We are now 11 days into 2015, the target year for the Millennium Development Goals (MDGs) to be achieved. So where are we at and what can we realistically expect to achieve by the end of the year?
For a little background on the MDGs in case anyone is unfamiliar: The 8 Millennium Development Goals (shown in the graphic below) form a blueprint, agreed upon by the world’s countries, of the most pressing issues to address to help the world’s poorest citizens. These goals were established in 2000, through a United Nations resolution, with the hope of achieving specific targets for each goal by the end of 2015. We’re down to only 354 days left.
Goals 4, 5, and 6 directly relate to public health, with goal 6 directly related to infectious diseases.
Child mortality has almost halved globally since 1990, however many areas of the world are not going to meet the target of reducing by two-thirds the under five mortality rate. According to the Millennium Development Goals Report of 2014, only Eastern Asia and Northern Africa have achieved the goal. Latin America and the Carribean are close, as is Western Asia. Most of these kids are still dying from infectious diseases such as pneumonia, malaria and diarrhea. Malnutrition was also a large factor as in the poorest parts of the world, malnutrition and infectious diseases present a high burden. Measles vaccination has had a substantial impact on improving under five mortality rates in many areas of the world, but measles is not the only thing contributing to under five mortality rates.
Almost 300,000 women died globally in 2013 from causes related to pregnancy and childbirth. Unfortunately, not one area of the world has achieved the target of reducing the maternal mortality ratio by 3/4, although Eastern Asia is close. Most of the maternal deaths are concentrated in two populous countries, India with a maternal mortality rate of 17%, and Nigeria with a rate of 14%. Most maternal deaths are preventable but a lack of healthcare access means many of these treatable conditions result in death. The presence of skilled birth attendants can help reduce maternal mortality, but there’s a lack of skilled birth attendants in rural areas around the world. On the bright side, all areas of the world have shown an increase in the proportion of women who receive at least four antenatal visits, adolescent childbearing has decreased worldwide, and more women have access to contraceptives than ever before.
The target of halting and reversing the spread of HIV/AIDS has not quite been accomplished yet. While we have reached the tipping point of HIV/AIDS globally, some areas of the world still have a much higher burden than others. The lack of education surrounding HIV/AIDS is contributing to the continued incidence of HIV. While HIV/AIDS cases may be impacting some areas of the world more than others, the world is on track to meet the target of having 15 million people on antiretroviral therapy (ART) by the end of 2015. This is great news, but there are still far too many people who are not on ART to prevent the spread of HIV, and the distribution of ART is not reaching many of the most vulnerable people like sex workers, children and adolescents.
Between 2002 and 2012 an estimated 3.3 million deaths from malaria were averted due to a huge expansion of malaria interventions. Most (90%) of those averted deaths were children under five in Sub-Saharan Africa. This progress means that the world is on track to meet the malaria target of halting and reversing the incidence of malaria. I’m sure most people have heard about interventions like insecticide treated bed nets which have helped decrease malaria, but many populations still don’t have access to the malaria interventions. The efforts to fight tuberculosis have saved an estimated 22 million lives worldwide and with continued focus and effort, the world may be able to achieve the tuberculosis target of halting and reversing the incidence of TB. However, there are still issues with multi-drug resistant TB and HIV-TB co-infection that continue to make TB a challenging target.
While the world continues to wait and see where we stand on the MDGs on December 31, 2015, many NGOs, think tanks, government agencies and foundations are thinking about the next set of 17 goals, the Sustainable Development Goals (SDGs), to be achieved by 2030.