AIDS Care Watch

Wednesday, August 24, 2005

Millenium Development Goals: Moving Backwards

by Gustavo Capdevila, Inter-Press Service, GENEVA, Aug 22

(IPS) - A new World Health Organisation (WHO) report shows that less than encouraging results have been obtained so far in the international community's efforts to fulfil the Millennium Development Goals (MDGs). These targets are aimed at eradicating extreme poverty and improving the health and welfare of the world's poorest people by the year 2015.

Although some progress has been made, health outcomes have been unacceptably poor across much of the developing world. While noting that sub-Saharan Africa is the region with the worst outlook, the report adds that "there are extreme and acute pockets of ill-health in all regions."

"If trends observed during the 1990s continue, the majority of poor countries will not meet the health MDGs," the WHO warns in Health and the Millennium Development Goals, a study released Monday.

Through the MDGs, adopted in September 2000 by 189 heads of state and government, the world's rich and poor countries alike assumed a commitment to eradicate extreme poverty and hunger, achieve universal primary education, promote gender equality and empower women, reduce child mortality, improve maternal health, combat HIV/AIDS, malaria and other diseases, ensure environmental sustainability, and develop a global partnership for development.

While the targets set by the eight MDGs pertain primarily to the developing world, they also emphasise the contributions that can be made by the developed countries through trade, assistance, debt relief, and access to essential medicines and technology transfer. The WHO report stresses that "health is at the heart of the MDGs," in recognition of the fact that "it is central to the global agenda of reducing poverty as well as an important measure of human well-being."

While health is specifically represented in three of the eight goals, it makes a clear contribution to the achievement of all the other goals, particularly those related to the eradication of extreme poverty and hunger, education, and gender equality.

With regard to the first health-related goal, reducing infant mortality, the study notes that although some progress has been made in specific countries, nearly 11 million children under the age of five continue to die every year around the world. In fact, in 16 countries - 14 of them in Africa - levels of under-five mortality are higher than in 1990, the reference point for the reduction targets.

"None of the poorest regions of the developing world is currently on track to meet the child mortality target," the report underlines. Malnutrition contributes to over half of all child deaths, it adds, noting that progress in reducing child malnutrition has been slow. Over 150 million children under the age of five in the developing world are underweight, which indicates malnourishment.

Almost half the children in southern Asia are underweight, while in sub-Saharan Africa, the number of underweight children actually increased from 29 million to 37 million between 1990 and 2003. In many countries of sub-Saharan Africa, the downward trend in child mortality has been reversed over the past decade.

"Overall, 35 percent of Africa's children face a greater risk of dying today, as compared with 10 years ago," states the report. With regard to the goal of improving maternal health, the study reveals that while there have been increases in the rate of attended deliveries in Southeast Asia and North Africa, more than 500,000 women die in pregnancy and childbirth each year, and maternal death rates in sub-Saharan Africa are 1000 times higher than in high income countries.

In general terms, the WHO's research indicates that declines have been limited to countries that already exhibited lower levels of maternal mortality, while countries with high mortality are experiencing stagnation or even reversals.

The third health-related MDG is aimed at combatting HIV/AIDS, malaria and other diseases. Although some countries have successfully managed to reverse the spread of HIV/AIDS, "the story is bleak in many countries," says the study.

"With three million deaths from HIV/AIDS alone each year, the worsening global pandemic has reversed life expectancy and economic gains in several African countries," it adds. The study reports that just under half the people living with HIV around the world are female. But as the pandemic worsens, it adds, the share of infected women and girls is growing, owing to physiological reasons and the fact that they typically lack power in sexual relations with men, making them more vulnerable to infection.

In the study's conclusions, WHO maintains that efforts to combat communicable diseases, reduce child and maternal mortality, and increase access to HIV/AIDS treatment "all face the same constraint - provision of quality services cannot be scaled up while the health system remains fragile, fragmented and inequitable."

The organisation accuses donor countries and national policy makers of failing to pay sufficient attention to strengthening health systems, and calls for efforts to ensure that health has a more prominent place in economic and development policies. While the MDGs represent a commitment to reduce global poverty and close the gap between rich and poor, current trends in health suggest that the world is moving in the opposite direction, the study warns. "In short, the MDG vision - to create a better and fairer world - will fail unless we can do more to improve the health of poor people," it concludes.

Source: IPS online