Keeping their eyes on the prize

The ONE Campaign, a nonprofit established by the legendary Irish rocker turned global health expert Bono in 2004 to combat poverty and disease, released an 84-page report this week that actually might be worth reading. 

Titled “Financing the Fight for Africa’s Transformation,” the 2013 data report looks at how countries—particularly those in sub-Saharan Africa—are progressing toward achieving eight core United Nations’ Millennium Development Goals (MDGs) by 2015.  

The timing of the report is obvious. With less than two years to go, the ONE Campaign compiled the data-laden report—which ranks the progress of  nearly 140 counties—to instill a greater urgency in meeting the ambitious MDG targets, which address poverty, water quality, HIV/AIDS, hunger, education, child mortality, maternal mortality and gender issues. 

By way of example, one of the MDGs—to reduce deaths among children under age five by 66% between 1990 and 2015—could fall short should developing countries be forced to scale back immunization programs.  

“Promoting a ‘war room’ mentality and ensuring that the 2015 deadline remains firmly in the forefront, is about ensuring that the effective use of billions of public sector development finance dollars and saving millions of lives,” say the authors of the report.    

The list of ONE’s recommendations for poor countries and their donors include quarterly meetings led by the UN and World Bank to track MDG outcomes and trends, and renewed emphasis on budget and aid transparency. The ONE Campaign also urged African governments and their donors to fulfill current funding commitments, and for rich countries to sustain and increase support for multi-lateral aid programs such as  The Global Fund to Fight AIDS, Tuberculosis and Malaria, the World Bank’s International Development Association, and the African Development Fund.   

The report spotlights a number of trailblazers, such as Mali, Rwanda and Uganda in  Africa, and Sri Lanka in Asia, that have made strides in meeting a number of the MDGs. Coming in dead last: the Democratic Republic of the Congo and Zimbabwe.   

Using data collected by the World Bank, the report compared current performances by individual countries in meeting the eight MDGs against what the current performance ought to be. For instance, to halve extreme poverty between 1990 and 2015, each country would have needed to achieve annual reductions in poverty of around 2% over the 25 years.   

Notably, the ONE Campaign report also underscored the unfortunate volatility of the World Bank data used to generate such estimates, observing how frequently they are revised. These changes, ONE says, have made it difficult to assess exactly how well countries are performing year to year. 

For the most part, the report highlights the tremendous challenges countries face in reaching MDG targets. HIV/AIDS is a prime example. The global community set its sights on halting and reversing the tide of HIV/AIDS by 2015, including the elimination of mother-to-child transmission of HIV.   

The report found, however, that only about 32% of countries are on track to meet their HIV/AIDS targets. Many, however, have improved in this area pretty consistently since 2010. In fact, the most recent report from the Joint United Programme on HIV/AIDS notes that the spread of HIV appears to have stabilized in most regions, and more HIV-infected individuals are surviving longer.   

John McArthur, a senior fellow at the Brookings Institution, noted in a recent article that no issue has been more closely interconnected with the MDGs than HIV/AIDS treatment. Thirteen years ago, the US Agency for International Development deemed large-scale treatment for AIDS to be impossible in Africa. Instead, Jim Yong Kim, then head of the World Health Organization’s HIV/AIDS Department, introduced the “3 by 5” initiative in 2003, which aimed to have three million HIV-infected people in the developing world on treatment within five years.   

Today, new infection rates have fallen by 50% in more than 25 countries—13 of them in sub-Saharan Africa—and more than 8 million HIV-infected people in developing countries are receiving antiretroviral therapy, according to UNAIDS.   

But as the saying goes, the last six miles of a marathon are the hardest. The ONE Campaign just wants to make sure enough resources and political will exist to finish the race.