Millennium Development Goals

Carla AbouZahrCarla AbouZahrCoordinator, Statistics, Monitoring and AnalysisCoordinator, Statistics, Monitoring and AnalysisDepartment of Health Statistics and InformaticsDepartment of Health Statistics and Informatics

World Health Editors NetworkWorld Health Editors NetworkGeneva 18 May 2008Geneva 18 May 2008

Summary

Some good newsSome good news Some mixed Some mixed Continuing challenges - mortalityContinuing challenges - mortality Understanding the nature of the problemUnderstanding the nature of the problem What needs to be done byWhat needs to be done by

CountriesCountries Development partnersDevelopment partners WHOWHO

In 2006, childhood deaths fell below 10 millionIn 2006, childhood deaths fell below 10 million

Measles immunization increased since 1990Measles immunization increased since 1990

Underweight prevalence has declined:Underweight prevalence has declined:58 countries on track to achieve MDG158 countries on track to achieve MDG1

76 developing countries on track to reach MDG 76 developing countries on track to reach MDG target on safe drinking watertarget on safe drinking water

Use of insecticide treatment bed nets has increased Use of insecticide treatment bed nets has increased But coverage far short 60% Abuja Declaration targetBut coverage far short 60% Abuja Declaration target

The number of people living with HIV The number of people living with HIV continues to rise continues to rise but is lower than previously estimatedbut is lower than previously estimated

Child mortality: few countries will achieve MDG 4

*MDG4 = 4.3% annual reductionSource:Christopher MurrayInstitute for Health Metrics and Evaluation

Progress toward MDG4Rapid progress is possible.Further analysis of these “well performing” countries under way.No country in sub-Saharan

Africa

The 10 countries with least progress are in sub-Saharan Africa

Contextual factorsHigh HIV prevalenceConflict

Infections and diarrhoea kill most under 5sInfections and diarrhoea kill most under 5sBut one in three deaths occurs in 1st month But one in three deaths occurs in 1st month

Source: WHO, World Health Report 2005

Malnutrition

MDG5: Risk of pregnancy and childbirth UNICEF, UNFPA, World Bank estimates for 2005

None of these countries are in

sub-Saharan Africa or South

Asia

Even among the ten “best

performers”

7 have ratios over 100

12 of 13 countries with highest MMRs are in sub-Saharan Africa

Progress toward MDG5

High HIV prevalence (>5%, 8/10)

Armed conflict (2/10)

Interventions able to be scheduled routinely (antenatal care) Interventions able to be scheduled routinely (antenatal care) have higher coverage than those needing functional have higher coverage than those needing functional health systems and 24-hour availability health systems and 24-hour availability (care during delivery, treatment of childhood illnesses)(care during delivery, treatment of childhood illnesses)

Of 18 life-saving interventions for mothers and children, Of 18 life-saving interventions for mothers and children, only vaccinations are reaching 80% coverageonly vaccinations are reaching 80% coverage

Failures in coverage of care

The poor are least likely to access care:The poor are least likely to access care:Unmet need for care (coverage gap) Unmet need for care (coverage gap) higher for poorest than for richesthigher for poorest than for richest

What can countries do?

Invest in health systems Recognize that health services often contribute

to increasing inequities Remove financial barriers (user fees, etc) Prioritize diseases of the poor Deploy/improve services where the poor live Employ appropriate delivery channels Monitor implementation, coverage and impact

with an equity lens

What can the development community do?

Invest in health systems Embed health in social and economic

planning; multisectoral response Ensure long-term predictable aid Hold all partners accountable for their

performance against international agreements

What will WHO do?

Strengthen health situation and trends monitoring: global health observatory

Equity focus: poverty, gender, geography Cause-specific mortality trends. Monitor global health initiatives and their

impact on health services. Enhance understanding of data limitations

and need for investments in health information systems

World Health Statistics 2008

Country-by-country health indicators

Ten highlights in global health

Understanding the data and estimates