Wednesday, June 4, 2014

Week 12: What About The Millenium Development Goals?

This topic was actually covered in week 10, but since the lecture in week 12 was quite short I thought I'd explore it in this post as a nice way to close out the blog (at least for now).

The Millenium Development Goals are a series of targets that wealthy countries set for the betterment of the circumstances in developing nations starting in 2000 and ending in 2015.  It was really the first time that the developed world got together and announced a commitment and responsibility to bringing about specific improvements in poorer countries.

So what were these goals?  Let's see if I can remember them without any help:

  • Reducing extreme poverty
  • Reducing child mortality and morbidity
  • Improving maternal health and reproductive services
  • Reducing the spread of HIV/AIDS, TB, Malaria and other illnesses
  • Access to education
  • Reduction in climate change

How did I do?  Here are the real 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. Global partnership development

Well, I wasn't too far off.

With 2015 fast approaching, how have we done over the past 14 years?  What progress has been made regarding these indicators?  Was the developed world successful in improving situations in developing nations or were these goals more of a distraction and series of well-meaning promises that would inevitably be broken than a way to drive overall development?

What has been achieved:
  • The goal to reduce extreme poverty (those living on less than $1/day (now $1.25/day)) is on track, however progress differs between regions.  The overall improvement in numbers is mostly thanks to successes in Asia and to an extent, masks the poor outcomes in other regions.  
  • The goal to halve the number of people suffering from extreme hunger probably won't be met in time.
  • Child survival has considerably improved (mortality reduced by more than 40%), and fewer children are underweight (25% lessened to 17%).  However, the goal of reducing mortality by two-thirds probably will not be met.
  • The spread of HIV has slowed and 8 million people in developing countries have been placed on antiretroviral treatment (ARTs)
  • Countries with lower prevalence rates of malaria have been more successful at reducing the number of cases and malaria-related deaths.
  • The goal of access to safe-drinking water will be achieved, however the progress desired for hygiene and sanitation will not.
  • Maternal mortality in 2010 was almost half of what it was in 1990, more women have been attending at least one antenatal visit and fewer have been giving birth without a skilled birth attendant.  However, the figures are still very poor in some regions, particularly in Africa and the goal of reducing maternal mortality by 75% will not be met.
 (Berkley et al., 2013; Dunham 2014)

Despite the fact that most of the specific targeted measures will not be met, a great deal of progress has been made and I doubt that those improvements would have been made without the establishment of the Millenium Development Goals.  While development is not specifically mentioned by the goals, indicators that both reflect and promote development are (i.e. improved health and education, etc) are.  Focusing on these factors provided developed nations with tangible, quantifiable targets that were far easier to measure than the very broad scope of development (freedom, productivity, happiness, wellness, infrastructure, political stability), which is difficult to assess.  These were figures that organizations and public health experts could identify to clearly illustrate need and progress in a way that policymakers could easily understand.

As a graduate of exercise science, I know that setting specific targets is pivotal to achieving goals for individuals and I would assume the same could be said on the larger scale of communities and countries.  Long-term goals should be bolstered by smaller, short-term targets that are easier to attain and function as progressive stepping stones in the strategy leading to successful completion of the ultimate objective.  We need to identify the means to get to the desired end.  In this respect, I believe that the Millenium Development Goals were not very well-designed, seeing as the finer details of the process were not outlined, they really only stated the intended outcomes.

I also know that strategies should be flexible and goals must be realistic and attainable, otherwise they will almost certainly not be achieved and may actually be so overwhelming that they discourage efforts all together.  Perhaps the Millenium Development Goals were a bit too ambitious to actually achieve, especially considering the fact that no initiative of that magnitude had ever been attempted before.

I do believe that it is unfortunate that so much emphasis was put on achieving only these goals that progress in other areas was no longer on the radar, especially considering that some countries had other problems to deal with as well (i.e. conflict, reproductive health, etc).  But, at least the goals gave the world something to work towards.

Another criticism is that countries, organizations and public health workers tended to concentrate their efforts on the goals that were easier to achieve (in other words, the low-hanging fruit).  If a target was closer to being met in one area or population than another, that would get more attention so that the goal could be met faster and with less resources instead of improving the overall state of affairs everywhere, which would be much more difficult to do.  For example, if the goal was to get a certain number of people living on more than $1/day, in many cases, they began with raising the income of those earning close to that, say $0.95/day rather than those earning less because there was less of a gap, therefore it was easier to accomplish.  Unfortunately, this means that those who are the most disadvantaged can be left out.

But, if people in need are still benefiting, is it really a bad way to go about bringing change?  Ideally help would eventually improve circumstances across the board, but maybe small successes to start with help build confidence and trust in programs and can serve as learning platforms.  I'm really undecided on this point.  I actually function that way a lot of the time.  When I'm writing an exam, I tend to answer all of the easier questions that I know I'll get right first to ensure that I am at least getting those marks locked down before I start chipping away at the more difficult answers that I may not do well on or even complete.  It's my way of optimizing my time to get the best results possible.  Having better results increases my chances of being able to continue studying and working in that field, much like having positive, concrete outcomes increases the likelihood that organizations and researchers will continue to receive funding.

In the end, the efforts put forth to achieve the outlined targets have improved health, which is essential to spurring productivity and development.  In that sense, having the development goals has been useful.

Where will we go moving forward?  Once 2015 comes and goes, what will the world strive towards to further improve circumstances?

The general consensus appears to be that one of the new goals should be universal healthcare for everyone (The struggle for universal health coverage 2012).  But, not just the idea or presence of universal healthcare, well-functioning systems with enough trained professionals to provide good, effective care to everyone (or as many people as possible) so as to reduce health and consequently other inequalities (economic, social, etc) (The struggle for universal health coverage 2012).  Universal primary healthcare will be important, not only for the treatment of illness and injury when present, but also to foster healthy and capable populations.  This will be especially pertinent considering the growing problem of noncommunicable, chronic diseases that lead to premature death and disability and therefore strained systems and reduced productivity.

I believe that the lessons learned while trying to achieve the Millenium Development Goals will provide immense knowledge moving forward and will help to shape and accomplish future health and development targets.

This assignment has truly helped me to further explore the topic of health and development in my own way and for that I am immensely grateful.  I hope that these posts have proved for an interesting read because I have really enjoyed writing them and I look forward to any feedback.



Berkley S, Chan M, Dybul M, Hansen K, Lake A, Osotimehin B & SidibĂ© M 2013, 'A healthy perspective: the post-2015 development agenda', The Lancet, vol. 381, no. 9872, pp. 1076-1077.  Available from: <>. [16 May 2014].

Dunham J 2014, Topic 9: Millenium Development Goals, lecture notes distributed in Health and Development PUBH7113 at The University of Queensland, Brisbane, 14 May 2014.
'The struggle for universal health coverage' 2012, The Lancet, vol. 380, no. 9845, pp. 859.  Available from: <>. [16 May 2014].

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