With the creation of the Millennium Development Goals (MDGs) in 2000, the United Nations established a precedent for multisectoral effort to alleviate poverty that even its advocates labeled ambitious. Yet the U.N. has just released its 2014 MDG Report, which shows considerable progress over the last 15 years against important health indicators like malaria and tuberculosis, as well as economic obstacles of gender disparity in primary education and extreme poverty.
In addition to marking the penultimate year of progress, the report is a comprehensive source of data on countless issues affecting global health, development, and disease in the poorest countries of the world. According to the report, extreme poverty has been cut in half since 1990. Chronic hunger has also been reduced, but malnutrition remains a persistent problem, particularly in sub-Saharan Africa, where one-quarter of the population is undernourished. Similarly, gains in universal primary education have been great, though sub-Saharan Africa remains the region with the lowest net enrollment rate at 78 percent. The report indicates that a full two-thirds of the world’s poor live in just five countries: India, China, Nigeria, Bangladesh, and the Democratic Republic of the Congo, in descending order. In 2010, one-third of the world's extreme poor lived in India alone.
Several members of the Mailman School’s Board of Governors, including Alan Batkin, Naveen Rao, Ercument Tokat, and Jeff Walker, hold major roles on the leadership team of Ray Chambers, U.N. Secretary General’s Special Envoy for Financing the Health Millennium Development Goals and for Malaria. Their focus on the MDG’s health-related goals, including child and maternal health, led to child mortality rates cut in half and six million fewer deaths in 2012 than in 1990. The report points out that these declines were enjoyed across countries at all income levels. Maternal health saw increases in the number of women with four or more antenatal visits during pregnancy and in the proportion of deliveries in the presence of trained health care personnel, though rural areas fall far behind urban areas.
For public health practitioners, the MDGs, a global "pledge to uphold the principles of human dignity, equality, and equity, and free the world from extreme poverty," according to Secretary General Ban-Ki Moon, represent a triumph of collaboration over the planet’s most severe problems. As we enter the final 500 days of the MDG timeframe, public health leaders can assess the value of this bold global agenda, careful monitoring of data, and integrated contributions of public and private sectors working towards critical shared objectives.
Margaret Kruk, associate professor of Health, Policy, and Management, offered that the MDGs showed that peer pressure, better measurement, and focused attention can bring results. "Now with the MDG finish line looming, the question is how to tackle challenges shared by rich and poor countries alike—pollution, inequality, non-communicable diseases—and close remaining gaps in avertable mortality."
Mailman School faculty were involved with the formulation of the MDGs well in advance of their ratification by the General Assembly on September 18, 2000. Lynn P. Freedman, professor of Population and Family Health, was key to understanding global capacity to address maternal mortality, as was her departmental colleague, the late Allan Rosenfield, who served as the School’s dean from 1986 to 2008.
"Though extreme poverty and inequality continue to frustrate robust population health, progress on health toward the MDG goals is encouraging for several reasons," says Linda P. Fried, Dean of the Mailman School. "Global collaborations of national governments, philanthropy, medicine, civil society, and public health have been created to sustain the promise of the MDGs in the months that remain, and after 2015 when the new, Sustainable Development Goals continue to advance the largest, most successful effort to improve global health in the history of humankind."