Millennium Development Goals
In September 2000, representatives from 189 countries (and 147 Heads of State) met at the Millennium Summit in New York to adopt the Millennium Declaration. The Declaration set out principles and values that should govern international relations in the 21st century and identified seven areas in which national leaders made a series of specific commitments: peace, security and disarmament; development and poverty eradication; protecting our common environment; human rights, democracy and good governance; protecting the vulnerable; meeting the special needs of Africa; and strengthening the United Nations.
The Millennium Development Goals (MDGs) relate to the section of the Millennium Declaration dealing with development and poverty eradication and summarize some of the key commitments made at the major United Nations conferences of the 1990s. Within the Declaration, 4 of the 8 goals, 8 of the 16 targets and 17 of the 48 indicators are health-related.
A first annual report by the United Nations Secretary-General on the implementation of the Millennium Declaration was presented to the General Assembly and distributed on 31 July 2002 (UN Document No. A/57/270). It summarized progress made since 1990 and concluded that many of the goals will not be reached by 2015 unless international efforts are significantly increased. Across regions, progress towards the health goals and targets has been uneven. Sub-Saharan Africa has made the least progress, and much of South Asia is also unlikely to achieve the targets. There is also concern that, because the health goals are expressed in terms of national averages rather than gains among the poor or disadvantaged (as other MDGs are), they could be reached without significant improvement for the poorest groups.
Progress on selected health goals can be summarized as follows:
- Goal 4, Target 5: to reduce child mortality by two-thirds between 1990 and 2015. The Middle East and North Africa, Latin American and the Caribbean, and Europe and Central Asia are on track to meet this target, although within each of these regions there are countries that are not. Sub-Saharan Africa and South Asia are both off-track, with sub-Saharan Africa much less likely to reach the goal.
- Goal 5, Target 6: to reduce maternal mortality between 1990 and 2015. A similar pattern exists here: sub-Saharan Africa and South Asia are unlikely to meet the target and other regions are currently on track. However, the challenge is greater here than for Target 5, as the percentage of births attended by skilled personnel is improving only very slowly (or even falling) in sub-Saharan Africa, and rising only slowly (from a very low base) in South Asia.
- Goal 6, Target 7: to have halted or begun to reverse the spread of HIV by 2015. This target is measured by looking at a reduction in HIV prevalence among young pregnant women aged 15-24, while also taking into consideration reductions in the number of HIV/AIDS orphans and increases in condom use among women and men aged 15-24. The focus on this age group addresses the fact that over half of all new infections occur among young people. Outside sub-Saharan Africa, it is “likely” or “possible” that almost all countries will reach this target.