4.04 Health-related Millennium Development Goals

Secretariat annotation on EB Agenda

WHO’s role in the follow-up to the high-level plenary meeting of the sixty-fifth session of the United Nations General Assembly on the review of the Millennium Development Goals (September 2010). [Outcomes Document]

 The report includes information on the progress made in the implementation of resolutions WHA63.15 and WHA63.24, the latter of which expanded the coverage of the annual report on the monitoring of the achievement of the health-related Millennium Development Goals to include an account of progress towards achievement of Millennium Development Goal 4 to reduce child mortality: prevention and treatment of pneumonia. At the request of a Member State, the report also presents an overview of WHO’s engagement in the high-level plenary meeting on the review of the Millennium Development Goals and the follow-up activities, describing the key health outcomes, implications for WHO and for countries, and required actions to achieve the Goals in the next five years.

• Document EB 128/7
• WHA63.24 (page 51): Accelerated progress towards achievement of Millennium Development Goal 4 to reduce child mortality: prevention and treatment of  pneumonia 

Background Documentation

1. The Health MDGs and the 2010 MDGs Review Summit
(report by Arab NGO Network for Development)

2. Prof.Samir Amin writes on the concept of MDGs

In September 2000, at the United Nations Millennium Summit, the 191 member countries in the United Nations agreed to a set of eight Millennium Development Goals for the world’s poor nations. These goals, targeted for fulfillment by 2015, have since become the fulcrum for public policy discussions and actions concerning economic and social development.

Meetings and conferences on the goals under the auspices of the United Nations and the governing bodies of member countries have been held regularly since 2001. The aim of these meetings and conferences has been to reiterate the goals and to reaffirm the commitment of countries to them, as well as to assess the extent to which progress has been made toward their fulfillment.

Most of the Millennium Development Goals may seem at first sight unobjectionable. Nevertheless, they were not the result of an initiative from the South itself, but were pushed primarily by the triad (the United States, Europe, and Japan), and were co-sponsored by the World Bank, the International Monetary Fund, and the Organization for Economic Cooperation and Development.

All of this has raised the question of whether they are mainly ideological cover (or worse) for neoliberal initiatives. Samir Amin’s systematic and revealing critique of the Millennium Development Goals is therefore of the utmost significance. (Read the full critique)

PHM Comment in Letter to EB members

In Document EB128/7 the Secretariat reports on progress towards achievement of health related Millennium Development Goals and particularly Goal 4 (to reduce child mortality - through the prevention and treatment of pneumonia).

This report is focused largely on the technical interventions which will form part of any health development program but is very thin with respect to the political and economic context in which these interventions might be mounted. Despite the mention of the Commission on Social Determinants of Health there is little in this report which reflects the focus on equity and adressing upstream determinants which were elaborated by the CSDH. There is no reference to the constant pressure to liberalise trade which in many settings has exacerbated hunger and malnutrition.

The Secretariat is to be commended for its emphasis on the need for health system strengthening but we suggest that it could articulate more clearly the links between privatization policies forced on many L&MICs and the collapse of health systems;

These are issues which are not widely understood. The WHO’s leadership role demands that it takes the lead in researching, analyzing and developing appropriate policies to address these issues.

Watch Report of EB Discussion

This agenda item took a long time to discuss with many delegations and three NGOs making interventions and the consideration of a draft resolution (EB128.R1). The delegates asked for more emphasis on many different aspects of the MDGs including rational use of medicines, generic drugs, strengthening regional offices, accountability and reporting requirements. Unfortunately there was very little consensus created for more focus on any aspect other than woman's and children's health, which was the focus of the report anyway.

Many interventions were predominantly proclamations about the success of initiatives launched and proceeding within countries. Funding was a concern of many nations, Mauritius proposed booster packages for African countries and China requested an investigation into the MDG funding deficit.

Hungary, on behalf of the EU, advocated for developing nations to be enabled to take greater responsibility for their own development to reduce aid dependency and encourage Primary Health Care. Samoa made some important comments concerning aid; firstly that the World Bank conditionalities make aid harmonization more difficult, secondly that health professionals are struggling with current procedures of procurement and finally warning that other partners are taking over the WHO's role in many places.

International Baby Food Action Alliance delivered an intervention to argue that breast feeding rates and duration demonstrably affect all of the MDGs and therefore should be used as an MDG indicator. Next the International Council of Nurses called for improved human health resource remuneration and retention strategies. Finally the International Alliance of Patients' Organizations praised the focus that has recently been given to non-communicable diseases and calls for it to continue.

The resolution (EB128.R1) is an expression of disappointment with progress in women's and children's health [MDGs 4 & 5]. It stresses the need for greater monitoring of resource flows and results, and the need to address issues of health equity and rights. It finishes by requesting that the Director General ensures effective engagement of all stakeholders and reports at the 64th WHA on the progress of the commission on information and accountability for women's and children's health.

Timor L'este suggested some minor amendments to the draft resolution and subsequently USA asked for the evening to examine them. The next day the EB accepted the amended resolution without any objections. During the proceedings we were pleased to notice that concept of health system strengthening was ubiquitous among the interventions.