How much would poor people gain from faster progress towards the Millennium Development Goals for health?
Davidson R Gwatkin
Lancet 2005; 365: 813–17
The health objectives set out in the United Nations Millennium Development Goals (MDGs) do not share the focus on poor people that typiﬁes the MDGs overall. Rather, they call for improvements in national averages that can be achieved through gains in both advantaged and disadvantaged groups. As a result, any reduction in society-wide average rates of death or illness can provide a wide range of outcomes for poor people. Since expanded health services typically reach better-off groups before disadvantaged ones, poor people are unlikely to be the principal beneﬁciaries of efforts to accelerate progress towards the MDGs by providing additional resources to the health sector, as presently constituted. More plausible is faster progress among privileged groups and a rise in poor-rich health disparities. Such an outcome is not inevitable; but achieving faster progress for poor populations will need reorientation in addition to expansion of health activities.
MDGs for health
The MDGs, which were contained in a declaration adopted unanimously in September, 2000, by member countries of the United Nations,1 drew together and enlarged a set of development objectives that were agreed during a series of global conferences over the preceding decade. As subsequently published, they consist of eight speciﬁc aims,2 which are all expressed in general terms and accompanied by between one and six speciﬁc targets and by several indicators for measurement of progress towards the targets. The overall tone of the MDGs is set by the ﬁrst and most prominent of the eight goals—to “eradicate extreme poverty and hunger”. The two targets accompanying this aim call for halving, by 2015, of the proportion of people with daily incomes of less than US$1 and suffering from hunger in 1990. Other MDGs deal with education, gender,... [continues]
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