Millennium Development Goals (MDGs) relate to Health

[Guest guest]

Key Millennium Development Goals (MDGs) relate to health

The Straits Times (Singapore)01/08/2002

AT THE United Nations Millennium Summit in September 2000, 180 world

leaders pledged to achieve significant advances in the well-being of

the world's poor by 2015.

Several of the key Millennium Development Goals (MDGs) relate to

health - in particular, controlling epidemic diseases and reducing

the death rates of mothers during childbirth and young children.

To further the summit's goals, I was asked to head a commission on

macroeconomics and health aimed at charting a path for the world to

achieve those MDGs in health and poverty reduction.

The commission released its findings on Dec 20 after grappling with

the challenge of burgeoning epidemic diseases ravaging the poorest

countries of the world, especially in sub-Saharan Africa. The core

findings are easily summarised:

First, the disease burden in the poorest countries constitutes a

fundamental barrier to their economic advancement.

Second, millions of impoverished people die tragic deaths each year

from infectious diseases that are preventable and treatable simply

because they lack access to the needed health services.

Third, using existing technologies, it would be possible to save

eight million lives per year by the end of the decade, but only if

rich countries help poor countries to obtain these technologies.

Specifically, the commission calls for rich countries to put aside

one-tenth of 1 per cent of their gross national product - or just one

penny out of every US$10 (S$18.48) of income - on behalf of health

services for the world's poor.

As the combined income of rich countries is around US$25 trillion a

year, this would mobilise US$25 billion a year, which, when combined

with the poor countries' own increased contributions, would

dramatically improve the health conditions of the world's low-income

countries.

This modest contribution would save 21,000 lives daily in the poor

countries. The contributions to health would also translate into huge

economic strides.

Improved health conditions would help the poor countries to escape

from the poverty trap: Poor health has led to poverty and economic

stagnation, which, in turn, has led to poor health.

If the programme is adopted, countries with high fertility rates and

rapid population growth will see lower fertility rates and slower

population growth as households gain confidence that their children

will survive to adulthood.

Population pressures will ease, as will the strain on fragile

tropical ecosystems. Foreign investors will be able to invest in an

African labour force no longer shattered by disease.

The economic benefits would be more than US$360 billion a year from

2015 to 2020. The substantial benefits of donor aid for health have

already been demonstrated.

Smallpox was eradicated even in the most remote impoverished

countries; polio is well on its way to eradication. Immunisation

campaigns, when properly funded, have reached huge proportions of

very poor children.

Recent efforts against African River Blindness, leprosy and trachoma,

backed by industrial leaders, such as Merck, Novartis, and Pfizer,

have also performed wonders.

The main problem is that the scale of worthy efforts has been a

shadow of what is needed.

The commission notes that R & D investments directed at the diseases of

the poor are likely to have enormous social returns, not only because

of recent breakthroughs in science but also because so little is

invested in these areas currently.

Malaria accounts for roughly 3 per cent of the world's disease burden

but attracts just one-sixth of 1 per cent of global R & D outlays in

biomedical research.

The commission advocates a series of measures to boost R & D on

diseases of the poor, including donor R & D outlays of roughly US$3

billion a year, or 5 per cent of the global total.

The new Global Fund to Fight Aids, Tuberculosis and Malaria, which

was initiated by UN Secretary-General Kofi n and will begin

operation this year, can be a critical mechanism here.

Programmes will be conceived at the country level and will be

submitted to the new fund for financial backing. The commission calls

on each potential recipient country to establish national-level

commissions to set long-term health priorities and strategies worthy

of donor backing.

The paradox of the global economy is that rich countries are now so

rich and poor countries so poor that even small contributions from

the rich can perform wonders.

A penny on US$10 would make historic breakthroughs in health; another

penny on US$10 could address the critical needs in education as well.

The idea of controlling epidemic diseases and cutting absolute

poverty sharply by 2015 is not naive idealism, but hard-headed

thinking amply supported by the best evidence.

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The writer is Galen L. Stone Professor of Economics and director of

the Center for International Development, Harvard University.

Copyright: Project Syndicate.

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