Syndicate content

Africa and the Millennium Development Goals

Shanta Devarajan's picture

At a recent DFID conference on the Millennium Development Goals, I argued that Africa can meet the MDGs, if not by 2015 then soon thereafter. Here is why:

1. Although most African countries are off-track on most of the MDGs, Africa has, since the mid-1990s, arguably been making the greatest progress towards the goals. 

2. Africa’s progress in the MDGs since the mid-1990s was due to economic growth and improved service delivery. 

3. While Africa was probably hardest-hit by the global economic crisis, the response of African policymakers helped to dampen the impact, and set the stage for the continent to benefit from a global recovery.


Let me elaborate:

1. Although most African countries are off-track on most of the MDGs, Africa has, since the mid-1990s, arguably been making the greatest progress towards the goals The poverty rate has been declining at about one percentage point a year.  There is some evidence that child mortality in Africa, after stagnating for some time, is beginning to fall sharply.  Countries such as Rwanda, Ethiopia, Gambia and Malawi have seen declines of 25-40 percent in under-five mortality in the last decade.  And in primary completion, if you take 1999 as the starting point, the fastest progress has been in Africa and South Asia.  While this has to do with the fact that these two regions had the lowest levels of primary completion, it is still significant that, unlike previous periods, the growth rate in Africa is the highest.
































































2. Africa’s progress in the MDGs since the mid-1990s was due to economic growth and improved service delivery.  Economic growth accelerated after 1995.  It was sustained for a decade, and accelerated even further until the onset of the global economic crisis of 2008.  Not only was Africa’s average economic growth during this period about 5 percent a year (rising to 6.2 percent in 2007), but it was relatively widespread. 

Some 22 non-oil-exporting African countries enjoyed better-than-four-percent average annual growth from 1998-2008.  The growth, in turn, was due to a combination of increased external resources (aid, debt relief, remittances and private capital flows), high commodity prices and a buoyant global economy, and improved economic policies.

Secondly, recognizing that money alone would not deliver the MDGs, some African countries introduced programs to improve the delivery of basic services.  Rwanda’s “paying-for-performance” scheme that increased incentives for health workers to provide services contributed to the country’s significant improvement in health indicators, as shown by comparing facilities that were and were not enrolled in the scheme.


In addition to facing a sharp drop in growth (from 5 percent in 2008 to 1.7 percent in 2009), throwing 7-10 million more Africans into poverty, and leading to the deaths of 30-50,000 additional infants before their first birthday, African policymakers were confronted with the fact that the payoffs to the economic reforms they had been pursuing over the past decade had suddenly declined. 

Rather than slowing or reversing these reforms, however, they by and large continued to pursue prudent economic policies during the crisis.  Those countries that had fiscal space (thanks to prudent policies before the crisis), such as Tanzania and Zambia, ran modest fiscal deficits; those that did not, such as Ghana, contracted their fiscal deficits.  Some countries accelerated their reforms.  As a result, economic growth is expected to be about 4 percent this year, which is still below pre-crisis levels but certainly a faster turnaround than Africa registered in previous crises.

Putting these points together, I conclude that, with a major effort by African governments, civil society, the private sector and the international community, Africa can meet the Millennium Development Goals, if not by 2015 then soon thereafter.


Submitted by John umoren on
I want to salute the soul lifting comments by Shanta, for me, it is very refreshing that at last the effort of many social workers, policy makers, Civil society groups ,women, professionals and African leaders is being seen collectively to yeilding some result. It must however be appreciated that a better Africa will benefit the entire world.

Submitted by Jacques Fremy on
With respect I fully disagree with you. The list of severe issues is growing by the day in the field among poor people when inequalities are growing at full speed mainly because of absurd human resources and natural management practices. Current trends for the agricultural and food sectors are contrary to good and sustainable practices in order to help millions of small African producers to put affordable and healthy food for all african consumers on the table. Solutions do exist but no one wants to listen to highly qualified African practitioners and specialists themselves. A very sad story. Uncle Jacques.

Jacques: Thank you for your comment. There is no question that, even if the aggregate statistics are showing improvement, millions of poor people in Africa are suffering, so I don't think we disagree. I would be interested in hearing about your solutions for helping small African producers in the agricultural and food sectors, whom we definitely need to support in escaping poverty.

Escaping poverty?I think Infrastructure should be a point of departure. In Tanzania, for example, more than 80% of the country's population depends on agriculture and I think it worth capitalizing on the same by among other things improving the Infrastructure to easily access the markets, something that Africa has not yet achieved. Infrastructure is broad. Harnessing the technology, Information and Communication if utilized properly might bridge the gap by reducing the physical movements of goods and that will grossly cut down the transaction cost in the process.

Submitted by Nderingo G. on
I totally agree with u Thomas in the issue of infrastructure, I work in rural Tanzania and I have observed that among other things, infrastructure is the major obstacle in the development of smallhoder and medium scale farmers and if improved (infrastructure) will help those farmers to fetch good market for their produces and easily access inputs required in agricultural production, technology, information and roads have to be improved if we need to see growth in the economy of farmers and Tanzania.

Submitted by Ian Miller on
What are you guys coming up with for incentives relating to protein substitution? I am specifically referring to weaning protein craved populations off stressed and endangered species harvested for bushmeat? would be curious to know latest developments.-I

Submitted by Prof. Nwadiuto Onofeghara on
At least two issues make me to disagree. Mechanised farming has not been pursued vigorously and the land tenure system is inimical to sustained mechanised farming to feed the teeming population. Two is that some countries have not dispelled with the habit of corrupt politicians who are in office to corner public funds into personal pockets rather than use funds for development. Thirdly there is hardly a determination to meet deadlines on crucial factors for economic development eg. deadlines for improved power supplies and to stop gas flaring in Nigeria

Submitted by Dessalegn M. Ketema on
First of all I appreciate what you have made an important analysis on MDGs in Africa. In my opinion, the eight (8) MDGs are context specific in nature which might be difficult to generalize, let alone for Africa it is hard to conclude for sub regions. On the other hand, when we see each MDGs, they do have their own specific characteristics. One can be achieved within the capacity and capability of the specific countries (like Combating HIV/AIDS and Malaria). Others need a global and/or regional partnership to be achieved (like ensuring environmental sustainability and developing global partnership for Development). Some countries, may achieve (at least 70%) of some of MDGs like Achieving universal primary education. But, I am not sure Africa can achieve all MDGs within this Time frame (2015) Do not forget we are on 2010, we have left with only 5 years. Even some report suggested that MDGs are not achievable within the time frame it was projected. Conversely, I strongly agree that Africa will achieve MDGs sooner or later if and only if it makes strong regional partnership in trade, environmental sustainability and governance and very importantly with the genuine political will of Developed countries. Dessalegn

Submitted by Anonymous on
Althougth there's some economic progress due to more trade openess particularly with China and the explosion of the telecommunication sector. The underlining of well define governance with the rule of undermines any private iniative who has no connection with rulers. Unless we get back to those principles Africans will always continue to lament for their condition. One of the best success we have seen is the Chinese willingness to bet and put their trust in getting a better return of investment in Africa. This is fostering a new shift in how other inveStor are seeing Africa.

Stop relying on factors, convention and graphs to claim that Africa would get out of the woods moments 2015. Stop pleasing African leaders by endorsing inept management of resources. I do not agree with your projections. Come to Nigeria and see pain and anguish. Is it a nation of 140 million people battling to share less than 3,000 megawatts that is recovering?

Submitted by Dr. Abel Anyieni on
I do agree with you that Africa has made remarkable strides on meeting the MDGs but the evidence is scattered(selective). In my opinion most countries in Africa will meet the universal primary education, but issues like universal health, life expectancy, inequality are wanting. A country like Kenya life expectancy has reduced inequality increased comparing it in the 1980s.In my opinion in most countries in Africa it maybe be be delayed for 20 year more. The main reason why this is so is that there are no strong institutions in Africa to implement the policies. There fore the people in power corner the resources and channel them to their own pockets and the common people do not have right to information to make the policy makers and the delivery system accountable. In my opinion if the people have right to information of all government projects the way India does then the people will be able to demand the services if not delivered to them.

Abel, I fully agree with you that the key to reducing poverty is strong institutions that enable poor people to hold policy makers and service providers accountable. I would however caution in thinking that simply having a right-to-information law is sufficient to achieve this. It certainly helps, but in India (which you cite as an example), the progress towards the MDGs is not impressive. In fact, over the last ten years, poverty in Africa has been falling faster than in India. Furthermore, India still suffers from some of the service-delivery failures we associate with Africa--teacher absenteeism (25 percent), doctor absenteeism (40 percent), etc.

Submitted by Makori on
I think it will take a while before we attain the MDGs.First the health systems in many African countries are wanting.Two,most of our people live in rural areas which are experiencing extreme poverty levels and rampart corruption from the same officials who are tasked to implement this goals.Thirdly,our education should also emphasize on vocational training rather than liberal education.Many people in rural areas don't seem to know or understand the MDGs, hence concerted effort needs to be done by all the stakeholders.

Submitted by Otabor Isaac on
The argument that Africa can meet the MDGs,if not by 2015 then soon thereafter is a big hope/dream.We are really concerned that Africa may not achieved the MDGs by 2015 or soon thereafter,for the following reasons: 1.The present level of poverty in Africa 2.The level of infrastructural development 3.The level of educational development 4.Corruption in most Africa countries 5.Wastage of resources 6.High level of unemployment Meanwhile,the above challenges could be resolved if African leaders and indeed,Africans will be committed to the realisation of the MDGs. Thank you.

Submitted by Roy machoko on
I think there is need to strengthen agro based value chains to encourage value addition at community level thus improving the livelihoods of the small holder farmers .The potential of Natural resources to take rural poor out of poverty can not be under estimated .The commercialization Non Timber forest products can assist the rural poor in if they are supported with appropriate technologies and product development facilities. Community based enterprises are the key to local economic development in Africa

Submitted by Dessalegn M. Ketema on
This is a continuation of what I have stated earlier, look at your figure (Un MDG Report 2009). The percentage of goal achieved by 2007 and percentage of goal needed to be achieved by 2007 to be on track. For Sub-Saharan Africa( which is considered to be the hot spot of every problem for Africa) except one case (Access water), in all cases the percentage of goal needed to be achieved by 2007 to be on track ( that means unachieved) is higher than that of the % of goal achieved by 2007. Therefore, how someone dare to say “Africa will achieve the MDGs in the near future”.

Thanks for your comment, Dessalegn. I deliberately posted the figure to show how much of a stretch it will be. However, when I look at the progress made over the past decade and a half, I cannot but be impressed at how rapidly several African countries are closing the gap. For instance, Ghana will achieve the MDG on poverty. Malawi the same for child and maternal mortality. And Mauritania for girls' education. Furthermore, several countries, including Ethiopia, Rwanda, Uganda and others, have started making rapid progress since 1995, so the problem is that there was very little progress until 1995 (so they started from further behind). These are the reasons why I believe that, if the rapid progress can be sustained, Africa can reach the MDGs if not by 2015, then soon thereafter.

Submitted by DG on

Submitted by Anonymous on
Dear Shanta, That is an interesting post. I would like to learn more about your thoughts on the importance of foreign aid and employment policies in achieving the MDGs. Policies should also be implemented to make sure that once those targets have been achieved, they can be sustained. You also might be interested to know that the International Policy Center for Inclusive Growth (IPC-IG) will be hosting an Academic Forum on the 12th and 13th of April in correlation to the India-Brazil-South Africa (IBSA) summit to be held in Brasilia, Brazil on the 15th of April. I would like to invite you to participate and share you thoughts and inputs on the 'Ideas for Development blog' (http://www.ideas4development.org). An Academic Forum Hot site will also be launched shortly. The Forum will address, among other things, the role of cash transfers and employment programs/policies for economic development. And your knowledge on the issues of poverty and economic development will highly contribute to the discussion. Thanks.

Submitted by Klaus Winkel, Denmark on
I agree that it is important to highlight the many positive trends in Africa - the general concern being, I believe, actually tropical Africa. Optimism is needed for many reasons, and so is realism. The relatively high GNI growth rates achieved should be reduced by the population growth of 2.6 % (average for tropical Africa)and then translated into absolute figures. For an average tropical African this means an extra 25 USD per annum.So modest is the resource base increase from which so many needs should be met. If, furthermore, we compare to an average rich country it is seen that in normal years its GNI per capita increases with a USD amount corresponding to the BNP per capita of the average tropical African country. The gap thus is widening dramatically. The challenge is huge, let no optimism conceal this.

Submitted by Ramata Sore on
Africa could make more than that if we have leaders who can take the right decisions and help their people to live decently. Look at the BRIC, there are wonderful growing fast countries thanks to their own policies. What about Africa, what our leaders, I'm talking about who care about our continent, are doing right? Yes, I'm full of hope but the change will happen only if the new generations are aware and advocate for really changes.

Submitted by Andrew on
2015 is actually four years near,and the fact is some progress has been made but Africa is still facing awareness problems on service delivery(information,Accountability in terms of who,where,when and how to demand for services.these questions solicit for empowerment,capacity,participation and governance which are still rare or non existent in so many countries.Then availability and affordability mainly on issues of maternal health and child mortality make MDGs in Africa stay along distance from success.There is need for infrastructure development if we are to be there.the roads,health infrastructure,hardware(water)software,personnel,these have been eaten away by corruption in many countries and it will be hard to hit the target if those are not addressed.Thanks for the space for discussion.

Submitted by Raj Raina on
Hi Shanta, Thank you for your blog. I am a regular reader. My question in response to your statement - how can we measure progress if we don't know the initial starting point and therefore the target we are trying to achieve at the country level? If today you visit mdgs.un.org website the tables with the available data is surprising empty. I will provide some examples to make the point. 1.1 Population below $1 (PPP) per day, percentage half of 1990. In order to figure out if a country will meet the target you need to divide 1990 level of poverty by 2 and determine the 2015 target. However, there no data on the above website from 1990 to 1995 for: Zimbabwe; Togo; Swaziland; Sudan; Somalia; Seychelles; Sao Tome and Principe; Rwanda; Reunion; Mozambique; Mauritius; Malawi; Liberia; Gambia; Gabon; Ethiopia; Eritrea; Equatorial Guinea; Djibouti; Democratic Republic of the Congo; Congo; Comoros; Chad; Cameroon; Cape Verde; Benin; Angola. The same is true for these indicators: 1.8 Children under 5 moderately or severely underweight, percentage half of 1990. How can we know what half if we don't know 1990? 1.9 Population undernourished, percentage half of 1990 Same here? 4.1 Children under five mortality rate per 1,000 live birthsone third of 1990. What is a third? 5.1 Maternal mortality ratio per 100,000 live births 75% less than 1990. Completely empty... 6.61 Notified cases of malaria per 100,000 population less 1990 level Other indicators are not quantifiable so I have left them out. I understand data is very hard to gather and efforts are being made to improve data collection etc But what baffles me is how can the world leaders agree upon achieving MGDs when they don't know what they have to achieve? (Yes, at the regional level we can come up with aggregate figures but at the national level it seems we don't know what are target should be)

Shanta! I do not need to agree or disagree with your assessment of the MDGs and the 2015 deadline. Having conducted a thorough research for my Masters Dissertation at the Millennium Village Project in Bar-Sauri in Kenya, it came to my attention that the UN and the MDGs Team are either getting wrong information from the ground, or are INTENTIONALLY hoodwinking the International community so that they continue to get the funds flowing from the pockets of the likes of Bono. This places the credibility of the UN Millennium Reports in jeopardy. I suggest that you get hold of my Report and see the FACTS from the ground. What is Definitely clear, however, is that Africa in general and Kenya, in particular, will have to shift goalposts come 2015! By the way, we're only four years behind the date... That should be no CONSOLATION given the facts on the ground!

Submitted by Anonymous on
Kindly share your research with me, and, which university is this you are/were studying from...

Submitted by Anonymous on
I fail to understand why Shanta believes that his argument tht Africa "CAN" meet the MDGs is earth shattering and so so insightful. That Africa will develop and catch up with the rest of the world is INEVITABLE. It will. It may take time, but the continent and people will. There is more than enough room for modesty on the part of those among us who like to pontificate about Africa. All across the continent, development is palpable. You can touch it. You can feel it. You cam live it. The research that suggests that poverty in Africa isn't falling is wrong. Go to most African cities and villages, you see the emerging trappings of the middle class - more shopping malls, decreasing average age of cars, taller and healthier children. Imperfect household surveys cannot capture these developments. Even maternal mortality is falling! Just go to the hospitals. Go to the villages, go to the slums and ask a typical person how many women they've heard of in the recent past who died during child birth. The answer you'll get will surprise. In my own village in southern Nigeria, no woman has died during child birth in the past 20 years. None! Where the World Bank gets it figures, only God knows. But we have to continue to maintain that development is a challenge so that we can keep our jobs, travel the globe and stay in the best hotels and dine in the best restaurants - a life style very few of us can maintain in retirement. It is time we - the World Bank especially - stopped its very condescending treatment of Africa. I am sure poverty is more endemic in India and Bangladesh than it is in Africa yet those societies are treated with more respect by the commentariat than Africa is.

Submitted by Tangutenet on
hey, I just read all the post in this blog as I was searching for ideas for my college-end-of-term paper and I wanted to reply this. there is no way that Africa will "develop and catch up with the rest of the world". I am NOT saying Africa won't develop. it will! it definitely will! but developing and catching up with the rest of the world are two completely unfamiliar terms. development is not a standard we can use to compare countries' advancement. in fact, it is a subjective term. the way how the world sees Africa is painful because they compare or expect us to be similar to them and that is totally stupid because Africa will never be the same as any part of the world in any sense. (do you know what I mean?) yes Africa will develop but how is it possible to compare that development? Africa is so unique from any part of the world in terms of nature, society, culture, language....and many more reasons and the progress we could bring are determined by these uniqueness. and I think the problem with the MDGs is that it tries to serve as a single key for 'African' development by denying all the differences which to me seems vague.

Submitted by Douglas on
With the fact that many African countries'economies are reliant on agriculture, a focus on development in agriculture, agricultural systems, value addition, processing factories and infrastructure will ensure that these countries economies continue looking upward. On the other hand Africa has more than adequate resources to ensure it is self reliant-Solar, Fertile soil, friendly climate, Fuel and mineral deposits... A focus on regional infrastructural upgrading and more development, microfinancing of small and micro enterprises through the use accessible micro-enterprise mechanization and affordable microcredit is likely to pay off bigtime. Forgetting the fact that many leaders and civil service might notbe in a position to account for time services and resources to them, I believe Africa has some resilience and determination that things can be made better and life can always be improve, with a little more effort. I might not have the figures nor the numbers at the fingertips, but having grown up as the son of a peasant farmer who has witnessed the need for concerted efforts even in small holder farms, I have the belief that this can surely bea reality

Submitted by Hudson Lucky Masheti on
The International Development Goals for the 21st century - adopted by the global development community and endorsed by many developing country governments - set targets for poverty reduction, education, health, gender equality and environmental sustainability for 2015. The performance needed to halve the incidence of absolute poverty depends on the period in which it is to be achieved. Demery and Walton (1998)consider a period of 25 years, corresponding to the interval between the latest data available (for 1990) when the goals were formulated and 2015. this also produces a useful minimal criterion for Africa. the region's population is doubling every 25 years at current growth rates, so achieving this target would mean that the absolute number of absolute poor is neither increasing nor falling. Adding in an increase in the savings rate of 10% (percentage points) spread over 25 years suggests a target GDP growth rate of 5 percent a year just to prevent an increase in the number of the poor. Only a few African countries including Botswana, Mauritius and Uganda, sustained such growth rates in the 1990s and a resent evaluation suggests that few countries have the conditions and resources to sustain such growth in the long-run (UNECA 1999). The African peoples have realized that better governance is a development imperative for most African countries. They now focus in restructuring and reforming Africa's institutions of governance for they understands that good governance must aim to achieve the "three E's":- (i) Empower citizens to hold governments accountable through participation and decentralization. (ii) Enable governments to respond to new demands by building capacity. (iii) Enforce compliance with the rule of law and greater transparency. The African people have also realized that Africa's future lies in its people, in this regard impressing the principle of investing in people. Investing in people is becoming more important for two reasons; (1) Africa's future economic growth will depend less on its natural resources, which are being depleted and are subject to long-run price declines and more on its labor skills and its ability to accelerate a demographic transition. Growth in today's information based world economy depends on a flexible, educated and healthy workforce to take advantage of economic openness. (2) Investing in people promotes their individual development and gives them the ability to escape poverty. This again requires education and health cares as well as some measure of income security. In addition, African people have identified the need to build on the platform of the Growth and Development Summit (GDS) recommendations to create a sustainable growing and job-creation economy. Some of the other Developmental Programmes for Africa to attain the MDGs are; (i) A single Currency for Africa - this shall integrate the continent, also the creation of Regional Central Bank and African Monetary Fund. (ii) Building Blocs for Monetary Unions - that shall help Africa in negotiating favorable trading arrangements either globally or bilaterally. (iii) Switching back to its development renaissance system of trade dependency not aid dependence. (iv) Forging a new strategic development partnership {NEPAD}. (v) Impressing the governance systems for equitable resource distribution and Public-Private sector Partnership development engagements. (vi) A large number of Low-income countries are now receiving debt relief under the Heavily Indebted Poor Countries {HIPC} and Enhanced HIPC initiatives, launched by the IMF and the World Bank in 1996 and 1999, respectively. (vii) The African Leaders have realized that "Corruption" can be addressed without ever uttering the "C" word that is a threat to MDGs attainment. The key lies in finding alternate "entry points" that will lead inevitably to the underlying governance-based drivers of corruption. For example;- =Service delivery performance; =Citizen empowerment; =Information dissemination; =Economic policy reform; and =Involvement of other stakeholders. Mr. Hudson Lucky Masheti Kenya (East Africa)

Submitted by Anonymous on
Shanta, Thank you for sharing this important information and hope of meeting the MDG goals. I agree that Africa has taken great leaps in eradicating extreme poverty since the establishment of the MDG. However, because of the extreme barriers much of Africa has to fight in order to meet the MDG, I’m afraid I don’t see their goal being met in the next 5-7 years. Although I very much hope that this is not the case, it seems that there are some very serious and deep contributing factors to the poverty crisis in Africa, specifically in Sub-Saharan Africa, that will make the MDG delayed by perhaps another 5 years after 2015. Disease, transportation opportunities, and history are not on their side. Disease is a huge barrier. Of the 1-3 million global deaths per year due to Malaria, nearly 90% of them are in Africa. The most difficult part about the Malaria problem is that the unique climate enables a more effective spread of the disease. Thick jungles and extreme humidity breed the strongest and most effective disease carrying mosquitoes the world knows. These factors make stopping the spread of the disease that much more difficult. Until something can be done to change this, millions more of Africa’s intellectual capital will continue to die. This is not even considering the AIDS deaths and the adversity this brings. Furthermore, transportation barriers continue to hinder Africa’s hopes of completing the MDG in the next 5 years. Again, natural factors contribute to the barrier. Dense jungles, rivers that can’t be navigated, and a lack of main roadways across the countries make it extremely difficult to transport goods and supplies around the nations. These hindrances to the transportation of goods will slow down any relief process. Additionally, the natural barriers found in the jungles and mountains make the development of major roadways all the more difficult, especially in an already struggling Africa. This lack of transportation of goods also very much contributes to the slow trickle of available modern technology. A third major factor that seems to me to make the MDG delayed is the history that Africa has to overcome. Many countries haven’t possessed independence from the European imperialism for very long. Some African nations were even puppets of other outside nations throughout the Cold War. Recovering from this recent liberation is not a quick process. Also, we can still see the effects that the slave trade is having on Africa’s development, even so many years after. Because of the slave trade, so much of Africa’s coasts were abandoned for more centralized living. This being realized, Africa lacks numerous vital coastal port cities as receivers of goods. Shipping and goods transportation are again hindered (although here not by natural factors). The history of struggle that Africa has faced in the past still very much effect their future hope of healthy lives, and more specifically here, reaching the MDG. I would like to say, I hope I am wrong. I hope so very much that Africa is able to receive substantial and long-term relief much sooner than expected. And, as a Christian living in America, I believe myself as well as others here who call themselves Christians should be willing to sacrifice the comfort of our own lives in order to help the people in Africa who are suffering so greatly. If so many of us call ourselves Christians in America, then so many of us should be willing to obey the teachings of Christ and reflect the compassion that God wants us to have for the poor and suffering. In the Bible the book of James even tells Christians that true religion according to God specifically includes caring for orphans and widows in their times of need. In the face of current situations, it seems that Africa has plenty of orphans and widows in need and to continue on, Christians in America most definitely have the means of which to care for them. This isn’t to say I don’t think people of all beliefs should not be helping to relieve our fellow humans in Africa; I’m just focusing on American Christians specifically because of our clear instructions to take care of those who are suffering, and unique ability to do so because of our wealth. If more professing Christian Americans were willing to obey our teachings on taking care of orphans and widows, then perhaps aspirations like the Millennium Development Goals would be completed more rapidly and effectively. I pray that alleviation will come sooner than expected for these suffering people in our world.

Submitted by Doctor Michel ODIKA on
We are at a crucial moment in our response to malaria. This year marks a decade since the Millenium Summit was held (September 2000, New York). At the 55th session of the United Nations General Assembly, global leaders agreed that malaria was a development issue of the highest priority. Since then, however, there has been little progress in reducing mortality, rallying political leadership, improving governance and mobilizing resources. LESSONS ON DEALING WITH MALARIA Malaria has reached crisis levels in much of Africa. Otherwise said, most sub-Saharan African countries are now paying the price for decades of inadequate investment in environmental safety and sustainability. Across the region, for example, people experience a damaging mismatch between where money is most needed (hygiene, sanitation and prevention) and where money is most spent (care and treatment, counterfeit drugs included). To date, consequently, poor sanitation is the single biggest obstacle to an innovative, effective, sustained and wide-reaching response to malaria, making it ever more unrealistic to hope the disease mortality -notably childhood mortality- will be reversed by 2015, the goal set out in the Millenium Declaration (United Nations, September 2000). MALARIA OBSERVATORY: CAPACITY BUILDING TOWARDS EFFECTIVE AND INNOVATIVE RESPONSES Better governance and further leadership are still urgently required, and thus these two areas of focus remain essential. But now there is widespread recognition that a third focus is also crucial and vital: Making the available resources (human, financial, technical) work more effectively. That, in the final analysis, is the chief reason why I advocate for a "Malaria Observatory" (1,2,3) in my native country (Congo-Brazzaville, Central Africa). To me, such an approach appears to be, not only a "sweeping shift from the reactive to the active and strategic", but equally a "strong foundation on which to build an effective and innovative response to malaria. Detailed explanations of this Human Development Project can be found through comments on an article: - entitled "Malaria Deaths in Africa" (Scientific American); - written by Jeffrey SACHS (notorious health economist); - available at http://www.scientificamerican.com/article.cfm?id=ending-malaria-deaths-in-africa. SO TO SPEAK... Malaria "simply" rewrites the rules. And - not surprisingly - to prevail we too must rewrite these rules in ways that save millions of lives and billions of dollars. Best regards. Doctor Michel ODIKA 1. Malaria Observatory (Slide presentation available at http://www.slideboom.com/presentations/183737/Malaria-Observatory). 2. Advocacy for a Malaria Observatory in Congo-Brazzaville (http://www.booksie.com/health_and_fitness/article/michel_odika/advocacy-for-a-malaria-observatory-in-congobrazzaville/nohead/pdf/ver/8). 3. Action on malaria at a cross-roads (http://www.booksie.com/health_and_fitness/article/michel_odika/action-on-malaria-at-a-crossroads/nohead/pdf/ver/8).

Submitted by Mapi on
On line 31 of this comment, it should say: "Ending Malaria Deaths in Africa", instead of "Malaria Deaths in Africa"

Submitted by Doctor Michel ODIKA on
Today, the foundations exist for malaria-affected countries to mount a response commensurate with the challenge of reversing - the disease the most concrete proof that malaria is a problem with a solution… Unfortunately, malaria still illustrates some enormous and often frightening divides: - between the number of people exposed and the number being protected; - between what we could be doing to curb the expansion of the disease and what is actually being done. BREAKING NEW GROUND First of all, it bears reminding that the crucial question is not how many dollars governments spend on addressing malaria. Rather, breaking new ground suggests that HOW, FOR WHAT and FOR WHOM money is spent matters considerably. Why? Plausible and credible answer: When money is scarce, the effects of errors, whether by omission or by commission, are disproportionately amplified. Particularly in resource-constrained settings where the envelope devoted to the malaria response is very small, every dollar that is allocated sub-optimally tends to make a significant difference in terms of mortality/morbidity reduction… MEASURING THE GAP To date, few malaria-affected countries, notably those in sub-Saharan Africa (the hardest-hit region), have produced estimates based on sound evidence of where spending is needed (1). Similarly, few have mechanisms (2,3,4) through which connecting actors from converging sectors agree on estimates and priorities and allocate resources accordingly. In addition, donor countries have their own priorities and these often fall short of complying with recipient countries' priorities. As a result, there is a significant mismatch between spending and actual needs. In recent years, some donors have increased their aid in response to the need for building capacity to tackle malaria. A question now being asked can be summarized as follows: Why does capacity building (3) seem to be lagging so far behind the increase in aid? The answer is complex. However, two crucial fact(or)s stand out. First, donors' policies often limit the scope for using their aid. To illustrate, if this aid comes in the form of money, it is frequently tied to conditions that require currency exchange and purchase of imported goods - i.e. drugs - not necessarily responsive to the real challenges - e.g. hygiene, sanitation and prevention. If it comes in another form, it predominantly consists of foreign technical assistance or foreign-managed construction of health facilities. Second, countries' needs are mostly for core budget expenditures that are mainly local - i.e. wages for nurses, physicians and other personnel - and are recurring. Clearly, there is now strong and consistent evidence that current malaria spending patterns are inefficient and ineffective. Another question now being asked is exactly this: What can be done about it? CLOSING THE GAP The money spent from all sources on providing malaria-affected countries with the full range of services remains far short of meeting people's needs and expectations. Otherwise said, a comprehensive, effective, innovative and evidence-based response to malaria critically depends on sustained growth in annual funding until the disease is reversed - the goal set out in the Millenium Declaration (New York, September 2000). In the worst-affected countries, advocacy to boost and sustain political will and commitment remains crucial. Also crucial is making far better use of funding flows that are available. That basically means streamlining the flow of financial resources to the front lines of the disease, putting it to optimal use and providing malaria-related services. Unfortunately, too many countries, most of them in sub-Saharan Africa, still experience a disconnection between where money is most needed (hygiene, sanitation and prevention) and where money is most spent (curative medicine, counterfeit drugs included). To help identify funding requirements, Malaria Observatories (2,3,4), once established, could be helpful in improving estimates, modelling and projections. Nevertheless, spending decisions in any particular country should be based on assessments of that country's unique circumstances and needs. Additionally, financial efforts should be reviewed in terms of resources and programmes, their cost-effectiveness, where more effort (sanitation and prevention) might be focused. What else? It is also crucial to recognize that an estimate has its limitations, due to limited availability of data and inherent uncertainty about the future... ULTIMATELY... Today, there is no convincing evidence that growing spending on malaria automatically results in better outcomes in terms of mortality/morbidity reduction. However, this offers perspectives for transforming and adapting the response to malaria, which is much more limited in a context of shrinking government budgets and disinvestment. Consequently, there must be action on two key fronts. First, money must be spent where it can be most efficient and effective (1). Second, malaria-affected countries must stay on course and scale up efforts to build capacity (3). Doctor Michel ODIKA (Congo-Brazzaville) 1. Malaria response: spending money where it most helps (http://www.booksie.com/health_and_fitness/article/michel_odika/malaria-response:-spending-money-where-it-most-helps). 2. Malaria Observatory (http://www.slideboom.com/presentations/183737/Malaria-Observatory). 3. Malaria observatories: premium on capacity-building and building-capacity (http://www.booksie.com/health_and_fitness/article/michel_odika/malaria-observatories:-premium-on-capacitybuilding-and-buildingcapacity/nohead/pdf/ver/8). 4. Malaria observatory: timely public health intelligence (http://www.booksie.com/health_and_fitness/article/michel_odika/malaria-observatory:-timely-public-health-intelligence/nohead/pdf/ver/8).

Submitted by Needam Confidence on
I am a Nigerian, a student of Agricultural Extension and applied Economics in RSUST. A nation that is trapped in corruption can not achieve this important goal. I think if fighting corruption is included in MDGs to make it nine, it will go along way. On the mass media i have heard several billions of Naira been set aside for the improvement of agricultural activities. All these end on paper,radio and television. Where are all money going? I have seen where a practicing lawyer given a professional as agriculture to head. What i will suggest is that graduates agriculture be giving grants to practice agriculture and the undergraduates in agriculture be scholarship to encourage the young ones to agriculture. Adequate incentive be given to farmers while government subsidize farm produce.

Submitted by Doctor Michel ODIKA on
CAUSE FOR CAUTIOUS OPTIMISM... This is the sort of news we all need. In concrete terms, Congo-Brazzaville, malaria-endemic country (Central Africa), is on track to establish the world’s first “Malaria Observatory” (1). BACKGROUND AND CONTEXT… With the Millenium Development Goals (MDGs, New York, September 2000) in sight, Congo-Brazzaville is attempting to ensure the highest possible coverage with malaria prevention and treatment programmes by the end of 2015. This will require not only adequate resources, be they human or financial, but also the strengthening of the Congolese health system, with special emphasis on governance requirements… What else? We know that malaria is still a formidable opponent, and that if we are to ultimately eradicate this disease, we need new tools, such as “open and collaborative models” (2,3)… MALARIA OBSERVATORY: MILLENIUM DEVELOPMENT GOALS WITHIN REACH… Now more than ever, the response to malaria demands innovative approaches. In other words, only multisectoral responses – i.e. multi-stakeholder partnerships and networks – can be helpful in reaching and achieving most of the Millenium Development Goals (MDGs), notably those related to: - mitigating the damaging impact of poverty (MDG I); - rolling back child mortality (MDG IV); - improving mother and child health (MDG V); - fighting… malaria (MDG VI); - promoting environmental safety and sustainability (MDG VII); - fostering partnerships for development on a global scale (MDG VIII). MALARIA OBSERVATORY: PATH TO OPTIMAL COVERAGE… While much remains to be done, high-burden countries, most of them in sub-Saharan Africa, can save millions of lives (4) and billions of dollars over the coming years by scaling up evidence-based, effective and cost-efficient policies (5). At the same time, however, the worst-affected countries will need to support operational research as an integral part of malaria programming, so that they can learn as they implement and continuously refine their delivery strategies… MALARIA OBSERVATORY: IDEA WHOSE TIME HAS COME… Malaria Observatories constitute a critical component of the long-term strategy against a public-health issue of the highest priority. Otherwise said, these platforms for better governance can be regarded as “Timely Public health Intelligence”. Why? Plausible answer: “There is no method but to be intelligent” (Thomas ELIOT, poet and dramatist). So it is with the global response to malaria… Credible answer: “Health is the state about which medicine has nothing to say” (W.H. AUDEN, poet). So it is with the multisectoral response to malaria… ULTIMATELY… The power of a Malaria Observatory must be matched by the capacity to deliver adequate interventions to all who need them. If malaria-affected countries fail to meet this crucial requirement, then they will have squandered a tremendous… opportunity (6,7). Doctor Michel ODIKA (Project coordinator, Congo-Brazzaville) 1. Michel ODIKA (Projet de société, République du Congo): “Observatoire du Paludisme: projet de souveraineté sanitaire” (http://www.slideboom.com/presentations/384480). 2. Michel ODIKA (Malaria Atlas Project, 2010): “Malaria Observatory – Human Development Project” (http://comminit.com/?q=ict-4-development/node/289841). 3. Michel ODIKA (Tribune de Genève, 2011): “Observatoires du Paludisme: carte à jouer » (http://momentum.blog.tdg.ch/archive/2011/05/28/observatoire-du-paludisme-ca.html). 4. Jeffrey SACHS (Scientific American, 2007): « Ending Malaria Deaths in Africa » (http://www.scientificamerican.com/article.cfm?id=ending-africa-malaria-deaths-extended). 5. Michel ODIKA (Tribune de Genève, 2011): “Observatoire du Paludisme: genèse et exégèse d’un projet » http://momentum.blog.tdg.ch/archive/2011/07/09/27538a981918304f6e292a26439ce6a9.html). 6. James FRIES (New England Journal of Medicine, 1993): “Reducing health care costs by reducing the need and demand for medical services” (http://healthpolicyandreform.nejm.org/?p=10876). 7. WHO/ World Malaria Report 2010 (http://www.slideboom.com/presentations/384480).

Submitted by Perry Yenika on

Africa and the millennium development goal; Population

Add new comment