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Barriers to achieving the health MDGs and how these can be overcome Action for Global Health UK Policy Conference London, 28 June 2010 Isabelle de Zoysa. Health-related MDGs – Scorecard 2010. AFR AMR EMR EUR SEA WPR World. MDG 4. Child Mortality Measles immunization
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Barriers to achieving the health MDGs and how these can be overcomeAction for Global Health UK Policy ConferenceLondon, 28 June 2010Isabelle de Zoysa
Health-related MDGs – Scorecard 2010 AFR AMR EMR EUR SEA WPR World MDG 4 Child Mortality Measles immunization Maternal mortality Skilled birth attendant Contraceptive use HIV/AIDS incidence TB treatment success Malaria impact MDG 5 MDG 6
Proportion (%) Proportion (%) 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 25 25 25 25 20 20 20 20 15 15 15 15 Proportion (%) Proportion (%) 10 10 10 10 5 5 5 5 0 0 0 0 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 1990 1991 Proportion of HIV-related under-5 mortality in African sub-regions, 1990-2007 Central Africa West Africa Southern Africa East Africa
Leading causes of death among women of reproductive age (15-44 yrs) Source: Women and Health report, WHO, 2009
Maternal Mortality Trends, 1980-2008 Source: Hogan et al, 2010
Progress diverges across interventions FAST - scale-up of people receiving ARVs in low- and middle-income countries • SLOW – coverage of skilled attendant at delivery, especially in Africa Millions % Receiving ARVs Skilled birth attendant
Women and children are dippingin and out of the health care system
Don't turn away now .5 m cases multidrug resistant TB 1 m malaria deaths 2.7 m new HIV infections 5 m people in need without access to ARVs 3-800,000 maternal deaths 3 m diarrhoea & pneumonia deaths in children 8.8 child deaths 1100 m people without access to sanitation
Addressing the challenges Sustain high level political commitment Ensure sustainability of resources in times of economic crisis Strengthen health systems to deliver integrated interventions across the life course Promote implementation research to learn from successes and failures across countries and interventions Build sound information systems to identify problem areas and monitor change.
Opportunities to make a difference Regional commitments (such as the Maputo Plan of Action and Campaign on Accelerated Reduction of Maternal Mortality in Africa) The Joint Action Plan and accountability framework Muskoka Initiative – additional funding for a comprehensive and integrated approach to accelerate progress towards MDGs 4 & 5 Commitment to integrating approaches to maximize health outcomes related to MDGs 4, 5 and 6, while strengthening health systems Global mobilization around scaling up PMTCT towards elimination GF Board Decision to explore options for optimizing synergies with Maternal and Child Health; GF replenishment Other programming and financing opportunities (GHI/PEPFAR etc)