Wish List for a Decent Life

A recent article from the New York Times, “­U.N. Poverty Goals Face Accountability Questions” reflects our recurring theme of global health measures. In the article, Neil MacFarquar briefly discusses controversial approaches to the Millennium Development Goals (MDGs) and their relevancy to improving global health outcomes.

U.N. Poverty Goals Face Accountability By Neil MacFarquar

Published: September 18, 2010

Gemunu Amarasinghe/Associated

A mother and her baby in a Nepal hospital. One of the Millennium Development Goals is improving maternal health.

The Millennium Development Goals, as Esther Duflo, a development expert at M.I.T. stated, “serve as a useful wish list for what everyone on the planet should have access to for a decent life, but the glaring hole is the absence of information about why they work in some places and not in others.”

It seems much of the controversy is not so much about the goals themselves (although agenda-setting can be another debate in itself), but how to effectively apply and interpret health indicators across all countries. As our class readings have highlighted and MDG reports have revealed, global averages skew statistics and even data on the national level can be too simplistic.  For example, Mac Farquar discusses the case of Nigeria, where the mortality rate for children under age five is about 1 in 4 in the northern Nigeria, and 3 times lower in southern Nigeria.  These regional disparities apply to a number of countries on various target goals set forward by the MDGs.

With this in mind, can health indicators really tell the entire story behind a country’s road to development, health, and progress? No, of course not.  But the blogger of “Death and Taxes” makes a great point by saying that these measures—while flawed—are important in creating “a framework whereby populations and individuals can be more precisely compared, and therefore health policies/ funding can be more appropriately channeled to where it is needed most.”

And should we consider the MDGs as just a “useful wish list”? I’d hope not.  (Maybe because the last time I wrote a wish list, I was 9 and I asked Santa for a new bike) I’m sure U.N. Delegates consider maternal health, universal primary education, gender equality, and child health more than just some “wishes” to be granted.  They are goals—specific goals—with targets and indicators for progress.  While these targets and indicators may be imperfect, they are important tools for highlighting progress and setbacks. More importantly, they can set forth new policies to improve problem areas and strengthen the policies that have been proven effective.


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