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Issues in attaining Millenium Development Goals
- Badri Raj Pande (18 August 2004)
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Millenium Development Goals: Whose Goals and for Whom?
- Udaya S Mishra (19 August 2004)
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Accelerating Action to Achieve MDGs
- Paul S Zeitz (26 August 2004)
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Badri Raj Pande, Free lance Consultant Kathmandu-3, Nepal
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I could not agree more with your observation that the attainment of Millenium Development Goals (MDG) calls for serious commitment of developing countries to improve the health system and address inequality not merely on the basis of aggregate national figures. It is as much as the responsibility of developed countries to fulfill their promise to assist them, e.g. by ensuring provision of 0.7 per cent of their gross national income to development assistance, debt relief, technology transfer etc. Time is ticking and the progress particularly in low income countries is less than desirable to meet the deadline. Emergence of conditions like HIV/AIDS and re-emergence of malaria, kalazar etc with increase in life style diseases in developing countries still suffering from communicable diseases have put drain in the resources. Maternal mortality is very high and unacceptable.Neonatal mortality has not registered decline. Though policies are laid down clearly to direct health services to the poor and disadvantaged, in practice, there is the problem of access. With growing privatization in absence of implementation of 'pro-poor' regulations and shortage of trained staff in public facilities, even the poor are ‘lured’ to private facilities, most of which do not have record of providing proper service and good value for money. In countries without provision for social health insurance, a heavy burden is thus put on the poor. Shortage of trained staff is more acutely felt in rural public facilities.As a result, patients resort to ‘no treatment’, ‘self- treatment’ or treatment by the ”quacks” which could be a necessity in rural areas. These issues need to be addressed to attain the MDG. The minimum investment recommended by the WHO Commission on Macroeconomics and Health for essential health care intervention is on average US$34 per person. Many countries are spending less than one third and may not be in a position to expend more. With donor assistance the amount may increase, but will this assure improvement in service and better access for the poor? Technical capacity building is necessary in formulation of need-based policy and implementation of activities with strong focus on the poor and the disadvantaged and should be strongly supported. It should be the nationals who take the lead.Strong coordination among the donors is necessary to harmonise financial support to ensure adquate provision and sustainability. Donors, government and civic societies should periodically monitor the programme. There should be no hesitation in taking corrective measures and even reprogramming if necessary. Competing interests: None declared |
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Udaya S Mishra, Takemi Fellow, Dept of PIH, HSPH Harvard School of Public Health, 665, Huntington Avenue, Boston MA 02115
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Millenium development goals are the most recent statement of commitment towards narrowing gaps between the developed and developing regions of the world. But how realistic are these goals? While goals help in making assessments of progress, they should not be blind to existing potentials for progress, which is conditioned by the existing status as well as the motivation of nations/states towards realizing them. Unfortunately, MDGs are considered as a tool for assessing accountability and demonstrate need for urgency, which could violate the autonomy of nations/states, that in turn raises, the question ` whose goals are they?'. Often such initiatives are seen as global priorities overriding local concerns. The best example is vaccination initiative, which has consistently reflected failures by countries without the required infrastructure. In other circumstances such externally aided initiatives are never integrated into the local health system to make the most of such intervention. In terms of measuring the extent of achievement of such goals, caution need to be taken in assessing progress conditioned by local realities which may not always be conducive for making the expected progress. Finally, it needs to be made clear as to who benefits from the achievement of such goals. Would there be any space to account for inequities resulting in achievement of such goals? If yes the assessment of progress in achieving these goals needs to make adjustments for it in order to have a realistic evaluation of progress. Competing interests: None declared |
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Paul S Zeitz, Executive Director Global AIDS Alliance, 1225 Connecticut Avenue, Suite 401, Washington, D.C. 20036
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I am writing to share some thoughts with you regarding the need for a new innovative financing mechanism to galvanize faster action to achieve the MDGs. In response to a global desire to accelerate action against AIDS, TB, and Malaria, the global community unified itself to create the Global Fund to Fight AIDS, TB, and Malaria (Global Fund) as a new international financing mechanism in 2002. The Global Fund finances locally designed strategic plans that involve civil society, the private sector and governments in its governance structures at the global and national levels. The Global Fund is a radically new governance approach to international financing and it is already bearing fruit. With grants underway in over 160 countries, there are historic results being achieved in the battle against these diseases of mass destruction. Inherent in the creation process of the Global Fund during 2001-2002 was a widespread realization and recognition that the UN, WB, IMF and ongoing bilateral programs were necessary, but not sufficient to achieve the desired results. As your article describes, the UN and the international community is mobilizing itself to support the achievement of the Millennium Development Goals. Many activists are focusses on raising more money. However, there remains serious questions about how that money can be effectively programmed through existing financing instruments to achieve the desired results. To address this reality, I am working with the "Global Peace Organization" virtual network of over 150 members who represent: civil society, government, private sector, faith institutions, the private sector, multilateral institutions, and universities. Members work on five Continents (N.Am, S. Am, Eur, Afr, Asia). Members have expertise in business, change, entertainment industry, communications, development, economics, environment, information, law, management, medicine, politics, public health, religion, science, sociology, and other related fields. It is our hypothesis that all of the existing institutions are necessary, but not sufficient to achieve the MDGs. In response to this analysis, we are proposing that a new international financing mechanism called the "Global Peace Organization (GPO)" be created with due haste in order to achieve the MDGs. The proposed governance structure of the GPO creates a pentagonal governance structure that includes governments, civil society, the private sector, faith organizations, and existing multilateral institutions. The GPO would is designed to fund local determined strategic plans that are developed by local partners to acheive the MDGs. Please contact me if you would like to receive a detailed concept paper that more fully describes the GPO or any other information. Please join the GPO virtual network and our participatory creative process by sending an email to: global-peace-organization-subscribe@yahoogroups.com I will not attend the meeting in 2015 that declares that "we" failed to meet the MDGs, as is the norm now with internationl adopted goals. I will only attend a meeting that declares that "we" exceeded or met the MDGs. I believe that the GPO is only way to make that happen. I know that we humans on the planet at this time in history have the capacity to achieve this in reality. Let's join together in an unprecedented mobilization for peace make history by achieving or exceeding the MDGs. Sincerely yours, Paul Zeitz Competing interests: None declared |
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