- How did the Millennium Development Goals come about?
- How do the goals relate to health?
- Will the goals be met?
- Who is responsible for meeting the goals – wealthy or developing countries?
- Can eight goals really address all our development challenges?
How did the Millennium Development Goals come about?
The United Nations Millennium Declaration of 2000 commits world leaders to combat poverty, hunger, disease, illiteracy, environmental degradation and discrimination against women. The Millennium Development Goals (MDGs) are derived from this declaration.
189 UN member states agreed to try to achieve the goals by 2015. The World Health Organisation (WHO) has particular leadership on efforts to meet the health-related targets.
How do the goals relate to health?
All the MDGs are strongly related to health because of the close link between health and poverty. Three of the goals and eight of the targets are explicitly health focussed. The eight goals are:
- to eradicate extreme poverty and hunger
- to achieve universal primary education
- to promote gender equality and empower women
- to reduce child mortality
- to improve maternal health
- to combat HIV/AIDS, malaria, and other diseases
- to ensure environmental sustainability
- to develop a global partnership for development.
There are 21 targets and 60 indicators to measure progress.
Will the goals be met?
Sadly it is extremely unlikely. Some developing countries have made good progress towards the goals, particularly on primary education and gender equality, but many more are falling behind. Progress is particularly slow, or even negative, in sub-Saharan Africa.
- The goal on poverty is likely to be met at the global level, but in sub-Saharan Africa the number of people in poverty is rising. The financial crisis and global recession look set to compound this.
- Recent food price rises have eroded the very limited gains made in reducing hunger and malnutrition.
- There has been little progress reducing child mortality, particularly in sub-Saharan Africa where the child mortality rate is 157 deaths per 1,000 live births.
- Maternal mortality decreased by less than 1% a year between 1990 and 2005, much slower than the 5.5% decrease needed to reach the target.
Who is responsible for meeting the goals – wealthy or developing countries?
Both are. Developing countries have targets to meet for each of the goals. They have a responsibility to implement policies and shape government priorities for the benefit of all their citizens. Policies to increase the proportion of spending going to health are particularly important.
Wealthy countries have responsibilities because of their position as aid donors, trading partners, debt collectors and the source of many new technologies and essential medicines. So far commitments on aid have not been kept, and policies on trade, debt, medicines and technology continue to undermine progress.
Can eight goals really address all our development challenges?
No. The goals have had a positive effect in focusing attention on development issues, but they must be part of a broader approach.
- Some issues with a major impact on health are not included, such as non-communicable diseases like cancer.
- The need for comprehensive and sustainable health systems, which are essential to the achievement of all health goals, is not explicitly set out in the goals, targets or indicators.
- Are the right indicators assigned to each target? If not, some major health challenges risk not being addressed. For example, national sensitivities meant that it took until 2006 for a new indicator measuring access to reproductive health services to be agreed for Goal 5 on maternal health.
- Setting goals and targets can downplay the fact that much poor health has its roots in poverty.
Last modified: 14/12/2010
