Speakers from many sectors, including health, education and agriculture, from the School of Oriental and African Studies (SOAS), London School of Hygiene and Tropical Medicine (LSHTM) and the Institute of Education (IoE), stressed the opportunities for, and lack of, coordination between certain MDGs. They observed that many challenges are shared across MDGs, including poor quality data, misplaced priorities, a lack of commitment to capacity building and problems of equity as efforts are focused on “low hanging fruit” often missing those most in need. Future challenges and the difficulties posed by the current global economic slowdown were also raised at the conference called No Goals at Half-time: What Next for the Millennium Development Goals? Professor Jeff Waage, Director of LIDC, said: “It was an extraordinary event. There cannot have been many occasions when such a depth of academic expertise on each of the very different MDGs has been brought together for critical review and comparison, and it has generated much useful material for follow-up by LIDC”.The conference was LIDC’s response to the heightened interest in the MDGs following the major meeting held in
The MDG1 targets aim to reduce poverty and hunger and increase gainful employment. Although there are substantial data and methodological difficulties in tracking the targets, it is clear that despite some significant achievements they will be missed in many parts of the world in 2015. It is very important to understand these achievements and failures, and their respective causes. Agriculture and food are critical to MDG1 in a number of ways, particularly in areas where progress has already been slow. There are major new challenges here, and important questions about the roles of states and markets in agricultural growth in poor economies.
MDG 2, the achievement of universal primary education, has a target of ensuring that by 2015 children everywhere will be able to complete a full course of primary schooling. Net enrolment ratios have increased, with notable regional increases in sub-Saharan Africa and South and West Asia. However, regional ratios disguise wide variations between countries. National ratios disguise variations in enrolment patterns across the grades of primary education and in the enrolment by grade patterns by income group, gender and location. Many educational challenges remain, not least the provision of 18 million additional teachers if the 2015 goals are to be reached. This presentation underlines the inter-relations between the MDGs. It concludes by asking whether global partnerships are adequate to the task of providing integrated, horizontally coordinated and simultaneous action across sectors at the points where it is most needed - children, households and communities.
This presentation looked at the ways in which MDG3 was conceptualised as foundational to the other MDGs with an earlier target date. It highlights the debate as to whether this position enabled the MDG project to take a global agenda for women's rights further or contributed to a fracturing of the alliances built in the wake of the Beijing conference in 1995. In reviewing the limited progress made against the indicators and the significance of some key aspects of women's inequality for which there are no indicators, notably the levels of violence against women, this presentation posed the question as to what type of opportunity MDG3 offers to understand and monitor gender equality and the empowerment of women worldwide.
The intensity of international efforts to reduce child mortality has varied since global child mortality data became available. During the 1980s UNICEF spearheaded a “Child Survival Revolution” focused on simple, mainly vertical, interventions, yet in the 1990s interest waned as UNICEF focused on other issues and child survival seemed to disappear from WHO’s agenda. The MDGs have given renewed energy to the child survival movement, especially MDG4’s target to reduce under-five mortality by two-thirds. This is meant to be a global and regional goal, not a country-level goal. It may be particularly unfair for Africa, which starts from a much higher baseline. There is an irresistible trend with donors towards country-level vertical strategies and the inevitable result is growing inequity in child survival. Like all quantitative goals, the MDGs are likely to lead to distortions in reported data, particularly in the neonatal mortality field, where existing data are notoriously unreliable.
Delivering a baby can be a time of great celebration, but is also a time of great risk. Two-fifths of maternal deaths occur from the start of labour until 24 hours later. Every minute a woman dies in childbirth or from complications during pregnancy. The current slow progress in achieving MDG 5’s target to reduce maternal mortality by three-quarters requires us to speed up the provision of good quality delivery care. There are also huge differences in coverage of such care between and within countries. Maternal mortality is the public health indicator with the greatest gap between rich and poor countries, with 99 per cent of deaths in the developing world. Even in poor countries, the richest women have much greater access to services than rural women. The potential gains from expanding quality delivery facilities are enormous and extend to improvements in neonatal survival. We need to renew our commitment to meeting this priority.
Progress is being made to achieve the targets for MDG 6 but there is more work to be done. Global trends for HIV show that the epidemic is beginning to plateau but the need for treatment and prevention continues to outpace current interventions. Malaria interventions with bed-nets and appropriate anti-malarial treatment for children under five are making inroads into reducing deaths. The global incidence of tuberculosis (TB) is levelling off but TB control strategies (DOTS) will need to be accelerated in sub-Saharan Africa and the Commonwealth of Independent States (CIS) if the global targets are to be achieved by 2015. Important themes of poverty, health systems and inter-sectoral collaboration are emerging as foci for future approaches to communicable disease control strategies. These interlinking themes will help to relate each of the MDGs to the overall goal of improving health worldwide.
This presentation provided some basic definitions of environmental sustainability. It also identified the players that can determine the pace at which sustainability may be achieved. It was shown that there are a number of different ways of 'knowing' sustainability and 'doing something about' bringing it about. The role of consumption was highlighted, and the challenges of changing behaviour in both the South and the North. This framework contributed to the analysis of MDG 7 and provided an explanation of outcomes and the basis of a critique. The review focused on water - on both water resources and on water supply and sanitation. It was shown that the MDG targets are not being met in many countries in Africa. Problems of getting resources mobilised effectively were exemplified at many administrative and social levels. The importance of deploying international assistance by fully and effectively engaged intermediaries such as WaterAid was also noted.
