In 2000 the UN Millennium Declaration was adopted at the largest ever meeting of heads of state and committed those countries – rich and poor – to doing all they could to eradicate poverty. Promote human dignity and equality and achieve peace, democracy and environmental sustainability. World leaders agreed to work together to deliver an agreed programme of Goals – 8 in all – and to do so by the year 2015.
This module explores those Goals, the context in which they operate, the costs of their realisation, the strategies needed to achieve them and the views expressed by commentators worldwide as to whether the Goals are real and achievable or just more words and promises without meaning.
The 8 Millennium Development Goals
Goal 1: Eradicate extreme poverty and hunger
Goal 2: Achieve universal primary education
Goal 3: Promote gender equality and empower women
Goal 4: Reduce child mortality
Goal 5: Improve maternal health
Goal 6: Combat HIV/AIDS, malaria and other diseases
Goal 7: Ensure environmental sustainability
Goal 8: Develop a Global Partnership for Development
Goal 1: Eradicate extreme poverty and hunger
- Target 1: Halve, between 1990 and 2015, the proportion of people whose income is less than one dollar a day
- Target 2: Halve, between 1990 and 2015, the proportion of people who suffer from hunger
Poverty
Extreme poverty is defined as having to live on less than €1 a day – in 1990, 30% of the developing world’s population lived in extreme poverty, by 2000, it had fallen to 23%. Some 1.2 billion – 1 in every 5 beings on the planet – live in such poverty, concentrated in South and East Asia and sub-Saharan Africa. The numbers living in poverty increased in the 1990s in Latin America, the Arab states and Central and Eastern Europe.
Key obstacles to eliminating poverty:
- poor economic growth that is poverty focused (some countries with improved economic growth still witnessed an increase in poverty)
- economic growth needs to be broadly based rather than focused in some regions or sectors
- peace, stability and good government is also vital
- the huge inequalities between the rich and poor in developing countries, where the vast majority of assets and income is concentrated in very few hands, is an enormous obstacle to reducing poverty
Hunger
In the 1990s, the number of hungry people fell by nearly 20 million but, if we exclude China, the number actually increased. South Asia and sub-Saharan Africa remain the regions most affected. Over the past 40 years, global food production has doubled and food prices have halved to an all-time low – food is plentiful but not in some areas and certainly not for very many poor people.
815 million people still cannot get the food they need for healthy, active lives. In the developing world, two third’s of child deaths are directly or indirectly linked to malnutrition.
Key obstacles to tackling hunger:
- poverty is the main obstacle, poor people cannot get enough food, either by growing it or buying it
- the distribution of already existing food is a problem, relying on the market to ensure food supplies discriminates against the poor and against poor regions and countries
- agricultural productivity, especially in sub-Saharan Africa, need to be improved greatly
- landlessness remains a key issue
- subsidies that the developing world pays to its own farmers, combined with the tariffs on exports from the developing world make it difficult for farmers in the developing world to get a fair price for crops
Goal 2: Achieve universal primary education
- Target 3: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
Education
Throughout the developing world, about 80% of children are enrolled in primary school, but yet, some 115 million do not attend school at all and 3/5ths of these are girls. Again figures for South Asia and sub-Saharan Africa are seriously low (57% in the latter case). However, once in school in Africa, there is only a 1 in 3 chance that a student will complete primary level.
Additionally, 1 in every 6 adults is illiterate.
Key obstacles in education:
- failure to complete primary schooling
- the poor quality of much education
- inequality in the funding of education and its general availability
- the costs of education, fees, uniforms, books, food
- gender inequality
- issues such as HIV and AIDs
- declining levels of international aid for education
Goal 3: Promote gender equality and empower women
- Target 4: Eliminate gender disparity in primary and secondary education, preferably by 2005 and in all levels of education no later than 2015
Gender Equality and education
An estimated two-thirds of the 300 million children without access to education are girls, and two-thirds of the 880 million illiterate adults are women. In 1996, 29 per cent of the world’s females over age 15, compared to 16 per cent of males, were illiterate. In the developing world as a whole, the gender gap at the primary level has narrowed significantly, but it persists in sub-Saharan Africa, North Africa and South Asia.
Female representation generally decreases at secondary and post-secondary levels, but the gender gap has narrowed somewhat in recent decades. Education, in particular that of women, has a larger impact on infant and child mortality than the combined effects of higher income, improved sanitation and employment.
Key obstacles:
- poverty which often forces parents to choose between the education of a boy and girl child
- attitudes towards the education of girls
- the need for girls to perform ‘caring roles’ in the family
- wider gender gaps are to be seen in regions with lower overall levels of education
- family size influences education – children of either sex from small families have better educational opportunities
Goal 4: Reduce child mortality
- Target 5: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
Child Mortality
- every year more than 10 million children die of preventable diseases – 30,000 per day. More than 500,000 women die in pregnancy and childbirth with women in Africa, almost 100 times more likely to die than those in richer countries
- in sub-Saharan Africa, child mortality rates are running average 172 deaths per 1,000 compared with 9 per 1,000 in developed regions
- the major causes of deaths of under 5’s in sub-Saharan Africa include malaria, acute respiratory infections, diarrhoea and AIDS
- there are more than 600,000 new cases of HIV in children each year and most cases the infection is passed to them from their mother
Key obstacles:
- diseases such as HIV/AIDS
- economic decline, conflict, inequality and persistent poverty
- under-resourced health services
- lack of progress in reducing the numbers of deaths of newborn babies. Most die from preventable causes such as diarrhoea, pneumonia, malaria, measles, AIDS, and other illnesses
Goal 5: Improve maternal health
- Target 6: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio
Maternal Mortality Rate
- a poor woman in a poorest country is over 100 times more likely to die in pregnancy and childbirth than a woman in a developed country
- up to 80% of maternal deaths are directly caused by just 5 common obstetric complications: bleeding, infection, complications of abortion, high blood pressure and prolonged or obstructed labour
- up to 2 million children each year are orphaned because their mother has died
Key obstacles:
- mothers not receiving skilled care during their labour and emergency care if complications occur
- there are 3 key delays in maternal health: time taken to decide to get help; getting to the help, and for the help to actually be provided – these delays can make the difference between life and death
- women are still treated as second-class citizens
- health services are severely constrained
Goal 6: Combat HIV/AIDS, malaria and other diseases
- Target 7: Have halted by 2015, and begun to reverse, the spread of HIV/AIDS
HIV/AIDS
- over 37.8 million are living with HIV and over 20 million have already died since the first AIDS cases in 1981
- 4.8 million people became newly infected with HIV in 2003
- in the hardest hit countries, life expectancy will fall to 30 years by 2010
- In 1999, an estimated 860,000 African children lost their teachers to AIDS
- 13 million children in Africa have lost at least one parent to AIDS, by 2010, this will rise to an estimated 25 million.
Key obstacles:
- funding for treatment and for research
- poor co-operation between donors
- the relatively high cost of drugs
- a lack of political will and commitment plus follow through
- attitudes towards the disease and those who suffer from it.
- Target 8: Have halted by 2015, and begun to reverse, the incidence of malaria and other major diseases
Malaria
- about 100 countries in the world have malaria, almost half of which are in sub-Saharan Africa. There are now more than 2.4 billion people are at risk
- there are an estimated 200-500 million malaria cases each year with about 90% occurring in sub-Saharan Africa
- malaria kills between 1.1 and 2.7 million people each year, of whom about 1 million are children under 5 years in sub-Saharan Africa
- economic losses due to malaria in Africa are estimated to be about US$12 billion per year.
Key obstacles
- interventions costs e.g. it would cost US$22.5 million to provide all under 5’s in a country of 20-30 million people with insecticide treated nets
- malaria is now resistant to many drugs and the new range are very expensive.
Tuberculosis (TB)
- every 15 seconds someone dies of TB
- more than 8 million people become sick with TB each year and each one can infect between 10 and 15 people in one year just by breathing
- TB is a disease of poverty, 92% of cases and deaths occur in low income and lower middle-income countries.
Key obstacles
- TB is spreading faster than TB control efforts
- the emergence now of HIV-associated TB and multi-drug resistant TB
- more needs to be done to target services to control TB amongst poor people.
Goal 7: Ensure environmental sustainability
- Target 9: Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources
- Target 10: Halve, by 2015, the proportion of people without sustainable access to safe drinking water
Environment
- major threats from climate change – reduced annual rainfall, increased temperature and rainfall variability, increased risk of flooding and/or drought, and sea level rise
- water consumption per person is 10 times higher in developed countries than in developing countries
- forests were being cut down at the rate of more than 9 million hectares a year during the 1990’s, equivalent to losing 2.4% of the total forested area each year
- 75% of fisheries stocks are exploited at or above their maximum capacity and several have already collapsed due to over-fishing.
Key obstacles:
- the poor, who are most dependent on natural resources and most affected by environmental degradation, do not always have access to information, rights, or decision making and policy development
- powerful interests are opposed to fundamental change re the environment
- public attitudes to environmental issues
- lack of effective political leadership.
Why reaching the environmental Goal is so important for the other Goals
1. Eradicate extreme poverty and hunger
Poor people’s livelihoods and food security often depend on ecosystem goods and services. Poor people tend to have insecure rights to environmental resources and inadequate access to markets, decision-making and environmental information – limiting their capacity to protect the environment and improve their livelihoods and well-being. Lack of access to energy services also limits productive opportunities, especially in rural areas.
2. Achieve universal primary education
Time spent collecting water and fuel wood reduces time available for schooling. In addition, the lack of energy, water and sanitation services in rural areas discourages qualified teachers from working in poor villages.
3. Promote gender equality and empower women
Women and girls are especially burdened by water and fuel collection, reducing their time and opportunity for education, literacy and income-generating activities. Women often have unequal rights and insecure access to land and other natural resources, limiting their opportunities and ability to access other productive assets.
4. Reduce child mortality
Diseases (such as diarrhoea) tied to unclean water and inadequate sanitation and respiratory infections related to pollution are among the leading killers of children under five. Lack of fuel for boiling water also contributes to preventable waterborne diseases.
5. Improve maternal health
Inhaling polluted indoor air and carrying heavy loads of water and fuel wood hurt women’s health and can make them less fit to bear children, with greater risks of complications during pregnancy. And lack of energy for illumination and refrigeration, as well as inadequate sanitation, undermine health care, especially in rural areas.
6. Combat major diseases
Up to 20% of the disease burden in developing countries may be due to environmental risk factors (as with malaria and parasitic infections(. Preventive measures to reduce such hazards are as important as treatment – and often more cost effective. New biodiversity-derived medicines hold promise for fighting major diseases.
7. Develop a global partnership for development
Many global environmental problems – climate change, loss of species diversity, depletion of global fisheries – can be solved only through partnerships between rich and poor countries. In addition, predatory investments in natural resources can greatly increase pressure to overexploit environmental assets in poor countries.
Slum Dwellers
- Target 11: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers
- there are 900 million slum dwellers and this is likely to increase to an estimated 2 billion by 2020
- almost half the population of African and Asian towns and cities live in slums
- in sub-Saharan Africa, an estimated 72% of urban population lives in slums
- conditions in slums as regards housing, water, sanitation and health threaten to undermine many other dimensions of human development.
Key obstacles
- urbanisation is rapid and policymakers and planners are often unwilling or unable to keep up in terms of planning for shelter and basic services, or to invest the public expenditure needed
- slum dwellers have few rights as urban citizens and consequently little power or influence to change their circumstances
- slum dwellers have few or no basic services, low life expectancy and little access to justice. They are frequently the victims of crime and many live under constant threat of eviction
Improving the lives of slum dwellers
An estimated one-third of the developing world’s urban population lives in slums. They contend with overcrowding, substandard housing and poor access to safe water and sanitation – resulting in high rates of disease and infant mortality.
Rapid urban growth suggests that the problems of slum dwellers will worsen in cities already vulnerable. The united nations projects that between 2000 and 2010, 85% of the growth of the world’s population will occur in urban areas – almost entirely in Africa, Asia and Latin America. In 201 more than 71% of the urban populations in the least developed countries and Sub-Saharan Africa lived in slums. Without substantial interventions, this figure will increase.
MDG 7 calls for significant improvements in the lives of at least 100 million slum dwellers by 2020. Traditionally, donors (of official aid) have been less focused on the needs of urban residents. But with growing pressure to manage rapid urban growth, that is beginning to change.
Though cities are often associated with environmental destruction, their high population densities offer opportunities to build crucial infrastructure – such as sanitation, transport and health care services – at lower costs per capita than in rural areas. Urban environments can also offer better prospects for making governments more responsive and accountable to people’s needs. The success of slum dweller associations around the world – such as in Mumbai, India and Nairobi, Kenya – suggests that higher population densities and closer proximity to decision-makers enable poor urban residents to make their voices heard.
Total urban and slum populations worldwide, mid-2001
| Region | Total population (billions) | Urban population (%) | Urban slum population (%) | Urban slum population (000’s) |
| World | 6.1 | 47.7 | 31.6 | 923,986 |
| Rich regions | 1.2 | 75.7 | 6.0 | 54,068 |
| Developing regions | 4.9 | 40.9 | 43.0 | 869,918 |
| North Africa | 0.2 | 52.0 | 28.2 | 21,355 |
| Sub-Saharan Africa | 0.7 | 34.6 | 71.9 | 166,208 |
| Latin America & the Caribbean | 0.5 | 75.8 | 31.9 | 127,567 |
| East Asia and Oceania | 1.4 | 39.0 | 36.3 | 194,323 |
| South-Central Asia | 1.5 | 30.0 | 58.0 | 262,354 |
| South-East Asia | 0.5 | 38.3 | 28.0 | 56,781 |
| West Asia | 0.2 | 64.9 | 33.1 | 41,331 |
| Central and Eastern Europe and the CIS | 0.4 | 62.9 | 9.6 | 24,831 |
Estimates from African Population and Health Research Center in collaboration with UN Habitat in UNDP (2003) Human Development Report
Goal 8: Global Partnership
By 2015, all 189 UN member states have promised to:
- develop further an open trading and financial system that is rule-based, predictable and non-discriminatory. Includes also a commitment to ‘good governance’, development and poverty reduction – nationally and internationally
- address the special needs of the world’s least developed countries – tariff and quota-free access for exports, better debt relief for heavily indebted countries, cancellation of bi-lateral (county to country) debt and increased official aid
- deal with the problems of landlocked and small island developing state
- deal with developing countries debt problems through both national and international measures
- increase efforts to find productive work for young people
- in cooperation with drug companies, provide access to affordable essential drugs in developing countries
- along with the private sector, make available the benefits of new technologies – especially information and communication technologies
What this means:
Aid
The central argument within the goals is for more and more effective aid. Recent studies estimate that current aid levels need to increase by between $40 and $100 billion per year. The lower figure would require, in effect, a doubling of the current level of aid. Official aid is normally measured as a percentage of each country’s gross national income per person and, it was agreed internationally in 1969 that the target figure would be 0.7%. Between 1990 and 2001, the average figure for developed country aid fell from 0.33% to 0.22% but since the late 1990s and through the early 2000s, the figures have begun to increase again, but not at the levels needed to achieve the MDG targets.
Sadly, the countries that experienced the negative impact of aid cuts throughout the 1990s were the world’s least developed and poorest countries. Of the 49 least developed countries, 31 now receive less aid than they did in 1990 (8.5% of their own GDP as against 12.9%).
However, things may now be improving with aid allocations increasing in Austria, Ireland, Luxembourg, the Netherlands, the United Kingdom and the United States. But, such increases have occurred before and need to be maintained over significant periods of time.
The second element of discussion over aid and the MDGs relates directly to the effectiveness of such aid. Official aid has always had its critics and continues to do so – arguments usually relate to whether aid ever gets to its intended recipients, whether it is focused on the real needs of the poor, whether it is ‘tied’ (linked to purchases from the donor country), the issue of corruption etc. (see the Debating Aid module). A recent World Bank study described official aid as having been ‘ … highly effective, totally ineffective and everything in between … ‘. Official aid has had many notable successes in the areas of health, education, agriculture, women’s rights, infrastructure, civil service reform etc. The quality of official aid has varied greatly depending on the attitudes and policies of the donor and recipient governments. But, far too often, aid has gone to governments guilty of extensive corruption or has been given to ‘friendly’ governments by donors for essentially non-development related purposes.
The three areas in which official aid policies need to change are:
- the need for stronger and better ‘governance’ – greater transparency and honesty
- increased ownership, especially by local governments, structures and institutions that go beyond politicians and civil servants alone
- increased effectiveness meaning increased focus on poorer countries, increased direct focus on poverty, less ‘tied aid’, greater co-ordination between donors and better integration into general recipient government programmes and strategies.
Debt
Over 75% of the high priority countries as regards the MDGs are highly indebted – debt relief is considered vital in terms of releasing much needed funds for development. The overall objective is to create a situation where no such ‘high priority country’ has a debt problem it cannot effectively manage. The central arguments from campaigners for debt relief are that such debt are unjust, they were unjust from the very beginning and that they have been paid over and over again.
For those countries that have achieved a degree of debt relief (some 30 to date), the value of released funds amounts to a reduction in yearly debt payments of approximately $1.2 billion. In countries such as Uganda, Senegal, Mali and Mozambique these savings have been translated into greater spending in education, health, HIV and AIDS strategies etc. Overall, debt relief is considered more effective than aid in promoting the MDGs.
As regards future strategies on debt relief, the central issues remain:
- strengthening the links between debt relief and the MDGs
- more debt relief, focused specifically on the needs of poor people
- providing greater supports against ‘shocks’ of different types – natural disasters and sudden and serious price collapses for commodities.
Trade
Opening up markets and reducing subsidies for developed country goods are two key planks in the MDG trade strategy. High priority countries within the MDG framework remain very heavily dependent on exports of primary products that have suffered from declining prices in recent years. Increased aid and higher debt relief will certainly make a difference in the shorter term but changes in world trading patterns and pricing to the benefit of developing countries are a must for the longer-term.
Developing countries need to diversify their exports but this is very difficult as it now, more than ever before, requires capital, knowledge and technology to move away from primary to processed commodities and from low-skill manufactured goods to more skill-intensive goods. According to most observers, there is very considerable scope for developed countries to open up their markets to goods from developing countries.
Despite some recent actions, trade policies in developed countries remain highly discriminatory against products produced in developing countries – especially in the areas of agriculture and textiles. Tariffs remain consistently higher for goods from developing countries than similar goods from developed countries (e.g. Bangladesh pays 14% tariff on goods to the US whereas France only pays 1%), New Zealand imposes a tariff of 5% on coffee beans but charges 15% on ground coffee thus undermining efforts to increase the value of developing country exports. Quotas or limitations on the volume of imports are another means of discrimination – quotas on clothes and textiles are supposed to be eliminated in 2005 although there is much doubt as to whether this will actually be done.
Of particular importance is the use of rich country export subsidies (especially in the area of food – amounting to $311 billion per year) thus undermining developing country industries and markets. For example, EU-subsidised exports have contributed to the decline of the dairy industries in Brazil and Jamaica and the sugar industry in South Africa. West African cotton producers cannot compete with the subsidised exports of rich country producers. It has been pointed out that OCED per capita subsidies for cows and cotton exceed per capita aid to Sub-Saharan Africa.
Greater use of technology focused on the needs of the poorest people is also key to achieving the MDGs. In 1999, tropical diseases (such as sleeping sickness, Chagas disease and kal-azar – all parasitic diseases that can kill) accounted for 11% of the world disease burden but only 1% of new drugs dealt with such diseases. In 1999, the World Health Organisation found that only 10% of health research and development is focused on the health needs of 90% of the world’s people. Developing countries make up just 2% of the world market for drugs meaning that pharmaceutical companies remain focused on the health needs of the rich at the expense of those of the poor.
Rich countries have taken few steps to share technology (in areas such as drugs) or to implement the TRIPS agreement (Trade Related Intellectual Property Rights) which would not only improve access to technology and information but would also protect local knowledge and products.
Rich Country Responsibilities
| Country | Aid 2001 | Debt | Trade | ||
| Total (US millions) & as % of GNP | Percent tied | Pledges to HIPC Trust Fund in US millions – November 2002 | Average tariff and non-tariff barriers in %, 2000(see note 1 below) | Imports from Developing Countries as % of total imports – 2001 | |
| Australia | 873(0.25) | 41 | 14 | 13.4 | 37.5 |
| France | 4,198(0.32) | 33 | 181 | 21.4 | 17.4 |
| Ireland | 287(0.33) | 0 | 24 | 22.9 | 13.6 |
| Norway | 1,346(0.83) | 1 | 300 | 61.1 | 12.3 |
| UK | 4,579(0.32) | 6 | 77 | 20.9 | 18.9 |
| USA | 11,429(0.11) | NA | 40 | 9.7 | 46.4 |
Note 1 – this is an aggregate measure of trade barriers towards developing countries and includes monetary barriers and non-monetary barriers.
Commitment to Development Index (CDI)
This is a newly created index that attempts to measure individual country ‘commitment’ to development. The CDI measures 4 key areas – Trade, Aid, Investment and Migration and was developed by the Center for Global Development and Foreign Policy magazine in the US. The Index goes beyond traditional ways of looking at aid as the key measurement and examines a broader set of issues including both the quantitative and qualitative aspects of aid, trade barriers, the environment, investment, migration and peacekeeping.
From a total of 21 countries listed in the 2004 Index, the Netherlands, Switzerland and Denmark top the list, Ireland comes in 13th while France, the United states and Finland come in at the bottom.
There are many different criticisms of the CDI in that it is based on very complex statistical calculations and a set of assumptions that many might disagree with. Nonetheless, it is one attempt to measure the degree to which individual rich countries are actually committed to the development of poorer countries and peoples.
