With nearly one thousand days to go before the world calls time on the Millennium Development Goals, there is a heightened sense of urgency to ensure we do everything possible to meet this ambitious deadline – and to make sure that a new set of goals are set that keep up the critical momentum.
Since they were established and endorsed by every United Nations member state in 2000, the MDGs have become a report card for how the world is performing against major problems affecting the world’s poorest. The eight MDGs look at specific, measurable targets in health, hunger, education, gender equality, and environmental sustainability that all countries are working together to achieve by 2015. While there are wide variations, overall they have helped drive unprecedented rates of progress for the poorest.
For example, the dramatic reductions in global child mortality from the nearly 12 million deaths a year in 1990 to the fewer than 7 million in 2011, while still short of the global target of a two-thirds reduction, represent an astonishing success that highlights the best of what the MDGs have helped galvanize and that the world can and must build on.
This week, I was in in Botswana to participate in a global consultation with health ministers, senior UN officials, and experts from the private sector, NGOs, and academic and research institutions to reflect on how health should best fit in to the post-2015 development agenda. Our report from this meeting will go back to United Nations Secretary-General Ban Ki-moon and a High-level Panel he has appointed to provide him with recommendations ahead of a major UN meeting on the topic in September.
There’s a lively global debate about whether the next set of MDGs should also look at broader issues like the environment, improved governance and sustainable economic growth. Based on the Foundation’s experience in global health and development, and my own experience on the UN team that helped negotiate the original goals, we think the MDGs should focus on retaining and building on what has worked.
The next set of goals should ideally be:
- Focused on the poorest. Addressing extreme poverty and its manifestations is in large part what drove the focus of the original MDGs and should remain the global community’s top priority as it sets the post 2015 goals.
- Measurable and time-bound. Targets and deadlines add urgency, enable tracking of progress, and thereby foster accountability and action.
- Ambitious but achievable. Purely visionary goals are easier for governments to ignore. Because the MDGs were concrete and there was global consensus around them, governments felt accountable for achieving them.
- Limited in number to ensure focus and joint global prioritization.
- Simple and clear. The simplicity and clarity of the current goals has resonated with policymakers and the public alike, both making them an effective advocacy rallying cry and making it easier to track and push for governmental accountability for their achievement.
- Able to secure global cooperation. Global consensus-building is difficult. We should focus on those issues where global action is needed and where the universal political support enjoyed by the MDGs can be secured.
In health specifically, we believe MDGs 4,5, and 6, whose focus is on maternal and child mortality, reproductive health and the three infectious diseases that have the most impact on the lives of the poorest – HIV/AIDS, Tuberculosis and Malaria, need to be updated with new targets and deadlines, but remain at the heart of the post-2015 agenda.
Overall the Botswana discussions were wide-ranging and fascinating. There was consensus on the continued relevance of the current MDGs after 2015 and the need to address important areas that the first MDGs did not pay enough attention to, such as Non-communicable diseases (NCDs) and increasing access to good primary health care systems.
There were some more challenging discussions around whether these should all be subsumed beneath one broader goal like “universal health coverage” or “healthy life expectancy”.
In a statement I shared there, I set out in more detail how and why we at the Gates Foundation believe updating the existing goals represents the best overall approach.
Over the next several months, discussions will continue on in many forums on what these goals should look like post-2015. As they do you, you will hear from me and other foundation leaders on what we are doing with our partners both to really drive energy and action for the “Last 1000 Days” for the current goals and to ensure that tackling extreme poverty and the factors contributing to it stay front and center in the global debate.