More than 11 million children in developing countries die every year from preventable illness, while as many as 500 000 women don't survive during pregnancy or childbirth. More than 39 million people are living with HIV/AIDS and the epidemic is growing.
These and other urgent health problems will be tackled at this week's High-Level Forum (HLF) on the Health Millennium Development Goals (MDGs) in Abuja, Nigeria, 2-3 December 2004.
The HLF, hosted by the government of Nigeria and organized by the World Health Organization (WHO) and the World Bank, brings together many of the world’s leaders in health and development, ministers of health and finance, aid donors, senior representatives of the global development community and charitable foundations such as the Bill and Melinda Gates Foundation. As the second part of a series of high-level fora, they will address some of the world’s most challenging health problems in order to help accelerate progress towards achieving the health MDGs.
In September 2000, 189 world leaders made a commitment to achieve the Millennium Development Goals by 2015. Three of the eight goals relate directly to health: to reduce maternal mortality by three-quarters, child mortality by two-thirds, and combat HIV/AIDS, malaria and other diseases. Health is an essential component of three further targets: to halve the proportion of people who suffer from hunger, improve access to safe drinking water and sanitation and ensure affordable, safe access to essential drugs. The HLF comes in advance of 2005, the "report card year", when Heads of State will meet to review progress at the Millennium +5 Summit in September.
Statistics show that at current rates of progress, these goals will not be met in many parts of the world. However, Dr. LEE Jong-wook, Director-General of WHO said, progress is possible with commitment: “Technology and proven health interventions are often available and affordable." Dr. Lee points to countries with little money, such as Peru, Mozambique and Vietnam, where systematic efforts to improve health care are working: “We believe that there is much we can do now, to move from promises to better lives for millions of poor people.” The members of the HLF on the health MDGs will map out action in several key areas of international health and development. They include: increased funding from national governments and donors to attainment of the health goals, better coordination between donors to manage aid; urgent action to address a massive shortage of health workers, particularly in southern Africa and finally, greater attention to "fragile states" - countries affected by crisis.
“We need to look at measures such as committing increased resources to meeting the health-related MDGs, and working with countries to use those resources more effectively in countries,” said James D. Wolfensohn, President of the World Bank. “Strengthening human resources in the health sector and improving monitoring and evaluation, through the optic of a strong country and equity focus, will be particularly important.”
The scale of the challenge is significant: if trends observed during the 1990s continue, the majority of poor countries will not meet the health MDGs. No region of the developing world is currently on track to meet the child mortality target. For maternal mortality, evidence indicates that declines have been limited to countries with lower levels of mortality; countries with the high maternal mortality are experiencing stagnation or even reversals. However, data on coverage of health interventions are more encouraging: measles immunization is rising in many countries; the proportion of women who have a skilled medical person with them during delivery has increased rapidly in some regions, especially Asia, albeit from low levels; and use of insecticide-treated bed nets has risen. Finally, the world is on track to meet the drinking water target, but, at current rates, the global sanitation target will be missed by half a billion people - most of them in rural Africa and Asia.
Developing countries are ready to strengthen their health systems but the issue is complex in most countries. Many developing countries are also calling for coordination by donors. “When aid is unpredictable, we cannot blame planners in our countries for being overcautious,” says the host of the conference and Finance Minister of Nigeria, Ngozi Okonjo Iweala. “We simply cannot commit to hiring new doctors and nurses or to putting more people on treatment for AIDS if resources suddenly dry up. We understand donors need reassurance that their money is well spent. But governments also need freedom to set priorities.” The first HLF on the Health MDGs took place in January 2004 in Geneva. Representatives from twenty-two countries are expected to attend the Abuja Forum. Ministers from the following countries are expected to attend: Burkina Faso, Ethiopia, Iran, Liberia, Malawi, Mali, Mongolia, Mozambique, Nigeria, Pakistan, Peru, Timor-Leste, Uganda, and Zambia