Vector Issue 12 - 2011

Why should Australia be interested in the
Millennium Development Goals (MDGs)?
Despite the fact that focus is indeed on
developing nations, Aboriginal & Torres Straight
Islander (ATSI) communites have health statistics
comparable to poorer countries. So there is much
that is relevant especially with our poor track record
in improving ATSI health and, not only that, when
this country is faced with an unsustainable health
system there is much to be learnt from some of the
successes of the approach.
The initiative was launched in September 2000,
building upon a decade of major United Nations
conferences and summits where world leaders came
together at the United Nations Headquarters in
New York to adopt the United Nations Millennium
Declaration, committing their nations to a new
global partnership to reduce extreme poverty. It is
important to note the time for planning and gaining
a commitment compared to how long this country
takes to plan and implement health interventions. A
series of time-bound targets were set with a deadline
of 2015. Such long term planning and goals are
impossible in Australia thanks to our electoral cycle
and the short term funding of health projects.
The eight goals were assessed for progress and
further resources were allocated to countries that
were clearly not going to achieve their goals without
extra support.
Australia set the National Health Goals and Targets
in 1994 1 ]. What happened to them? We seemed
to have moved to measuring activity leaving the
question open as to whether the activity promotes
the health of all Australians.
This is the appeal of the MDGs in that they are
focussed on populations as opposed to individuals.
This is consistent with the well known aphorism
of Dr Geoffrey Rose 2 , ‘... a preventive measure that
brings large benefits to the community offers little
to each participating individual.’ In Australia the
focus is on the customer with a disease and no cost is
spared to bring the benefits of the latest technology
to bring a cure or to palliate. This has led to inverse
care law being alive and well in that the provision
of cutting-edge health services is located where the
need is least 3,4 .
Many strategies included in the MDG approach
are synonymous with the social determinants of
health, ten of which were identified by Wilkinson
and expatriate Professor Sir Michael Marmot (visit
http://www.who.int/social_determinants/en/). He
also emphasised the importance more recently of
www.ghn.amsa.org.au
12
MDGs not only for
vector FEB 2011
Dr Bret Hart, Head of Public Health Unit , Nort