from to

Significant progress has also been achieved with regard to
education, with the primary school net enrolment rate in
the developing regions reaching 91% in 2015, up from 83%
in 2000. Many more girls are now in school compared to
15 years ago, with developing regions as a whole having
achieved the target to eliminate gender disparity in primary,
secondary and tertiary education, which is likely to yield
considerable maternal and child health benefits. 16
Major progress has been made on water and sanitation,
which has a significant impact on the transmission of
infectious diseases. In 2015, 91% of the global population is
using an improved drinking-water source, compared to 76%
in 1990, thus meeting the MDG target, while the proportion
of people practising open defecation has fallen almost by
half. Globally, 147 countries have met the drinking-water
target, 95 countries have met the sanitation target and 77
countries have met both.
Progress on the specific health-related goals and targets,
MDG 4, MDG 5 and MDG 6, has also been encouraging
(see chapters 4 and 5). Globally, the HIV, TB and malaria
MDG targets have been met. Child mortality has fallen by
53% and maternal mortality by 43%. Even though this
is a cause for celebration, both declines fall well short
of the MDG targets of two thirds and three quarters
reductions from the 1990 levels. Regional progress has
also been uneven, as can be seen in Table 1.1, and substantial
inequalities remain within and across countries. 17 More
detailed assessments of the progress made are provided
in chapters 5 and 6.
Strengths and limitations of the MDGs
The MDGs have been more influential than any other
attempt at international target setting in the field of
development. The rapid acceleration of global progress
towards the poverty reduction, gender, health and education
goals since 2000, and particularly since 2005, is just one
example of their beneficial impact. The adoption of a simple,
clear and time-bound framework that is compelling, easy
to communicate and measurable has been one of the
MDGs’ great strengths, encouraging donor governments,
international agencies and country decision-makers to focus
attention on areas of need, and to measure the results of
initiatives undertaken. And while it is hard to isolate specific
causal effects, it seems reasonable to suppose that the
intensity of focus (and investment) has been a key driver of
innovation, enabling the scale-up of new interventions, such
as antiretroviral therapy (ART), long-lasting insecticidal
nets (LLINs), artemisinin-based combination therapies
(ACTs), vaccines against pneumonia and diarrhoeal disease,
and new and better diagnostic tests for multiple diseases.
The emphasis on measuring results has also had a positive
impact on country data systems. A good example is the
improvement in country data availability for a subset of 22
official MDG indicators between 2003 and 2014. 3 While
in 2003, only 2% of developing countries had at least two
data points for 16 or more of the 22 indicators, by 2014 this
figure had reached 79%, reflecting the increased capacity
of national statistical systems to address monitoring
requirements. Development partners played an important
role in boosting monitoring capacity, most successfully by
providing long-term support to national health surveys,
especially the United Nations Children’s Fund (UNICEF) and
the United States Agency for International Development
(USAID). These surveys, mostly conducted by national
statistical offices in collaboration with ministries of health,
also generated data on inequalities in health, especially for
reproductive, maternal and child health indicators. 18,19 One
important benefit of increased monitoring was highlighting
the importance of accountability involving a cyclical process
of monitoring, review and remedial action. The importance
of accountability has been underlined at all levels through,
for instance, the recommendations of the Commission on
Information and Accountability for Women’s and Children’s
Health, and has not only improved monitoring, but is
also gradually leading to more inclusive and transparent
reviews of progress involving civil society, politicians and
the media. 20,21
6 HEALTH IN 2015: FROM MDGs TO SDGs