In preparation of People's Health Assembly II - part 9
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TOWARDS THE MILLENNIUM DEVELOPMENT GOALS: YES, BUT.
I have, for long, been on record to be very ambiguous about
goals and targets.
What I keep reading in the postings I get is a mixture of a
praise for having (a) goal(s) to strive for now, and active
steps being taken to get there in many countries trying to build
a united front. In this context though, one should not and can-
not forget how many goals have come and gone without sorrow or
glory!
I have read that colleagues feel disappointment that ordinary
people do not have a clue about the MDGs: does anybody really
think it would make much of a difference given the almost nil
power they have to change things? A better question would be:
why were 'people' not invited to set the MDGs to begin with??
We are told 'MDGs are within reach' -- if only guidance (top-
down?) is given on how to accomplish this; yes, but are they
really within reach?
Here is a further sample of what I get to read:
- that MDGs have renewed our sense of urgency; yes, but have
they really?
- that MDGs have given us a new sense of direction; yes, but
have they really given as a 'new' sense?
- that, PRSPs can create thousands of jobs annually and raise
the GDP substantially keeping the inflation rate low; yes, so
far, but have they really?
- that, in many developing countries, the quality of life over
the past 20 years (measured as child deaths) has dropped; do we
have any indication the trend has changed for the better?
- that the various MDG Progress Reports assert little if any
progress, but that, by 2015 there will be a decrease in malnu-
trition; yes, but based on what more upbeat data?
- that, before 2010, Vitamin A deficiency will be eliminated in
many countries through the production and consumption of nutri-
tious foods, yes, but are we really seeing this happening?
- that new policies will go a long way in achieving MDGS; yes,
but are they really?
- that accountable government will make sure these policies are
enacted; yes, but are there any objective signs of this?
- that many governments have demonstrated renewed commitment to
the MDGs; yes but do the deeds show this too?
- that, overall, more prevention will result in improved quality
of life; yes, but has it really?
- that educational policies should strive for attaining univer-
sal access to primary education; yes, but have they increased to
these levels?
- that repetition and drop-out rates will decrease; yes, but
have they really?
- that child labour will be reduced; yes, but has it really?
- that free school feeding will be given to children in poor ar-
eas; yes, but have they really?
- that gender equality still needs implementation - an honest
exception here since women do need to take up leadership posi-
tions and participate in all debates.
- that many governments have committed themselves to mainstream-
ing gender issues; yes, but have they really?
- that MOHs around the world have set up several programmes to
address reproductive health needs of women; yes, but have they
performed up to MDGs standards?
- that the political commitment towards, HIV, TB and malaria has
increased; yes, but has this had measurable effects?
- that national malaria strategies will measurably reduce morbi-
mortality from the disease; yes, but has it really?
- that countries have shown progress in achieving MDGs; yes, but
has there really been measurable progress commensurate to the
promise, e.g. in water and sanitation, community-based pro-
grammes, women's income generation activities (needing govern-
ment setting aside funds to support these)?
- that nutrition is a key component of development; yes, but
have the new programmes performed? Anything has happened beyond
'proposed' new policies?
- that food production is targeting population needs; yes, but
has it really?
- that renewed political commitment has translated into funding
and the provision of essential services; yes, but has it really?
- that nutrition empowers individuals and communities and leads
to poverty reduction; yes, but through what magic automatic
mechanism(s)?
I do not know (nor do I claim to know) if all my 'yes, but'
questions are justified and/or are exposing broken promises.
But, already being half through 2005, my point is that we have
to get to the deeds: enough of grandiose pronouncements and
empty promises, lest the MDGS become one more crutch to delay or
fake needed action. I keep reading the clauses 'the government
should' or 'policies are needed', well, that is not good enough
for the MDGs to get there by 2015, I am afraid. Most governments
simply do not have the will and the commitment -- and we better
begin accepting this.
So much for this long saga. The best thing about this "yes, but"
approach is that it invites for a yearly follow-up essay along
the same lines, because SOMEBODY has to keep asking every year
from now to 2015: where are we beyond pronouncements and prom-
ises? Would any of our readers take up the challenge? You can
continue calling those future essays: "Towards the Millennium
Development Goals: Yes, but, and add the year in which the re-
view is done.
If anyone dares, I promise to help.
Claudio Schuftan
Ho Chi Minh City, Vietnam
mailto:claudio@hcmc.netnam.vn