|How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Assessing the status of United Nations Millennium Development Goals. Ann Trop Med Public Health 2016;9:87-9
|How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Assessing the status of United Nations Millennium Development Goals. Ann Trop Med Public Health [serial online] 2016 [cited 2016 Mar 28];9:87-9. Available from: https://www.atmph.org/text.asp?2016/9/2/87/177373
The millennium development goals (MDGs) are the eight international development goals set by the United Nations (UN) in the year 2000, which are to be achieved by 2015 by the member states of the UN.  The signatory member states are committed to address the global public health concerns of poverty, hunger, illiteracy, gender inequality, child mortality, maternal health, disease, and environmental degradation by fostering global partnership between different stakeholders to ensure global development.  Each of the MDGs has a target set to be achieved by the end of 2015, and thus indicators have been suggested to monitor the progress of each goal by comparing them with the estimates in 1990. 
The year 2015 is the final year for the nations to achieve the proposed targets, and the current analysis by the World Health Organization (WHO) has revealed mixed results for the health-related MDGs.  Although some of the nations have shown remarkable progress and are set to achieve most of the MDGs, the stakeholders are more worried about those nations that are significantly behind, probably because of the factors such as high prevalence of infectious diseases, existing conflicts in the region, and poor standard of living of the residents.  From the global public health perspective, the MDGs have motivated policymakers to work in coordination with other stakeholders in a concerted and effective manner to address the identified concerns. The current global status of the MDG is as follows:
- Eradicate extreme poverty and hunger (MDG 1): The recent estimates suggest that though the rate of progress is close to the rate required to meet the MDG target, nevertheless the progress is not uniform and variable in different regions. As undernutrition remains the predominant etiological reason for the deaths of close to 45% of under-five children worldwide, the proportion of underweight children has been significantly reduced from 28% in the year 1990 to 17% in 2013 in developing nations alone. , In fact, this improvement has been attributed to the increase in expenditure on health, and the adoption of local initiatives such as microcrediting. ,
- Reduce child mortality (MDG 4): Worldwide, a remarkable improvement has been observed in reducing the under-five mortality rate (49% reduction compared to 1990 estimates), as in the year 2013 around 6.3 million under-five deaths were reported in contrast to the 12.7 million deaths reported in the year 1990. ,, However, still the world will not be able to achieve the target of reducing the child mortality by two-thirds by the end of this year. This is because of the inability of the health sector to reduce the number of deaths resulting because of preterm complications, asphyxia, diarrhea, acute respiratory infections, and measles, most of which is preventable provided timely medical attention is given to those who are in need. 
- Improve maternal health (MDG 5): The proposed target was to reduce by 75% the maternal mortality ratio and to ensure universal access to reproductive health by 2015.  Even though, the number of maternal deaths has reduced from 0.52 million in 1990 to 0.28 million in 2013, the rate of decline is not satisfactory.  This is probably attributed to the failure of the policymakers to ensure quality assured reproductive health-care services.  Conclusive evidence is available to suggest that even now the unmet need for family planning was quite high, the reach and utilization of antenatal care services was poor, and skilled personnel were unavailable at the time of delivery (African region). ,,,
- Combat HIV/AIDS, malaria, and other diseases (MDG 6).
- HIV/AIDS: The set target was to halt by 2015 and then reverse the spread of HIV/AIDS, and to achieve universal access to antiretroviral therapy (ART). The recent estimates suggest that the world has begun to reverse the spread as 2.1 million cases were reported in 2013 in contrast to 3.4 million in the year 2001 (viz. decline of 38%). However, the most important challenge to the program managers is to ensure the availability of ART, as more than 64% of the HIV infected people from the middle- and low-income nations have no access to ART. ,,
- Malaria, tuberculosis, other diseases: The UN has advocated that the world should halt by 2015 and begun to reverse the incidence of malaria and other major diseases. In response to the interventions, such as distribution of insecticide-treated nets and indoor residual spraying, the incidence and mortality of malaria have reduced by 30% and 47%, respectively, in the 2000-2013 period, and hence the proposed global target for malaria has been achieved. Similarly, the world has even achieved the target of tuberculosis (TB), but the emergence of multidrug resistant TB has seriously questioned the diagnostic and therapeutic services of TB. Encouraging results have also been obtained for dracunculiasis, leprosy, filariasis, and visceral leishmaniasis. ,
- Ensure environmental sustainability (MDG 7): The target pertaining to the access to safe water was met worldwide as in the year 2012, almost 90% of the general population had an access, which was only 76% in the year 1990.  However, the target of basic sanitation has not yet been achieved because in 2012 close to 1 billion people were still practicing open air defecation, which is a major hurdle for the local program managers. , In fact, the observed improvement in the accessibility to safe water is also not uniform, and variable pattern is being observed based on the region (worst in African and Eastern Mediterranean regions) or urban/rural areas. ,
- Developing a global partnership for development (MDG 8): The predominant health-related target was to enhance the accessibility of the people to affordable essential medicines in the developing nations.  This target has not been met and most of the nation has limited access to the basic medicines. , In fact, recognizing the magnitude of the problem the WHO has pledged to improve the access to basic drugs worldwide to avoid the adverse consequences of uninterrupted supply of drugs. 
Now, the question arises, what next? The plan is to propose newer 17 goals set to be achieved by the year 2030, and will be officially released in the next UN meeting. , Till then, the WHO is assisting nations to formulate and implement guidelines, performing comprehensive strength-weakness-opportunity-threat (SWOT) analysis and devising mechanisms to evaluate the outcome of the interventions, so that eventually the health indicators can be improved. ,
To conclude, if the current trends prevail, the world will achieve the global targets for halting and reversing the trends of HIV, malaria, and TB, and increasing accessibility to safe water. In fact, significant improvement has also been observed in bringing about a reduction in child undernutrition, maternal and child deaths, and accessibility to sanitation services. However, multiple gaps have been identified, which have not allowed the policymakers to accomplish the proposed MDGs. Thus, there is an indispensable need to put in sustainable efforts so that health indicators and quality of life of vulnerable section of people can be improved in the years to come.
Park K. Health care of the community. In: Park K, editor. Textbook of Preventive and Social Medicine. 21 st ed. Jabalpur: Banarsidas Bhanot; 2011. p. 831-4.
World Health Organization. Millennium Development Goals (MDGs) – Fact sheet N°290; 2015. Available from: . [Last accessed on 2015 Jun 22].
World Health Organization. World Health Statistics reports on global health goals for 194 countries; 2015. Available from: . [Last accessed on 2015 Jun 19].
Pérez W, Blandón EZ, Persson LÅ, Peña R, Källestål C. Progress towards Millennium Development Goal 1 in northern rural Nicaragua: Findings from a health and demographic surveillance site. Int J Equity Health 2012;11:43.
Palma MA, Ortiz R, Alvarez-Dardet C, Ruiz MT. Policy determinants affecting the hunger millennium development goal. Soc Sci Med 2009;68:1788-92.
MacLeod S, Rane A. Seeking improved global child health: Progress toward millennium development Goal 4. Paediatr Drugs 2014;16:101-3.
Schröders J, Wall S, Kusnanto H, Ng N. Millennium development goal four and child health inequities in Indonesia: A systematic review of the literature. PLoS One 2015;10:e0123629.
World Health Organization. World Health Statistics 2015. Geneva: WHO Press; 2015. p. 1-22.
Vogel JP, Pileggi-Castro C, Chandra-Mouli V, Pileggi VN, Souza JP, Chou D, et al. Millennium Development Goal 5 and adolescents: Looking back, moving forward. Arch Dis Child 2015;100(Suppl 1):S43-7.
Campbell DD, Moran B. Sustaining the vision for Millennium Development Goal 6, to halt and reverse the spread of HIV/AIDS and other infections. J Obstet Gynecol Neonatal Nurs 2010;39:600-5.
World Health Organization. HIV/AIDS – Fact sheet N°360; 2014. Available from: http://who.int/mediacentre/factsheets/fs360/en/. [Last accessed on 2015 Jun 19].
Brown TM. Yogi Berra, Ezekiel J. Emanuel, and millennium development goal 7. Am J Public Health 2012;102:203.
World Health Organization. WHO moves to improve access to lifesaving medicines for hepatitis C, drug-resistant TB and cancers; 2015. Available from: http://who.int/mediacentre/news/releases/2015/new-essential-medicines-list/en/. [Last accessed on 2015 Jun 22].
Source of Support: None, Conflict of Interest: None