At the dawn of the 21st century, 189 UN member states adopted the Millennium Declaration as the first common framework for promoting global development, committing to eight goals (six covering health and education) with time-bound targets and indicators. Much of the commentary from that period draws on UN secretary-general Ban Ki-Moon’s reference to the goals as “ambitious but feasible”. In 2015, as the Millennium Development Goals (MDGs) come of age, the qualifier has dropped to simply ambitious. And nothing short of a miracle will see all goals comprehensively realised by the year’s end.
In Bill and Melinda Gates’ seventh annual letter on global development, they suggest that “the lives of people in poor countries will improve faster in the next 15 years than at any other time in history”. This is thanks to major breakthroughs driven by technological innovations, such as new vaccines, cheaper smart-phones and hardier crops: “[People in poor countries] will be living longer and in better health. They will have unprecedented opportunities to get an education, eat nutritious food, and benefit from mobile banking.”
But looking back over the past 15 years, what have been the achievements of one of the world’s most ambitious projects and what didn’t work so well, despite the grand aspiration? It is easy enough to check the summary progress for the MDGs on health and education – MDGs one to six – through official UN data. For each goal there are statements of achievement, tempered by one or more statements of what is yet to achieve.
1: Eradicate Extreme Poverty and Hunger
The very first is the biggie: halve, between 1990 and 2015, the proportion of people whose income is less than US$1.25 a day. This target was met five years early, although it should be noted that this was largely due to acceleration due to economic growth in China and to some extent India initiated before the goals came into being, an argument often raised in critical discourse around the MDGs.
Additional targets in this goal included the achievement of full and productive employment and decent work for all, and to halve the proportion of people who suffer from hunger. UN data indicates that the hunger target should be met in time, but impedance in global economic growth generally between 2008 and 2013, along with significant outstanding gender gaps, mean that the employment target is way off course.
2: Achieve Universal Primary Education
The second goal aims to ensure that by 2015 children everywhere, boys and girls alike, will be able to complete a full course of primary schooling.
The UN says: “Enrolment in primary education in developing regions reached 90% in 2010, up from 82% in 1999, which means more kids than ever are attending primary school.”
It then goes on to say that in 2012, 58m children of primary school age were out of school. If this figure represented a nation it would be the 24th most populous on the planet, just above South Africa in a list of 248.
3: Promote Gender Equality and Empower Women
The third goal is to eliminate gender disparity, focusing first on primary and secondary education (2005) and then all levels (2015). The UN said: “The world has achieved equality in primary education between girls and boys, but few countries have achieved that target at all levels of education.”
The reality is that the significant majority of those 58m children out of school are girls and the UN admits that: “in many countries, gender inequality persists.”
4 & 5: Reduce Child Mortality and Improve Maternal Health
Goals four and five are to reduce child mortality by two-thirds and improve maternal health. Notwithstanding population growth, the global figure for child mortality has reduced by about half, from 12.7m deaths (of children under five) in 1990 to 6.3m in 2013 and the UN translates this as “about 17,000 fewer children dying each day” – which is to be celebrated. However it also notes that “an increasing proportion of child deaths are in sub-Saharan Africa and southern Asia. Four out of every five deaths of children under age five occur in these regions.”
It is the sub-Saharan Africa region that remains the heart of global crisis, with extensive under-performance across the MDGs, particularly in maternal health where – with the highest adolescent birth rate and greatest unmet need for family planning – it is a strong contributor to the gap between the target reduction of 75% and the actual fall of 45%. Asia has made the fastest progress, but started the furthest back in the race.
In the target for universal access to reproductive health, more women are receiving antenatal care – but access to contraception, family planning and reproductive health care remains low in developing regions and continues to be a cause for concern.
6: Combat HIV/AIDS, Malaria and Other Diseases
The goal to combat HIV/AIDS, malaria and other diseases is the hardest to summarise, as even the targets (to halt a disease and reverse its spread) are difficult to quantify at scale. Generally, new infections are declining and deaths are down but the formal statements that have been made on achievements here are mostly unrelated to pre-MDG figures, providing snapshots of progress within the period rather than against a baseline.
The Pros and Cons of Universal Objectives
One of the biggest criticisms of the MDGs is that the universal targets set the same objectives for everyone. Countries which were way behind to start with have had much further to go, meaning goals that were feasible for some have been impossibly ambitious for others.
Even within countries, the data for rural areas is often significantly different than data for the cities, leading to a mean indicator that is grossly divergent from the reality for most people both at national and international level. We can talk in simple terms about meeting or not meeting the global outcomes of the MDGs, but the massive amounts of (often shaky, albeit improving) data that sit behind official UN statistics show myriad complexities across countries and regions. While advocating a need for equity in development, we have not seen equity in development goals.
It is then, in itself, massively ambitious to make statements of global parity from which local actions can be devolved. At their best, the MDGs have brought together diffuse public, private, and non-profit organisations across global north-south divides and amid tremendous complexities to co-operate over a common enterprise with some outstanding results.
The MDGs kick-started unprecedented progress and improved the lives of hundreds of millions of people, mobilising development efforts through and towards an emphasis on outcomes. They have contributed to the empowerment of whole populations by providing standards to which governments can be held accountable. And finally let’s not forget that they have provided learning – something that the Gates Foundation and others can build on – and maybe that is their greatest legacy in informing what comes next.