Nearly 15 years ago, the global community rallied behind eight goals in the hopes of building a better and more prosperous world. The Millennium Development Goals (MDGs) set measurable targets and a 2015 deadline for achieving them. During my 33 years with UNICEF I have witnessed the challenges and remarkable accomplishments made throughout the world, and the MDGs have over the last 15 years been a great driver of progress.
As that deadline draws near, UNICEF has examined global data to determine whether children now have a greater chance to survive and thrive than they did when the goals were set in 2000. The results, showcased in UNICEF’s Progress for Children report, clearly show that despite significant achievements, millions of the world’s most vulnerable children have not benefitted from development efforts in the past 15 years.
The data show global advancements: Since 1990, half as many children under five are dying, nearly 100 million fewer children under five are stunted, the number of people living in extreme poverty has nearly halved, and between 1999 and 2012, the number of primary school-age children out of school decreased by 45%.
Here in the East Asia and Pacific region, progress since 1990 is also clear as these examples show:
- A remarkable 75% reduction in stunting and an under five mortality rate reduction of 79%
- The number of Primary School-aged children out of school has dropped from 12 to 7 million
- 69% reduction in open defecation rates and increased access to piped water
But these successes – while impressive – are only part of the story.
My work in this region started in China in 1996 with a focus on nutrition. Since then, my work has taken me to all countries across the Asia-Pacific region, with an even wider focus including communicable diseases as well as maternal newborn and child health.
Still too many left behind
Despite the impressive aggregate numbers showing a remarkable decline in child mortality, it should be noted that this is largely due to vaccination coverage. This coverage, however, is not the same everywhere and there are continued outbreaks of vaccine-preventable diseases, including Pertussis and Diphtheria. These are diseases which should have been well under control given the availability of effective vaccines for decades.
Circumstances beyond a child’s control – such as gender, place of birth and the social and economic situation of his or her family – continue to deny millions of the most vulnerable children a fair chance to realize their potential.
For example, children from the poorest households are more than twice as likely to die before their fifth birthday as children from the wealthiest and nearly five times more likely to be out of school.
Inequities are also clear in this region:
- Access to improved sanitation facilities in rural areas lags behind that in urban areas. In addition, the Pacific region has shown little progress in increasing access to improved sanitation since 1990
- Stunting remains a serious issue for many countries in the region, including Timor-Leste (57.7%), Papua New Guinea (49.5%), Cambodia (40.9%), Lao PDR (43.8%), Indonesia (36.4%), and Myanmar (35.1%). The poorest are always most at risk
- Maternal mortality rates are generally higher in rural areas than urban areas, with rural mothers generally receiving less health care support, such as neonatal visits, than their urban counterparts
These inequities begin at birth and develop into vicious cycles of deprivation that affect children’s lives today, and echo through generations – threatening national stability and prosperity.
The task ahead
The pursuit of the MDGs show us that equitable progress is possible. Gender parity at the primary education level has been achieved in East Asia and the Pacific. And East Asia and the Pacific has achieved a marked reduction in the urban-rural gap for stunting, but there is still a long way to go in many countries, as we have seen.
We know, therefore, that a fair start in life for every child is within reach and we know what it will take to achieve this:
- Sufficient investments focused on the most disadvantaged children and communities and backed by committed leadership
- Robust data that allow us to identify the most vulnerable children and understand the challenges they face in accessing services
- Innovations, including mobile technology and the rise of social media, that make it more possible than ever to break geographical barriers and reach excluded children
- Stronger systems for health, education, child protection and social protection that target those at greatest risk
I have seen first-hand the impressive investments being made by governments across the region but also glimpses of some of the chronic failures, including weak or unreliable delivery platforms in rural and hard-to-reach areas. Improvements will be required in service quality as well as logistics and care-seeking behaviours.
In September, world leaders will again sit down to agree to goals for making the world fairer, more prosperous and more peaceful over the next 15 years. The MDGs provide lessons that can guide this effort. Shame on us if we fail to learn those lessons and if we fail the children the MDGs passed by. Doing so we will not only be letting those children down, but their children too.
Basil Rodrigues, Regional Adviser Child Survival & Development, UNICEF East Asia and Pacific Office