Millennium Development Goals

Lord Chidgey Excerpts

Thursday 22nd November 2012 Lords Chamber

[Lord Chidgey]

My Lords, I, too, congratulate my noble friend Lady Nicholson on an illuminating speech—I look towards her so that she can hear what I am saying. I also congratulate the noble Baroness, Lady Kinnock, on her contribution, which I think I can build on.

There has been, I think, almost universal agreement that the MDGs have been successful in reaching most of the world’s poor. Sadly and frustratingly, they have not reached the world’s most poor. Forty per cent of the populations living in fragile states are living below the poverty threshold of $1.25 a day. A third of the world’s poorest live in the 45 states identified as fragile by the OECD. Not a single fragile state has met any of the MDGs.

World Vision argues that a new set of goals must first correct the development deficit in fragile states if global initiatives are going to address the root causes of poverty. They point out that, within fragile states, women and children suffer most from the lack of progress in the MDGs, with fragility being the key driver of the high death rates for preventable illnesses.

World Health Organisation statistics show that 14 out of the l5 countries with the highest neonatal mortality rates have recently experienced, or are in the midst of, a civil conflict. A child born in a fragile state is twice as likely to die before their fifth birthday as one born in a stable, low-income state. They are five times more likely to die before their fifth birthday than a child born in a middle-income country. On average in a fragile state, 140 children die per 1,000 live births.

World Vision has pushed for a reduction in child and maternal mortality, MDGs 4 and 5, through its Child Health Now campaign. The United Kingdom has focused its efforts on securing a major push on MDGs concerning women and children’s health. More than a third of a million women have died during pregnancy or childbirth in the past year.

A number of strategies are being promoted to keep health high on the agenda post-2015. Save the Children, another well known charity, points out that there is a need to build on the health MDGs by first addressing their shortfalls. For example, the MDGs are aggregate targets and mask inequity within countries. The majority of MDGs could be achieved statistically by targeting only the “low hanging fruit”, the easy targets, without changing the situation of the poorest, the most vulnerable and the most isolated. The post-2015 agenda needs to ensure that health gains are further accelerated and sustained, with public health systems sufficiently invested domestically and through donors to serve the health needs of whole populations.

Our Prime Minister is now appointed to co-chair the high-level panel charged by the United Nations with addressing the post-2015 provision. He is in a prime position to lead the debate. We need the Prime Minister to ensure a specific focus on fragile contexts in the post-2015 framework in ways that draw on the principles of the new deal for fragile states, launched at the high-level forum at Busan, which builds on goals for peace-building and state-building.

In the post-2015 framework, we need to know what the thinking is about introducing overarching goals for health. How can the post-2015 development agenda both build on the successes and address the shortfalls of the health MDGs? What indicators would encourage a greater focus on equity and on reaching the poorest and most marginalised populations? Probably the most glaring omission from the MDGs has been a governance goal—the lack of a mechanism allowing citizens to hold Governments to account on the selection of development projects and the distribution of aid in health, education and so on, in their communities.

At the fourth high-level forum on aid effectiveness in Busan in December last year, a global partnership for effective development co-operation was unanimously agreed. It created a new partnership that is broader and more inclusive than ever before, founded on shared principles, common goals and commitments for effective international development. The post-Busan co-ordinating committee, of which our Secretary of State for International Development is a co-chair, is charged with developing global indicators for aid effectiveness. One of the most important is that dealing with ownership, results and accountability.

For the first time, Parliaments and local governments are recognised as playing critical roles in linking citizens with government and in ensuring broad-based and democratic ownership of countries’ development processes. This is the forerunner of a “governance goal”, with the target of accelerating and deepening the implementation of existing commitments and strengthening the role of Parliaments in the oversight of development processes, including by supporting capacity development, backed by adequate resources and clear, defined action plans.