Fact Sheet: Progress on the Millennium Development Goals
Progress on the MDGs
- Since 2000, more than 34 million additional children in the developing world gained the chance to attend and complete primary school—one of the most massive expansions in history. More than 550 million children were vaccinated against measles, driving down measles deaths in Africa by 75 percent. The number of developing-country AIDS patients with access to antiretroviral treatment increased from 240,000 in 2001 to over 1.6 million at mid-2006.
- Yet, all regions are off-track on the child mortality goal, and several regions are off-track on at least some of the other MDGs. The two regions that lag the furthest behind are South Asia (SAR) and Sub-Saharan Africa (SSA). Based on the latest data, the Global Monitoring Report raises the questions of whether the strong push to expand coverage is doing so at the expense of quality.
Nutrition (MDG 1)
Nearly one-third of all children in developing countries are estimated to be underweight or stunted, and an estimated 30 percent of the total population in the developing world suffers from micro nutrient deficiencies. Under-nutrition is the underlying cause of over 55 percent of all child deaths, linking nutrition directly to reduction of child mortality (MDG4).
- The highest rates of malnutrition are found in SAR: underweight prevalence is estimated between 38 percent and 51 percent in the large countries—Afghanistan, Bangladesh, India and Pakistan—none of which is on track to meet the nutrition goal.
SSA is estimated to have a 26 percent prevalence of child malnutrition, and in some countries such as Burkina Faso and Zambia, trends are worsening. East Asia, Latin America, and Eastern Europe and Central Asia (ECA) show better performance although all have some countries that are off-track.
Universal primary completion (MDG2)
Globally the primary school completion rate rose between 2000 and 2005 from 78 percent to 83 percent and the pace of progress in many countries has accelerated.
- Gains are especially strong in North Africa, SSA, and SAR. But 38 percent of developing countries are unlikely to reach 100 percent primary completion by 2015 and another 22 percent of countries which lack adequate data to track progress are also likely to be off-track.
- The groups facing the biggest obstacles to completing primary school are those that are ‘doubly disadvantaged’: girls from ethnic, religious, or caste minorities—amounting to three quarters of the 55 million girls who remain out of school.
- New research on learning levels suggests that the rapid expansion in enrollment in developing countries has not always led to increases in learning. While increasing access to education remains important, the quality of outcomes is critical.
Child Mortality (MDG 4)
In 2005 only 32 of 147 countries were on track to achieve the child mortality MDG. Moreover, 23 countries reveal stagnant or worsening mortality rates. Problems in fragile states are particularly severe: nearly a third (31 percent) of all child deaths in developing countries are in fragile states, and only two of the 35 states currently considered fragile are on track to meet MDG4.
- Progress on child mortality lags despite the availability of simple, low-cost interventions: oral rehydration therapy, insecticide treated bed nets, breastfeeding, and common antibiotics for respiratory diseases could prevent an estimated 63% of child deaths a year.
Maternal Health (MDG 5)
The latest survey data show that in 27 out of 32 developing countries, the proportion of deliveries with a skilled attendant has increased in recent years—notable progress was made in Morocco, Nicaragua, Indonesia, and Egypt.
- Lack of direct data on maternal mortality requires the use of ‘skilled attendance at delivery’ as a proxy measure. Survey evidence showing progress in these 27 countries also suggests that advances are concentrated among richer households—equity gaps for access to skilled attendance are larger than for any other health or education service.
AIDS, Malaria and Tuberculosis (MDG 6)
By end 2006 an estimated 39.5 million people were living with HIV, up 2.6 million since 2004. An estimated 3 million people died from AIDS in 2006.
- While the spread of AIDS has slowed in Africa, it is a rapidly growing epidemic in ECA. Recent experience in combating the spread of AIDS has demonstrated some important messages: reversing its spread is possible, treatment is effective in the developing world, but prevention efforts need to be intensified.
Annually there are an estimated 300 to 500 million cases of malaria, and 1.2 million deaths, mainly among children and mostly in sub-Saharan Africa.
- Several new initiatives hold promise for inroads against malaria: With support from the Dutch and the ‘Roll Back Malaria’ initiative, the Malaria Booster Program, which supports country-led efforts to deliver concrete and measurable results, such as delivery of insecticide-treated bed nets and malaria treatment for young children and pregnant women, is operating in 10 countries and aims to expand to 20 over the next five years.
Tuberculosis is estimated to have led to 2 million deaths in 2004, and 9 million new cases.
- While incidence of TB is falling in five of six developing regions, global growth of 0.6 percent annually is attributed to rapid increases in infections in SSA, with HIV infected people particularly vulnerable. The Directly Observed Treatment Short course (DOTS) method has expanded rapidly, with high burden countries showing large decreases in TB incidence due to DOTS (eg. Indonesia and Cambodia).
Water Supply and Sanitation (MDG 7)
Globally, there has been significant progress on water supply; access to improved water sources has increased from 71 percent in 1990 to 80 percent in 2004.
- Africa is the region most seriously off track to reach the water target. However, there are some promising trends from Africa: 17 of 36 countries for which data are available are on or almost on track and five of the 10 countries making fastest progress globally are low-income countries in Africa.
- In contrast, global progress on sanitation has lagged, increasing only from 37 percent in 1990 to 52 percent in 2004. Only two regions (EAP and LAC) are on track and only one African country for which data are available is on track.
- Despite its importance for achievement of multiple MDGs, aid for water and sanitation declined from the mid-1990s through 2002 and still has not recovered the 2000 level.
Is MDG Progress Reaching the Poor?
In 21 countries for which data is available, child mortality rates are 70 per 1,000 live births for the richest quintile and 125 for the population as a whole, but 148 for the poorest quintile.
While primary completion rates average 81 percent for the highest income quintile and 55 percent for the population as a whole, they average 36 for children from the poorest quintile.
Similarly, 82 percent of children in the top quintile and 69 percent of all children were immunized for measles in these countries, but only 59 percent of children in the bottom quintile were.
On the other hand, in regions where service delivery is expanding there are many countries where the gains for the poorest children are either the same or larger than for the population as a whole:
- In 15 of the 17 countries making progress in reducing child mortality
- In 14 of the 15 countries that have increased measles immunization rates
- In 11 of the 13 countries which show increased primary completion rates
Financing MDG Progress
- External financing for health and education has nearly doubled in real terms since the MDGs were adopted—though over the past year aid for healthy continued to rise and for education began to decline.
- Government spending on health and education has grown as a share of GDP in all regions—most so in SAR, where, on the other hand, education spending is the world’s lowest.