Health and the MDGs: the challenges ahead.

• Author: Chan, Margaret
• Position: Millennium Development Goals

In 2000, the international community endorsed the Millennium Declaration, which sets out an historic commitment to eradicate extreme poverty and improve the health of the world's poorest people by 2015. The Declaration and the resulting internationally agreed targets for the Millennium Development Goals (MDGs) place health squarely at the centre of the international development agenda and champion it as a key driver of economic progress.

Health is represented in three of the eight MDGs and makes an acknowledged contribution to the achievement of all the others, in particular those related to the eradication of extreme poverty and hunger, education and gender equality. Goal 8, which calls for a global partnership for development, is a unique feature of the MDGs, because it recognizes that there are certain actions that rich countries must take if poor countries are to achieve all the other Goals. MDG 8 is a reminder that global security and prosperity depend on a more equitable world for all.

Health has never before received such international attention or enjoyed such wealth as in recent years. More than 100 partnerships, mainly focusing on individual diseases, have been formed. Official development assistance for health increased sixfold in real terms, from $1.7 billion in 1985 to over $9.7 billion in 2005. (1) At the 2005 G8 Summit at Gleneagles, rich countries agreed to double aid to Africa by 2010; many announced timetables to increase their development assistance to 0.7 per cent of their gross national product. Furthermore, the number of innovative financing mechanisms, such as the International Finance Facility for Immunization, Advance Market Commitments and UNITAID, continues to grow. Such mechanisms are seen as an important component for a more sustainable and performance-driven approach to development assistance, and an attempt to address aid shortfalls.

At the midpoint in the countdown to 2015, the target year given so much significance by the Millennium Declaration and its MDGs, we can see several examples of success. In 2007, the global burden of under-five mortality has fallen for the first time below 10 million deaths and is now estimated at 9.7 million per year. Increased coverage of interventions, such as exclusive breastfeeding, measles vaccinations, vitamin A supplements and insecticide-treated bed nets, have contributed to this decline.

In 2005, it was estimated that seven high-burden countries--Bangladesh, Brazil...