Article originally appeared in SmartPlanet
DELHI — Sixty percent of the world’s population lives in the Asia-Pacific, which makes its performance critical to achieving the global Millennium Development Goals by 2015. It stretches from Turkey in the west to the Pacific island nation of Kirabati in the east, and from the Russian Federation in the north to New Zealand in the south.
The latest assessment, however, indicates that the region is performing poorly on reducing child mortality and improving maternal health. In 2010, over 3 million children died before their fifth birthday.
The eight MDGs are eradication of extreme poverty and hunger, achieving universal primary, promoting gender equality, reducing child mortality, improving maternal health, combating HIV/AIDS, and ensuring environmental sustainability.
Experts noted said that these goals can still be met. For instance, reducing child malnutrition needed less than 2% annual improvement from 14 off-track countries. “We are so close to the finishing line…it is time for a big final push to 2015 on the MDGs,” said Noeleen Heyze, the top official for UNESCAP (United Nations body for the region).
The big picture
The situation, however, is not all gloom and doom. Between 1990 and 2000, the region has reduced the proportion of people living on less than $1.25 per day from 50 to 22 percent (from 1.57 billion to 871 million). It has also reduced gender inequality in education and halved the number of people without access to water.
But the latest report, by the United Nations and Asian Development Bank (ADB), finds stark differences between sub regions and nations of the Asia Pacific. The regional average of people living on less than $1.25 is 22% but this ranges from 0% in Malaysia to 55% in Nepal. For infant mortality, the regional average is 36 per 1000 births but it ranges from 103 in Afghanistan to 10 or less in other countries. Cross- country disparities, the report finds, is widening between nations in poverty and child mortality.
“It is absolutely unacceptable that amid the unprecedented economic growth in recent history, disparities within and between countries are growing in our region and mothers and children are dying unnecessarily,” said Bindu Lohani, a senior official at the ADB.
There are also striking disparities within nations between urban and rural areas, boys and girls, and between more and less educated people. Different problems overlap for the same people. So improving water access, for instance, does not necessarily improve the level of poverty in the family.
South Asia and Sri Lanka
Overall, South Asia is lagging behind with the exception of Sri Lanka. Progress on eight goals is measured by 22 indicators. While South Asia is on track for nine indicators, Sri Lanka is on track for 15—outperforming its neighbours.
With 42 percent of its 1.2 population living on less than $1.25 per day, India is holding back the sub region from attaining goals on poverty reduction. India has taken significant strides on improving safe access to drinking water and reducing HIV prevalence.
Sri Lanka’s figures are notable. It’s doing well on improving access to safe drinking water and basic sanitation. Less than 15 percent of its population lives on less than $1.25 a day. Almost all its children are enrolled in primary education and there is hardly any HIV prevalence among 15-24 year age group. Sri Lanka, too, has made little progress in reducing under-5 mortality and maternal health.
The report finds that countries with faster economic growth had spent more on public health. In these countries, people also have more income to spend on public and private healthcare providers. Interestingly, the report noted that public health expenditure had helped reduced child malnutrition but private spending had reduced under-5 and maternal mortality.
The highest proportion of spending on preventive and public health was made by the island nation of Palau at one-third of total health expenditure. Proportions were much lower in Singapore, Republic of Korea, Mongolia and India. In proportion to GDP, Pakistan and Indonesia had low spending. Myanmar had the lowest expenditure on health.
The report noted that social detriments like gender inequality prevents good health for people even in countries with high economic growth and improvement in household incomes. To counter this, the study suggested, that governments will need to improve status of women and provide effective reproductive health services.
For primary heath care to have an impact, the study emphasized the need to improve basic infrastructure like roads, electricity, sanitation and access to clean water. In the region, 1.8 billion people do not have access to sanitation.
Infant mortality, the report said, could be reduced by two-thirds by implementing comprehensive breastfeeding programs, controlling vector-borne diseases and strengthening immunization programmes. It also recommended keeping medicines affordable to poor by producing generics.
“Every country has to address its own specific circumstances,” it said. “Nevertheless countries can be inspired by their neighbors to drive their own experiments and innovations.”