Theme 3: Health & UN Millennium Development Goals

  • In recent times there have been significant advances in modern medicine, leading to improvements in life expectancy and reduction in infant mortality rates. However:
    • In 2009, 8.1 million children under the age of 5 died – more than 22,000 children each day and almost 1000 every hour.
    • In 2008, 1.7 million children under the age of 5 died from vaccine-preventable diseases.
  • An estimated 23 million infants worldwide are still not being reached by routine immunization services.
  • How can we define wellbeing as an aspiration for society?
  • How can we tackle the issue of global disease affecting lives of men, women and children?
  • What strategies can we adopt to both find and implement solutions to epidemics?
  • Is the world better off today than in 2000 AD with respect to basic nutrition, vaccination, infant mortality and preventive healthcare?
  • Is the contribution of individual philanthropic efforts more effective than that of governments?

Goals 4, 5 and 6 of the United Nations Millennium Development Goals for 2015 focus on health as a key issue in the fight to end poverty: reducing child mortality, improving maternal health and combatting HIV/AIDS, malaria and other diseases.These goals reveal a commitment to wellbeing as an aspiration for global society and require various strategies both to find and to implement solutions to epidemics. Whether governments or private philanthropists have been more effective in the past and hold more promise for improving global health in the future is also an important issue to consider as we think through how to improve universal access to nutrition, vaccination and preventive healthcare.

Reducing Child Mortality

Goal 4 of the UN Millennium Development Goals is to reduce by two-thirds the mortality rate of children under five, from 100 in 1,000 (10%) in 1990, to 33 in 1,000 (3.3%) in 2015.

The basic facts about this issue are as follows:

  • From 1990 to 2008 the number of children who died before they reached five years-old dropped from 100 to 72 deaths per 1,000 live births.
  • Approximately 9 million children die each year before their fifth birthday. That is nearly 25,000 children under five dying every day, on average.
  • 1 in 7 children died in 2008 in sub-Saharan Africa before their fifth birthday.
  • Progress has been faster in some countries than in others. In particular, rates have improved significantly since 1990 in Northern Africa, Western and Eastern Asia and Latin America, while in sub-Saharan Africa and Southern Asia rates remain extremely high. 1

Though increased fertility rates can be seen as one factor accounting for high child mortality particularly in poor areas of sub-Saharan Africa, additional causes include malnutrition and lack of primary care and infrastructure. Pneumonia, diarrhoea, malaria and HIV/AIDS causes death in nearly half of cases, while another one-third has been connected to malnutrition. 2

Solutions depend on the particular circumstances different communities face: In Cambodia, breastfeeding initiatives have made a significant dent in local child mortality rates, while in sub-Saharan Africa providing mosquito nets in the fight against malaria has been a productive strategy. 3 The United Nations has promised to:

  1. “Enhance financing, strengthen policy and improve service delivery” for global reporting,
  2. Effectively purchase and deliver vaccines through partner and family organizations, and
  3. Work with other international and local organizations to provide basic health education related to newborn care.

Improving Maternal Health

The target for the fifth goal to improve maternal health is to reduce by three-quarters the maternal mortality ratio from 1990 to 2015, also achieving universal reproductive healthcare by 2015.

The facts on this issue are as follows:

  • Over 350,000 women die each year from complications of pregnancy or childbirth, the vast majority of them in developing countries. Most of these deaths are avoidable.
  • In sub-Saharan Africa, the maternal mortality risk is 1 in 30 versus 1 in 5,600 in industrialized societies.
  • Over 1,000,000 children are left motherless each year. These children are “up to 10 times more likely to die prematurely than those who have not” lost their mother. 4

As with child mortality, maternal mortality is most prevalent in southern Asia and sub-Saharan Africa. Major causes of mortality include haemorrhage, hypertension, sepsis, unsafe abortion and obstructed labour, all of which are usually preventable with adequate health care infrastructure including human and material resources.

Providing greater access to human and material resources to improve maternal health care is vital for resolving this problem. The United Nations has also promised to provide for reporting and accounting on progress in maternal health care, aid in providing for greater emergency neonatal care and work with partner organizations to increase the capacity of midwives and reproductive health supplies in developing countries.

Combating HIV/AIDS, Malaria and Other Diseases

The third UN Millennium Development Goal concerning health for 2015 is to combat HIV/AIDS, malaria, and other diseases, reversing the spread of such by 2015 and achieving by 2010 universal access to treatment for HIV/AIDS.

  • Over 7,000 are infected with HIV and over 5,000 die from AIDS-related illnesses every day.
  • 33,000,000 were living with HIV in 2008, most of them in sub-Saharan Africa.
  • Malaria kills one child every 45 seconds on average. 90% of malaria deaths are in Africa.
  • Nearly 2 million people died from tuberculosis in 2008. 5

HIV infection rates have decreased from 3.5 million per year in 1996 to 2.7 million in 2008, while rates of incidences of malaria and tuberculosis are decreasing. 6 However, by any measure universal access to treatment is hardly forthcoming, though it has been shown to be most effective for decreasing HIV/AIDS-related deaths among those with HIV. Through national government and local partnerships the United Nations aims to prevent mother-to-child transmission of HIV through education, support of those living with HIV/AIDS, providing HIV/AIDS preventative education, and otherwise supporting other organizations’ efforts to reduce the impact and prevalence of HIV/AIDS, malaria, tuberculosis and other diseases.

Is Our World Well Today?

The facts of child and maternal mortality and the spread of deadly illnesses force us to consider the question: Is our world well today? By some measures discussed above, we can identify improvements in health care in the developing world in the last decade. However, when we consider global wealth and the tremendous increases in technological capacity and medical innovation in the last few decades, can we do more on a global level to decrease preventable illnesses and deaths? What would it take to prioritize global health over competing financial and political-economic concerns we face in society today? Is more required of those of us who have the resources available, or can make them available, to protect the most vulnerable members of our world community?

Governments Versus Individuals

As a global organization the United Nations aims to partner with local and regional organizations rather than to independently work to solve these and other problems we face today. But is this enough? Critics point out the following limitations to working with national governments to solve problems in global health:

  • Funds are wasted on overpriced goods and services from donor countries.
  • Aid does not reach the poorest, who need it most.
  • Money can be embezzled at the local level lacking systems for accountability external to the national or regional climate. 7

But do these limitations mean that organizations should leave the challenges of world health to individuals?Can international organizations and national governments incentivize corporate or individual behaviour to provide aid aiming to increase the wellbeing of the poorest in society?What is the best way of providing aid to meet the global health challenges faced today? Should philanthropists provide aid in a more direct and obviously beneficial manner or is their giving enhanced by the structures in place today to improve healthcare in the poorest places systematically? These are tough questions which require our thorough consideration as we seek to identify the best solutions for increasing global health.

Notes:

  1. United Nations, Millennium Goals 2015, High-level Plenary Meeting of the General Assembly, New York, September 20-22, 2010, http://www.un.org/millenniumgoals/pdf/(2011_E)%20MDG%20Report%202011_Book%20LR.pdf.
  2. United Nations, Millennium Goals 2015.
  3. United Nations, Millennium Goals 2015.
  4. United Nations, Millennium Goals 2015.
  5. United Nations, Millennium Goals 2015.
  6. United Nations, Millennium Goals 2015.
  7. Anup Shah, “Foreign Aid for Development Assistance,” Global Issues, 5 Jun. 2011,http://www.globalissues.org/article/35/foreign-aid-development-assistance.