Health, development and the Millennium Development Goals

Department for Health Policy, Development and Services, EIP/HDS, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland.
Pathogens and Global Health (Impact Factor: 1.66). 08/2006; 100(5-6):379-87. DOI: 10.1179/136485906X97471
Source: PubMed


The Millennium Development Goals (MDG), which emerged from the United Nations Millennium Summit in 2000, are increasingly recognized as the over-arching development framework. As such, the MDG are increasingly guiding the policies of poor countries and aid agencies alike. This article reviews the challenges and opportunities for health presented by the MDG. The opportunities include that three of the eight MDG relate to health--a recognition that health is central to global agenda of reducing poverty, as well as an important measure of human well-being in its own right. A related point is that the MDG help to focus attention on those health conditions that disproportionally affect the poor (communicable disease, child health and maternal health), which should, in turn, help to strengthen the equity focus of health policies in low-income countries. Further, because the MDG are concrete, it is possible to calculate the cost of achieving them, which in turn strengthens the long-standing calls for higher levels of aid for health. The challenges include that, while the MDG focus on specific diseases and conditions, they cannot be achieved without strengthening health systems. Similarly, progress towards the MDG will require health to be prioritized within overall development and economic policies. In practice, this means applying a health 'lens' to processes such as civil-service reform, decentralization and the drawing-up of frameworks of national expenditure. Finally, the MDG cannot be met with the resources available in low-income countries. While the MDG framework has created pressure for donors to commit to higher levels of aid, the challenge remains to turn these commitments into action. Data are presented to show that, at current rates of progress, the health-related MDG will not be achieved. This disappointing trend could be reversed, however, if the various challenges outlined are met.

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    • "Without strengthening health systems and building capacity, large-scale efforts will meet the same end as a host of vertical programs from the past, whereby progress in one comes by detracting from the others (Unger et al., 2003), and achievements erode or collapse as soon as external funding shifts to new programs, new priorities, and new countries (Bossert, 1990; Smithson, 1995). It will be decades before developing countries can financially support conditions satisfying the Millennium Development Goals on their own (Dodd and Cassels, 2006). In the meantime, development experts continue to call for a rapid increase in external assistance for health sector programming (Sachs, 2001; Feachem and Sabot, 2006). "
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    International Journal of Health Planning and Management 10/2009; 24(4):326-50. DOI:10.1002/hpm.1012 · 0.97 Impact Factor
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    • "Measles elimination is one of the major global public health priorities [1]. While half of the world is close to eliminating measles, many countries in Sub-Saharan Africa (SSA) are still struggling to control the disease [2]. "
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    BMC Public Health 12/2008; 8(1):386. DOI:10.1186/1471-2458-8-386 · 2.26 Impact Factor
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    • "The year 2008 is halfway to the MDGs target date of 2015 (UN, 2007). Dodd and Cassels (2006) emphasised that in many, if not all, areas progress has been depressingly ineffective; indeed they conclude that limited, if any, progress has been made. The Department for International Development (DFID) reiterate this lack of success towards the specific targets of MDG 6 on HIV and malaria ( "
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    ABSTRACT: This paper suggests that the 'other diseases' of Millennium Development Goal 6 (MDG 6) are ignored by policy-makers and politicians who overfocus on unachievable objectives and targets around the 'big three' diseases of HIV, tuberculosis (TB) and malaria, which if the planet was viewed by aliens would be seen as the only diseases that existed on the planet. The diseases of the majority of the poor represent 'low hanging fruit' for control and elimination and opportunities are ignored despite the availability of cheap or donated drugs and ample evidence that such interventions are effective and reduce incidence, as well as mortality and morbidity. The time frame available to achieve the MDGs of some 7-8 years requires a re-evaluation of what can be done with the tools available now and which can address the problems faced by the majority of poor people afflicted by disabling conditions which together represent a global burden greater than malaria or TB. The author considers also the volume of research relevant to the MDGs and their achievement is distorted by the focus on high tech end research which cannot be delivered by 2015 and that in terms of the 90:10 gap in research relevant to the problems of the poorest the real gap is 99:1. The concepts of distortion of donor funding for diseases of MDG 6 for implementation of largely curative interventions which do not reduce incidence as well as research which addresses problems that cannot reach poor people in the time frame to 2015 is emphasised. New paradigms are required if any impact on MDG 6 is to be achieved recognising the needs of the majority via an equitable distribution of funding.
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