Millennium Development Goals

About the Millennium Development Goals

The MDGs are a special challenge for the Americas a region that while not the poorest, is the most unequal. The MDGs emphasis on addressing all forms of inequality is a historic opportunity, a chance to capitalize on the highest and most unambiguous level of political will, a chance to mobilize the efforts of developing and developed countries towards achieving measurable and tangible goals, and as a result significant improvements on the lives of those most in need. The core values of the MDGs are closely linked to PAHO's values, vision, and mission and therefore are a critical element of the organization's technical cooperation.

The Eight Millennium Development Goals

Millennium Development Goal 1: To eradicate extreme poverty and hunger

Target 1. Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day
Target 2. Halve, between 1990 and 2015, the proportion of people who suffer from hunger

Millennium Development Goal 2: To achieve universal primary education

Target 3. Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling

Millennium Development Goal 3: To promote gender equality and empower women

Target 4. Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015

Millennium Development Goal 4: To reduce child mortality

Target 5. Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate

Millennium Development Goal 5: To improve maternal health

Target 6. Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio

Millennium Development Goal 6: To combat HIV/AIDS, malaria, and other diseases

Target 7. Have halted by 2015 and begun to reverse the spread of HIV/AIDS
Target 8. Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

Millennium Development Goal 7: To ensure environmental sustainability

Target 9. Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources
Target 10. Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation
Target 11. Have achieved by 2020 a significant improvement in the lives of at least 100 million slum dwellers

Millennium Development Goal 8: To develop a global partnership for development

Target 12. Develop further an open, rule-based, predictable, nondiscriminatory trading and financial system (includes a commitment to good governance, development, and poverty reduction?both nationally and internationally)
Target 13. Address the special needs of the Least Developed Countries (includes tariff- and quota-free access for Least Developed Countries? exports, enhanced program of debt relief for heavily indebted poor countries [HIPCs] and cancellation of official bilateral debt, and more generous official development assistance for countries committed to poverty reduction)
Target 14. Address the special needs of landlocked developing countries and small island developing states (through the Program of Action for the Sustainable Development of Small Island Developing States and 22nd General Assembly provisions)
Target 15. Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term
Target 16. In cooperation with developing countries, develop and implement strategies for decent and productive work for youth

Millennium Development Goals in Perspective

In 2000, during the United Nations Millennium Summit, heads of state and government, ministers and heads of delegations from 189 countries committed themselves to the goal of liberating hundreds of millions of men, women and children from conditions of dehumanizing poverty.

These commitments inspired the Millennium Development Goals (MDGs) of 2000. Five years later, the group of United Nations agencies working in the America’s Region published the report The Millennium Development Goals: A Latin American and Caribbean Perspective. This document, coordinated by the Economic Commission for Latin America and the Caribbean (ECLAC), predicted that, from the perspective of health and development, achieving the MDGs in the PAHO Region would require intensified efforts focused on the following areas:

1) Reducing Inequity: Respond to the specific inequalities of the most vulnerable groups and municipalities.

2) Work at the Local Level: Locally address the impact of social and economic determinants of health, particularly in communities with the greatest risks and levels of neglect.

3) Promote Primary Health Care and Health Promotion: Foster social participation, so that members of the community can identify and recognize their problems and become direct participants in the management of solutions for all.

4) Intersectoral Work: Coordinate among diverse institutions and sectors to integrate policies and programs, linking national and local authorities.

5) Foster Interagency and External Cooperation: Agencies of the United Nations and Inter-American systems must work together to advance the MDGs, prioritizing the most vulnerable groups.

MDGs and the Americas

In November 2003, a conference was organized in Brazil to promote political consensus around the implementation of the Millennium Development Goals (MDGs) in Latin America and the Caribbean. The outcome of this meeting was the Brasilia Declaration, signed by heads of state, parliamentarians, senior officials, civil society, and the private sector. The declaration reinforced the partnership principle inherent in the MDGs and spelled out the responsibilities of governments, legislators, civil society, and the international community.

Evolution of the MDGs:

While the Americas seem to fare well in comparison with other Regions of the world, analyses have suggested that no country in the region is likely to reach all of the MDG targets. Indeed, some of the greatest challenges for the countries of the Americas lie within the health area, along with the reduction of poverty.

The region as a whole is on a good track for meeting the goal of reducing hunger, infant malnutrition and mortality, access to safe drinking water and gender equity in education. However, progress varies enormously between countries, therefore it is important to look beyond regional averages and focus on the most vulnerable groups and the worst areas. Regional advancement towards the goals in some areas has not been sufficient, and efforts must be maintained on poverty reduction - especially as an adverse pattern has developed where the countries with the highest poverty rates tend to improve less.
Another challenge is maternal mortality, as efforts have not yielded the expected outcomes. While the region has seen an increase in the number of children of all genders attending elementary school, there is still a long road ahead before universal primary education becomes a reality. It is necessary to make further efforts to move ahead on basic sanitation and environmental sustainability. Within this context, health plays a pivotal role that assists and strengthens all efforts in poverty alleviation. For the Americas, the MDGs constitute a historic opportunity to attain the highest level of political will to target efforts to reduce poverty and therefore improve health.

Political Commitments:

The concept of economic, social, and cultural rights with a special emphasis on the right to health is a political commitment expressed in the "Protocol of San Salvador”. Building on this concept, the Summit of the Americas Process, through its High-Level Hemispheric Head of State Meetings held every four years, and the Resolutions and Plans of Action they produce, have made clear that the MDGs are the centerpiece of development and the promotion of health in the region.

PAHO and the MDGs:

PAHO is a key contributor to the effort towards the attainment of the MDGs in the countries of the Americas. The Organization’s vision on the MDGs was approved by member countries during the 45th Session of the Directing Council in September 2004, and led to an official resolution calling for countries and PAHO to use the MDGs as a guide for national and international efforts towards better health for the peoples of the Region.

MDGs approach:

By nature, in order to be achieved, the MDGs require focalized actions targeting society’s most vulnerable groups, and coordinated efforts towards poverty reduction, and the improvement of health, education, gender equity, and the environment. In other words, it is necessary to have a synergistic approach in order to successfully reduce extreme poverty and its consequences to health. Therefore, the MDGs require coherent public policies that strengthen intersectoriality and that are directed to the populations most in need.

Participation from all sectors:

The Goals are also based on the notion that the citizens of the World should be awarded economic, social, and cultural rights, among which is the right to health. In that regard, social protection for health was recognized as a key element for national progress. The countries of the Region are committed to broadening prevention, care, and promoting strategies, with a particular focus on the most vulnerable segments of society, thus taking on the challenge, and the commitment, to ensure social cohesion to its peoples. Furthermore, given the interconnectedness of the Goals, it is impossible to advance towards the achievement of the MDGs without the creation of strategies based on the analysis of the social determinants of health, and the establishment of policies requiring the participation of a multiplicity of sectors in unison. The social determinants of health pertain to the specific characteristics of the social context as well as the ways in which social conditions affect health and how these can be modified through informed action. They must be analyzed bearing in mind the historical and structural factors that have placed women and ethnic minorities at a disadvantage. They also require the attentive study and consideration of geography, ethnicity, race and generational groups.

PAHO Principles

PAHO's work on the MDGs relies on a general conceptual framework based on the following principles.

Equity

By nature, in order to be achieved, the MDGs require focalized actions targeting society's most vulnerable groups, and coordinated efforts towards poverty reduction, and the improvement of health, education, gender equity, and the environment through inter-sector efforts. In other words, it is necessary to have a synergistic approach in order to successfully reduce extreme poverty and avoid its consequences on public health. Therefore, the MDGs require coherent public policies that strengthen inter-sectoriality and that are directed to the populations most in need.

Right to Health

The MDGs are based on the notion that the citizens of the world should be awarded economic, social, and cultural rights, including the right to health. This vision reflects the political agreement entrenched in the "Protocol of San Salvador" of the Inter-American Convention on Human Rights, area of Economic, Social, and Cultural Rights. Signed in San Salvador, El Salvador during the eighteenth regular session of the General Assembly of the Organization of American States on November 17, 1988, the protocol regards the social protection of health as a key element for national progress.

Social Cohesion

The countries of the Region are committed to broaden prevention, care, and promotion strategies, with a particular focus on the most vulnerable segments of society, thus taking on the challenge, and the commitment, to ensure social cohesion of its peoples.

Social Determinants of Health

Furthermore, given the interconnectedness of the goals, it is impossible to advance towards the achievement of the MDGs without the creation of strategies based on the analysis of the social determinants of health, and the establishment of policies requiring the participation of a multiplicity of sectors in unison. The social determinants of health pertain to the specific characteristics of the social context as well as the ways in which social conditions affect health and how these can be modified through informed action. They must be analyzed bearing in mind the historical and structural factors that have placed women and ethnic minorities at a disadvantage. They also require the attentive study and consideration of geography, ethnicity, race and generational groups.

The year 2015 was set as the target date of completion for the Millennium Development Goals. As this date comes closer, the world must address both the fact that all goals might not be universally reached by this time and also work toward developing a new Post-2015 Development Agenda that includes many key issues that have emerged since or were left out of the initial Millennium Development Goals. The world must continue to work toward achieving the original MDGs by 2015 while also setting up a new framework that will be ready to go post-2015. The inclusion of non-communicable conditions, violence and insecurity, human rights and peace, female rights and empowerment, environmental sustainability, and occupational health have been discussed for the new agenda.

The United Nations has set up an official task force, the United Nations System Task Team on the Post-2015 UN Development Agenda, to formulate a plan of action on the post-2015 Development Agenda. The Task Team has released a report with recommendations that can be found below here: icon UN Systems Task Team Post-2015 Report

The official United Nations website on the Post-2015 Development Agenda can be found here: http://www.un.org/millenniumgoals/beyond2015.shtml. This site contains an overview of the post-2015 debates, a timeline of events related to the creation of a post-2015 framework, resources for the post-2015 agenda setting, and Thematic Think Pieces on key issues relating to the Post-2015 Development Framework.

Post 2015 Development Agenda and the Consultation Process

The World We Want (www.WorldWeWant2015.org) is a movement begun by the United Nations and Civil Society to encourage people from around the world to contribute their vision of an overall plan to build a just and sustainable world for the future. In order to do this, the United Nations is planning a series of thematic and national consultations, as well as consultations of experts and a High-Level Panel that will advise the Secretary General in the creation of a Post 2015 Development Framework, to help shape the Post 2015 Agenda. The World We Want 2015 Website is an accessible, shared virtual space in which people from all sectors, including civil society, government, the private sector, and underrepresented individuals themselves, can contribute to the dialogue about what should be included in the Post 2015 Development Agenda.

In addition, PAHO has created a similar web platform, www.paho.org/mdgpost2015, to serve as a virtual space in which issues specific to the Americas can be discussed. Pages have been created with detailed information (including a Background, Consultation Points of Contact, Relevant Literature) about each of the 11 thematic consultations (Inequalities, Health, Food Security and Nutrition, Energy, Governance, Education, Conflict and Fragility, Water, Growth and Employment, Environmental Sustainability, and Population Dynamics), as well as the 11 national consultations in the region (Brazil, Costa Rica, Colombia, Peru, Haiti, Bolivia, El Salvador, Honduras, Santa Lucia, Ecuador, and Guatemala). An online consultation for issues specific to the Americas is also being planned to begin soon on www.paho.org/mdgpost2015.