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THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Foreword the Goals are achievable when nationally owned

The Millennium Declaration in 2000 was a milestone development strategies, policies and programmes

in international cooperation, inspiring development are supported by international development partners.

efforts that have improved the lives of hundreds of At the same time, it is clear that improvements in

millions of people around the world. Ten years later, the lives of the poor have been unacceptably slow,

world leaders will gather again at the United Nations and some hard-won gains are being eroded by the

in New York to review progress, assess obstacles climate, food and economic crises.

and gaps, and agree on concrete strategies and

actions to meet the eight Millennium Development The world possesses the resources and knowledge

Goals by 2015. to ensure that even the poorest countries, and others

held back by disease, geographic isolation or civil

The Goals represent human needs and basic rights strife, can be empowered to achieve the MDGs.

that every individual around the world should be

able to enjoy—freedom from extreme poverty and Meeting the goals is everyone’s business. Falling

hunger; quality education, productive and decent short would multiply the dangers of our world – from

employment, good health and shelter; the right of instability to epidemic diseases to environmental

women to give birth without risking their lives; and a degradation. But achieving the goals will put us on

world where environmental sustainability is a priority, a fast track to a world that is more stable, more just,

and women and men live in equality. Leaders also and more secure.

pledged to forge a wide-ranging global partnership

for development to achieve these universal Billions of people are looking to the international

objectives. community to realize the great vision embodied in the

Millennium Declaration. Let us keep that promise.

This report shows how much progress has been

made. Perhaps most important, it shows that Ban Ki-moon

Secretary-General, United Nations 3

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UNITED NATIONS

Overview • Major increases in funding and a stronger commitment

Keeping the promise to control malaria have accelerated delivery of malaria

interventions. Across Africa, more communities are

Five years from the target date for the Millennium benefi ting from bed net protection and more children

Development Goals, leaders from around the world are being treated with effective drugs.

will be gathering at the United Nations to undertake a

comprehensive review of progress and together chart a • The rate of deforestation, though still alarmingly high,

course for accelerated action on the MDGs between now appears to have slowed, due to tree-planting schemes

and 2015. combined with the natural expansion of forests.

Many countries are moving forward, including some of the • Increased use of improved water sources in rural

poorest, demonstrating that setting bold, collective goals areas has narrowed the large gap with urban areas,

in the fi ght against poverty yields results. For every life that where coverage has remained at 94 per cent—almost

has benefi ted from the establishment of a quantitative, unchanged since 1990. However, the safety of water

time-bound framework of accountability, the MDGs have supplies remains a challenge and urgently needs to be

made a real difference. addressed.

But unmet commitments, inadequate resources, lack of • Mobile telephony continues to expand in the developing

focus and accountability, and insuffi cient dedication to world and is increasingly being used for m-banking,

sustainable development have created shortfalls in many disaster management and other non-voice applications

areas. Some of these shortfalls were aggravated by the for development. By the end of 2009, cellular

global food and economic and fi nancial crises. subscriptions per 100 people had reached the 50 per

cent mark.

Nevertheless, the data and analysis on the following

pages provide clear evidence that targeted interventions, Bridging the gaps

sustained by adequate funding and political commitment,

have resulted in rapid progress in some areas. In others, the

poorest groups, those without education or living in more Though progress has been made, it is uneven. And without

remote areas, have been neglected and not provided the a major push forward, many of the MDG targets are likely

conditions to improve their lives. to be missed in most regions. Old and new challenges

threaten to further slow progress in some areas or even

Building on successes undo successes achieved so far.

The most severe impact of climate change is being felt

The collective efforts towards achievement of the MDGs by vulnerable populations who have contributed least to

have made inroads in many areas. Encouraging trends the problem. The risk of death or disability and economic

before 2008 had put many regions on track to achieve at loss due to natural disasters is increasing globally and is

least some of the goals. The economic growth momentum concentrated in poorer countries. Armed confl ict remains

in developing regions remains strong and, learning from the a major threat to human security and to hard-won MDG

many successes of even the most challenged countries, gains. Large populations of refugees remain in camps

achieving the MDGs is still within our grasp: with limited opportunities to improve their lives. In 2009,

42 million people had been displaced by confl ict or

• Progress on poverty reduction is still being made, persecution, four fi fths of them in developing countries.

despite signifi cant setbacks due to the 2008-2009

economic downturn, and food and energy crises. The The number of people who are undernourished has

developing world as a whole remains on track to achieve continued to grow, while slow progress in reducing the

the poverty reduction target by 2015. The overall poverty prevalence of hunger stalled—or even reversed itself—in

rate is still expected to fall to 15 per cent by 2015, which some regions between 2000-2002 and 2005-2007. About

translates to around 920 million people living under the one in four children under the age of fi ve are underweight,

international poverty line—half the number in 1990. mainly due to lack of food and quality food, inadequate

water, sanitation and health services, and poor care and

• Major advances have been made in getting children into feeding practices.

school in many of the poorest countries, most of them in

sub-Saharan Africa. An estimated 1.4 billion people were still living in extreme

poverty in 2005. Moreover, the effects of the global fi nancial

• Remarkable improvements in key interventions—for crisis are likely to persist: poverty rates will be slightly

malaria and HIV control, and measles immunization, higher in 2015 and even beyond, to 2020, than they would

for example—have cut child deaths from 12.5 million in have been had the world economy grown steadily at its

1990 to 8.8 million in 2008. pre-crisis pace.

• Between 2003 and 2008, the number of people Gender equality and the empowerment of women are at the

receiving antiretroviral therapy increased tenfold—from heart of the MDGs and are preconditions for overcoming

400,000 to 4 million—corresponding to 42 per cent of poverty, hunger and disease. But progress has been

the 8.8 million people who needed treatment for HIV. sluggish on all fronts—from education to access to political

decision-making.

4

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THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Towards 2015

Achieving the MDGs will also require increased attention

to those most vulnerable. Policies and interventions will The Millennium Declaration represents the most important

be needed to eliminate the persistent or even increasing promise ever made to the world’s most vulnerable people.

inequalities between the rich and the poor, between those The MDG framework for accountability derived from the

living in rural or remote areas or in slums versus better-off Declaration has generated an unprecedented level of

urban populations, and those disadvantaged by geographic commitment and partnership in building decent, healthier

location, sex, age, disability or ethnicity: lives for billions of people and in creating an environment

that contributes to peace and security.

• In all developing regions, children in rural areas are

more likely to be underweight than urban children. In The Millennium Development Goals are still attainable.

Latin America and the Caribbean and parts of Asia, this The critical question today is how to transform the pace of

disparity increased between 1990 and 2008. change from what we have seen over the last decade into

dramatically faster progress. The experience of these last

• The gap between the richest and the poorest ten years offers ample evidence of what works and has

households remains enormous. In Southern Asia, 60 per provided tools that can help us achieve the MDGs by 2015.

cent of children in the poorest areas are underweight The Millennium Development Goals summit in September

compared to 25 per cent of children in the richest will be an opportunity for world leaders to translate this

households. evidence into a concrete agenda for action.

• In developing regions overall, girls in the poorest 20 per

cent of households are 3.5 times more likely to be out

of school than girls in the richest households and four

times more likely to be out of school than boys from the

richest households.

• Even in countries close to achieving universal primary

education, children with disabilities are the majority of

those excluded.

• Maternal health is one of the areas in which the gap

between rich and poor is most conspicuous. While

almost all births are attended by skilled health personnel SHA ZUKANG

in the developed countries, less than half of women Under-Secretary-General for Economic and Social Affairs

receive such care when giving birth in parts of the

developing world.

• Disparities in access to care during pregnancy are also

striking, with women in the richest households 1.7 times

more likely to visit a skilled health worker at least once

before birth than the poorest women.

• Lack of education is another major obstacle to

accessing tools that could improve people’s lives. For

instance, poverty and unequal access to schooling

perpetuate high adolescent birth rates, jeopardizing the

health of girls and diminishing their opportunities for

social and economic advancement.

• Contraceptive use is four times higher among women

with a secondary education than among those with no

education. For women in the poorest households and

among those with no education, negligible progress was

seen over the last decade.

• Only about half of the developing world’s population

are using improved sanitation, and addressing

this inequality will have a major impact on several

of the MDGs. Disparities between rural and urban

areas remain daunting, with only 40 per cent of rural

populations covered. And while 77 per cent of the

population in the richest 20 per cent of households use

improved sanitation facilities, the share is only 16 per

cent of those in the poorest households. 5

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UNITED NATIONS TARGET

Goal 1 Halve, between 1990 and 2015, the proportion of people

whose income is less than $1 a day

The global economic crisis has slowed

Eradicate progress, but the world is still on track to

meet the poverty reduction target

extreme

poverty and Proportion of people living on less than $1.25 a day,

1990 and 2005 (Percentage)

hunger Sub-Saharan Africa 58

51

Southern Asia 49

39 1990

2005

Southern Asia, excluding India 45 2015 Target

31

CIS, Asia

6 19

South-Eastern Asia 39

19

Eastern Asia 60

16

Latin America & the Caribbean

11

8

Western Asia

2 6

Northern Africa

5

3

Transition countries of South-Eastern Europe

0.1

1

CIS, Europe

2

0.3

Developing regions 46

27

10

0 20 30 40 50 60 70

Robust growth in the fi rst half of the decade reduced the

number of people in developing regions living on less than

$1.25 a day from 1.8 billion in 1990 to 1.4 billion in 2005,

while the poverty rate dropped from 46 per cent to 27 per

cent. The global economic and fi nancial crisis, which began

in the advanced economies of North America and Europe

in 2008, sparked abrupt declines in exports and commodity

prices and reduced trade and investment, slowing growth

in developing countries. Nevertheless, the momentum of

economic growth in developing countries is strong enough

to sustain progress on the poverty reduction target. The

overall poverty rate is still expected to fall to 15 per cent by

6

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THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Prior to the crisis, the depth of poverty

2015, indicating that the Millennium Development had diminished in almost every region

Goal (MDG) target can be met. This translates

into around 920 million people living under the

international poverty line—half the number in 1990. Poverty gap ratio at $1.25 a day, 1990 and 2005

Newly updated estimates from the World Bank (Percentage)

suggest that the crisis will leave an additional Sub-Saharan Africa

50 million people in extreme poverty in 2009 26

21

and some 64 million by the end of 2010 relative Southern Asia

to a no-crisis scenario, principally in sub- 14

Saharan Africa and Eastern and South-Eastern 1990

10 2005

Asia. Moreover, the effects of the crisis are Southern Asia, excluding India 14

likely to persist: poverty rates will be slightly 8

higher in 2015 and even beyond, to 2020, than CIS, Asia

they would have been had the world economy 2

grown steadily at its pre-crisis pace. 5

South-Eastern Asia 11

The fastest growth and sharpest reductions 4

in poverty continue to be recorded in Eastern Eastern Asia

Asia. Poverty rates in China are expected to 21

4

fall to around 5 per cent by 2015. India, too, Latin America & the Caribbean

has contributed to the large reduction in global 4

poverty. Measured at the $1.25 a day poverty 3

line, poverty rates there are expected to fall Western Asia

from 51 per cent in 1990 to 24 per cent in 2015, 1 2

and the number of people living in extreme Northern Africa

poverty will likely decrease by 188 million. All 1

developing regions except sub-Saharan Africa, 1

Western Asia and parts of Eastern Europe and Transition countries of South-Eastern Europe

<0.1

Central Asia are expected to achieve the MDG 0.2

target. These shortfalls refl ect slow growth CIS, Europe

in sub-Saharan Africa in the 1990s and the 1

transition from planned to market economies 0.1

that saw poverty increase, albeit from very low Developing regions 16

levels, in some countries of Eastern Europe 8

and the former Soviet Union. 10

0 20 30

The lack of good quality surveys carried out The poverty gap measures the shortfall in incomes of

at regular intervals and delays in reporting people living below the poverty line. While the international

survey results continue to hamper the poverty line is set at a level typical of very poor countries,

monitoring of poverty. Gaps are particularly many people live on even less than that amount. Economic

acute in sub-Saharan Africa, where more growth and improvements in the distribution of income or

than half of countries lack suffi cient data consumption reduce the depth of poverty. Since 1990, the

to make comparisons over the full range of depth of poverty has decreased in all regions except Western

the MDGs, and among small island states Asia. In 2005, the average income of people living below

in the Pacifi

c and the Caribbean. Surveys the poverty line stood at $0.88. The depth of poverty was

deliver important information—not just in the greatest in sub-Saharan Africa, but has fallen since 1999 to

change in average income or consumption, reach the level of Eastern Asia in 1990.

but also in its distribution. This year’s poverty

estimates integrate 31 new household surveys.

Combining these new surveys with last year’s

growth forecast suggests a 0.5 percentage

point decline (after taking into account the

effect of the fi

nancial crisis) in the aggregate

poverty headcount index in 2015—from 15.5

per cent to 15.0 per cent. Only with more timely

data can accurate reports on progress towards

the MDGs be provided. 7

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UNITED NATIONS

Investments in disaster risk TARGET

Achieve, full and productive employment and decent

reduction can yield long-term work for all, including women and young people

benefi

ts, including progress

on the MDGs Deterioration of the labour market,

triggered by the economic crisis, has

The risk of death or disability and resulted in a decline in employment

economic loss resulting from natural

disasters is increasing globally and is

concentrated in poorer countries. Reducing Employment-to-population ratio, 1998, 2008 and

such risk can have multiplier effects that 2009 preliminary estimates

can accelerate achievement of the MDGs.

The horrifi c loss of life from earthquakes Eastern Asia 74

in Haiti, Chile and China, and fl oods in 70

70

Brazil, underscore the need to make the Oceania

built environment more resilient in the face 1998

66 2008

66

of potential hazards—both seismic and 2009*

67

climatic (or weather-related). South-Eastern Asia 66

66

Urbanization, climate change and 66

ecosystem degradation are increasing the Sub-Saharan Africa 64

toll of natural disasters, and countries least 65

65

able to reduce their risk are suffering the Latin America & the Caribbean

most. An estimated 97 per cent of global 58 61

mortality risk from natural disasters is 60

faced by populations in low- and lower- CIS 53

middle-income countries, which also 58

experience higher economic losses relative 57

to the size of their economies. From the Southern Asia 57

start of 2008 through March 2010, 470,000 56

55

people were reportedly killed as a result of Transition countries of South-Eastern Europe

natural disasters; economic losses were 53

49

estimated to be more than $262 billion (not 48

including 2010). Small island developing Northern Africa 44

states and landlocked developing countries 46

together constitute 60 per cent and 67 46

per cent, respectively, of the countries Western Asia 47

considered to have a high or very high 46

44

economic vulnerability to natural hazards. Developed regions 56

57

Experience from countries has shown 55

that investments in disaster risk reduction Developing regions 63

produce long-term benefi ts—from reduced 62

future losses and avoided reconstruction 62

to co-benefi ts such as more robust 10

0 20 30 40 50 60 70 80

livelihoods, resilient communities, and * Data for 2009 are preliminary.

protective and productive ecosystems.

In Peru, incorporation of risk reduction

into development has led to benefi ts that The bursting of the housing bubble in the United States in

exceeded costs by as much as 37 times. 2007 and subsequent paralysis of the global fi nancial system

When China spent $3.15 billion on reducing became an economic and labour market crisis that plagued

the impact of fl oods between 1960 and the world throughout 2009. The cascading crisis crippled

2000, it averted losses estimated at $12 economies, reduced enterprise capacities and forced millions

billion. of people out of work. Many workers resorted to vulnerable

forms of employment as the ranks of the working poor swell.

8

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THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

As jobs were lost, more workers have

As the crisis deepened, government been forced into vulnerable employment

stimulus measures began to curb the slide

in economic activity and lessen the impact

of global job losses. The coordinated efforts

of countries responding to the crisis have Proportion of own-account and contributing family

been instrumental in averting even greater workers in total employment, 1998, 2008 and

social and economic hardships. However, 2009 second scenario (Percentage)

labour market conditions have continued to

deteriorate in many countries and will likely Oceania 74

threaten much of the progress made over the 78

79

last decade towards decent work. Southern Asia 80

76

The economic deterioration resulted in a 77

Sub-Saharan Africa

sharp drop in employment-to-population 82

ratios. In addition, labour productivity 75

77

declined in 2009. In most regions, the South-Eastern Asia 63

decrease in gross domestic product was 1998

61 2008

even greater than the decline in employment, 61 2009*

Eastern Asia

resulting in diminishing output per worker. 62

53

Preliminary estimates indicate a negative 53

growth in output per worker in all regions CIS, Asia 47

except Northern Africa, Eastern Asia and 41 44

Southern Asia. The largest fall in output per Northern Africa

worker was in CIS countries in Europe, the 35

31

transition countries of South-Eastern Europe 34

and in Latin America and the Caribbean. Latin America & the Caribbean

35

Declining labour output contributes to poorer 31

32

working conditions, worsening the plight of Transition countries of South-Eastern Europe

workers in regions where labour productivity 32

24

was already low before the economic crisis, 29

as in sub-Saharan Africa. Western Asia 39

27

28

CIS, Europe

8

9

10

Developed regions

11

10

11

Developing regions 65

59

60

0 20 30 40 50 60 70 80 90

10

*Forecasts for 2009 are based on the International Labour Organization’s

second scenario. Details are available at mdgs.un.org

The positive downward trend in vulnerable employment was

interrupted by deteriorating conditions on the labour market

following the fi nancial crisis. For many wage and salaried

workers who lost their jobs, as well as fi rst-time job seekers

who entered the labour market in the midst of the crisis, own-

account and unpaid family work are options of last resort.

Those engaged in ‘vulnerable employment’, defi ned as the

sum of own-account workers and contributing family workers,

are not typically bound by formal work arrangements. They

are therefore more likely to lack benefi ts associated with

decent employment, such as adequate social security 9

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UNITED NATIONS Since the economic crisis, more workers

and recourse to effective mechanisms for fi nd themselves and their families living

social dialogue. Vulnerable employment is

often characterized by inadequate earnings, in extreme poverty

low productivity and substandard working

conditions that undermine fundamental labour

rights. Proportion of employed people living below

$1.25 a day, 1998, 2008 and 2009 second

Prior to the economic crisis, over three scenario (Percentage)

quarters of workers in Oceania, Southern

Asia and sub-Saharan Africa were without the Sub-Saharan Africa 67

security that wage and salaried jobs could 58

provide. The crisis is likely to have further 64

increased the number of workers engaged Southern Asia 55

in vulnerable employment in these regions in 44 51

2009. The International Labour Organization Oceania

(ILO) estimates* the global vulnerable 1998

45 2008

46

employment rate in 2009 to be between 49 2009*

50

per cent and 53 per cent, which translates South-Eastern Asia 45

into 1.5 billion to 1.6 billion people who are 23

working on their own or as unpaid family 28

CIS, Asia

workers worldwide. 26

19

* Details are available at http://mdgs.un.org 21

Eastern Asia 52

11

13

Western Asia

8

8 12

Latin America & the Caribbean

13

7

8

Northern Africa

6

3

4

Transition countries of South-Eastern Europe

1

0.4

0.6

CIS, Europe

4

0.1

0.2

Developing regions 48

26 31

0 20 30 40 50 60 70 80

10

*Data for 2009 are based on the ILO’s second scenario.

Details are available at mdgs.un.org

The ‘working poor’ are defi ned as those who are employed

but live in households where individual members subsist on

less than $1.25 a day. Most of these workers are engaged

in jobs that lack the social protection and safety nets that

guard against times of low economic demand, and they are

often unable to generate suffi cient savings to offset hard

times. Since vulnerable employment is often characterized

by low productivity work, and the global fi nancial crisis has

resulted in declining output per worker, working poverty is

likely to have increased as well. The small decreases in the

percentage of working poor in 2009 that would result from a

10

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THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

continuation of historical trends (scenario 1) TARGET

are therefore not likely to have materialized. Halve, between 1990 and 2015, the proportion of people

Rather, it is estimated that an additional 3.6 who suffer from hunger

per cent of the world’s workers were at risk

of falling into poverty between 2008 and

2009 (scenario 2), an alarming increase and a Hunger may have spiked in 2009, one of

setback of many years of steady progress. the many dire consequences of the global

The largest negative impact is most likely food and fi nancial crises

to be seen in sub-Saharan Africa, Southern

Asia, South-Eastern Asia and Oceania, where

extreme poverty among the employed may Proportion of people who are undernourished in the

have increased by four percentage points or developing regions (Percentage) and number of

more in the second scenario. These estimates undernourished people (Millions), 1990-1992,

refl ect the fact that, prior to the crisis, many 1995-1997, 2000-2002 and 2005-2007

workers in these regions were only slightly

above the poverty line. In the case of sub- 1500 25

Number of undernourished people

Saharan Africa, the large majority of workers Percentage of undernourished people

(63.5 per cent) were at risk of falling below the 1200 20

extreme poverty line in this scenario. Percentage

900 15

Millions 830

817 805

797

600 10

300 5

0 0

1990-1992 1995-1997 2000-2002 2005-2007

Since 1990, developing regions have made some progress

towards the MDG target of halving the proportion of

people suffering from hunger. The share of undernourished

populations decreased from 20 per cent in 1990-1992 to 16

per cent in 2005-2007, the latest period with available data.

However, progress has stalled since 2000-2002. Overall

progress in reducing the prevalence of hunger has not been

suffi cient to reduce the number of undernourished people. In

2005-2007, the last period assessed, 830 million people were

still undernourished, an increase from 817 million in 1990-

1992.

Food prices spiked in 2008 and falling income due to the

fi nancial crisis further worsened the situation. The Food and

Agricultural Organization of the United Nations estimates that

the number of people who were undernourished in 2008 may

be as high as 915 million and exceed 1 billion in 2009. 11

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UNITED NATIONS

Progress to end hunger has Prices of staple foods remained high in 2009, after the initial

food crisis of 2008. At the same time, the incomes of poor

been stymied in most regions households diminished because of higher unemployment

following the economic downturn. Both crises contributed to

a considerable reduction in the effective purchasing power

Proportion of undernourished population, of poor consumers, who spend a substantial share of their

1990-1992, 2000-2002 and 2005-2007 income on basic foodstuffs.

(Percentage) Though international food prices continued to decline in

Sub-Saharan Africa 31 the second half of 2008, consumer food price indexes rose.

30

26 International food prices have not yet stabilized and threats of

Southern Asia, excluding India new food crises loom.

26

23

23 Aggregate food availability globally was relatively good

1990-92

Southern Asia 21 2000-02 in 2008 and 2009, but higher food prices and reduced

20 2005-07 employment and incomes meant that the poor had less

21 2015 Target

South-Eastern Asia access to that food.

24

17

14

Oceania 12 16

13

Eastern Asia, excluding China

8 13

12

Eastern Asia 18

10

10

Latin America & the Caribbean

12

10

9

Western Asia

5 8

7

Northern Africa

<5

<5

<5

Developing regions 20

16

16

0 5 15 20 25 30 35

10

Before the onset of the food and fi nancial

crises, a number of regions were well on their

way to halving, by 2015, the proportion of their

population that were undernourished. South-

Eastern Asia, which was already close to the

target in 2005-2007 made additional progress,

as did Latin America and the Caribbean and

Eastern Asia. Progress in the latter region was

largely due to reductions in hunger in China.

The prevalence of hunger also declined in

sub-Saharan Africa, although not at a pace

that was suffi ciently fast to compensate for

population growth and to put the region on

track to meet the MDG target.

12

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THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Despite some progress, one in Halving the prevalence of underweight children by 2015

(from a 1990 baseline) will require accelerated and concerted

four children in the developing action to scale up interventions that effectively combat

world are still underweight undernutrition. A number of simple and cost-effective

interventions at key stages in a child’s life could go a long way

in reducing undernutrition, such as breastfeeding within one

Proportion of children under age five who hour of birth, exclusive breastfeeding for the fi rst six months

are underweight, 1990 and 2008 of life, adequate complementary feeding and micronutrient

(Percentage) supplementation between six and 24 months of age.

Southern Asia Undernutrition among children under fi ve continues to be

51 widely prevalent, due to both a lack of food and lack of

46

Sub-Saharan Africa quality food, inadequate water, sanitation and health services

31 1990 as well as less than optimal caring and feeding practices.

27 2008 Until improvements are made in all these areas, progress will

South-Eastern Asia be limited. In Southern Asia, for example, feeding practices

37 are often poor and shortages of quality food are common.

25 But in addition, nearly two thirds of the population are without

Western Asia

14 improved sanitation and nearly half practise open defecation,

14 resulting in repeated episodes of diarrheal diseases in

Eastern Asia children. Moreover, more than 25 per cent of infants are

17 underweight at birth. Many of these children are never able

7 to catch up in terms of their nutritional status. All of these

Northern Africa factors have made underweight prevalence in Southern

11 Asia—at 46 per cent—the highest in the world.

7

Latin America & the Caribbean

11

6

Developing regions 31

26

0 20 30 40 50 60

10

Note: Prevalence of underweight children is estimated

based on the NCHS/WHO/CDC reference population.

The United Nations Children’s Fund (UNICEF) is in the

process of converting its entire child undernutrition

database according to the new World Health Organization

(WHO) Child Growth Standards.

From 1990 to 2008, the proportion of children

under fi ve in the developing regions who are

underweight declined from 31 per cent to 26

per cent. Progress in reducing underweight

prevalence among children has been made

in all regions except Western Asia. Eastern

Asia, Latin America and the Caribbean, and

CIS countries in Asia have reached or nearly

reached the MDG target, and South-Eastern

Asia and Northern Africa are on track.

Progress is being made, but not fast enough

to reach the MDG target. Data are not yet

available to fully understand the impact of

the food and fi nancial crises on underweight

prevalence, but the achievement of the MDG

target may be further threatened by them. 13

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UNITED NATIONS

Children in rural areas are In some regions, the prevalence of

nearly twice as likely to be underweight children is dramatically

underweight as those in urban higher among the poor

areas Proportion of under-five children who are underweight,

by household wealth, around 2008 (Percentage)

Ratio between the proportion of under-five 70

children who are underweight in rural Southern Asia

areas and urban areas, 1990 and 2008 Developing regions

60

Southern Asia Sub-Saharan Africa

1.3 Northern Africa

1.4 Around 1990 CIS, Asia

South-Eastern Asia Around 2008 50

1.4 Parity

1.2

Sub-Saharan Africa

1.5 40

1.4

Northern Africa 1.7 30

1.5

Latin America & the Caribbean

2.0 2.4 20

Western Asia 2.1 2.5

Eastern Asia 10

2.1 4.8

Developing regions 0

1.7 Poorest 20% Poorer 20% Middle 20% Richer 20% Richest 20%

1.9

0.0 1.0 2.0 3.0 4.0 5.0 Across the developing world, children from the poorest

Rural children disadvantaged households are twice as likely to be underweight as children

from the richest households. The disparity is most dramatic

in regions with a high prevalence of underweight children.

In all developing regions, children in rural This is the situation in Southern Asia, where as many as 60

areas are more likely to be underweight than per cent of children in the poorest families are underweight,

children living in cities and towns. In parts of compared to about 25 per cent in the richest households.

Asia and in Latin America and the Caribbean,

the relative disparity actually increased

between 1990 and 2008. In Eastern Asia,

there was a striking increase in the rural/

urban ratio (from 2.1 to 4.8), indicating that, in

2008, children in rural areas were almost fi ve

times as likely to be underweight as children

in urban areas. This region, however, has

already achieved the target—in both rural and

urban areas—of halving the 1990 underweight

prevalence: only 2 per cent of children in

urban areas are underweight, versus 9 per

cent of rural children.

South-Eastern Asia, sub-Saharan Africa and

Northern Africa have succeeded in reducing

child malnutrition more rapidly in rural areas

and in narrowing the gap with the urban

population, demonstrating that more equitable

progress is indeed possible.

14

MDG Report 2010 En 20100604 r14 Final.indd Sec2:14 6/15/2010 12:51:39 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Over 42 million people have been

uprooted by confl ict or persecution

Number of refugees and internally displaced

persons, 2000-2009 (Millions)

40 15.2

16.0 15.2

16.0 14.6 13.8 14.3

13.7

30 13.0

15.9

20 27.1

26.0 26.0

25.3

25.0 25.0 24.6 24.4

23.7

21.2

10

0 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009

Internally displaced persons Refugees

Confl icts are a major threat to human security and to

hard-won MDG gains. Years after a confl ict has ended,

large populations of refugees remain in camps with limited

employment and education opportunities and inadequate

health services. Not surprisingly, refugees often become

dependent on subsistence-level assistance and lead lives of

poverty and unrealized potential.

More than 42 million people are currently displaced by

confl ict or persecution. Of these, 15.2 million are refugees

(residing outside their countries of origin) and 27.1 million

people have been uprooted but remain within the borders of

their own countries. Developing countries hosted four fi fths

of the global refugee population in 2009. They included 10.4

million people who fall under the aegis of the United Nations

High Commissioner for Refugees (UNHCR) and 4.8 million

Palestinian refugees, who are the responsibility of the United

Nations Relief and Works Agency for Palestine Refugees in

the Near East (UNRWA).

The number of refugees has remained relatively stable over

the past two years—about 15 million—in part because of the

lack of durable solutions. In 2009, some 250,000 refugees

were able to return to their homes voluntarily, the lowest level

in 20 years. Afghans and Iraqis continue to be the largest

refugee populations under the UNHCR mandate, totalling

2.9 million and 1.8 million people, respectively, at the end of

2009. Together they account for nearly half of all refugees

under UNHCR care. 15

MDG Report 2010 En 20100604 r14 Final.indd Sec2:15 6/15/2010 12:51:40 PM

UNITED NATIONS TARGET

Goal 2 Ensure that, by 2015, children everywhere, boys and girls

alike, will be able to complete a full course of primary

schooling

Achieve Hope dims for universal education by

2015, even as many poor countries make

universal tremendous strides

primary Adjusted net enrolment ratio in primary education,*

education 1998/1999 and 2007/2008 (Percentage)

Sub-Saharan Africa 1999

58 76 2008

CIS, Europe 89 93

Western Asia 83 88

Southern Asia 79 90

CIS, Asia 95

94

Northern Africa 86 94

South-Eastern Asia 93

95

Latin America & the Caribbean 94

95

Eastern Asia 95

96

Developing regions 82 89

Developed regions 97

96

World 84 90

0 20 40 60 80 100

* Defined as the number of pupils of the theoretical school age for primary

education enrolled in either primary or secondary school, expressed as a

percentage of the total population in that age group.

Note: Data for Oceania are not available.

Enrolment in primary education has continued to rise,

reaching 89 per cent in the developing world. But the pace of

progress is insuffi cient to ensure that, by 2015, all girls and

boys complete a full course of primary schooling.

16

MDG Report 2010 En 20100604 r14 Final.indd Sec2:16 6/15/2010 12:51:41 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Sub-Saharan Africa and Southern Asia

To achieve the goal by the target date, all are home to the vast majority of children

children at the offi cial entry age for primary

school would have had to be attending out of school

classes by 2009 or so, depending on the

duration of the primary level and how well

schools retain pupils to the end of the Distribution of out-of-school children by region,

cycle. But in half of the sub-Saharan African 1999 and 2008 (Percentage)

countries with available data, at least one in 100

four children of primary-school age were out Sub-Saharan Africa

Southern Asia

of school in 2008. Eastern Asia

South-Eastern Asia

To meet the goal, countries will also need to Latin America

80

ensure that there are enough teachers and & the Caribbean

classrooms to meet the demand. Between Western Asia

now and 2015, the number of new teachers Developed regions

needed in sub-Saharan Africa alone equals CIS

60

the current teaching force in the region. 43 Northern Africa

46 Rest of the world

Despite these challenges, a good deal has

been accomplished in many regions. Though

enrolment in sub-Saharan Africa remains the 40

lowest of all regions, it still increased by 18

percentage points—from 58 per cent to 76 27

per cent—between 1999 and 2008. Progress 34 6

was also made in Southern Asia and Northern 20 6 5

Africa, where enrolment increased by 11 and 8 4 4

3

percentage points, respectively, over the last 4

4 4

decade. 2 2

1 2

3

0 0.7

0.2 1999 2008

Major advances have been made even in

some of the poorest countries, most of

them in sub-Saharan Africa. The abolition

of primary school fees in Burundi resulted Even as the number of school-age children continues to rise,

in a threefold increase in primary-school the total number of children out of school is decreasing—from

enrolment since 1999, reaching 99 per cent 106 million in 1999 to 69 million in 2008. Almost half of these

in 2008. Similarly, the United Republic of children (31 million) are in sub-Saharan Africa, and more than

Tanzania doubled its enrolment ratio over a quarter (18 million) are in Southern Asia.

the same period. Guatemala, Nicaragua and

Zambia The gender gap in the out-of-school population has also

also broke through the 90 per cent narrowed: the share of girls in this group decreased from 57

threshold towards greater access to primary per cent to 53 per cent globally between 1999 and 2008. In

education. some regions, however, the share is much larger; in Northern

Africa, 66 per cent of out-of-school children are girls.

Getting children into school is a vital fi rst step.

But to receive the full benefi ts of education,

they must continue to attend classes. In

half the countries in sub-Saharan Africa

with available data, more than 30 per cent

of primary-school students drop out before

reaching the fi nal grade. 17

MDG Report 2010 En 20100604 r14 Final.indd Sec2:17 6/15/2010 12:51:42 PM

UNITED NATIONS

Inequality thwarts progress towards universal education

Out-of-school children by wealth quintile and area of residence, girls and boys,

42 countries, 2000/2008 (Percentage)

40 39 Girls

36 Boys

30 31 31

28 27

25 23

20 19 17 15 14

10 11 10

0 Poorest 20% Second 20% Middle 20% Fourth 20% Richest 20% Rural Urban

Household data from 42 countries show that barriers to education are also common. In many countries,

rural children are twice as likely to be out of educating girls is widely perceived as being of less value

school as children living in urban areas. The than educating boys. And children with disabilities across

data also show that the rural-urban gap is the world face far more limited opportunities than their non-

slightly wider for girls than for boys. But the disabled peers.

biggest obstacle to education is poverty. Girls

in the poorest 20 per cent of households have The link between disability and marginalization in education

the least chance of getting an education: they is evident in countries at all levels of development. In Malawi

are 3.5 times more likely to be out of school and the United Republic of Tanzania, being disabled doubles

than girls in the richest households and four the probability that a child will never attend school, and in

times more likely to be out of school as boys Burkina Faso the risk rises to two and a half times. Even

in the richest households. Boys from the in some countries that are closer to achieving the goal

richest households are the least likely to be of universal primary education, children with disabilities

out of school (10 per cent), compared to all represent the majority of those who are excluded. In Bulgaria

other groups. and Romania, net enrolment ratios for children aged 7 to

15 were over 90 per cent in 2002, but only 58 per cent for

Children remain out of school for a variety of children with disabilities.

reasons, including cost. Social and cultural

18

MDG Report 2010 En 20100604 r14 Final.indd Sec2:18 6/15/2010 12:51:43 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

19

MDG Report 2010 En 20100604 r14 Final.indd Sec2:19 6/15/2010 12:51:44 PM

UNITED NATIONS TARGET

Goal 3 Eliminate gender disparity in primary and secondary

education, preferably by 2005, and in all levels of

education no later than 2015

Promote For girls in some regions, education

remains elusive

gender

equality and Girls’ primary-school enrolment in relation to boys’,

1998/1999 and 2007/2008 (Girls per 100 boys)

empower Primary 89

Oceania 91 1999

2008

91

Sub-Saharan Africa 85

women 92

Western Asia 87 2015

94

Northern Africa 90 Target

96

Southern Asia 84 = GPI

97

Latin America & the Caribbean 97 between

97

South-Eastern Asia 96 97 and 103

99

CIS 99 104

Eastern Asia 101

96

Developing regions 91

Secondary 79

Sub-Saharan Africa 83 86

Western Asia 76 87

Southern Asia 75 87

Oceania 89 98

CIS 101 98

Northern Africa 93 103

South-Eastern Asia 95 105

Eastern Asia 93 108

Latin America & the Caribbean 107

95

Developing regions 88

Tertiary 67

Sub-Saharan Africa 71 76

Southern Asia 65 84

Oceania 81 92

Western Asia 82 95

Northern Africa 74 100

Eastern Asia 66 107

South-Eastern Asia 95 125

Latin America & the Caribbean 115 130

CIS 121

97

Developing regions 82

20 40 80 100 140

0 60 120

The developing regions as a whole are approaching gender

parity in educational enrolment. In 2008, there were 96 girls

for every 100 boys enrolled in primary school, and 95 girls

for every 100 boys enrolled in secondary school. In 1999, the

ratios were 91:100 and 88:100 for the two levels of education,

respectively. Despite this progress, gender parity in primary

and secondary education—a target that was to be met by

20

MDG Report 2010 En 20100604 r14 Final.indd Sec2:20 6/15/2010 12:51:45 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Poverty is a major barrier to education,

2005—is still out of reach for many developing

regions. For primary education, the steepest especially among older girls

challenges are found in Oceania, sub-Saharan

Africa and Western Asia. Proportion of girls and boys who are out of school, by

In secondary education, the gender gap in age and household wealth, in 42 countries with surveys

enrolment is most evident in the three regions during 2001/2008 (Percentage)

where overall enrolment is lowest—sub- 50

Saharan Africa, Western Asia and Southern 50

Girls

Asia. In contrast, more girls than boys have Boys

signed up for secondary school in Latin 40

America and the Caribbean, Eastern Asia and 37

South-Eastern Asia. 30 30

In tertiary education, the ratio between girls 25 24

20

and boys in the developing regions is close to 19

parity, at 97 girls per 100 boys. This is largely

due to the fact that many more girls than boys 10 10

are enrolled in higher education in the CIS 9

countries, Latin America and the Caribbean, 0

Northern Africa and South-Eastern Asia. But Wealthiest 40% Poorest 60% Wealthiest 40% Poorest 60%

in most other regions, the number of boys Primary-school age Secondary-school age

heavily outweighs that of girls in colleges

and universities. In sub-Saharan Africa and

Southern Asia, for example, only 67 and 76 Poverty puts girls at a distinct disadvantage in terms of

girls per 100 boys, respectively, are enrolled in education. Girls of primary-school age from the poorest 60

tertiary levels of education. per cent of households are three times more likely to be out

of school as those from the wealthiest households. Their

Other gender disparities found in tertiary chances of attending secondary school are even slimmer,

education relate to areas of study, with and older girls in general are more likely to be out of school.

women being overrepresented in the In the poorest households, about twice as many girls of

humanities and social sciences and secondary-school age are out of school compared to their

signifi cantly underrepresented in science, wealthier peers.

technology and, in particular, engineering.

Completion rates also tend to be lower among Household survey data also indicate that girls in rural areas

women than men. face added challenges in getting an education and that the

gender gap is much wider for girls of secondary-school age.

21

MDG Report 2010 En 20100604 r14 Final.indd Sec2:21 6/15/2010 12:51:46 PM

UNITED NATIONS In every developing region except the

CIS, men outnumber women in paid

employment

Employees in non-agricultural wage employment who

are women, 1990–2008, and projections to 2015

(Percentage)

60 51.5

50.6

CIS

50 45.1

42.4

Latin America & the Caribbean 42.5

Eastern Asia 41.2

40 39.2

South-Eastern Asia 37.1

38.1 36.7

36.0

Oceania 32.4

30 Sub-Saharan

Africa 22.2

Western Asia 21.8

20.1

Northern Africa

20 19.2

19.2 19.2

Southern Asia

10

0

1990 1995 2000 2005 2008 2015

Globally, the share of women in paid employment outside

the agricultural sector has continued to increase slowly and

reached 41 per cent in 2008. But women in some regions

are seriously lagging behind. In Southern Asia, Northern

Africa and Western Asia, only 20 per cent of those employed

outside agriculture are women. Gender equality in the labour

market is also a concern in sub-Saharan Africa, where only

one in three paid jobs outside of agriculture are occupied by

women.

But even when women represent a large share of waged

workers, it does not mean that they have secure, decent jobs.

In fact, women are typically paid less and have less secure

employment than men.

In countries where the agricultural sector predominates,

women are mostly employed in agriculture and largely in

vulnerable jobs—in subsistence farming, as unpaid family

workers or as own-account workers—with no or little fi nancial

security or social benefi ts.

22

MDG Report 2010 En 20100604 r14 Final.indd Sec2:22 6/15/2010 12:51:48 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Women are largely relegated The 2008 fi nancial crisis has eroded employment around

to more vulnerable forms of the world. As both women and men lost their jobs,

unemployment rates shot up, especially in the fi rst half of

employment 2009. The good news is that the rate at which unemployment

is increasing appears to be slowing, according to the latest

data. However, the fact that women are disproportionately

Proportion of own-account and represented in temporary employment, and occupy a

contributing family workers in total substantial share of jobs in export-oriented manufacturing

employment, 2009 projections industries in many developing countries, may result in higher

(Percentage) unemployment rates for women.

Oceania While the crisis has drawn attention to the levels of

85

73 unemployment, the quality of available jobs is also worrisome.

Sub-Saharan Africa Many wage and salaried workers who lost their jobs, as

84 well as many fi rst-time job seekers who entered the labour

71 market in the midst of the fi nancial turmoil, have resorted to

Southern Asia own-account or unpaid family work, resulting in deteriorating

84 working conditions and lower incomes for the poorest.

74 Women are more likely than men to be in vulnerable jobs,

South-Eastern Asia 65 with the gap being particularly evident in those regions where

58 paid employment opportunities for women are the lowest—in

Eastern Asia Western Asia and Northern Africa.

58

50

Northern Africa 53

28

Western Asia 37

26

Latin America & the Caribbean

31

32

CIS 17

20

Transition countries of South-Eastern Europe

26

30 Women

Developing regions Men

65

57

0 20 40 60 80 100 23

MDG Report 2010 En 20100604 r14 Final.indd Sec2:23 6/15/2010 12:51:49 PM

UNITED NATIONS

Women are overrepresented in Top-level jobs still go to men — to an

informal employment, with its overwhelming degree

lack of benefi

ts and security Share of women in top-level and all occupations,

average for the period 2000/2008 (Percentage)

Informal employment as a percentage

of total non-agricultural employment, CIS 49

women and men, selected countries, 37

2003/2005 (Percentage) Latin America & the Caribbean

Mali 36

89 32

74

India Sub-Saharan Africa

88 45

84 29

Ecuador (urban areas) 77 South-Eastern Asia

73 39

Peru (metropolitan Lima) 72 26

65 Oceania

South Africa 65 39

51 21

Colombia 62 Eastern Asia

61 45

Mexico 16

54

48 Western Asia

Brazil (urban areas) 24

52 10

50

Venezuela Northern Africa

52 20

47 9

Panama 50 All occupations

Southern Asia

49 Senior officials

20

Kyrgyzstan and managers

41 9

47 Developed regions

Turkey 36 45

Women

35 32

Men

Republic of Moldova

18 0 20 30 40 50

10

25

Russian Federation

8 Though the number of women who secured paid jobs

10 outside the agricultural sector increased between 1990 and

0 20 40 60 80 100 2008, women have generally failed to access higher-level

positions. The top jobs—as senior offi cials or managers—are

still dominated by men. Globally, only one in four senior

It is likely that the recent fi nancial crisis has offi cials or managers are women. And in all regions, women

also led to a surge in informal employment are underrepresented among high-level workers, accounting

due to job losses in the formal sector. In for 30 per cent or more of such positions in only three out

some developing countries, over 80 per cent of 10 regions. In Western Asia, Southern Asia and Northern

of workers have informal jobs—as owners Africa, less than 10 per cent of top-level positions are held by

of informal-sector businesses, contributing women.

family workers or employees without written

contracts or social security benefi ts (including

subcontracted workers operating from home

and domestic services workers). In most of

these countries, women are overrepresented

in informal employment.

24

MDG Report 2010 En 20100604 r14 Final.indd Sec2:24 6/15/2010 12:51:50 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Women are slowly rising to offi cers in 269 parliamentary chambers (13 per cent) in

political power, but mainly January 2010, up from 24 in 1995.

when boosted by quotas and Following parliamentary elections and renewals in 2009, gains

other special measures for women were registered in sub-Saharan Africa, where 29

per cent of the renewed seats went to women, bringing the

regional average up to 18 per cent. In South Africa, women

took 44 per cent of seats in the lower-house election, placing

Proportion of seats held by women it third in terms of global ranking, after Rwanda and Sweden.

in single or lower houses of national Similarly, there was some progress in most countries in Latin

parliaments, 2000 and 2010 (Percentage) America and the Caribbean, with 25 per cent of seats up for

Oceania renewal going to women. Bolivia’s upper house elected more

3.4 2000 than 40 per cent women members, bringing the regional

2.5 2010

Northern Africa average up to 23 per cent.

2 9 At the opposite end of the spectrum, 58 countries have 10

Western Asia per cent or fewer women members of parliament and, in

5 9 nine chambers, women have no seats at all. During 2009,

CIS no women gained seats in parliamentary renewals in the

7 Comoros, the Federated States of Micronesia and Saudi

15 Arabia.

Southern Asia 7 18 Electoral systems, quota arrangements and other affi rmative

Sub-Saharan Africa action measures taken by political parties continue to be key

9 predictors of progress for women. During 2009, the average

18

South-Eastern Asia share of women elected to parliament reached 27 per cent

10 in countries that applied such measures; in contrast, women

19 gained only a 14 per cent share of seats in countries that did

Eastern Asia not. Women are also elected in far greater numbers under

19.9

19.5 systems of proportional representation, rather than majority/

Latin America & the Caribbean plurality systems.

15 23 In addition to electoral systems and quotas, gender-sensitive

Developed regions 17 electoral arrangements, well-trained and fi nanced women

24 candidates and political will at the highest levels of political

Developing regions parties and governments are key to overcoming gender

11 imbalances in the world’s parliaments. Given that there are

18

World still four men for every one woman in parliament, efforts will

12 be needed on all these fronts if the target of 30 per cent is to

19 be met.

10

0 5 15 20 25 Progress in achieving greater representation by women in the

executive branches of government is even slower than in the

The global share of women in parliament legislative branches. In 2010, just nine of 151 elected heads

continues to increase slowly and reached of state (6 per cent) and 11 of 192 heads of government (6

an all-time high of 19 per cent in 2010. per cent) were women. This is an improvement over 2008,

This represents a gain of 67 per cent since when only seven women were elected as heads of state and

1995, when 11 per cent of parliamentarians eight as heads of government. On average, women hold

worldwide were women. But it is far short 16 per cent of ministerial posts and only 30 countries have

of the target of 30 per cent of women in more than 30 per cent women ministers. On the other hand,

leadership positions that was to be met by 16 countries have no women ministers at all. The majority of

1995, and further still from the MDG target of these countries are in Northern Africa and Western Asia, the

gender parity. Caribbean and Oceania.

Women make up 30 per cent or more of the

members of lower houses of parliament in 26

countries and 40 per cent or more in seven

countries. There were 35 women presiding 25

MDG Report 2010 En 20100604 r14 Final.indd Sec2:25 6/15/2010 12:51:52 PM

UNITED NATIONS TARGET

Goal 4 Reduce by two thirds, between 1990 and 2015, the

under-fi ve mortality rate

Child deaths are falling, but not quickly

Reduce child enough to reach the target

mortality Under-five mortality rate per 1,000 live births,

1990 and 2008

Sub-Saharan Africa 184

144

Southern Asia 121

74

Oceania 76

60

CIS, Asia 1990

78

39 2008

South-Eastern Asia 73 2015 Target

38

Western Asia 66

32

Northern Africa 80

29

Latin America & the Caribbean

52

23

Eastern Asia 45

21

CIS, Europe

26

14

Transition countries of South-Eastern Europe

30

12

Developed regions

12

6

Developing regions 100

72

0 50 100 150 200

Substantial progress has been made in reducing child

deaths. Since 1990, the mortality rate for children under age

fi ve in developing countries dropped by 28 per cent—from

100 deaths per 1,000 live births to 72 in 2008. Globally, the

total number of under-fi ve deaths declined from 12.5 million in

1990 to 8.8 million in 2008. This means that, in 2008, 10,000

fewer children died each day than in 1990. An encouraging

sign is the acceleration of progress after the year 2000: the

average annual rate of decline increased to 2.3 per cent for

the period 2000 to 2008, compared to 1.4 per cent in the

1990s.

26

MDG Report 2010 En 20100604 r14 Final.indd Sec2:26 6/15/2010 12:51:53 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Revitalizing efforts against pneumonia

The greatest advances were made in Northern

Africa, Eastern Asia, Western Asia, Latin and diarrhoea, while bolstering nutrition,

America and the Caribbean, and the countries could save millions of children

of the CIS. But most striking is the progress

that has been made in some of the world’s

poorest countries. Against steep odds, Causes of deaths among children under age five, 2008

Bangladesh, Bolivia, Eritrea, Lao People’s (Percentage)

Democratic Republic, Malawi, Mongolia 2 AIDS 1 Measles

and Nepal have all reduced their under-fi ve 3 Injuries

mortality rates by 4.5 per cent annually or 8

more. Ethiopia, Malawi, Mozambique and 12 Preterm births

Malaria

Niger have seen absolute reductions of more 41

than 100 per 1,000 live births since 1990. 14 Globally, more Neonatal 9 Asphyxia

Pneu- than one third of causes

monia child deaths are

Despite these achievements, and the fact attributable to 6 Sepsis

that most child deaths are preventable undernutrition 4 Pneumonia

14

or treatable, many countries still have 3 Congenital

Diarrhoeal anomalies

diseases

unacceptably high levels of child mortality 1 Diarrhoeal diseases

16 1 Tetanus

and have made little or no progress in recent Other causes 5 Other neonatal

years. What’s more, among the 67 countries causes

with high child mortality rates (defi ned as 40

or more deaths per 1,000 live births), only 10

are on track to meet the MDG target on child Four diseases—pneumonia, diarrhoea, malaria and AIDS—

survival. The highest rates of child mortality accounted for 43 per cent of all deaths in children under

continue to be found in sub-Saharan Africa. In fi ve worldwide in 2008. Most of these lives could have been

2008, one in seven children there died before saved through low-cost prevention and treatment measures,

their fi fth birthday; the highest levels were including antibiotics for acute respiratory infections, oral

in Western and Central Africa, where one in rehydration for diarrhoea, immunization, and the use of

six children died before age fi ve (169 deaths insecticide-treated mosquito nets and appropriate drugs for

per 1,000 live births). All 34 countries with malaria. The need to refocus attention on pneumonia and

under-fi ve mortality rates exceeding 100 per diarrhoea—two of the three leading killers of children—is

1,000 live births in 2008 are in sub-Saharan urgent. The use of new tools, such as vaccines against

Africa, except Afghanistan. Although under- pneumococcal pneumonia and rotaviral diarrhoea, could add

fi ve mortality in sub-Saharan Africa has momentum to the fi ght against these common diseases and

declined by 22 per cent since 1990, the rate of provide an entry point for the revitalization of comprehensive

improvement is insuffi cient to meet the target. programming. Ensuring proper nutrition is a critical aspect of

Furthermore, high levels of fertility, combined prevention, since malnutrition increases the risk of death.

with a still large percentage of under-fi ve

deaths, have resulted in an increase in

the absolute number of children who have

died—from 4.0 million in 1990 to 4.4 million in

2008. Sub-Saharan Africa accounted for half

of the 8.8 million deaths in children under fi ve

worldwide in 2008.

Under-fi ve mortality also remains very high in

Southern Asia, where about one in 14 children

died before age fi ve in 2008 and where

progress is too slow to meet the 2015 target. 27

MDG Report 2010 En 20100604 r14 Final.indd Sec2:27 6/15/2010 12:51:54 PM

UNITED NATIONS

Recent success in controlling Globally, routine immunization against measles has continued

measles may be short-lived if to rise and protect millions of children against this often

fatal disease. In 2008, coverage reached 81 per cent in the

funding gaps are not bridged developing regions as a whole, up from 70 per cent in 2000.

Such averages, however, mask signifi cant inequalities in

access to the vaccine. Data from 178 Demographic and

Proportion of children 12-23 months old Health Surveys suggest that access to measles vaccinations

who received at least one dose of varies across different social and economic groups, with

measles vaccine, 2000 and 2008 lower coverage for children in households that are poor or

(Percentage) located in rural areas, or whose parents have lower levels

of education. Higher birth order (that is, having many older

Oceania siblings) is also associated with lower measles vaccine

68

58 coverage. Disparities between girls and boys in immunization

2000

Sub-Saharan Africa coverage are not signifi cant, except in some South Asian

2008

55 countries.

72

Southern Asia 58 A single-dose vaccine strategy is not suffi cient to prevent

75 measles outbreaks. As of 2008, a total of 132 countries used

Western Asia a two-dose schedule routinely. In countries with weak health

84 systems, the second dose is offered during campaigns

83

South-Eastern Asia to ensure high coverage. Between 2000 and 2008, the

80 combination of improved routine immunization coverage and

88 the provision of a second-dose opportunity led to a 78 per

Northern Africa cent reduction in measles deaths globally—from an estimated

93

92 733,000 deaths in 2000 to 164,000 in 2008.

Latin America & the Caribbean 92 But recent successes may be short-lived. Funding for

93 measles-control activities has recently declined, and

Eastern Asia 85 many priority countries are confronting funding gaps for

94 immunization campaigns. Projections show that without

Transition countries of South-Eastern Europe supplementary immunization activities in these countries,

93 mortality will quickly rebound, resulting in approximately

95

CIS 1.7 million measles-related deaths between 2010 and 2013.

95 However, with suffi cient funding, political commitment and

96 high-quality implementation of the second-dose measles

Developed regions strategy in priority countries, the exceptional gains made so

91

93 far can be maintained.

Developing regions 70 81

0 20 40 60 80 100

28

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THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

29

MDG Report 2010 En 20100604 r14 Final.indd Sec2:29 6/15/2010 12:51:56 PM

UNITED NATIONS TARGET

Goal 5 Reduce by three quarters, between 1990 and 2015, the

maternal mortality ratio

Achieving good maternal health requires quality reproductive

Improve health services and a series of well-timed interventions to

ensure a women’s safe passage to motherhood. Failure to

maternal provide these results in hundreds of thousands of needless

deaths each year—a sad reminder of the low status accorded

health to women in many societies.

Measuring maternal mortality—death resulting from the

complications of pregnancy or childbirth—is challenging

at best. Systematic underreporting and misreporting are

common, and estimates lie within large ranges of uncertainty.

Nevertheless, an acceleration in the provision of maternal and

reproductive health services to women in all regions, along

with positive trend data on maternal mortality and morbidity,

suggest that the world is making some progress on MDG 5.

New estimates of maternal mortality are currently being

fi nalized by the World Health Organization (WHO), the United

Nations Children’s Fund (UNICEF), the United Nations

Population Fund (UNFPA) and the World Bank. Preliminary

data show signs of progress, with some countries achieving

signifi cant declines in maternal mortality ratios. However, the

rate of reduction is still well short of the 5.5 per cent annual

decline needed to meet the MDG target. The complete data

set will be available at mdgs.un.org

30

MDG Report 2010 En 20100604 r14 Final.indd Sec2:30 6/15/2010 12:51:56 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Most maternal deaths could be Giving birth is especially risky in

avoided Southern Asia and sub-Saharan Africa,

where most women deliver without

skilled care

Causes of maternal deaths, developing

regions, 1997/2007 (Percentage) Proportion of deliveries attended by skilled health

1 Embolism personnel, 1990 and 2008 (Percentage)

9 8

Abortion and Sepsis Southern Asia

miscarriage 30 45

35

Haemorrhage Sub-Saharan Africa

11 41

Other direct

causes 46 1990

Oceania 2008

54

18

Indirect causes 57

18

Hypertension South-Eastern Asia 46 75

Western Asia 62 78

The leading causes of maternal mortality in Northern Africa

developing regions are haemorrhage and 46 80

hypertension, which together account for half Latin America & the Caribbean*

of all deaths in expectant or new mothers. 72

Indirect causes, including malaria, HIV/ 86

AIDS and heart disease, result in 18 per cent CIS 97

of maternal deaths. Other direct causes, 98

such as obstructed labour, complications Eastern Asia

of anaesthesia or caesarean section, and 94

ectopic pregnancy, lead to 11 per cent of all 98

deaths during pregnancy or childbirth. Transition countries of South-Eastern Europe 98

99

The vast majority of these deaths are Developed regions

avoidable. Haemorrhage, for example, which 99

99

accounts for over one third of maternal Developing regions

deaths, can be prevented or managed 53

through a range of interventions administered 63

by a skilled health-care provider with 0 20 40 60 80 100

adequate equipment and supplies. * Includes only deliveries in health-care institutions.

The proportion of women in developing countries who

received skilled assistance during delivery rose from 53 per

cent in 1990 to 63 per cent in 2008. Progress was made in all

regions, but was especially dramatic in Northern Africa and

South-Eastern Asia, with increases of 74 per cent and 63 per

cent, respectively. Southern Asia also progressed, although

coverage there, as well as in sub-Saharan Africa, remains

inadequate. Less than half the women giving birth in these

regions are attended by skilled health personnel. 31

MDG Report 2010 En 20100604 r14 Final.indd Sec2:31 6/15/2010 12:51:58 PM

UNITED NATIONS

The rural-urban gap in skilled TARGET

care during childbirth has Achieve, by 2015, universal access to reproductive

narrowed health

Ratio of urban women to rural women More women are receiving antenatal care

attended by skilled health personnel during

delivery, 1990 and 2008

Sub-Saharan Africa Proportion of women attended at least once

2.3 during pregnancy by skilled health-care personnel,

2.2

Southern Asia 1990 and 2008 (Percentage)

2.9

2.0 Southern Asia

Oceania 48

1990

2.0

1.9 2008 70

Western Asia 1990

1.9 Sub-Saharan Africa 2008

1.6 67

Latin America & the Caribbean* 76

1.8

1.5 Northern Africa

Northern Africa 46

2.5

1.3 78

South-Eastern Asia 1.8 Western Asia

1.2 53

CIS in Asia 79

1.1

1.0 Eastern Asia

Eastern Asia 80

1.0

1.0 91

0.0 1.0 2.0 3.0 4.0 South-Eastern Asia

Parity: Rural women and urban women equally likely to 72

receive skilled care at delivery 93

* Includes only deliveries in health-care institutions. Latin America & the Caribbean

More rural women are receiving skilled assistance 79

during delivery, reducing long-standing disparities 94

between urban and rural areas. In Southern Asia, CIS, Asia

for example, urban women were three times 90

more likely as their rural counterparts to receive 96

professional care at childbirth in 1990; by 2008, Developing regions

they were only twice as likely to receive such care, 64

indicating some improvement. Still, inequalities 80

persist, especially in regions where attendance by

skilled personnel is lowest and maternal mortality 0 20 40 60 80 100

highest—notably in sub-Saharan Africa, Southern

Asia and Oceania. In all regions, progress is being made in providing pregnant

Serious disparities in coverage are also found women with antenatal care. Remarkable gains were recorded

between the wealthiest and the poorest in Northern Africa, where the share of women who saw

households. The widest gaps are in Southern Asia a skilled health worker at least once during pregnancy

and sub-Saharan Africa, where the wealthiest increased by 70 per cent. Southern Asia and Western Asia

women are fi

ve times more likely and three times reported increases of almost 50 per cent.

more likely, respectively, as the poorest women

to be attended by trained health-care workers

at delivery. In the developing regions as a whole,

women in the richest households are three times

as likely as women in the poorest households to

receive professional care during childbirth.

32

MDG Report 2010 En 20100604 r14 Final.indd Sec2:32 6/15/2010 12:51:59 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Inequalities in care during pregnancy are striking

Proportion of women attended at least once during pregnancy by skilled health personnel,

by household wealth quintile, 2003/2008 (Percentage)

100 CIS

90 Sub-Saharan Africa

South-Eastern Asia

80 Developing regions

70 Northern Africa

60

50 Southern Asia

40 Poorest 20% Second 20% Middle 20% Fourth 20% Richest 20%

Large disparities also exist between women living in rural and

Disparities in the share of women receiving urban areas, although the gap narrowed between 1990 and

antenatal care by wealth are striking, 2008. In sub-Saharan Africa, the proportion of urban women

particularly in Southern Asia, Northern Africa who received antenatal care at least once increased from 84

and sub-Saharan Africa. Even in South-Eastern per cent in 1990 to 89 per cent in 2008. The corresponding

Asia, where over 90 per cent of women receive proportions for rural women are 55 to 66 per cent, indicating

skilled care during pregnancy, only 77 per that coverage has improved at a faster pace among rural

cent of women in the poorest households are women.

covered, versus almost 100 per cent of women

in the wealthiest households. 33

MDG Report 2010 En 20100604 r14 Final.indd Sec2:33 6/15/2010 12:52:00 PM

UNITED NATIONS

Only one in three rural women Progress has stalled in reducing the

in developing regions receive number of teenage pregnancies, putting

the recommended care during more young mothers at risk

pregnancy Number of births per 1,000 women aged 15-19, 1990,

2000 and 2007

Proportion of women attended four or

more times during pregnancy by Sub-Saharan Africa 124

area of residence, 2003/2008 (Percentage) 119

121

Northern Africa 49 Latin America & the Caribbean 91

70 80

74

Rural

Sub-Saharan Africa 37 Urban Oceania 1990

63 83 2000

2007

63

Latin America & the Caribbean 61

63 Southern Asia

84 89

59

Southern Asia 53

25 Western Asia

58 62

52

South-Eastern Asia 53

68 South-Eastern Asia

84 53

Developing regions 39 44

34 67 Northern Africa 43

0 20 40 60 80 100 31

31

CIS 52

Women should receive care from a 28

trained health-care practitioner at least 29

four times during the course of their Eastern Asia

pregnancies, according to WHO and UNICEF 15

6

recommendations. However, less than half 5

of pregnant women in developing regions Developed regions

and only a third of rural women receive the 29

recommended four visits. Among rural women 25

23

in Southern Asia, the share is only 25 per

cent. Developing regions 65

55

52

0 20 40 60 80 100 120 140

In all regions, the adolescent birth rate (the number of births

per 1,000 women aged 15 to 19) decreased between 1990

and 2000. Since that time, progress has slowed and, in some

regions, increases have even been recorded. The highest

birth rate among adolescents is found in sub-Saharan Africa,

which has seen little progress since 1990. Adolescents,

in general, face greater obstacles than adult women in

accessing reproductive health services.

34

MDG Report 2010 En 20100604 r14 Final.indd Sec2:34 6/15/2010 12:52:01 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Poverty and lack of education perpetuate high adolescent birth rates

Adolescent birth rates by background characteristics in 24 sub-Saharan African countries,

1998/2008 (Number of births to women aged 15-19 per 1,000 women)

250

200 207

184

150 164 149

139

141

100 113 79

50 58 48

0 Richest Fourth Middle Second Poorest Secondary Primary No education Urban Rural

20% 20% 20% 20% 20% education education

or more

Data for 24 countries in sub-Saharan Africa

show that adolescents in the poorest

households are three times more likely

to become pregnant and give birth than

those in the richest households. In rural

areas, adolescent birth rates are almost

double those of urban areas. But the largest

disparities are linked to education: girls with

a secondary education are the least likely to

become mothers. The birth rate among girls

with no education is over four times higher.

Even more worrisome is the widening of

disparities over time. The adolescent birth

rate declined in 18 of the 24 sub-Saharan

countries studied. However, in almost all

these 18 countries the decline was largest

among adolescents living in urban areas,

among those with at least a secondary

education, and among those belonging to

the richest 20 per cent of households. Thus,

disparities between those groups and rural,

less educated and poorer adolescents have

increased, rather than decreased, over time. 35

MDG Report 2010 En 20100604 r14 Final.indd Sec2:35 6/15/2010 12:52:02 PM

UNITED NATIONS

Progress in expanding the use 2000 and a widening gap among regions. From 2000 to

of contraceptives by women 2007, the annual rate of increase in contraceptive prevalence

in almost all regions was lower than it had been during the

has slowed 1990s. Moreover, contraceptive prevalence in sub-Saharan

Africa and Oceania continues to be very low. And in several

subregions, traditional and less effective methods of

Proportion of women who are using any contraception are still widely used.

method of contraception among women Satisfying women’s unmet need for family planning—that is,

aged 15-49, married or in union, facilitating access to modern contraceptives by women who

1990, 2000 and 2007 (Percentage) desire to delay or avoid pregnancy but who are currently not

Sub-Saharan Africa using contraception—could improve maternal health and

12 20 reduce the number of maternal deaths. Recent estimates

22 indicate that meeting that need could result in a 27 per

Oceania cent drop in maternal deaths each year by reducing the

28 1990 annual number of unintended pregnancies from 75 million

2000

28 2007 to 22 million. Preventing closely spaced pregnancies and

28 pregnancies among adolescents would also improve the

Southern Asia 40 health of women and girls and increase the chances that their

47 children will survive.

54

Western Asia The unmet need for family planning remains moderate to high

46 51 in most regions, particularly in sub-Saharan Africa, where one

55 in four women aged 15 to 49 who are married or in union and

Northern Africa have expressed the desire to use contraceptives do not have

44 access to them.

59

60

South-Eastern Asia 48 57 62

CIS 61 69

70

Latin America & the Caribbean 62 71

72

Eastern Asia 78 86

86

Developed regions 70

71

71

Developing regions 52 60

62

0 20 40 60 80 100

During the 1990s, use of contraceptives

increased among women in almost every

region. By 2007, over 60 per cent of women

aged 15 to 49 who were married or in union

were using some form of contraception. Yet

this average masks two disturbing trends:

a considerable slowdown in progress since

36

MDG Report 2010 En 20100604 r14 Final.indd Sec2:36 6/15/2010 12:52:06 PM

THE MILLENNIUM DEVELOPMENT GOALS REPORT 2010

Use of contraception is lowest among the poorest women and those with

no education

Contraceptive prevalence by background characteristics in 22 sub-Saharan African countries,

surveys around 1994-2003 and 1998-2008 (Percentage of women using at least one

contraceptive method among women aged 15-49, married or in union)

50 First survey: 1994-2003

Second survey: 1999-2008

40 42

39 38

34

34

30 34

30 25

24

20 21 19

18

34

17 14

14 13

10 11

10 10

10 10

0 Rural Urban No education Primary Secondary Poorest Second Middle Fourth Richest

education education 20% 20% 20% 20% 20%

or more

Ensuring that family planning services reach In these countries, contraceptive use is four times higher

poor women and those with little education among women with a secondary education than among those

remains particularly challenging. Surveys with no education, and is almost four times higher among

conducted in 22 countries in sub-Saharan women in the richest households than those in the poorest

Africa show that contraceptive use to avoid households. Almost no improvement has been made over

or delay pregnancy is lowest among rural time in increasing contraceptive prevalence among women in

women, among women with no schooling and the poorest households and among those with no education.

among those living in the poorest households. 37

MDG Report 2010 En 20100604 r14 Final.indd Sec2:37 6/15/2010 12:52:06 PM

UNITED NATIONS

Inadequate funding for family planning is a major failure in fulfi lling

commitments to improving women’s reproductive health

Official development assistance to health, total (Constant 2008 US$ millions) and proportion

going to reproductive health care and family planning, 2000-2008 (Percentage)

20,000 100

39

Total aid to health (Constant 2008 US$ millions )

18,000 health care (Percentage)

Reproductive

planning (Percentage)

Family

16,000 80

US$ 14,000

of Percentage

millions 12,000 60

10,000

2008 8,000 40

Constant 6,000

4,000 20

2,000

0 0

2000 2001 2002 2003 2004 2005 2006 2007 2008

health declined sharply between 2000 and 2008, from 8.2 per

Ensuring that even the poorest and most cent to 3.2 per cent. Aid to reproductive health services has

marginalized women can freely decide the fl uctuated between 8.1 per cent and 8.5 per cent. External

timing and spacing of their pregnancies funding for family planning in constant 2008 US dollars

requires targeted policies and adequately actually declined during the fi rst few years of this decade and

funded interventions. Yet fi nancial resources has not yet returned to its 2000 level.

for family planning services and supplies

have not kept pace with demand. Aid for

family planning as a proportion of total aid to

38

MDG Report 2010 En 20100604 r14 Final.indd Sec2:38 6/15/2010 12:52:08 PM


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DESCRIZIONE DISPENSA

Materiale didattico per il corso di "Diritto internazionale dello sviluppo" della Prof.ssa Cristiana Carletti utile alla presentazione degli elaborati finali. Trattasi del rapporto del 2010 delle Nazioni Unite sui Millennium Development Goals. Il testo, in inglese, è corredato di dati analitici sugli obiettivi del millennio accompagnati dalla spiegazione ed illustrazione grafica.


DETTAGLI
Corso di laurea: Corso di laurea magistrale in relazioni internazionali
SSD:
A.A.: 2007-2008

I contenuti di questa pagina costituiscono rielaborazioni personali del Publisher Atreyu di informazioni apprese con la frequenza delle lezioni di Diritto internazionale dello sviluppo e studio autonomo di eventuali libri di riferimento in preparazione dell'esame finale o della tesi. Non devono intendersi come materiale ufficiale dell'università Roma Tre - Uniroma3 o del prof Carletti Cristiana.

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