On Sept. 20-22, 2010,  world leaders met at the United Nations (UN) in New York City to discuss the progress made and near-term strategy for achieving the Millennium Development Goals (MDGs), a set of eight major antipoverty and global health goals.  The MDGs were adopted in 2000 by 189 UN member states and provide a framework for focus and accountability by setting international development objectives, including objectives in global public health. With five years remaining for the timetable to meet the MDGs, the UN held a high-level plenary meeting of world leaders to review the progress, assess obstacles and gaps, and discuss strategies and actions to help meet the MDGs by the target date of 2015.

MDGs
The MDGs consist of eight major objectives that require the participation of developed and developing nations. They entail time-bound targets for addressing extreme poverty, hunger and disease, gender equality, education, education, and environmental sustainability. They also express basic human rights: the rights of everyone to good health, education, and shelter. The eighth goal, to build a global partnership for development, includes commitments in development assistance, debt relief, trade, and access to technologies. The MDGs are: eradicate extreme poverty and hunger;achieve universal primary education; promote gender equality and empower women; reduce child mortality; improve maternal health; combat HIV/AIDS, malaria, and other diseases; ensure environmental sustainability; and develop a global partnership for development.The UN established 60 official indicators to assess the progress on achieving the goals.

Following the conclusion of the MDG summit in late September, world leaders attending the summit adopted a global action plan to achieve the eight MDGs by the target date of 2015 and also announced specific initiatives in women’s and children’s health and other initiatives against poverty, hunger, and disease. Highlights are the strategic plan are outlined below  as specified by a Sept. 22, 2010 UN press release.

Goal 1: eradicate extreme poverty and hunger
• The World Bank will increase its support to agriculture to between $6 billion and $8 billion a year during  the next three years, up from $4.1 billion annually before 2008, under its Agriculture Action Plan to help boost incomes, employment, and food security in many low-income areas
• The Republic of Korea pledged $100 million to support food security and agriculture in developing countries
• Chile announced an Ethical Family Income initiative, to be launched in 2011, to supplement the income of the poorest families and those in the vulnerable middle class.
• Monster.com committed to expand access to job opportunities for rural youth in India by promoting access toRozgarduniya.com, an Internet job portal, in 40,000 villages across nine states in India.

Goal 2: Achieve universal primary education
• Japan will provide $3.5 billion during five years for education in developing countries, beginning in 2011
• The World Bank will increase its zero-interest and grant investment in basic education by an additional $750 million, with a focus on the countries that are not on track to reach the educational MDGs by 2015, especially in sub-Saharan Africa
• Trinidad and Tobago committed to provide laptop computers to all secondary students within five years
• Dell committed to give $10 million toward education-technology initiatives this year.

Goal 3: Promote gender equality and empower Women
• The Earth Institute, Ericsson, and Millennium Promise launched Connect To Learn, a nonprofit global education initiative to improve the access to and quality of secondary education for children around the world — especially girls. Connect To Learn provides three-year scholarships to attend secondary school and covers tuition, books, uniforms as well as access to broadband technology. The first 100 scholarships will be provided in Millennium Villages in Ghana and Tanzania within the next 100 days as of Sept. 22, 2010
• UPS International pledged $2 million to the World Association of Girl Guides and Girl Scouts to empower women through leadership and environmental- sustainability programs in 145 countries
• ExxonMobil committed $1 million in a partnership with Ashoka’s Changemakers, the International Council for Research on Women and Thunderbird Emerging Markets Laboratory to support technologies that help women increase their productivity and participate more effectively in the economy. The program is expected to directly benefit more than 13,500 people, with indirect benefits reaching more than 475,000 in the next two years.

Goal 4: Reduce child mortality and Goal 5: improve maternal health
•  A commitment of $40 billion in resources was pledged for the Secretary-General’s Global Strategy for Women’s and Children’s Health
• Canada reaffirmed its commitment to mobilize more than $10 billion from G8 and non-G8 leaders, key donors and private foundations during the next five years through the Muskoka Initiative for maternal, newborn and child health
• LifeSpring Hospitals committed to provide an estimated 82,000 Indian women and their families with access to quality healthcare. Over the next five years, LifeSpring will increase the number of hospitals serving mothers and children throughout India from 9 to 200, which will improve standards of care and reduce maternal and childhood deaths.

Goal 6: Combat HIV/AIDS, Malaria and Other Diseases
• France announced funding of $1.4 billion to the Global Fund to Fight AIDS, Tuberculosis and Malaria for 2011-2013 an increase of 20%, and additional funding was pledged by other sources in early October
• Japan announced a contribution of $800 million in the coming years to the Global Fund to Fight AIDS, TB and Malaria
• The United Kingdom announced a tripling in its financial contributions to fight malaria, increasing its funds for malaria from £150 million ($239 million) a year to £500 million ($797 million) by 2014
• China will, within the next three years will donate $14 million to the Global Fund to Fight AIDS, TB and Malaria
• The World Bank announced an increase in the scope of its results-based health programs by more than $600 million until 2015 to scale up essential health and nutrition services and strengthen the underlying health systems in 35 countries, particularly in East Asia, South Asia and sub-Saharan Africa
• Sumitomo Chemical committed to donate 400,000 of its antimalarial Olyset Nets to every Millennium Village from 2010-2011 following a previous donation in 2006 of 330,000 nets.

Goal 7: Ensure environmental sustainability
• The United States announced a commitment of $51 million during the next five years for a Global Alliance for Clean Cookstoves, a public-private partnership led by the United Nations Foundation, that seeks to install 100 million clean-burning stoves in kitchens around the world
• Cameroon’s Energy Sector Development Program will double energy production by 2015 and triple it by 2020
• The Asian Development Bank plans to double its financing for clean energy to $2 billion a year by 2013
• WaterHealth International committed to build 75 water-purification plants in Bangladesh and expand its existing network of water-purification plants to an additional 100 villages in India, providing access to clean water for 175,000 people in underserved communities in Bangladesh and India.
• PepsiCo committed to ensure access to clean water for 3 million people around the world by 2015

Goal 8: Global Partnership for Development
• The European Union offered funding amounting to €1 billion ($1.4 billion) to the most committed and needy countries to make progress on the goals they are furthest from achieving
• Belgium pledged €400,000 ($558,000) for the UN Conference on Least Developed Countries, to take place in Turkey in 2011
• China committed to give zero-tariff treatment to more products from least-developed countries and to continue to cancel debts.

US perspective. President Barack Obama spoke at the MDG summit in New York last month, which outlined the US commitment to participate in achieving the MDGs and the importance of international development goals in global and national policy. “.Let’s put to rest the old myth that development is mere charity that does not serve our interest,” he said, according to a Sept. 22, 2010 White House press statement. “And let’s reject the cynicism that says certain countries are condemned to perpetual poverty, for the past half century has witnessed more gains in human development than anytime in history…My national security strategy recognizes development not only as a moral imperative but [as] a strategic and economic imperative.”

At the MDG summit, Obama announced the new US Global Development Policy, which he said is was the first such comprehensive policy by an American administration. “It’s rooted in the America’s enduring commitment to the dignity and potential of every human being. And it outlines our new approach and the new thinking that will guide our overall development efforts, including the plan that I promised last year and that my administration has delivered to pursue the Millennium Development Goals. Put simply, the United States is changing the way we do business.”

This approach entails changing the way it defines development, to not only include the amount of money provided in international aid, but also using other tools such as diplomacy, trade, and investment policies, to help developing countries move from poverty to prosperity. This new approach also involves changing the view of the goal of development as a focus for long-term development and reducing the dependence of developing countries on aid. “Instead of just managing poverty, we have to offer nations and peoples a path out of poverty,” said Obama in the White House statement. He emphasized the use of the criteria specified by the US Agency for International Development for measuring the success of the MDGs such as the use of new and sustainable technologies, mutual accountability, and improved tracking of development outcomes.

Global health
Women’s and children’s health. As previously mentioned, at the UN MDG summit, several new initiatives in global health were announced. One such initiative is the Global Strategy for Women’s and Children’s Health. The strategy identifies the financing, policy changes, and interventions needed to meet key goals in improving the health and safety of women and children. The strategy aims to prevent, between 2011 and 2015, the deaths of more than 15 million children under the age of five, as well as 33 million unwanted pregnancies and the deaths of 740,000 women from complications related to pregnancy and childbirth.

“The 21st century must and will be different for every woman and child,” said UN Secretary-General Ban Ki-moon, in a Sept. 22, 2010 press release. The global strategy involves a $40-billion commitment by the private sector, foundations, international organizations, civil society groups, and research groups. Several agencies, including the UN Children’s Fund (UNICEF), the UN Population Found (UNFPA), the Joint UN Program on HIV/AIDS (UNAIDS), the World Health Organization (WHO), and the World Bank are collaborating to mobilize ongoing political and operational support, including fighting for universal access to care for all women and children. In addition, the Bill and Melinda Gates Foundation, the Global Alliance for Vaccines and Immunizations (GAVI), and the Global Fund to Fight HIV/AIDs, Tuberculosis and Malaria are working with this team to ensure integrated services and efforts across a range of health needs.

“This team will identify and connect resources to the people who need them based on the priorities set by countries in their national health plans,” according to the UN press release. “The Global Strategy asks us to be smart, strategic, and resourceful as never before,” said WHO Director-General Margaret Chan, in the UN press release. “By integrating their actions, the eight international-related health agencies will strengthen capacities across the board, in ways that meet the comprehensive needs of women and children.”

HIV/AIDs. Following the MDG summit, the UN released a report showing progress in improving access to HIV/AIDs services in 37 developing countries. The report, Towards Universal Access, was produced by WHO, UNICEF, and UNAIDS, and assesses progress in 144 low- and middle-income countries. The report’s findings showed that 5.25 million people had access to HIV treatment in low- and middle-income countries last year, accounting for 36% of those in need, an increase of 1.2 million people compared with 2008. In eastern and southern Africa, the regions most severely affected by HIV, treatment coverage increased from 32% to 41$ in one year, and half of all pregnant women were able to access HIV testing and counseling. In sub-Saharan Africa, close to one million people began antiretroviral treatment, resulting in 37% coverage of those in need. The rate in other regions included: Latin American and the Caribbean, 50%; East, South and Southeast Asia, 31%; Europe and Asia, 19%; and North Africa and the Middle East, 11%. Globally, a record 53% of pregnant women needing services to prevent mother-to-child transmissions received them.

Despite the gains, the report also called attention to significant challenges in delivering universal access in most countries such as funding shortages, limited human resources, and weak procurement and supply-management systems for HIV drugs and diagnostics. The report called for a set of actions to be taken by the international community, consistent with the key strategies proposed in the new Global Health Sector Strategy for HIV/AIDS (2011-2015). WHO is developing the strategy, which is intended to guide the next phase of the health-sector response to HIV/AIDS once it is discussed and ratified by WHO’s World Health Assembly next year, according to a Sept. 28, 2010 UN press release.

HIV/AIDS, tuberculosis, and malaria. In early October 2010, donor countries, private foundations, corporations, and individuals that met at the UN pledged more than $11.5 billion in new funding during the next three years for the global partnership to fight three killer diseases:  HIV/AIDS, tuberculosis, and malaria.

“At a time when so many governments are tightening their belts, these commitments send a powerful message. It shows that many world leaders want to do the right thing beyond their borders, too,” said Secretary-General Ban Ki-moon, who chaired a two-day replenishment meeting for the Global Fund to Fight AIDS, TB and Malaria. “However, the demand for funding will outstrip even the important commitments made today. That means we must continue to mobilize more resources, more will, more quickly,” he noted at a at UN headquarters on Oct. 5, 2010 after the meeting concluded. “This work is not just about replenishing the fund; it is about replenishing hope and dignity in people’s lives,” he added.

During the past eight years, the programs supported by the Global Fund have saved an estimated 5.7 million lives, provided AIDS treatment for 2.8 million people and TB treatment for 7 million people, and distributed 122 million bed nets to prevent malaria.

The Global Fund was created in 2002 to scale up resources to fight HIV/AIDS, tuberculosis, and malaria. To date, the fund has committed $19.3 billion in 144 countries to support large-scale prevention, treatment and care program against the three diseases.

While welcoming the pledges made, the Executive Director of the Global Fund, Michel Kazatchkine, noted that they are not enough to meet expected demand and to met the MDGs by their target deadlines, and additional public and private funding is needed.