mdg report 2013 english version

7/30/2019 Mdg Report 2013 English version

1/64

asdf

The Milleium Developmet Gols Report

2013

UnITED naTIOnS


2/64

Cover Inside

This report is bsed o mster set o dt tht hs bee compiled by Iter-agecy d Expert Group o

MDG Idictors led by the Deprtmet o Ecoomic d Socil airs o the Uited ntios Secretrit, i

respose to the wishes o the Geerl assembly or periodic ssessmet o progress towrds the MDGs. The

Group comprises represettives o the itertiol orgiztios whose ctivities iclude the preprtio o oe

or more o the series o sttisticl idictors tht were idetied s pproprite or moitorig progress towrds

the MDGs, s refected i the list below. a umber o tiol sttisticis d outside expert dvisers lso

cotributed.

InTERnaTIOnaL LaBOUR ORGanIZaTIOn

FOOD anD aGRICULTURE ORGanIZaTIOn OF THE UnITED naTIOnS

UnITED naTIOnS EDUCaTIOnaL, SCIEnTIFIC anD CULTURaL ORGanIZaTIOn

UnITED naTIOnS InDUSTRIaL DEVELOPMEnT ORGanIZaTIOn

WORLD HEaLTH ORGanIZaTIOn

THE WORLD BanK

InTERnaTIOnaL MOnETaRY FUnD

InTERnaTIOnaL TELECOMMUnICaTIOn UnIOn

ECOnOMIC COMMISSIOn FOR aFRICa

ECOnOMIC COMMISSIOn FOR EUROPE

ECOnOMIC COMMISSIOn FOR LaTIn aMERICa anD THE CaRIBBEan

ECOnOMIC anD SOCIaL COMMISSIOn FOR aSIa anD THE PaCIFIC

ECOnOMIC anD SOCIaL COMMISSIOn FOR WESTERn aSIa

JOInT UnITED naTIOnS PROGRaMME On HIV/aIDS

UnITED naTIOnS CHILDREnS FUnD

UnITED naTIOnS COnFEREnCE On TRaDE anD DEVELOPMEnT

UnITED naTIOnS EnTITY FOR GEnDER EQUaLITY anD THE EMPOWERMEnT OF WOMEn - Un WOMEn

UnITED naTIOnS DEVELOPMEnT PROGRaMME

UnITED naTIOnS EnVIROnMEnT PROGRaMME

UnITED naTIOnS FRaMEWORK COnVEnTIOn On CLIMaTE CHanGE

UnITED naTIOnS HIGH COMMISSIOnER FOR REFUGEES

UnITED naTIOnS HUMan SETTLEMEnTS PROGRaMME

UnITED naTIOnS POPULaTIOn FUnD

InTERnaTIOnaL TRaDE CEnTRE

InTER-PaRLIaMEnTaRY UnIOn

ORGanISaTIOn FOR ECOnOMIC CO-OPERaTIOn anD DEVELOPMEnT

WORLD TRaDE ORGanIZaTIOn


3/64

The Millennium Development Goals Report2013

asdfUnited nations

new York, 2013


4/64


5/64

Foreword | 3

Foreword

The Millennium Development Goals (MDGs) have beenthe most successul global anti-poverty push in history.

Signicant and substantial progress has been madein meeting many o the targetsincluding halving thenumber o people living in extreme poverty and theproportion o people without sustainable access toimproved sources o drinking water. The proportion ourban slum dwellers declined signicantly. Remarkablegains have been made in the ght against malaria andtuberculosis. There have been visible improvements inall health areas as well as primary education.

We are now less than 1,000 days to the 2015 target

date or achieving the MDGs. This years report looksat the areas where action is needed most. For example,one in eight people worldwide remain hungry. Too manywomen die in childbirth when we have the means tosave them. More than 2.5 billion people lack improvedsanitation acilities, o which one billion continueto practice open deecation, a major health andenvironmental hazard. Our resource base is in seriousdecline, with continuing losses o orests, species andsh stocks, in a world already experiencing the impactso climate change.

This report also shows that the achievement o theMDGs has been uneven among and within countries.Children rom poor and rural households are muchmore likely to be out o school than their rich and urbancounterparts. Wide gaps remain in basic knowledgeabout HIV and its prevention among young men andwomen in sub-Saharan Arica, which has been hardesthit by the epidemic.

In more than a decade o experience in workingtowards the MDGs, we have learned that ocused globaldevelopment eorts can make a dierence. Throughaccelerated action, the world can achieve the MDGsand generate momentum or an ambitious and inspiring

post-2015 development ramework. Now is the timeto step up our eorts to build a more just, secure andsustainable uture or all.

Ban Ki-moon

Secretary-General, United Nations


6/64

4 | The millennium developmenT Goals reporT 2013

Overview

With the deadline or the MDGs on the horizon,progress can be reported in most areas, despite theimpact o the global economic and nancial crisis.Several important targets have or will be met by2015, assuming continued commitment by nationalgovernments, the international community, civil societyand the private sector. That said, progress in manyareas is ar rom sucient. Redoubled eorts areurgently needed, particularly in regions most behindto jumpstart advancement and achieve maximumgains. The world community should take pride in itsaccomplishments thus ar, while building on existingmomentum to reach as many goals as possible by 2015and to realize gains or all.

Several MDG targets have already beenmet or are within close reach

The proportion o people living in extreme poverty

has been halved at the global level

The world reached the poverty reduction target veyears ahead o schedule. In developing regions, theproportion o people living on less than $1.25 a dayell rom 47 per cent in 1990 to 22 per cent in 2010.About 700 million ewer people lived in conditions oextreme poverty in 2010 than in 1990.

Over 2 billion people gained access to improved

sources o drinking water

Over the last 21 years, more than 2.1 billion peoplegained access to improved drinking water sources. Theproportion o the global population using such sourcesreached 89 per cent in 2010, up rom 76 per cent in1990. This means that the MDG drinking water targetwas met ve years ahead o the target date, despitesignicant population growth.

Remarkable gains have been made in the fght

against malaria and tuberculosis

Between 2000 and 2010, mortality rates rom malariaell by more than 25 per cent globally. An estimated1.1 million deaths rom malaria were averted over thisperiod. Death rates rom tuberculosis at the global leveland in several regions are likely to be halved by 2015,compared to 1990 levels. Between 1995 and 2011, acumulative total o 51 million tuberculosis patients weresuccessully treated, saving 20 million lives.

The proportion o slum dwellers in the cities and

metropolises o the developing world is declining

Between 2000 and 2010, over 200 million slum

dwellers benetted rom improved water sources,

sanitation acilities, durable housing or sucientliving space, thereby exceeding the 100 million MDGtarget. Many countries across all regions have shownremarkable progress in reducing the proportion o urbanslum dwellers.

A low debt burden and an improved climate or

trade are levelling the playing feld or developing

countries

The debt service to export revenue ratio o alldeveloping countries stood at 3.1 per cent in 2011,down rom nearly 12 per cent in 2000. Their duty-reemarket access also improved in 2011, reaching 80 percent o their exports. The exports o least developedcountries benetted the most. Average taris are alsoat an all-time low.

The hunger reduction target is within reach

The proportion o undernourished people worldwide

decreased rom 23.2 per cent in 19901992 to 14.9per cent in 20102012. Given reinvigorated eorts,the target o halving the percentage o people sueringrom hunger by 2015 appears to be within reach.Still, one in eight people in the world today remainchronically undernourished.

Accelerated progress and bolder action are

needed in many areas

Environmental sustainability is under severe threat,

demanding a new level o global cooperation

The growth in global emissions o carbon dioxide(CO2) is accelerating, and emissions today are morethan 46 per cent higher than their 1990 level. Forestscontinue to be lost at an alarming rate. Overexploitationo marine sh stocks is resulting in diminished yields.More o the earths land and marine areas are underprotection, but birds, mammals and other speciesare heading or extinction at an ever aster rate, withdeclines in both populations and distribution.

Big gains have been made in child survival, but

more must be done to meet our obligations to the

youngest generationWorldwide, the mortality rate or children under vedropped by 41 per centrom 87 deaths per 1,000 livebirths in 1990 to 51 in 2011. Despite this enormousaccomplishment, more rapid progress is needed tomeet the 2015 target o a two-thirds reduction in childdeaths. Increasingly, child deaths are concentrated inthe poorest regions, and in the rst month o lie.

Most maternal deaths are preventable, but progress

in this area is alling short

Globally, the maternal mortality ratio declined by 47

per cent over the last two decades, rom 400 maternal


7/64

overview | 5

deaths per 100,000 live births to 210 between 1990and 2010. Meeting the MDG target o reducing the ratioby three quarters will require accelerated interventionsand stronger political backing or women and children.

Access to antiretroviral therapy and knowledge about

HIV prevention must expand

While new HIV inections are declining, an estimated34 million people were living with HIV at the endo 2011. The MDG target o universal access toantiretroviral therapy or all who need it by 2010 wasmissed, but is reachable by 2015 i current trendscontinue. The ultimate goal is preventing the spreado HIV, but knowledge o the virus and how to avoidtransmission remains unacceptably low.

Too many children are still denied their right to

primary education

Between 2000 and 2011, the number o children out

o school declined by almost halrom 102 million to57 million. However, progress in reducing the numbero children out o school has slowed considerably overtime. Stalled progress means that the world is unlikely tomeet the target o universal primary education by 2015.

Gains in sanitation are impressivebut not good

enough

From 1990 to 2011, 1.9 billion people gained access toa latrine, fush toilet or other improved sanitation acility.Despite these accomplishments, more rapid progressis needed to meet the MDG target. Stopping opendeecation and instituting the right policies are key.

There is less aid money overall, with the poorest

countries most adversely aected

In 2012, net aid disbursements rom developedto developing countries totalled $126 billion. Thisrepresents a 4 per cent drop in real terms comparedto 2011, which itsel was 2 per cent below 2010levels. This decline aected least developedcountries disproportionately. In 2012, bilateral ocialdevelopment assistance to these countries ell by13 per cent, to about $26 billion.

Our attention needs to ocus ondisparities, which oten stand in the way

o urther improvements

Rural-urban gaps persistaccess to reproductive

health services and to clean drinking water are only

two examples

In 2011, only 53 per cent o deliveries in rural areaswere attended by skilled health personnel, versus84 per cent o them in urban areas. Eighty-three percent o the population without access to an improved

drinking water source live in rural communities.

The poorest children are most likely to be out o

school

Children and adolescents rom the poorest householdsare at least three times more likely to be out o schoolthan children rom the richest households. Girls aremore likely to be out o school than boys among bothprimary and lower secondary age groups, even or girlsliving in the richest households.

Gender-based inequalities in decision-making power

persist

Whether in the public or private sphere, rom thehighest levels o government decision-making tohouseholds, women continue to be denied equalopportunity with men to participate in decisions thataect their lives.

Successul completion o the MDGs

by 2015 must remain a global priority,creating a stable oundation or uture

development action

Eorts to achieve a world o prosperity, equity,reedom, dignity and peace will continue beyond2015. The United Nations is working concertedly withgovernments, civil society and other partners to buildon the momentum generated by the MDGs and to cratan ambitious, yet realistic, post-2015 developmentagenda. A successul conclusion to the MDGs will be animportant building block or a successor development

agenda. And volumes o experience and lessons learnedalong the way can only benet the prospects orcontinued progress.

The analysis in this report, based on a wide range ostatistics, shows that the actions o all stakeholders arecoalescing in the achievement o many o the MDGs.At the same time, many items on the agenda remainincomplete. The results o this report give us a clearindication where our eorts must be directed in thedays remaining beore the 2015 deadline.

wu honGBo

Under-Secretary-General or Economicand Social Aairs


8/64

6 | The MillenniuM DevelopMenT Goals RepoRT 2013

Goal 1

Eradicateextremepoverty andhunger

TargeT 1.a

Halve, between 1990 and 2015, the proportion opeople whose income is less than $1 a day

Th MDg tt hs bn mt, but 1.2 billionpopl still liv in xtm povty

X Poverty rates have been halved,and about 700 million ewer people

lived in conditions o extremepoverty in 2010 than in 1990.

X The economic and nancialcrisis has widened the global jobsgap by 67 million people.

X One in eight people still goto bed hungry, despite majorprogress.

X Globally, nearly one in sixchildren under age ve are

underweight; one in our arestunted.

X An estimated 7 per cent ochildren under age ve worldwideare now overweight, another aspecto malnutrition; one quarter othese children live in sub-SaharanArica.

Quick cts

22

29

52

30

38

51

48

52

56

0 10 20 30 40 50 60

12

16

60

22

27

47

26

31

41

3

5

4

5

6

912

45

19

14

1

4.6

5.1

Proportion of people living on less than $1.25 a day, 1990,2005 and 2010 (Percentage)

Developing regions

Developing regions (excluding China)

Northern Africa

Western Asia

Latin America & the Caribbean

Eastern Asia (China only)

South-Eastern Asia

Southern Asia (excluding India)

Southern Asia

Sub-Saharan Africa

1990 2005 2010 2015 Target

Note: No sufficient country data are available to calculate the aggregate valuesfor Oceania.


9/64

Goal 1: eRaDicaTeexTReMepoveRTyanDhunGeR | 7

New poverty estimates rom the World Bank haveconrmed last years nding that the world reached theMDG target ve years ahead o the 2015 deadline. Indeveloping regions, the proportion o people living onless than $1.25 a day ell rom 47 per cent in 1990 to22 per cent in 2010. About 700 million ewer people

lived in conditions o extreme poverty in 2010 than in1990.

Extreme poverty rates have allen in every developingregion, with one country, China, leading the way. InChina, extreme poverty dropped rom 60 per centin 1990 to 16 per cent in 2005 and 12 per cent in2010. Poverty remains widespread in sub-SaharanArica and Southern Asia, although progress in thelatter region has been substantial. In Southern Asia,poverty rates ell by an average o one percentagepoint annuallyrom 51 per cent in 1990 to 30 per

cent two decades later. In contrast, the poverty rate insub-Saharan Arica ell only 8 percentage points overthe same period.

Despite this impressive achievement at the global level,1.2 billion people are still living in extreme poverty. Insub-Saharan Arica, almost hal the population live onless than $1.25 a day. Sub-Saharan Arica is the onlyregion that saw the number o people living in extremepoverty rise steadily, rom 290 million in 1990 to 414million in 2010, accounting or more than a third opeople worldwide who are destitute.

The World Bank projects that, by 2015, about 970million people will still be living on less than $1.25 aday in countries classied as low- or middle-income in1990. Sub-Saharan Arica and Southern Asia will eachbe home to about 40 per cent o the developing worldpopulation living in extreme poverty.

Around the world, abject poverty is ound in areaswhere poor health and lack o education deprivepeople o productive employment; environmentalresources have been depleted or spoiled; andcorruption, confict and bad governance waste publicresources and discourage private investment. The

international community now needs to take the nextsteps to continue the ght against poverty at all thesevarious levels.

Chllns in monitoin povty

hmp ctiv policymkin

Measuring poverty continues to be a barrier to

eective policymaking. In many countries, theavailability, requency and quality o povertymonitoring data remain low, especially in smallstates and in countries and territories in ragilesituations. The 2010 estimates included in thisreport are still provisional due to the limitedavailability o data rom national householdsurveys collected between 2008 and 2012,particularly in sub-Saharan and NorthernArica. Institutional, political and nancialobstacles hamper data collection, analysis andpublic access. The need to improve household

survey programmes to monitor poverty in thesecountries is urgent.


10/64


TargeT 1.B

Achieve ull and productive employment anddecent work or all, including women and youngpeople

Th slowin o conomic owth spllscontinud job losss, with youn poplbin th bunt o th cisis

labour orce participation and rising unemployment.According to the International Labour Organization(ILO), unemployment has increased by 28 millionsince 2007, and an estimated 39 million peoplehave dropped out o the labour market, leaving a 67million jobs gap as a result o the global economic and

nancial crisis.

From 2007 to 2012, the developed regions registereda 1.7 percentage point drop in the employment-to-population ratio. Over the same period, the developingregions experienced a decline o 0.9 percentagepoints. Within this group, the largest declines wereound in Southern Asia and Eastern Asia, which sawdrops in the employment-to-population ratio o 2.1 and1.5 percentage points, respectively.

During 2012, global economic growth slowed evenurther, substantially weakening the employment-generating capacity o national economies. The globalratio o employment to the working-age populationdeclined rom 61.3 per cent in 2007 to 60.3 in 2012,ater a moderate increase rom 2003 to 2007. The top

two contributors to the decline in the ratio are alling

0 10 20 30 40 50 60 70 80

62

55

70

68

67

64

62

59

54

45

43

63

57

72

68

66

64

61

57

56

43

43

2012*2007

Employment-to-population ratio, 2007 and 2012*

(Percentage)

Developing regions

Developed regions

Eastern Asia

Oceania

South-Eastern Asia

Sub-Saharan Africa

Latin America & the Carbbean

Caucasus & Central Asia

Southern Asia

Western Asia

Northern Africa

*Data for 2012 are preliminary estimates.

0 10 20 30 40 50 60 70 80 90

75

73

62

76

73

71

79

68

75

78

68

68

48

49

48

64

64

58

56

50

49

30

20

18

0 10 20 30 40 50 60 70 80 90

75

73

62

76

73

71

79

68

75

78

68

68

48

49

48

64

64

58

56

50

49

30

20

18

World

Developed regions

Developing regions

Eastern Asia

Oceania

Sub-Saharan Africa

South-Eastern Asia



Southern Asia

Western Asia

Northern Africa

Employment-to-population ratio, women and men,

2012* (Percentage)

Women Men

* Data for 2012 are preliminary estimates.


11/64


The gender gap in employment persists, with a 24.8percentage point dierence between men and womenin the employment-to-population ratio in 2012. Thegap is most acute in Northern Arica, Southern Asiaand Western Asia, where women are ar less likelyto be employed than their male counterparts. The

dierences in the employment-to-population ratiobetween men and women in these three regionsapproached 50 percentage points in 2012.

Young people have borne the brunt o the crisis.Negative labour market trends or youth accounted or41 per cent o the decline in the global employment-to-population ratio since 2007, due to risingunemployment and alling participation.

Thouh wokin povty hs dclind, ov 60 p cnt o woks in th dvlopinwold still liv on lss thn $4 dy

The number o workers living in extreme poverty hasdeclined dramatically over the past decadedespitethe global nancial crisis. Since 2001, the number o

workers living with their amilies on less than $1.25a day has declined by 294 million, leaving a total o384 million below this threshold classied as theworking poor. In developing regions, the working poorconstituted 15.1 per cent o the employed labour orcein 2012, down rom 32.3 per cent in 2001 and 48.2per cent in 1991.

For the rst time, the ILO has broken downemployment statistics into ve economic classes. The

new estimates show that, in addition to the workersthat are extremely poor, 19.6 per cent o workers andtheir amilies are moderately poorliving on $1.25

to $2 a dayand 26.2 per cent o workers are nearpoor, living on $2 to $4 a day. Altogether, 60.9 percent o the developing worlds workorce remainedpoor or near poor in 2011, living on less than $4a day. These gures underscore the urgent need toimprove productivity, promote sustainable structuraltransormation and expand social protection systemsto ensure basic social services or the poor and mostvulnerable workers and their amilies.

0

10

20

30

40

50

60

70

80

90

100

1991 2001 2011* 1991 2001 2011* 1991 2001 2011*

0

10

20

30

40

50

60

70

80

90

100

1991 2001 2011* 1991 2001 2011* 1991 2001 2011*

Employment by economic class, developing regions, 1991, 2001 and 2011 (Percentage of total employment)

Developing regions Developing regions excluding Eastern Asia Eastern Asia

Extremely poor (


12/64


TargeT 1.C

Halve, between 1990 and 2015, the proportion opeople who suer rom hunger

Th hun duction tt is withinch i cnt slowdowns in poss cnb vsd

750

800

850

900

950

2015

0

5

10

15

20

25

750

800

850

900

950

1 000

0

5

10

15

20

25

1990

-92

1993

-95

1996

-98

1999

-01

2002

-04

2005

-07

2007

-09

2010

-1220

15

Number and proportion of people in the developing

regions who are undernourished 1990-2012

Number of undernourished people

Proportion of undernourished people

2015 Target

Millions Percentage

15

1

3

7

8

10

11

12

12

18

27

23

2

4

14

15

7

30

21

14

27

32

0 5 10 15 20 25 30 35

15

1

3

7

8

10

11

12

12

18

27

23

2

4

14

15

7

30

21

14

27

32

0 5 10 15 20 25 30 35

Proportion of people who are undernourished,

1990-1992 and 2010-2012 (Percentage)

Developing regions

Developed regions

Northern Africa



Western Asia

South-Eastern Asia

Eastern Asia

Oceania

Southern Asia

Sub-Saharan Africa

1990-1992 2010-2012 2015 Target

According to new estimates, about 870 million people,or one in eight worldwide, did not consume enoughood on a regular basis to cover their minimum dietaryenergy requirements over the period 2010 to 2012.The vast majority o the chronically undernourished(852 million) reside in developing countries.

While their numbers remain disturbingly high, theproportion o undernourished people in the totalpopulation has decreased rom 23.2 per cent in19901992 to 14.9 per cent in 20102012. This

suggests that progress in reducing hunger has beenmore pronounced than previously believed, and thatthe target o halving the percentage o people sueringrom hunger by 2015 is within reach.

Contrary to earlier predictions, chronic hunger ratesdid not spike during the 20072009 ood price andeconomic crises. However, the nancial situation opoor amilies has undoubtedly worsened in manycountries, and progress against hunger has slowedsignicantly. Purposeul and coordinated action bynational governments and international partners is

needed to reverse recent trends.

Disparities remain large in the rate o reduction inundernourishment among regions and countries.Progress has been relatively swit in South-EasternAsia, Eastern Asia, the Caucaus and Central Asia andin Latin America. However, the pace o change in theCaribbean, Southern Asia and, especially, sub-SaharanArica and Oceania appears to be too slow to meet the

MDG target. Western Asia is the only region that hasseen a rise in the prevalence o undernourishment rom19901992 to 20102012. Behind these regionaldisparities are vastly dierent levels o vulnerabilityand markedly dierent capacities to deal witheconomic shocks, such as ood price increases andeconomic recessions.


13/64


Poverty is among the main determinants o hunger andinadequate access to ood. Poor households generallyspend large portions o their incomes on ood and mosto them, including many small-holder armers, are netood buyers. The inability to consume enough ood, inturn, aects labour productivity and the ability o the

undernourished to generate income, thus reinorcingthe poverty trap.

Mo thn 100 million childn und v still undnouishd ndundwiht

Mthods to ssss hun nd ood

scuity impovin

The Food and Agriculture Organization o theUnited Nations (FAO) has introduced a numbero signicant improvements in the methodologyit uses to measure the prevalence o hunger.

Despite these improvements, better data andadditional indicators are needed to provide amore holistic assessment o undernourishmentand ood security. This, in turn, requires strongcommitment by international agencies to supportthe statistical capacity o developing countries.

For its part, the FAO has launched severalinitiatives to improve the quality o basic data onood production, utilization and consumption,storage, trade and other key variables. Thisincludes the ormation o an internationalpartnership or the implementation o the Global

Strategy to Improve Agricultural Statistics.

Globally, an estimated 101 million children under age

ve were underweight in 2011. This represents 16 percent o all children under ve that year, or one in six.The number o underweight children in 2011 ell by36 per cent rom an estimated 159 million children in1990. Still, this rate o progress is insucient to meetthe MDG target o halving the proportion o people whosuer rom hunger by 2015.

Underweight prevalence in 2011 was highest inSouthern Asia (31 per cent) and sub-Saharan Arica(21 per cent). This translates into 57 million and 30million underweight children in Southern Asia and sub-

Saharan Arica, respectively.

0 20 40 60

3

3

4

5

5

14

17

21

31

25

7

15

14

15

10

19

31

29

50

16

0 20 40 60

3

3

4

5

5

14

17

21

31

25

7

15

14

15

10

19

31

29

50

16

Proportion of children under age five who are

moderately or severely underweight, 1990 and 2011

(Percentage)

World


Eastern Asia


Western Asia

Northern Africa

Oceania

South-Eastern Asia

Sub-Saharan Africa

Southern Asia

1990 2011 2015 Target

Note: The trend analysis presented above is based on updated statisticalmethods that reflect, for the first time, harmonized estimates on childmalnutrition from UNICEF, WHO and the World Bank.


14/64


Evidence pointing to the negative eects oundernutrition on survival, personal and nationaldevelopment, and long-term health is irreutable,demanding urgent action.

Dspit stdy ins, on in ou childnound th wold show sins o stuntdowth

The interventions currently under way that directlyaect stunting and other nutrition indicators need tobe expanded. These include simple, cost-eectivemeasures during the critical 1,000-day windowduring pregnancy and beore a child turns two. The

well-established benets o age-appropriate eedingpractices or inants and young children should beapplied throughout the continuum o care, includingtimely initiation o breasteeding (within one hour obirth), exclusive breasteeding or the rst six monthso a childs lie, and continued breasteeding or twoyears or more. Globally, less than hal o newbornswere breasted within the rst hour o birth and only39 per cent o children were breasted exclusively orthe rst six months.

Stunting in inants and children, dened as inadequatelength or height or their age, captures early chronicexposure to undernutrition. Globally, more than onequarter (26 per cent) o children under age ve werestunted in 2011. Though still unacceptably high,the percentage represents a 35 per cent declinerom 1990 to 2011 (rom 253 million to 165 millionchildren). Analysis o the data shows that children inthe poorest households are more than twice as likely tobe stunted as children rom the richest households.

All regions have observed reductions in stunting overthis period, while the prevalence o children who areoverweight, another aspect o malnutrition, is rising.An estimated 43 million children under age ve wereoverweight in 2011, which represents 7 per cent o theglobal population in this age group. In sub-SaharanArica, the overweight prevalence rate has more thandoubled rom 1990 to 2011rom 3 per cent to 7per cent. In combination with population growth, threetimes as many children are overweight in that regionthan in 1990. Sub-Saharan Arica is now home to

nearly one quarter o the worlds overweight children.

0

50

100

150

200

250

300

1990 2000 20110

10

20

30

40

50

0

50

100

150

200

250

300

1990 2000 20110

10

20

30

40

50

Number and percentage of children under age five

who are moderately or severely stunted, 1990, 2000

and 2011

Millions Percentage

Number of children under five

Percentage of children under five


15/64


Th numb o popl upootd byconfict o pscution is t its hihstlvl in 18 ys

The Millennium Declaration calls or protecting and

assisting reugees, promoting global burden-sharingand helping displaced persons return home. Towardsthis end, many o the MDG targets have addedsignicance or survivors o confict and persecution.

Despite progress in some countries, armed confictcontinues to uproot people rom their homes, placingthem in oten precarious situations. By the end o2012, some 45.1 million people worldwide wereorcibly displaced due to confict or persecution. Othese, 15.4 million are considered reugees, including10.5 million who all under the responsibility o the

United Nations High Commissioner or Reugees(UNHCR) and 4.9 million Palestinians registeredwith the United Nations Relie and Works Agency orPalestine Reugees in the Near East (UNRWA). An

additional 28.8 million people have been uprootedrom their homes but remain within the borders o theirown countries. Another one million people are asylumseekers. Overall, the number o people uprooted byconfict or persecution in 2012 was at its highest levelsince 1994.

Excluding Palestinian reugees under UNRWAsmandate, most reugees originate rom Aghanistan,Iraq, Somalia, the Sudan and the Syrian ArabRepublic. At the end o 2012, these ve countriesaccounted or more than hal (55 per cent) o allreugees under UNHCRs care worldwide.

Developing regions carry the heaviest burden in hostinguprooted populations. By the end o 2012, developingcountries hosted 8.5 million reugees, accounting or81 per cent o the reugee population alling under

the aegis o the UNHCR. In 2012, least developedcountries provided asylum to 2.5 million o thosereugees.


16/64


Goal 2

Achieveuniversalprimaryeducation

TargeT 2.a

Ensure that, by 2015, children everywhere, boys and

girls alike, will be able to complete a ull course o

primary schooling

If cunt tnds continu, th wold will not

mt th ol of univsl pimy duction

by 2015

X In 2011, 57 million children

o primary school age were out o

school, down rom 102 million in

2000.

X More than hal o these out-o-

school children live in sub-Saharan

Arica.

X Globally, 123 million youth

(aged 15 to 24) lack basic reading

and writing skills; 61 per cent o

them are young women.

Quick fcts

97

96

95

95

93

92

77

89

93

94

95

78

86

60

80

93

88

53

83

97

97

96

90

83

80

74

97

96

98

0 20 40 60 80 100

Developed regions

Developing regions

Eastern Asia

Northern Africa

South-Eastern Asia



Southern Asia

Western Asia

Sub-Saharan Africa

1990 2000 2011

Note: Data for Oceania are not available. Data for 1990 for Caucasus & Central Asia arenot available.

Adjusted net enrolment rate in primary education,*

1990, 2000 and 2011 (Percentage)

* Defined as the number of pupils of the official school age for primary education enrolledeither in primary or secondary school, expressed as a percentage of the total population inthat age group.

Developing regions have made impressive strides in expanding

access to primary education, with the adjusted net enrolment rate


17/64

Goal 2: achieveuniversalprimaryeducation | 15

growing rom 83 per cent in 2000 to 90 per cent in

2011. Over the same period, the number o children out

o school worldwide declined by almost halrom 102

million to 57 million.

But a closer look at the most recent data tells a

dierent story. The progress seen at the start o the

decade has slowed considerably. Between 2008 and

2011, the number o out-o-school children o primary

school age ell by only 3 million. That means that, at

the current rate, the world is unlikely to meet the target

o universal primary education by 2015.

Sub-Saharan Arica is home to more than hal the

worlds out-o-school children. Between 2000 and

2011, the adjusted primary net enrolment rate

increased rom 60 per cent to 77 per cent. However,

the region continues to ace a rising demand or

education rom a growing population. In 2011, 32

million more children were o primary school age thanin 2000.

Considerable progress has also been made in Southern

Asia, where the adjusted net enrolment rate o children

o primary school age increased rom 78 per cent to

93 per cent between 2000 and 2011. Almost hal

the reduction in the global number o children out

o school can be attributed to this region, where the

number o such children ell rom a high o 38 million

in 2000 to 12 million in 2011.

Poverty is a key factor keeping children

out of school, but gender and place of

residence also matter

41 44 36 32

3938

17

12

34

4

2

73

3

3

4 5

4

3

3 3

2

2

43

3

3

3 2

0

20

40

60

80

100

120

1990 2000 2005 2011

Number of out-of-school children of primary school

age, 1990, 2000, 2005 and 2011 (Millions)

Rest of the world

Northern Africa

Western Asia

South-Eastern Asia

Latin America &

the Caribbean

Eastern Asia

Southern Asia

Sub-Saharan Africa

35

13

98

30

9

31

28

22

12

24

15

0

5

10

15

20

25

30

35

28

31

0

5

10

15

20

25

30

Poorest 20% Ri chest 20% Poorest 20% Richest 20%

Pri mary s chool age Lower s econdary s chool age

Girls

Boys

Primary and lower secondary school age children out

of school by household wealth, sex and urban andrural areas, 63 countries, 2005-2011 (Percentage)

Primary school age Lower secondary school age

Rural

Urban

Household poverty is the single most important

actor keeping children out o school. This is one o

the fndings o an analysis o data collected through

household surveys in 63 developing countries between

2005 and 2011. Children and adolescents rom the

poorest households are at least three times as likely to

be out o school as their richest counterparts. Location

o residence also matters. Rural children are nearly

twice as likely to be out o school as urban children.


18/64


19/64


20/64


21/64


22/64


Womens access to paid employment is an indication

o their integration into the market economy. As women

benet rom more regular income, they are more

likely to achieve greater autonomy, sel-reliance in the

household and in their personal development, and

decision-making power.

Globally, 40 out o every 100 wage-earning jobs in the

non-agricultural sector were held by women in 2011.

This is a signicant improvement since 1990, when

only 35 out o 100 jobs were held by women. However,

important dierences can be observed among regions

and countries. In Eastern Asia, the Caucasus and

Central Asia, and Latin America and the Caribbean,

parity in the number o women and men holding

wage-earning jobs has been nearly achieved. But in six

other developing regions, the share o women in non-

agricultural wage employment was under 40 per cent.

In Western Asia, Northern Arica and Southern Asia,

it was under 20 per cent. Access to paid employment

remains a distant target or women in these regions.

In the majority o countries, womens share in

public sector employment is much higher (at least 5

percentage points) than in non-agricultural sectors. In

act, in many countries it exceeds 50 per cent. Women

are, however, more likely to work in local rather than

central government oces.

Womn inin ound in th lbou

mkt, thouh not in ll ions nd not

in ll s o wok

15

19

19

14

20

24

33

33

37

35

39

38

42

43

44

38

44

45

48

35

40

19

0 10 20 30 40 50

Employees in non-agricultural wage employment who

are women, 1990 and 2011 (Percentage)

1990 2011

Western Asia

Northern Africa

Southern Asia

Sub-Saharan Africa

Oceania

South-Eastern Asia

Eastern Asia



Developed regions

World


23/64

Goal 3: pRoMoTeGenDeRequaliTyanDeMpoweRwoMen | 21

In vy dvlopin ion, womn tnd

to hold lss scu jobs thn mn, with

w socil bnfts

These gaps may be explained by a variety o actors,

including regulations and practices governing work and

amily lie. Womens responsibilities in unpaid care

work, the lack o childcare acilities and other social

rights may also play a signicant role in womens non-

participation in the labour orce, in their occupational

choices, and in their employment patterns.

50

48

85

70

85

70

84

70

84

70

81

74

81

74

65

58

65

58

53

46

53

46

50

30

50

30

41

38

41

38

37

21

37

32313231

9

11

50

48

0 20 40 60 80 100

World

Women Men

Sub-Saharan Africa

Oceania

Southern Asia

South-Eastern Asia

Eastern Asia

Northern Africa


Western Asia


Developed regions

Proportion of own-account and contributing family

workers in total employment, women and men, 2012*

(Percentage)

* Data for 2012 are preliminary estimates.

Increases in income-earning opportunities or women

do not mean they have secure, decent jobs. Nor does

it mean they are on an equal ooting with men. In act,

the data suggest that women in developing regions are

more likely than men to work as contributing amily

workerson arms or other amily business enterprises

or as own-account workerswith little or no nancial

security or social benets.

This type o gender gap is particularly evident in

Western Asia and Northern Arica, where paid

employment opportunities or women are limited.

It is also high in sub-Saharan Arica and Oceania.


24/64


25/64


26/64


27/64


28/64


A growing proportion o child deaths occur at or around

the time o birth, a clear sign that child survival eorts

must ocus on the precarious rst month o lie. Over

the past two decades, mortality in children under ve

has declined by 2.5 per cent a year, compared to the

much slower rate o 1.8 per cent a year or newborns

in their rst month. As a result, the share o neonatal

deaths among under-ve mortality worldwide has

grown rom about 36 per cent in 1990 to 43 per cent

in 2011.

The same trend is observed in all regions. In Eastern

Asia, or instance, which has made the most rapid

progress in reducing under-ve mortality overall,

neonatal deaths constituted 57 per cent o all child

deaths in 2011. In Latin America and the Caribbean

and Southern Asia, they accounted or more than

hal o under-ve deaths. Sub-Saharan Arica, which

accounts or 38 per cent o neonatal deaths globally,has the highest neonatal mortality rate (34 deaths per

1,000 live births in 2010) and has recorded, along

with Oceania, the least improvement over the past two

decades. The health o inants in the rst month o lie

will need to be addressed more eectively i progress

on child mortality overall is to continue at a rapid pace.

Mtin th tt by 2015 will qui

t ocus nd nwd commitmnt

to chin th most vulnbl childn

I the MDG target is to be met, eorts must

concentrate on those countries and regions where the

most child deaths occur and where child death rates

are highest. India and Nigeria, or example, account or

more than a third o all deaths in children under ve

worldwide, while countries such as Sierra Leone and

Somalia have under-ve mortality rates o 180 or more

per 1,000 live births. O 49 countries in sub-Saharan

Arica, only eight (Botswana, Cape Verde, Ethiopia,

Liberia, Madagascar, Mali, Nigeria and Rwanda) are

expected to achieve the MDG target i current trends

continue.

At the same time, systematic action is required to

target the main causes o child death (pneumonia,

diarrhoea, malaria and undernutrition) and the most

vulnerable children. This includes a stronger ocus

on neonatal mortality, which is now a driving actor

in child mortality overall. Simple, cost-eective

interventions such as postnatal home visits have

proven eective in saving newborn lives.

Emerging evidence has shown alarming disparities

in under-ve mortality within countries, and these

inequities must be addressed. Children born into

the poorest households are almost twice as likely to

die beore age ve as their wealthiest counterparts.

Poverty is not the only divider, however. Children are

also at greater risk o dying beore age ve i they

are born in rural areas or to a mother denied basic

education. A context o violence and political ragility

adds to a childs vulnerability. Eight o the 10 countries

with the worlds highest under-ve mortality rates are

marked by confict or violence or are characterized by

weak central governments.

MDg monitoin hihlihts th

continuin nd o libl dt

Monitoring through the MDGs has drawn global

attention to the problem o child mortality,established targets or its reduction, and

inormed policymakers about the impact o

their actions. Yet in many developing countries,

complete vital registration systems, the

best source o monitoring data, are lacking.

Continued eorts are needed by countries and

international agencies to strengthen statistical

capacity and to ll data gaps through a wide

variety o household surveys.

Monitoring is central to A Promise Renewed,

a global call to action to end preventable child

deaths by 2035. The initiative, launched in2012 by the United Nations Childrens Fund

(UNICEF) and the United States Agency or

International Development (USAID), has already

been endorsed by 179 countries. As part o

their pledge, governments and partners rom

civil society, the United Nations and the private

sector are working together to strengthen the

monitoring and reporting o child survival

within and among countries. The availability o

accurate, timely data is critical to strengthening

accountability or global commitments made on

behal o children.


29/64

Goal 4: ReDucechilDMoRTaliTy | 27

Sinc 2000, msls vccins hv

vtd ov 10 million dths, but

continud poss is unctin

Measles vaccination rates have increased in most

regions, particularly in sub-Saharan Arica and

Southern Asia, where the disease has taken its

harshest toll. However, outbreaks in these two

regions continue. This is due in part to weak routine

immunization systems and delayed implementation o

accelerated disease control, which have contributed to

stalled momentum towards regional and global measles

control and elimination targets. In 2011, 90 per cent

o all measles deaths occurred in sub-Saharan Arica

and Southern Asia.

Measles can be prevented with two doses o a sae,

eective and inexpensive vaccine. Between 2000 and

2011, global coverage o the rst-dose measles vaccine

increased rom 72 per cent to 84 per cent. Over the

same period, it rose rom 53 per cent to 74 per cent in

sub-Saharan Arica, with similar progress in Southern

Asia. Impressive as they are, these gains remain ragileand insucient. The recommended rst-dose coverage

levels o at least 90 per cent nationally and at least 80

per cent in all districts were not achieved. Some 20.1

million inantsmany o whom are among the poorest,

most marginalized children on earthdid not receive

even a rst-dose o measles vaccine in 2011. Measles

immunization remains a key strategy in reducing child

mortality. Stronger political and nancial commitment

is needed to control and prevent this deadly disease, in

accordance with the 2010 World Health Assembly.

806040200 100

64

67

74

53

76

76

7758

86

86

89

80

94

94

95

93

96

93

99

84

83

70

92

92

84

72

2000 2011

Proportion of children in the appropriate age groupwho received at least one dose of measles-containing

vaccine, 2000 and 2011 (Percentage)Oceania

Sub-Saharan Africa

Caribbean

Southern Asia

Western Asia

South-Eastern Asia

Latin America


Northern Africa

Eastern Asia

Developing regions

Developed regions

World

An estimated 10.7 million deaths were averted rom

2000 to 2011 due to immunizations against measles.

In 2011, the disease killed 158,000 people, mostly

children under ve, ar less than the estimated

548,000 measles deaths in 2000. Still, these deaths

were preventable.


30/64


31/64


32/64


TargeT 5.B

Achieve, by 2015, universal access to

reproductive health

Hlth c duin pnncy cn svlivs, but only hlf of womn in dvlopin

ions civ th commndd mount

of c

Good quality care during pregnancy is undamental to

the health, well-being and survival o mothers and their

babies. In developing regions, coverage o antenatal

care (at least one visit with a doctor, nurse or midwie

during pregnancy) increased rom 63 per cent to 81

per cent rom 1990 to 2011. Southern Asia, Northern

Arica and Western Asia made the most progress overthe past decade, while regions such as the Caribbean,

Eastern Asia, Latin America and South-Eastern Asia

have already achieved coverage rates o 90 per cent or

more.

The World Health Organization has recommended a

minimum o our antenatal care visits to ensure the

well-being o mothers and newborns. These visits

should include tetanus toxoid vaccination, screening

and treatment or inections, and the identication

o warning signs during pregnancy. Pregnant women

are also tested or HIV; i positive, they receive help

and guidance in living with the virus and avoidingtransmission to their babies. In countries where

malaria is endemic, pregnant women should also

receive intermittent treatment to prevent the disease,

thereby averting adverse outcomes or mother and

baby i inected during pregancy.

Antenatal care can save lives. Yet in developing regions

overall, only hal o all pregnant women receive the

minimum recommended number o antenatal visits

(our). Regions such as Northern Arica and South-

Eastern Asia showed substantial progress during the

past two decades in improving coverage o antenatal

care, while Southern Asia and sub-Saharan Arica

lagged behind. In 2011, only 36 per cent o pregnant

women in Southern Asia and 49 per cent in sub-

Saharan Arica received at least our antenatal care

visits during their latest pregnancy. Care can vary in

terms o quality, a dimension that is hard to measure

and is not refected in the data. Monitoring is required

to ensure high-quality antenatal care that actually

contributes to improved pregnancy outcomes.

51

89

77

72

66

36

44

82

69

66

37

27

37

69

45

59

23

52

9080706050403020100

24

49

49

Proportion of women aged 15-49 attended four or

more times by any provider during pregnancy, 1990,

2000 and 2011 (Percentage)

Developing regions

Latin America

South-Eastern Asia

Caribbean

Northern Africa

Sub-Saharan Africa

Southern Asia

1990 2000 2011


33/64


34/64


Th nd fo fmily plnnin is slowly

bin mt fo mo womn, but dmnd

is incsin t pid pc

As contraceptive prevalence has increased, the unmet

need or amily planningdefned as the percentage

o women aged 15 to 49, married or in union, who

report the desire to delay or avoid pregnancy but are

not using any orm o contraceptionhas declined

overall. Worldwide, unmet need or amily planning

dropped rom 15 per cent in 1990 to 12 per cent

in 2011, driven by progress in developing regions.

Current levels o unmet need range rom a low o 4

per cent in Eastern Asia to a high o 25 per cent in

Oceania and sub-Saharan Arica. This translates into

more than 140 million women (married or in union)

who would like to delay or avoid pregnancy, but are not

using contraception. By 2015, total demand or amily

planning among married women is projected to grow

to more than 900 million, mostly due to population

growth. This is one indication o the unfnished agenda

in reproductive health and the scale o eorts needed

to keep pace with the demand or contraceptives,

especially more eective modern methods.

0 10 20 30 40 50 60

4

10

12

13

15

16

17

25

25

3

12

14

16

14.4

18

20

18.5

26.6

27

6

17

23

19

19

22

22

19.3

27.4

28

10

10

11

13

14

17

49

14.1

Developed regions

Developing regions

Eastern Asia

Latin America

Northern Africa

South-Eastern Asi a


Southern Asia

Western Asi a

Caribbean

Sub-Saharan Africa

Oceania

1990 2000 2011

Proportion of women aged 15-49, married or in union,

who have an unmet need for family planning,

1990, 2000 and 2011 (Percentage)


35/64


36/64


37/64


38/64


39/64

Goal 6: CoMbaT hiv/aiDs, MalaRiaanDoTheRDiseases | 37

TargeT 6.B

Achieve, by 2010, universal access to treatmentor HIV/AIDS or all those who need it

Univsl ccss to ntitovil thpyis within ch, but will qui sustind

politicl suppot

Most regions made signicant progress in providing agrowing share o eligible populations with antiretroviraltherapy. At the end o 2011, 11 countries, includingve with generalized HIV epidemics (Botswana,Namibia, Rwanda, Swaziland and Zambia) and six withlow and concentrated epidemics (Cambodia, Cuba,

Dominican Republic, Fiji, Guyana and Mexico) hadachieved universal access, commonly understood asthe provision o antiretroviral therapy to at least 80 percent o the people who need it. Yet elsewhere, mostdeveloping countries are ar rom achieving that goal.

Access to antiretroviral therapy varies by sex and age.In 2011, coverage was higher among women (63 percent) than men (46 per cent). An estimated 560,000children under age 15 were receiving treatment at theend o 2011. However, this represented only about28 per cent o all eligible children under age 15 in

developing regions that year.

2 0 0 4 2 0 0 6 2 0 0 8 2 0 1 0 2 0 1 1

0

1

2

3

4

5

6

7

8

2 0 0 2 2 0 0 3 2 0 0 5 2 0 0 7 2 0 0 9

Number of people receiving antiretroviral therapy,

number of deaths from AIDS-related causes,

and number of people newly infected with HIV,

developing regions, 2002-2011 (Millions)

Number of people receiving antiretroviral therapyNumber of deaths from AIDS-related causesNumber of people newly infected with HIV

At the end o 2011, 8 million people in developingregions were receiving antiretroviral medicines or HIVor AIDS. This represents an increase o about 1.4million people rom December 2010, which comes ontop o similar gains in previous years. At the currentrate o increase, close to 15 million people may bereceiving this lie-sustaining treatment by the end o2015, the goal agreed to at the United Nations High-Level Meeting on AIDS held in June 2011.

Despite this progress and a positive outlook, the MDGtarget o universal access to antiretroviral therapy or

all who need it by 2010 was missed: At the end o2011, only 55 per cent o the 14.4 million people indeveloping countries in need o treatment received it.Furthermore, it is now recommended that antiretroviralmedicines be used earlier and more widely or clinicalbenets among certain populations. This includeslielong treatment or all pregnant women who are HIV-positive. As a result, the number o people eligible ortherapy is rising, widening the gap between those whoneed and actually receive treatment. Reaching the goalo universal access to antiretroviral therapy requiressustained political momentum and increased eciency

and eectiveness in the global response to AIDS.

0 20 40 60 80

11

15

19

40

47

55


Northern Africa & Western Asia

Eastern Asia

Southern Asia

South-Eas tern Asia & Oceania

Sub-Saharan Africa


Developing regions

2009 2010 2011

Proportion of people living with HIV who are receiving

antiretroviral therapy*, 2009, 2010 and 2011

(Percentage)

* Antiretroviral therapy coverage is measured among people living with

HIV with a CD4 cell count at or below 350 cells/mm3.


40/64


Without treatment, approximately one third o childrenborn to women living with HIV will become inectedwith the virus in the womb, at birth or throughbreasteeding. This risk can be greatly reducedby treating an expectant mother with eective

Between 2000 and 2010, mortality rates rom malariaell by more than 25 per cent globally. An estimated1.1 million malaria deaths were averted over this

period, with more than hal o those lives saved inthe 10 countries with the highest malaria burden.By 2011, 50 o 99 countries with ongoing malariatransmission were on track to reduce their malariacase incidence rates by 75 per cent by 2015. Thesereductions constitute major achievements in the globalght against malaria. But sustaining these gains willtake extra eort and renewed commitment rom theinternational community.

Young children are most likely to succumb to thedisease: In 2010, about 219 million cases o malaria

worldwide led to some 660,000 deaths; over 80 percent o them were among children under ve. Together,the Democratic Republic o the Congo and Nigeria

account or over 40 per cent o the estimated numbero malaria deaths worldwide. Malaria continues to bea disease o poverty. Within countries, the prevalenceo malaria inections in children under ve is highestamong the poor and those living in rural areas.

Sleeping under an insecticide-treated mosquito net isthe most eective way to prevent malaria transmission.Over the past decade, substantial progress has beenmade across sub-Saharan Arica in scaling up bothhousehold ownership and use o insecticide-treated nets(use is estimated at 90 per cent among households

antiretroviral medicines. An estimated 57 per cent opregnant women in developing regions in need o suchtreatment received it in 2011. Sub-Saharan Arica ishome to about 93 per cent o the 1.5 million pregnantwomen who should be receiving antiretroviral drugs.

TargeT 6.C

Have halted by 2015 and begun to reverse the incidence o malaria and other major diseases

Mo thn 1 million dths fom mli w vtd ov th lst dcd, but

nwd commitmnt is ndd to sustin ins

10

21

36

26

30

38

4345

64

70

2629 30

33 3536

3739 39

47

57

64

70 71

0

10

20

30

40

50

60

70

2

10

18

26

50

55

Chad

Came

roon

Centr

alAfrican

Republi

cCong

o

Ethiop

ia

DRCon

go

Ugan

da

Burun

di

URTanzan

ia

Rwan

da

Swaz

iland

Zimba

bwe

Mozam

bique

Angola

Zamb

ia

Mala

wi

Guine

a

Nige

ria

Sierra

Leon

e

Gamb

ia

Sene

gal

Guine

a-Bissau

Liberia

Cte

d'Ivo

ire

Ghan

a

Burkina

FasoTo

goN

iger

Mali

Benin

Central Africa Eastern Africa West Africa

Proportion of children under age five sleeping under insecticide-treated mosquito nets, African countries,by regions*, 2010-2012 (Percentage)

* The composition of the four subregions in Africa is shown on page 59 in the section on regional groupings.


41/64


42/64


0

100

200

300

400

1990 1993 1996 1999 2002 2005 2008 2011

0

100

200

300

400

1990 1993 1996 1999 2002 2005 2008 2011

0

100

200

300

400

1990 1993 1996 1999 2002 2005 2008 2011

0

100

200

300

400

1990 1993 1996 1999 2002 2005 2008 2011

0

100

200

300

400

1990 1993 1996 1999 2002 2005 2008 2011

0

100

200

300

400

1990 1993 1996 1999 2002 2005 2008 2011

0

50

100

150

200

0

50

100

150

200

0

50

100

150

200

1990 1993 1996 1999 2002 2005 2008 2011 1990 1993 1996 1999 2002 2005 2008 2011 1990 1993 1996 1999 2002 2005 2008 2011

0

50

100

150

200

1990 1993 1996 1999 2002 2005 2008 2011

0

50

100

150

200

1990 1993 1996 1999 2002 2005 2008 2011

Sub-Saharan Africa OceaniaCaucasus & Central Asia

South-Eastern Asia Southern Asia Eastern Asia

Western AsiaNorthern AfricaLatin America & the Carribbean

Developing regionsDeveloped regions

Range of estimates

Incidence trends

Note: The scale used for the first six regions isdifferent from the scale used for the other regionsdue to the higher tuberculosis incidence levels inthe former regions.

Estimated number of new tuberculosis cases per 100,000 population including people who are HIV-positive,

1990-2011


43/64

Goal 6: CoMbaT hiv/aiDs, MalaRiaanDoTheRDiseases | 41

Succssful ttmnt of tubculosis is

xcdin lobl tts, but mo wok

lis hd

In 2011, 5.8 million people were ocially notied that

they had tuberculosis. This represents two thirds othe estimated number o new cases. Among patientsdiagnosed in 2010, 87 per cent were successullytreated. This was the third year in a row that thetarget o successully treating at least 85 per cent oconrmed cases was exceeded at the global level.

Progress against tuberculosis ollows 15 years ointensive eort to implement the Directly ObservedTreatment Short Course (DOTS) strategy (during19952005) and its successor, the Stop TB Strategy,launched in 2006. Between 1995 and 2011, a

cumulative total o 51 million tuberculosis patientswere successully treated through such programmes,saving 20 million lives.

More work lies ahead. More than one third o alltuberculosis cases are not treated using the DOTSprotocol. And most o the estimated 310,000 caseso multidrug-resistant tuberculosis among notiedpatients are not being diagnosed and treated accordingto international guidelines. Many tuberculosis cases areamong people who are HIV-positive and do not knowtheir HIV status; nor are they receiving antiretroviraltherapy, which hinders their progress.

Monitoin of tubculosis tuns

hlth cisis into n MDg succss stoy

Twenty years ago, Cambodia had one o the

worlds highest rates o tuberculosis and ahealth system weakened by decades o confictand economic hardship. In 1993, global ocuson the resurgence o the disease triggeredthe newly elected government to re-launchits national tuberculosis programme, withstrong support rom WHO and internationalpartners. Although it took some years togather momentum, Cambodia transormedthe programme rom a hospital-based systemto one that provides ree, universal accessto tuberculosis care at the grass-roots level,

through primary health-care centres. At thecore o the new approach was the DOTS/StopTB strategy recommended by WHO, whichocuses on supporting patients in ollowing ashortened six-month treatment regimen.

In 2002, Cambodia launched a nationalpopulation-based survey o tuberculosisprevalence, reaching more than 30,000peoplethe rst o its kind in a low-incomecountry. The survey conrmed an extremelyhigh tuberculosis burden o 15.1 casesper 1,000 people. Strengthened national

surveillance and monitoring capacity allowedocials to identiy populations with loweraccess to health services, and to implementcorrective actions. A second national survey in2011 ound that tuberculosis prevalence hadbeen reduced by nearly halto 8.17 casesper 1,000 peoplein nine years. Incidence isnow estimated to be alling at a rate o over 3per cent per year. Cambodia is well on track toachieving all tuberculosis-related MDG targetsor 2015, including halving prevalence andmortality rom the disease rom 1990 levelsand reducing incidence.


44/64


45/64


46/64


Wid commitmnt nd clos

monitoin o ozon-dpltin

substncs hv st pcdnt o

succssul ction inst climtchn

The Montreal Protocol on Substances that

Deplete the Ozone Layer is an undisputed

and still ongoingsuccess story, leading

to a 98 per cent reduction in consumption

o ozone-depleting substances since 1986.

Because most o these substances are potent

greenhouse gases, the Montreal Protocol is also

contributing signicantly to the protection o

the global climate system.

The prerequisites or successul international

action include sound scientic and technical

inormation; a fexible, adaptable mechanism;

the commitment o all stakeholders; exchange

o inormation and transer o technology; and

eective monitoring. Monitoring continues

to require adequate data on ozone-depleting

substances, all o which can be derived rom

national production and international trade

statistics.

Ovxploittion o min fsh stocks is

sultin in diminishd yilds

In 2009, 30 per cent o marine sh stocks were

overexploited and outside their sae biological limits,

compared to 10 per cent in 1974. This means that

marine sh stocks globally are now below the level

at which they can produce maximum sustainable

yields. Over the past 40 years, the overall condition o

global sheries has declined in spite o actions taken

by coastal states in terms o policy development and

sheries management. More and more stocks have

become overshed due to continuing expansion o the

shing industry in many countries.

The highest proportion o overshed stocks were

recorded in major parts o the Atlantic Ocean, the

Mediterranean and the Black Sea, where 50 per cent

or more o sh stocks are outside their sae biological

limits. The lowest proportion (about 10 per cent) o

overshed stocks are ound in the eastern central,

northeast and southwest Pacic Ocean.

Overshing reduces the productivity o sh stocks. As

a result, the total marine catch brought ashore (known

as landings) has diminished worldwide rom a peak

o 87.7 million metric tons in 1996. Rebuilding sh

stocks through strict management plans will restore

their productivity. At the same time, it will improve

the economic eciency o sheries and enhance the

biodiversity and unctioning o marine ecosystems.

50

55

60

65

70

75

80

85

90

95

50

55

60

65

70

75

80

85

90

1970 1975 1980 1985 1990 1995 2000 2005 2010

Percentage Millions of metric tonnes

Fish stocks within their safe biological limits

Fish landings (catch that is brought ashore)

Proportion of fish stocks within their safe biologicallimits, 1974-2009 (Percentage) and fish landings,

1970-2011 (Millions of tons)


47/64


48/64


global economies. In act, a signicant portion o

the worlds population depend on protected areas or

their livelihoods. Recognizing the importance o both

biodiversity and ecosystem services, the Convention on

Biological Diversity seeks to conserve at least 17 per

cent o the worlds terrestrial areas and 10 per cent

o coastal and marine areas by 2020 through a global

protected area network that is eectively and equitably

managed and ecologically representative o the earths

natural resources.

Latin America leads the way in conservation o its land

and coasts, with 21.3 per cent o its terrestrial areas

and 15.4 per cent o its marine areas under protection.

Other regions lag ar behind. Continued eorts are

needed to improve the coverage and, in particular, the

eectiveness o the global protected area network.

Bids, mmmls nd oth spcis hdin o xtinction

Species are moving towards extinction at an ever

aster pace, with declines in both populations and

distribution. These are the ndings o the Red List

Index, compiled by the International Union or

Conservation o Nature and its partners. The index

measures trends in the overall extinction risk o sets o

species.

The Red List Index is now available or all the worlds

birds (10,000 species), mammals (4,500 species),amphibians (5,700 species) and warm-water ree-

building corals (700 species). The most recent

updateor birds, presenting ndings up to 2012

shows that declines are continuing at the same, or

even an accelerating, pace. All groups with known

trends are deteriorating in status, and other classes

o organisms are likely to mirror this pattern. Reduced

biodiversity will have serious consequences or the

ecosystem services upon which all people depend. In

recent years a number o countries, including Denmark

and Sweden, have succeeded in reducing the risk o

extinction or certain native species. More countries

need to ollow suit.

TargeT 7.C

Halve by 2015, the proportion o the

population without sustainable access to sae

drinking water and basic sanitation

Mo thn 2.1 billion popl hv ind

ccss to impovd dinkin wt soucs

sinc 1990, xcdin th MDg tt

0 20 40 80 10060

50

56

4963

89

86

71

89

85

90

72

90

87

92

68

92

85

94

70

87

98

99

89

76

Proportion of population using an improved watersource, 1990 and 2011 (Percentage)

Oceania


South-Eastern Asia

Northern Africa

Eastern Asia

1990 2011 2015 Target

World

Sub-Saharan Africa

Western Asia

Southern Asia


Developing regions

Developed regions


49/64


50/64


51/64


52/64


TargeT 7.D

By 2020, to have achieved a signicant

improvement in the lives o at least 100

million slum dwellers

Thouh th MDg tt hs bn mt,

ubniztion continus to outpc

impovmnts in slum conditions

dwellers even urther. Eastern Asia, Southern Asia and

South-Eastern Asia achieved the largest decreases

in percentage terms. However, the high proportion

o slum dwellers in sub-Saharan Arica dropped only

slightlyrom 65 per cent in 2000 to 62 per cent in

2012.

Although the MDG slum target has been reached, the

number o slum dwellers, in absolute terms, continues

to grow, due in part to the ast pace o urbanization.

The number o urban residents in the developing world

living in slum conditions was estimated at 863 million

in 2012, compared to 650 million in 1990 and 760

million in 2000. Stronger, more ocused eorts are

needed to improve the lives o the urban poor in cities

and metropolises across the developing world.

Lssons om countis tht hv tckldth multictd poblms o ubn slums

my bnft oth countis

Many countries across all regions have shown

remarkable progress in reducing the proportion o slum

dwellers in their cities, with large countries such as

China, India and Indonesia driving this regional and

global trend. However, in other countries, particularly

those aected by confict, slum prevalence remains

very high and the proportion o urban residents living

in slums increased rom 2000 to 2012. Slum dwellers

in these countries oten lack improved water sources,improved sanitation acilities, durable housing,

sucient living area or a combination o these our

characteristics that now dene slums. Improving the

lives o the urban poor will thereore require large,

multisectoral investments.

In light o burgeoning slum populations, urther action

is needed. Based on the experience o successul

countries, a number o actors have been identied as

prerequisites or meeting the slum reduction target at

the national level: appropriate policies, access to basic

services, security o land tenure, and harmonization

o the denition o slums and methods or monitoring

and evaluating them. Towards that end, governments

and regional and local authorities have been invited

to enumerate their own slum populations and, on that

basis, to set voluntary and realistic national, regional

and local targets to be met by 2020, to ease the plight

o the urban poor.

Between 2000 and 2010, over 200 million slum

dwellers gained access to improved water sources,

sanitation acilities, durable housing or sucient living

space, thereby exceeding the 100 million MDG target.

In act, between 2010 and 2012 alone, conditions

improved to the point where an additional 44 million

people were no longer considered to be living in slums.

The proportion o slum dwellers in developing regions

decreased rom 39 per cent in 2000 to 33 per cent in

2012. The decline was observed across most regions.

Northern Arica reduced its already low share o slum

0 20 40 806010 30 7050 90

116

65

62

46

35

40

31

37

28

21

25

24

24

29

24

20

13

39

33

Proportion of urban population living in slums, 2000and 2012 (Percentage)

Sub-Saharan Africa

South-Eastern Asia

Eastern Asia


Northern Africa

Developing regions

2000 2012

Southern Asia

Western Asia

Oceania


53/64


54/64


55/64


56/64


57/64


58/64


59/64


60/64


61/64


62/64


63/64


64/64

mdg report 2013 english version

Documents