World Health Day: Where developing Asia stands on the health MDGs
As we approach the deadline for the Millenium Development Goals, how has developing Asia performed so far on achieving the MDGs related to health? Here are a few highlights based on ADB’s latest data.
Later this year, world leaders will meet at the UN General Assembly in New York to decide on 17 new Sustainable Development Goals set to replace the 8 Millennium Development Goals (MDGs) when the latter formally expire on 31 December, 2015. As we approach the deadline and given it is World Health Day, how have ADB’s 48 developing member countries in Asia and the Pacific performed so far on achieving the MDGs related to health? Here are a few highlights based on the latest available data from the Key Indicators for Asia and the Pacific 2014, ADB’s flagship annual statistical publication. MDG 4: Reduce the mortality of children under 5 years old by two-thirds from 1990 levels.
- Although substantial progress has been achieved in reducing under-5 mortality, the region still falls short of the MDG target reduction of two-thirds of the 1990 rate, with 15 countries expected to not meet the goal by 2030.
- Developing Asia’s infant mortality rate has been halved from 66 per 1,000 live births in 1990 to 32 in 2012, slightly better than the global average of 35. However, the percentage reduction has been lower than the reduction in under-5 mortality, implying that infant deaths are accounting for a large proportion of under-5 deaths.
- Maternal mortality in developing Asia had been reduced by 61% from 343 in 1990 to 133 in 2012, 63% lower than the global average of 210 but short of the three-quarters target reduction.
MDG 5: Reduce maternal deaths by three-quarters from 1990 levels and achieve universal access to reproductive health services.
- Immunization against measles increased from 74% in 1990 to 85% in 2012, on par with the global average of 84%. By 2012, almost two-thirds of countries in developing Asia had at least 90% of their 1-year-old children immunized against measles.
- Up to 90% of births were attended by skilled health personnel in 25 out of 43 surveyed countries, although in 6 other countries the figure dropped to below 50%.
- Since the 1990s, the rate of babies born to adolescents has declined in all but 9 developing economies. The adolescent birth rate remains high, though in six countries, where over 80 births per 1,000 women are to mothers between the ages of 15 and 19 years.
HIV/AIDS prevalence declined in some countries with the highest rates of infection in developing Asia, but increased in some economies in Central and West Asia and Southeast Asia.MDG 6: Halt and begin to reverse the spread of HIV/AIDS, malaria and other diseases, achieve universal access to antiretroviral treatment.
- Access to antiretroviral drugs has increased, particularly in Cambodia, Papua New Guinea, and Thailand.
- Half of the 25 reporting economies have made significant progress in reducing malaria incidence to less than 1,000 per 100,000 people and associated death rates to near zero. Malaria is still a severe problem in some countries where the incidence is over 5,000 or the associated death rate is 10 or more per 100,000 people. However, drug-resistance malaria in Southeast Asia is becoming a real public health threat across borders.
- The incidence and prevalence of tuberculosis as well as death rates from tuberculosis have declined overall in the region, where almost all countries have either already met or are on track to meet the MDG target. This achievement is threatened by the increasing prevalence of multi-drug-resistant TB, dangerous and hard to treat.
Although overall developing Asia has achieved substantial progress on the health-related MDGs,this has to be interpreted with caution since the MDGs are monitored at the national level, and don’t reflect subnational disparities and inequities. For example, India accounted for 29% of the global burden of maternal deaths in 2010, while Afghanistan, the Lao People’s Democratic Republic and Timor-Leste suffer some of the highest maternal mortality in the world.
Progress in achieving access to health services is still patchy, uneven and unequal, and developing Asia leads the world in out-of-pocket health expenditure.
For the SDGs to work, the region needs to continue the unfinished business of the MDGs as well as tackle new health challenges – and all of this calls for increasing investments in health systems.