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[Title] Keeping the promise: a forward-looking review to promote an agreed action agenda to achieve the Millennium Development Goals by 2015 (A/64/665)

[Date] February 12, 2010
[Source] United Nations General Assembly
[Notes] 10-23802 (E)
[Full text]


Distr.: General

12 February 2010

Original: English

Sixty-fourth session

Agenda items 48 and 114

Integrated and coordinated implementation of and follow-up to the outcomes of the major United Nations conferences and summits in the economic, social and related fields

Follow-up to the outcome of the Millennium Summit

Keeping the promise: a forward-looking review to promote an agreed action agenda to achieve the Millennium Development Goals by 2015

Report of the Secretary-General*


This report, which is issued pursuant to General Assembly resolution 64/184, presents information on progress made in achieving the Millennium Development Goals through a comprehensive review of successes, best practices and lessons learned, obstacles and gaps, and challenges and opportunities, leading to concrete strategies for action. It consists of four main sections. The introduction examines the importance of the Millennium Declaration and how it drives the United Nations development agenda. The second section reviews progress on achieving the Millennium Development Goals, presenting both shortfalls and successes in the global effort and outlines emerging issues. The third section sums up lessons learned to shape new efforts for accelerating progress to meet the Goals and identifies key success factors. The fourth and final section lists specific recommendations for action. The report calls for a new pact to accelerate progress in achieving the Goals in the coming years among all stakeholders, in a commitment towards equitable and sustainable development for all.

I. Introduction

1. The adoption of the Millennium Declaration*1*in 2000 by 189 States Members of the United Nations, 147 of which were represented by their Head of State, was a defining moment for global cooperation in the twenty-first century. The Declaration captured previously agreed goals on international development, and gave birth to a set of concrete and measurable development objectives known as the Millennium Development Goals. Spurred by the Declaration, leaders from both developed and developing countries committed to achieve these interwoven goals by 2015.

2. The Millennium Development Goals are the highest profile articulation of the internationally agreed development goals associated with the United Nations development agenda, representing the culmination of numerous important United Nations summits held during the previous decade, including summits on sustainable development, education, children, food, women, population and social development. They are the world's quantified, time-bound targets for addressing extreme poverty, hunger and disease, and for promoting gender equality, education and environmental sustainability. They are also an expression of basic human rights: the rights of everyone to good health, education and shelter. The eighth Goal, to build a global partnership for development, includes commitments in the areas of development assistance, debt relief, trade and access to technologies.

3. During the past decade, the Millennium Declaration and the Millennium Development Goals have led to unprecedented commitments and partnerships reaffirmed in successive summits and meetings, including the 2002 International Conference on Financing for Development at Monterrey, Mexico, the 2002 World Summit on Sustainable Development, in Johannesburg, South Africa, and the 2005 World Summit in New York. During this same period, the public and their Governments have also had to contend with new unanticipated challenges. Some have been specific to countries or regions, while others have been global, such as the food and economic crises of the last three years.

4. Our challenge today is to agree on an action agenda to achieve the Millennium Development Goals. With five years to go to the target date of 2015, the prospect of falling short of achieving the Goals because of a lack of commitment is very real. This would be an unacceptable failure from both the moral and the practical standpoint. If we fail, the dangers in the world -- instability, violence, epidemic diseases, environmental degradation, runaway population growth -- will all be multiplied.

5. Achievement of the Millennium Development Goals remains feasible with adequate commitment, policies, resources and effort. The Millennium Declaration represents the most important collective promise ever made to the world's most vulnerable people. This promise is not based on pity or charity, but on solidarity, justice and the recognition that we are increasingly dependent on one another for our shared prosperity and security.

6. The Millennium Development Goals provide a historic framework for focus and accountability. This fabric of accountability, however, is being tested and will need to be further strengthened to achieve the Goals by 2015. This is all the more important as the Goals are crucial stepping stones towards equitable and sustainable ent for all. Meanwhile, the devastating impact of climate change looms large, and the international community is facing the challenge of working together to ensure the end of extreme poverty and sustainable development to save the planet and its people, especially the most vulnerable.

7. This report calls on all stakeholders, including national Governments, donor and other supportive Governments, the business community and civil society at large, to work in concert to ensure that the Millennium Development Goals are met by 2015. The high-level plenary meeting of the General Assembly to review the implementation of the Goals in September 2010 will provide a unique opportunity to strengthen collective efforts and partnerships for the push to 2015. The present report assesses achievements and shortfalls thus far, and suggests an action agenda for the period from 2011 to 2015.

II. Progress so far

8. A number of countries have achieved major successes in combating extreme poverty and hunger, improving school enrolment and child health, expanding access to clean water and access to HIV treatment and controlling malaria, tuberculosis and neglected tropical diseases. This has happened in some of the poorest countries, demonstrating that the Millennium Development Goals are indeed achievable with the right policies, adequate levels of investment, and international support. Considering their historical experience, some poor countries and even whole regions have made remarkable progress. For example, sub-Saharan Africa has made huge improvements in child health and in primary school enrolment over the past two decades. Between 1999 and 2004, sub-Saharan Africa achieved one of the largest ever reductions in deaths from measles worldwide.*2*

9. Nevertheless, progress has been uneven and, without additional efforts, several of the Millennium Development Goals are likely to be missed in many countries. The challenges are most severe in the least developed countries, landlocked developing countries, some small island developing States and countries that are vulnerable to natural hazards and recurring lapses into armed violence. Countries in or emerging from conflict are more likely to be poor and face greater constraints, because basic infrastructure, institutions and adequate human resources are often absent and lack of security hampers economic development.

10. Later this year, the Millennium Development Goals Report 2010 and MDG Gap Task Force report will assess progress on achieving the Goals. The latest update of the 60 official Millennium Development Goal indicators will be presented in an addendum to the present report, to be issued later this spring. The following section of the report assesses successes, obstacles and gaps in order to draw lessons on actions needed to achieve the Goals.

A. A mixed picture of shortfalls and successes*3*

Progress on poverty reduction has been uneven and is now threatened

11. According to the World Bank's much cited "dollar-a-day" international poverty line, revised in 2008 to $1.25 a day in 2005 prices, there were still 1.4 billion people living in extreme poverty in 2005, down from 1.8 billion in 1990*4*. However, as China has accounted for most of this decrease, without China, progress does not look very encouraging; in fact, the number of people living in extreme poverty actually went up between 1990 and 2005 by about 36 million. In sub-Saharan Africa and parts of Asia, poverty and hunger remain stubbornly high. The number of "$1 a day poor" went up by 92 million in sub-Saharan Africa and by 8 million in West Asia during the period 1990 to 2005*5*. The poverty situation is more serious when other dimensions of poverty, acknowledged at the 1995 World Summit for Social Development, such as deprivation, social exclusion and lack of participation, are also considered.*6*

Hunger is increasing and remains an important global challenge

12. Despite earlier progress, the number of hungry has been rising since 1995 and the proportion of hungry people in the global population has been rising since 2004-2006. There are still over a billion hungry people, and more than 2 billion people are deficient in micronutrients; 129 million children were underweight and 195 million under age 5 were stunted. The number of hungry people worldwide rose from 842 million in 1990-1992 to 873 million in 2004-2006 and to 1.02 billion people during 2009, the highest level ever. This was largely a result of reduced access to food because of high food prices and the global financial and economic crisis, which has lead to lower incomes and higher unemployment. Rising global hunger has undermined confidence in the declining global poverty estimates, as extreme poverty is supposed to be measured in terms of the income or expenditure considered necessary to avoid hunger*7*. Of the 117 countries for which data are available, 63 are now on track to meet the Millennium Development Goal underweight target, compared with 46 countries in 2006. Most of the 20 countries that have made no visible progress are in sub-Saharan Africa.*8*

Target for full and decent employment for all remains unfulfilled

13. Even though there is no deadline for meeting the target of achieving full and productive employment and decent work for all, no country can claim to have reached this target. Economic growth in many countries over the past decades did not produce rapid job growth, prompting the term "jobless growth". The lack of progress in creating productive and decent jobs in urban areas, together with stagnant farm productivity in many rural areas, have been the key reasons for the persistence of poverty and the rise in the number of working poor. It is estimated that in 2008, some 633 million workers (21.2 per cent of the workers in the world) lived with their families on less than $1.25 per person per day. As a result of the economic and financial crisis, it is estimated that in 2009 this number increased by up to 215 million, including 100 million in South Asia and 28 million in sub Saharan Africa.*9* This suggests that up to an additional 7 per cent of workers were at risk of falling into poverty between 2008 and 2009.

14. Over 300 million new jobs will need to be created over the next five years to return to pre-crisis levels of unemployment.*10*The unemployed need more than just jobs; they need decent work that will give them adequate income and rights. The unemployment rate for young people (aged between 15 and 24 years) has risen faster than the overall unemployment rate worldwide. It reached as much as 14 per cent in 2009, an increase of 1.9 percentage points since 2008.*9*

Progress on universal access to education, but the goal remains unmet

15. There has been remarkable progress towards achieving universal primary education in developing countries since 2000, with many countries having crossed the 90 per cent enrolment threshold.*11* Enrolment in primary education has increased fastest in sub-Saharan Africa, from 58 per cent in 2000 to 74 per cent in 2007. However, the rapid rise in enrolment may cause pressure on the capacity of schools and teachers to deliver quality education.

16. Around 126 million children are still involved in hazardous work, and more than 72 million children of primary school age around the world, about half of them in sub-Saharan Africa, remain out of school. Furthermore, dropout rates remain high in many countries, implying that achieving 100 per cent primary school completion rates remains a challenge.

17. Inequalities continue to pose major barriers to attaining universal primary education. Children from the poorest 20 per cent of households account for over 40 per cent of all out-of-school children in many developing countries. In most developing countries, children from the wealthiest 20 per cent of households have already achieved universal primary education, while those from the poorest quintile have a long way to go.11 Income-based disparities intersect with wider inequalities: children from rural areas, slums and areas affected by or emerging from conflict, children with disabilities and other disadvantaged children face major obstacles in accessing good quality education.

Insufficient progress on gender equality

18. Redressing gender inequality remains one of the most difficult goals almost everywhere, with implications that cut across many other issues. The root causes of gender disadvantage and oppression lie in societal attitudes and norms and power structures, as identified in the Beijing Platform for Action.

19. The share of national parliamentary seats held by women has increased only slowly, averaging 18 per cent as at January 2009. While this is far from the 30 per cent target envisioned in the Beijing Platform for Action, it represents a rise from 11 per cent 10 years earlier, a significantly greater increase than the 1 per cent increase between 1975 and 1995. Still, at the present rate it will take another 40 years for developing countries to reach between 40 and 60 per cent share of parliamentary stats for women.*12*

20. The gender gap in primary school enrolment has narrowed in the past decade, albeit at a slow pace. In developing countries in 2007, over 95 girls of primary school age were in school for every 100 boys, compared with 91 in 1999. Progress in secondary schooling has been slower, and in some regions, gaps are widening. In sub-Saharan Africa, the percentage of enrolment of girls compared with boys in secondary education fell from 82 per cent in 1999 to 79 per cent in 2007. Only 53 of the 171 countries with available data had achieved gender parity in both primary and secondary education, 14 more than in 1999.*13*

21. While participation of women in the labour force has increased, there are still significant gender gaps in participation rates, occupational levels and wages. Paid employment for women has expanded slowly and women continue to assume the largest share of unpaid work. Close to two thirds of all employed women in developing countries work as contributing family workers or as workers on their own account, typically in forms of employment that are extremely vulnerable and lack job security and benefits. Women's share of waged non-agricultural employment has increased in the last decade but only marginally, and women have generally failed to get decent jobs. In the Middle East, North Africa and South Asia, for example, the share of females in total employment is below 30 per cent.*14*

22. Violence against women remains a major blight on humanity everywhere. While there have been increased initiatives to address violence against women, such efforts are often not comprehensive, consistent, sustained or well-coordinated.*12*

Significant progress on some health-related Millennium Development Goals

23. Deaths among children under five years of age have been reduced from 12.5 million per year (1990) to 8.8 million (2008)*15*. The number of people in low- and middle-income countries receiving antiretroviral therapy for HIV increased 10 fold in five years (2003-2008)*16*, and there has been significant progress in reducing deaths from measles and providing interventions to control tuberculosis and malaria. More than 500 million people are now treated annually for one or more neglected tropical diseases.

24. Nonetheless, based on current trends, many countries are unlikely to achieve the Millennium Development Goal health targets by 2015. The child mortality rate in developing countries fell from 99 deaths per 1,000 live births in 1990 to 72 in 2008.*15* This is well short of the target of a two-thirds reduction (to 33 deaths per 1,000 live births). Furthermore, the rate of improvement has been uneven both among and within countries. Most noteworthy is the lack of progress in reducing deaths during the first month after birth (the neonatal period). Globally, 36 per cent of deaths among children under 5 years of age happen in this period.

25. The number of new HIV infections was 2.7 million in 2008, a decline of 30 per cent from the peak of 3.5 million in 1996. Meanwhile, the proportion of people receiving antiretroviral therapy increased from less than 5 per cent of those in need at the beginning of the decade to 42 per cent in 2008, and the number of women receiving treatment for prevention of mother-to-child transmission of HIV trebled, from 15 per cent in 2005 to 45 per cent in 2008.*16*

26. This progress has not yet been enough, however, to reverse the trajectory of the epidemic, because interventions for prevention and treatment often fall short in coverage: for every two people starting antiretroviral treatment, there are five new HIV infections. Prevention has not received sufficient priority.

27. Moreover, in 2008 only 21 per cent of pregnant women received HIV testing and counselling, while only one third of those identified as HIV-positive during antenatal care were subsequently assessed for eligibility to receive antiretroviral therapy for their own health. The voluntary family planning needs of persons living with HIV and their access to services are not routinely monitored. These problems are most pressing in sub-Saharan Africa, where the prevalence of HIV is, by far, the highest. Elsewhere, HIV epidemics are mostly concentrated within key populations that are at greater risk, including injecting drug users, sex workers and men who have sex with men.

28. The global incidence of tuberculosis appears to have peaked in 2004, and is now falling slowly in most parts of the world (except in African countries with a high prevalence of HIV). However, the burden of tuberculosis remains high. The epidemic of multi-drug-resistant tuberculosis is a major concern, with growing evidence of extensively drug-resistant tuberculosis.

29. Approximately 250 million malaria episodes occurred in 2008, leading to approximately 850,000 deaths; about 90 per cent of these deaths occurred in Africa, most among children under 5 years of age. However, major progress in increasing key malaria control interventions with a proven impact on the number of cases and deaths has been documented in many countries and areas. Approximately 200 million nets, out of the more than 340 million nets needed to achieve universal coverage (defined here as one net for every two people), were delivered to countries in Africa during the period 2004 to 2009. Use of insecticide-treated nets by children (one of the most vulnerable groups) rose from just 2 per cent in 2000 to 22 per cent in 2008 in a subset of 26 African countries with trend data (covering 71 per cent of the under-5 population in Africa), with 11 of these countries achieving at least a tenfold gain.*19*

Least progress in reducing maternal mortality

30. Access to reproductive health services remains poor where women's health risks are greatest. Deliveries attended by skilled health workers in developing regions have increased since 1990, from 53 per cent in 1990 to 61 per cent in 2007, but there has been little progress in reducing maternal deaths; maternal mortality declined only marginally, from 480 deaths per 100,000 live births in 1990 to 450 in 2005. At this rate, the target of 120 deaths per 100,000 live births by 2015 cannot be achieved. As part of broader investment in public health programmes, adequate financing for maternal health, especially dedicated to ensure safe deliveries, is critical.

31. Adolescent pregnancy rates have declined most in countries where initial levels were relatively low, while high adolescent fertility has persisted in many countries. The adolescent birth rate is highest in sub-Saharan Africa, where the rate of 123 births per 1,000 teenage girls was almost twice that of Latin America and the Caribbean, the second ranked region.

32. Unsafe abortions continued to account for one out of eight maternal deaths in 2005, despite increased contraceptive use among married women and women in unions. Nevertheless, 11 per cent of women in developing countries (including 24 per cent in sub-Saharan Africa) who want to delay or stop childbearing are not using contraception.

Limited progress on environmental sustainability

33. Some progress has been achieved towards the target of halving the proportion of people without access to clean water, but the proportion without improved sanitation decreased by only 8 percentage points between 1990 and 2006. The goal of improving the lives of at least 100 million slum dwellers has proved to be much less ambitious than necessary to reverse the trend of increasing numbers of slum dwellers.

34. The Montreal Protocol on Substances that Deplete the Ozone Layer has resulted in the production and use of over 98 per cent of all controlled ozone-depleting substances being successfully phased out. In contrast, the rate of growth of carbon dioxide emissions was much higher during the 1995-2004 period than during the 1970-1994 period, and that trend has not changed. While net deforestation rates have decreased, some 13 million hectares of the world's forests are still lost each year, including six million hectares of primary forest.14 This loss has been only partially compensated for by afforestation. As a result, worldwide, around 7 million hectares of forest cover is lost every year.

35. The target to reduce the rate of biodiversity loss by 2010 has not been met. In the latest reports submitted to the Conference of the Parties to the Convention on Biological Diversity, many Governments admit that the target will be missed at the national level. The International Union for the Conservation of Nature has reported that nearly 17,000 plant and animal species are known to be threatened with extinction. Major threats and drivers of biodiversity loss, such as over-consumption, habitat loss, invasive species, pollution and climate change, are not yet being effectively tackled.

B. Emerging issues and challenges

36. This section of the present report highlights some challenges and some mitigating factors that have the potential to rollback gains and create obstacles to achieving development goals, including the Millennium Development Goals. The challenge is to turn the challenges into opportunities, based on a proper analysis of the underlying causes and development of appropriate policies to tackle them.

Climate change

37. The most severe impacts of climate change are being experienced by vulnerable populations who have contributed the least to the problem. Addressing the climate change challenge provides opportunities for broader improvements in economies, governance, institutions and intergenerational relations and responsibilities; achieving the Millennium Development Goals should also contribute to the capacities needed to tackle climate change.

38. Switching to low greenhouse gas emitting, high-growth pathways to meet the development and climate challenges is both necessary and feasible. Combating global warming cannot be achieved without eventual reductions in emissions by both developed and developing countries. Technological options for a shift towards such pathways exist. Such a switch would entail unprecedented and costly socio-economic adjustments in developing countries. For this to happen, the shift will require much greater international support and solidarity.

39. Achieving such a transformation hinges on a global new deal capable of raising investment levels and channelling resources towards massive investment in renewable energy, and building resilience with respect to unavoidable climate changes. Most developing countries currently do not have the financial resources, technological know-how or institutional capacity to deploy such strategies at a speed commensurate with the urgency of the climate challenge. Failure to honour long-standing commitments of international support in these three areas remains the single biggest obstacle to meeting the challenge of climate change.

40. Climate-resistant development is imperative, and investments to achieve it will be the main way to overcome the perception of a trade off between development and addressing climate change. Beyond existing official development assistance (ODA) commitments, adaptation and mitigation in developing countries would require financial assistance of perhaps an additional 1 per cent of the gross domestic product (GDP) of rich countries in 2015*23*, a small sum compared with the likely costs of inaction. Many alternative approaches -- such as large-scale solar power or restoration of heavily degraded or unused land -- will need to be encouraged, supported and even subsidized. Economic incentives will be required to accelerate a transition to cleaner technologies.

The current crises: finance, the economy and food security

41. Although the measures taken so far in response to the global financial and economic crisis have been able to prevent a deeper recession, they do not yet add up to a sustainable long-term solution. Little has been done to address speculative forces that caused financial markets to undermine the real sector priorities. Official international discussion of financial reforms was until recently largely focused on executive remuneration, rather than on better regulation of financial markets, let alone the impacts of the crisis on currency and commodity markets and on the trading system.

42. The global financial architecture will need to be overhauled. The failings of the financial sector certainly require improved regulatory oversight, higher buffer capital requirements, and effective and equitable measures to deal with financial institutions deemed "too big to fail". There is also a need to make financial markets less volatile and more predictable. At the same time, these initiatives will need to be properly designed to ensure that they also help to boost both investment and private demand, as well as to make sure that the economic recovery does not collapse as soon as public efforts are withdrawn. It is also vital that recovery efforts do not resort to open or disguised protectionist measures. Productive integration of economies must proceed with an eye to increasing equity and providing social floors and other social protection.

43. Innovative measures should be used to address the food and other crises. There are many important cost-effective innovations in the field of nutrition ready to be scaled up. They include complementary and supplementary nutritious food items (nutrient supplements) to address the specific needs of young children and the ill, including those living with HIV, and more diversified production of nutritious local foodstuffs. Agriculture's share of ODA -- merely 4 per cent in 2006 and down from almost 20 per cent a few decades ago -- should increase. There should be significant new investment in enhancing capacities of small farmers, more efficient water management technologies, restoration of soil nutrients, more stress-resistant agricultural varieties and market opportunities for small farmers.

Intensifying prevention of violence and responses to humanitarian crises

44. The risk of disasters is increasing globally and is highly concentrated in middle- and low-income countries.*24* Reducing that risk and increasing resilience to natural hazards in different development sectors can have multiplier effects and accelerate achievement of the Millennium Development Goals. The Hyogo Framework for Action 2005-2015: Building the Resilience of Nations, and Communities to Disasters, endorsed by Member States, commits all countries to make major efforts to reduce their risk of disaster by 2015. The horrific loss of life in Haiti underscores the need to ensure that the human-built environment is resilient in the face of an array of potential hazards, both seismic and climatic.

45. Armed violence, conflict (inter-State, civil and criminal) and the resulting breakdown of the rule of law, justice and security are also a major threat to human security and to the hard-won Millennium Development Goal gains. Thus, there is an urgent need to focus on the root causes of conflict and armed violence and on advancing people-centred solutions. This requires strengthening institutions that monitor and mitigate conflicts, crime and violence, as well as identifying and addressing the underlying drivers, risk factors and tensions before they turn into armed conflicts and humanitarian crises. Reforms to strengthen institutions should include promoting transparency and giving voice and representation to previously underrepresented communities to make them stakeholders in the peace process.

46. What happens after conflicts are resolved is also vital. This should include promoting the rule of law, justice and security, implementing armed violence reduction strategies, early economic recovery support, rebuilding capacities, building democratic institutions and re-engaging countries in the global architecture without undermining national ownership of strategies. This period must be used more effectively to eliminate inequalities and discrimination in law and in practice, and to guarantee equal access to resources and opportunities.

Addressing the special needs of the most vulnerable

47. Attention must be focused on the special needs of the most vulnerable and the large and increasing inequalities in various economic and social dimensions, including geography, sex, age, disability, ethnicity and other vulnerabilities. Some urgent issues are highlighted below:

(a) Children from poor households, rural areas, slums and other disadvantaged groups face major obstacles in access to a good quality education. The literacy gap between the children from the wealthiest 20 per cent of households and those from the poorest 20 per cent is more than 40 percentage points. Children with disabilities remain among the most marginalized and least likely to go to school;11

(b) Very young children are especially vulnerable. Children who are stunted at age 2 tend to suffer severe life-long consequences in terms of poorer health and reduced cognitive development and economic opportunities;

(c) Indigenous people are overrepresented among the poor, with their level of access to adequate health and education services well below national averages. They are especially vulnerable to environmental degradation. Indigenous peoples make up 15 per cent of the world's poor and a third of the world's 900 million extremely poor rural people;*25*

(d) Around 1.8 million children under the age of 15 in sub-Saharan Africa live with HIV, while some 12 million children under the age of 18 have lost one or both parents to AIDS. In 56 countries for which recent household survey data are available, orphans who had lost both parents were 12 per cent less likely to be in school*26*, and often become a head of household, assuming enormous responsibilities at an early age. The impact of being orphans may be especially severe for girls, who are generally more likely than boys not to be in school. Children without the guidance and protection of their primary caregivers are more at risk of becoming victims of violence, exploitation, trafficking, discrimination and other abuses resulting in malnutrition, illness, physical and psychosocial trauma, and impaired cognitive and emotional development. Unaccompanied girls are at especially high risk of sexual abuse;

(e) At the end of 2008, there were some 42 million forcibly displaced people worldwide. This included 15.2 million refugees, 827,000 asylum-seekers (pending cases) and 26 million internally displaced persons. Women and girls represent 47 per cent of refugees and asylum-seekers and half of all internally displaced persons and returnees. Among refugees and asylum-seekers, 44 per cent are children below 18 years of age. More than 5.7 million refugees are trapped in protracted situations for which there is limited hope of finding a solution in the near future, including some 70 per cent of refugees in Africa.*27* In sub-Saharan Africa, 7 out of 10 refugees reside in often isolated and insecure refugee camps, with restrictions on movements affecting employment, education and health and other services.*28* They become dependent on subsistence-level assistance, or less, and lead lives of poverty, frustration and unrealized potential.

III. Lessons learned for accelerating progress in achieving the Millennium Development Goals

A. Lessons learned

National ownership*29*

48. National ownership of development strategies is fundamental, as one-size-fits-all policies and programmes are bound to fail owing to wide variations among countries in terms of their capacity (resources, institutions, administration) and historical and geographical circumstances. Ownership is also vital to ensure national commitment to development goals. Successful countries have pursued pragmatic, heterodox mixtures of policies, with enhanced domestic capacities. Countries should therefore be encouraged to design and implement their own development strategies and to strengthen their domestic capacities. Global partnerships should support such national development strategies and domestic capacity-building efforts.

Sustained and equitable growth

49. Sustained and equitable growth based on dynamic structural economic change is necessary for making substantial progress in reducing poverty. It also enables faster progress towards the other Millennium Development Goals. While economic growth is necessary, it is not sufficient for progress on reducing poverty. The countries that were most successful in reducing extreme poverty managed to sustain high economic growth over prolonged periods, and most managed to do so by jumpstarting the growth process by increasing agricultural productivity followed by dynamic growth of modern industry and services sectors. Effective industrial policies typically underpinned the economic transformation, and high growth facilitated job creation and income growth for workers. Income growth underpinned greater resource availability, facilitating -- when combined with adequate social policies -- better coverage and quality of social services in support of the achievement of the other Millennium Development Goals.

Macroeconomic policies

50. Forward-looking macroeconomic policies are needed to safeguard the sustainability of public investment strategies in support of broad-based growth and the achievement of the Millennium Development Goals. Macroeconomic policies should not focus narrowly on debt stabilization and curbing inflation, but should ultimately be supportive of growth of real output and employment. It is often necessary, therefore, to relax unnecessarily stringent fiscal and monetary restrictions and to use countercyclical fiscal and monetary policies to boost employment and incomes and to minimize the impact of external and other shocks on poverty. This requires countries to strengthen mobilization of domestic resources and adopt mechanisms that promote countercyclical policy responses. Enhanced international cooperation to strengthen tax revenue collection and increase sovereign debt sustainability can greatly buttress the fiscal capacities of all Governments.

Social services

51. Ensuring universal access to social services and providing a social protection floor with wide coverage are essential to consolidate and achieve further gains in achieving the Millennium Development Goals. The social consequences of economic crises have been most severe in countries where social protection systems were weakest and least adequate, made worse by their weak institutional and fiscal capacity. More importantly, when growth collapses owing to external shocks, natural disasters or health epidemics, societal cohesion may rupture, leading to civil violence. Not surprisingly, civil violence is more prevalent and also more likely to recur in poorer societies, especially where Governments are unwilling or unable to afford social protection or promote social integration. Countries should therefore have universal social protection floors in place to support the maintenance and regeneration of livelihoods, particularly of disadvantaged and vulnerable groups. The "social protection floor" concept promotes a set of social transfers and rights allowing individuals to access essential goods and services. Social protection schemes are not merely desirable, but are a sine qua non for inclusive development by addressing inequality and social exclusion. Social development should be considered broadly to include: support for smallholder agriculture, nutrition programmes, school meals, access to primary health and education, access to safe water and sanitation, and support for indigent, disabled and otherwise impoverished households. Food-for-work programmes can often provide a vital buffer. The provision of basic social protection schemes (like social pensions and other cash transfer programmes) for all are fiscally affordable for most developing economies,*30* but not for the poorest, unless they receive ample international assistance to finance such programmes.


52. Inequality and social exclusion, which limit the contribution of growth to the Millennium Development Goals, must be addressed. Inequalities of access, social protection and opportunities need to be greatly reduced. While most interventions related to the Goals primarily seek to redress inequalities in access to services

(e.g., employment, health, education, water and sanitation), other interventions put greater emphasis on inequalities in social protection and economic opportunities.

The community

53. Holistic, community-led strategies are more effective than stand-alone programmes. The Millennium Villages project, supported by the United Nations Development Programme (UNDP) with many partner institutions in civil society, academia and business, has shown that synergistic investments in agriculture, health, education, infrastructure, business development and environmental conservation can lead to rapid and considerable progress in food security, school attendance and performance, reduced hunger and improved livelihoods in a short period of time. Governments and development partners should put more emphasis on such holistic approaches in both rural and urban contexts, and should scale up successful efforts currently under way.


54. Targeted intervention programmes, based on complementary public and private investments, have proven successful and have been crucial for progress towards achieving most Millennium Development Goals. Investments in smallholder agriculture are vital for fighting hunger; investments in schools and teachers are vital for universal primary education; investments in public health are vital for Goals 4, 5 and 6. Investments in water and sanitation are vital for Goal 7. When public investments are targeted and of sufficient scale, progress in achieving the Goals is more likely to be rapid. When public investments are not forthcoming, as in efforts to ensure maternal deliveries, then progress has been modest at best.

55. Accelerating interventions is feasible and is of paramount importance in order to speed up progress where current trends make achievement of the Millennium Development Goals unlikely. Targeted interventions can quickly improve people's lives by providing access to essential goods and services. Examples include providing subsidized agricultural inputs, scaling-up school meal programmes, eliminating user fees for education and health care, and providing conditional cash transfers to poor households. While such measures should not substitute for well-planned and managed national development strategies backed by responsive partnerships for development, they should not wait for longer-term structural transformations as delays have irreversible adverse consequences for the poorest and most vulnerable.

Financial support

56. Adequate, consistent and predictable financial support, as well as a coherent and predictable policy environment, at both the national and international levels, are crucial for achievement of the Millennium Development Goals. Lack of adequate and predictable international financing has been an important constraint. There is an urgent need to broaden and strengthen partnerships to ensure supportive international frameworks for trade, taxation, technology and climate change mitigation and adaptation to sustain long-term human development; and for sufficient, predictable and well-coordinated financing for development, including national budgets, ODA, philanthropy, debt relief and new financing sources, instruments, arrangements and institutions.


57. Governance and institutional implementation capacities at the country level, which are both development outcomes and desirable ends in themselves, can contribute to accelerating progress towards achieving the Millennium Development Goals. Countries can accelerate progress by adhering to the fundamental norms and values of the Millennium Declaration, including human rights, gender equality and democratic governance. In order to achieve the Goals, integrity, accountability and transparency are crucial for managing resources, recovering assets and combating the abuse, corruption and organized crime that are adversely affecting the poor. Democratic governance, as a process of empowering people and communities, is essential for human development. "Good governance" goals should however be pursued in conjunction with development, especially in the face of limited fiscal resources and administrative capacities. Pragmatic developmental governance reforms to address bottlenecks in the process of accelerating development and progress towards the Millennium Development Goals should be emphasized in the short term.


58. Better monitoring and data are vital for better design of and timely intervention in programmes and policies. It is also crucial for ensuring accountability by development partners and stakeholders.*31* Although slowly improving, the availability of reliable statistics for monitoring development remains inadequate in many poor countries and the challenge of building effective in-country capacity to produce better policy-relevant data remains huge. Although statistics are increasingly recognized as an indispensable tool for development, resources devoted to statistics are still very limited. With support from development partners, countries also need to increase public expenditure for national statistical systems to effectively monitor progress towards the Millennium Development Goals and other development indicators in order to better inform policy interventions.

Key success factors

Key success factors*32* are listed below:

    1. Effective Government leadership and national ownership of development strategies.

    2. Effective policies to support implementation, defined in this context as laws, regulations, standards, administrative procedures and guidelines (general or specific to the Millennium Development Goals) that affect private behaviour and the conduct of service providers and others with whom they must interact.

    3. Improved quantity, quality and focus of investments, financed both by domestic sources and international development assistance, based on a holistic approach, including smallholder agriculture, health, education, infrastructure, business development and environmental conservation.

    4. Appropriate institutional capacity to deliver quality services equitably on a national scale, such as adequate facilities, competent staff, appropriate supplies and equipment and effective monitoring and evaluation.

    5. Civil society and community involvement and empowerment, which enhances the likelihood of success by giving individuals and communities the ability to take charge of their own lives.

    6. Effective global partnerships, involving all relevant stakeholders, including donor Governments, local communities, non-governmental organizations, the private sector and foundations, with mutual accountability of all stakeholders.

    7. Good governance by donors and recipients, which, inter alia, involves timely and predictable delivery of aid by donors on the one hand, and enhanced State and societal capacity of recipient countries to manage scaled-up resource flows transparently and with accountability on the other.

59. One significant achievement of the past decade is that national Governments and their partners, even in countries lagging far behind on many Millennium Development Goals, have a good sense of the programmes and interventions required to meet the Goals. The three critical challenges, in most cases, have been to have in place a feasible national scale-up plan, to obtain adequate financing based on both domestic and foreign sources, including development assistance, and to develop well-functioning delivery mechanisms for public investment and service delivery. The success stories highlight, for each Millennium Development Goal, how these critical success factors came together to produce remarkable results. While country characteristics (geographic, demographic, economic, cultural) inevitably vary and the specific interventions that have been successfully implemented differ with country specificities, the examples demonstrate these common success factors.

60. The success stories underscore the imperative of a holistic approach and confirm that positive results across the Millennium Development Goals and the broader enabling environment enhance the likelihood of sustained progress towards each of the Goals. They help define our collective accountability, but must be seen holistically. The synergies among the Goals are clear and indisputable, as demonstrated in the Millennium Villages. Taking advantage of these will reduce costs, increase effectiveness and catalyse local action. The education target, for example, requires progress on health. The health targets require progress on hunger and nutrition. The hunger target requires progress in agriculture and nutrition, and so on. There are many positive examples of integrated approaches to the Goals yielding tremendous success. We must learn from these examples and scale up successful interventions. The goals, targets and indicators of the Millennium Development Goals were conceived to reflect an integrated approach to development as worded in the Millennium Declaration and the 2005 World Summit Outcome document.

B. Accelerating progress

61. The critical question today is how to dramatically increase the pace of change on the ground in the remaining five years, so that the promises of 2000 translate into real progress for the world's poorest people, particularly at this time of global economic downturn. In the light of the 2015 deadline, accelerating progress is essential; with barely half a decade left, much more accelerated progress is required, especially for the poorest countries.

62. Significant gaps still remain and many targets are not on track to being achieved in a good number of countries. Moreover, challenges persist in areas such as environmental sustainability, even in countries that have made impressive gains in reducing poverty over the past decade, including large parts of Asia. Rollbacks on progress as a result of the food, fuel and financial crises, and emerging issues such as climate change, have compounded the challenge. Delayed job recovery from the global economic downturn remains a major challenge for poverty reduction in the years to come, and climate change is likely to have devastating impacts on vulnerable countries and communities.

63. Although the primary focus of the Millennium Development Goals is developing countries, where deprivation is most stark, deficits in human development are to be found in developed countries as well, especially among specific marginalized communities. Vulnerability, discrimination, social exclusion and gender disparities still persist in advanced countries and must not be overlooked.

64. As the country success stories demonstrate, targeted, near-term, "acceleration" interventions -- such as subsidizing crucial agricultural inputs, immunization, eliminating user fees for education and health services and addressing human resource constraints in health -- are still of paramount importance to speed up progress where current trends make achievement of the Millennium Development Goals unlikely. New technology-based solutions that did not exist when the Goals were endorsed, can and should be leveraged to allow for rapid scaling up. The most important of these technologies involve use of mobile telephones, broadband Internet, and other information and communications technologies.

65. At the same time, interventions need to be framed in the context of national development strategies that define actions to ensure sustainability of the results in the long term. Especially, even if not exclusively, in times of global economic, food and climate volatility, when Millennium Development Goals reversals are a real possibility, creating the enabling environment essential to sustaining progress towards the Goals can be just as important as accelerating achievements. While a short-term perspective, focused on securing immediate gains, can be effective in saving lives and alleviating suffering, it should not be understood as exclusive of, or even incompatible with, longer-term structural changes necessary to sustain progress over time.

66. The very fact that the challenges of poverty, food, energy, global recession and climate change are all interrelated has presented the global community with a unique opportunity to tackle them together. The critical requirement for a "global green new deal" is a commitment by all to frontload large public investments in renewable energy in order to achieve economies of scale and learning, generate employment in both rich and poor countries, and lay the foundation for a new phase of global economic and technological advancement. Besides benefiting the poor, such investment would also lay the basis for sustainable development, stimulate complementary investments in infrastructure and agriculture, and help raise agricultural productivity, thus enhancing food security and creating decent jobs for the rural poor.*33*

67. The main elements of this framework include ensuring that responses to the economic downturn provide support for what has worked in the past, especially protecting the growth momentum in developing countries, sustaining support for integrated poverty eradication programmes, enhancing the reach of targeted interventions, laying the infrastructural foundations for a new era of sustainable economic development, and protecting poor countries and communities from the adverse impacts of global crises.

68. Both acceleration and sustainability of progress must therefore be pursued concomitantly. Accelerated and sustainable progress towards achievement of the Millennium Development Goals will be contingent on our combined efforts to do three things much more effectively than we have been able to do in the past:

(a) To scale up implementation of proven and innovative interventions in such key domains as gender, sustainable agriculture (including inputs for smallholders and sustainable environmental management), energy, education and health. This effort needs to be backed by targeted investment, informed community participation, and adequate institutional capacities to effectively mobilize and manage financial resources and deliver public services;

(b) To build the structural and economic foundations to support and sustain progress and mitigate risks of reversal in achieving the Millennium Development Goals through effective social and economic policies and institutions grounded in universal rights and supportive of structural changes and social cohesion, improved conditions for peace, security and good governance, public and private investments that lead to faster pro-poor growth, and effective measures to ensure environmental sustainability;

(c) To broaden and strengthen partnerships to ensure greater global and regional integration, a supportive international framework for trade, technology transfer and climate change mitigation and adaptation in order to sustain long-term human development; and to ensure sufficient, predictable, and well-coordinated financing for development, including national budgets, ODA, philanthropy, debt relief and new financing instruments. This third element builds on the recognition that both within and across countries, no single stakeholder can achieve the first two strategic priorities on their own.

69. Specific Millennium Development Goals will require specific acceleration efforts, as outlined below:

Poverty and hunger (Millennium Development Goal 1)

70.To achieve Millennium Development Goal 1:

(a) Poor countries with large agricultural sectors should focus on bolstering agricultural productivity and output quality. A sharp increase in agricultural productivity can accomplish several things simultaneously: (i) reduced hunger; (ii) reduced child mortality through improved nutrition; (iii) reduced maternal mortality through improved nutrition; and (iv) higher household incomes and economic growth;

(b) To boost productivity, smallholder farmers must gain immediate access to inputs -- such as fertilizer, high-yield seeds, equipment, small-scale irrigation, technical extension and post-harvest storage -- in order to modernize and commercialize traditional farming. At the same time, sustainable agricultural practices need to be introduced. Intensive farming, if not properly regulated, can lead to the depletion of water sources, pollution by chemical fertilizers and pesticides, and a loss of biodiversity;

(c) Producing more food directly affects only one aspect of food security*34* (i.e., availability) and must be complemented by other interventions to address inequities of access to food and to bolster nutrition. Food security programmes should therefore also address issues of access to adequate nutritious food (taking into account local food consumption preferences and different nutritional requirements) and implement integrated nutrition programmes for the poor and vulnerable. In the short term, hunger hotspots within countries should be a top priority. Prevention-based interventions such as the distribution of vital micronutrient fortification and supplementation, as well as targeted support of children through the provision of school-based meals, must also be complemented by treatment-based interventions such as the treatment of severe and moderate levels of acute malnutrition and mass de-worming for children;

(d) Access to decent and productive employment and promotion of entrepreneurship is fundamental to pro-poor growth and efforts to address poverty and hunger. Successful programmes, especially employment-intensive initiatives, small and medium-sized enterprise promotion, employment guarantee schemes and conditional cash transfers, as well as vocational and technical training and entrepreneurial skills development, especially for unemployed youth, can yield positive results in reducing poverty and should be more widely applied to cover larger parts of the population, especially women and in rural areas;

(e) Close attention should be paid to the recommendations contained in the Global Jobs Pact, adopted by the Governments and employers' and workers' delegates of the International Labour Organization (ILO) 183 member States. The Pact proposes a range of tested crisis-response and recovery measures that focus on employment and social protection. It is not a one-size-fits-all solution, but a portfolio of tried and tested policy options that countries can adapt to their specific needs and situation.

Education (Millennium Development Goal 2)

71. To achieve Millennium Development Goal 2:

(a) National education systems need to be strengthened by addressing infrastructure, human resource and governance constraints, backed by international donor support;

(b) When scaling up education budgets, inequalities across income, gender and geographical, linguistic and ethnic lines should be addressed when allocating resources. Interventions should address problems of access to schooling from the supply and demand side. On the supply side, adequate services need to be provided and made accessible based on a robust needs analysis. On the demand side, targeted measures need to be put in place to attract children from poor households, rural areas or minority ethnic groups to school. Successful examples of making primary education more available, accessible and affordable include abolishing school fees, subsidies for other costs (e.g., textbooks, uniforms and transportation) and innovative approaches to school (e.g., community schools, mobile schooling, distance learning and multi-grade teaching). Programmes strengthening linkages between education, health and nutrition, such as school meal programmes and social protection measures (e.g., cash transfers and social insurance), have also proven successful;

(c) Progression through the school system -- retention, completion and learning achievement -- is another challenge that needs to be urgently addressed. Appropriate learning environments and quality of education can be ensured through the development of child-friendly schools, effective and comprehensive teacher strategies (e.g., recruitment and retention policies, underpinned by initial and in-service teacher education and development; teacher status and working conditions), enhanced pedagogical support and learner-relevant curricula, educational materials and languages of instruction.

Gender equality (Millennium Development Goal 3)

72.To achieve Millennium Development Goal 3:

(a) Key barriers to girls' education need to be removed, including by providing scholarships, cash transfers and eliminating user fees; support for girls, especially at the secondary level where too many girls are forced to leave school because of school expenses, should be expanded; completion and attendance rates need to be tracked; the quality of education must be improved; and investment in girls' enrolment in secondary school must be scaled up;

(b) The generation of full and productive employment and the creation of decent work and income for those beyond school age must be made the primary goal of macroeconomic, social and development policies, including by promoting equal skills development and employment opportunities, reducing wage gaps between women and men;

(c) Social protection measures and labour laws and policies that are gender-responsive should be introduced; and legal protections for the most vulnerable women workers introduced and enforced. Particular attention should be paid to gender gaps in school-to-work transition for young people, making education and training relevant to labour market demand, based on a life-cycle and rights-based approach;

(d) Positive action to improve the numbers and influence of women in all political decision-making should be introduced, including by investing in women's leadership in local decision-making structures and by creating an even playing field for men and women within political parties. With few exceptions, the 26 countries that have achieved or surpassed the goal of women securing 30 per cent of seats in national assemblies over the past five years have introduced some form of positive action;

(e) National-level capacity to track and report on progress, gaps and opportunities should be improved through better generation and use of sex-disaggregated data and statistics, including on time use;

(f) Women's work burden must be reduced through investment in infrastructure, labour saving technologies and gender-responsive economic stimulus packages;

(g) Accountability for enhancing women's rights and ending gender discrimination should be strengthened -- in line with commitments made in the Committee for the Elimination of Discrimination against Women, the Beijing Platform for Action and relevant ILO conventions -- including through eliminating inequalities in access to land and property and by investing in implementation of laws, policies and programmes to prevent and address violence against women;

(h) Investments for gender equality must be scaled up, including by institutionalizing "gender-responsive budgeting", as part of public financial management reforms to ensure that financial commitments advance gender equality.

Health (Millennium Development Goals 4, 5 and 6)

73. To achieve Millennium Development Goals 4, 5 and 6:

(a) Strengthening national health systems with the active participation of civil society organizations can significantly improve both maternal and child health. Strengthening health systems involves addressing human resource constraints, building new infrastructure, upgrading and improving supply systems, and improving governance and stewardship through a larger role in informal, formal and decentralized systems of health protection. Additional international development assistance is vital for scaling up health systems in low-income countries;

(b) Targeted interventions in key areas -- such as immunization programmes, increasing the number of trained midwives and the use of insecticide-treated bednets -- are known to have strong positive impacts but are more sustainable when embedded in a strategy aimed at providing comprehensive universal primary health care;

(c) Interventions that have the greatest impact on health-related Millennium Development Goal targets, such as universal access to sexual and reproductive health, immunization and key child-survival interventions, HIV prevention, mitigation and treatment, prevention and treatment of neglected tropical diseases, prevention and treatment services for malaria and tuberculosis and low-cost access to safe water and sanitation should be urgently scaled up and made universal to accelerate progress on the health Millennium Development Goals;

(d) There is a need for a scale up of global financing, but it needs to be done in predictable ways. Targeted disease-control programmes have been highly successful;

(e) Specific regions and vulnerable and marginalized groups should be prioritized (with special attention to the poor, rural populations, women and youth) with a view to extending health protection to those in need and the excluded;

(f) The capacity of all stakeholders to address issues of gender equality and delivery of health services should be strengthened and partnerships with civil society organizations, including women's groups, non-governmental organizations and the private sector, should be promoted.

Promoting sustainable development (Millennium Development Goal 7)

74.One of the difficulties in making progress towards the overall objective of Millennium Development Goal 7 is the lack of a framework or means of integrating different components of environmental sustainability. While Goal 7 contains elements that contribute to environmental sustainability, when added together, they do not provide a full picture. This weakness can be exacerbated at the national level if countries mechanically adopt the global set of targets and indicators without explicitly linking or tailoring them to national priorities. What is needed is for countries to adopt the principle of environmental sustainability and then adapt that principle to national priorities and policies, the local context and subnational or ecosystem specificities.

Ecological sustainability and addressing climate change

75. Efforts to accelerate progress towards the Millennium Development Goals must take account of the rapidly changing development landscape transformed by ecosystem decline, including the challenges posed by climate change. Pro-poor development centred on natural resources can be pursued at a local or community level or on a national scale. Both approaches are necessary for maximum poverty reduction. Comprehensive and coherent development planning frameworks, including national sustainable development strategies, are a useful means of integrating all of the aspects related to environmental sustainability that are relevant to any given country in a balanced manner. This is one of the conclusions drawn from the indicators that are making good progress. Furthermore, successful strategies tend to build on the active involvement of the local and municipal authorities and population and of all relevant stakeholders in the planning, programming and budgeting cycle, as well as the adoption of strong national legislation with mandatory targets and commitments towards the attainment of the objectives. It is important that public-private partnerships ensure genuine contributions by the private sector that would not have occurred without such partnerships.

76. Greater efforts are needed in both developed and developing countries to promote alternative renewable energy sources and low-emission technologies. Policy reforms to substantially reduce perverse subsidies for carbon-intensive development, and to create positive incentives, appropriate taxes and other initiatives (such as a global feed-in tariff arrangement to encourage renewal energy generation and use) that will encourage the adoption of renewable energy sources and low-emission technologies, are urgently needed. The internationally subsidized generation of renewable energy as the basis for development in developing countries will address the perceived trade-off between addressing climate change at the expense of development and will in addition provide major new opportunities for private investment to emerge from the economic crisis and generate considerable employment.

77. Greatly expanded investment in sustainable ecosystem management is needed to reduce the vulnerability of the poor and to maximize the contribution of natural resources to rural development. Poor people need secure resource rights and other enabling conditions for poverty reduction. Biodiversity protection measures must respect indigenous peoples' traditional rights to marine- and forest-based livelihoods.

78. National action plans and investment in energy efficiency and renewable energy will be key to shifting to low carbon growth, creating "green" employment and reducing poverty.

Safe drinking water and sanitation

79. Considering the lack of progress on sanitation, delivering on sanitation targets will require considerable political will together with significant financial, technical and human resources. Past experience suggests that the main problems have been over-reliance on supply-driven approaches, neglect of user needs and emphasis on large-scale projects, often due to public sector neglect or relinquishment of responsibility, often due to fiscal constraints. A demand-responsive approach is almost always constrained by poor people not having enough purchasing power to pay for improved sanitation. Retaining public provisioning of such services often conserves scarce governance and regulatory capabilities in developing countries, while achieving more universal access.

80. Integrated national water strategies addressing the four main uses of fresh water -- agriculture, households, industry and ecosystem services -- must robustly respond to the growing water shortages, which are exacerbated by climate change.

Reducing slum populations

81. Cities in developing countries around the world are home to rising numbers of poor people and do not have the capacity to create jobs to sustainably absorb the population influx and achieve the necessary progress needed to meet the Millennium Development Goals. In the face of rapid urbanization, these challenges will only become more acute unless adequate corrective actions are taken. These measures should include sound urban planning, which is essential for the sustainable growth of urban centres. They should stipulate the roles of the key stakeholders -- local authorities, organizations of the urban poor, private sector (formal and informal), central Government, district, state and provincial authorities and line ministries. Ultimately, more balanced growth, including rural development, is the only long-term solution insofar as it addresses the pull and push factors involved in rural-urban migration.

Expanding and strengthening international partnerships (Millennium Development Goal 8)

82. In the countdown to 2015, amidst a global economic crisis, the need to accelerate delivery on Millennium Development Goal 8 commitments has now reached emergency proportions, rather than simply being a matter of urgency.

Official development assistance

83. Although ODA reached its highest level ever in 2008, there remain large gaps in meeting existing and long-standing commitments. The Gleneagles Group of Eight (G-8) ODA target for 2010 is approximately $154 billion in present values, and additional flows of $35 billion by 2010 will need to be delivered this year to achieve this target. Africa would need an extra $20 billion of the increase in ODA in 2010 in order to reach the Gleneagles target level of $63 billion for the region by 2010. In 2007, ODA to the least developed countries was equivalent to 0.09 per cent of the gross national income of the countries of the Organization for Economic Cooperation and Development (OECD), with less than half the OECD Development Assistance Committee (DAC) countries meeting the 0.15 to 0.20 per cent target for aid to the least developed countries.

84. The distribution of development assistance remains highly skewed. Although the share of ODA flows allocated to the poorer countries increased somewhat between 2000 and 2007, with sub-Saharan Africa continuing to be the largest recipient of ODA, having more than doubled receipts in current dollar terms, most of the increase in ODA since 2000 has been limited to a few post-conflict countries, including Iraq and Afghanistan. Together, these two countries received about a sixth of country allocations from DAC countries, even though they account for less than 2 per cent of the total population of the developing countries. African aid lags far behind commitments and far behind needs. Detailed analyses by the International Monetary Fund and UNDP have shown that highly worthy Millennium Development Goal-based programmes are unfunded because of non-delivery of promised donor funding.*35*

85. There is an urgent need to improve the quality, predictability and durability of aid, in addition to the quantity. Developing countries and their partners will have to reduce the fragmentation of assistance and ensure that ODA supports national development strategies. Pooling of donor resources into multi-donor funds has proved time and again to be a fruitful approach, with great successes, for example, in the control of several infectious diseases. The 2005 Paris Declaration on Aid Effectiveness and the 2008 Accra Agenda for Action set out a number of principles and practices to enhance aid effectiveness which need to be implemented urgently. The $20 billion over three years pledged for food security by the G-8 at L'Aquila, Italy, and the Group of Twenty (G-20) at Pittsburgh, United States of America, should be provided urgently to initiate implementation of the comprehensive plan of action for smallholder farmers, notably through the launch of a new multi-donor trust fund.

Trade and development

86. The failure to reach agreement in the Doha Round of multilateral trade negotiations represents a major gap in strengthening the global partnership for achieving the Millennium Development Goals by depriving developing countries of the benefits of more timely completion of a truly developmental round of negotiations. As currently envisaged, the Doha Round falls short of the original developmental promise that was intended. This would include effective market access for agricultural, manufactured and service exports, particularly in sectors and modes of supply of interest to the developing countries, including modes 1 (cross-border supply) and 4 (movement of natural persons), and removal of trade distorting agricultural subsidies. In the negotiations there has been some progress in reaching agreement on a range of hitherto intractable issues, but progress on other key issues, including implementation issues and concerns of developing countries, as well as special and differential treatment, is falling short of what had been envisioned. In addition, the process of accession to the World Trade Organization by developing countries and countries with economies in transition should be facilitated, consistent with World Trade Organization agreements and their development status.

87. There are large regional and sectoral variations in market-access conditions between developing countries and least developed countries, as well as among least developed countries. Generally, developing countries that do not fall into the category of least developed countries continue to face higher average tariffs than least developed countries for their exports, including agriculture, textiles and clothing. Since 2000, small-island and African least developed countries have gained substantial preferences in major markets for their exports, while Asian least developed countries, which tend to be more competitive, continue to face higher tariffs and receive lower duty-free access, especially on their clothing and textile exports. However, the preferential access of least developed countries, compared with all developing countries, continues to be eroded except in agricultural exports.

88. Aid for trade is also critical in helping least developed countries, which continue to experience difficulties in fully utilizing preferential schemes and in overcoming supply-side constraints. In 2007, total aid for trade commitments increased by 8 per cent from 2006 and by over 20 per cent from the 2002-2005 baseline; but more than half the amount was provided to only 11 countries.

89. Donors need to deliver on commitments to substantially increase technical, financial and political support for aid for trade and the Enhanced Integrated Framework initiative. Aid for trade is especially vital to finance export-oriented infrastructure (e.g., roads, ports and power) to support the export competitiveness of low-income countries. Developed countries also need to honour the 2005 pledge to eliminate, by 2013, all export subsidies including on agriculture, which remain a major distortion affecting trade and farm production in developing countries. Even though overall agricultural support in relation to the GDP of developed countries declined further in 2007, it remained high in absolute terms and in relation to ODA.

90. Since late 2007, the multilateral trading system has come under heightened pressure as the food and financial crises have given rise to new waves of protectionism. It is crucial to maintain an open, equitable, rule-based, predictable and non-discriminatory multilateral trading system during the crises by ensuring that protectionist measures are dismantled as soon as possible and that new measures, including new non-tariff barriers, are resisted.

Debt sustainability

91. Substantial progress has been made with regard to debt relief, but full delivery on the heavily indebted poor countries (HIPC) initiative requires continued efforts from the international community. By September 2009, 35 out of 40 eligible countries had qualified for debt relief under the initiative, 26 of which had qualified for irrevocable debt relief under the HIPC Initiative and the Multilateral Debt Relief (MDR) initiative. The 35 qualifying countries have received, or are expected to receive, debt relief totalling $57 billion under the HIPC initiative and $23 billion in additional debt relief under the MDR initiative.

92. Prior to the global financial turmoil, high commodity prices and strong trade growth had improved the export revenues of many developing countries. Consequently, the burden of servicing external debt for the developing countries as a group had fallen from almost 13 per cent of export earnings in 2000 to below 4 per cent in 2007. This has allowed the HIPC countries to increase their social expenditure, but this trend is being reversed as developing country exports and commodity prices have fallen starkly as a consequence of the current crisis. The ratios of external debt to GDP and external debt service to exports for developing countries have risen significantly since the last quarter of 2008. Developing countries also face significant reversals in access to new external financing because of the global credit crunch.

93. The combination of these factors is creating increasing balance-of-payment problems for a large number of countries. Rising risk premiums on borrowing by developing countries and currency depreciations are also increasing the cost of external public borrowing. This, in turn, is limiting the ability of developing countries to undertake countercyclical measures and to sustain adequate levels of public spending on infrastructure, education, health and social protection. In the light of the global crisis, measures such as additional concessional financing, standstills on debt obligations, debt relief and debt restructuring should be considered to help countries facing severe financial distress as a consequence of the crisis to avoid harsh domestic adjustments jeopardizing the achievement of the Millennium Development Goals and avoid public indebtedness reaching unsustainable levels.

Access to affordable essential medicines

94. Many essential medicines are inaccessible to the poor in developing countries for two main reasons. Firstly, there are large gaps in the availability of medicines in both the public and private sectors; secondly, the prices of the medicines that are available are high in relation to their international reference prices. The multinational drug companies, based mostly in developed countries, should be encouraged to practise dual pricing policies, i.e., lower prices for developing countries.

95. Access to affordable essential medicines remains a concern, particularly as the response to outbreaks of contagious diseases and the development of resistant strains of infection create new difficulties. Basic packages of essential medical services require more adaptation to local needs, and better alignment to Millennium Development Goal health targets. The affordability of medicines is expected to deteriorate as a result of the global economic crisis. Incomes for many are falling and currency depreciations are further pushing up the cost of imported medicines. The situation is most difficult for countries with poorly funded or inefficiently run public sector procurement and distribution systems, countries where poorer households have no access to health insurance or public supplies of medicines, and countries where medicines are mostly brand names, rather than generic. Actions are needed to protect low-income families from increases in the cost of medicines brought about by the crisis.

Access to new technologies

96. Advances in technology provide an opportunity to accelerate poverty reduction through pathways not available to countries that developed earlier. Reducing the technology gap can accelerate leap-frogging to innovative and low-cost development solutions. Such technology facilitates communication and information exchange. Simple access to mobile telephones translates into reductions in mortality rates through provision of information about prevention and treatment and improvement of transport to vital interventions (such as emergency obstetric care), long-distance learning, better chances of survival and adaptation by sharing information on the location of pastures and water using mobile telephony, and empowerment of community health workers and other health personnel.

97. Considerable progress had been made in access to information and communications technologies, especially in cellular telephony, in recent years. Use of the Internet has increased steadily, with almost one fourth of the world's population having Internet access. However, less than 18 per cent of the population in developing countries was using the Internet (and only 4 per cent in the least developed countries), compared with over 60 per cent in developed countries.*36* Greater efforts are needed, especially through strengthened public-private partnerships, to close the large gaps that remain in access and affordability across countries and income groups.

98. Addressing the challenges of climate change has necessitated further access to new technologies. For both climate change mitigation and adaptation, massive investments are needed in research, development and deployment of technologies.

IV. The way forward

99. The Millennium Development Goals work by engaging national and global society as a whole. The actions of individuals, organizations, private companies and Governments in the cause of international development cooperation should be guided by the key principles set out below:

    Guiding principles for an action agenda

    1. National ownership and leadership complemented by supportive global programmes, measures and policies that align with national priorities and respect national sovereignty are essential.

    2. The interdependence of human rights, gender equality, governance, development and peace and security must be recognized to attain success and sustainability.

    3. The need to look at the Millennium Development Goals through a gender lens is critical, since women and girls typically face the greatest burdens of extreme poverty, hunger and disease. All of the action areas need to include specific strategies for tackling challenges faced by girls and women. On top of this, critical actions are needed to focus on overarching priorities for gender equality, including challenges of women's political representation and the intolerable ongoing epidemic of violence against women.

    4. The norms and values embedded in the Millennium Declaration and international human rights instruments must continue to provide the foundation for engagement, in particular the key human rights principles of non-discrimination, meaningful participation and accountability.

    5. The need to empower the poor through scaled-up efforts focused on citizen monitoring of Millennium Development Goal delivery, capacity-building and improving access to financial and legal services remains crucial.

Action-oriented agenda for all stakeholders

Creating the policy and fiscal space to accelerate and sustain progress

100. Achieving the Millennium Development Goals will need accelerated interventions in key areas. These interventions should be framed within the broader development framework of national development strategies for long-term equitable and sustainable growth and structural change. The immediate priority would be to ensure the sustainability of economic recovery, rising rural productivity and decent work generation in a period in which economic growth is likely to be slower than before the current crisis.

101. National Governments, with the full involvement of civil society organizations and supported by the international community must take urgent measures to implement growth and trade strategies enabling accelerated reduction in poverty, inequality and marginalization. This means promoting the fiscal space for delivery of key public services and long-term public investments in infrastructure, agriculture and human skills. It also means re-examination of prevailing macroeconomic frameworks, particularly to restore national capabilities to minimize the adverse effects of capital mobility, which has severely undermined domestic resource mobilization and monetary and exchange rate management. Without sustained employment and income growth, all measured Millennium Development Goal progress will prove to be short lived.

102. Financial sector policies must be supportive of accelerating proven interventions in addition to seeking stability through prudential regulations. These policies should also promote financial inclusion and may include specialized financial institutions and incentives for financial institutions to cater to small and medium-sized enterprises, poor populations, agriculture and non-farm activities. Inclusive finance will involve a continuum of affordable financial services (savings, loans, payments, receipts and insurance) available to poor households to improve their standards of living, and for enterprises to grow. Trade and industry policies should support dynamic sectors and activities in terms of productivity growth and creation of decent jobs characterized by high wages and employment security.

103. Progress must be protected in an era of increased economic insecurity arising from global economic instability, volatile food prices, natural disasters and health epidemics. This requires universal social protection and measures to support the most vulnerable communities. There should be effective measures to address all forms of discrimination and social exclusion including through legislative and enforcement measures, awareness campaigns and social mobilization.

Expanded global partnership to support the Millennium Development

Goal agenda

104. Working in partnership with all stakeholders, the international community must support national development strategies, expand national policy space, accelerate investment in developing countries, minimize the likelihood of crisis and conflict and substantially improve the international response to humanitarian, rehabilitation and recovery needs, and encourage and sustain reforms for a more conducive international environment for development. In the coming months, concrete steps will be taken at all levels to improve coordination and management in support of the Millennium Development Goals. United Nations country teams, central to the United Nations country efforts, will be tasked to support the overall and sector-specific Millennium Development Goal plans of Member States.

105. Millennium Development Goal interventions along the lines outlined above will require expanded fiscal and institutional capacity at all levels in both donor and recipient circles, and rigorous public-private management systems to ensure that the money gets to the right place, at the right time and for the right uses. For several Millennium Development Goals, despite knowledge of what effective interventions are required, there have been shortfalls in the financing and management needed for effective implementation.

106. Raising resources to finance the Millennium Development Goals should start at home. Therefore, effective and innovative measures to raise domestic revenues in a sustainable manner and to efficiently allocate these resources for development are essential. Most importantly, the international community should intensify international tax cooperation, respecting the sovereign right of countries and enabling them to raise considerably greater domestic fiscal resources. The onus of responsibility falls most heavily on the OECD economies, which should not only support domestic financial resource mobilization in developing countries, but also reform international economic relations to enhance financing for development by ensuring developmental reforms in the areas of international investment, international trade, aid, debt and systemic reform as promised by the Monterrey Consensus and reiterated in the 2008 Doha Declaration.*37*

107. The community of donors must deliver on its existing promises of greatly expanded ODA, while enhancing aid effectiveness and eliminating onerous conditionalities. If these promises are not met, the poor will suffer and, indeed, die in large numbers. Honouring commitments by the rich countries is a bulwark of global solidarity and a sine qua non for success in implementing the Millennium Development Goals in the low-income countries.

108. In the past few months, several Governments have put forth promising proposals to ensure adequate financing for the Millennium Development Goals, including the call for new financing to build better health systems, the G-8 2009 L'Aquila food security initiative and the associated call for financing a multi-donor trust fund, which could support millions of farm families seeking to enhance food productivity, the United Nations Framework Convention on Climate Change mitigation and adaptation funds and others. These opportunities must be acted upon quickly to ensure that longstanding international commitments are kept by the time of the 2010 G-8 and G-20 summits in Canada.

109. At the same time, there is a need to look beyond traditional ODA to more innovative financing models that can increase financial flows and their predictability. Several new programmes, schemes and models are promising, and should be urgently considered for scale-up opportunities. Private philanthropy for the Millennium Development Goals has also grown considerably in recent years and proven effective in mobilizing support from individuals and supplementing available financing to achieve the Goals.

110. Developed countries must also live up to their promises by eliminating trade-distorting agricultural subsidies and finally giving genuinely unrestricted market access to developing countries to help them lift themselves out of poverty.

111. The time has come for an accountability mechanism between developed and developing countries (as agreed in the Monterrey Consensus and the Accra Plan of Action), and between Governments and their citizens, to ensure that Millennium Development Goal commitments are honoured. The 2010 high-level plenary meeting should be an occasion for endorsement of an accountability framework that consolidates global commitments, links them to results with timelines, and establishes monitoring and enforcing mechanisms.

Harnessing private sector potential for sustainable development

112. Harnessing private sector potential begins with the farmer in the rural village, who is the backbone of the private sector in his or her country. It extends all the way to the major multinational companies that often operate in more than 100 countries around the world. The private sector often plays the central role in economic development, but can play that role effectively only when the public sector is doing its job as well: in regulation, public investments in key infrastructure such as roads and power, and the provision of public services such as education and health.

113. Many businesses are already taking specific action in support of the Millennium Development Goals -- assisting in poverty reduction, food security, environmental stewardship, gender equality, health care and education through their core business operations, social investments and advocacy. Beyond responsible practices, business should think of new and creative ways of working with and investing in pro-poor business models, products and services that can bring about thriving markets.

114. The United Nations Global Compact, in which the world's major companies are committed to global social responsibility, will this year take on the Millennium Development Goals as a central focus of its participating companies. These companies will share technologies, business models, outreach strategies and skilled managers towards the scaling-up of Millennium Development Goal initiatives in many parts of the world. At its high-level meeting, the United Nations will release a framework for strategic business action in support of the Millennium Development Goals. It will also call on companies to align their social investments with development in general and the achievement of the Millennium Development Goals in particular. Many are already partners in the Millennium Villages and related programmes. Many more companies can and will join the global Millennium Development Goal effort.

115. The Millennium Development Goals have triggered the largest cooperative effort in world history to fight poverty, hunger and disease. They have become a rallying cry in poor and rich countries alike, and a standard for non-governmental organizations and corporations as well. Nearly 10 years after they were adopted, they are alive and stronger than ever, which is a rarity among global goals. The world wants them to work.

116. The shortfalls in progress towards the Millennium Development Goals are not because they are unreachable or because the time is too short, but rather because of unmet commitments, inadequate resources, lack of focus and accountability, and insufficient interest in sustainable development. This has resulted in failure to deliver on the necessary finance, services, technical support and partnerships. As a consequence of these shortfalls, aggravated by the global food and economic crises as well as the failure of various development policies and programmes, improvements in the lives of the poor have been unacceptably slow to achieve, while some hard won gains are being eroded.

117. The Millennium Development Goals represent a pact, not just among Governments, but also among all development stakeholders. Each actor must focus on the best use of its assets, acting efficiently, effectively and collectively to fulfil a specific role, as follows:

(a) Developing countries: establish policies and institutions to achieve the Goals, involving administrations, communities and citizens towards this end. Through South-South cooperation, they also need to pledge to help other developing countries through the transfer of knowledge, technology and resources;

(b) Civil society actors, including those ensuring Government accountability and those delivering services: commit to the Millennium Development Goal agenda;

(c) Private businesses: disseminate technologies, create decent employment and otherwise work to support the goals;

(d) Private philanthropy: provide a catalytic role in fostering new innovations for later adoption by the public sector and through public-private partnerships;

(e) Developed countries: fulfil existing commitments to increase the quantity and improve the effectiveness of development assistance and improve market access for developing countries' exports;

(f) The multilateral system, including the United Nations agencies, funds and programmes: improve its coherence and effectiveness in support of the Millennium Development Goals.

118. Ten years have passed since the adoption of the Millennium Declaration and the historical commitment to cut extreme poverty by half through the implementation of eight measurable and time-bound goals: the Millennium Development Goals. This vision and those measures remain relevant today. Our world possesses the knowledge and the resources to achieve the Millennium Development Goals and embrace a sustainable development process for a brighter, more secure and more prosperous future for all. Coming together in September with a renewed commitment to build on our achievements so far and to bridge the gaps identified, we can deliver on our shared responsibility to build a better world for generations to come.

119. The United Nations has affirmed the right to development in addition to the other economic, social and cultural rights stated in the Universal Declaration of Human Rights. The rights approach affirms human rights to social protection and rejection of social exclusion, thus contributing to overall security and well-being. Fulfilling the rights of each and every citizen requires adequate resources. The Millennium Development Goal framework has identified stakeholders and duty-bearers with well-defined responsibilities, establishing accountability for development outcomes.

120. In recent decades, Government resources for development have often become increasingly constrained, while the private sector has taken over many areas of service and utility provision. New and innovative instruments are being promoted to finance development needs, including through multi-donor trust funds such as the L'Aquila food security initiative. However, the promise of delivering adequate aid remains unfulfilled, while the urgency to ensure that the international financial and trading systems support development has heightened in the wake of the current global crisis; hence, ensuring the adequacy of resources is the major challenge in achieving development, including the Millennium Development Goals.

121. We must not fail the billions who look to the international community to fulfil the promise of the Millennium Declaration for a better world. Let us meet in September to keep the promise.


Suggested themes for the round tables

Poverty, hunger and gender equality

1. How can we better support and facilitate employment-intensive, sustained and equitable growth and structural change?

2. How can we support holistic community-led approaches to achieve the synergies of the Millennium Development Goals?

3. How can international commitments support national efforts to raise agricultural output in order to overcome hunger and ensure food security?

4. How can we ensure that new and existing commitments, by all stakeholders, are adequately monitored and met?

5. What institutional reforms and commitments are required to overcome gender inequality and the main obstacles to women's empowerment?

6. How can Governments be supported to expand social protection systems where they indicate this is a priority?

Health and education

1. How do we enhance access to public health care?

2. What cost-effective key interventions in health are needed, especially to improve maternal health? How can national policies and international partnerships overcome the current institutional and resource constraints?

3. What are the best strategies to overcome institutional and resource deficiencies in achieving education for all?

4. How can we ensure that new and existing commitments, by all stakeholders, are adequately monitored and met?

Promoting sustainable development

1. What are the most cost-effective national policies to increase the availability of safe drinking water on a sustainable basis and to improve sanitation?

2. What international partnerships and resources are needed to support national efforts?

3. What are the most cost-effective ways of improving the welfare of slum- dwellers and of ensuring their access to basic services on a sustainable basis?

4. What institutions and reforms will protect biodiversity and forest cover?

5. How can we ensure that new and existing commitments, by all stakeholders, are adequately monitored and met?

Widening and strengthening partnerships

1. How do we ensure that aid commitments are met and what else can be done to improve aid predictability?

2. How do we ensure debt sustainability through enhanced international cooperation? What are the best ways to facilitate debt relief and debt workouts?

3. How do we ensure that the Doha Round of World Trade Organization trade negotiations realizes its development promise?

4. How do we ensure easier and cheaper access to medicines and new agricultural and renewable energy technology?

5. How can stakeholders work more effectively together to prevent conflict and armed violence and to strengthen the rule of law, justice and security?

6. How can we ensure that new and existing commitments, by all stakeholders, are adequately monitored and met?

Addressing the special needs of the most vulnerable

1. What more should be done to address the special needs of the poorest countries?

2. What should be done to better identify and address the special needs of the most vulnerable countries, communities and people?

3. What can be done to break the cycle of poverty, political and economic exclusion and civil violence?

4. What is the developmental potential of humanitarian, disaster relief and peacebuilding efforts?

5. How can we ensure that new and existing commitments, by all stakeholders, are adequately monitored and met?

Addressing emerging issues and evolving approaches

1. What are the most effective measures to enhance food security?

2. How should climate change mitigation and adaptation be incorporated into broader efforts to enhance sustainable development?

3. How can financing be ensured for global public goods, including meeting existing commitments on financing for development and new challenges such as climate change?

4. How should the international community address new emerging issues that are intimately linked with the achievement of the Millennium Development Goals, such as security, armed violence, migration and others?

5. How should the international financial system be reformed to better support sustainable and equitable development?

6. How should the international community reform international economic governance to better support sustainable and equitable development?

7. How can we ensure that new and existing commitments, by all stakeholders, are adequately monitored and met?

{* In preparing this report, reference is made to many other reports, including: "Consensus for maternal, newborn and child health" (Partnership for Maternal, Newborn and Child Health, 2009); The Millennium Development Goals 2009 (United Nations, 2009); Achieving the Millennium Development Goals in Africa: Recommendations of the MDG Africa Steering Group (June 2008); Investing in Development:

A Practical Plan to Achieve the Millennium Development Goals (United Nations Millennium Project, 2005); Rethinking Poverty: Report on the World Social Situation 2010 (United Nations, 2010); and others. Invaluable inputs were received from the different funds, programmes, agencies and departments of the United Nations that have been working closely with Governments, civil society and the private sector over the past decade to advance progress towards the Millennium Development Goals.}

{*1* General Assembly resolution 55/2.}

{*2* It should be noted that accurately measuring progress towards the Millennium Development Goals is sometimes difficult when precise data are not available or come with a long time lag. Furthermore, progress at the global level obscures uneven progress at the regional, country and local levels. Thus, caution is needed in interpreting aggregate data and making judgements about overall progress. Evaluating the goals, targets and indicators by country may understate progress by the poorest countries, for example, halving poverty from 60 to 30 per cent of the population is much more difficult than from 6 to 3 per cent, especially as a 20 per cent increase in per capita income from $1,000 per annum is worth only a tenth of a similarly proportioned increase from $10,000.}

{*3* This section draws on the Millennium Development Goals Report 2009 (United Nations publication, Sales No. E.09.I.12) unless otherwise indicated.}

{*4* This new estimate is about 50 per cent higher than the earlier World Bank estimate of poverty in 2005, based on its earlier $1.08/day poverty line, up from the original $1/day line in 1993 prices. Using 1993 as the baseline, and adjusting for consumer price inflation in the United States of America, would suggest a poverty line in 2005 of $1.45, rather than the $1.25 used by the Bank.}

{*5* The food and fuel crises in 2007-2008 and the global financial and economic crisis have made the situation worse. The World Bank estimates that 100 million people in low-income countries were pushed deeper into poverty as a result of a doubling of food prices. According to the World Bank's Global Economic Prospects 2010, globally, and notwithstanding upward revisions to growth projections for 2010, the number of people living on $1.25 per day or less is still expected to increase by some 64 million as compared with a no-crisis scenario.}

{*6* See Rethinking Poverty: Report on the World Social Situation 2010 (United Nations publication, Sales No. E.09.IV.10).}

{*7* Food and Agriculture Organization of the United Nations, The State of Food Insecurity in the World: Economic Crisis: Impacts and Lessons Learned (Rome, 2009).}

{*8* United Nations Development Group, MDG Gap Task Force, "MDG 1: Eradicate extreme poverty and hunger: review of progress, 2000-2010", available at http://www.undg.org/docs/ 10816/MDG-1.doc.}

{*9* International Labour Organization, Global Employment Trends, January 2010.}

{*10* Ibid., "Recovering from the crisis: a Global Jobs Pact", adopted by the International Labour Conference at its ninety-eighth session (Geneva, June 2009).}

{*11* United Nations Educational, Scientific and Cultural Organization, Education for All Global Monitoring Report 2009.}

{*12* United Nations Development Fund for Women, Progress of the World's Women, 2008/2009.}

{*13* United Nations Development Group, MDG Gap Task Force, "MDG-3: Promote gender equality and empower women", available at www.undg.org/docs/10821/MDG-3.doc.}

{*14* World Bank, Global Monitoring Report 2009, annex, Monitoring the MDGs: selected indicators.}

{*15* See www.childinfo.org.}

{*16* Joint United Nations Programme on HIV/AIDS, AIDS Epidemic Update 2009.}

{*17* World Health Organization, Joint United Nations Programme on HIV/AIDS and United Nations Children's Fund,Towards Universal Access, progress report (September 2009).}

{*18* World Health Organization, World Malaria Report 2009.}

{*19* Prompt and effective treatment is critical for addressing life-threatening complications from malaria. Anti-malarial treatment for children with fever is moderately high across Africa, although many febrile children are still being treated at home and with less effective medicines. Only four African countries currently have trend data for the use of artemisinin-based combination therapies among febrile children, which is the first-line treatment for uncomplicated malaria in nearly all African countries. Nevertheless, these limited data show promising gains in effective treatment coverage. Ghana, for example, increased artemisinin-based combination therapies coverage from 4 per cent in 2006 to 22 per cent in 2008, while coverage in the United Republic of Tanzania rose from 2 per cent in 2005 to 21 per cent in 2008 (World Malaria Day 2010, brochure, forthcoming (April 2010)).}

{*20* World Health Organization and United Nations Children's Fund Joint Monitoring Programme for Water Supply and Sanitation, Progress on Drinking Water and Sanitation: Special Focus on Sanitation (New York and Geneva, 2008).}

{*21* International Union for the Conservation of Nature, Wildlife in a Changing World, 2009 (report based on the analysis of the 44,838 species on the IUCN Red List).}

{*22* World Economic and Social Survey 2009 (United Nations publication, Sales No. E.09.II.C.1).}

{*23* Nicholas Stern, "Deciding our future in Copenhagen: will the world rise to the challenge of climate change?", Grantham Research Institute on Climate Change and the Environment, policy brief (December 2009); p. 3; and World Economic and Social Survey 2009.}

{*24* United Nations, 2009 Global Assessment Report on Disaster Risk Reduction: Risk and Poverty in a Changing Climate.}

{*25* International Fund for Agricultural Development, "Statistics and key facts about indigenous peoples", available at www.ruralpovertyportal.org.}

{*26* Joint United Nations Programme on HIV/AIDS, "Report on the global AIDS epidemic" (2008).}

{*27* Office of the United Nations High Commissioner for Refugees, 2008 Global Trends: Refugees, Asylum-seekers, Returnees, Internally Displaced and Stateless Persons (2009).}

{*28* Ibid., The State of The World's Refugees 2006: Human Displacement in the New Millennium (2006).}

{*29* For evidence and an analytical discussion, see Rethinking Poverty: Report on the World Social Situation 2010 and the work of the United Nations Development Group Millennium Development Goal Gap Task Force (see www.undg.org). See also World Bank, Economic Growth in the 1990s: Learning from a Decade of Reform (2005).}

{*30*I nternational Labour Organization, "Can low-income countries afford basic social security?" Social security policy briefings, No. 3 (Geneva, 2008).}

{*31* Millennium Development Goal tracking and monitoring at the global, regional and country levels, briefing note prepared by the Bureau for Development Policy, United Nations Development Programme, 27 August 2009.}

{*32* For further details, see "Accelerating progress towards the Millennium Development Goals" (United Nations Development Programme, forthcoming) and the work of the United Nations Development Group Millennium Development Goal Task Force.}

{*33* The World Economic and Social Survey 2009 contains a detailed proposal for synergistic achievement of developmental and climate goals. See also, World Bank, World Development Report 2010: Development and Climate Change.}

{*34* Food security exists when all people, at all times, have access to sufficient, safe and nutritious food for an active and healthy life.}

{*35* United Nations Development Programme and International Monetary Fund, "Scaling up development assistance to Africa: the Gleneagles scenario approach" (2009).}

{*36* International Telecommunication Union, World Telecommunication/ICT Indicators Database, 2007 and 2008.}

{*37* General Assembly resolution 63/239, annex.}