Friday, 17 September 2010


This week’s issue of The Lancet has a paper and a couple of commentaries on the MDGs, all free-to-view and doubtless in preparation for next week’s UN Summit on the Millennium Development Goals in New York:

The Millennium Development Goals: a cross-sectoral analysis and principles for goal setting after 2015 by The Lancet and the London International Development Centre Commission (the ‘webappendix’ to this paper is a particularly good review of progress/lack of progress on all the MDGs, though nothing new on WatSan),

The MDG decade: looking back and conditional optimism for 2015 by Jeffrey Sachs, and

Africa faces an uphill struggle to reach the MDGs by Wairagala Wakabi.

Sachs says:
All of the estimates [of costs needed to implement a basic primary health system in a low-income setting], when appropriately updated to 2010 conditions, suggest a cost of around US$50–60 per person per year in current dollars … [whereas] the plausible level of domestic resource mobilisation for public health is of the order of $15 per person per year. … That leaves a financing gap of around $40 per person per year to be filled by external donors. … Many large donors are letting poor regions down. … Most poor countries are ready to lead domestically, and have the management and technical capacities to do so with local skills
and internal technical support when needed. The key limiting factor for success is external aid. If the high-income countries build on their successes of the past decade, and deliver a mere 0.1% of GDP for health-sector official development aid as part of a larger overall aid programme, they and their low-income partners will celebrate great MDG successes as of 2015.

So, if low-income countries don’t meet all the health targets of the MDGs, then it’s all the fault of the high-income donor countries? I don’t think so!

Wakabi, a Ugandan journalist, certainly doesn’t put the blame on donor countries, more on the low-income countries: “Despite scoring some notable successes, funding shortfalls and a sapping of political will are stymying progress towards attaining the health MDGs in Africa” – shortfalls, that is, in local funding and a lack of local political will.