By Tim Ledwith
NEW YORK, USA, 22 September 2010 – The UN Millennium Development Goals summit wrapped up with a strong emphasis on targeting the poorest and most vulnerable communities in order to meet the MDGs by their 2015 target date. In the final stretch of the busy three-day meeting, UNICEF participated in side events on three critical MDG target areas: maternal health, water and sanitation, and education.
Among other targets, this goal calls for reducing maternal mortality and achieving universal access to reproductive health.
Since 1990, maternal mortality has been reduced by more than a third worldwide, yet approximately 1,000 women still die each day from complications in pregnancy and childbirth – most of them in sub-Saharan Africa and South Asia.
While the vast majority of these deaths are preventable, MDG 5 is not on track for success, based on current trends. An orchestrated global effort will be needed to achieve it. The importance of taking an equity-based approach to maternal health was at centre stage in the panel discussion.
“For years, many have believed that it was simply too expensive to save women’s lives in the most disadvantaged places,” said UNICEF Executive Director Anthony Lake. Referring to the findings of UNICEF’s recent ‘Progress for Children’ report, he added: “By focusing our efforts on scaling up practical interventions that reach the poorest and most marginalized women, we can reach MDG 5 more quickly, more cost-effectively and more equitably.”
India’s Secretary of Health, Sujatha Rao, also stressed the need to reach marginalized women with maternal and reproductive health care. “Those who are most affected are also the poorest and the most disadvantaged, and that’s a large population in India. So equity is absolutely the most essential if we want to have a stable society,” she said.
“We must deliver results,” asserted Dr. Margaret Chan, Director-General of the World Health Organization (WHO). “We must reach the poorest of the poor and the hardest-to-reach child and woman.”
Maternal health interventions
To that end, UNFPA, UNICEF, WHO and the World Bank have joined forces in the ‘Health 4+’ alliance – later joined by UNAIDS – to aid countries with the highest rates of maternal and newborn mortality. The agencies and their partners are working to increase the proportion of births attended by skilled health personnel and to extend antenatal care coverage for mothers and newborns.
Providing care and treatment to women living with HIV is another part of the maternal health challenge, explained Dr. K.C.S. Malefho, Permanent Secretary of the Ministry of Health in Botswana, which has succeeded in reducing mother-to-child transmission of HIV to newborns.
“The Botswana Government had a very simple understanding that it would be pointless to save babies and let their mothers die,” said Dr. Malefho. “So our programme for the prevention of mother-child transmission was, from the beginning, linked to the safe motherhood programmes.”
Impact of water and sanitation
Beyond maternal health, another goal that is not making sufficient progress is MDG 7. This goal aims to halve the proportion of people lacking sustainable access to safe drinking water and basic sanitation. It was the subject of a high-level panel at a breakfast meeting held at UN headquarters this morning.
His Royal Highness Crown Prince Willem-Alexander of the Netherlands – who chairs the UN Secretary-General’s Advisory Board on Water and Sanitation – led the call to save millions of lives by scaling up water-and-sanitation initiatives. Other panellists noted that such programmes receive low funding priority compared to other sectors, even though they bolster progress on many of the MDGs.
Adequate sanitation facilities for girls and boys improve school attendance, for example, and safe-water projects reduce child mortality by preventing deadly waterborne diseases. The lack of safe water is most cruelly evident in Africa, where nearly half of child deaths due to diarrhoea occur.
Cause for concern
“Although optimistic about what we have achieved, I’m nevertheless concerned,” Liberian President Ellen Johnson Sirleaf said at the breakfast meeting. “Despite the critical role that sanitation, water and hygiene play in enhancing progress in all other areas in Africa, the sector is under-discussed, under-prioritized and, therefore, under-resourced.”
Added US Under Secretary of State Maria Otero: “Our progress is too slow…. We have the technology, we have the know-how. This is not rocket science.”
The Governments of Japan, the Republic of Korea, Liberia, Senegal, Tajikistan and the United States sponsored the water-and-sanitation event, which also featured supportive remarks by UN Secretary-General Ban Ki-moon.
Central role of education
UNICEF later co-hosted a high-level roundtable on the central role of education in meeting the MDGs. Participants discussed the importance of achieving education for all as a fundamental right – and as a means of stepping up progress across all of the development goals.
“We have to accelerate our efforts not only to do more of what we are doing right but also to do better in the design and delivery of education,” said Dr. Waheed Hassan, Vice President of the Maldives, in his opening remarks. “Education has to be seen as an investment and therefore worth financing through borrowing if necessary.”
The roundtable was presented in partnership with the Government of Qatar as well as Save the Children and UNESCO. The heads of each sponsoring organization underscored the importance of placing education, particularly for the most marginalized children, higher on the global agenda. New York Times columnist Nicholas Kristof moderated the discussion.
The distinguished participants stressed that consistent and predictable funding is key to achievement of universal access to primary education, the target established by MDG 2. In response, Australian Minister for Foreign Affairs Kevin Rudd said his government would contribute $5 billion in predictable international assistance for education programmes over the next five years.
“It reflects a common conclusion – that without MDG 2, we won’t get there. It’s critical,” said Mr. Rudd. His comment was a promising signal of support for the overarching theme of this week’s events: achieving the MDGs with equity.
Anja Baron, Nina Martinek and Chris Niles contributed to this story.