2015 is the final year for the UN Millennium Development Goals (MDGs) – goals set by governments in 2000 to guide global efforts to end poverty. This year's World Health Statistics – published by the World Health Organisation – assesses progress towards the health-related goals in each of the 194 countries for which data are available. The results are mixed.
By the end of this year if current trends continue, the world will have met global targets for turning around the epidemics of HIV, malaria and tuberculosis and increasing access to safe drinking water. It will also have made substantial progress in reducing child under-nutrition, maternal and child deaths, and increasing access to basic sanitation. "The MDGs have been good for public health. They have focused political attention and generated badly needed funds for many important public health challenges," says Dr Margaret Chan, director-general of WHO. "While progress has been very encouraging, there are still wide gaps between and within countries. Today’s report underscores the need to sustain efforts to ensure the world's most vulnerable people have access to health services."
Progress in child survival worldwide is one of the greatest success stories of international development. Since 1990, child deaths have almost halved – falling from an estimated 90 deaths per 1000 live births to 46 deaths per 1000 live births in 2013. The report says despite great advances, this is not enough to reach the goal of reducing the death rate by two-thirds. Less than one third of all countries have achieved or are on track to meet this target by the end of this year. The top killers of children aged less than 5 years are now: preterm birth complications, pneumonia, birth asphyxia and diarrhoea.
The number of women who died due to complications during pregnancy and childbirth has almost halved between 1990 and 2013. This rate of decrease won’t be enough to achieve the targeted reduction of 75% by the end of this year. The maternal mortality ratio has fallen in every region. However, 13 countries with some of the world’s highest rates have made little progress in reducing these largely preventable deaths. In the WHO African Region, 1 in 4 women who wants to prevent or delay childbearing does not have access to contraceptives, and only 1 in 2 women gives birth with the support of a skilled birth attendant. Less than two-thirds (64%) of women worldwide receive the recommended minimum of 4 antenatal care visits during pregnancy.
The world has begun to reverse the spread of HIV, with new infections reported in 2013 of 2.1m people, down from 3.4m in 2001. The revised target of achieving universal access to treatment for HIV will be more challenging as WHO's recommendations have resulted in much higher numbers of people needing treatment. At current trends, the world will exceed the target of placing 15m people in low- and middle-income countries on antiretroviral therapy (ARTs) in 2015. By the end of 2013, almost 13m people received ARTs globally. Of these, 11.7m lived in low- and middle-income countries, representing 37% of people living with HIV in those countries.
While the global target for increasing access to safe drinking water was met in 2010, the WHO African and Eastern Mediterranean Regions fall far short, particularly for poor people and those living in rural areas. The world is unlikely to meet the MDG target on access to basic sanitation. Around 1bn people have no access to basic sanitation and are forced to defecate in open spaces such as fields and near water sources. Lack of sanitation facilities puts these people at high risk of diarrhoeal diseases (including cholera), trachoma and hepatitis.
In September, countries will decide on new and ambitious global goals for 2030 at the UN General Assembly in New York. In addition to finishing the MDG agenda, the post-2015 agenda needs to tackle emerging challenges including the growing impact of non-communicable diseases, like diabetes and heart disease, and the changing social and environmental determinants that affect health.
The draft post-2015 agenda proposes 17 goals, including an overarching health goal to "ensure healthy lives and promote well-being for all at all ages".
[link url="http://www.who.int/mediacentre/news/releases/2015/world-health-statistics-2015/en/"]World Health Organisation material[/link]
[link url="http://apps.who.int/iris/bitstream/10665/170250/1/9789240694439_eng.pdf?ua=1&ua=1"]WHO report[/link]