Health Issues on a Global Scale: The UN Millennium Development Goals


By Jim Bourque, MSW

While we cannot doubt for a minute that the USA has serious healthcare access issues, we can have some confidence in the outcomes once access is achieved. The situation facing most of the world’s population is different. Way, way too many people have no access to any healthcare and much less faith in its positive outcomes. The reasons are poverty, lack of education, political corruption, and a woeful infrastructure.

That is why the United Nations in 2000 issued its Millennium Declaration announcing a global effort to meet eight Millennium Development Goals (MDGs) by 2015. This international partnership seeks to reverse the impact of poverty, hunger, disease, the oppression of women, and the destruction of the environment on the world’s most vulnerable people.

Three of the eight goals are health-related:

  • Goal 4 is to reduce by two-thirds the under-five mortality rate
  • Goal 5 hopes to reduce by three-quarters the maternity mortality rate
  • Goal 6 seeks to halt and reverse the incidence of HIV/Aids, Malaria and other major diseases

The overall effort is interconnected: what will reducing world hunger do for world health? And what about the introduction of universal primary education and improvement in the quality of drinking water?

Your obvious question is a good one – can it possibly be achieved? No matter what one thinks of the United Nations as an effective institution, can anything of this scope be realized? Can it be done? In some areas the solutions are simple, low-cost, and at hand – provide chemically treated bed nets to kill malaria-bearing mosquitoes, stabilize the price of drugs that treat HIV/AIDS, multiply the number of clinics and rural health centers that will help diagnose and treat tuberculosis in children and adults, train midwives and pregnant moms in the need for sanitation and good nutrition. Other solutions—perhaps the ultimate solutions—are more difficult and weighted down with political concerns. Encourage developed nations to beat swords into ploughshares by cutting back on military aid and transferring those funds to funding for health and development projects.

The UN itself admits that it will fall short in the areas of the health-related MDGs. It does claim some success, some significant improvement in all of them, but also admits that the rise of a middle class in large countries like China, Brazil, and India have made the global numbers look better than they might actually be.

Still, look at these results noted on the World Health Organization’s website:

  • Globally, the number of deaths of children under five years of age fell from 12 million in 1990 to 6.9 million in 2011
  • In developing countries, the percentage of underweight children under five years old dropped from 28% in 1990 to 17% in 2011
  • While the proportion of births attended by a skilled health worker has increased globally, fewer than 50% of births are attended in the WHO African Region
  • Globally, new HIV infections declined by 24% between 2001 and 2011
  • Existing cases of tuberculosis are declining, along with deaths among HIV-negative tuberculosis cases
  • The world has met the United Nations Millennium Development Goals target on access to safe drinking water but more needs to be done to achieve the sanitation target

So, our global health is improving—in some places more and faster than others. The situation is encouraging enough that we can continue to believe that the United Nations Universal Declaration of Human Rights is still a living document with 21st century relevance. We can continue to work to improve our own American health care system and help our global partners work on theirs.

Jim Bourque holds a half-time position as an Instructor of Social Work at Wheelock College and coordinates the Wheelock@Worcester MSW program. He teaches Social Welfare Policy and Social Work Practice with Groups, Organizations, and Committees. Jim has an MSW from Boston University and a career of 30+ years as a community organizer/developer, mostly with the United Way.