Martin Carroll: Time is running out to achieve the Millennium Development Goals

Martin CarrollTo many observers in 2000, the Millennium Development Goals (MDGs) seemed to herald a new era in efforts to improve the lives of those living with poverty, disease, and hunger. A historic agreement between all 193 United Nations member states, the MDGs pledged to overcome the obstacles to human development in the 21st century, which were encapsulated in eight goals. These drivers for change aimed to halve poverty by 2015 and to combat HIV/AIDS, TB, and Malaria. The agenda was ambitious, but it consolidated a great deal of the work by international development conferences during the 1990s and presented a clear, well-timed vision, which was both inspirational and feasible. 

Ten years on, in September 2010, a high level plenary meeting of the UN General Assembly acknowledged that progress towards the MDGs had fallen far short of what was needed. Many goals were badly off-track. With just four years left, the UN emphasised the need for “mutually supportive and integrated policies across a wide range of economic, social, and environmental issues” if the goals were to be achieved by 2015.

The UN’s call for an integrated approach is timely. One criticism frequently levelled at the MDGs concerns their focus on outcomes rather than strategies, which some feel has helped to foster a segmented response to development efforts. As a result, in recent years, programmes and policies have increasingly focused on the priorities of individual sectors, such as health, education, water, etc.

A new report released today challenges this way of thinking about the MDGs and advocates an alternative approach which is already proven to work. “Join Up, Scale Up,” a joint publication by six campaigning organisations from across the development sector, reminds us that the MDGs are in fact interconnected and mutually reinforcing. Our best hope for achieving them lies therefore with strategies which coordinate interventions from different sectors that are responsive to the way poverty, health, education and other challenges overlap in people’s daily lives.

Or put more simply: achieving change means working together.

The report’s six success stories provide compelling real-world examples of how this approach can work in a variety of settings. We learn of a pioneering programme in Kenya where co-operation between the child health, water, and sanitation and nutrition sectors resulted in new guidelines on diarrhoeal disease which have helped to reduce child mortality.

In Zimbabwe, the government, NGOs, faith based organisations and local communities in Bulawayo (Zimbabwe’s second largest city) have established a network of community gardens where families grow vegetables to boost nutrition. The repair of nearby water boreholes to provide safe drinking water has resulted in a sharp reduction in the incidence of diarrhoeal disease and malnutrition in the area.

Integrated approaches also work at the national level. The Ethiopian government has shown that a cross sectoral approach to healthcare, encompassing a nationwide package of family health services, disease prevention, sanitation, and health information, can improve health and hygiene practices at the local level.

The message from the report is clear: the key to scaling up efforts to overcome the challenges of poverty and preventable disease lies in joining up and working with others who share that vision. A more immediate – but hopefully achievable – challenge lies in encouraging individuals, communities, NGOs, and governments to do just that. For more information read the report at:

Martin Carroll is the deputy head of the International Department, British Medical Association.