The current MDGs were based on figures from 1990, with a target for 15 years in the future. The World has changed a lot since then, the population has surged and there has been mass migration from rural to urban areas.
LMICs are no longer one and the same; development in Asia has soared, leaving the majority of Sub-Saharan Africa trailing behind, skewing results for poverty eradication and health provision.
After 2015, where will we be? Current statistics show that many of the targets may not be reached, and different areas will reach certain targets disproportionately to others. A local based approach for the future may be the way forward; we are no longer in a situation where inequality doesn’t matter.
Reports on where we are and where to go next include:
1. Eradicate extreme poverty and hunger:
46% of the population in LMIC in 1990 lived on less than $1 a day, this decreased to 27% in 2009. For the target to reduce extreme poverty by a half, this seems to be on target however:
- As a result of the global economic crisis 16% people in 2009 were undernourished, a rise from 14% in 2005.
- Most people now live in urban areas, compared to rural areas in the 1990s posing different challenges to those that were faced when the goals were set.
- The majority of poor people now live in MIC, is a HIC donor focus on poverty alleviation the right one?
2. Achieve universal primary education:
Worldwide coverage was 90% in 2009 up from 84% in 1990. In LMICs there was an increase to 89% from 82%.
Those that are out of school tend to be in the poorest quartile within their countries. If this target is not achieved by 2015 then a focus on the social circumstances of this population group may assist in alleviating this issue.
3. Promote gender equality and empower women:
- The World as a whole is a lot more aware of the importance that women play in society and this is being shown in the male:female ratio in education. In 2009 the male to female ratio for those in primary education was 100:96 up from 100:91 in 1990.
- Employment is still a major area in which improvement needs to be made.
4. Reduce child mortality:
The majority of deaths of Under-5s are preventable and a third are attributable to under-nutrition.
The 2015 target is 30 deaths per 1000 live births; in 2009 throughout all LMICs the Under-5 mortality rate was 72 per 1000 a decrease from 1990 when there were an average of 100 deaths per 1000 live births.
- Focus on other MDG targets will improve this as a secondary measure, as more people are able to afford healthcare and education is improved.
5. Improve Maternal Health:
Haemorrhage accounts for 35% of all maternal deaths, a preventable cause, easily improved by the presence of skilled-birth attendants. In 2009 63% of births in LMICs were attended by skilled birth-attendants and increase from 53% in 1990.
Education of women and empowerment will ultimately improve this situation, as increased knowledge of the risks will improve attendance to ante-natal clinics and specialist services.
6. Combat HIV/AIDS, Malaria and other diseases:
- Progress is being made with HIV; fewer people are becoming newly infected (around 2.7 million in 2008) and people are living longer. 42% in LMIC in 2008 with HIV/AIDS receive ARVs, up from 16% in 2005.
- Global awareness about malaria has increased and subsequently the use of nets in all areas has increased. However, poverty still determines whether or not a child with malaria gets treatment.
- With TB being conjunct with HIV infection, rates are only recently being to slow. Globally infections were 139 per 100,000 in 2008.
7. Ensure environmental sustainability:
CO2 emissions are rising worldwide leading to increases in climate catastrophes and desertification of once arable farming land are affecting the fight against all MDGs. Future targets need to incorporate the issues of climate change without diverting effort away from poverty alleviation. Those most affected by climate catastrophes need to have the ability to be more resilient to reduce the need for gross emergency aid.
8. Develop a global partnership for development:
The UN target for aid donation from HICs is 0.7% of GDP, only 5 countries reach this currently. However alleviation of debt burdens, preferential tariffs for imported goods from LDCs alongside duty free imports for products from LMICs has helped to improve international trading.
Aid driven targets may no longer be the solution for sustainable development and a focus on decent work and labour standards will help to further development globally.
Amelia Cutts: [email protected]
Amelia is a final year medical student at Southampton, UK. She has an interest in health politics, especially health inequalities, and have been actively involved in Medsin and related campaigns over her time at medical school.