PAHO’s Approach in Support of Member States for the Attainment of the Health- related Millennium Development Goals SCPP March th Session of the Subcommittee on Planning and Programming Washington, D.C., March 2004 PAHO´s Approach in Support of Member States for the Attainment of the Health-related Millennium Development Goals

Millennium Development Compact Collective intentionality to reduce poverty through building on mutual responsibilities: The Millennium Development Goals are the first global development vision that combines global political endorsement with a clear focus on, and means to engage directly with, the world’s poor people.

Millennium Development Goals The Millennium Development Goals are time-bound and measurable goals and targets to be achieved between 1990 and They include: 1.halving extreme poverty and hunger 2.achieving universal primary education 3.promoting gender equality 4.reducing under 5 mortality by two-thirds 5.reducing maternal mortality by three-quarters 6.reversing the spread of HIV/AIDS, malaria, and TB 7.ensuring environmental sustainability 8.developing a global partnership for development, with targets for aid, trade, and debt relief.

Brasilia Declaration (November 2003) “ Promoting political consensus around the implementation of the Millenium Development Goals in Latin America and the Caribbean” Organized by the IDB, World Bank, ECLAC, UNDP, and Brazilian Government with the presence of Heads of State, parlamentarians, senior officials, and representatives of civil society and the private sector, and representatives of the international community

MDGs and Health The MDGs have brought the investment in people’s health to the very center of the global development agenda. This opens new opportunities for the health sector and health organizations to gain wide support for the health agenda. But: the progress on the health MDGs is too slow, particularly in low-income countries.

HLF on Health MDGs (January 2004) WHO and the World Bank convened a meeting of the High-Level Forum on Health on 8 and 9 January Outcomes of the meeting include: a recommendation to the Development Committee for practical steps to ensure a closer relationship between the PRSP process and the achievement of the MDGs; joint work to assess the effectiveness of donor harmonization in health; a mandate for further joint work on human resources for health, and to explore a link with the Global Commission on International Migration; and an endorsement of plans to establish the Health Metrics Network.

MDG Target Synergy for Health Classic social determinants of health Environmental determinants of health New global determinants Health targets as a contribution to poverty reduction and quality of life

Indivisibility and Synergy The goals need to be seen as an indivisible package.

Health and Development Synergy Poverty Hunger Primary education Gender disparity

Health and Development Synergy Safewater Poverty Hunger Primary education Gender disparity Environment Slumdwellers

Health and Development Synergy Safewater Poverty Hunger Primary education Gender disparity Environment Slumdwellers Financialsystem Trade Smallnations Debt relief Work IT

Health and Development Synergy Under 5 MORTALITY MATERNALMORTALITY HIV/AIDS MAL/INF DIS Safewater Poverty Hunger Primary education Gender disparity Environment Slumdwellers Essentialdrugs Financialsystem Trade Smallnations Debt relief Work IT MDG

PAHO Priorities and MDGs The unfinished health agenda The new health challenges Maintaining health achievements HFA - Reducing the gap - Ensuring access - Achieving results

Four Principles Country ownership Accountable governance and targeted development Costing for investment to reach the poorest Policy not charity

Key Principle: Country Ownership While the MDG documents call for the simultaneous achievement of multiple targets by 2015, each country in turn must debate which of these benchmarks would enable the most effective use of scarce resources to help the poor – according to criteria set by the country. Trade-offs and synergies between targets also need to be explored as well as synergies between various international activities, ie PRSPS.

Strategic Goals to Support Countries Increase awareness of and investment in the health priorities. Intensify action on national health development to support MDG progress. Integrate the work on MDGs with the initiatives on health goals and targets and outcome- oriented health policies in the Americas. Increase health literacy and empowerment of communities.

Strategic Goals to Support Countries Improve measurement of progress through high- quality disaggregated health data at regional, subregional, and country levels. Initiate research to strengthen the evidence base and generate new knowledge. Integrate the strategic dimensions of the work on MDGs with other strategic efforts. Engage and increase cooperation with other partners—particularly at the country level—to obtain results.

PAHO Integrated Approach to MDGs HPR PH PHCSOC PRO INTSEC COMPART Health promotion Public health Primary health care Community participation Inter- sectorality Social protection

MDGs and Democracy MDGs as a democratic debate about government performance, especially through making impartial data available: Posted at the door of every village hall.