This month is always a boom time for eye-opening reports on the state of global poverty, as world leaders gather in New York for the annual United Nations General Assembly. Activists, researchers, development officials and everyone concerned with improving the state of the world’s poor all chime in to convince leaders to act. Yet it can be a daunting task to sort through both the sobering statistics and hopeful success stories.
We’re most concerned with the state of global health here at the Millennium Foundation and the 66th General Assembly has been flush with new data. In this post, we’ve tried to curate what we learned before, during and after this year’s “UN Week:”
In early September, before the masses arrived in New York, the Roll Back Malaria Partnership (RBM) released what was probably the best news the whole month: According to their research, global malaria deaths have dropped by an estimated fifth over the last decade. This means that over a million lives have been saved thanks to more funding, in the form of malaria drugs and mosquito bed-nets.
According to the report, 43 countries have cut malaria deaths by 38%, with 11 of them in Africa. A decade ago, malaria-bearing mosquitoes reaped a grim toll in sub-Saharan Africa, with children and pregnant mothers the most at risk. Now for the first time, it is possible to imagine zero malaria deaths in the near future. “The results of the past decade exceed what anyone could have predicted and prove that malaria control is working,” said Robert Newman, director of the World Health Organization’s (WHO) global malaria program.
September is the anniversary of the 2000 United Nations Millennium Summit, when leaders of 189 countries agreed to the eight Millennium Development Goals (MDGs). Today, these goals provide concrete guidelines for the global fight against poverty. A question on everyone’s mind last week: How are we doing?
According to the UN’s Millennium Development Goal (MDG) Gap Task Force Report, last year was a record year for development aid, with $129 billion provided by donor countries. Yet experts agree that without new funding, these targets will not be met by the deadline in 2015. “There is a troubling distance between what we have promised and what we are actually doing to support the global partnership for development,” said UN Secretary-General Ban Ki-moon at the report’s launch.
But the report made room for successes as well. UNITAID, the drug-purchasing facility that financed MASSIVEGOOD, was mentioned for its success in bringing down HIV drugs prices, a key challenge in meeting MDG 6: Fight HIV/AIDS, malaria and tuberculosis. According to the report:
In cooperation with the Clinton HIV/AIDS Initiative (CHAI), UNITAID has provided predictable funding for large-scale purchases of pediatric ARVs. [Child-friendly HIV treatments] The results have been most impressive: the average number of suppliers per pediatric product has doubled, the coverage of treatment of children in need increased from 10 per cent in 2005 to 38 per cent in 2008 and the price of quality AIDS medicines for children has dropped by 60 per cent since 2006.
But other goals remain distant, especially the MDGs of ending childhood and maternal mortality (see below). At the beginning of the month, the WHO said that only seven African countries were on track to meet the fourth MDG on reducing child mortality by 2015, according to Devex. Only two countries are on track to achieve the fifth MDG on maternal mortality.
Moreover, despite UNITAID’s successes in lowering drug prices, overall funding for the fight against HIV/AIDS actually dropped by 10%, according to a study this August by the Kaiser Family Foundation and the Joint United Nations Program on HIV/AIDS. They found that donor governments disbursed US$ 6.9 billion in 2010 for HIV prevention, treatment, care and support—US$ 740 million less than in 2009.
As clinical trials this summer showed that HIV treatments can also be used to prevent transmission of the disease, public health experts now worry that funding shortfalls could endanger these incredible breakthroughs.
While many activists focused on obtaining more monetary commitments to improve global health, others focused on the human face of the public health profession – the frontline workers that provide the care. No matter how much money is raised in high-level meetings in Manhattan, it is the local community worker in India or the district nurse in Uganda that saves lives. As Jonathan Glennie argued on the Guardian’s “Poverty Matters Blog,” 3.5 million more public and NGO health workers are needed worldwide.
All throughout UN Week, international charity Save the Children led a campaign to raise awareness about the need for health workers. Last week the charity held an event in Times Square, gathering supporters, activists and celebs like Alexis Bledel to hold up parts of a “human mosaic,” seen in the photo above. The event helped get the message out that there are children in the world who are dying due to a lack of health workers. According to Save the Children, one single health worker can reach 5,000 children per year with life saving treatment.
Save the Children also found a direct correlation between health workers and child mortality in one of the more interesting studies released in the run-up to UN Week. The charity’s Health Worker Index rates the best and worse countries for a child to fall sick in. 161 countries are rated based on availability of trained health workers. Chad and Somalia are at the bottom of the index, while Switzerland and Finland are at the top.
According to Sarah Boseley’s Global Health Blog on the Guardian:
It stands to reason. Children die of malnutrition, of diarrhea, of malaria, of pneumonia and many other diseases in the poorest countries in the world. They need treatment, but often it is not just the drug or the food supplement that is lacking – it is the nurse or the community health worker who can diagnose what is wrong and do something about it. In some places, children never see a health worker in their sometimes pitifully short lives.
Last September saw a landmark in global health, with the creation of Every Woman Every Child, a strategy to save 16 million women and children by 2015. It wasn’t a coincide that UN
Secretary-General Ban Ki-moon launched this in 2010, on the 10th anniversary of the MDG summit: As mentioned above, maternal health is one MDG that lacks significant commitment, with 350,000 women still dying each year from complications related to pregnancy and birth. As part of this strategy, $40 billion was pledged by governments, NGOs and companies.
This year, the World Health Organization issued its first review with a great bit of news – the strategy has attracted the support of numerous private sector partners. This includes a partnership with Johnson & Johnson to train health workers in Tanzania and Ethiopia – the first-ever corporate grant to a joint UN program. Read about this initiative and more here.
But behind these commitments lie the hard facts. The stats are difficult – after all, behind every number is a mother who died in what is supposed to be the most precious time in a parent’s life, the birth of a newborn. On September 19th, the Institute for Health Metrics and Evaluation (IHME) at the University of Washington released promising but still unacceptable stats:
- Under-5 child deaths declined from 11.6 million in 1990 to 7.2 million deaths in 2011
- Maternal mortality has also continued to decline, from 409,100 deaths in 1990 to 273,500 deaths in 2011