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Progress towards MDGs continues to be a mixed bag

Sep 21, 2010

Sustained economic growth will continue to be the main vehicle for making progress toward the MDGs. But ancillary policies that address rising inequality and recent setbacks caused by the global financial crisis will also be necessary.

The global picture masks considerable variation across income groups, regions, and countries. Of the 84 developing countries with available data, 45 have already achieved or are on schedule to meet the poverty reduction target; the rest are off track. Sub Saharan Africa continues to lag the farthest behind on the poverty reduction MDG, despite very rapid growth and impressive reductions in poverty in a number of countries.

The policies in these countries need to encourage public investment in basic infrastructure linking the economies of lagging regions to those of leading ones. They also need to promote public services that improve access to basic health, education, and employment opportunities for poor and disadvantaged populations, including women and ethnic minorities. And there is a need to invest in cost-effective social safety net systems that ensure achievements are not lost to unexpected future shocks.

MDG 1: Eradicate Poverty and Hunger

The global MDG of cutting the poverty rate in half appears well within reach–by 2015, the global income poverty rate is projected to be 15%, well below the target of 21%. Much of the progress is attributable to smallholder agricultural productivity growth in China where the poverty rate declined from 60 to 16% as the absolute number of extreme poor people fell from 683 million to 208 million. 

Excluding China, the drop in poverty is less dramatic, but still impressive, from 35.2% in 1990 to 18.2% in 2015. In some cases, progress has been tempered by population growth: resurgent growth saw poverty in SSA fall from 58% in 1990 to 51% in 2005, but population growth meant that the absolute number of poor rose from 296 million to 388 million. 

Likewise, poverty incidence in India fell from 51 to 42% over a decade, although the number of poor people rose from 436 million to 456 million.

Progress on meeting the MDG of halving the proportion of people who suffer from hunger was almost completely reversed in 2008 with the food price spike. In 1990, the share of hungry people was 20%; by 2005, this share had dropped to 16%, but it rose to an estimated 19% in 2009.

 Before the global food price crisis, 63 developing countries (out of 117 with available data) were on track to halve the prevalence of underweight children under five by 2015. However, in 34 countries progress is insufficient; 20 countries, most of them in Africa, have made no progress toward this target. Many of the countries most hurt by the food crisis were those with high preexisting levels of malnutrition. 

Although international prices were somewhat close to their pre-crisis level by the end of 2009, the price of staples in domestic markets continued to increase throughout 2009, and volatility is expected to remain high. Moreover, any relief from the decline in food prices was more than offset by the global economic crisis.

Progress on the other MDGs (MDGs 2 to 7) has been uneven. Almost two-thirds of developing countries reached gender parity at the primary school level by 2005, and the target of achieving gender parity in primary and secondary education looks likely to be met by 2015. SSA is making progress but remains far behind.

MDG3:Promote Gender Equality and Empower Women

MDG4: Reduce Child Mortality Rate

MDG5:Improve Maternal Health 

Prospects for the MDGs relating to health are not promising. The under-five mortality rate in developing countries declined from 101 deaths per 1,000 live births to 73 between 1990 and 2008. This is insufficient to meet MDG 4 of reducing under-five mortality by two-thirds. 

In 2008, 8.5 million children under the age of five died from preventable diseases, down from 13 million in 1990. Deaths from diarrhea remain extremely high–more than 1.8 million per year. These deaths are closely linked to inadequate sanitation and poor hygiene practices, and are mainly among children under 5 years old living in the world's poorest countries. 

The HIV/AIDS epidemic and civil conflicts have impeded SSA’s progress. In 2008, the region’s under-five mortality rate was still 144 deaths per 1,000 live births, although down from 185 in 1990. SSA has 20% of the world’s children under age five but 50% of all child deaths in this age group. 

Child immunisation has expanded dramatically since 1990, with 63 countries in 2007 recording at least 90% coverage (up from just 13 in 1990), and 18 countries reporting universal coverage. A number of sub-Saharan African countries are in the top ten in terms of absolute progress, but immunisation coverage also declined in 11 countries since 1990. Immunisation rates for one-year-olds have also fallen in China and Viet Nam, with India reporting the lowest level of immunisations in South Asia.

Despite a significant worldwide drop in maternal mortality, progress toward this MDG has fallen short. Overall, maternal deaths for every 100,000 live births decreased from 320 in 1990 to 251 in 2008.

 In sub-Saharan Africa, central and eastern regions have shown some improvement since 1990, but southern and western regions have deteriorated because of the significant number of pregnant women who died from HIV. The proportion of women who have access to health professionals shows more dramatic variation however than any of the other MDG indicators examined, ranging from 6% in Ethiopia to nearly 100% in a number of countries. 

In some regions, especially the Caribbean, CIS, and most of Latin America, a high percentage of births are attended by skilled personnel. Professional birth attendance is lowest in sub-Saharan Africa and parts of South and South-East Asia, again with huge variations. 

In India birth attendance at 47% is in sharp contrast with China’s 98% coverage. Progress has been relatively slow or has even reversed in some cases, including Sudan, where coverage fell from 86% to 49% between 1991 and 2006.

MDG6: Combat HIV, AIDS, Malaria

Progress in halting the spread of major communicable diseases (MDG 6) has been mixed. The rapid spread of HIV and related deaths in the 1990s has been halted in the 2000s, and has even showed some signs of decline in recent years. 

However, an estimated 33 million people were living with HIV/AIDS in 2008, and there were an estimated 2.7 million new infections and about 2 million AIDS-related deaths. SSA remains the region most heavily affected, accounting for over two-thirds of all people living with HIV and nearly three-quarters of AIDS-related deaths in 2008. Women are most affected; they account for nearly 60% of those living with HIV in SSA; the infection rate is 1.1% for young men ages 15 to 24 and a shocking 3.2% for young women. 

While HIV prevalence in SSA has declined in recent years, it has risen in other regions, albeit from much lower levels. Although antiretroviral treatment now reaches almost one-third of people living with HIV/AIDS in developing countries, few countries will meet the target of universal access to treatment.

Efforts to expand access to safe drinking water are on track globally and in most regions. This is partly due to the rapid expansion of infrastructure. Progress on this aspect of MDG 7 remains vital for child survival and improvements in health. 

Between 1990 and 2008, more than 1.6 billion people in developing countries gained access to improved sources of drinking water, raising the proportion of population with access from 72 to 84%. As many as 76 developing countries are on track to attain the target but 23 others have made no progress and five have fallen back. 

Improving access to sanitation has been more difficult. Sanitation coverage in developing countries rose from 43% in 1990 to 54% in 2008. But the global target will be missed. In Sub-Saharan Africa, the proportion with access rose from 27% in 1990 to 31% in 2008, and in South Asia from 22% to 36%.

MDG7: Ensure Environmental Sustainability

MDG 7 also calls for integrating sustainable development into country policies and programs and reversing environmental losses. Progress on this broader agenda is picking up as countries increase their focus on environmental sustainability and climate change. Progress on improving access to drinking water has been very strong. 

In 82% of countries (92 out of 112), access to safe drinking water improved between 1995 and 2008, declining in only 10% of countries (Figure 41). In nine countries, no progress has been achieved, although these include seven countries that had already achieved coverage rates of between 90% and 100% by 1995 and therefore had less potential to make progress. In order to reach the global target, it will be important that countries with large populations make good progress.

The trends are encouraging: China has achieved the target,32 having increased access from 74% to 89% of the population, as has India, increasing access from 76% to 88% of the population. Other populous countries like Brazil and Mexico have also met the target, although a number of others (e.g. Indonesia, Bangladesh, Pakistan and Nigeria) have not.

The greatest rates of relative progress have been in countries with higher initial levels of access, although there have also been some large setbacks among such countries. For example, access in Algeria has fallen from 93% to 83%. Top performers in terms of relative progress are from a variety of regions. Progress in Viet Nam and Namibia is particularly striking: Both countries have reached levels above 90%, starting from 68% and 73%, respectively, in 1995.

MDG 8: Developing global partnership for development

More progress is needed to develop a global partnership for development. MDG 8 covers cooperation in aid, trade, debt relief, and access to technology and essential drugs. Aid from members of the Organisation for Economic Co-operation and Development’s (OECD) Development Assistance Committee (DAC) rose by 0.7% in real terms in 2009 (to $119.6 billion)―well short of earlier commitments. 

At the G8 summit in Gleneagles, donors pledged to increase aid from approximately US$80 billion (in real terms) in 2004 to nearly US$130 billion in 2010. On the basis of 2010 budget proposals and latest gross national income (GNI) figures, the ODA level for 2010 is estimated at US$108 billion, with the ODA/GNI ratio rising to 0.32%. The shortfall relative to 2005 commitments particularly affects SSA, which is likely to receive less than half of the US$25 billion increase envisaged at Gleneagles.

 Despite repeated pledges to conclude the Doha Round, a new multilateral trade agreement that would contribute to creating a more vibrant global economy and opening markets to developing countries remains elusive. On the positive side, progress continues in reducing most poor countries’ debt burdens and assistance from non-DAC donors as well as from private sources is rising fast.


A look into the progress made in several countries and how it is being achieved, reveals there are several contributing factors. 

• Consistent leadership committed over an extended period of time to reducing poverty, backed by strong implementation and human capacity.

• Sound macro-economic policies, open trade, and recognition and active management of the complementary roles of market and state.

• Long-term institutional reform aimed at making the public sector accountable to citizens, and devolution of responsibility and accountability to local levels.

• Prioritisation of investment in human development, and protection of budgets in health and education.

• Active community and civil society participation, encouraged by government.

• Openness to new technologies, and support for innovation, adaptation, and scaling up.

• Support from, and partnership with, the international community including government and non-government agencies.

[This study is based on reports Unfinished Business: Mobilising New Efforts to Achieve the Millenium Development Goals by World Bank and Millennium Development Goals Report Card: Learning from progress  by the Overseas Development Institute]

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