7 Lessons from the Health-Related Millennium Development Goals Steinar Andresen and Masahiko Iguchi
When assessing the Sustainable Development Goals, it makes sense to consider the lessons learned from the Millennium Development Goals. While the former are universal goals and the latter focuses on developing countries, there are still similarities between these two goal-based approaches (see Young, this volume, chapter 2). What are the successes and failures of the Millennium Development Goals, and how can the best lessons be applied while avoiding the pitfalls and mistakes? In the next section of this chapter we go through the status of the Millennium Development Goals and account for what goals have been achieved and where goal achievements are less impressive. While a lot has been achieved, there has also been considerable criticism and questions raised as to their significance. Maybe the most fundamental criticism is the difficulty in establishing a causal link between the Millennium Development Goals and actual performance on the ground. In other words, examination of the significance of “externalities” to the success of the Millennium Development Goals is critical to draw implications for the Sustainable Development Goals. This crucial point has not been much addressed in UN circles. Our account illustrates that some goals have been met, and others have not; these are categorized in table 7.2 below as achievements and remaining challenges. Considering that goals may be quite random and the strong variations in underlying causal factors, this does not tell the whole story in terms of what efforts have been initiated and achievements made in reaching the various goals. We zoom in on this aspect in the third section, focusing on the health-related goals. They have played a very prominent role in the overall focus of the Millennium Development Goals, since three of the eight goals are addressing health issues. Our main focus is on Goal 4, which addresses reducing mortality among children. We will illustrate that a massive effort has been invested by various types
