Much has happened since then, and it is no longer possible for world leaders to ignore the plight of these countries: finance ministers from the wealthiest nations in the world will be debating again at the G8 summit in Evian in two weeks time; Gordon Brown will be trying to persuade his counterparts of the desperate need for an extra $50bn a year in aid for the poorest countries; and backroom trading in the US Congress last night resulted in the offer of an extra billion dollars for the global fund for Aids, TB and malaria - if others match it - and a proposal for more debt relief, based on the ability of governments to pay.

A huge sum of money has already been written off: $36.3bn to be precise. These are sums that no campaign, aid agency or government department could dream of granting as aid. Annual debt payments by 26 countries have been cut by 40% - and that freed-up money is being spent, in Africa, on health and education. The long-term benefits will be immense. But while debts were being written off, aid has been run down. According to Jubilee Research, total resource flows to the 53 countries identified as highly indebted have fallen sharply, from $6.2bn at the time of the Birmingham summit to $4.3bn in 2000. The G8 last year promised to reverse this decline for the poorest countries, but the developed world still gives with one hand, and ridiculously, unconscionably and cruelly takes with the other.

Debt relief comes with conditions: G7 leaders (through the IMF) require countries to jump impossible economic hurdles they themselves decline. "Open up your markets" is one condition, "but don't expect us to do the same". "Structurally adjust your economies - but don't expect the same of us - even though we are living well beyond our means". "Lower the prices of your commodities, but don't expect us to lower the prices of our exports". "Get out of commodities - but God help you if you try and compete with our value-added industries". "Remove all protection from your producers - but don't ask us to reform the state-backed protection we give to pharmaceutical industries".

How much harder can we make it? It's not just that we won't write off debts that cripple their economies - we won't let them earn their way out of poverty through trade either. It's a dreary tale: the age-old story of the playground bully, picking on the weak and vulnerable.

The world is not a pretty sight. Each day we are assaulted by random terror; opportunistic diseases; the threat of economic instability. Aids devastates families, communities and economies in Africa and beyond. We hear the rhetoric, and see a bit of money flowing, but it's all so far removed, in countries "of which we know little". And while we don't have to live with the consequences, why should we know?

But it won't stay that way. Back in the 19th century, we learned there was no sense in driving the heavily indebted into the gutter, into debtor's prisons, or into purgatory. So we invented a framework for resolving the problem of debt - bankruptcy - which recognised that both creditor and debtor bear responsibility for unpayable debts. Bankruptcy, unpleasant as it is, puts balance sheets back into order, makes individuals and corporations productive again, and draws a line under human error.

We have no such international framework. So this whole sorry saga drags on, with debtor nations spiralling downwards. Their impoverishment impacts on richer economies, whether through the spread of disease, drugs or crimes of random terror. And in the meantime, millions suffer.

I will return to Ethiopia next week. This country, which Britain so magnificently helped in 1985, has 14 million people at risk of famine. In 2001, Ethiopia lost $81m in foreign exchange through the sudden, calamitous collapse of the price of coffee. But in 2002 the country transferred approximately $149m in debt service to foreign creditors, and will transfer out nearly $90m for each of the next two years.

Getting Ethiopia and other countries back on their feet will not cost the rich countries dear. Short-sighted meanness and refusal to accept the responsibilities of globalisation while enjoying the benefits can only exacerbate polarisation in the world. It is neither a naive nor impossible demand to eliminate all debt, to stabilise and make equitable trade agreements, or to help the dying with the freely available drugs. All this is do-able and all this, regardless of political persuasion, is right. The world cannot be the fiefdom of eight men around a table. It is, and must be, ours to do with how we choose.

In Birmingham in 1998, 70,000 people offered leadership to the world's most powerful individuals. It is not too late for them to throw off their old and tired excuses to take up that baton.

But I will not stand in front of dying families again next week and tell them that this is not their world, too. I will say that it will change. They may die before they see it - indeed, I may die before I see it - but change it will because change it must.

· Bob Gedolf is a musician and debt campaigner.