SciDev.Net

This report summarises progress towards each of the eight Millennium Development Goals (MDGs) in ten regions, based on data available as of June 2008. Each goal is reviewed, clearly identifying the different targets embedded in each and presenting data to show progress to date and gaps in achievement.

The report emphasises the deep commitment made by the international community to meeting the goals and highlights some of the advances made in areas such as primary school education, health, access to safe drinking water, use of ozone-depleting substances and access to critical drugs.

At the same time, the report points to areas where the goals are unlikely to be met unless additional, or corrective, action is taken. These include child malnutrition, gender parity, sanitation, carbon emissions and international trade negotiations.

A key message is the need to improve developing countries' capacity to produce, analyse and disseminate data. The report points to a number of initiatives aimed at helping this happen.

The Millennium Development Goals (MDGs) practically define health efforts in the 21st century, but they virtually ignore non-communicable diseases such as mental health, say these authors. This is despite evidence that mental health disorders are among the most important cause of sickness and disability and even premature mortality. The authors argue that tackling mental health problems will be vital to achieving the MDGs, and three in particular — eradicating poverty, reducing child mortality, and improving maternal health.

Poverty and hunger are well-recognised risk factors for mental health, but mental health also makes it harder for people to escape the hunger trap. Mothers who are depressed during pregnancy and post natally, are more likely to have underweight babies; not only that, the illness means these mothers are more likely to stop breastfeeding and less likely to ensure their children are properly immunised than mothers without depression.

The authors advocate that strengthening basic health-care systems should be holistic. For example, developing countries need more and better-trained health workers but they should not only know how to deliver babies but also how to counsel new mothers. HIV/AIDS programmes, as another example, should ensure that individuals not only have good access to antiretrovirals but also to treatment for depression if they need it.

In 2003, the Gates foundation infused new vigour into global health efforts by declaring that the 21st century's "grand challenges" included developing new vaccines and overcoming drug resistance. This new grand challenges initiative, launched by a collaboration of top global chronic disease experts, identifies priorities in tackling diseases like diabetes and cardiovascular disease, and explains in detail how research should be directed to meet each challenge (a challenge was defined as a critical barrier that if removed would help solve an important health problem).

To distill the range of opinions and priorities, the coordinators sought input from 155 stakeholders from different countries and disciplines. The initiative requires the participation of agencies like the WHO, individual governments, and non-governmental organisations as well as civil society and business if it is to succeed. The authors point out that the Gates initiative was linked to large funding, whereas this project will rely on multiple funding agencies to coordinate on these priorities.