Millennium Development Goals Mask More Serious Health Challenges

The UN just hosted a pledging session for its Millennium Development Goals (MDGs). Of the eight goals, two are for reductions in infant mortality, and maternal and child health rates. An expected refrain from the shortfall in progress toward stated objectives by 2015 is a lack of financial resources. Have donor funds been insufficient; how much of the progress made can be attributed to the MDGs; and what diseases are being ignored?

In April, a research paper published by the University of Washington, funded through the Gates Foundation, found that development aid for health jumped from $8 billion in 1995 to $19 billion in 2006. It also found that health aid to government had a negative effect on domestic government spending, such that for every $1 of health aid to government, government health expenditures from domestic sources were reduced by 0.43 cents.

During the period 2004–2008, Hudson Institute’s "Index of Global Philanthropy and Remittances" documented the contrast between U. S. Official Development Assistance (ODA) and non-governmental resource flows to the developing world via foundations, corporations, religious organizations, etc. The five-year total by 2008 for ODA was $119.4 billion, while non-governmental resource flows were $729.4 billion. In 2004, ODA was 20% of the total, declining to 14% in 2008.

What is the cost of implementing MDGs?  In 2005, an Organization for Economic Co-operation and Development (OECD) report detailed the cost of technical experts hired by the government of the UK to work in three countries. In Tanzania, the average cost was $187,000 per annum; in Jamaica, $200,300; in Bangladesh, $173,600. These costs did not include benefits or overhead, which would have increased each by at least $90,000.

ActionAid, an international charity, conducted a study on consultant wages, calculating that the cost of 740 international advisors in Cambodia exceeded the combined wages of 166,000 civil servants.

Planners for the MDG pledging session are concerned that rich countries are using the global recession as a justification to lower their ODA commitments. Yet this has been going on well before the crisis. In 2005, debt cancellation accounted for more than 20% of ODA from Austria, Germany, Italy, the UK, France, Japan, and Spain, and nearly 70% of Portugal’s ODA in 2004 came from writing off bad loans. Donor countries count the loans and inflated interest, often going back 30 years, as part of their ODA, though there is no real cash transfer to developing countries.

The Gates Foundation-funded research paper found that, on debt forgiveness, it had no detectable effect on governments’ domestic health spending. They were supposed to have increased their health and education budgets by an amount equal to that which was forgiven.