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MILLENNIUM DEVELOPMENT GOALS
Child malnutrition accounts for more than a third of the disease burden of children under age five. And malnutrition during pregnancy accounts for more than 20 percent of maternal mortalities. The proportion of children under five who are underweight declined from 31 percent in developing countries in 1990 to 26 percent in 2007, a much slower pace than needed to halve malnutrition by 2015. Progress has been slowest in Sub-Saharan Africa and South Asia, with severe to moderate stunting affecting as many as 46 percent of children under five—more than 140 million children. Progress on full and productive employment, especially for women, was lacking even before the crisis. (figure 1.9). The employment-to-population ratio is the proportion of a country’s working-age population (ages 15 years and older) that is employed. Considerable underemployment in informal sectors and subsistent activities of rural areas are of course hard to account for in developing countries. The female employment ratios have consistently been lower than male ratios, particularly in the Middle East and North Africa and in South Asia. Nonetheless, progress is noted in the female ratios for Latin America and the Caribbean and to a slight extent in the Middle East and North Africa (figure 1.9). Gender parity is weak beyond primary education. MDG 3 also calls for gender parity in tertiary education (figure 1.10), gender equality in employment, and greater political representation of women. Progress toward these targets has been slower and less even. The gender targets face added risk from the current crisis because evidence from past crises suggests that women in general are more vulnerable. Access to sanitation has been elusive. Sanitation coverage, another important target of MDG 7 on environmental sustainability, rose from 43 percent in 1990 to 55 percent in 2006, in low- and middle-income countries. But the global target will be missed. Almost half the people in developing countries lack
GLOBAL MONITORING REPORT 2010
adequate sanitation. In Sub-Saharan Africa the proportion with access rose from 26 percent in 1990 to just 31 percent in 2006, and in South Asia, from 18 percent to 33 percent. MDG 7 also calls for integrating sustainable development into country policies and programs and reversing the losses of environmental resources. Progress on this broader environmental agenda, although fairly slow, is picking up as the world focuses on environmental sustainability and climate change.6 Prospects are worst for most MDGs relating to health, such as infant mortality. The under-five mortality rate in developing countries declined from 101 deaths per 1,000 to 74 between 1990 and 2007, showing notable but insufficient progress to meet MDG 4 for reducing child mortality under five by twothirds. In 2006, 10 million children died before age five from preventable diseases, compared with 13 million in 1990. The human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) epidemic and civil conflicts have impeded Sub-Saharan Africa’s progress. Its under-five mortality rate stood at 144 deaths per 1,000 in 2008, down from 185 in 1990. Sub-Saharan Africa has 20 percent of the world’s children under age five but 50 percent of all child deaths. Progress in reducing infant mortality is also well short of the target in South Asia. The situation is similar for universal access to reproductive health (MDG 5.b). For example, the contraceptive prevalence rate has increased for all income groups between 1990 and 2007 but is still quite low at only 33 percent for low-income countries in 2007 (figure 1.11). Progress in halting the spread of major communicable diseases has been mixed (MDG 6). An estimated 33.4 million people were living with HIV/AIDS in 2008; there were 2.7 million new infections and about 2 million AIDS-related deaths. The rapidly rising trends of HIV spread and related deaths that were recorded in the 1990s were halted in the 2000s and were showing some signs of decline in recent years (figure 1.12). However, further actions are still necessary to achieve