Millennium Development Goals

1. Millennium Development Goals Carla AbouZahr Coordinator, Statistics, Monitoring and Analysis Department of Health Statistics and Informatics World Health Editors Network Geneva 18 May 2008

2. Summary • Some good news • Some mixed • Continuing challenges - mortality • Understanding the nature of the problem • What needs to be done by • Countries • Development partners • WHO

3. In 2006, childhood deaths fell below 10 million Measles immunization increased since 1990 Underweight prevalence has declined: 58 countries on track to achieve MDG1 76 developing countries on track to reach MDG target on safe drinking water

4. Use of insecticide treatment bed nets has increased But coverage far short 60% Abuja Declaration target The number of people living with HIV continues to rise but is lower than previously estimated

5. Child mortality: few countries will achieve MDG 4 Source: Christopher Murray Institute for Health Metrics and Evaluation *MDG4 = 4.3% annual reduction

6. Progress toward MDG4 Rapid progress is possible. Further analysis of these “well performing” countries under way. No country in sub-Saharan Africa • The 10 countries with least progress are in sub-Saharan Africa • Contextual factors • High HIV prevalence • Conflict

7. Infections and diarrhoea kill most under 5sBut one in three deaths occurs in 1st month Source: WHO, World Health Report 2005 Malnutrition

8. MDG5: Risk of pregnancy and childbirth UNICEF, UNFPA, World Bank estimates for 2005

9. Progress toward MDG5 None of these countries are in sub-Saharan Africa or South Asia Even among the ten “best performers” 7 have ratios over 100 12 of 13 countries with highest MMRs are in sub-Saharan Africa • High HIV prevalence (>5%, 8/10) • Armed conflict (2/10)

10. Of 18 life-saving interventions for mothers and children, only vaccinations are reaching 80% coverage Interventions able to be scheduled routinely (antenatal care) have higher coverage than those needing functional health systems and 24-hour availability (care during delivery, treatment of childhood illnesses)

11. Failures in coverage of care

12. The poor are least likely to access care: Unmet need for care (coverage gap) higher for poorest than for richest

13. What can countries do? • Invest in health systems • Recognize that health services often contribute to increasing inequities • Remove financial barriers (user fees, etc) • Prioritize diseases of the poor • Deploy/improve services where the poor live • Employ appropriate delivery channels • Monitor implementation, coverage and impact with an equity lens

14. What can the development community do? • Invest in health systems • Embed health in social and economic planning; multisectoral response • Ensure long-term predictable aid • Hold all partners accountable for their performance against international agreements

15. What will WHO do? • Strengthen health situation and trends monitoring: global health observatory • Equity focus: poverty, gender, geography • Cause-specific mortality trends. • Monitor global health initiatives and their impact on health services. • Enhance understanding of data limitations and need for investments in health information systems

16. World Health Statistics 2008 • Country-by-country health indicators • Ten highlights in global health • Understanding the data and estimates