Lancet-LIDC Commission on the Millennium Development Goals: Introduction and Summary of Findings - Professor Jeff Waage, LIDC

Editor's Notes

• #2: Good afternoon. My name is Jeff Waage and I am the Director of the London International Development Center. I am going to kick off this presentation of our Commission with an introduction on how we did it, and a summary of its findings.
• #3: As we approach the two-thirds mark for the achievement of these goals in 2015, attention is focused on accelerating progress towards these 8 Millennium Development Goals and their targets. Projections suggest that we may not achieve the targets identified here for the majority of goals, particularly in Sub-Saharan Africa and also in South Asia. In these regions, increasing poor populations will undermine efforts to achieve our first, poverty targets, while reduction in hunger has proven challenging to both measure and achieve. For primary education, net enrolment ratios are improving but they wont reach the global target and there is a real risk that quality of learning may be sacrificed in the rush towards it. The gender target was set early and effort has been narrowly focused on educational parity, but even this will not be met. Improvements in child survival are not occuring at a rate that would achieve the target by 2015, while improvement in maternal health, considered by some to be the most unsuccessful MDG to date, will also struggle to approach its targets. MDG6 is likely to succeed with its disease reduction targets but there is considerable concern about the sustainability of this achievement, and the continuity of funding for medicine supply. For MDG7, the target of water supply will probably be reached, but sanitation lags far behind, as does reversing environmental degradation, while MDG8, the MDG for rich countries, notable in its lack of specific targets, has failed to approach the commitments necessary for its broad goal. So the broad picture is one of patchy progress, but not at a pace capable of achieving these goals by 2015. Two questions arise – is this just a matter of effort, can we accelerate this process towards 2015, or are there fundamental problems with the MDGs themselves that will hamper their achievement. Does our experience to date point to a need for a different approach to the MDGs, post 2015? In our study we have focused on the second question – what we can learn so far about the nature of the MDGs as development goals, their problems and how they can be addressed in future goal setting beyond 2015. But before I lead us there, let me stress again that, despite their trajectories, progress is being made towards almost all goals. Further,
• #4: Besides making progress towards their targets, the MDGs have delivered other benefits. They have encouraged a uniquely broad political consensus, provided a focus for advocacy and improved the targeted flow of aid. Significantly, they have also improve monitoring of development projects and progress.
• #5: Most evaluations of the MDGs such as our own, and there are quite a few now in advance of next weeks summit, take one of two approaches – either they focus sectoral and technical experts on specific MDGs and what needs to be done about them, or they take a broad view, from a more development theory and policy perspective. We believe that our study is unique in that it has tried to combine these approaches, bringing specialists together to work across their sectors and disciplines. This approach draws upon the unique nature of the London International Development Centre, which is a consortium of six London Colleges dedicated to working together on international development research and training.
• #6: Of these six Colleges, three have been specifically involved in our project, the Institute of Education, London School of Hygiene and Tropical Medicine and School of Oriental and African Studies.
• #7: Researchers from each school have picked up specific MDGs in which they have expertise and, with partners identified in other countries – evaluated their progress. So our commission evaluates progress on MDGs 1-7 and draws out cross-cutting issues that limit MDGs, and then it builds a cross-sectoral vision of development goal setting beyond 2015>
• #8: Here is our approach. Each participant and their partner analysed the MDG with which they had experience. These reports are summarized in the appendix to our Commission, and provided the evidence base for a cross-cutting comparision of MDGs, which we did through workshops. Finally, on the basis of this cross-cutting analysis, we developed a set of principles for future goal setting.
• #9: Let me know very briefly summarize our second activity, the cross cutting analysis. When we brought together our individual MDG studies, we found that, despite their specific targets and “communities”, they had a number of common features that had, in one way or another, limited the implementation of each, and all, goals.These features fell into three categories what we called “conceptualization and execution”, “ownership” and “equity”I shall say a bit about the first of these, and Elaine Unterhalter with follow up with some observations on ownership and equity.
• #10: The MDGs are conceptualized as a set of goals, with targets and indicators. In fact, they began as targets, and for virtually all the goals, these targets had been identified by different, sector-specific development campaigns in the 1990s. As a result, while the Millennium Declaration in 2000 set out a broad, fairly inclusive vision of development needs, what actually emerged as MDGs was a very narrowly defined subset of this vision, a set of goals constructed around these pre-existing targets.Two problems emerged from building goals around such narrowly defined targets – firstly there were considerable gaps in coverage between goals, and secondly, this distance between goals undermined their capacity to achieve some interaction and synergy in advancing development. In our study we discuss many of these gaps, the focus on primary but not secondary and tertiary education, the vertical approach to health goals that left gaps in health coverage across health systems. We also point to how this conceptualization failed to achieve synergies.
• #11: For instance, improvements arising from the education MDG should contribute to improvement in health through improved health practice, reduced fertility and improved child and maternal health – but the focus of the education MDG on primary education reduces this synergy as it does not support secondary level training for family planning or tertiary training for health professionals.Improvements from the health MDGs should contribute to improved education through better enrolment, progression and learning achievement, and the evidence is that they do, but the vertical focus of health MDGs has contributed to the neglect of some particular opportunities to improve health through education, for instance through education regarding sanitation in schools.
• #12: At another level it their conceptualization, we found problems with how targets and indicators delivered goals. For instance, across the MDGs, targets frequently failed to capture the complexity of delivering goals. Income proves to be an unsatisfactory proxy for poverty reduction, enrolment ratio a poor proxy for learning, and school gender ratios a poor proxy for the challenge of establishing gender equity in societyIn many cases, targets and indicators were revised later in an attempt to address this problem and improve the relevance of what is measured to what is sought. But, across the MDGs, these follow up targets and indicators share problems of complexity and lack of ownership which has limited their contribution to improving goals. More generally, lack of, or unclear ownership of MDG targets, by national bodies and by international bodies, which have often competed for, or sometimes avoided, MDG responsibilities, has contributed to problems with implementation of a range of goals – in particular, only targets and indicators with championship or ownership, usually a fraction of those in any Goal have show substantial progress.
• #13: I shall leave further comment on cross-MDGs ownership issues, and on equity issues, to the next talk. I hope that, in reading the Commission, you find our inter-disciplinary approach interesting and useful.