Did you hear about the latest success for the Millennium Development Goals (MDGs)? Don’t be ashamed to say no – most of the world missed it with you.
So what happened? You’ll remember that the MDGs are the promises made by world leaders to dramatically improve the plight of the poor by 2015. To track progress, they signed up to eight goals (the MDGs), with 18 targets and 48 measurable indicators.
So, we are celebrating progress towards indicator 30 of target 10 of MDG 7. Excited yet? Let me rephrase: the UN announced that 89% of the world’s population now has access to improved drinking water.
Now this actually should be exciting. Diarrhoea from unclean water kills more children every day and every year than HIV, tuberculosis and malaria combined. Only pneumonia kills more children under the age of five. We now have vaccines against the leading causes of childhood diarrhoea and pneumonia, and countries are working hard to put them to use.
The GAVI Alliance, to which Australia has committed $200 million over three years, has agreed to support the introduction of the rotavirus vaccine to protect 16 countries against diarrhoea and pneumococcal vaccines to fight pneumonia and meningitis in 37 countries.
But unclean water causes harm beyond childhood illnesses and death, so the nearly 800 million people who still lack access to safe water continue to suffer. Gathering water consumes huge amounts of time every day for women and girls. It exposes them to risks including exposure to disease (whether malaria or from water-borne infections) and often to violence as they walk alone for considerable distances to fetch water. And of course, while girls are fetching water, they are not at school or doing homework.
So the announcement that 2 billion people have better access to better water is really important.
Yet even the UN leaders were guarded in their remarks about the achievement. They recognised that 2.5 billion people had little or no sanitation and that one billion people still practice open defecation. So there’s still a long way to go and essentially no prospect that MDG 7, “Ensuring environmental sustainability”, will be met.
Nor will it be the only MDG that isn’t achieved.
But will we really know? Our assessment of progress for all of the MDG targets remains severely hampered by a lack of data. Donors have spent billions of dollars through their bilateral programs and through partnerships such as GAVI and the Global Fund to Fight AIDS, Tuberculosis and Malaria, but they have barely invested in systems to monitor their effect.
What are we learning?
Last week, Melbourne was fortunate to host Dr Seth Berkley, the CEO of GAVI Alliance, the organisation responsible for financing vaccines for the poorest countries. He pointed out that the household data that GAVI uses – essentially the same sources used to track MDG 7 – can be very problematic. For example, in some conflict-ridden countries national surveillance is so weak that you can’t tell if 86% of children are immunised as claimed by the World Health Organisation (WHO) and UNICEF or if the true figure is closer to the 36% estimated by other experts. These numbers matter because they translate into lives saved or lost.
These numbers also matter because they point to another key issue: these are not problems that can be solved by any single agency or ministry alone.
Ministries of health and the WHO can’t solve even the health-focused MDGs on their own. Today’s globalised world faces issues that are vastly more complex than in the post-World War II era when the UN was founded. Governments don’t have all the answers, just as they don’t have all of the expertise or resources required.
A new era requires new ways of working
We are entering an era that demands better collaboration – across government ministries and between government and non-government actors.
The UN recently has made some attempts to adapt, but it is fundamentally hamstrung because its governance is comprised entirely of states. Understandably, governments don’t want to cede any control, especially by inviting in non-state actors, such as NGOs. So there is often more rhetoric about partnership than comfort enabling engagement and action.
This needs to be overcome in the next few years. Those interested in global development have started to discuss the “post-MDG era”. They are asking if it’s better to undertake a new set of targets (and what should they include) or whether we now too disillusioned to try. Or, is the world too broken?
Targets are important. They fundamentally underpin accountability. Even if civil society is kept somewhat on the outer during intergovernmental negotiations, targets are an important tool for advocacy and fundraising. But it would be much better for the UN to open up and engage with others in the planning as well as the implementation of future commitments.
Multi-stakeholder partnership was a minor focus of MDG 8, which mostly calls for more collaboration between governments and the UN. For greater progress to improve the lives of the poorest, future targets need to be explicit about bringing together diverse actors and assigning roles and responsibilities. We need to be clear when we celebrate successes - and when we demand accountability for inaction and failure.