Millennium development goals are under threat from financial crisisBMJ 2009; 338 doi: https://doi.org/10.1136/bmj.b1755 (Published 27 April 2009) Cite this as: BMJ 2009;338:b1755
The global economic crisis is pushing many poor nations, especially those in sub-Saharan Africa, into a danger zone and poses a serious threat that many of the United Nations’ millennium development goals will not be met by the 2015 target date. The prospects are gravest for goals related to health, warns a report by the International Monetary Fund and the World Bank.
Robert Zoellick, president of the World Bank, and Dominique Strauss-Kahn, managing director of the International Monetary Fund, warned that the financial crisis risks becoming “a human and social crisis.”
“The prospects of reaching the MDGs [millennium development goals] by 2015, already a cause for serious concern, now look even more distant,” the two agency chiefs observed. They emphasised that international efforts “must be redoubled” to recover the lost ground in progress towards the goals.
The joint report estimates that the current crisis could cause “200 000 to 400 000 more infant deaths per year on average between 2009 and the MDG target year of 2015,” or an additional 1.4 million to 2.8 million infant deaths over the period.
“The world can, and should, do better,” says the report. “Acceleration of progress requires a shared commitment to pursue the development agenda with greater vigour and urgency.” It calls on donors to pick up the pace in delivering on their aid commitments.
Zia Qureshi, a World Bank adviser and lead author of the 2009 global monitoring report, said that the crisis “gives added urgency to reinforcing key programmes in health and education, such as control of major diseases, including HIV and AIDS and malaria.”
The report says that the crisis calls for a special focus on social protection programmes and services that shield poor and vulnerable households from severe effects such as a rise in child mortality.
“This implies a high priority for primary health care and nutrition programmes in rural areas and in poor neighbourhoods,” the report says.
The renewed efforts, it says, also require improvements in key health services and greater involvement of the private sector. It says that in sub-Saharan Africa and South Asia half of the maternal, reproductive, and child healthcare services relevant to achievement of the millennium development goals are privately provided.
Private providers, it says, also have a major role in the treatment of communicable diseases such as tuberculosis, malaria, and HIV.
With regards to child mortality, the report says the rate has not fallen fast enough to meet the target to reduce it by two thirds between 1990 and 2015.
“Over three quarters of countries with available data are not on track. Nearly half of all deaths of children under 5 occur in Sub-Saharan Africa,” it says.
Progress in lowering infant mortality is also “well short of the target in South Asia,” it noted.
The goal in which the least progress has been made is that to improve maternal health, where the target is to reduce the mortality ratio by three quarters from 1990 to 2015.
“Most regions are off track on this goal, sub-Saharan Africa and South Asia most seriously,” the report says.
It says that progress made towards the target of halting and beginning to reverse by 2015 the spread of major communicable diseases such as HIV and malaria has been mixed.
“Most countries face difficulty in reaching the MDG targets related to HIV/AIDS,” it says.
Finally, the report says that the number of chronically hungry people is expected to climb to more than a billion this year, reversing gains made in fighting malnutrition.
It points out that malnutrition accounts for 35% of the disease burden in children under 5 years old and that more than 20% of maternal mortality is attributable to malnutrition.
Cite this as: BMJ 2009;338:b1755
Global Monitoring Report 2009: A Development Emergency is available at www.worldbank.org.