World Health Editors Network P rogress towards the health-related Millennium Development Goals

1. World Health Editors NetworkProgress towardsthe health-related MillenniumDevelopment Goals Carla Abou-Zahr, Ties BoermaFiona Gore, Annet MahananiDepartment of Health Statistics and Informatics

2. WHO and MDGs • The Millennium Development Goals (MDGs) • Health-related MDGs • Progress and Challenges • Moving forward

3. The Millennium Development Goals • In September 2000, 191 heads of state adopted the UN Millennium Declaration and endorsed a framework for development, the plan being for countries and development partners to work together to: • reduce poverty and hunger, and tackle ill health, lack of education, gender inequality, lack of access to clean water and environmental degradation • Eight Millennium Development Goals (MDGs) were established, with targets for 2015, and indicators to monitor progress • At the 2008 World Health Assembly, WHO Member States tasked the Organization to provide an annual update on progress towards the health-related MDGs, starting in 2009.

4. Health-related MDGs • MDG 1: Target 1C: Halve the proportion of people who suffer from hunger (underweight) • MDG 4: Target 4A: Reduce child mortality by two thirds • MDG 5: Improve maternal health • MDG 6: Combat HIV/AIDS, malaria, and other diseases • MDG 7: Halve the proportion of people without sustainable access to safe drinking water and basic sanitation • MDG 8, Target 8E: Access to affordable essential medicines in developing countries

5. Progress is being made, but huge challenges remain Currently available data show that while some countries have made impressive gains in achieving health-related targets, others are falling behind. Often the countries making the least progress are those affected by high levels of HIV/AIDS, economic hardship or conflict.

6. Progress on the health-related MDGs • Fewer children are dying • Annual global deaths of children under five years of age fell from 12.6 in 1990 to 8.8 million in 2008 – down by 30% • Fewer children under five are underweight: • % has dropped from 25% in 1990 to 16% in 2010 • Although more women get skilled help during childbirth globally, for women in Africa and South-East Asia fewer than 50% of all births were attended.

7. Progress on the health-related MDGs • Fewer people are contracting HIV - New HIV infections declined by 16% globally between 2001 and 2008 • Tuberculosis treatment is more successful - existing cases of TB are declining, along with deaths among HIV-negative TB cases • More people have safe drinking-water, but….not enough have toilets

8. Health-related MDG scorecard MDG4 MDG 5 MDG 6 MDG 7

9. The WHO African and Eastern Mediterranean regions are most off-track to achieve the MDG4 target Off track On track Off track On track On track On track

10. MDG 5: Improve maternal healthMaternal mortality not moving fast enough in the right direction MDG Required annual pace of decline Lancet estimates 1990-2008 UN estimates 1990-2005 New UN estimates - in preparation %

11. Discrepancies in coverage of key maternal and child health interventions Coverage of interventions such as antenatal care and immunization is relatively high Coverage of interventions that are dependent on a functioning health care system, such as skilled care during delivery, management of diarrhoea and care for pneumonia tends to be comparatively low

12. Dipping in and out of the health care system;low- and lower middle-income countries

13. More people in need are receiving antiretroviral therapy in low- and middle-income countries 2002–2008 Source: Towards universal access: scaling up priority HIV/AIDS interventions in the health sector.WHO/UNAIDS/UNICEF Progress Report 2009

14. Challenges • Conflict-affected and fragile states are furthest away from achieving the MDGs • More efforts and investment are necessary to prevent set backs, and to accelerate progress towards the MDGs • Better data are key – the lack of investment in health information systems at country level to assess achievements is a significant problem • Time is short – urgent action is needed!

15. Moving forward • Better health outcomes depend on effective interventions delivered by better health systems • Better health requires coherent policies and a comprehensive approach that also addresses the social, environmental and economic determinants of ill-health • Outcomes, interventions, programmes and systems come together in a robust country-led national health policy & strategy requiring an inclusive process of consultation to ensure democratic ownership • There is an urgent need to align external support around the national health policy & strategy to reduce fragmentation and the burden on countries

16. 8.8 million deaths in children under 5 3 million diarrhoea & pneumonia child deaths 1 million malaria deaths 2.7 million new cases of HIV infections 33 million people living with HIV/AIDS 5 million people in need without access to ARVs 1100 million people without access to sanitation We can't afford to look away…..

17. Key messages to conclude • The MDGs have been a powerful force in the fight to reduce poverty and inequity • Progress towards the health MDGs is being made, but is unequal and fragile • Health is at the centre of the development agenda. All the MDGs influence health, and all causes of ill-health affect the achievement of the MDGs …We need to ensure the momentum remains around the MDGs and that political commitment is sustained!

18. Thank you

19. WHO Activities • Setting prevention and treatment guidelines and other global norms and standards; • Providing technical support to countries to implement them; • Analyzing social and economic factors and highlighting the broader risks and opportunities for health • Assisting national authorities as they develop health policies and plans; • Helping governments work with development partners to align external assistance with domestic priorities; • Collecting and disseminating data on health so countries can plan health spending and track progress.