An Analysis of the United Nations Development Goals:

Moving from MDGs to SDGs to empower women and children

through nutrition

“Only through broad empowerment of women, and broad pursuit of equality, will true

progress be seen in tackling food security.”

~ O. De Schutter, 2013

Assignment #2 for CHL 5117:

A Global Perspective on the Health of Woman and Children

Submitted by: Vanessa Young (1001616655)

Submitted to: Akwatu Khenti, Julia Lee, and Catherine Chalin

March 19, 2015

Introduction

Unprecedented progress has been made in improving the lives of some of our world’s

neediest populations through the United Nation’s (UN’s) leadership in steering the multi-national

policy initiative of the Development Goals. Currently we stand at a pivotal point between reflecting

upon and evaluating outcomes of the Millennium Development Goals (MDGs; adopted in 2000 to

be met by 2015), and the development and implementation of the new Sustainable Development

Goals (SDGs; being set now for achievement in 2030) (UN, n.d.). For decades, the Goals have driven

agendas, directed funds, and shaped programs in both the public and private spheres alike, and will

likely continue to do so as we work to execute the post-2015 agenda (Adams and Tobin, 2014).

A key element of global development, and therefore both sets of Development Goals, is

nutrition and food security. Adequate and quality nutrition is essential for survival and leading a

productive life, regardless of age or gender. For women and children, however, the stakes are

particularly high when nutritional needs are unmet; for women and children, nutrition, health, and

social statuses are inextricably related. This paper will examine these connections and compare

both MDGs and SDGs efficacy in addressing them, as well as address the utility, implications,

processes, and outcomes of the UN Development Goals themselves.

Importance of Nutrition to Women and Children

Nutrition is directly associated with the health outcomes of women and children. In fact, the

eradication of hunger has been named an “essential condition” to meeting all other MDGs (FAO,

2005). Hunger increases the risk of contracting infectious diseases and is the cause of nearly half of

child mortalities worldwide (FAO, 2005). But its effects begin even before the child is born.

Malnutrition takes a heavy toll on pregnancy, childbirth, and breastfeeding; maternal

undernutrition accounts for 800 000 neonatal deaths each year globally (Bhutta et al., 2013). Even if

a child survives the vulnerable first few years of life and is not one of the three million under the

age of five who die annually from insufficient nutrition (Horton and Lo, 2013), malnutrition can

greatly hamper cognitive and physical development. This radically reduces opportunities for

education and employment later in life.

In 2011, stunting (failure to reach the proper height) affected approximately 165 million

children globally, and wasting (thinness) affected at least 52 million (Black et al., 2013). For this

reason, recent research has focused on the first 1000 days of a child’s life, beginning at conception,

as a key window of opportunity for shaping a child’s long-term health through nutrition. As

emphasized by De Schutter (2013), the quality of nutrition as young infants during the 1000 day

window is a major determinant in their future height and learning performance – and thus their

income as adults. Undernutrition in these 1000 days can begin a vicious cycle of low birth weights,

carrying from one generation to the next – one of many compelling reasons to make malnutrition a

priority area for global action (De Schutter, 2013) and simultaneously target poverty.

Although undernutrition continues to be all too prevalent, particularly in Asia and Africa

(Black et al., 2013), insufficient food is not the only nutrition issue facing our world’s women and

children. Overweight and obesity have been steadily increasing for decades – more than doubling

since 1980 – and not just in high-income countries. In fact, the rate of increase among low- and

middle-income countries is now 30% faster than that of high-income countries, and Sub-Saharan

Africa is now home to over 10 million overweight children under the age of five (De Schutter, 2013).

Although counterintuitive, overweight and obesity is actually linked with more deaths annually than

underweight. Given the fact that there were 42 million children under the age of five worldwide

who were overweight or obese in 2014 (WHO, 2015), this problem adds significantly to the burden

of other diseases plaguing women and children and is in urgent need of attention.

Malnutrition is not a matter that can be remedied by solely focusing on food. There are

deeper-rooted health-influencing factors than nutrition which must be addressed in order for food

security to become a reality. For instance, diseases such as malaria, HIV/AIDS, and tuberculosis also

contribute to nutritional failures (UN, 2014a). Gender inequality – and inequality in general – is

another such root cause which impacts not only the women and girls, but society as a whole (De

Schutter, 2013). Unequal rights to education, land ownership, and other economic opportunities

results in the marginalization of women and undermines the value potential of their collective voice

and leadership. Truly addressing malnutrition means entering into a complex web of interconnected

factors and thinking “upstream” from food itself. Global actors must move beyond “piecemeal

actions” (De Schutter, 2013) towards changing the deeper driving forces of inequality and

discrimination in order to effect change in food security.

For these reasons, investing in undernutrition is not often an attractive spending option for

those in power; addressing it’s social, political, and economic causes would take a much longer than

a single political cycle (Horton and Lo, 2013). Consequently, it has been said that nutrition was one

of the greatest “missed opportunities” of the MDG era (Horton and Lo, 2013). Yet at the same time

it remains an unparalleled opportunity. If nutrition is given the focus it needs as a sustainable

development objective (and woven throughout other non-nutrition objectives), the effects of the

benefits can extend far beyond physical health – and far beyond one generation. Food security and

proper nutrition can help bring about economic independence of women, furthering their ability to

access adequate food for themselves and their families – a virtuous cycle.

Millennium Development Goal Success

Arising out of a landmark summit in Rio de Janeiro in 1992, the MDG’s (see Appendix) were

the first global-scale demonstration of the ability of international leaders to unify in a strategic,

specific fight against poverty, gender inequality, child mortality, and disease, among others (UN,

2014b). The most nutritionally-relevant of these eight ambitious goals was to “eradicate extreme

hunger and poverty”; closely linked to this discussion were goals to “promote gender equality and

empower women,” as well as “reduce child mortality” and “improve maternal health” (UN, 2014b).

Progress has been impressive for several of the goals. According to a very optimistic report from the

UN, the MDGs have since generated unparalleled improvements around the world through

innovative approaches, new data, and new technology (UN, 2014b).

The statistics speak to this success: more than 700 million people have been lifted out of

extreme poverty, and steady improvements have been made in primary school enrolment, access to

child and maternal health care, and in the participation of women in politics (UN, 2014b). Notably,

success has been achieved in halving the number of hungry people and those with unsafe drinking

water, and the proportion of people unable to obtain enough food to live a healthy and active life

decreased from 23% in 1990 to 14% in 2013 (UN, 2014a). Other encouraging progress includes 46

countries now having at least 30% female parliament membership, and official development

assistance having reached the highest amount ever recorded at $134.8 billion in 2013

(Post2015.org, 2014). Reviews of the MDGs also quote improved transparency, strengthened

multilateral approaches, and enhanced international cooperation as secondary outcomes of the

MDG process (UN, 2014b).

Millennium Development Goal Criticisms

Despite these commendable wins, the MDG experience is not without blemish. There

remains some serious gaps in achieving health for women and children, and concerted effort will be

essential for continued progress (UN, 2014b). The MDGs are seen by many as “unfinished work”

which we must continue, a springboard into the future, or a foundation on which we must build

(UN, 2014b). In order to craft a healthier, more equitable future for women and children, lessons

learned from the MDG experience ought to inform our next steps in working towards these ends.

To begin, some of the health issues for women and children outlined above are completely

missed in the MDG’s. The two indicators for MDG #1 (which is to halve the number of people who

suffer from hunger) are the prevalence of underweight children under five years of age, and the

proportion of the population below the minimum level of energy consumption (UN, n.d.). The one-

sided focus on underweight and lack of direction in addressing micronutrient deficiencies,

overweight, and obesity is concerning. It is also surprising, considering that the UN has already

noticed these trends and declared that in countries where both sides of the malnutrition problem

exist, interventions particularly targeting women are required which encompass a wide range of

policies dealing with health, hygiene, and education (UN, 2014b).

Secondly, can we compare all countries to a common standard? Is it realistic and fair to do

so? In a 2009 article entitled “How the Millennium Development Goals are Unfair to Africa,” William

Easterly describes how the cut-offs selected to define success of the MDGs are not attainable by

most African countries, despite perhaps exceptional progress compared to historical trends or to

other regions. For example, the indicator of MDG #1 is the proportion of people living below the

poverty line (on less than $1 per day). However, no value is given to the number of people who

move closer to the poverty line but do not rise above it (Easterly, 2009), so progress statics reported

according to the targets set by the MDG indicators could be discouraging and misleading. For this

reason, Easterly reproaches the MDGs as having painted Africa in a bad light by emphasizing

shortcomings compared to other regions. He also reports that those involved in setting the MDGs

have even admitted that Africa will miss all the MDG targets. On the other hand, it could be argued

that the MDGs, as they are, focus more attention on Africa and therefore bring more aid to the

neediest areas of the world.

Another question is whether the goal outcomes should be measured in relative or absolute

numbers. Although great strides have been made towards MDG1, a closer look at the numbers

reveals that not only has progress been quite uneven across and within countries, but the absolute

number of people suffering from hunger has only somewhat decreased (De Schutter, 2013). Far

more ambitious than halving the proportion of people suffering from hunger (the MDG target)

would be to halve the actual number of hungry people – precisely what the 1996 World Food

Summit (WFS) set as a goal to be achieved by 2015. According to 2014 report “The State of Food

Insecurity in the World,” although there was a 40% reduction in the proportion of the world’s

undernourished people (the MDG goal) from 1990 to 2014, there was only a 21% decrease in the

number of the world’s undernourished people (the WFS target) over the same time span.

Furthermore, as measured by proportion, every world region showed improvements, but when

measured by absolute numbers, some regions such as Africa even showed increases in hunger (FAO,

2014). For this reason, less than half of the countries achieving MDG #1 also achieve the WFS target

(FAO, 2014).

Finally, many critics feel that gender-specific goals are necessary for true advancements of

women’s health, and that reported data should be disaggregated for gender. For example, De

Schutter (2013) points out that a shortcoming of the MDGs is that they are “gender-blind,” focusing

on overall progress and thereby allowing disparities within populations to be unnoticed. Because of

this characteristic of MDGs, many countries have been able to boast of achieving national targets by

focusing on easy wins while data for the poorest and most marginalized populations within national

boarders may remain the same or worsen (De Schutter, 2013). This can lead to worsening

inequalities within countries, despite national data which reports of MDG success.

Transitioning Into Sustainable Development Goals

Upon evaluation of the MDGs, stakeholders voiced that the world needs to continue this

course of action, but that there are key sustainable development gaps such as the multi-

dimensional aspects of poverty and human rights that need to be addressed (UN, 2014b). In 2012,

another landmark UN conference held in Rio de Janeiro again brought world leaders together to

vision-cast for future development. This UN Conference on Sustainable Development launched

the process of developing the SDGs (see Appendix) by producing the document “The Future We

Want” which captures both the lessons learned from experience with MDGs (including gaps that are

yet to be filled), as well as a summary of what the world desires to see in the next sustainable

development agenda (UN, 2014b). In 2013, a diverse Open Working Group was tasked with

developing the specific proposed goals (UNDESA, 2015), which were delivered in July 2014. The

next step is the finalization of the goals and their targets which will happen through three

international meetings this year (UN, 2014).

So what do people want in a post-2015 development agenda? Some ‘asks’ outlined in “The

Future We Want” include building democratic processes and accountability; eliminating inequalities

across gender, class, race, and religion; and opportunities to make sustainable livelihoods through

development of the ‘pro-poor’ economic policies (Waituru, 2013). Others, recognizing that gender-

based discrimination is a key obstacle to sustainable development, have asked for new goals to

aggressively eliminate disparities (De Schutter, 2013). Specific to food security, De Schutter (2013)

addresses the importance of measurement by saying that targets – such as those on hunger –

should not be achievable on paper if they are not also achieved for disadvantaged groups such as

women.

The 17 proposed SDGs and their attached 169 detailed targets are praised for being

more inclusive, addressing more root causes of poverty such as human rights, and being

applicable to all nations, not just developing ones (Engel, 2015). So how do the proposed goals

differ from MDGs and how will they address food security for women and children? Besides the

prominent nutrition-related SDG #2 to “end hunger, achieve food security and improved nutrition

and promote sustainable agriculture” (UNDESA, 2015), several others also influence food security

and sustainable agriculture, and therefore, women and children’s health. These include goals to end

poverty in all forms, to promote well-being for all, to achieve gender equality, to promote economic

growth and education for all, to reduce inequality within and between countries, and to ensure

sustainable production and consumption patterns (Galatsidas, 2015).

Unfortunately, some elements of the Goals have not been improved upon from the MDGs.

For example, there is still no direction for combatting overweight, obesity, or micronutrient

deficiencies. In addition, the majority of indicators are still measured as proportions as opposed to

absolute numbers. Because many indicator statements are broad such as “eradicate extreme

poverty for all people everywhere”, whereas others have specific numerical targets (e.g., “reduce

the global maternal mortality ratio to less than 70 per 100,000 live births” (UNDESA, 2015)), Beattie

(2014) critiques the SDG goals and targets for being a mixture of “arbitrarily precise and

comfortingly vague.” The SDGs are also faulted for being unwieldy due to the large number of goals,

targets, and indicators. Stoksad (2015) asserts that only 29% of the targets are well-defined and

scientifically rigorous, and that the rest lack specific endpoints and therefore can’t be accurately

measured. He warns that ambiguous targets could deter donors and allow too much latitude in

evaluating progress (Stoksad, 2015).

Many other aspects of the goals have been improved, however. Learning from the MDG

feedback in setting the post-2015 agenda, the SDGs are much more context-relevant. For example,

a novel feature of the SDGs is that they take into account country-specific circumstances, and

contain both global targets and those which make sense in the national context and which consider

national priorities (UN, 2014b). This can be evidenced by the phrase “as nationally appropriate”

which appears several times among the MDG indicators. Special attention was also devoted to

least developed countries and countries in situations of conflict (UN, 2014b). This is a difficult but

crucial balance to attain because it would be counterproductive for a country to feel the goals don’t

apply to them, or to feel overwhelmed by the seemingly unattainable standard set.

One common criticism of the MDGs had been that they were prioritized and decided upon

“behind closed doors,” dominated by the OECD countries (Nabila Kabeer in an interview with

UNICEF Innocenti, 2012). That is why the new global conversation on the post-2015 development

agenda is being applauded. Stakeholder input has been much more diverse for the development of

the SDGs; consultations have taken place in all 193 UN member states with millions of voices being

heard. Through community consultations, online surveys, and interviews, ideas have been heard

from young people, women, parliamentarians, academics, those from the business sector, and

those below the poverty line (UN, 2014b). This certainly reduces the sense of “cockpit-ism” – the

top-down steering by governments to address global problems (Hajer et al., 2015).

Another encouraging outcome in response to the demand for gender-disaggregated data is

that many of the goals contain gender-specific gender targets such as “reduce at least by half the

proportion of men, women and children of all ages living in poverty in all its dimensions according to

national definitions.” Women are also emphasized in several nutrition-related targets such as

“double the agricultural productivity and the incomes of small-scale food producers, particularly

women…including through secure and equal access to land…” (UNDESA, 2015). During the transition

from MDGs to SDGs, there seems to have been an evolution in understanding of the connections

between gender equality, agriculture, and food security.

One example of such connections involves trading markets for agricultural goods. According

to Swain (2009), almost every developed country spends generously on agricultural subsidies. This

depresses global market prices, rendering farmers in developing countries unable to compete with

imported crops, and drastically reduces the amount of potential revenue to be gained by exports of

crops from developing nations. This phenomenon undoes much of the benefit from donated foreign

aid; it’s as if developed countries are giving with one hand and taking away with the other (IMF,

2003). There is also a harmful reverse trend existing when goods are imported from developing to

developed countries with exceptionally low tariffs and duty charges. These factors contribute to a

stagnation of the debt burden of developing countries which has been hovering around 3% of

export revenue (Post2015.org, 2014).

The good news is that the Development Goals are this time devoted to levelling the playing

field for agriculture producers. It helps that sustainable agriculture lies at the intersection of food

security and environmental concern (which takes prominence in the SDGs). Some indicators for SDG

#2 deal directly with this issue by declaring trade distortions in world agricultural markets should be

corrected by the “elimination of all forms of agricultural export subsidies” and that measures are to

be adopted which “ensure the proper functioning of food commodity markets and their derivatives,

and facilitate timely access to market information, including on food reserves, in order to help limit

extreme food price volatility “(UNDESA, 2015). If these goals are taken seriously by high-income

countries, the beneficial effects on small-scale farmers and their families in low-income countries

could be tremendous.

Finally, a few ways to increase chances of success as we embark on the SDG adventure. It

will be important to empower indigenous leadership and community capacities, carefully

incorporating their wisdom and local experience. Another key prerequisite for food security goals is

for the nutrition community to be more engaged in this latest round of development goals, and for

it to forge strategic partnerships with those outside nutrition (Gillespie et al., 2013). We must

ensure that food security gaps are decreased not only between countries but within them as well.

Strong monitoring and data collection will also be necessary; for example, the measurement of

national budget spending on nutrition can be key to ensuring strong accountability (1,000 Days,

n.d.). Most importantly, it will be necessary for nations to be united in considering the SDGs a

universal agenda. As we tackle problems that transcend boarders, all countries – with their

respective approaches – will need to make changes for the global common good (UN, 2014b).

Conclusion

While far from perfect, the Development Goals have rallied international leaders and

created cohesion for what would otherwise be a disjointed effort at best; they have served as both

the lens through which we understand the world’s need and the standard by which we measure our

efforts. Important lessons have been learned from our global experience with MDGs, many of which

have informed a more applicable, intelligent list of goals and targets in the SDGs. The health of

women gets more much-needed attention, and many deeper causes of food insecurity are

addressed. As we strive towards combining international efforts to reach these goals, we may truly

be moving towards a more sustainable, healthier future.

References:

1,000 Days. (n.d.) Priority Nutrition Indicators for the Post-2015 Sustainable Development

Framework. Available from: http://www.thousanddays.org/resource/priority-nutrition-

indicators-for-the-post-2015-sustainable-development-framework/

Adams, B., and Tobin, K. (2014). Confronting Development: A Critical Assessment of the UN’s Sustainable Development Goals. Retrieved from: http://www.rosalux-nyc.org/wp-content/files_mf/adamssdgsengwebsite.pdf

Beattie, A. (2014, Aug 21). The New UN Development Goals, Still Missing the Point. [Web log comment]. Retrieved from http://blogs.ft.com/beyond-brics/2014/08/21/the-new-un-development-goals-still-missing-the-point/

Bhutta ZA, Das JK, Rizvi A, Gaffey MF, Walker N, Horton S, Webb P, Lartey A, Black, RE. (2013). Evidence-based interventions for improvement of maternal and child nutrition: what can be done and at what cost? The Lancet. 382: 452–77.

Black RE, Victora CG, Walker SP, Bhutta ZA, Christian P, Onis M, Ezzati M. (2013). Maternal and child undernutrition and overweight in low-income and middle-income countries. Lancet. 382: 427–51.

De Schutter, O. (2013). Advancing women’s rights in post-2015 development agenda and goals on food and nutrition security. EGM/MDG/EP. Retrieved from: http://www.unwomen.org/~/media/headquarters/attachments/sections/csw/58/ep10-olivierdeschutter%20pdf.pdf

Easterly, W. (2009). How the Millennium Development Goals are Unfair to Africa. World Development. 37(1): 26-35

Engel, L. (2015 January 16). 6 things to know about the status of global nutrition. [Web log comment]. Retrieved from http://blogs.unicef.org/2015/01/16/6-things-to-know-about-the-status-of-global-nutrition/

Food and Agriculture Organization (FAO). (2005). Hunger slows progress towards Millennium Development Goals.

Food and Agriculture Organization of the United Nations (FAO). (2014). “State of Food Security in the World.” Retrieved from: http://www.fao.org/publications/sofi/2014/en/

Galatsidas, A. (2015). Sustainable Development Goals: changing the world in 17 steps – interactive. The Guardian. Retrieved from: http://www.theguardian.com/global-development/ng-interactive/2015/jan/19/sustainable-development-goals-changing-world-17-steps-interactive

Hajer M, Nilsson M, Raworth K, Bakker P, Berkhout F, de Boer Y, Rockström J, Ludwig K, and Kok M. (2015). Beyond Cockpit-ism: Four Insights to Enhance the Transformative Potential of the Sustainable Development Goals. Sustainability. 7: 1651-1660.

Horton, R., and Lo, S. (2013). Nutrition: a quintessential sustainable development goal. The Lancet. 382: 371-372.

International Monetary Fund (IMF). (2003). Declaration by the Heads of the IMF, OECD and World Bank. [Press Release No. 03/150]. Retrieved from: https://www.imf.org/external/np/sec/pr/2003/pr03150.htm

Post2015.org. (2014). The Millennium Development Goals Report 2014. Retrieved from: http://post2015.org/2014/07/07/the-millennium-development-goals-report-2014/

Swain, SR. (2009). Trade Externalities of Agricultural Subsidies and World Trade Organization. American Journal of Economics and Business Administration. 1(3): 225-231.

Stoksad, E. (2015). Sustainable Goals from the UN Under Fire. Science. 347(6223).

UNICEF Innocenti. (2012). The Debate: Post 2015 – What’s Next? Retrieved from https://www.youtube.com/watch?v=Ostj_xxAGMg

United Nations. (2014a). The Millennium Development Goals Report. Retrieved from: http://www.un.org/millenniumgoals/2014%20MDG%20report/MDG%202014%20English%20web.pdf

United Nations. (2014b). “The Road to Dignity: Ending Poverty, Transforming All Lives and Protecting the Planet” [Synthesis Report of the Secretary-General on the Post-2015 Agenda]. Retrieved from: http://www.un.org/disabilities/documents/reports/SG_Synthesis_Report_Road_to_Dignity_by_2030.pdf

United Nations Department of Economic and Social Affairs (UNDESA). (2015). Open Working Group proposal for Sustainable Development Goals. Available from: https://sustainabledevelopment.un.org/sdgsproposal

United Nations. (n.d.). We Can End Poverty: Millennium Development Goals and Beyond 2015. Available from: www.un.org/millenniumgoals/

Waituru, M. (2013). Lessons from the Implementation of MDGs in Kenya: Options for a Post-2015 Framework. IDS Bulletin. 44.5-6: 30-33.

World Health Organization (WHO). (2015). “Obesity and Overweight.” Fact sheet N°311. Retrieved from: http://www.who.int/mediacentre/factsheets/fs311/en/

Appendix: Millennium Development Goals and the Sustainable Development Goals

The Millennium Development Goals (from http://www.unmillenniumproject.org/goals/)

Goal 1: Eradicate Extreme Hunger and Poverty

Goal 2: Achieve Universal Primary Education

Goal 3: Promote Gender Equality and Empower Women

Goal 4: Reduce Child Mortality

Goal 5: Improve Maternal Health

Goal 6: Combat HIV/AIDS, Malaria and other diseases

Goal 7: Ensure Environmental Sustainability

Goal 8: Develop a Global Partnership for Development

Sustainable Development Goals (from https://sustainabledevelopment.un.org/sdgsproposal)

Goal 1 End poverty in all its forms everywhere

Goal 2 End hunger, achieve food security and improved nutrition and promote sustainable agriculture

Goal 3 Ensure healthy lives and promote well-being for all at all ages

Goal 4 Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all

Goal 5 Achieve gender equality and empower all women and girls

Goal 6 Ensure availability and sustainable management of water and sanitation for all

Goal 7 Ensure access to affordable, reliable, sustainable and modern energy for all

Goal 8 Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all

Goal 9 Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation

Goal 10 Reduce inequality within and among countries

Goal 11 Make cities and human settlements inclusive, safe, resilient and sustainable

Goal 12 Ensure sustainable consumption and production patterns

Goal 13 Take urgent action to combat climate change and its impacts*

Goal 14 Conserve and sustainably use the oceans, seas and marine resources for sustainable development

Goal 15 Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss

Goal 16 Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels

Goal 17 Strengthen the means of implementation and revitalize the global partnership for sustainable development