The MDGs and their relation to Health and Development Policy - PDF document

The MDGs and their relation to Health and Development Policy "MDGs, Poverty and Health: Connecting Parliamentarians with Ground Realities" 12-14 December 2004, Kuala Lumpur, Malaysia Dr Sergio Spinaci World Health Organization 1 World Health Organization 1

Outline • Introduction to MDGs • Progress to date towards reaching the MDGs • Disease burden and underlying causes • Challenges to reaching the MDGs? • Strategic directions to accelerate progress • What can parliamentarians contribute? • Conclusions 2 World Health Organization 2

The Millennium Development Goals – a unique opportunity • Derived from the Millennium Declaration • Common development priorities agreed upon by national governments, international agencies and the UN System • Endorsed at the 2002 Monterrey Conference on Financing for Development • Compact between North and South • 2015 goal provides critical momentum 3 World Health Organization • The Millennium Development Goals (MDGs) are derived from the Millennium Declaration which was adopted by all 191 United Nations Member States at the Millennium Summit in September 2000. • For the first time, National governments, international agencies and the UN System agreed on a common set of priorities for their development efforts, and a set of targets against which to measure progress. • At the 2002 Monterrey Conference on Financing for Development, the rich and the poor countries adopted a compact (James Wolfensohn; Francois Bourguignon Development and Poverty Reduction: Looking Back, Looking Ahead. World Bank, Washington D.C., 2004). • developed countries reaffirmed their commitment to make concrete efforts towards the target of 0.7 per cent of GNI as Official Development Assistance. Countries set themselves individual targets for increasing their ODA ranging from • 0.17 per cent of GNI (United states by 2006) • to 1 per cent of GNI (Norway and Luxemburg by 2005). • In addition, developed countries committed to opening their markets to trade, and supporting capacity building in developing countries. • The poor countries accepted the responsibilities of good governance, serious policy design, transparency and openness to real implementation • The MDGs are a compact between North and South, defining the role and responsibility of developing and developed countries • The MDGs set targets for quantifiable improvements in key areas of human development by 2015. 3

Millennium Development Goals 1. Eradicate extreme poverty and hunger 2. Achieve universal primary education 3. Promote gender equality and empower women 4. Reduce child mortality 5. Improve maternal health 6. Combat HIV/AIDS, Malaria and other diseases 7. Ensure environmental sustainability 8. Develop a global partnership for development 4 World Health Organization The MDGs define the key areas of improvement. For each goal, more concrete, quantitative targets were set against which to measure progress. Most of the targets set for progress on the Millennium Development Goals are benchmarked for 1990 to 2015 (WHO 2004, www.who.int/mdg): Goal 1: Eradicate extreme poverty and hunger: • Health Target: Halve the proportion of people whose income is less than one dollar a day • Health Target: Halve the proportion of people who suffer from hunger Goal 4: Reduce child mortality • Health Target: Reduce by two-thirds the under-five mortality rate (probability of dying before age of 5 expressed as rate per 1000 live births) Goal 5: Improve maternal health • Health Target: Reduce by three-quaters the maternal mortality ratio (proportion of deaths of women of reproductive age from maternal causes) Goal 6: Combat HIV/AIDS, Malaria and other diseases • Health Target: Have halted by 2015 and begun to reverse the spread of HIV/AIDS • Health Target: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases. Goal 7: Ensure environmental sustainability • Health Target: Halve by 2015 the proportion of people without sustainable access to safe drinking-water and sanitation. Goal 8: Develop a global partnership for development • (Health Target: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries) • The last goal identifies actions developed countries must take if targets are to be achieved (debt-relief, lowering trade barriers, allowing a freer exchange of goods and services with developing countries). Taking a broader look (also at social determinants of health), all goals are associated with health (implication of education and gender targets on health) 4

Goal 1, Target: Halve the proportion of people living on less than one dollar a day Source: www.developmentgoals.org 5 World Health Organization • Looking at all developing countries: Poverty level is down since 1990 and we are on track to reach the goal of reducing extreme poverty. There were at least 118 million fewer people living in extreme poverty at the decade’s end than at its beginning 1990 compared to 1999. • But progress is uneven: rapid progress in Asia will do nothing to alleviate the crushing burden of poverty in Sub-Saharan Africa (see diverting trend) and the strong diversion of the trend in Europe & Central Asia (economic breakdown of SU/ transition without social safety nets). • In 2001, most people who lived on less than one dollar a day lived in Asia and SSA: • South Asia: about 428 million people (region with greatest number of poor) • Sub-Saharan Africa about 314 million people (region with highest proportion of poor) • East Asia & Pacific (without China) about 284 million people • China alone about 212 million people (Source: (World Bank, www.developmentgoals.com/Poverty.htm) Note: World Bank Regions are similar to WHO regions but excluding high-income countries. The major additional differences regarding the distribution of bigger developing countries are: • East Asia & Pacific: WPRO but including Indonesia, Myanmar, Thailand • Europe & Central Asia: EURO • The Latin America & Caribbean : AMRO • Middle East & North Africa: EMRO except for Afghanistan, Pakistan, Quatar, Somalia, Sudan, Syrian Arab Republic including West Bank & Gaza and Algeria. • South Asia: SEARO except for Democratic People's Republic of Korea, Indonesia, Myanmar, Thailand including Afghanistan and Pakistan. • Sub-Saharan Africa: AFRO region excepting Algeria and including Sudan and Somalia. 5

Goal 1, 4 and 5, Targets: Halve proportion of people suffering from hunger; Reduce under-five mortality rate by two-thirds; Reduce maternal mortality ratio by three-quaters 6 Source: World Bank, 2004 World Health Organization This figure shows the percentage of people who live in countries which are "on track" for different health targets in every region • Underweight children (dark-yellow columns). Progress has been fastest for this goal, reflecting in part the lower target for this indicator (a halving of the rate between 1990 and 2015, compared with a three-quarters reduction in the case of maternal mortality ratio). • Under-five mortality (see the centre column for each region), progress has been very slow, varying between 60 percent of the people are in countries on track in the Middle East and North Africa to 0 % in SSA. • Maternal mortality (the lightest columns): progress varies between a rate of 84 percent of people in the Middle East and North Africa which are in countries on track to reach the goal for maternal mortality very low percentages in South Asia, Latin America and the Caribbean, and Sub- Saharan Africa. • We can see that progress towards these MDGs has varied across goals, across regions, but also within regions. But looking at countries "on track" on average, may hide substantial local disparities. • It shows that all region face challenges to get all countries "on track" for at least some of the goals indicated, including regions with many middle-income countries. • Additional analysis of data by income level shows that the poorest countries suffer the highest burdens of premature mortality and malnutrition and are generally least on track for reaching the related goals. (Source: Wagstaff,Adam; Claeson,Mariam, The millennium development goals for health: rising to the challenges , World Bank, 2004) 6