MDGs including major recent reductions of the disease burden and deaths from malaria, polio, AIDS, measles, and other killers. Yet there are also major opportunities for public health and disease control not yet achieved because of the absence of appropriate management and funding streams. These include maternal survival through emergency obstetrical care, neonatal (first 28-day) survival, parasitic disease control, and control of major childhood killers including diarrhoeal diseases and pneumonia. Success in these areas can be summarized as building a Primary Health System, which ensures training and staffing of community health workers, construction and maintenance of local facilities, emergency obstetrical care, ambulance services, and logistics for key commodities. Many governments have rightly called for new health systems financing. The best approach would be to merge GAVI and GFATM into a new single Global Health Fund with added responsibilities for health systems. The fifth need is for climate financing, for example a Global Climate Fund as proposed by the Government of Mexico. There are two major commitments on climate financing coming out of Copenhagen: US$10 billion per year during 2010-2012, and a rising trajectory to $100 billion per year by 2020. A new Global Climate Fund or comparable mechanism or mechanisms would ensure systematic international financing for climate change adaptation and mitigation, perhaps through an assessment based on each country’s carbon emissions. A sixth unmet objective is support for empowering girls and women, through legal changes and through practical investments in micro-finance, smallholder farming (where most of the farmers are women), and other means to empower poor women in poor communities. The UN’s new Women’s Agency will be tapped for leadership of MDG 3. A seventh unmet need involves infrastructure: roads, power, rail, and broadband connectivity. The world has long recognized that infrastructure, typically financed in part by the public sector, is a key input to economic development, and indeed is vital for a healthy and productive private sector economy. Yet it remains the case that we lack a consistent framework for truly largescale and sustainable infrastructure in low-income countries. Financing remains somewhat haphazard and unpredictable. For example, an estimated 1.6 billion people still lack access to electricity. Africa’s roads and rail networks urgently need upgrading and expanding. The World Bank and the Regional Development Banks should create a new and expanded platform for financing sustainable infrastructure. The eighth unmet need is to help countries integrate the various strategies and goals at the local level, by creating networks of MDG teams in villages and districts throughout their countries. The Millennium Villages Project has powerfully demonstrated the advantages of a strong MDG team at the village level, able to capture the synergies of integrated investments in agriculture, health, education, infrastructure, and business development. These integrated efforts introduce powerful systems of delivery, community participation, women’s empowerment, and accountability. A global funding stream to enable countries to launch integrated rural development programs along the lines of
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the Millennium Village Project would greatly accelerate success at the local level in the world’s poorest regions.
A chance to make progress The MDG Summit in September this year gives us the opportunity to scale up the best thinking and experience. The world has the crucial opportunity to innovate, by creating new institutions and new ways of doing things, in both the public and private spheres. The MDGs are more than technical targets. They hold the world’s hopes and dreams for a global end of extreme poverty, hunger, and disease. We have many inspiring successes and many setbacks. Some countries have been plunged into conflict – the very opposite of development. Some despots have ignored the pleas of their own citizens. And too many wealthy countries have yet to live up to large words and deep hopes. Working together, we can help the world to fulfil its profoundest aspirations for shared peace and prosperity.
“Working together, we can help the world to fulfil its profoundest aspirations for shared peace and prosperity.” We still have time to reach many of the MDGs throughout the world, but have already lost time to reach others. This is not a reason, however, to slow down, or lose heart, but to speed up, and take new confidence in our purpose and our ever-improving tools. The world leaders should therefore arrive at the MDG Summit this September with the agreed plans, partnerships, and financing to accelerate our progress. And let us commit, as President Obama bid us to do this year at the UN General Assembly, to look beyond success of the MDGs to the end of extreme poverty in our time.
About the Author Professor Jeffrey D Sachs is Director of The Earth Institute at Columbia University. He is also Special Advisor to UN Secretary-General Ban Ki-moon. From 2002 to 2006, he was Director of the UN Millennium Project and Special Advisor to UN Secretary-General Kofi Annan on the MDGs.
About the Organization The Earth Institute’s overarching goal is to help achieve sustainable development primarily by expanding the world’s understanding of earth as one integrated system.
Enquiries The Earth Institute, Columbia University 405 Low Library, MC 4335 535 West 116th Street New York, NY 10027, USA Tel: +1 212 854 3830 Fax: +1 212 854 0274 Email: jjamal@ei.columbia.edu Website: www.earth.columbia.edu
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