their aid last year" because of the global economic crisis, she said. "We're just nervous that it will be governments bringing together a lot of previous commitments, and that won't mean much for poor people."
Aid agencies overall welcomed the prospect of more money for programs that will save the lives of mothers and children.
"There is a face to hunger and poverty, and it is female," said Josette Sheeran, executive director of the U.N.'s World Food Program. "We know that the most powerful intervention we can do is ensure women have access to food so they can build a future for their children, for themselves and for their villages."