Transcript Slide 1

World Health Editors Network
Progress towards
the health-related Millennium
Development Goals
Carla Abou-Zahr, Ties Boerma
Fiona Gore, Annet Mahanani
Department of Health Statistics and Informatics
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WHO and MDGs
 The Millennium Development Goals (MDGs)
 Health-related MDGs
 Progress and Challenges
 Moving forward
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The Millennium Development Goals
 In September 2000, 191 heads of state adopted the UN Millennium
Declaration and endorsed a framework for development, the plan
being for countries and development partners to work together to:
– reduce poverty and hunger, and tackle ill health, lack of education, gender
inequality, lack of access to clean water and environmental degradation
 Eight Millennium Development Goals (MDGs) were established,
with targets for 2015, and indicators to monitor progress
 At the 2008 World Health Assembly, WHO Member States tasked
the Organization to provide an annual update on progress towards
the health-related MDGs, starting in 2009.
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Health-related MDGs
 MDG 1: Target 1C: Halve the proportion of people who suffer from hunger
(underweight)
 MDG 4: Target 4A: Reduce child mortality by two thirds
 MDG 5: Improve maternal health
 MDG 6: Combat HIV/AIDS, malaria, and other diseases
 MDG 7: Halve the proportion of people without sustainable access to safe drinking
water and basic sanitation
 MDG 8, Target 8E: Access to affordable essential medicines in developing countries
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Progress is being made, but huge
challenges remain
Currently available data show
that while some countries
have made impressive gains
in achieving health-related
targets, others are falling
behind.
Often the countries making the least
progress are those affected by
high levels of HIV/AIDS,
economic hardship or conflict.
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Progress on the health-related MDGs
 Fewer children are dying
 Annual global deaths of children under five years of age fell from 12.6
in 1990 to 8.8 million in 2008 – down by 30%
 Fewer children under five are underweight:
 % has dropped from 25% in 1990 to 16% in 2010
 Although more women get skilled help during childbirth globally, for
women in Africa and South-East Asia fewer than 50% of all
births were attended.
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Progress on the health-related MDGs
 Fewer people are contracting HIV - New HIV infections
declined by 16% globally between 2001 and 2008
 Tuberculosis treatment is more successful - existing
cases of TB are declining, along with deaths among HIVnegative TB cases
 More people have safe drinking-water, but….not
enough have toilets
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Health-related MDG scorecard
Africa
Under 5 mortality per 1000
MDG4
live births
Measles immunization %
coverage
Maternal mortality
per 100 000 live births
MDG 5
Skilled birth attendant
% births
Contraceptive use
% married women aged 15-49
HIV/AIDS prevalence
% adults aged 15-45
MDG 6
Malaria mortality
per 100 000 population
TB treatment
success rate %
MDG 7
Water
% using improved sources
Sanitation
% using improved facilities
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Americas
Eastern
Mediterranean
Europe
SouthEast Asia
Western
Pacific
World
The WHO African and Eastern Mediterranean regions are most
off-track to achieve the MDG4 target
MDG 5: Improve maternal health
Maternal mortality not moving fast enough in the right direction
MDG Required annual pace of decline
Lancet estimates
1990-2008
0.5
UN estimates 1990-2005
New UN estimates - in preparation
%
0
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1
2
3
4
5
6
Discrepancies in coverage of key maternal
and child health interventions
 Coverage of interventions such as antenatal care and
immunization is relatively high
 Coverage of interventions that are dependent on a
functioning health care system, such as skilled care during
delivery, management of diarrhoea and care for pneumonia
tends to be comparatively low
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ARVs for HIV
infection
TB treatment
success
Contraception
ARI treatment
ORT
ITN use <5
Measles
DPT3
PMTCT
Skilled birth
attendant
ANC 4+
ANC 1+
Percentage
Dipping in and out of the health care system;
low- and lower middle-income countries
100
80
60
40
20
0
More people in need are receiving antiretroviral therapy
in low- and middle-income countries 2002–2008
Source: Towards universal access: scaling up
priority HIV/AIDS interventions in the health
sector.
WHO/UNAIDS/UNICEF Progress Report 2009
Challenges
 Conflict-affected and fragile states are furthest away
from achieving the MDGs
 More efforts and investment are necessary to prevent
set backs, and to accelerate progress towards the MDGs
 Better data are key – the lack of investment in health
information systems at country level to assess
achievements is a significant problem
 Time is short – urgent action is needed!
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Moving forward
 Better health outcomes depend on effective interventions delivered
by better health systems
 Better health requires coherent policies and a comprehensive
approach that also addresses the social, environmental and
economic determinants of ill-health
 Outcomes, interventions, programmes and systems come together in
a robust country-led national health policy & strategy requiring an
inclusive process of consultation to ensure democratic ownership
 There is an urgent need to align external support around the
national health policy & strategy to reduce fragmentation and the
burden on countries
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We can't afford to look away…..

8.8 million
deaths in children under 5

3 million
diarrhoea & pneumonia child deaths

1 million
malaria deaths

2.7 million
new cases of HIV infections

33 million
people living with HIV/AIDS

5 million
people in need without access to ARVs

1100 million
people without access to sanitation
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Key messages to conclude
 The MDGs have been a powerful force in the fight to reduce
poverty and inequity
 Progress towards the health MDGs is being made, but is
unequal and fragile
 Health is at the centre of the development agenda. All the
MDGs influence health, and all causes of ill-health affect the
achievement of the MDGs
…We need to ensure the momentum remains around the
MDGs and that political commitment is sustained!
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Thank
you
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WHO Activities
 Setting prevention and treatment guidelines and other global norms
and standards;
 Providing technical support to countries to implement them;
 Analyzing social and economic factors and highlighting the broader
risks and opportunities for health
 Assisting national authorities as they develop health policies and
plans;
 Helping governments work with development partners to align external
assistance with domestic priorities;
 Collecting and disseminating data on health so countries can plan
health spending and track progress.
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