The List

The Save-the-World Clock

Global leaders promised a decade ago to end poverty by 2015. With just five years left, the U.N. General Assembly -- including an estimated 140 heads of state -- will meet this week to assess progress. How much good has been done? Here's a hint: not enough.

Ten years ago, 189 heads of state sat down at the United Nations headquarters in New York and drafted an impressively ambitious set of anti-poverty goals -- to cut destitution in half, to reduce hunger, to boost school enrollment, and to make the world a more equal, just place. They called their eight targets the Millennium Development Goals, with an aim to "free our fellow men, women and children from the abject and dehumanizing conditions of extreme poverty, to which more than a billion of them are currently subjected." All this was to be accomplished by 2015.

Now, with only five years left until the deadline, country leaders are gathering in New York for a 2010 review summit to determine what can still be done to meet it.

In some ways, the so-called MDGs have already made history. Their adoption marked the first time that the entire world agreed that the poor --- the least politically empowered group of people on earth -- would suddenly become a priority. The goals were refreshingly specific, for example calling for a reduction in the deaths of children under five by two-thirds. Humanity could be proud of the promises made.

Yet a decade on, it's clear the world has too often, and in too many cases, fallen behind. There has been progress: School enrollment for example, has skyrocketed even in the poorest countries, and the world will likely meet its goal to halve poverty overall. But while countries such as Ghana and Rwanda have made strides, many others are showing little improvement. For instance, U.N. Secretary-General Ban Ki-moon's pre-summit report notes that without China, progress on overall poverty rates "does not look very encouraging. In fact, the number of people living in extreme poverty actually went up between 1990 and 2005." Gender equality and women's rights have shown the least improvement since 2000. Inequality has remained stubbornly high; children from the poorest households worldwide, for example, are twice as likely to die as their wealthy peers.

So, did the world bite off more than it could chew? Yes, mostly likely we did -- though that was kind of the point. Peter Yeo, the executive director of the Better World Campaign, an advocacy group supporting U.N. anti-poverty efforts, told me that what the goals have done is create political momentum for the fight on poverty -- they are the beginning of a journey, not the end. And as to how the world will keep pursing them after 2015, "That discussion has already begun."

The most important question now, experts say, is not whether the world can meet these goals, but how and where we won't -- in other words, what we need to do better from here on. Here's a quick look at each of the goals, the progress made, and why there's still far more work to be done.

In the last half-century that the world has been trying to do "development," perhaps the biggest lesson that analysts and aid workers have learned is that cutting poverty is pretty much an all-or-nothing proposition: You can't, for instance, improve education if you don't empower women; you can't feed people if you don't shore up the international trading regime; and you can't reduce inequality when corruption pervades.

With this in mind, the MDGs were designed to be broad, including everything from children to women to agriculture to health. But they also point to specific, quantifiable goals that policymakers could work toward, and be held accountable for, if progress stalls.

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GOAL: ERADICATE EXTREME POVERTY AND HUNGER

Targets: The first goal aims to improve the lot of humanity's bottom line -- halving the proportion of people whose income is less than $1 per day, reaching full employment for all people regardless of their age and gender, and halving the proportion of people who go to bed hungry.

Reality: Global poverty rates have dropped almost enough to meet the goal, and the numbers would look even better if the Great Recession hadn't struck, an International Monetary Fund study to be released at the summit will note. If not for the economic downturn, 71 million more people would have escaped poverty today.

Back in 1990, the base year of comparison for all the MDGs targets, 46 percent of the world lived on less than $1.25 a day. In 2005, it was just 27 percent -- an incredible drop. But that's mainly because China alone lifted half a billion people out of poverty during the last 30 years; the rest of the world isn't doing as well. In sub-Saharan Africa, poverty rates fell by 10 percent, but because of population growth, the absolute numbers of the destitute actually rose. And even within China, some 254 million remain in extreme poverty, working on about 52 cents a day. Unemployment rates skyrocketed with the global recession; simply returning to pre-crisis levels will require 300 million new jobs, according to the U.N.'s pre-summit report.

Meanwhile, the ranks of the hungry have grown along with food prices, hitting an all-time high of more than 1 billion people in 2009. A recent report from the U.N. Food and Agriculture Organization finds that this number has fallen slightly, but warns, "The recent increase in food prices, if it persists, will create additional obstacles in the fight to further reduce hunger." G-20 countries have responded, for example by creating a global agriculture fund in 2009. But today, just 6 percent of the promised contributions have arrived.

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GOAL: ACHIEVE UNIVERSAL PRIMARY EDUCATION

Target: By 2015, countries should have every child -- both girls and boys -- enrolled in and completing primary school.

Reality: Primary education is probably the most pronounced success story of the MDGs so far. Today, some 89 percent of children in developing regions are enrolled in school, according to the United Nations, up from 82 percent in 1999. That jump includes a remarkable 18 percentage-point boost in sub-Saharan Africa, where rates now hover around three-quarters of all children. Such gains still leave 72 million children not enrolled in primary school, though the U.N. projects the number will be down to 56 million by 2015.

Policies such as cutting school fees and offering school meals have been responsible for much of the progress. Another effective tool came in the form of debt-for-education swaps, through which countries such as Indonesia, Nicaragua, and El Salvador agreed to increase their investment in education in return for debt relief.

But learning is about more than just showing up, and the increased enrollment has created a new problem: massive overcrowding. The number of new teachers that will be needed in Africa's schools by 2015, for example, is now equal to the total number of teachers on the continent today, according to the U.N. Quality hasn't kept up with increasing numbers of pupils, and so many countries now have a "high number of secondary-level graduates with fairly irrelevant skills," explains Sigrid Kaag, assistant secretary general at the U.N. Development Program.

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GOAL: PROMOTE GENDER EQUALITY AND EMPOWER WOMEN

Target: The aim here is to level the playing field for women, beginning from childhood, by enrolling equal percentages of boys and girls in school. Global leaders are charged with creating more opportunities for more women in politics and the workplace as well.

Reality: Progress clearly isn't moving fast enough to meet this goal. Less than a third of all 171 countries monitored have achieved equal enrollment of girls and boys in school.

There are two main explanations for why the world is falling short here. The first is that women's empowerment is more fungible and more culturally fraught than many of the other goals. "What's coming into play is the complexity of change," says Thoraya Obaid, head of the United Nations Population Fund, noting that women's issues aren't solved with technical fixes but rather require major behavioral and cultural shifts. There is no NGO or donor who can do that, she notes; "change can only come from within."

The second explanation is that women have not been a political priority. For the duration of this 10-year experiment, politicians have tended to focus on one goal at a time, says Jeffrey Sachs, an economist and advisor to the U.N. secretariat on the MDGs. "Every year there's been one" goal that's in fashion, he notes. And women haven't been the "it" thing until this year, when they will take center stage for the first time. (The newfound focus follows a wake-up call from data showing the world making the least progress on gender equality of any of the goals.)

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GOAL: IMPROVE MATERNAL HEALTH

Targets: Hundreds of thousands of mothers die each year while giving birth; the aim here is to reduce maternal mortality by three-quarters through the provision of a trained birth assistant and access to emergency medical care. Countries are also urged to provide women with universal access to reproductive health, including family planning and neonatal services.

Reality: Little progress has been made, and the world is now trying hard to catch up. Some 358,000 women died from treatable causes while giving birth in 2008, down from 546,000 in 1990, according to a World Health Organization report released this week. Still, the rate of progress is "less than half of what is needed" to reach the goal's target, the report says.

The world has known just how important women are when it comes to development for a while now. Beginning in the mid-1990s, social scientists began to notice that women had a key impact on reducing poverty in households by spending income on such things as education and the health of their children. The implication was that improving the status of women would also have knock-on effects on other facets of development.

Yet now is really the first time that there has been such a political push to move that research into practice. The U.N. secretary-general's August 6 strategy on women and children's health notes the residual effects on poverty, economic productivity, and growth. The hope is that working to improve the lives of women will boost, rather than take away from other goals.

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GOAL: REDUCE CHILD MORTALITY

Target: As with women in childbirth, many of the children who die under the age of 5 perish from preventable and treatable conditions. Governments resolved to trim child mortality by two-thirds by 2015.

Reality: Mortality rates have certainly fallen overall, but not fast enough to reach the goal, and some 10 million children still die every year -- almost half from four treatable causes: pneumonia, diarrhea, malaria, and HIV/AIDS. Moreover, a UNICEF study released on September 7 found that inequalities in child mortality are growing in some cases. The study warns that region- or country-wide averages tell a misleading story, as they "can conceal broad and even widening disparities in poverty" between rich and poor.

It's the poorest communities tend to be the most burdened by preventable childhood disease -- they often lack sanitation and water treatment that would prevent conditions such as diarrhea in the first place; nor do they typically have access to the basic medical care. What's more, UNICEF notes, "the poorest and most marginalized communities are not systematically assessed and are often forgotten when national development plans are laid and resources allocated." Correcting this disparity will require a big push in the other direction, UNICEF now argues: Targeting children at the bottom of the income ladder will be the U.N. children's agency's focus over the coming five years.

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GOAL: COMBAT HIV/AIDS, MALARIA, AND OTHER DISEASES

Targets: The MDGs were written at the height of the HIV/AIDS epidemic, and their targets prioritize getting the disease under control by containing infection rates and providing universal access to treatment, the latter of which was meant to be achieved by 2010. The goals also single out malaria, tuberculosis, and other neglected diseases for improvement.

Reality: Thanks to an incredible funding push over the last decade, more people are now on treatment for HIV/AIDS than could have been imagined back in 2000 -- some 5.2 million in the developing world. U.S. President George W. Bush's emergency HIV/AIDS program, PEPFAR, poured an unprecedented $2.4 billion into fighting and treating the disease in just one year alone. The United States also helped push for the creation of the Global Fund for HIV/AIDS, Tuberculosis, and Malaria, a reservoir for donor money that coordinates global efforts. The fund is estimated to have saved 4.9 million lives since it was founded in 2002.

Today there are some 33 million people living with HIV, most of them women and most in sub-Saharan Africa, says Bertil Lindblad, head of the UNAIDS New York Office. "That's due to the good fact that we have given more people access to [treatment,]" he explains. The major concern for HIV/AIDS campaigners now is whether funding levels can be kept up in hard financial times and even broadened in focus. "AIDS is not only a medical and health issue," Lindblad explains, "It has to do with services, discrimination, the workplace, you name it."

Malaria, meanwhile, still kills 1 million people every year. There are simple ways to prevent the disease -- for example using bed nets to keep out the disease-causing mosquitoes from biting --  but implementing those fixes on the ground is often more complicated. Bed nets, for example, only work if families use them. Malaria has also proven extremely complicated to vaccinate and treat; strains of the parasite have developed resistance against several previously effective drug regimens.

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GOAL: ENSURE ENVIRONMENTAL SUSTAINABILITY

Targets: This goal was written before climate change became the overriding issue for environmentalists, and accordingly it focuses instead on "sustainability" -- the idea that economic growth can be achieved without depleting natural resources. One sub-goal was to reduce the number of species that disappear each year by 2010. A second component was to halve the proportion of people who have access to sanitation and drinking water and to make life better for the millions of slum dwellers worldwide.

Reality: In a word, disaster. The world didn't meet its 2010 targets to stop the loss of species, and 13 million hectares of forest are still uprooted each year. And with climate change accelerating, these problems may well get worse before they get better. Nor is life improving much for slum dwellers, of which there are some 828 million today, an increase from 657 million in 1990. Sanitation is also lagging, having improved just 8 percentage points between 1990 and 2006, according to the secretary-general's pre-summit report. By 2015, 2.4 billion people will still be without sanitation systems, the World Health Organization estimates -- the same number who lack them today.

The collapse of the U.N. climate summit in Copenhagen in December 2009 does not bode well for future political agreements on environmental damage. There was one piece of good news from the summit, however: an offer by rich countries to pay developing countries some $30 billion to conserve forest land.

Improving sanitation systems, meanwhile, turns out to be one of the more difficult tasks that governments have encountered, particularly in rural areas where the infrastructure often has to be built up from scratch. Only 45 percent of rural dwellers worldwide have access to such sanitation systems. "It's the biggest global system gap," says John McArthur, CEO of Millennium Promise, an organization set up to help promote the MDGs. Much of the improvement that has come about has been less technical than educational -- improving awareness about sanitation and intestinal parasites.

Even more critical than the technical challenge, however, is the political one -- and here, the MDGs offer less help. NGOs can build wells, donors can give money, but at the end of the day, regulating water is a question for governments. McArthur cites Senegal as a country that has made progress in this area by making it a priority for the government, targeting specific economic and regional groups that are in most need of new facilities. Other countries have struggled to divert scarce resources to what is an expensive, long-term problem. Worldwide, it would cost an estimated $142 billion to build the needed sanitation systems and another $216 billion to maintain them, the World Health Organization estimates.

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GOAL: DEVELOP GLOBAL PARTNERSHIP FOR DEVELOPMENT

Targets: The final goal of the MDGs is a sort of political capstone, one drafted in hopes of guaranteeing that politics don't thwart the world's own best intentions. That means paying attention to the countries lagging furthest behind, creating a regulated and rule-based global financial system, eliminating country debt, pushing for affordable access to prescription drugs, and working with the private sector to get new technologies in the hands of the poor.

Reality: This goal was always going to be the hardest to reach, because it involves resolving a host of competing interests. While the world has broadly agreed that agricultural subsidies should be lifted, for example, domestic considerations have kept talks on the matter, the so-called Doha round, from moving forward. There has been some progress on financial architecture, with the United States and Europe approving new financial rules, and the Basel Committee, which monitors international banks, recommended new standards for banks on September 12, 2010. Debt reduction has come further, with three-quarters of eligible countries passing through the IMF's debt-relief program.

Aid reform advocates say that accountability is the key to making sure that governments address the real structural issues, that donors don't float from fad to fad, and that the goals don't just remain lofty rhetoric. Unfortunately, when countries signed on, there were few mechanisms -- aside from public shaming -- to force them to follow through. This week's session is unlikely to produce any such mechanisms either, judging from the near-final draft seen by FP. (One Western diplomat expressed particular frustration that the G-77, the major developing-country grouping in the U.N. General Assembly, had rejected the idea of any accountability measures.)

This is the key flaw of the MDGs. And it has led many, including Dessima Williams, Grenada's representative to the talks, to believe that there has been "Too much talk, too much playing with the romance of the MDGs." Without anyone to answer to, there is no way to ensure that donors' promised aid comes through or that governments put the money to good use. And so, a project that was conceived by 189 heads of state with the aim of sidestepping politics and getting things done has found that the old rules still apply. Unless, when they meet in New York this week, they surprise us all.

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