PHA-Exchange> Millennium development holes

[claudio at hcmc.netnam.vn]

from Vern Weitzel <vern.weitzel at undp.org> -----
    
http://www.nature.com/nature/journal/v446/n7134/full/446347a.html

Editorial

Nature 446, 347 (22 March 2007) | doi:10.1038/446347a; Published online 21 
March 2007

Millennium development holes

Abstract

The political commitment to helping the developing world is failing to deliver 
on its promises. The 
problem is made worse by the questionable evaluation of progress.

In 2000, 189 world leaders committed to eight Millennium Development Goals 
(MDGs), ranging from 
halving extreme poverty and hunger, and rolling back killer diseases such as 
AIDS and malaria, to 
providing universal primary education. The deadline of 2015 to achieve all 
these ambitious goals is 
now rapidly approaching.

As a rallying cry that has pushed development up the international political 
agenda, the goals have 
been an indisputable success. They have also, for better or worse, conferred 
power and legitimacy on 
interests within the international aid machine, in particular the United 
Nations (UN) and the World 
Bank.

But the goals are ultimately political promises, and as such they are fickle. 
As the economist 
Jeffrey Sachs pointed out at last week's 'BioVision' meeting in Lyon, France, 
the G8 leaders 
promised in 2005 to double aid to Africa from US$25 billion in 2004 to at 
least $50 billion in 2010. 
But African countries still have no idea how or when aid levels will increase. 
Creative accounting 
means that supposed new aid is sometimes just a repackaging of existing aid or 
a debt cancellation. 
What aid has emerged has not led to the organized, massive expansion of 
investments in clinics, 
schools, agriculture and infrastructure that is needed.

This bad situation is made even worse by the pseudoscientific veneer conferred 
by evaluating 
progress on the MDGs using 48 quantitative indicators compared with a 1990 
baseline. Every year, the 
UN rolls out reports with slick graphics, seemingly noting with precise 
scientific precision 
progress towards the goals. But the reports mask the fact that the quality of 
most of the underlying 
data sets is far from adequate. Moreover, the indicators often combine very 
different types of data, 
making aggregation and analysis of the deficient data even more complicated.

There are decent data for just a handful of indicators, such as child 
mortality, but for most of the 
163 developing countries, many indicators do not even have two data points for 
the period 1990–2006. 
And few developing countries have any data for around 1990, the baseline year. 
It is impossible to 
estimate progress for most of the indicators over less than five years, and 
sparse poverty data can 
only be reliably compared over decades. To pretend that progress towards the 
2015 goals can be 
accurately and continually measured is false.

Significant efforts are now being made to improve data collection. Meanwhile, 
UN agencies fill in 
the missing data points using 'modelling' — in practice, a recipe for 
potentially misleading 
extrapolation and political tampering.

Indeed, the lack of data makes it impossible not only to track progress, but 
also to assess the 
effectiveness of measures taken. Has the existence of the MDGs changed pre-
existing trends? Are 
bednets helping to control malaria? Are improvements in Asia down to the MDGs 
or simply economic 
growth? Currently, it's impossible to tell. Meanwhile, spurious claims of 
achievement are promoted.

     A lack of data makes it impossible not only to track progress, but also 
to assess the 
effectiveness of measures taken.

Funding the scientific evaluation of interventions would pay dividends in 
enabling rigorous project 
management. But although billions of dollars are now flowing into aid and 
disease control, 
researchers complain that they struggle to get even tiny funds for evidence-
based research to assess 
which interventions work. "If I want 10 tonnes of DDT it's no problem; if I 
want $10,000 to see if 
the 10 tonnes made any difference, forget it," says one malaria researcher.

It is important to take action towards the goals rather than use the lack of 
reliable information as 
an excuse for inaction. But investment in an evidence-based approach to aid 
interventions, assessed 
independently of the UN, is also essential. Otherwise, in 2015, the MDGs could 
be buried in 
history's graveyard alongside other well-intentioned but failed development 
efforts.



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