Jeffrey Sachs: On the MDGs, the Cynics Lost

Earlier this week, a group of journalists met with UN Deputy Secretary-General Jan Eliasson, Special Advisor to the Secretary-General Jeffrey Sachs, and Special Advisor to the Secretary-General on Post-2015 Development Planning Amina J. Mohammed to discuss progress on the Millennium Development Goals (MDGs) and the outstanding challenges.

The meeting comes at a crucial time. We are approaching the finish line–and there is a real question over whether or not the international community will sprint, or limp to the finish.

The speakers highlighted the achievements in health care access, children’s education and treatment for malaria and HIV before detailing the particular issues posed by sanitation, reproductive care and energy expenditure. While the entire UN system is working to meet the MDGs in just under two years, their ultimate success depends on both political will and the financial investments that will come with the financial replenishment round set for this year – a process that will undoubtedly be influenced by economic and fiscal austerity programs around the world.

Even with these difficulties, Sachs said, if there’s one lesson of the MDGs it’s that “the cynicism and the skepticism were profoundly misplaced.”

On The Path To Success

While there is still much to be done to meet the MDGs, Sachs emphasized the fact that global poverty has fallen by half in the past 40 years, with the biggest gains seen in East Asia and China specifically, but with nearly all corners of the world seeing poverty decline. The key, Sachs said, is a combination of general economic growth and targeted investments in people.

Despite enormous gains, there are still more than a billion people living in extreme poverty, and goals like sanitation and maternal health lag behind. Inequalities are not only between nations but within nations, with more poor people residing in middle-income countries than in poor countries. Thirty-seven percent of humanity still lacks access to toilet, and many don’t have clean water. Those problems go beyond the immediate benefits of sanitation; they impact health, gender equality and even education, Eliasson said. The MDGs overlap in purpose and communities served, making meeting as many of them as possible by 2015 widely and multilaterally beneficial.

The UN plans to deploy a million community-based health workers in Africa by 2015. To secure adequate funding to meet the MDGs, new countries and new partners are encouraged to come forward and participate in the process. Right now, on the ground, the outlook is good. “Malaria is down,” Sachs said. “People are being treated for AIDS. Children are in school. These things work.”

Funding Roadblocks and Opportunities

Making the MDGs sustainable, though, is no easy task. Funding for the programs remains subject to economic fluctuations, with local austerity initiatives leading to cuts. The only way to make sure the MDGs are met, Eliasson said, is to demonstrate to countries that these aren’t just good international solutions, but that they are in the national interest.

The business world is also a necessary partner, and many business leaders realize, Sachs said, that “They’re at the top of the world economy and they know that economic disaster impacts them.”

Promoting health and eradicating poverty is ultimately in the interest of businesses and national governments. “To live in a society with grave inequalities is not only unfair, it’s dangerous,” Eliasson said. “It’s a security issue.”

The Energy Emergency

The growth of energy use in emerging economies coupled with the high levels of carbon emissions already taking place also demands our attention, putting us on an extraordinarily dangerous trajectory even in the next few decades. Solving this problem the right way, Sachs said, “is the hardest challenge that humanity has ever faced in terms of an economic issue.”

The hope is that tackling environmental and energy issues will be a global priority, despite organizational and political difficulties. “There is a growing realization,” said Eliasson, “that we are on the voyage of this ship together, and this is an untenable course.”

Women’s Health: Underfunded and Underserved

Also untenable is the high birth rate in many low-income nations, and the related maternal health issues. While maternal deaths have declined by half in the past 40 years, reproductive health care remains chronically underfunded and deeply politicized. It is a human right to access reproductive health services, but those services – abortion in particular, but also contraception – can be politically sensitive. Women’s health care also poses complex local challenges and requires systematic funding. Saving women involves antenatal visits, access to family planning and contraceptives, as well as emergency care during pregnancy and childbirth. Maternal health needs are not as widely met as many other pressing health care problems because of both logistics and funding: “An emergency obstetric intervention is harder than a bed net,” Sachs said.

Gains are being made, with wider access to contraceptives driving down family size and leading to better health outcomes for mothers and children. But birth rates remain very high in Africa and South Asia, and access to family planning tools remains limited.

“Africa’s fertility rates are so high that it jeopardizes Africa’s development,” said Sachs. “[Family planning] is in my view one of the most strategic investments for the well-being of the children, of the parents and of the environment.”

The disconnect between that necessity and the low prioritization of maternal health, Mohammed suggested, perhaps comes from a lack of knowledge as to the wide variety of benefits that health care provides. Situating reproductive rights in the context of women’s health has been helpful in illustrating the necessity of those rights across culture and religion. Making that connection with women on the ground, with governments and with international organizations must continue to fully promote women’s health and rights. “Education is going to play a huge role,” Mohammed said.

Going Forward, Full Steam Ahead

With the MDG deadline rapidly approaching, Sachs, Eliasson and Mohammed all implied a need to balance recognition of the achievements in poverty reduction and health improvements with the many outstanding challenges and complexities in fully meeting the goals.

Ultimately, Sachs said, the UN system is aiming high and continuing their concerted effort to turn the goals into reality. “For the next thousand days,” he said, “there is no rest.”