Regional progress towards achieving the health-related Millennium Development Goals – ReliefWeb

Executive Summary

The experience gained during 15 years of pursuing the health-related Millennium Development Goals (MDGs) has been vast and invaluable for the Governing Bodies of the Pan American Health Organization (PAHO). From a regional perspective, this document presents a summary of the achievements toward the health-related MDGs and the remaining challenges to be considered by the post-2015 agenda. Its intent is to supplement the evaluations that will be conducted by Member States at the national, subnational, and municipal levels.

Given this regional perspective; the political and socio-economic structural determinants such as income, education, gender, occupation, ethnicity or social class, and health systems; the determinants intermediates such as conditions and lifestyle determine the prevailing health standards for different segments of the population, highlighting the critical need to transform the aforementioned determinants into positive factors, through implementation of targeted social protection programs designed to increase access to and universal coverage by the health services, and by encouraging deliberate national policies that act positively on the social determinants of health. Said transformation is illustrated through descriptions of the positive impact that economic growthapproximately 5% per yearhas had on the Region during the last decade. Finally, this contextual background concludes by recognizing that, in addition to ethnic minority status or urban or rural location, gender is one of the most relevant determinants of inequality. However, promotion of gender equality first required carrying out a set of core tasks to lay the groundwork for a plan of action, one that may yield its first results in the near future.

These general considerations provide the basis for a summary of the progress and remaining challenges revealed by the regional indicators for each health-related MDG. The conclusion reached is that, in some cases, many of the MDG targets were met in the Region. Nevertheless, as pointed out throughout the document, gaps persist and will require special attention in the forthcoming stage.

PAHO has continuously collaborated, even prior to the Millennium Declaration, with Member States to transform objectives and goals into results; those are mentioned in this report. In addition, this MDG period represents a valuable source of experience for the countries of the Region and for PAHO itself. The lessons learned by countries and by PAHO provide essential conclusions that will shape new targets and the recently-adopted Sustainable Development Goals (SDGs).

This review concludes by looking ahead, beyond 2015. First, it summarizes the remaining challenges, highlighting the persistent high maternal, neonatal, and child mortality rates in some countries, especially among the poorest and those in the most vulnerable of situations, where the highest rates of chronic malnutrition also persist.

Gaps in reproductive health contribute to the persistence of high fertility rates, especially among young people 15-24 years old. In the Region, no significant reduction in HIV/AIDS prevalence has been achieved; simultaneously, antiretroviral drug coverage and access has required even further expansion.

Limited access to basic sanitation, in contrast to the increase in water service coverage, continues to create high health risks. Furthermore, because Latin America has become largely urban since the second half of the 20th century, the challenge of ensuring a safe water supply and basic sanitation requires massive investment in infrastructure. Such investment should not, however, surpass coverage of broad segments of the population that live in poorer areas, especially rural and peri-urban regions.

By acknowledging these remaining challenges, one deduces there is a need for more universalization of social policies to address local gaps, particularly gaps masked by national and regional averages. Broad demographic segments remain vulnerable due to geographic location, educational level, wealth, ethnicity, and gender issues. Furthermore, in view of the synergy in health and economic growth, it is essential that business cycles be closely monitored because recessions increase the vulnerability of the poorest populations. Social spending, in particular, decreases when biased austerity measures are imposed during adjustments made to overcome recessions.

This extensive experience and the networks that have been established should continue to support the process of sustainable development in the Americas and the Sustainable Development Goals. The last part of this document includes a set of suggested initiatives, the execution of which will help achieve the health-related SDG 3 and boost the generation of reliable evidence to support effective decision-making.

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Regional progress towards achieving the health-related Millennium Development Goals - ReliefWeb