Achievements and Challenges

Source: Realizing the Future We Want for All, 2012.

The world has made great strides toward reaching the Millennium Development Goals, but this progress has been very unequal, and, in many countries, too slow to actually reach the goals by 2015. In the Americas, some of the greatest challenges exist in health. Currently, the situation varies significantly among the countries of the Region, among different populations, as well as among different indicators of the goals. It is difficult to predict if the Region will reach its ambitious health targets in totality.

Since 1990, Latin America and the Caribbean have shown noteworthy progress in the reduction of infant mortality.  In 2009, the rate of infant mortality in our region was the lowest in the world among developing countries, and its decline was faster than in all other regions.  Nevertheless, infant mortality regional averages hide great disparities between countries, as well as in the countries themselves.

For example, Goal #5 is to reduce maternal mortality by 3/4 between 1990 and 2015.  Only 40% of the countries analyzed present a downward trend in the Maternal Mortality Ratio (MMR), but at levels that make it difficult to predict if they will reach the reduction of 3/4 of the indicator by 2015.  It is necessary to improve the data of maternal mortality, as well as to continue building information systems, applying the active searching of maternal deaths to improve the registry and classification with the help of the modified RAMOS Methodology (Reproductive Age Mortality Survey).  One of the greatest advantages of this search is its ability to obtain more reliable data about the number of maternal deaths through the study and documentation of each individual death, which gives the countries a better understanding of the reality of the number and cause of deaths, as well as the factors that condition maternal mortality in each country; finally, it gives countries the opportunity to apply better preventative strategies at the local level.

Goal #6 – Fight HIV/AIDS, Malaria, and other diseases.  In accordance with the Joint United Nations Programme on HIV/AIDS, the estimated number of new infections of the Human Immunodeficiency Virus (HIV) at the global level reached its peak in 1996, and ever since, it has been declining, until it reached 2.7 millon/year in 2008.  In 2010, about 9% (245,000) of the global sum came from the Region of the Americas:

170,000 in Latin America
55,000 in North America
20,000 in the Caribbean.

Although the number of new cases of HIV is globally declining, the rates of incidence of HIV infection are, in fact, generally increasing: the risk of HIV infection in the Region of the Americas increased from 26.2 for every 100,000 inhabitants in 2001 – the year the Declaration of Commitment on HIV/AIDS was signed – to 26.6 for every 100,000 in 2008.  This regional tendency has been caused by the increase in the incidence of HIV infection in Latin America.  It went from 30.6 to 31.8 for every 100,000 inhabitants in this period, while in North America and the Caribbean, the incidence of HIV infection decreased from 16.1 to 15.9 and from 53.8 to 48.0 for every 100,000 inhabitants, respectively.  In the Region of the Americas, the majority of the countries evaluated have made important gains in the control of Malaria.  Only 19% of the countries evaluated were still far from reaching the goal, but they could still quickly change their situation considering the epidemiology of the disease.

In order to maintain the Malaria goal, sustained efforts are necessary, adequate funding, a major collaborative effort between health programs and other sectors, adequate hiring and training of health employees, the participation of different social sectors in the prevention and control of the disease, as well as the strengthening of health systems and the definition of policies based on documented evidence.

To evaluate the progress in efforts to eradicate tuberculosis, the rate of incidence of tuberculosis per 100,000 inhabitants was studied.  The countries with the greatest decrease were Ecuador and Puerto Rico (-51%), Cuba and Chile (-42%), Honduras (-38%), Costa Rica (-35%) and Nicaragua (-32%).

More information about health indicators can be found here.  The site contains data, definitions, methodologies, and official sources about the more than 60 indicators used to measure the progress toward the achievement of the MDGs.

World Health Statistics Series

In addition, the World Health Statistics Series is the World Health Organization’s annual compilation of health-related data for its 194 Member States and includes a summary of the progress made toward achieving the health-related Millennium Development Goals (MDGs) and associated targets.  The report, along with indicators chosen based on their relevance to global public health, gives a comprehensive summary of the current status of national health and and health systems in the following ten areas:

  • life expectancy and mortality
  • cause-specific mortality and morbidity
  • selected infectious diseases
  • health service coverage
  • risk factors
  • health workforce, infrastructure and essential medicines
  • health expenditure
  • health inequities
  • demographic and socioeconomic statistics
  • health information systems and data availability.

For more information about the progress toward reaching the MDGs, specifically in the Region of the Americas, please visit this site.