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Tough Goals

Asian nations struggle to measure up to the world’s most ambitious development goals

WORKING HUNGRY A Cambodian child carries water lily flowers next to barbed wires in Takeo province, south of Phnom Penh. The prevalence of hunger in developing countries is on the rise, from 16% in 2006 to 17% in 2008, according to the 2009 MDG progress report.
Photo by AFP

YUAN POWER The People’s Republic of China (PRC ) has reduced the number of people living in “absolute poverty” from 250 million to 15 million since 1978, according to a report of the PRC government in July 2009.
Photo by AFP

GIMME AN "M"… "D"… "G" Volunteers take part in an event to promote awareness about the United Nations Millennium Campaign in New Delhi, India in 2007. The Millennium Development Goals have been credited with bringing newfound confidence to people in disadvantaged or disempowered groups.
Photo by AFP

STRUGGLING FOR EQUALITY Burqa-clad women walk on the outskirts of Kabul. Though the country has made progress in the area of girl’s education, Afghanistan’s women are among the worst-off in the world as measured by life expectancy, maternal mortality, and malnutrition.
Photo by AFP

In the teeming slum of Comilla, Bangladesh, 17-year-old Shamima Shetu goes door-to-door armed with a painting: one side shows the world where water is dirty and sanitation practices poor; the other, where water is clean and community sanitation good.

She is a “hygiene monitor” who checks whether her neighbors are drinking safe water, using clean toilets, washing their hands before eating, and disposing of rubbish properly.

An estimated 2,500 people live in atrocious conditions in this 1-square-kilometer community outside Dhaka, the capital, yet Shamima’s work has made a difference. By reinforcing simple behaviors, she is making the neighborhood cleaner and residents healthier. “Before this program I saw many unhygienic latrines,” she says. “Now [people are] much more hygienic.”

This is one of hundreds of simple stories of progress in Asia that can be directly linked to government and United Nations (UN)–sponsored programs that sprang from a seminal decision taken by 189 countries in 2000. At the Millennium Summit, the UN General Assembly formally chartered eight Millennium Development Goals (MDGs) to tackle disadvantage and disease in the developing world. Heads of state agreed to reach the goals by 2015. The MDGs have been widely trumpeted as the most ambitious developmental undertaking ever embraced by the international community—and the subject of much debate and controversy.

More than halfway to the 2015 deadline, have they been successful? In parts of Asia, yes. For example, in eastern, southeastern, and western Asia, the target to cut the under-5 mortality rate by two-thirds between 1990 and 2015 will likely be met, according to Millennium Development Goals Report 2009, the UN’s annual update.

Not surprisingly, much progress has been made by the booming People’s Republic of China (PRC), which has reduced the number of people living in “absolute poverty” from 250 million to 15 million since 1978, according to a report of the PRC government in July 2009. “We believe China will achieve the Millennium Development Goals fully and on schedule,” it says.

The battle against disease, the sixth goal, has been especially encouraging. The 2008 Report on the Global AIDS Epidemic by UNAIDS notes that the global percentage of people living with HIV has stabilized since 2000, though the report cautions that the overall number of people living with HIV has increased.

Significantly, the quality of life for people with HIV is improving in Asian nations. Rajendra Shirke is a recent graduate of a leadership and managerial proficiency course at the Xavier Institute of Management in Orissa in eastern India. He is one of 93 people living with HIV who graduated from the course run by the UN Development Programme, which helps monitor the goals.

“The course helped me to learn how to manage work and life better,” says Mr. Shirke, who is now studying for a master’s degree in social work. “I know I‘m capable of achieving more if I just try.”

For others, quality of life means simply being able to maintain dignified employment. Another Bangladeshi, Shamima Begum, is one of more than 24,000 who have benefited from a UN and government social safety net project providing employment for destitute or socially marginalized rural women.

Ms. Begum’s life has improved markedly. She has had primary health and hygiene training and was able to buy a cow with money earned working as “crew on project sites. She recently opened a small grocery shop, which she runs from the front of her house. Her son helps out after school.

The MDGs have also been credited with bringing newfound confidence to people in disadvantaged or disempowered groups. When countries signed onto the MDGs, they agreed to work to lift the living standards of all their people, particularly the least advantaged. Minority groups have used this commitment by their governments to fight for their rights, experts note.

One such community is the lowercaste Dalit, who number some 300 million throughout southern Asia. A recent meeting in New Delhi by the National Conference of Dalit Organisations, for example, agreed that progress toward the goals can offer them a better life.

The summit heard grim stories of oppression against the Dalit. In a recent case in Bihar state, an upper-caste landowner chopped off all five fingers of a 10-year-old Dalit girl’s hand with a sickle for stealing spinach leaves from his property.

The recent struggle of a handful of Dalit women for land rights in a small hamlet in Andhra Pradesh shows there is hope. When upper-caste landowners claimed that waste grazing land belonged to them, the women filed a right-to-information claim with local authorities. With the help of the media, they won the right to work on the land.

Yet despite the best of intentions and advances made, the picture remains disappointing in many places. Recent studies by a partnership of the Asian Development Bank, the United Nations Development Program and ESCAP, as well as those by World Bank and IMF, indicate that most Asian nations, along with most developing countries, will not meet all the targets.

Moreover, advances in the fight against poverty and hunger have begun to slow as a result of the global economic and food crises. The UN acknowledges that progress against extreme poverty in South Asia is in danger of disappearing because of the global economic contraction and job loss.

In reducing the maternal mortality rate, India is faring particularly badly: of the 536,000 women worldwide who die during pregnancy or childbirth, 117,000 are Indian, according to the 2009 MDG report released in July. This incidence is “a human rights catastrophe,” says Paul Hunt, former UN Special Rapporteur on the Right to Health.

Meanwhile, poverty in West Asia has been increasing steadily with the absolute number of poor almost quadrupling from 3 million to 11 million between 1990 and 2005.

None of this may surprise critics of the MDGs, who observe the initiatives should, or would, have been set in motion anyway and that the excessive focus on aid could deter sound domestic policy.

One of the most trenchant critics is Samir Amin, an economist and authority on the developing world. He says that while commendable, the goals are vague, “ideological cover” for Western neoliberals, and redolent of “pious hope.”

Mr. Amin attacks, in particular, the way the goals are monitored. Equality is measured by access to education and empowerment by the proportion of wage-earning women, he observes in an online critique. Many cultures ignore the rights of women and the family, he says. “Without discussion, declarations on this question are only empty talk.”

Censure may be warranted, but even if most Asian nations fall short of targets, most sensible people will agree that some progress is better than none.

An expert subscribing to this view is John Ruxin, assistant clinical professor of public health at New York’s Columbia University, who has spent years as an aid worker in developing countries.

Looking at the MDGs as a failure is to fail to see what they intend to do, according to Mr. Ruxin. “Don’t we need global goals?” he asks. “What’s the alternative? It might not be a blueprint for action, but it’s a tool that helps ensure these issues stay on governments’ radar when they might not otherwise have done so. How are we doing? How can we do better?”

Besides, many initiatives in Asia are of the grassroots variety: they encourage people’s aspirations, set an example, and may lead to the formation of small business enterprises.

Consider the “barefoot solar engineers” in the Barmer district of India. Night has fallen on the edge of Rajasthan, where shifting dunes mark the border with Pakistan. In four adjacent villages in the Barmer district, naked bulbs in the courtyards of houses act as tiny beacons in the desert.

These communities, scattered across an undulating landscape, have had their nights lit by incandescent bulbs for the first time ever, thanks to the work of four young women colloquially known as “barefoot engineers.

The women—one from each village—assembled the lights and are paid to maintain and repair them as part of a renewable energy project for rural livelihoods by the Government of India and the UN. They spent 2 months training and now undertake regular checks, respond to complaints, repair faulty lights, and maintain batteries that power these.

Each family with a light contributes to a fund from which their “barefoot engineer” is paid a monthly salary ranging from the equivalent of about $20 to $25. Little girls now trail their local expert and watch in awe as she fiddles with wires and fuses, hoping they will be engineers some day.

Are more advances likely? The 2009 MDG report flags major developments causing concern. Funding gaps are evident for programs needed to improve maternal health, the goal toward which least progress has been made. And developing countries have had a major reduction in donor funding for family planning since the mid-1990s on a per-woman basis, despite the big contribution such programs can make toward improving maternal and child health.

The ability of most Asian countries to finance development programs adequately may be in jeopardy. Industrialized countries made a commitment to raise their aid contributions to 0.7% of national income by 2015, yet the figure in 2007 was only 0.28% termed a “shameful failure” by the UN.

Meanwhile, export revenues have fallen in the past year as the financial meltdown in high-income economies has trickled down, and the debt service-to-export ratio is likely to deteriorate further. “The world is confronted with a global economic crisis whose full repercussions have yet to be felt,” asserts Francesca Perucci, chief of the Statistical Planning and Development Section of the UN Statistics Division.

Most Group of Eight nations have committed publicly to increasing aid. But as the global economy contracts, these commitments have dropped because most are expressed as a percentage of national income. For many developing nations, this could reverse gains made, says the 2009 MDG report.

Other experts note that aid is not the main route to achieving the goals. A bigger problem, for example in India, which is a large country with adequate domestic resources, is the prioritization of funds toward meeting the goals. This includes better use of existing public resources and harnessing private, NGO, and community efforts.

The MDG report calls on governments and agencies involved to revitalize their efforts. Among areas critically in need of attention, it says, are the provision of productive and decent employment for all, including women and young people.

The report urges governments to intensify efforts to get all children into school and eliminate inequalities in education based on gender and ethnicity. Prospects are hopeful on this front. ADB research notes that the majority of countries in the region will reach gender parity in primary and secondary education, though not in tertiary.

“Greater political will” must be mustered to reduce maternal mortality, especially in South Asia and sub-Saharan Africa, it adds. Rapid acceleration of progress is needed to bring improved sanitation—toilets or latrines—to the 1.4 billion people still lacking, or the 2015 sanitation target will also be missed.

Specifically, the Millennium Campaign calls on donor countries to urgently agree to a timetable to accelerate delivery of aid commitments, make “rapid progress” toward simplifying and streamlining aid, reduce or eliminate agricultural subsidies, and ensure poor countries are fully represented in decision-making bodies and in restructuring the global financial infrastructure.

The campaign calls on developing countries to ensure their national development policies and plans are pro-poor and focused on women and excluded groups, prioritize expenditures on the MDGs, ensure accountability and transparency in managing public money, and prioritize “domestic resource mobilization.”

In some cases, a nation’s ability to meet these goals may depend largely on forces beyond its control. Take Nepal. Its government has identified a need for public investment of $12.6 billion over the next decade to reach its MDG commitment. To do so, donors must double their funding for development in the country over the next 10 years. That seems unlikely, even though Nepal, like Sri Lanka, has made great progress on health-related and other goals.

RIGHT TO EDUCATION A boy struggles among adults to obtain books during a literacy event in Jakarta. The Millennium Development Goals Report 2009, the United Nation’s annual update on the issue, urges governments to intensify efforts to get all children into school and eliminate inequalities in education based on gender and ethnicity.
Photo by AFP

Attempts to motivate governments to do more with sweeping calls for “more action” at a time when they cannot afford it may seem like an exercise in futility. “It’s a hell of a question with no easy answer,” concedes Mr. Ruxin. “The international community can’t use carrots and sticks successfully, or you wouldn’t have the Zimbabwes of the world.”

Yet Mr. Ruxin takes a philosophical view, confessing that he never had the greatest expectations for the goals. At the same time, countries that have made good progress almost always have shown leadership and have competent, transparent governments. Encouraging such transparency is one of the best ways forward, Mr. Ruxin suggests.

As testimony, he points to Rwanda, which has improved conditions for its people, particularly around children’s health, since its genocidal civil war in the 1990s. Now it is on the road to meet and exceed many of the MDGs by 2015. Child mortality between 2005 and 2007 declined between 20% and 30%. Over 60,000 people are receiving retroviral drugs for HIV/ AIDS, one of the best figures in sub-Saharan Africa. “If Rwanda can do it, why can’t others that are far richer?” questions Mr. Ruxin.

The African nation’s success, he believes, stems from a government which, while autocratic, is relatively transparent, uncorrupt, and committed, and has strong institutions. That combination has helped the public health sector build good programs with international support.

“I believe there are steps the international community can take through having more democratic elections and good institutions,” he says. “When you start to do this, progress is made. It happened in Uganda.”

MARKET DAY Buyers pick vegetables in a market in Kolkata, India. The global economic crisis, coupled with high food prices, has derailed progress made on eradicating poverty and has pushed between 55 million and 90 million more into extreme poverty, according to the United Nations.
Photo by AFP

Salil Shetty, director of the UN Millennium Campaign, believes it is a straightforward question of political will. Rich country governments that have made pledges but not delivered to those who need it most should simply get on and do so.

Since the inception of overseas development assistance nearly 50 years ago, donor countries have given a total of about $2 trillion in aid, Mr. Shetty says. Yet over the past year, $18 trillion has been found globally to bail out financial institutions.

“The stark contrast between the money dispersed to the world’s desperately poor after 49 years of painstaking summits and negotiations, and the staggering sums found virtually overnight to bail out the creators of the global economic crisis makes [sic] it impossible for governments to claim any longer that the world can’t find the money to help the 50,000 people who are dying of extreme poverty every day,” says Mr. Shetty.

There seems to be no easy solution to this conundrum. Nevertheless, as the Director-General of the World Health Organization, Dr. Margaret Chan, has told Development Asia, the very fact that the goals’ reporting process is so visible helps focus attention and can stimulate political will. Plus, the strong emphasis on monitoring progress is a major incentive for governments and development agencies to deliver on their promises, she says.

Ultimately the best hope may lie in the efforts of the people, agencies, and governments that work hard to make a difference and to meet their MDG commitments wherever and whenever they can with all the resources they can muster.

The classroom at the Manohar Basti Samudayik Learning Center in Nepal is lively with the chatter of over 50 housewives who have come to school after taking care of daily chores. Giggling and whispering, Man Kumari Subedi is exchanging notes with 45-year-old Kamala Shrestha as they discuss their schoolwork. At age 75, Ms. Subedi is attending school for the first time in her life.

“This is the best part of my day,” says Ms. Subedi, who like other illiterate women in her neighborhood, has enrolled in this “housewives’ program.” It’s part of a government scheme backed by the Millennium Campaign involving 85,000 volunteers to enable everyone to read and write by 2010.

For these women and thousands like them, cynicism about the MDGs is irrelevant. “I read the newspaper now and discuss the news with my husband,” says Krishna Karki, a 30-year-old school goer with two kids. Like more and more of her classmates, she no longer feels left behind.

In a remote village of the Jumla district in Nepal, lack of awareness and a shortage of medical care resulted in an above-average number of rural women dying in childbirth.

While expecting her second child, 20-year-old Jarsikala Kami was encouraged by a village development committee volunteer to visit a local birthing center.

“We took Jarsikala there on a homemade stretcher,” says her mother-in-law. “My granddaughter was born the next day with the help of a skilled birth attendant.”

When she was discharged, Ms. Kami was given the equivalent of about $30 to buy food—part of the Government of Nepal’s policy to encourage women to deliver babies at hospitals and health centers. It is working. The latest available data show 281 cases of maternal deaths per 100,000 live births annually, compared with 539 deaths in 1995. •