There are only five years left to deliver the targets set by the Millennium Development Goals for poverty, education, gender, health and the environment. The MDGs have had success so far: generating global consensus, supporting advocacy, mobilizing resources and improving the monitoring of development investment. But it is likely that most goals will miss their targets, and some are in serious trouble. Much attention will now be focused on accelerating progress towards 2015, but some should be focused on the question of how the MDG process itself could be improved, after 2015.
Our inter-college consortium, the London International Development Centre, has just produced a contribution to this second challenge. We brought together experts on seven very different MDGs, to consider how each has performed in delivering its targets, and then to work together to identify general problems across the MDGs and what this tells us about improving development goal setting in the future.
This cross-cutting analysis of the MDGs revealed three areas of common problems. First, the MDGs have been conceived and executed around a set of largely pre-exisiting and very narrowly defined targets, which were then retro-fitted into goals. The result is an agenda with large gaps where important areas for development investment are missed, and where goals are too far apart to realize synergies. For instance, a focus of MDG2 on primary education has under-emphasized secondary and tertiary education, which supports poverty reduction (MDG 1), family planning (MDG 5) and the training of professionals in low- and middle-income countries, like teachers and nurses, who are essential to meeting many MDG targets.
Second, a lack of ownership of the MDGs at the national and the international level has been a major factor limiting progress – competition between MDG 'owners' at an international level, e.g. for child and maternal health, has also been unhelpful. Third, and perhaps most importantly, because most goals and targets are focused on crossing specific thresholds (a level of income, a targeted proportion of a population benefiting from maternal care, clean water, primary education) the MDGs create a problem of equity. There has been a tendency to focus effort on 'near-threshold populations', but pulling them over the threshold leaves many behind and increases inequity.
Those who lose out are not just poorer, but often particular ethnic communities, women or remote populations, making inequity even more challenging. In the future, we need development goals that address these problems, and we argue that whatever they are, we need to ensure that they are developed from a consideration of all the factors that affect human well-being and how they interact, to avoid gaps. This needs to be done through a process that ensures national ownership.
While keeping the focus on poverty reduction, future goals need to be seen more clearly as global obligations for all countries, and they need to avoid problems of inequity in their delivery by taking a pro-poor approach. Finally, they need to be sustainable investments. One of the most promising MDG efforts has been on reversing the spread of HIV/AIDS, TB and malaria (MDG6). But this progress is now highly dependent on sustaining aid programmes and the provision of free medicines – is this sustainable? We have five more years of the MDGs, but future goal planning should begin now.
- YouTube video featuring Lancet-LIDC Commission, including clips of Andy Haines, LSHTM; Jeff Waage, LIDC; Andrew Dorward, SOAS; Geeta Kingdon, IoE; and Elaine Unterhalter, IoE.
- Podcast interview with leading health economists Anne Mills, LSHTM; and Viroj Tangcharoensathien, International Health Policy Program, Thailand - From LIDC's Development Matters Podcast Series