Using social tables, the author estimates global inequality (inequality among world citizens) from the early 19th century until the 21st century. The analysis shows that the level and composition of global inequality have changed over the past two centuries. The level has increased, reaching a high plateau around the 1950s, and the main determinants of global inequality have become differences in mean country incomes rather than inequalities within nations. The inequality extraction ratio (the percentage of total inequality that was extracted by global elites) has remained surprisingly stable, at around 70% of the maximum global Gini co-efficient, during the past 100 years.
Equity in Health
Global inequality and the global inequality extraction ratio: The story of the past two centuries
Milanovic B: World Bank Policy Research Working Paper 5044, September 2009
Interview with Archbishop Ndungane on outcomes of UN MDG Summit
Eldis Aid blog: 29 September 2010
In this interview with Archbishop Ndungane, president and founder of African Monitor, he assesses the outcomes of the United Nations Summit on the Millennium Development Goals (MDGs). On the positive side, he welcomes the fact that the outcome document is comprehensive, touching on almost everything that needs to be addressed if MDGs are to be met, with commitments that are measurable and therefore can be tracked. The specific amounts committed by specific stakeholders is also a step in the right direction, according to him. Clause 23 (c) makes specific reference to the promotion of national food security strategies that strengthen support for smallholder farmers and contribute to poverty eradication. This is key to poverty eradication, particularly where without exception, 70% of the population in rural areas depend on agriculture for their livelihood. According to the Archbishop also commendable are the specific focus on maternal and child health, the references to lessons learnt, particularly the issue of supporting community-led strategies; and the commitment to strengthening the statistical capacity to produce reliable and disaggregated data. He also pointed out a number of concerns about the Summit, in the lack of any guarantee that the concrete commitments will go beyond mere ‘lip service’; the lack of clear mechanisms for enforcement; and the repetition of principles that have proved difficult to operationalise without new angles on how they are going to be implemented in reality. Finally, although there are specific commitments, world leaders need to find mechanisms to reinvigorate and stimulate the local energies, initiatives and actions which are people-driven. They should look beyond 2015 and work for sustainable solutions.
Keeping the promise: United to achieve the Millennium Development Goals
United Nations General Assembly: 17 September 2010
The General Assembly adopted this outcome document at the sixty-fifth session of the General Assembly on the Millennium Development Goals, held in September 2010. It reaffirms the United Nations’ commitment to achieving the Millennium Development Goals (MDGs) and calls on all stakeholders, including civil society, to enhance their role in national development efforts as well as their contribution to achieving the MDGs. The resolution indicates that there has been a mix of successes and failures in achieving the MDGs, with uneven progress and many remaining challenges and opportunities. It recognises that developing countries have made significant efforts towards achieving the MDGs and have had major successes in realising some of the targets of the MDGs, such as combating extreme poverty, improving school enrolment and child health, reducing child deaths, expanding access to clean water, improving prevention of mother-to-child transmission of HIV, expanding access to HIV prevention, treatment and care, and controlling malaria, tuberculosis and neglected tropical diseases. However, much more needs to be done to reach the MDGs, as progress has been uneven among regions and between and within countries. Hunger and malnutrition rose again from 2007 through 2009, partially reversing prior gains. There has been slow progress in reaching full and productive employment and decent work for all, advancing gender equality and the empowerment of women, achieving environmental sustainability and providing basic sanitation. New HIV infections still outpace the number of people starting treatment. In particular, the Assembly criticised the slow progress that has been made in improving maternal and reproductive health.
MDGs: The contribution of family planning in Kenya
Mwita C: Africa Population and Health Research Centre, 28 September 2010
In this presentation, the author argues that meeting unmet need for family planning services in Kenya could help the country ‘significantly’ generate resources and save costs to achieve universal primary education, reduce child mortality, improve maternal health, ensure environmental sustainability, and help combat HIV and AIDS, malaria and other diseases. It draws on research to show that greater access to FP information and services in Kenya could contribute directly to the country’s attainment of Millennium Development Goals 4 and 5 (to reduce child mortality and improve maternal health).
South Africa and the MDGs: Talking left, walking right
Bond P: Pambazuka News (497), 23 September 2010
In this interview, Patrick Bond discusses the failings of South Africa’s drive towards meeting the Millennium Development Goals (MDGs) and the extent to which the country’s government continues to operate against the interests of its poor majority. According to Bond, South African urban poverty increased from 1993–2008 and rural poverty declined only because more poor people moved to the cities and the welfare grant system was extended. The South African economy is structured so as to generate poverty-expanding 'growth' of GDP (gross domestic product) so, as accumulation of capital occurs in much of South Africa, the rich grow richer and the poor grow poorer. That structuring happens in ways concordant with the speculative, financial-driven and profit-exporting character of capitalism, interrupted only briefly by the great crash of 2008. Most of Pretoria's economic policies amplify this trend because of their neoliberal (pro-business) character, he argues. South Africa cannot be confident of making progress on any MDGs, given the coming austerity associated with a failing global and national 'Keynesian' (deficit-based) macroeconomic strategy that was largely based on white-elephant infrastructure investments. Such spending – especially for now-empty World Cup soccer stadiums costing R22 billion – plus declining state revenues (as profits and taxes fell) moved the national budget from a surplus of around 1% of GDP to more than 7%. What is therefore likely, within five years, is a similar turn by the Treasury to the kind of austerity now being felt in many other countries which ratcheted up their deficits to deal with the crisis. As shown in the recent civil servants' strike, the state is willing to put services mainly utilised by the poor majority – public schools, clinics and hospitals – at risk to maintain some semblance of fiscal discipline, which does not bode well for future state expenditure on MDG-related needs.
The role of birth order in infant mortality in Ifakara in rural Tanzania
Sangber-Dery MD: INDEPTH Network, 2010
Compared with some countries in sub-Saharan Africa, infant mortality rate is relatively high in Tanzania, at 68 per 1000 live births (2004-2005). Studies of factors affecting infant mortality have rarely considered the role of birth order. This study aims to contribute to fill this research gap by determining the risk factors associated with infant mortality in Ifakara in rural Tanzania from January 2005 to December 2007. Data for 8,916 live births born from 1 January 2005 to 31 December 2007 was extracted for analysis. The study found that first and higher birth orders had highest levels of infant death, while mothers younger than 20 years old had the highest infant mortality. From 2005–2007, malaria remained the leading cause of infant death. Giving birth at the hospital was perceived by women to be associated with severe delivery complications. The study recommends that Tanzania’s health systems urgently need strengthening, and efforts should be made to communicate the benefits of health facility deliveries more effectively. Voluntary and community health workers also need to be trained adequately to recognise factors that put infants at risk.
Trends in maternal mortality: 1990 to 2008
World Health Organization, United Nations Children’s Fund, United Nations Population Fund and the World Bank: September 2010
This review uses Millennium Development Goal 5 (reducing the maternal mortality ratio by three quarters and achieving universal access to reproductive health by 2015) to assess global progress in improving maternal health. The main study limitation was a lack of reliable and accurate data on maternal mortality, particularly in developing-country settings where maternal mortality is high. An estimated 358,000 maternal deaths occurred worldwide in 2008, a 34% decline from the levels of 1990. Despite this decline, developing countries continued to account for 99% (355,000) of the deaths, with sub-Saharan Africa and South Asia accounting for 87% (313,000). Overall, it was estimated that there were 42,000 deaths due to AIDS among pregnant women in 2008. About half of those were assumed to be maternal. The contribution of AIDS was highest in sub-Saharan Africa where 9% of all maternal deaths were due to AIDS. These estimates provide an up-to-date indication of the extent of the maternal mortality problem globally. They reflect the efforts by countries, which have increasingly been engaged in studies to measure maternal mortality and strengthen systems to obtain better information about maternal deaths. The modest and encouraging progress in reducing maternal mortality, the review argues, is likely due to increased attention to developing and implementing policies and strategies targeting increased access to effective interventions. Such efforts need to be expanded and intensified, to accelerate progress towards reducing the still very wide disparities between developing and developed worlds.
A fair chance at life: Why equity matters for child mortality
Save the Children: September 2010
Save the Children’s research compares mortality rates of poor children and rich children in 32 countries. In many countries that are successfully reducing child mortality, progress is concentrated among the poorest and most disadvantaged children. Conversely, in countries making slow or no progress, disparities in life chances between children from the poorest and richest backgrounds tend to be extreme. Since 1990, the global child mortality rate has declined by 28%, which falls short of the target set by Millennium Development Goal (MDG) 4 (a two-thirds reduction by 2015). Still, many high-mortality countries have substantially reduced child deaths, and 19 of 68 high-priority countries are now expected to meet MDG 4. The findings underscore a great gap in reaching the poorest with essential health care, including pre-and post-natal care, skilled attendance at birth, and low-cost prevention and treatment for the major child killers – pneumonia, diarrhoea, and malaria. Save the Children found inequity in child survival to be a persistent and sometimes growing problem in many of the world’s developing countries, where 99% of all child deaths occur.
Accelerating progress on the MDGs: Country priorities for improving performance
Greeley M: Institute of Development Studies, September 2010
This report was prepared to advise the United Nations Development Group Millennium Development Goal (MDG) Task Force at the United Nations Summit on the MDGs, held from 20–24 September 2010, in the United States. It discusses six priorities to help countries to accelerate progress towards meeting the MDGs. 1. Country-led MDG strategies should integrate MDGs in their national development strategies, grounded in annual resource budgets that are planned through a medium-term expenditure framework. 2. A local accountability plan should be used to implement and evaluate results with mechanisms that are transparent and accountable to citizens. Policy, legal and institutional frameworks must make accountability real. 3. Governments should prioritise community participation and partnerships, taking full advantage of the efficiency and effectiveness gains from community involvement and through the use of the private sector and south-south partnerships. 4. Gender equality and women’s empowerment should be high on the agenda, and world leaders must recognise that progress on gender equality and women’s empowerment is critical to progress on the MDGs overall. 5. A policy of inclusion should be followed that addresses issues of inequality, exclusion and discrimination. Governments must assess and strengthen the targeting of public services and programmes to address inequality and all those that suffer from discrimination and social exclusion. 6. Resilience, for example in adapting to climate change, should help to protect the most vulnerable. Governments should adopt an effective and inclusive approach to social protection and prioritise sustainable development.
Countdown to 2015: Decade report (2000–2010): Taking stock of maternal, newborn and child survival
Countdown to 2015: 2010
This decade report collects and analyses data from the 68 countries that account for at least 95% of maternal and child deaths. It reviews progress made from 2000-2010 and provides a mix of good and bad news. Good news is that the under-5 child mortality rate has declined by 28% from 1990 2008, accounting for a reduction of nearly four million child deaths per year. Nineteen of the 68 Countdown countries are now on track to meet Millennium Development Goal (MDG) 4, which calls for reducing child deaths by two-thirds between the 1990 base line and 2015. However, many Countdown countries are still off track for achieving MDGs 4 and 5 and are not increasing coverage of key health interventions quickly enough, especially in sub-Saharan Africa. The report further found that most of the 68 Countdown countries were experiencing poorly functioning health infrastructure, inadequate numbers of health workers, slow adoption of evidence-based health policies and insufficient focus on quality of care. The report argues that only a dramatic acceleration of political commitment and financial investment can make achieving MDGs 4 and 5 possible by 2015.