Forging a Fairer Future
by Elena Martinez
The Millennium Development Goals stand out as a historic achievement amid a steady stream of resolutions and declarations emanating from the United Nations General Assembly and U.N. agencies in recent years. The millennium goals have a greater chance for realization than many previous high-minded declarations and resolutions, mainly because of the high-level political commitment to them expressed by both developed and developing countries. Moreover, the millennium goals feature clear, time-bound, and measurable targets for reducing poverty, hunger, illiteracy, disease, environmental degradation, and discrimination against women. They also set forth a pragmatic formula for cooperation between rich and poor countries that implies a global quid pro quo: financial and other support from rich countries in return for genuine efforts at sound economic and social reform by poor countries.
Goal 1: Eradicate extreme poverty and hunger
The number of poor people grew from 48 million to 57 million in Latin America and the Caribbean during the 1990s. One in 10 people in the region was living on less than $1 a day at the turn of the millennium.
The millennium goals are ambitious in both their scope and their call for achieving greater equity in the distribution of wealth and social well-being. This is especially relevant for poor countries in Latin America and the Caribbean, where wide disparities in economic and social indicators persist.
All of the goals depend on healthy economic growth and a reduction of inequality. The millennium framework goes beyond sector approaches, underlining the interdependence and complementary nature of the goals. Goals 1 through 7 are mutually reinforcing and directed at reducing poverty in all its forms. The last goal, calling for a global partnership for development, offers the means to achieve the first seven.
Goal 2: Achieve universal primary education
Literacy and school enrollment rates have increased dramatically in Latin America and the Caribbean, but disparities persist. In five countries, fewer than three out of four people complete primary school.
The millennium goals' most complex and ambitious challenge is to make progress on both Goal 1, Target 1—to halve, between 1990 and 2015, the proportion of people with incomes of less than $1 a day—and Target 2—to halve, over the same period, the proportion of people who go hungry. Economic growth to sustain a halving of poverty can be achieved only in an enabling environment of peace and democratic governance, as well as competitive markets that foster investment, production, and trade. Countries cannot sustain their efforts to fight poverty unless they ensure democratic rights and public participation, and a healthy and educated labor force. Indeed, none of the goals is likely to be met if social exclusion and crises in failed states are left unresolved.
Goal 3: Promote gender equality and empower women
The Americas have achieved near parity in education for girls and boys, and girls now have higher literacy rates. But only 18.5 percent of legislators in the region are women.
One of the goals' key strengths is the global partnership they embody. They assign responsibilities to both poor and rich countries: Developing countries that make genuine efforts to introduce reforms to fight poverty should be helped with generous development assistance and other means of support from developed partners. These partnerships are not limited to governments. The international sponsors of the millennium goals have also called on civil society, the private sector, and international organizations to give priority to reducing poverty and inequalities and investing in democratic governance, health, education, the environment, and other areas of human development.
Meeting Goal 1 in Latin America and the Caribbean is a tough challenge; the number of poor people is increasing, and the region is the most socially unequal in the world. Inequalities are high both across and within countries. Regional and country averages in social indicators mask wide disparities in income, ethnicity, gender, and geographic location.
The Millennium Declaration—signed by 189 heads of state and government at the United Nations Millennium Summit in New York City in September 2000—set out a framework...[Read more]The rate of economic growth in the region is way too low. According to the United Nations Economic Commission for Latin America and the Caribbean (ECLAC), the region’s economies grew by only 1.5 percent in 2003; moreover, per capita GDP growth was nil after being negative in 2001 and 2002.
The United Nations Development Program (UNDP), ECLAC, and Brazil’s Institute for Applied Economic Research (IPEA) carried out a study of 18 countries in the region in 2002 to determine the conditions under which each country would be able to halve, by 2015, its rate of extreme poverty (percentage living on less than $1 a day) as of 1999. The simulations, based on the countries' historical performance, give rise to concern. Given current trends, only seven of the 18 countries—Argentina (before the financial crisis), Chile, Colombia, the Dominican Republic, Honduras, Panama, and Uruguay—would meet the poverty targets by 2015. Six other countries—Brazil, Costa Rica, El Salvador, Guatemala, Mexico, and Nicaragua—would manage to reduce the incidence of extreme poverty, but at a very slow pace. The other five—Bolivia, Ecuador, Paraguay, Peru, and Venezuela—would actually register higher levels of extreme poverty, owing to increases in income inequality, decreases in per capita income, or both.
Goal 4: Reduce child mortality
More than 1,000 babies under age 1 die each day in the Americas. Every year, 140,000 children die from preventable diseases before age 5.
The study also includes simulations based on an alternative scenario, in which income disparities are reduced by policy interventions. These give cause for guarded optimism. Given interventions to reduce inequality, the study finds that the poverty reduction targets appear to be feasible. Even very small reductions in inequality can have very large positive impacts in terms of poverty reduction. For this to happen, however, the countries must demonstrate the political will to implement policies that go against historical trends—particularly with respect to seeking a more equal distribution of income.
The second target of Goal 1 is to halve, between 1990 and 2015, the number of people who suffer from hunger. Among the relevant indicators are the percentage of underweight children below age 5 (an indicator of malnutrition) and the percentage of the population with less than the minimum level of calorie intake. Econometric studies carried out as part of the ongoing Millennium Development Goal Reports have shown that children's weight is related to the number of prenatal visits, mothers' level of education, the number of economically active people in households, and access to electricity and sanitation services. Caloric deficit is related to total household expenditures, availability of supplementary food programs (such as school breakfasts and public dining rooms), and the number of household members who are economically active.
Goal 5: Improve maternal health
Every 25 minutes, a woman dies from pregnancy-related causes in Latin America and the Caribbean. The risk is 28 times higher for Latin American and Caribbean women than for those in North America.
Three of the eight millennium goals refer explicitly to health issues—reducing child mortality; improving maternal health; and combating HIV/AIDS, malaria, and other diseases. The first, child mortality, is closely linked to poverty. A large proportion of deaths under age 5 are the result of malnutrition, acute respiratory infections, diarrhea, measles, and malaria, or a combination of these. Only a minority of the world’s developing countries are likely to be able to reduce child mortality by two-thirds, as called for in Target 5. However, many countries in Latin America and the Caribbean are on track to achieve this target, and some have already done so. Success in this area requires overcoming economic, social, and cultural barriers that hamper pregnant women's access to health services. A study by Peru's Universidad del Pacífico found that child mortality correlates strongly with the number of well-child visits, the percentage of children fully immunized against measles, mothers' educational level, the quality of potable water and sanitation services, and the quality of health infrastructure. Similar variables correlate with infant, or under-1, mortality. Another recent study, in Ecuador, found that indigenous infants are no more likely to die before age 1 than nonindigenous infants if other variables are controlled. What matters most is access to medical assistance during childbirth.
Goal 6: Combat HIV/AIDS, malaria and other diseases
Some 119,000 people died of AIDS in Latin America and the Caribbean in 2003, and some 200,000 became newly infected with HIV. Nearly 1 million people in the region suffer from malaria.
The same study looked at Goal 5, which calls for reducing maternal mortality by three-quarters by 2015. The variables that had the most impact here included mother’s educational level, number of pregnancies, quality of available health services, availability of basic residential services, health care received through pregnancy and postdelivery, and mother’s health insurance coverage.
Such research helps identify those variables that affect millennium goal outcomes and suggests corrective policies that may improve them. In the case of Ecuador, for example, research shows that improving access to maternal and child care—through vaccinations, prenatal visits, and professionally assisted child delivery—is critical for reducing infant mortality. The same study suggests that financing the needed improvements would consume only .01 percent of the country’s GDP per year. What is required is a reorientation of the public health budget, a deepening of the immunization program to reach full coverage, expansion of free maternal health services, and improved use of available resources for personnel and infrastructure.
The Millennium Declaration makes clear that developing countries themselves have primary responsibility for achieving Millennium Development Goals 1 through 7. But these frameworks also embody a new approach, one in which developed countries increase their support through stepped-up financial assistance, trade concessions, and more debt relief in return for developing countries' demonstrating good-faith efforts to mobilize domestic resources, implement policy reforms, and improve governance.
Goal 7: Ensure environmental sustainability
In Latin America and the Caribbean, 130 million people (1 in 4) lack access to safe drinking water in their homes, and fewer than 1 in 5 are connected to adequate sanitation systems.
The fulfillment of Goal 8—developing a global partnership for development —is the key to success in all the other goals. Since the adoption of the Millennium Declaration, there has been an increase in pledges to countries in post-crisis situations and increased debt relief for countries under the Initiative for Heavily Indebted Poor Countries, as well as new agreements on intellectual property rights in the areas of technology and public health. However, these achievements fall short of promises made. The developed countries have done little to date to increase access to their markets or to boost investment in poor countries. Other important obstacles to further progress in these areas include the Iraq war, the tenuousness of the worldwide economic recovery, and the persistence of deadly diseases that claim millions of lives and put increased strain on developing economies.
In Latin America and the Caribbean, the mild recovery of 2003 (which has continued into 2004) suggests that the regional economy may be entering a new expansionary cycle. While the resumption of growth in the region is welcome, it may not be sufficient. The recovery in Latin America and the Caribbean, and indeed in all developing countries, must be not only sustainable but also accompanied by the consolidation of democratic institutions and the implementation of policies to combat poverty and inequality and improve education, health care, the environment, and gender equity. At the same time, the developed countries must fulfill their obligations under Goal 8 by creating an enabling international environment and by actively supporting the developing countries' efforts at human development.
Goal 8: Develop a global partnership for development
Latin America and the Caribbean received about $10 per person in international aid in 2002 but owed $265 per person to rich-country governments and lenders such as the World Bank.
These are all daunting challenges, and much remains to be done. But the Millennium Development Goals, with their unprecedented political backing, represent a unique opportunity for a new and effective partnership between rich and poor countries that can succeed in building a better world for us all. As the Millennium Declaration puts it, achieving these goals is this generation's collective responsibility to "all the world's people, especially the most vulnerable and, in particular, the children of the world, to whom the future belongs."
Elena Martinez is regional director for Latin America and the Caribbean of the United Nations Development Program.