Sunday, 10 June 2012

MDG: Progress towards the health-related Millennium Development Goals: WHO

Key facts

  • Fewer children are dying. Annual global deaths of children under five years of age fell to 8.1 million in 2009 from 12.4 million in 1990.
  • Fewer children are underweight. The percentage of underweight children under five years old is estimated to have dropped from 25% in 1990 to 16% in 2010.
  • More women get skilled help during childbirth. The proportion of births attended by a skilled health worker has increased globally, however, in the WHO Africa and South-East Asia regions fewer than 50% of all births were attended.
  • Fewer people are contracting HIV. New HIV infections have declined by 17% globally from 2001–2009.
  • Tuberculosis treatment is more successful. Existing cases of TB are declining, along with deaths among HIV-negative TB cases.
  • More people have safe drinking-water, but not enough have toilets. The world is on track to achieve the MDG target on access to safe drinking-water but more needs to be done to achieve the sanitation target.

In September 2000, 189 heads of state adopted the UN Millennium Declaration and endorsed a framework for development. The plan was for countries and development partners to work together to reduce poverty and hunger, tackle ill-health, gender inequality, lack of education, lack of access to clean water and environmental degradation.
They established eight Millennium Development Goals (MDGs), with targets set for 2015, and identified a number of indicators to monitor progress, several of which relate directly to health. All the goals and their targets are measured in terms of progress since 1990. Reporting on progress towards the MDGs has underscored the importance of producing more reliable and timely data.

Progress report on the health-related MDGs

While some countries have made impressive gains in achieving health-related targets, others are falling behind. Often the countries making the least progress are those affected by high levels of HIV/AIDS, economic hardship or conflict.

Detailed updates on the progress

Please note that the following statistics are estimates.

Halve, between 1990 and 2015, the proportion of people who suffer from hunger (MDG 1, target 1.C)

Children's nutrition has improved. The percentage of underweight children is estimated to have declined from 25% in 1990 to 16% in 2010. But 104 million children are still undernourished. Stunting in children under five years old has decreased globally from 40% to 27% over the same period. However, in the UN Africa Region, the number of stunted children is estimated to have increased from 45 million in 1990 to 60 million in 2010.

Reduce child mortality (MDG 4)

Annual deaths of children under five years of age in 2009 fell to 8.1 million, down by 35% from 1990. The rate of decline has doubled to 2.7% per year since 2000, compared to the previous decade (1.3%). The deaths of nearly 3 million children under five each year worldwide can be attributed to diarrhoea and pneumonia. An estimated 40% of deaths in children under five occur in the first month of life, so improving newborn care is essential for further progress. The coverage of infants immunized against measles increased from 73% to 82% from 1990 to 2009.

Improve maternal health (MDG 5)

The number of women dying as a result of complications during pregnancy and childbirth has decreased by 34% – from 546 000 in 1990 to 358 000 in 2008. Although the progress is notable, the annual rate of decline of 2.3% is less than half of the 5.5% needed to achieve the target. Almost all maternal deaths (99%) in 2008 occurred in developing countries.
From 2000 to 2010 just over half of all pregnant women made the WHO-recommended minimum of four antenatal visits. While the global proportion of births attended by a skilled health worker has increased, in the WHO regions of Africa and South-East Asia fewer than half of all births had skilled assistance.
Globally, contraceptive use has been on the rise, annually increasing 0.2% since 2000. From 2000 to 2008 there were 48 births per 1000 adolescent girls aged 15–19 globally.

Combat HIV/AIDS, malaria, and other diseases (MDG 6)

From 2001 to 2009 new HIV infections worldwide declined by 17%. In 2009, 2.6 million people contracted the virus and there were 1.8 million HIV/AIDS-related deaths. In 2009, around 53% of the 1.4 million HIV-positive, pregnant women in low- and middle-income countries received antiretroviral therapy (ART) to prevent the transmission of HIV to their babies. More than 5 million people in low- and middle-income countries were receiving ART by the end of 2009 but that left more than 9 million untreated HIV-positive people in these countries.
Despite a rise in the number of new tuberculosis (TB) cases worldwide – due to an increase in population – more people are being successfully treated. TB mortality among HIV-negative people has dropped from 30 deaths per 100 000 people in 1990 to 20 deaths per 100 000 in 2009. However, HIV-associated TB and multidrug-resistant TB are harder to diagnose and cure.
Indications are that 42 countries are on course to meet the MDG target for reducing malaria; in 2009 an estimated 225 million cases of malaria caused 781 000 deaths, mostly of children under five. The supply of insecticide-treated nets increased but need outweighed availability almost everywhere. Access to antimalarial medicines (especially artemisinin-based combination therapy) increased but it was inadequate in all countries surveyed in 2007 and 2008.
Other diseases
An estimated 1 billion people suffer from neglected tropical diseases. This includes lymphatic filariasis which in 2009 was endemic in 81 countries. There were over 220 000 cases of cholera reported in 2009, an increase over the previous year. In 2009, 244 617 cases of leprosy were reported, down from 5.2 million in 1985. In 2009, only 3190 cases of dracunculiasis were reported while in the 1989 the estimated number of cases was almost 900 000.

Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation (MDG 7, target 7.C)

Globally, the percentage of the world’s population with access to safe drinking-water increased from 77% to 87%, which is sufficient to reach the MDG target if the rate of improvement is maintained. In low-income countries, however, the annual rate of increase needs to double in order to reach the target and a gap persists between urban and rural areas in many countries.
In 2008, 2.6 billion people had no access to a hygienic toilet or latrine and 1.1 billion were defecating in the open. The slowest improvement has been in the WHO African Region, where the percentage of the population using toilets or latrines increased from 30% in 1990 to 34% in 2008. Inadequate sewerage spreads infections such as schistosomiasis, trachoma, viral hepatitis and cholera.

In cooperation with pharmaceutical companies, provide access to affordable essential medicines in developing countries (MDG 8, target 8.E)

Although nearly all countries publish an essential medicines list, the availability of medicines at public-health facilities is often poor. Surveys conducted in over 40 low-income countries show that 44% of public sector and 65% of private sector outlets had the listed generic medicines in stock. Lack of medicines in the public sector forces patients to go without or purchase medicines from private sector outlets where generic medicines cost on average 610% more than their international reference price.
Source: WHO 

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