Since its launching, one of the most important achievements of the Millennium Development Goals (MDGs) is it have kick-started progress where it was lacking,
especially in Africa, where unprecedented economic growth and poverty reduction are now taking place. From 1981 to 1999, extreme poverty in sub-Saharan Africa rose from 52 percent to 58 percent among the population.
But since the launch of the MDGs, it has declined sharply, to 48 percent in 2008. Much of this was likely driven by MDG-backed investments in healthier and better-educated work forces in the region. The global MDG campaign has also prompted support for small subsistence and cash-crop farmers, which has boosted growth in many low-income countries, such as Malawi.
Primary education rates have increased around the world too, with South Asia and sub-Saharan Africa experiencing particularly big jumps in enrolment. Much of this has been the result of funding from MDG-linked initiatives, such as the Global Partnership for Education, launched in 2002 by the World Bank and other development organizations to help poor countries address the large gaps they face in meeting MDG 2 and 3 goals, in areas of policy, capacity, data and finance. These same efforts have helped nearly every region in the world achieve gender parity in classrooms.
The greatest MDG successes undoubtedly concern health. According to the World Bank, the MDGs have invigorated multilateral institutions, such as the Global Alliance for Vaccines and Immunization, which seeks to achieve MDGs by focusing on performance and outcomes. The goals have also inspired a huge increase in private-sector aid. Thanks in part to this global effort, malaria-related mortality has dropped by approximately 25 percent since 2000, with most of those gains probably occurring since 2005.
Many pharmaceutical companies have also put forth major efforts to make their medicines widely available in poor countries, and new initiatives are continuing to take shape. The MDG Health Alliance, founded in 2011, is comprised of business and NGO leaders around the world working toward the MDG health targets, including the elimination of mother-to-child HIV transmission.
According to UNICEF, the combined results of these campaigns are remarkable. For example, in Senegal, child mortality has plummeted by half since 2000. In Cambodia, it has dropped by 60 percent. Rwanda has recorded a ten percent average annual reduction since 2000, one of the fastest declines in history. Even China has seen a significant decrease in child deaths, possibly because the expanded global emphasis on health has encouraged the country’s policymakers to pay more attention to relevant issues. Overall, despite rapid global population growth, there has been a decrease in children dying worldwide before their fifth birthday, from 11.7 million in 1990 to 9.4 million in 2000 and 6.8 million in 2011.
No issue has been more closely interconnected with the MDGs than the HIV/AIDS treatment campaign. According to UNAIDS, in 2000, nearly 30 million people were infected, the vast majority in Africa, where only approximately 10,000 people were in treatment and over one million people were dying every year from the disease. The next year, the head of the U.S. Agency for International Development (USAID) publicly deemed large-scale AIDS treatment in Africa impossible. Undeterred, the then UN Secretary General, Koffi Annan launched the Global Fund to Fight AIDS, Tuberculosis and Malaria, which aims to achieve long-term outcome and impact results related to the Millennium Development Goals.
Spurred by the launch of the MDGs, the HIV/AIDS Department of the World Health Organization (WHO) introduced the “3 by 5” initiative in 2003, which aimed to have three million people living with AIDS in the developing world receiving treatment by 2005. By the end of 2005, only 1.3 million people were receiving treatment, which was fewer than half of the target. But thanks to the interwoven AIDS-MDG campaign, the notion of service delivery targets has sunk in globally, helping expand AIDS treatment by orders of magnitude.
Also in 2005, the G-8 and the UN General Assembly endorsed a target of universal access to treatment by 2010, which is backed by major financial commitments. The latest report of WHO indicated that the MDG movement has expanded the world’s ambitions in tackling health crises and made extraordinary progress. In 2011, for example, more than eight million people worldwide were receiving AIDS treatment.
The MDGs have proved that with concentration and effort, even the most persistent global problems can be tackled. The post-2015 “Next-Generation Millennium Development Goals” should remain focused on eliminating the multiple dimensions of extreme poverty. They also need to address emerging global realities. These new challenges include the worsening environmental pressures affecting the livelihoods of hundreds of millions of people, the growing number of middle-income countries with tremendous internal poverty challenges, and rapidly spreading non-communicable diseases.
The new goals also need to be matched with resources. Without the Mexico agreements of 2002 and the financial commitments made at the G-8 summit in 2005, the MDGs might well have faded from the international agenda. It is crucial that the post-2015 negotiations not be left solely to foreign and development ministries. Many social analysts have already started saying that Finance ministries will need an equal say on many of the most central issues and therefore need to be included from the beginning. They further noted that other relevant ministries, such as those that deal with health and environmental issues, should be consulted regularly.
Additionally, other notable personalities and social activists added their remarks by stating that, in preparation for 2015, multilateral organizations, such as the World Bank and UN agencies, should conduct independent external reviews of their contributions to the MDGs and identify benchmarks for post-2015 successes of next-generation goals based on the results. And the United States needs to join the international community in making a solid commitment to long-term, goal-oriented foreign aid.
It is clearly evidenced that the MDGs have helped mobilize and guide development efforts by emphasizing outcomes. They have encouraged world leaders to tackle multiple dimensions of poverty at the same time and have provided a standard that advocates on the ground can hold their governments to. Even in countries where politicians might not directly credit the MDGs, the global effort has influenced local perspectives and priorities. The goals have improved the lives of hundreds of millions of people. They have shown how much can be achieved when ambitious and specific targets are matched with rigorous thinking, serious resources, and a collaborative global spirit.
Looking forward, the next generation of goals should maintain the accessible simplicity that has allowed the MDGs to succeed and also facilitate the creation of better accountability mechanisms both within and across governments. In addition, the new goals need to give low and middle-income countries a greater voice in shaping the agenda.
Most importantly, momentum matters. Just as progress in individual MDG areas has inspired other campaigns, so work done now, in the final stretch, will affect what happens in the future. The results achieved by 2015 will mark an endpoint, but even more, they will provide a springboard for the next generation of MDGs. I sincerely believe that there is no time to lose.