Sprinting To the MDG Finish Line

Ed note. This essay — by me —  originally appeared in the Diplomatic Courier

In 2000 world leaders gathered at the United Nations to agree on a set of eight targets for international development. Since then, the Millennium Development Goals, or MDGs have become the single most important organizing principle of the international community’s fight against extreme poverty and disease.

World leaders gave themselves a deadline of 15 years to reach these goals. Fast forward to April 2013 and we are now 1000 days until the MDGs are due. So how far have we come? What is left to do? What should replace the MDGs once they expire? And most importantly, what can ordinary citizens of the world do to help the cause?

On Friday, April 5th, over 70 organizations—including United Nations specialized agencies, governments from around the world, and members of the private sector and NGOs like the United Nations Foundation—marked the 1000 day countdown with a 1000 minute “digital media relay” to address those questions in a way that could not have been imagined just 15 years ago. Through Twitter and Facebook chats, Google Hangouts blog posts and more, millions of people came together from every corner of the globe to celebrate global progress in eradicating extreme poverty and disease and press world leaders to close the gap for those MDGs that have yet to be achieved.

The Momentum 1000 Project was an impressive show of global solidarity. It was also exceedingly necessary. If world leaders are going to achieve the goals they set for themselves 15 years ago we are going to need to sprint to the 2015 finish line.

Some MDGs have already been met. The very first Goal—to reduce by half the number of people living on less than $1.25/day—was reached in 2005. This was due in large part to the tremendous economic growth in India and China over the past decade, which lifted hundreds of millions of people out of abject poverty. China and India’s economic development pulled the aggregate global numbers up, but there are also success stories in regions that have not experienced that pace of growth. Cameroon and Guinea have achieved the target while Senegal, Gambia, Swaziland, Uganda, and Mauritania are very nearly there.

The second MDG deals with access to education. That is another great global success story. Primary education in developing regions reached 90 percent in 2010, up from 82 percent in 1999, which means more kids than ever are attending primary school. The progress in Africa has been even more dramatic: The aggregate net primary school enrollment for Africa rose from 64 percent in 2000 to 84 percent in 2009. Gender gaps in education are also disappearing—there are more girls enrolled in primary school now than at any other time in human history. This is progress for which all of humanity can be rightfully proud.

The genius of the Millennium Development Goals is that they put some of the great moral challenges of our times squarely on the political agenda of every single government of the world. Governments and civil society rose to the occasion by backing up the MDGs with new sources of funding to roll back some of the great global scourges of our time.

Nowhere has this been most apparent than in the health related MDGs. Rolling back the tide of HIV/AIDS, Malaria, and TB is at the heart of MDG 6. And fighting deadly childhood illnesses like diarrhea, pneumonia and measles is at the heart of MDG 5. Tackling these challenges required money. The levels of required funding is not an onerous amount in budgetary terms, but an injection of new funds was needed. In 2002, donor governments and civil society created the Global Fund to Fight AIDS, Tuberculosis, and Malaria in an effort to pool resources. Large philanthropies like the Bill and Melinda Gates Foundation added a new and nimble source of funding for global health; and in 2003, President Bush launched the President’s Emergency Plan for AIDS Relief (PEPfAR), which was the single largest injection of cash to fight HIV/AIDS worldwide.

The health related MDGs were the organizing principle around which these efforts coalesced. The results have been impressive. On Malaria, for example, prevention strategies like indoor residual spraying and long lasting insecticide treated bed nets have decreased infections by 17 percent globally since 2000. Deaths have decreased by 25 percent. Access to HIV medicines in the developing world has also increased substantially to about half of all people in need today. That is clearly not enough—the goal calls for universal access to HIV/AIDS medicines—but this progress has been meaningful nonetheless. For the first time since the AIDS epidemic began nearly 30 years ago the number of people who died from AIDS decreased in 2010.

The one set of goals, though, that need the most help is related to maternal health and maternal mortality. MDG 5 sets a target of reducing maternal mortality by three quarters and achieving universal access to reproductive health. Both goals, sadly, are far from their targets. Maternal mortality has only been decreased by 47 percent; and there are still about quarter of a million women who do not have access to family planning services. In many ways, these targets are the single most important of all the MDGs: studies have shown that investing in women and girls can have profoundly positive economic and social consequences society wide.

In 2010 the UN Secretary General took a hard look at the world’s collective failure to meet this MDG and launched an initiative called Every Woman, Every Child. This initiative used the UN’s unique convening power to secure financial commitments from donors and concrete political and policy commitments from recipient countries to help close the gap on women and children’s health.

Progress has accelerated since then, but this MDG is still behind schedule.

In the next 1000 days, we are unlikely to fully close that gap—but projects like the digital media relay help keep the spotlight on those MDGs that still need help—and can help make sure that this issue stays on top of the international agenda once the MDGs give way to the post 2015-agenda.

Surely, the experience over the last 13 years has demonstrated that combining some of the great moral challenges of our time with political and financial backing can yield impressive results. The UN system is now exploring ways to build on the successes of the MDGs—and on the momentum of the next 1000 days—to design a new global development agenda once the MDGs expire. Government leaders from the United Kingdom, Indonesia, and Liberia are co-chairing an important committee that will make recommendations to the United Nations about what should be included in a post-2015 development agenda. Their report is due at the end of May, and chances are it will build on the foundation of the MDGs, but expand them to include principles of sustainable development. That would be key. Among the greatest challenges of the next decade will be to maintain impressive levels of economic growth and social progress in the developing world, but in a way that does not jeopardize the health of the planet.

As the experience of the past 13 years demonstrates, this is a perfectly surmountable challenge so long as the international community keeps its eyes on the prize—and citizens keep up the pressure on their leaders.