Latin America and the Caribbean: looking ahead after the Millennium Development Goals by Publicaciones de la CEPAL, Naciones Unidas

Latin America and the Caribbean: looking ahead after the Millennium Development Goals Regional monitoring report on the Millennium Development Goals in Latin America and the Caribbean, 2015

Alicia Bárcena

Executive Secretary Antonio Prado

Deputy Executive Secretary Pascual Gerstenfeld

Chief, Statistics Division Ricardo Pérez

Chief, Publications and Web Services Division

This report was prepared under the coordination of Pascual Gerstenfeld, Chief of the Statistics Division of the Economic Commission for Latin America and the Caribbean (ECLAC), and Daniel Taccari, also of the Statistics Division. The following staff members participated in the overall drafting of the report: Georgina Cipoletta, Sebastián Herreros, Keiji Inoue, María Ortíz, Esteban Pérez, Sebastián Rovira, Pauline Stockins and Romain Zivy. Valuable input was also received from the following ECLAC staff members: Lais Abramo, José Eduardo Alatorre, Guiomar Bay, Guido Camú, Carlos de Miguel, Ernesto Espíndola, Enrique González, Dirk Jaspers_Faijer, Cornelia Kaldewei, Carlos Maldonado, Xavier Mancero, Rodrigo Martínez, Claudio Moris, Ana María Reyes, Jorge Rodríguez, Magda Ruiz, José Luis Samaniego, Lucía Scuro, Varinia Tromben and Heidi Ullmann. The respective statistical tables can be found in the electronic statistical annex available on the ECLAC website at http://www.cepal.org/es/dspace/38924. More information on these tables and other indicators can be accessed at the ECLAC databases and statistical publications portal, CEPALSTAT, [online] http://estadisticas.cepal.org/cepalstat/. Some of the vectors included in this publication were designed by freepik.com. The boundaries and names shown on the maps included in this publication do not imply official endorsement or acceptance by the United Nations. Explanatory notes: The data presented in this report come from official international sources or have been calculated using international methodologies and standards, to assure comparability among countries. For this reason, these values do not necessarily coincide with national figures. This edition of the report includes information available up to mid-July 2015. The totals given in the tables correspond to the sum or to the average of the individual values shown in each table, unless otherwise stated. The figures given for different groups of countries correspond to the set of reporting countries for that period or year, unless otherwise stated. For this reason, the years or periods in a series may not be strictly comparable. Individual figures and percentages in tables may not always add up to the corresponding total because of rounding. In this publication, the term “country” is used to refer to territorial entities, whether these are States as understood by international law and practice or simply territories for which statistical data are maintained on a separate and independent basis. All the information used and its respective sources are available in the online annex to this report. However, the graphic elements in the main body of the document portray information available from 2010 on, in order to provide a meaningful visual representation of the progress that the countries and the region have made towards the targets up to 2015. The following symbols and terms have been used in the figures and tables in the report: – Three dots (...) indicate that data are not available or are not separately reported. – A dash (-) indicates that the amount is nil or negligible. – A full stop (.) is used to indicate decimals. - The word “dollars” refers to United States dollars, unless otherwise specified. – A slash between years e.g. 2013/2014 indicates a 12-month period falling between the two years.

United Nations publication ISBN: 978-92-1-121897-8 (print) ISBN: 978-92-1-057225-5 (pdf) ISBN: 978-92-1-358014-1 (ePub) LC/G.2646 Copyright © United Nations, 2015 All rights reserved Printed at United Nations, Santiago S.15-00708P

This publication should be cited as: Economic Commission for Latin America and the Caribbean (ECLAC), Latin America and the Caribbean: looking ahead after the Millennium Development Goals. Regional monitoring report on the Millennium Development Goals in Latin America and the Caribbean, 2015 (LC/G.2646), Santiago, Chile, 2015. Applications for authorization to reproduce this work in whole or in part should be sent to the Secretary of the Publications Board, United Nations Headquarters, New York, N.Y. 10017, United States of America. Member States and their governmental institutions may reproduce this work without prior authorization, but are requested to mention the source and inform the United Nations of such reproduction.

Contents Foreword............................................................................................................................................................................5 Introduction......................................................................................................................................................................7 Goal 1 Eradicate extreme poverty and hunger..................................................................................................................... 11 Goal 2 Achieve universal primary education....................................................................................................................... 21 Goal 3 Promote gender equality and empower women...................................................................................................27 Goal 4 Reduce child mortality.................................................................................................................................................35 Goal 5 Improve maternal health............................................................................................................................................. 41 Goal 6 Combat HIV/AIDS, malaria and other diseases................................................................................................... 49 Goal 7 Ensure environmental sustainability........................................................................................................................57 Goal 8 Develop a global partnership for development.................................................................................................... 69 Conclusion...................................................................................................................................................................... 81 Bibliography................................................................................................................................................................... 88

Foreword The 15-year time frame originally set for meeting the Millennium Development Goals has come to an end. It is time to take stock of the progress made on the Goals deriving from the United Nations Millennium Summit in 2000. The eight Goals set out to encapsulate the commitments undertaken at the major development conferences and summits held during what came to be known as the “decade of policy-setting”, the 1990s. From that point on, the countries of Latin America and the Caribbean began tackling these Goals, each at its own pace. The United Nations agencies, including the Economic Commission for Latin America and the Caribbean (ECLAC), provided support to countries in the implementation and monitoring of the Goals. The Millennium Development Goals were a global, regional and national success from a communications standpoint, raising the profile of numerous quantitative gaps. The deadline for meeting the Goals was set for 2015 and 1990 was established as the baseline for measuring progress. Yet these Goals left out some grave problems, such as inequality, which is of crucial importance to Latin America and the Caribbean —the world’s most unequal region. The scope of the Millennium Development Goals was limited, as they were aimed primarily at developing countries, with the exception of Goal 8, which addressed the role of the international community in supporting the least developed countries. They did provide a good starting point, identifying the issues of poverty, hunger and unmet basic needs with respect to education, health, water, housing and living conditions. They also targeted specific issues faced by women and gender equality gaps and addressed, albeit in a limited fashion, the environment, employment and energy, among other topics. The international community and, in particular, developing countries quickly voiced the need to go beyond mere cooperation and take a much more universal and comprehensive approach to development issues. The outcome document of the United Nations Conference on Sustainable Development, entitled “The future we want”,1 recognized the need to build a post-2015 development agenda through a more participatory, interdisciplinary and systemic process that would treat development as a right, with dignity and equality at its core and the total eradication of extreme poverty as its main focus. The Member States of the United Nations agreed to begin negotiations to discuss and adopt a universal consensus on what came to be called the sustainable development goals. In September 2015, heads of State and Government will formally adopt the 2030 Agenda for Sustainable Development, which sets forth the 17 Sustainable Development Goals together with considerations regarding their implementation. The new agenda calls for decisive collective action in the provision of universally available global public goods, as well as progress on key issues for development, such as food security, climate security, decent work, access to sustainable energy and the closing of technology, trade, financial and other gaps. This will mean formulating and implementing active economic, social and environmental policies, closely aligned with an approach long advocated by ECLAC, which posits a structuralist approach to development with equality as its ultimate aim and policymaking as the instrument by which it can be achieved. This new Agenda also puts an end, once and for all, to the cycle of orthodox hegemony that discouraged State involvement in matters of public interest, leaving them instead to the market, and opens the way for the redefinition of a new, more democratic equation between the State, the market and citizens. Today sees the convergence of the deadline set for achieving the Millennium Development Goals and the launch of the 2030 Agenda for Sustainable Development. 1

Resolution 66/288, of 27 July 2012.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Building on the lessons we have learned, the new Agenda is universal and non-prescriptive. Owing to the broader participation by all relevant stakeholders, the new Agenda proposes commitments that touch upon the way our societies work overall, and changes that will help make our world more prosperous, sustainable and equal. This approach brings together, adds to and builds on past achievements. This report gives an overview of the progress made in relation to the Millennium Development Goals and will serve as a starting point for a more analytical reflection in relation to what must be achieved by 2030. In preparation for blazing this new trail, we must examine the successes and failures â&#x20AC;&#x201D;the lights and shadowsâ&#x20AC;&#x201D; of our previous steps, acknowledging where significant progress has been made and scrutinizing where we continue to fall short. We must learn from our experience of tackling the Millennium Development Goals gradually as they were adapted to national realities, in order to engage more quickly and effectively with the Sustainable Development Goals following their imminent adoption. Lastly, we must summon up the political will that will enable us, as a region, to undertake collective efforts over the long term. In order to answer the call to action arising from the 2030 Agenda for Sustainable Development and look to the future, Latin America and the Caribbean must have data and indicators describing the achievements made and the challenges outstanding with respect to the Millennium Development Goals. That is precisely the purpose that ECLAC has set out to fulfil with this publication: to look ahead to 2030 from the perspective of the Millennium Development Goals.

Alicia BĂĄrcena Executive Secretary Economic Commission for Latin America and the Caribbean (ECLAC)

Introduction Latin America and the Caribbean: looking ahead after the Millennium Development Goals Initial reflections This document affords a concise descriptive overview of the progress achieved by Latin America and the Caribbean in respect of the Millennium Development Goals. These Goals, which were established following the Millennium Declaration adopted in 2000 by the States Members of United Nations, encapsulated the issues that arose from the summits held during the “policy-setting decade” of the 1990s, and provided a framework for addressing them. The Economic Commission for Latin America and the Caribbean (ECLAC) has carried out many different assessments relating to the Millennium Development Goals in the past 15 years, involving almost 20 bodies of the United Nations system operating in the region.1 This new publication makes extensive use of infographics, including tables, figures and descriptive statistics, alongside brief explanatory texts that focus on core aspects of the region’s progress towards achievement of the Millennium Development Goals. It also includes references to developments in other world regions, and points to the heterogeneity of national trends in Latin America and the Caribbean, on the basis of a selection of relevant indicators that illustrate the countries’ performance on individual Goals and their respective targets. This concise analysis of the region’s progress towards the targets set forth under the eight Millennium Development Goals paints a mixed picture. While bright spots can clearly be identified, in that the region as a whole has made significant strides towards some targets, this progress has been uneven from one country to the next. This heterogeneity is essentially a reflection of the increasing ownership of the Millennium Development Goals and their gradual adjustment to the realities in each country, as well as the efforts deployed by Governments during the period of favourable conditions during the economic boom years that preceded the crisis. The region’s achievement stands in stark contrast with the insufficient efforts made by the developed countries, especially with regard to the commitments assumed under Goal 8 in relation to resources for development cooperation, trade and technology transfer. On the path towards sustainable development, 2015 represents both an arrival and a departure as the Millennium Development Goals and their accompanying road map give way to a new development policy framework consisting of the Sustainable Development Goals (SDGs). Perhaps the most significant change is that the Sustainable Development Goals and their targets are the outcome of exhaustive consultations between the representatives of the 193 States Members of the United Nations, enriched by contributions from academia, civil society and the private sector. The new Goals form part of the 2030 Agenda for Sustainable Development.2 Unlike the Millennium Development Goals, the Sustainable Development Goals are universal and non-prescriptive, with a 1

Significant inter-agency publications produced over this period include: Meeting the Millennium Poverty Reduction Targets in Latin America and the Caribbean (LC/G.2188-P), Santiago, 2002; The Millennium Development Goals: a Latin American and Caribbean Perspective (LC/G.2331-P), Santiago, 2005; Millennium Development Goals. 2006 Report: a look at gender equality and empowerment of women in Latin America and the Caribbean (LC/G.2352), Santiago, 2007; Millennium Development Goals: progress towards the right to health in Latin America and the Caribbean (LC/G.2364), Santiago, 2008; Millennium Development Goals: advances in environmentally sustainable development in Latin America and the Caribbean (LC/G.2428-P), Santiago, 2010; Achieving the Millennium Development Goals with Equality in Latin America and the Caribbean (LC/G.2460), Santiago, 2010; Sustainable Development in Latin America and the Caribbean: follow-up to the United Nations development agenda beyond 2015 and to Rio+20 (LC/G.2577), Santiago, 2013. See Transforming our world: the 2030 Agenda for Sustainable Development (A/69/L.85), New York, 2015.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

transformative vision that aspires to leave no one behind. By their very nature, they coincide with the agenda of ECLAC, which puts equality front and centre and proposes structural change as the way forward, and policymaking as the means to that end. The 2030 Agenda for Sustainable Development is thus more than a development agenda; it expresses an aspiration and a leap forward for civilization, marked by this singular change of era for humanity. Drawing on this collective effort, the 2030 Agenda in general and the Sustainable Development Goals in particular represent clear progress with respect to the Millennium Development Goals, with the number of goals rising from 8 to 17, accompanied by an increase in the number of targets. Moreover, the Sustainable Development Goals are underpinned by a more holistic, interdisciplinary and universal vision that goes beyond the restrictive sectoral focus of the Millennium Development Goals, which were originally conceived as targets for developing countries, within a paradigm of developed countries helping these to achieve a well-being threshold. The Sustainable Development Goals are expected to be geared towards closing structural gaps and rebalancing deep asymmetries in the areas of finance, trade and technology. In keeping with its broader perspective, the new Agenda aims to build on the Millennium Development Goal target of halving extreme poverty, measured by income, by 2015. The Agenda proposes not only to eradicate extreme poverty by 2030 but also, equally importantly, to reduce high levels of inequality; a challenge of particular relevance for Latin America and the Caribbean as the worldâ&#x20AC;&#x2122;s most unequal region. The new Agenda also proposes to enhance well-being in a climate of democratic coexistence and respect for human rights, and emphasizes the importance of jobs, technological innovation, environmental sustainability and the provision of public goods. Gender equality, as one of the most direct routes towards a truly sustainable and inclusive development, is also a key theme. The implementation of the 2030 Agenda presents a new challenge, firstly because the statistical community has been included from the outset in devising indicators to monitor the fulfilment of targets, and secondly because it proposes mechanisms for the evaluation of progress. These mechanisms include specific targets for making more and better statistical information available, while promoting the consideration of new traditional and non-traditional data sources, and the creative combination of these sources for follow-up purposes. This will be crucial in delivering timely and transparent accountability to foster active engagement by the public. In this final year of the Goals and targets that emerged from the Millennium Summit, significant global achievements may be identified in several of the spheres addressed by the proposed new Agenda. Nevertheless, many of the worldâ&#x20AC;&#x2122;s countries still face major challenges in achieving structural changes conducive to production diversification and industrialization, fully exploiting technological innovation to create employment with rights, and moving forward with a low-carbon, more environmentally friendly form of development. With regard to the Millennium Development Goals, the countries of Latin America and the Caribbean overall have taken major strides in reducing extreme poverty, hunger, undernourishment and child mortality, and in providing better access to improved drinking water and sanitation facilities. Conversely, not enough progress has been made on universal primary education, gender equality in the labour market and in national parliaments, maternal mortality, access to reproductive health services, and forest loss. Progress during the years since the Millennium Declaration has not been either continuous or consistent from one Goal to another. Some indicators point to a rapid improvement at the beginning of the period, some have shown steady improvement, and others have languished below the proposed target. Moreover, outcomes have differed by country and by subregion, confirming a general pattern of heterogeneous development in the region. For all these reasons, it is essential to have a concise but comprehensive assessment of what has been achieved and what progress remains to be made with respect to the Millennium Development Goal targets, as a basis for reflecting upon the challenges and opportunities that the Sustainable Development Goals present for the region. 8

MDG

Introduction

Box 1 The Millennium Declaration In September 2000, the Heads of State of 189 States Members of the United Nations convened in New York to adopt the Millennium Declaration. The Declaration would become the road map for attaining the development and well-being of peoples, within a framework of respect for and defence of the principles of human dignity, equality and equity, and of commitment to the purposes and principles of the Charter of the United Nations. These premises laid the foundation for a set of eight goals that were to be achieved by 2015. Known as the Millennium Development Goals, and based mainly on agreements reached at United Nations conferences and summits during the 1990s, they represented a commitment by all nations to reduce poverty and hunger, to combat diseases and gender inequity, to address gaps in education and the lack of access to drinking water and sanitation, and to halt environmental degradation.

Millennium Development Goals Goal 1: Eradicate extreme poverty and hunger Goal 2: Achieve universal primary education Goal 3: Promote gender equality and empower women Goal 4: Reduce child mortality

Goal 5: Improve maternal health Goal 6: Combat HIV/AIDS, malaria and other diseases Goal 7: Ensure environmental sustainability Goal 8: Develop a global partnership for development Each of the Goals included a set of targets, which detailed the desired outcomes in terms of: reducing extreme poverty, hunger, child and maternal mortality, the spread of HIV/AIDS, malaria and other communicable diseases, and biodiversity loss; eliminating gender inequalities; achieving full and productive employment and decent work for all; achieving the universal completion of primary education; improving sexual and reproductive health, access to drinking water and sanitation facilities and the living conditions of slum dwellers; integrating the principles of sustainable development; developing an open trading and financial system; addressing the special needs of least developed countries (LDCs), landlocked developing countries and small island developing States; dealing comprehensively with the debt problems of developing countries; providing access to affordable essential drugs in developing countries, and providing access to the benefits of new technologies, especially information and communications technologies. Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of United Nations, Millennium Declaration [online] http://www.un.org/millennium/declaration/ares552e.htm.

Goal 1 Eradicate extreme poverty and hunger

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Progress towards the targets Figure 1.1 Latin America and the Caribbean: official indicators for Millennium Development Goal 1 Target 1A: Halve, between 1990 and 2015, the proportion of people whose income is less than US$ 1.25 a day Indicator 1.1: Proportion of population whose income is below US$ 1.25 PPP (purchasing power parity) per day (Percentages) 60

Target

1990

2011

Indicator 1.2: Poverty gap ratio (distance from the poverty line of US$ 1.25 per day PPP, weighted by the percentage of households under that line) (Percentages)

2015a

50 40

0 a

5.2

Latin America and the Caribbean

World

Projection.

5.3

4.8

3.2

0 1990

1999

2005

Quintile IV

2.2

Developing countries

Quintile V

11.8

Latin America

100

Developing countries Latin America and the Caribbean

16.2

Indicator 1.3: Income distribution by quintiles a (Percentages)

2011

3.2

3.4

3.7

3.9

1999

2005

2010

2013

Quintile III Quintile II Quintile I

Complementary indicator calculated on the basis of household surveys conducted in the respective countries. a

Target 1B: Achieve full and productive employment and decent work for all, including women and young people Indicator 1.5: Employment rate, variation 1991-2014 a (Percentage points) 4.4

Indicator 1.6: Proportion of employed people living on less than US$ 1.25 PPP (purchasing power parity) per day (Percentages) 60

Developing countries

World

Developing countries World Latin America and the Caribbean Developed countries

Developed countries

Indicator 1.7: Proportion of own-account and contributing family workers in total employment (Percentages) 2000

2014

Developing countries World

Latin America and the Caribbean

-1.1

Developed countries

-2.5

1991

-3.3 a

1991

2000

2014

Proyección.

Target 1C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger Indicator 1.9: Proportion of population below minimum level of dietary energy consumption (Percentages)

Indicator 1.8: Prevalence of underweight children under age 5 (Percentages) 30

1990

2015a

0 a

Target

Projection.

World

Latin America and the Caribbean

Developed countries a

Target

1990-1992

2014-2016a

Developing World Latin America The countries and Caribbean the Caribbean Projection.

Latin America

Source: Economic Commission for Latin America and the Caribbean (ECLAC), based on United Nations, The Millennium Development Goals Report, 2015, statistical annex, New York, 2015.

MDG 1

Eradicate extreme poverty and hunger

Reducing poverty and inequality The countries of the region have made significant progress in reducing extreme poverty over the past two decades. By around 2008, the region was already on the verge of halving the poverty levels of 1990 and in 2011, the percentage of people living on less than US$ 1.25 a day was 4.6%, a 63% reduction on the 1990 figure (12.6%). The target was also achieved in 2011 in relation to the percentage of the population living on less than US$ 2 per day, since that figure fell by 14 percentage points from 1990 levels.

Figure 1.2 Latin America (18 countries): population living on less than US$1.25 PPP (purchasing power parity) a day and progress on the poverty reduction target, around 1990-around 2012 (Percentages)

Target

1990

2012

Honduras

46.91 (1990)

16.48 (2011)

Nicaragua

32.73 (1993)

8.54 (2009)

Panama

20.89 (1991)

3.99 (2012)

Guatemala

28.36 (1989)

13.70 (2011)

El Salvador

17.07 (1991)

2.53 (2012)

Brazil

16.23 (1990)

3.75 (2012)

Ecuador

14.59 (1994)

3.95 (2012)

Dominican Rep.

12.17 (1989)

2.25 (2012)

Costa Rica

8.45 (1990)

1.35 (2012)

Peru

9.81 (1994)

2.89 (2012)

Mexico

7.95 (1989)

3.26 (2012)

Chile

4.91 (1990)

0.83 (2012)

Colombia

8.18 (1991)

5.63 (2012)

Uruguay

0.45 (1989)

0.31 (2012)

Argentina

0.97 (1991)

1.41 (2012)

Paraguay

1.05 (1990)

3.03 (2012)

Bolivia (Plur. State of)

5.24 (1991)

7.98 (2012)

Latin America and the Caribbean

12.63 (1990)

4.63 (2011) Percentage points short of the target

Starting point in 1990 Progress achieved by 2012

10 Slipped back

Percentage points past the target 5 Stood still

Progress made but still short of the target

25 Target achieved

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, based on United Nations, Millennium Development Goals indicators database [online] http://mdgs.un.org/unsd/mdg/Default.aspx.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

In addition to the proportion of the population living on less than US$ 1.25 per day, the international standard measure of extreme poverty, ECLAC also calculates a total poverty measure based on an internationally comparable threshold consisting of the cost of a basic food and non-food basket. This provides a measure of poverty in keeping with realities in the countries, and supports a more intuitive interpretation of the results. The total poverty levels calculated on the basis of the poverty lines estimated by ECLAC show broad progress by the countries of the region. Projections for 2014 show 28% of Latin Americaâ&#x20AC;&#x2122;s population living in poverty, representing a cumulative fall of 20 percentage points since 1990. This virtually systemic decrease in poverty was interrupted only twice, between 1997 and 2002, and between 2012 and 2014, during which poverty levels remained relatively flat. The significant reduction in poverty levels over the period was largely due to relatively high economic growth rates, especially in 2003-2008, when labour income rose in most of the countries. Other contributing factors were a rise in transfers (public and private, including pensions) and in other sources of income, greater female participation in employment, and a reduction in household size and dependency ratios (ECLAC, 2013).

Figure 1.3 Latin America: population living in poverty according to poverty lines estimated by ECLAC, 1990-2014 (Percentages)

Upturn in economic growth and reduction in inequality

Economic growth and entrenched inequality 60 48.4

45.8

43.9

43.8

43.5

39.7 40 30

36.2

34.0 33.5 32.9

29.6

28.1 28.1 28.0

2014a

2013

2012

2011

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

1995

1994

1993

1992

1991

1990

2010

Standstill in economic growth and reduction in inequality

10 0

31.1

Economic stagnation and deteriorating distribution

2009

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, based on national household surveys. a Proyection.

Notwithstanding the positive developments discussed, since 2012 poverty reduction has stagnated and extreme poverty rates have edged slightly back up. ECLAC projections (ECLAC, 2014a) show around 71 million people in extreme poverty in 2014, a figure equivalent to the combined populations of Buenos Aires, Lima, Mexico City and SĂŁo Paulo.

MDG 1

Eradicate extreme poverty and hunger

Meanwhile, over 50% of the population is still vulnerable and barely has the resources to withstand economic downswings and slow employment growth, as the majority of those people do not have savings, access to social security or their own home (ECLAC, 2014a). With regard to inequality, income distribution has improved in the past decade. This progress can be attributed to the positive impacts of rising employment rates, a lower dependency ratio, redistributive cash transfers, and a narrowing wage gap between skilled and unskilled workers (ECLAC, 2014b). However, despite the improvement in income distribution between 2008 and 2013, this trend will be hard to sustain amid the economic slowdown the region is currently experiencing. .

An improving employment situation Employment is a key pillar for ensuring social inclusion and cohesion. Work is the master key that enables low-income households to generate income to move out of extreme poverty. Much of the progress made in reducing poverty and inequality has been thanks to the favourable labour market conditions of the past decade, during which the region achieved the best indicators of employment, unemployment and participation of the past 20 years. Employment growth has also led to a relative improvement in job quality, as wage employees have increased as a proportion of all workers and, in the past few years, employment in low-productivity sectors has fallen relative to the total. In the past decade, employment growth has also combined with an increase in real wages and minimum wages. The employed population has expanded in most of the countries, and the regional employment rate rose from 52.7% in 2000 to 55.7% in 2013.

Table 1.1 Latin America and the Caribbean: labour market indicators, selected years between 2000 and 2014 (Percentages)

2000

2001

2002

2005

2008

2010

2012

2013

2014

Employment-population ratio (Latin America and the Caribbean)

58.3

…

62.1

…

Employment rate (Latin America and the Caribbean)

52.7

52.5

52.0

53.7

54.9

55.3

55.7

…

Unemployment rate (Latin America and the Caribbean)

10.4

10.2

11.2

9.0

7.3

6.4

6.2

6.0

Urban employed in low-productivity sectors (informal sector) of the labour market (Latin America)

…

50.1

50.4

48.3

47.4

46.7

46.4

…

Wage workers (Latin America)

…

51.9

52.5

54.0

54.1

54.7

55.2

…

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database.

However, precarious employment conditions remain widespread, and this stands in the way of achieving sustainable well-being throughout society. While informal employment has been declining, as noted above, just under 50% of Latin America’s urban workers are still employed in low-productivity sectors, with the proportion higher for women than for men; 50% of women and 44% of men are informal employees, and the gap widens to over 10 percentage points in El Salvador, Nicaragua, Peru and the Plurinational State of Bolivia. In the Bolivarian Republic of Venezuela and the Dominican Republic, however, the gap is reversed, with a higher proportion of men in informal work. The proportion of urban workers employed in low-productivity sectors ranges from 27% in Chile to 60% in the Plurinational State of Bolivia. Particularly worrying is this indicator’s stubborn immobility

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

over the past two decades: the proportion of urban workers in low-productivity sectors has held steady in most countries during the period under consideration, falling only in Argentina, Chile, and, since the beginning of the twenty-first century, in Brazil, Paraguay and Uruguay.

Figure 1.4 Latin America (18 countries): urban employed in low-productivity sectors (informal sector) of the labour market, by sex, around 2013 (Percentages)

Argentina (2012) 36.7

39.0

Bolivia (Plur. State of) (2011) 54.8

Colombia (2013) 55.2

60.8

Costa Rica (2013) 33.1

El Salvador (2013) 46.9

63.1

50.5

51.0

31.7

43.9

46.6

56.0

41.2

Chile (2011) 22.8

51.2

49.3

Mexico (2012) 42.6

51.8

49.9

64.9

58.8

Nicaragua (2009) 34.6

54.5

Uruguay (2013)

Peru (2013) 50.2

32.1

Ecuador (2013)

Dominican Rep. (2013)

Paraguay (2013)

Venezuela (Bol. Rep. of) (2013) 52.9

41.3

34.9

Honduras (2010)

Panama (2013) 31.9

66.6

Brazil (2013)

32.4

37.5

Latin America (2013)

43.2

50.3

Women Men

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, based on national household surveys.

No less worrying is the situation of workers whose household income puts them below the extreme poverty line. Although extreme poverty trends have tracked total poverty trends since 1990 and both rates have fallen (recent figures show poverty having fallen by 40% across the region between 1997 and 2013), 10% of employed workers in Latin America still live in extremely poor households, as measured by the comparable national poverty lines calculated by ECLAC. Decent wages from decent work must be one of the tools for increasing peopleâ&#x20AC;&#x2122;s well-being. This ideal is a far cry from the reality in some countries, however; extreme poverty levels among the employed range from 0.8% in Chile to 39% in Honduras, according to the latest available data.

MDG 1

Eradicate extreme poverty and hunger

Figure 1.5 Latin America: total employed population, employed urban population and total population living in extreme poverty, 1990-2013 (Percentages)

19.0

19.3

18.6

15.7

12.9

12.1

14.0

11.0

10.0

9.4

11.7

9.9

9.7

5.3

5.4

8.4 6.8

Total employed population in extreme poverty

2009

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

Employed urban population in extreme poverty

6.1

2011

10.6

11.3

12.3

2008

11.6

2013

16.2

15.5

2010

2012

15.4

Total population in extreme poverty

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, based on national household surveys.

Reducing hunger The target of halving the proportion of people who suffer from hunger in the region has already been achieved. According to the Food and Agriculture Organization of the United Nations (FAO), the proportion of the population below the minimum level of dietary energy consumption in Latin America and the Caribbean overall has fallen steadily, from 14.7% in the biennium 1990-1992 to 5.5% in 2014-2016 â&#x20AC;&#x201D;in other words to less than half the figure at the start of the period. However, the Caribbean still needs to make significant efforts to reach the target, as the subregion achieved a reduction of only 27%. The situation across the region is very uneven today: 16 countries have already reached the target and 5 are very close to achieving it, with a reduction of between 40% and 50%, while 6 countries still face challenges in this regard.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 1.6 Latin America and the Caribbean (27 countries): proportion of population below minimum level of dietary energy consumption and progress made toward the respective target, 2014-2016 (Percentages)

Target not achieved

Target achieved

Very high level of undernutrition

Haiti More than 35%

High level of undernutrition 20% to 34%

Median level of undernutrition

The Caribbean

10% to 19%

Nicaragua Bolivia (Plur. State of)

Guatemala

El Salvador

5% to 9%

Jamaica

Honduras Ecuador Paraguay Colombia Belize

Dominican Rep. Guyana Panama

Suriname Trinidad Latin America and Tobago and the Caribbean

Low level of undernutrition Peru

Saint Vincent and the Grenadines

Negligible level of undernutrition Less than 5%

Costa Rica Barbados Uruguay

Venezuela (Bol. Rep. of) Chile Latin America

Cuba Argentina

Brazil Mexico

With regard to child undernutrition, the region has made great strides overall, but not equally well in relation to chronic undernutrition in children aged under 5 years. Chronic undernutrition remains a serious problem for Latin America and the Caribbean, as it affects the most vulnerable population and has a damaging impact on fetal development, infancy and early childhood. In 2012, there were still 7.5 million chronically undernourished children in the region (Martínez and Palma, 2015). Guaranteeing fulfilment of the right to food and nutrition security necessarily means achieving other goals: provide full access to food; eradicate developmental problems in children aged under 2 years caused by nutritional failings; ensure the sustainability of food systems; and eliminate food waste (Martínez and Palma, 2015). 18

MDG 1

Eradicate extreme poverty and hunger

Infographic 1.1 Latin America and the Caribbean: poverty, employment and hunger and the Millennium Development Goals

Target 1A: Halve, between 1990 and 2015, the proportion of people whose income is less than $ 1.25 a day LATIN AMERICA AND THE CARIBBEAN HAS REACHED THE TARGET OF HALVING THE PROPORTION OF PEOPLE WHOSE INCOME IS LESS THAN $ 1.25 A DAY Target

12.6%

ERADICATE EXTREME POVERTY BY 2030

Poverty 0

4.6%

1990

Poverty particularly affects:

2011

Percentage of the population living on less than $ 1.25 a day

CHILDREN

WOMEN THE REGION HAS IMPROVED INCOME DISTRIBUTION OVER THE PAST DECADE

INDIGENOUS PEOPLES

DESPITE THIS PROGRESS LATIN AMERICA AND THE CARIBBEAN IS STILL THE Factors that have helped to reduce poverty and inequality

MOST UNEQUAL REGION ON THE PLANET

Smaller wage gap between Higher cash Lower skilled and component in Increased dependency unskilled social employment spending rate workers

46% OF THE URBAN EMPLOYED WORK IN THE

Target 1B: Achieve full and productive employment and decent work for all, including women and young people

THE REGION NOW HAS THE BEST INDICATORS OF EMPLOYMENT, UNEMPLOYMENT AND PARTICIPATION OF THE PAST 20 YEARS

INFORMAL SECTOR

IN 2013, 10% OF EMPLOYED WORKERS LIVED IN EXTREMELY POOR HOUSEHOLDS

More women than men work in the informal sector

INCREASE INCLUSION FROM WITHIN THE LABOUR SYSTEM

2013

Target 1C: Halve, between 1990 and 2015, the proportion of people who suffer from hunger THE REGION HAS MET THE TARGET OF REDUCING BY 50% THE PROPORTION OF PEOPLE WHO SUFFER FROM HUNGER Very uneven situation between countries

7.5 MILLION CHILDREN UNDER AGE 5 SUFFER FROM CHRONIC UNDERNUTRITION

AGE

HEIGHT

THE REGION HAS ALSO MADE SIGNIFICANT PROGRESS IN REDUCING CHILD UNDERNOURISHMENT WEIGHT

Micronutrient deficit

ERADICATE CHILD UNDERNOURISHMENT AND TACKLE HIGH PREVALENCE OF OBESITY IN CHILDREN AND ADULTS This infographic contains the traditional description of the Goal and its indicators, for reference. However, the information is organized differently to show the targets in a systemic manner, highlighting the main achievements and challenges, on the one hand, and the main issues and links with other dimensions of development, on the other. Source: Economic Commission for Latin America and the Caribbean (ECLAC), 2015.

Goal 2 Achieve universal primary education

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Progress towards the targets Figure 2.1 Latin America and the Caribbean: official indicators for Millennium Development Goal 2 Target 2A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling Indicator 2.1 Net enrolment rate in primary education (Percentages)

Indicator 2.2 Proportion of pupils starting grade 1 who reach the last grade of primary (Percentages)

100 100

95 93.8

90 85

94.4

93.6 80

73.1

75.4

76.1

Developed countries Latin America and the Caribbean World

1991

2000

2005

2000

2015a

1990

100

95.5

Indicator 2.3 Literacy rate of 15- to 24-year-olds (Percentages)

World

Developing Latin America and Developed countries the Caribbean countries

World

Developing countries

Latin America and the Caribbean

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of United Nations, The Millennium Development Report 2015, statistical annex, 2015. a Projection.

Education is a fundamental human right and a key requirement for the development of individuals and nations, unlocking improvements in social, economic and cultural conditions. Achieving universal primary education is the first step towards increasing the population’s overall levels of schooling, as it tends to lead to higher completion rates in education at all levels.

Access and participation The Latin American and Caribbean region has high enrolment rates among the school-age population, particularly in primary school enrolment. The net enrolment rate for the region is estimated at almost 94% in 2015, as has been the case since 2000, indicating that progress towards achieving universal primary education has stalled. According to the United Nations Educational, Scientific and Cultural Organization (UNESCO), about 4 million children of primary school age in Latin America and the Caribbean were not enrolled in the education system in 2013. According to the most recent data available, nine countries in the region have primary enrolment rates below 90% and only six above 98%, which is the level established by UNESCO for achievement of the goal on universal primary education.

MDG 2

Achieve universal primary education

Figure 2.2 Latin America and the Caribbean (29 countries): net enrolment rate in primary education, latest year for which data are available (Percentages)

100 98 90 80 70 60 50 40

>98

<90

30 20 10

Uruguay (2010) Belize (2013) Aruba (2010) Ecuador (2013) Trinidad and Tobago (2010) Grenada (2013) Mexico (2013)a Bahamas (2010) Barbados (2011)b Cuba (2013) Saint Vincent and the Grenadines (2013) Peru (2013) Venezuela (Bol. Rep. of) (2013) Nicaragua (2010) El Salvador (2013) Chile (2013) Panama (2013) Colombia (2010) Costa Rica (2013) Honduras (2013) Dominican Rep. (2012) Guatemala (2013) Antigua and Barbuda (2012) Puerto Rico (2013) Saint Kitts and Nevis (2013) Bolivia (Plur. State of) (2013) Paraguay (2012) Suriname (2013) Guyana (2012) Latin America and the Caribbean (2013)a

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, on the basis of figures from UNESCO Institute for Statistics. a Estimates by the UNESCO Institute for Statistics. b National estimate.

Completion of studies High levels of access to and participation in education among children of primary school age have gone hand in hand with high completion rates. Although repetition and early dropout hamper the educational attainment of primary-age children in some cases, about 92% of 15- to 19-year-olds in Latin America have completed a full cycle of primary schooling. This rate has been improving gradually in recent decades, as shown by a comparison of the completion rates among different age groups, with the highest growth recorded in rural areas. The factors behind this improvement include not only greater access to primary education, but also better retention rates and more timely progression through the system.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 2.3 Latin America: population having completed primary education by age group, 2013 (Percentages)

100

Higher growth in rural areas

90 80 70 60 50 40 30 20 10 0

National

15-19

20-24

25-29

30-34

35-39

40-44

45-49

50-54

55-59

60-64

65 and over

Urban Rural

Younger generations have more years of formal education than their elders Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of household surveys conducted in the countries.

These primary completion rates are high, but fall short of the universal completion target. The inequalities between different income groups within school systems are stark: only 85% of 15- to 19-yearolds in the poorest 20% of the population have completed primary school and this percentage drops to 82% among those living in rural areas.

Literacy Illiteracy among young people aged 15 to 24 years in the region has fallen by more than 75% since 1990, dropping from 6.9% in 1990 to 1.7% in 2015, according to UNESCO estimates (United Nations, 2015b). However, some countries still require a major effort to boost the literacy of this age group by enough to meet the target. According to UNESCO data for 2015, El Salvador, Guatemala, Guyana, Haiti, Honduras, Jamaica, Nicaragua and the Dominican Republic still have youth illiteracy rates of over 2%. While illiteracy levels could be considered relatively low, the region still faces the challenge of addressing functional illiteracy, which affects large swathes of the population and widens social and economic inclusion gaps.

MDG 2

Achieve universal primary education

Figure 2.4 Latin America: population aged 15 to 19 years having completed primary education by income quintile (I and V), area of residence and sex, 2013 (Percentages)

100

100 Women 98.0

Urban 97.7

Men 97.5

Quintile V 96.7

95 National total 90

Women 92.6 Urban 90.7

91.6

Women 91.3 Men 90.1

Men 90.3

Rural 91.3

95 National total 91.6

Quintile I 85.3 85

85 Men 82.0 Rural 81.9

Women 81.9

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of household surveys conducted in the countries.

Similar inequalities are seen within the region with respect to pre-primary and secondary education. Major progress has been made in secondary coverage in several countries, but overcoming inequalities in access to, progression through and completion of secondary education remains a regional challenge. In 2012, only 73% of secondary-age adolescents were enrolled in school and only 57.5% of 20- to 24-year-olds had complete secondary schooling. ECLAC has argued that the region needs to focus its efforts on universalizing the completion of secondary education, as the minimum level of schooling people need in order to earn enough to avoid poverty. Indeed, the real threshold for accessing acceptable levels of well-being is post-secondary education in most of the countries (ECLAC, 2012). But expanding coverage, often by stepping up public spending on the education sector, is not enough if the education provided lacks in quality. Good-quality education is crucial in order to break intergenerational cycles of poverty and get on track towards ensuring people’s well-being and the fulfilment of their rights, with better living conditions and health care, broader opportunities to find decent work and participate in political and civic affairs, and stronger productivity and economic growth —all of which go towards building fairer and more peaceful and egalitarian societies.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Infographic 2.1 Latin America and the Caribbean: primary education and the Millennium Development Goals Target 2A: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling

Students enrolled a

66% PRE-PRIMARY

93%

73%

PRIMARY

SECONDARY

AmĂŠrica Latina y el Caribe

ODM2

MDG2 SLOW EXPANSION OF ACCESS FOR SMALL CHILDREN TO PRE-PRIMARY EDUCATION

LOW ENROLMENT IN SECONDARY EDUCATION HIGH ENROLMENT RATES AMONG PRIMARY-AGE CHILDREN

To secure sufficient income to keep out of poverty, people need complete secondary schooling; full primary schooling is not enough

Expand coverage of and access to early childhood and preschool education

Children and young people face an ever longer path to attaining the tools for economic and social inclusion, but in the process they gain increasing capacities to fully exercise their rights as citizens

Universalize completion of secondary school

a Refers to the net enrolment rate for each level of education, 2013. This infographic contains the traditional description of the Goal and its indicators, for reference. However, the information is organized differently to show the targets in a systemic manner, highlighting the main achievements and challenges, on the one hand, and the main issues and links with other dimensions of development, on the other.

Source: Economic Commission for Latin America and the Caribbean (ECLAC), 2015. a Refers to the net enrolment rate by level of education, 2013.

Goal 3 Promote gender equality and empower women

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Progress towards the targets Figure 3.1 Latin America and the Caribbean: official indicators for Millennium Development Goal 3 Target 3A: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015 Indicator 3.1 Ratio of girls to boys in primary, secondary and tertiary education 2015a Primary

Secondary

Tertiary

Indicator 3.2 Share of women in wage employment in the non-agricultural sector (Percentages) 50

1990

Indicator 3.3 Proportion of seats held by women in national parliaments (Percentages)

2013

1990

Developed countries

World

Latin America and the Caribbean

Developed countries

Developing countries

2015

Target

The Caribbean

Latin America 10

Latin America and the Caribbean

0.6 0.7 0.8 0.9

1.1 1.2 1.3 1.4

World Developed Latin America and countries the Caribbean

World

Developing countries

Developed countries 0

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, based on United Nations, The Millennium Development Goals Report, 2015, statistical annex, New York, 2015. a Projection.

Gender equality in the region has improved slowly but surely over the past 20 years. Progress has been uneven among and within countries and in different areas of development, resulting in a mixed picture. Major challenges remain, in particular, reducing multiple types of discrimination experienced by people living in rural areas, as well as indigenous women and women of African descent, and securing the progress made thus far against the risk of setbacks driven by countries’ social and political culture (ECLAC, 2015).

Education Significant progress has been made in girls’ access to formal education, particularly in secondary and tertiary education, compared with that of boys. The situation in the labour market and with regard to decision-making has also improved, but the efforts made in these areas have not been sufficient to achieve the proposed targets. In 2015, according to the UNESCO Institute for Statistics, throughout Latin America and the Caribbean, the rate of access to primary education is slightly lower for girls than for boys, but is within the range of values for which the goal is considered to have been reached (ratio of girls to boys between 0.97 and 1.03). The figures show that girls have better access to secondary education (1.07) and tertiary education (1.29). However, this is uneven across the different countries. According to the latest available data, around 2013, girls were still at a disadvantage with regard to access to primary education, with a ratio of less than 0.97 in Antigua and Barbuda, Dominican Republic, El Salvador, Grenada, Saint Lucia, Saint Vincent and the Grenadines, and Suriname, although the ratio in most of these countries was very close to the target. There is a similar state of affairs in secondary education, where the ratio in Guatemala and Saint Vincent and the Grenadines is below 0.97, while Mexico has not achieved gender parity in tertiary education, to the detriment of girls.

MDG 3

Promote gender equality and empower women

Figure 3.2 Latin America and the Caribbean (34 countries and territories): gender parity indices in primary, secondary and tertiary education, around 2013 Primary

+ boys

Secondary

Tertiary

+ girls

Guyana (2012) Saint Kitts and Nevis (2013) Aruba (2012) Puerto Rico (2013) Bahamas (2010) Ecuador (Prim. and Sec. 2013, Ter. 2012) Mexico (2012) Costa Rica (2013) Honduras (2013) Peru (2013) Cuba (2013) Argentina (2012) Barbados (2011) Venezuela (Bol. Rep. of) (2013) Colombia (Prim. 2010, Sec. and Ter. 2013) Nicaragua (2010) Dominica (Prim. 2013, Sec. 2011) Panama (Prim. and Sec. 2013, Ter. 2012) Bolivia (Plur. State of) (2013) Chile (2012) Uruguay (2010) Trinidad and Tobago (2010) Grenada (2010) Guatemala (Prim. and Sec. 2012, Ter. 2013) Paraguay (2011) Belize (2013) El Salvador (Prim. and Sec. 2013, Ter. 2012) Suriname (2013) Saint Vincent and the Grenadines (2013) Jamaica (2013) Antigua and Barbuda (2012) Dominican Rep. (2012) British Virgin Islands (2012) Saint Lucia (2013) Latin America and the Caribbean (2012) -0.5

0.0

0.5

1.0

1.5

2.0

2.5

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, based on UNESCO Institute for Statistics online database.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Labour market The parity levels in education have not led to similar improvements in women’s situation in the labour market or during their adult lives; on the contrary, inequality remains a structural hallmark of the labour market and the female labour force. On the one hand, women are still at a disadvantage with regard to male peers in terms of career path, access to equal pay and the right to an old age pension. Meanwhile, time-use differences between women and men reveal that the costs of labour force participation have been borne directly and solely by women. On the other hand, women with higher levels of education tend to have fewer dependent family members and more resources to pay for care services, and show higher rates of economic participation. Public policies must therefore continue to be developed in order to improve women’s access to the labour market and ensure that they remain in employment throughout their lifetime (ECLAC, 2015). The percentage of women employed in the non-agricultural sector is around 44% across the region. This figure has been improving since the beginning of the 1990s, with an increase of 6 percentage points to date during the Millennium Development Goals monitoring period. The average wage for a woman living in an urban area in Latin America is US$ 87 for each US$ 100 that a man earns in the same circumstances. Lastly, despite the auspicious drop in extreme poverty in the region, it is a more likely state for women than men and that gap has persisted in recent decades. Data indicate that extreme poverty femininity indices exceed 100 in all the countries except Honduras and, in some cases (Dominican Republic and Uruguay), the poverty rate is 50% higher among women than men.

MDG 3

Promote gender equality and empower women

Figure 3.3 Latin America (18 countries): selected indicators of women’s economic autonomy, around 2013 Population without own income

Poverty femininity index

(Number of women without own income for each man in the same situation)

Women in wage Dollars earned by a woman for employment in the each US$ 100 earned by a man non-agricultural sector (Percentages)

40 50 60 70 80 90 100 110 120 130 140 150 160

1990

2013

Argentina (2012)a Bolivia (Plur. State of) (2011) Brazil (2013) Chile (2013) Colombia (2013) Costa Rica (2013) Ecuador (2013)

37.1

42.4

35.2

36.7 b

40.2

47.4

37.3

39.0

41.8

46.4

37.2

43.4

30.9

38.4

El Salvador (2013) Guatemala (2006) Honduras (2010) Mexico (2012)

32.9

36.8

36.9

41.4

36.5 c 40.3

Nicaragua (2009) Panama(2013) Paraguay (2013)

43.4 d 43.9 e

41.0

Peru (2013) Dominican Rep. (2013) Uruguay (2013) Venezuela (Bolivarian Rep. of) (2013) Latin America (2013)

43.9

37.0

31.5 c 41.6 e

42.3

48.5

35.2

43.7

38.1 f 44.0 f

(total and those with 13 or more years of schooling) (Dollars) 13 and more Total

93.2

84.8

76.8

78.6

82.3

71.7

78.4

71.3

89.7

79.5

96.2

85.9

94.5

82.6

73.3

73.7

83.4

62.8

94.4

85.6

86.8

78.1

89,7

78,4

87.5

72.1

85.1

79.8

79.1

76.9

93.1

92.4

83.8

79.9

96.5

90.9

86.9

79.2

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, based on national household surveys. a The data from the femininity index of indigence refers to 2012 and includes only 31 urban agglomerations. b Refers to 2011. c Refers to 1991. d Refers to 1992. e Refers to 2012. f Refers to Latin America and the Caribbean overall.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Decision-making With regard to autonomy in decision-making, there has been a noticeable change in the democratic culture of the region. Much of the progress in Latin America and the Caribbean has been the result of institutional reforms of the executive, the legislature, electoral systems and the judiciary. Since the beginning of the 1990s, the region has almost tripled the number of seats held by women in national parliaments and, in the past decade, has increased the number of women at the highest levels of national government (ECLAC, 2015). In 2015, women’s percentage of seats in national parliaments for the region overall bordered the threshold set in the target (30%). The situation varies greatly in the different Latin American and Caribbean countries, however. Only nine countries in the region have exceeded the target, three are very close to achieving it, while less than 10% of the seats in the national parliaments of Belize, Brazil, Haiti and Saint Kitts and Nevis are held by women.

Figure 3.4 Latin America and the Caribbean (33 countries): proportion of seats held by women in national parliaments, 2015 (Percentages)

100 90 80 70 60 50 40 30 20 10 0

11.9% 1990 Seats held by men

Seats held by women

100 90 80 70 60 50 40 30 20 10 0

27.4% 2015

Source: Economic Commission for Latina America and the Caribbean (ECLAC), CEPALSTAT database, based on Inter-Parliamentary Union, “Women in National Parliaments” [online] http://www.ipu.org/Wmn-e/world.htm.

MDG 3

Promote gender equality and empower women

Infographic 3.1 Latin America and the Caribbean: progress towards gender equality and women’s empowerment SLOW, STEADY IMPROVEMENT IN WOMEN’S SITUATION

Significant cultural changes

REDUCE THE MULTIPLE TYPES OF DISCRIMINATION EXPERIENCED BY WOMEN LIVING IN RURAL AREAS, AS WELL AS INDIGENOUS WOMEN AND WOMEN OF AFRICAN DESCENT

Uneven progress Rural women

Indigenous women

Discrimination

Mixed picture

Women of African descent

Target 3A: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015 SIGNIFICANT PROGRESS HAS BEEN MADE IN GIRLS’ ACCESS TO FORMAL EDUCATION, MAINLY IN SECONDARY AND TERTIARY EDUCATION, COMPARED WITH BOYS

2012

Gender parity index in primary, secondary and tertiary education

+ boys

Primary

0.5

Secondary

+ girls

Tertiary

1.5

1.0

Economic autonomy

1 in 3 women has no income of her own

2013

Labour participation costs have been borne directly

and solely by women

Occupational segmentation barriers

100

Soci al

No change in the labour market structure

Wage gaps

How much a woman earns for every US$ 100 a man earns, around 2013

p rotection

THE MAIN INEQUITIES IN THE LABOUR MARKET STRUCTURE AND WOMEN’S EMPLOYMENT PARTICIPATION REMAIN UNCHANGED

Lack of social protection

Public policies have not been able to improve the conditions of women’s access to the labour market or to keep them there Jamaica

REDISTRIBUTE TIME USE AND WORK BETWEEN MEN AND WOMEN

Trinidad and Tobago

2015

Brazil

(July)

Decision-making autonomy

More women at the highest level of representation CHANGE IN THE DEMOCRATIC CULTURE

Chile Argentina

NEED TO CONSOLIDATE PROGRESS MADE

INTRODUCE JOINT RESPONSIBILITY FOR CAREGIVING

THE REGION HAS ALMOST TRIPLED THE NUMBER OF SEATS HELD BY WOMEN IN NATIONAL PARLIAMENTS AND, IN THE PAST DECADE, HAS INCREASED THE NUMBER OF WOMEN AT THE HIGHEST LEVELS OF NATIONAL GOVERNMENT Elimination of discriminatory laws LEGAL CHANGES Quota laws

Political and social culture in the countries Risk of setbacks

Physical autonomy PROGRESS HAS BEEN MADE IN RELATION TO WOMEN’S PHYSICAL AUTONOMY, BUT VIOLENCE AGAINST WOMEN PERSISTS IN ALL ITS FORMS, DESPITE A VARIETY OF INITIATIVES TO PREVENT, SANCTION AND ELIMINATE IT

LEGISLATIVE CHANGES Laws to combat violence against women Decriminalization of abortion Emergency contraception

This infographic contains the traditional description of the Goal and its indicators, for reference. However, the information is organized differently to show the targets in a systemic manner, highlighting the main achievements and challenges, on the one hand, and the main issues and links with other dimensions of development, on the other. Source: Economic Commission for Latin America and the Caribbean (ECLAC), based on data from the Gender Equality Observatory for Latin America and the Caribbean, 2015.

Goal 4 Reduce child mortality

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Progress towards the targets Figure 4.1 Latin America and the Caribbean: official indicators for Millennium Development Goal 4 Â&#x192;Â&#x192; Target 4A: Reduce by two thirds, between 1990 and 2015, the under-five mortality rate Indicator 4.1 Under-five mortality rate (Deaths per 1,000 live births) 100

100 80

Indicator 4.2 Infant mortality rate (under age 1) (Deaths per 1,000 live births)

Target 1990

2013

1990

2013

Developing countries

World

Developed Latin America and World countries the Caribbean

Developing countries

2013

The Caribbean

Target 1990

Indicator 4.3 Proportion of 1-year-old children immunized against measles (Percentages)

Latin America

Developed Latin America and World countries the Caribbean

Developing countries

Developed countries 0

100

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, on the basis of United Nations, The Millennium Development Goals Report 2015, statistical annex, 2015.

Latin America and the Caribbean is one of two regions that, by 2013, had achieved the goal of reducing by two thirds the mortality rate for children aged under 5 years. The region, second only to East Asia, made significant progress between 1990 and 2013, going from 54 to 18 deaths per 1,000 live births for this age group. Progress in this field is attributable to a combination of several factors, including advances in the provision of high-impact, low-cost primary care (mass vaccination programmes, oral rehydration therapy, the encouragement of breastfeeding, and health check-ups for healthy children), sustained socioeconomic and demographic changes, such as increased coverage of basic services, especially drinking water and sanitation, higher education levels, particularly among women, and declining fertility (ECLAC, 2010). Despite progress at the regional level, however, only five countries have met the target: Brazil, El Salvador, Mexico, Peru and the Plurinational State of Bolivia have reduced their under-five mortality levels by more than two thirds since 1990. Antigua and Barbuda, Chile, Cuba, Nicaragua and Saint Kitts and Nevis could soon join this group of countries as they are very close to the target (within 2Â percentage points) and the first three of these have recorded reductions of over 50%. With respect to success stories and key developments, Cuba registered the lowest child mortality rate in the region in the period under consideration and is the only country whose rates have fallen to the average for developed countries. In addition, Antigua and Barbuda, Chile and Costa Rica also achieved rates of fewer than 10 deaths per 1,000 live births for children aged under 5 years in 2013. Four countries recorded rates above 30 deaths per 1,000 live births for children aged under 5 years, and the situation in Haiti is particularly worrying, with a rate of over 70 deaths per 1,000 live births in 2013.

MDG 4

Reduce child mortality

Figure 4.2 Latin America and the Caribbean (33 countries): under-five mortality rate, 1990-2013 (Deaths per 1,000 live births and percentage reduction)

Target

1990

2013

Bolivia (Plur. State of) 122.7 Haiti 144.6 Peru 80.0 Guatemala 80.6 Brazil 61.5 El Salvador 59.5 Nicaragua 66.8 Honduras 59.1 Ecuador 56.9 Mexico 46.4 Dominican Rep. 59.7 Suriname 47.7 Guyana 61.2 Paraguay 46.2 Belize 39.6 Colombia 35.2 Saint Kitts and Nevis 28.5 Antigua and Barbuda 25.5 Venezuela (Bol. Rep. of) 29.5 Argentina 27.6 Panama 31.1 Jamaica 29.8 Uruguay 23.1 Chile 19.1 Bahamas 23.5 Grenada 22.2 Trinidad and Tobago 30.6 Saint Lucia 22.6 Costa Rica 16.9 Cuba 13.3 Dominica 17.2 Saint Vincent and the Grenadines 24.7 Barbados 18.1 Latin America and the Caribbean 54.0

39.1 72.8 16.7 31.0 13.7 15.7 23.5 22.2 22.5 14.5 28.1 22.8 36.6 21.9 16.7 16.9 10.2 9.3 14.9 13.3 17.9 16.6 11.1 8.2 12.9 11.8 21.3 14.5 9.6 6.2 11.4 19.0 14.4 18.0 Percentage points short of the target 100

Starting point in 1990 Progress achieved by 2013

40 Virtually unchanged

Percentage points past the target 20

Progress made but still short of the target

60 Target achieved

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, on the basis of Inter-agency Group for Child Mortality Estimation (IGME), Levels and Trends in Child Mortality. Report 2014, New York, United Nations, 2014.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Despite the overall decline in under-five mortality rates in the region, 196,000 children in this age group died in 2013 (IGME, 2014), which is equivalent to one death occurring somewhere in Latin America and the Caribbean every three minutes. Of the total deaths, 60% occur before children reach 1 year of age and 50% in the first 28 days of life. A large proportion of deaths in the neonatal period (first 28 days) are related to prematurity, birth asphyxia and infection. Meanwhile, pneumonia and diarrhoea are the leading causes of death between the end of the neonatal period and 5 years of age (WHO, 2014). Lack of basic services in the home, mothers living in socially vulnerable conditions and child malnutrition increase the risk of under-five mortality. A multidimensional, multi-system approach to care is required at this early stage of life. Vaccination is an important component of that care, especially early immunization against measles. The region managed to eradicate measles almost completely in the early 2000s thanks to national programmes and campaigns to vaccinate children. In 2013, coverage of measles immunization for children aged under 1 year exceeded 90% in many countries of the region and was above 95% in Antigua and Barbuda, Belize, Brazil, Cuba, Ecuador, Guyana, Nicaragua, the Plurinational State of Bolivia, Saint Kitts and Nevis, Saint Lucia, Saint Vincent and the Grenadines, and Uruguay. Coverage has expanded by more than 35% over 1990 levels in the Bolivarian Republic of Venezuela, Ecuador, Guyana, the Plurinational State of Bolivia and Suriname, and by 109% in Haiti. Despite these improvements, the situation remains worrying in the Bolivarian Republic of Venezuela, the Dominican Republic, Guatemala, Haiti and Peru, with measles immunization covering 85% or less of the target group. Furthermore, cases originating from other regions have caused isolated outbreaks in some countries in Latin America. According to the World Health Organization (WHO), cases have been confirmed in Brazil, Chile and Mexico in 2015, which could indicate that in some areas immunization rates have fallen below the levels needed to stop the spread of measles. Further efforts are therefore required to maintain coverage levels, especially in more vulnerable areas.

MDG 4

Reduce child mortality

Figure 4.3 Latin America and the Caribbean (33 countries): proportion of 1-year-old children immunized against measles, 2013 (Percentages)

100

Belize Brazil Cuba Guyana Nicaragua Saint Kitts and Nevis Saint Vincent and the Grenadines Saint Lucia Antigua and Barbuda Ecuador 95 - 99 Uruguay Bolivia (Plur. State of) El Salvador Grenada Jamaica Dominica Suriname 90 - 95 Bahamas Colombia Panama Paraguay Latin America and the Caribbean Argentina Costa Rica Trinidad and Tobago Barbados Chile Honduras Mexico

85 - 90 Guatemala Peru Venezuela (Bol. Rep. of)

80 Dominican Rep.

Under 85

Haiti

2013

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, on the basis of United Nation Childrenâ&#x20AC;&#x2122;s Fund (UNICEF), The State of Worldâ&#x20AC;&#x2122;s Children, various years [online] http://www.unicef.org/sowc/.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Infographic 4.1 Latin America and the Caribbean: under-five mortality and the Millennium Development Goals

Target 4A: Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate LATIN AMERICA AND THE CARIBBEAN IS ONE OF TWO REGIONS THAT, BY 2013, HAD ACHIEVED THE GOAL OF REDUCING BY TWO THIRDS THE MORTALITY RATE AMONG CHILDREN AGED UNDER 5 YEARS

Determinants

54 43 43

Mass vaccination schemes

Oral rehydration therapy

Breastfeeding

22 17

Health check-ups

Better coverage of basic services

18 Child mortality

(under age 5) 15 Infant mortality (under age 1)

(Deaths per 1,000 live births) 1990

1995

2000

2005

2010

2013

IN 2013 THERE WERE

196 000 DEATHS

1 CHILD DIES EVERY 3 MINUTES

AMONG CHILDREN AGED UNDER 5 YEARS IN THE REGION

SOMEWHERE IN LATIN AMERICA AND THE CARIBBEAN

60% OF THESE DIE BEFORE AGE 1

50% OF THESE DIE IN THE FIRST 28 DAYS

Pneumonia Diarrhoea

NEONATAL PERIOD Premature births Birth asphyxia Infections

STRENGTHEN HEALTH SYSTEMS

THE FIRST 48 HOURS AFTER BIRTH ARE THE MOST CRITICAL TIME FOR NEWBORN SURVIVAL SAFE BIRTH AND EFFECTIVE NEONATAL CARE

THE REGION ERADICATED MEASLES ALMOST COMPLETELY IN THE EARLY 2000s, THANKS TO NATIONAL CHILD VACCINATION PROGRAMMES AND CAMPAIGNS Despite this progress, cases originating in other parts of the world have caused isolated outbreaks in some countries in Latin America CONTINUE EFFORTS TO MAINTAIN COVERAGE LEVELS, ESPECIALLY IN MORE VULNERABLE AREAS This infographic contains the traditional description of the Goal and its indicators, for reference. However, the information is organized differently to show the targets in a systemic manner, highlighting the main achievements and challenges, on the one hand, and the main issues and links with other dimensions of development, on the other. Source: Economic Commission for Latin America and the Caribbean (ECLAC), 2015.

Goal 5 Improve maternal health

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Progress towards the targets Figure 5.1 Latin America and the Caribbean: official indicators for Millennium Development Goal 5 Target 5A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio Indicator 5.1 Maternal mortality ratio (Rate per 100,000 live births)

Indicator 5.2 Proportion of births attended by skilled health personnel (Percentages)

450 400 350 300

1990 Target 1990

2013

250

2014

200 150 100

50 0

Developed Latin Latin America The World Developing countries America and the Caribbean countries Caribbean

Latin America and the Caribbean

World

Developing countries

Target 5B: Achieve, by 2015, universal access to reproductive health Indicator 5.4 Adolescent birth rate (Number of live births per 1,000 women aged between 15 and 19 years and percentage reduction)

Indicator 5.3 Contraceptive prevalence rate (Percentages) 2013 Latin America

2012

Reduction 1990-2012

Latin America and the Caribbean

Developed countries

World

The Caribbean

Indicator 5.5 Antenatal care coverage, at least one visit and at least four visits (Percentages) 1990 2014

At least one visit

1990 2014

At least four visits 25 20

5 Latin America and the Caribbean

Developing countries

Developed World Developing The Latin America Latin countries Caribbean and the America countries Caribbean

Indicator 5.6 Unmet demand for family planning (Percentages)

Developing countries

100

1990

2013

Developed Latin Latin America World Developing The countries America and the countries Caribbean Caribbean

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of United Nations, The Millennium Development Goals Report 2015, statistical annex, New York, 2015.

MDG 5

Improve maternal health

Millennium Development Goal 5 focuses on the need to reduce maternal mortality and improve the populationâ&#x20AC;&#x2122;s access to sexual and reproductive health care as a key part of womenâ&#x20AC;&#x2122;s right to health. By 2013, no region in the world had progressed enough to meet the target of a three-quarters reduction in maternal mortality from 1990 levels. According to official data on the Millennium Development Goal indicators available to the United Nations, Latin America and the Caribbean overall had a maternal mortality ratio of 85 maternal deaths for every 100,000 live births, equivalent to a 39% reduction on 1990 levels, far short of the target of a 75% reduction. The still very high rate of maternal mortality, the high levels and scant reduction of adolescent fertility and poor antenatal care coverage in some countries in the region illustrate the various challenges that Latin America and the Caribbean still faces in order to improve womenâ&#x20AC;&#x2122;s sexual and reproductive health.

Figure 5.2 Latin America and the Caribbean: proportion of births attended by skilled health personnel, adolescent birth rate and maternal mortality rate, 1990, 2000 and 2013 Proportion of births attended by skilled health personnel (Percentages)

81%

88%

92%

Adolescent birth rate

(Number of live births per 1,000 adolescent women aged between 15 and 19 years)

85.8

86.2

75.5

Maternal mortality rate

350

(Rate per 100,000 live births)

Latin America Latin America and the Caribbean The Caribbean

300

300 250

230

200 150

190 130

140 98

100

110 77

50 0 1990

2000

2013

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, on the basis of United Nations, Millennium Development Goals indicators database [online] http://mdgs.un.org/unsd/mdg/Default.aspx.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

The figures mentioned above are calculated by the Maternal Mortality Estimation Inter-agency Group, in accordance with international standards established to ensure comparability between countries. Since some controversy has attached to this indicator, particularly in Latin American and Caribbean countries, the figure below also shows the latest available figures â&#x20AC;&#x201D;which are not comparable between countries and are given here for illustrative purposes onlyâ&#x20AC;&#x201D; reported by national ministries and secretariats of health to the Pan American Health Organization (PAHO) and available in PAHO online databases. Even in the PAHO figures, however, which are in many cases lower than those estimated by the Inter-agency Group, maternal mortality levels have not come down enough to meet the target set in Millennium Development Goal 5.

Figure 5.3 Latin America and the Caribbean (29 countries): maternal mortality rate according to the Pan American Health Organization, latest year for which data are available (Maternal deaths per 100,000 live births)

Argentina (2012)

Haiti (2013)

Barbados (2012)

Honduras (2010)

Bahamas (2011)

Jamaica (2012)

Belize (2012)

Mexico (2012)

Brazil (2012)

Nicaragua (2013)

Colombia (2011)

Panama (2012)

Costa Rica (2013)

Paraguay (2012)

Cuba (2013)

Peru (2011)

Chile (2012)

Saint Lucia (2012)

Dominican Rep. (2013)

109

157

Saint Vincent and the Grenadines (2013) 115

Ecuador (2012)

Suriname (2011)

El Salvador (2013)

Trinidad and Tobago (2010)

Grenada (2013)

Uruguay (2013)

Venezuela (Bol. Rep. of) (2011)

Guatemala (2012)

116

Guyana (2012)

123 Source: Pan American Health Organization (PAHO).

Maternal deaths are generally considered to be preventable and are associated with complications arising during pregnancy and birth, as well as unsafe abortions, especially in the most vulnerable populations that lack access to contraceptive or pregnancy termination services or emergency obstetric care. Gender-based violence is also an indirect cause of death for women during pregnancy, childbirth or the puerperium (ECLAC, 2015).

MDG 5

Improve maternal health

One of the key strategies for reducing mortality is ensuring the availability of adequate antenatal care and guaranteeing that births will be attended by skilled health personnel. The proportion of births attended by skilled health personnel in Latin America and the Caribbean has increased over 1990 levels. In 2014, 92% of births were attended by a skilled professional, equivalent to an 11 percentage point rise since 1990. Most countries reported a rise in levels of care in the latest available data: for 18 countries in the region the indicator exceeds 95%; for 10 it varies between 90% and 95%; in Honduras, Nicaragua and the Plurinational State of Bolivia it varies between 80% and 90%; and in Guatemala and Haiti it remains below 70%. Coverage of antenatal care in Latin America and the Caribbean is high compared with other regions. Of women aged 15 to 49 years having given birth to a live child in 2014, 97% received antenatal care from skilled health personnel (doctors, nurses and midwives) at least once during their pregnancy. According to the latest available data, coverage of this type of care is over 90% in most countries. However, a single session of prenatal care is now considered insufficient and the World Health Organization (WHO) recommends a minimum of four visits during pregnancy, to increase the probability of receiving effective care that could be vital for the health of mother and child (ECLAC, 2013). Furthermore, the limited progress in reducing maternal mortality in the region despite the high rates of antenatal care and births attended by skilled personnel suggests that thought needs to be given to the quality of care and to measures geared towards making the coverage achieved more effective. Another relevant factor for progressing towards women’s autonomy, furthering the exercise of reproductive rights and improving reproductive health, including the prevention of maternal deaths, is access to fertility control, especially in the adolescent population. The region still lacks adequate and timely policies and actions to reduce its high rates of adolescent fertility. Access to fertility control has increased substantially in Latin America and the Caribbean in the past 20 years, and this has been reflected in a reduction in unmet demand for family planning. Nevertheless, well documented gaps remain in this regard, to the detriment of poor and vulnerable population groups (ECLAC, 2013), and the region still faces a considerable challenge with respect to this target. Contraceptives use is particularly low among adolescents, who encounter a number of barriers to universal and timely access to these resources. The limited use of contraceptive measures in this group is reflected in a high adolescent fertility rate (75.5 live births to mothers aged between 15 and 19 years per 1,000 women in that age group), exceeded only by Sub-Saharan Africa (117.8‰). It is also well documented that the highest rates of unplanned fertility occur in this age group, indicating an obvious problem of exercise of reproductive rights. Accordingly, given the link between adolescent fertility and other key items on the regional agenda —such as tackling poverty reproduction and inequality— a crucial challenge for Latin America and the Caribbean is to provide sexual and reproductive health services targeting adolescents, in order to enable them to exercise their reproductive rights.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 5.4 Latin America and the Caribbean (21 countries): births attended by skilled health personnel and antenatal care coverage (at least one visit and at least four visits), around 2014 (Percentages)

Antenatal care coverage (Percentages)

Proportion of births attended by skilled health personnel (Percentages)

At least four visits

At least one visit

91.2

Suriname (2010)

37.3

Haiti (2012)

84.8

Bolivia (Plur. State of) (2012)

98.2

Uruguay (2013)

96.2

Belize (2011)

98.0

Bahamas (2013)

98a

99.1

Jamaica (2011)

92.4

Guyana (2014)

88.0

Nicaragua (2012)

91.6

Panama (2013)

99.1

Colombia (2013) (2010)

98.1

Brazil (2012)

82.9

Honduras (2012)

97.0

Argentina (2013) (2012)

98.0

El Salvador (2014)

99.1

Costa Rica (2011)

98,7

Saint Lucia (2012)

96.0

Mexico (2012)

97.7

Dominican Rep. (2014)

90.0

Peru (2014)

99.4

Cuba (2014)

92.0

Latin America and the Caribbean (2014)

77 83

91 95 93 97 98b 97 98 96 98 97

97 98 99 97

89 0

100

MDG 5

Improve maternal health

Infographic 5.1 Latin America and the Caribbean: maternal health and the Millennium Development Goals Target 5A: Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio BIRTH ATTENDANCE BY SKILLED HEALTH PERSONNEL HAS INCREASED IN THE REGION Proportion of birth attended by skilled health personnel

Adolescent fertility rate

MATERNAL MORTALITY REMAINS HIGH IN THE REGION

120

190 77 Deaths per 100,000

88% 92% Sub-Saharan Africa , 118

Latin America and the Caribbean, 76 Oceania, 59 Southern Asia, 50 Western and South-Eastern Asia, 45 Northern Africa, 37 Caucasus and Central Asia, 33

live births

THE CARIBBEAN

81%

100

Maternal mortality ratio

Deaths per 100,000 live births

2000 2014

Number of live children per 1,000 adolescent women aged 15-19 years

140

Maternal deaths are associated with complications during pregnancy, birth and puerperium

1990

20 0

LATIN AMERICA

Eastern Asia, 6 1990

2012

LATIN AMERICA AND THE CARIBBEAN HAS THE WORLDâ&#x20AC;&#x2122;S HIGHEST ADOLESCENT FERTILITY RATE AFTER SUB-SAHARAN AFRICA

PREVENT AND REDUCE ADOLESCENT PREGNANCY BROADEN ACCESS TO SEXUAL AND REPRODUCTIVE HEALTH CARE

Target 5B: Achieve, by 2015, universal access to reproductive health THE REGION HAS IMPROVED ANTENATAL CARE AND COMPARES WELL TO OTHER WORLD REGIONS IN THIS RESPECT 1990

Antenatal care coverage (at least one visit during pregnancy) 0

2000 2014 80

1990

Antenatal care coverage (at least four visits during pregnancy) 0

2000

100

2014 90

100

THE REGION HAS MADE PROGRESS REGARDING CONTRACEPTIVE USE AND IN MEETING FAMILY PLANNING NEEDS 80 70

72.9%

70.0%

72.7%

Contraceptive prevalence rate

61.3%

60 50 40

Latin America and the Caribbean

30 20

17.2%

Unmet need for family planning

12.7%

10.6%

10.7%

2000

2010

2013

10 0

1990

Goal 6 Combat HIV/AIDS, malaria and other diseases

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Progress toward the targets Figure 6.1 Official indicators for Millennium Development Goal 6 Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS Indicator 6.1 HIV prevalence among population aged 15-49 years (Percentages)

1.2

1990 Prevalence 2013 Incidence 2013 Estimation range

1.0 0.8

Target 6B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it Indicator 6.5 Proportion of population with advanced HIV infection with access to antiretroviral drugs Variation 2010-2013 (Percentage points)

0.12

0.1

0.08

0.6

0.06

0.4

0.04

0.2

0.02

Latin America Latin Developed World Developing The countries Caribbean and the America countries Caribbean

-20

Latin Latin America The America and the Caribbean Caribbean

World

Developing countries

Â&#x192;Â&#x192; Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases Indicator 6.6 Incidence and death rates associated with malaria, 2015 (Cases reported per 1,000 inhabitants)

Indicator 6.9 Incidence, prevalence and death rates associated with tuberculosis, 2013 (Number of new cases, existing cases and deaths per 100,000 people) 200

Oceania 154

Sub-Saharan Africa 240

West Asia 25

Prevalence

Death rates

160

120

2012

1994

20 Developing countries World The Caribbean

South Asia 18

Latin America and the Caribbean 8

Incidence

Indicator 6.10 Proportion of tuberculosis cases detected and cured under directly observed treatment short course (Percentages)

South-East Asia 26

Developed Latin Latin America The World Developing countries America and the Caribbean countries Caribbean

Latin America and the Caribbean Latin America Developed countries 0

8085

100

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, on the basis of United Nations, The Millennium Development Goals Report 2015, statistical annex, New York, 2015.

Millennium Development Goal 6 is aimed at improving the health status of the population, particularly by stopping the spread of HIV and expanding treatment, and reducing and preventing the spread of infectious diseases. Latin America and the Caribbean has made great progress in both areas, although these advances have been uneven between and within subregions and countries.

MDG 6

Combat HIV/AIDS, malaria and other diseases

Stopping the spread of HIV and expanding its treatment According to estimates by the Joint United Nations Programme on HIV/AIDS (UNAIDS, 2015), HIV was present in 0.5% of the adult population of Latin America and the Caribbean in 2014, representing almost 2 million individuals infected. The epidemic is concentrated in urban areas, along trade routes and in commercial ports. It is estimated that 100,000 people were infected with HIV in Latin America and the Caribbean in 2014, including more than 2,000 children aged under 14 years. In Latin America, the epidemic especially affects men who have sex with other men, and transsexual women. The young adult population is one of the most vulnerable to HIV infection: at least one third of new infections are among 15-to-24-year-olds. These cases are also concentrated in the most populous countries, such as Brazil, Mexico, Colombia, Argentina and the Bolivarian Republic of Venezuela, although these countries have a relatively low prevalence of HIV in the general population. In the Caribbean subregion the HIV epidemic affects men and women equally but is particularly prevalent among sex workers and is largely concentrated in Haiti and Jamaica, with a prevalence of close to 2% in both countries. Although HIV prevalence in Latin America (0.4%) is below the global average, it is higher in the Caribbean subregion, at 1.1%, which is thus the subregion with the second highest prevalence of HIV in the world, after Sub-Saharan Africa. However, while prevalence in Latin America has remained relatively low and stable in recent decades, the Caribbean reduced HIV incidence by 50% —more than any other region— between 2000 and 2014. Despite this progress, the Caribbean has met with less success in the goal of reducing AIDS-related deaths. Antiretroviral treatment is one of the measures with the greatest impact on HIV. According to the Pan American Health Organization (PAHO), Latin America and the Caribbean is a world leader in the supply and expansion of antiretroviral treatment. All the region’s countries provide free services for the care and treatment of HIV infection, with national and international funding (PAHO, 2013a). In 2012, 75% of HIV carriers with advanced infections had access to antiretroviral medication. In relation to the entire infected population, regardless of the disease’s progress, antiretroviral therapy coverage stood at 44% in 2013, rising by 10 percentage points in just two years and outperforming all other regions. The Caribbean, in particular, has been one of the most successful subregions in expanding antiretroviral treatment, increasing coverage of the total infected population from 26% to 41% between 2010 and 2013. High coverage of prevention of mother-to-child transmission (PMTCT) has helped to reduce the rate of infection (UNAIDS, 2015). The outlook is not equally promising in all countries or all population groups, as there are sharp disparities in access to therapy. Countries must thus continue to close the gaps in access and treatment by ensuring equity in service provision and reducing the heavy dependence on international funding mechanisms. Greater commitment is needed from the governments of the region to achieve sustainable funding for antiretroviral treatments (PAHO, 2013a).

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 6.2 Latin America and the Caribbean: incidence and prevalence of HIV among population aged 15 to 49 years and AIDS-related deaths, 1990-2014

HIV incidence among the population aged 15 to 49 years

(Number of new infections per 100 persons aged between 15 and 49)

0.3

Average Latin America

0.25

The Caribbean

Estimation range

0.2 0.15 0.1 0.05

2003

2004

2005

2006

2007

2008

2009

2010

2011

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2003

2004

2005

2006

2007

2008

2009

2010

2011

2012

2013

2014

2002

2002 2002

2013

2001

2001 2001

2012

2000

2000 2000

1999

1999 1999

1998

1998 1998

1997

1997 1997

1996

1996 1996

1995

1995 1995

1994

1994 1994

1993

1992

1991

1990

HIV prevalence among the population aged 15 to 49 years (Percentages)

2 1.5 1

1993

1992

1991

1990

0.5

AIDS-related deaths (Absolute numbers)

140 000 120 000 100 000 80 000 60 000 40 000

1993

1992

1991

1990

20 000

Source: Joint United Nations Programme on HIV/AIDS (UNAIDS), â&#x20AC;&#x153;How AIDS changed everything. MDG 6: 15 years, 15 lessonâ&#x20AC;?, 2015 [online] http://www.unaids.org/sites/default/files/media_asset/MDG6Report_en.pdf.

MDG 6

Combat HIV/AIDS, malaria and other diseases

Figure 6.3 World regions: proportion of HIV carriers with access to antiretroviral medication, 2010 and 2013 (Percentages)

Latin America

Latin America and the Caribbean

The Caribbean

World

Sub-Saharan Africa

Developing regions 17

South Asia

East Asia 21

West Asia

North Africa

19 19

Caucasus and Central Asia 0

2010 Average 2013

Estimation range

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of United Nations, The Millennium Development Goals Report 2015, statistical annex, New York, 2015.

Reduction and prevention of infectious diseases Malaria has been significantly reduced in the region and, according to projections, the rate of new infections will be 8 per 1,000 inhabitants in Latin America and the Caribbean in 2015. Despite these favourable figures, data from PAHO show that until 2012, almost half a million cases were reported annually, concentrated in a small group of countries (PAHO, 2014). The Bolivarian Republic of Venezuela, Brazil, Colombia, Guyana, Haiti and Peru reported rates of over 10 cases per 1,000 inhabitants in 2012. The infection rate in Guyana is particularly worrying, with 123 cases per 1,000 inhabitants in 2012 and a mortality rate of 24 deaths per 100,000, far above the levels in the rest of the region. Latin America and the Caribbean has met the target of stopping and reversing the incidence of tuberculosis by 2015 (50% reduction of prevalence and mortality), and the prevalence of tuberculosis was lowered by 57% between 1990 and 2013. Nevertheless, tuberculosis remains a public health issue in the region, and the second most common cause of death from infectious disease (PAHO, 2013b). According to estimates by the World Health Organization (WHO), the region had an incidence rate of 44 and a prevalence rate of 58 per 100,000 inhabitants in 2013, with large differences between countries. Prevalence rates are over 100 in Guatemala, Guyana, Peru and the Plurinational State of Bolivia, and over 200 in Haiti. Conversely, nine Caribbean countries have prevalence rates below 10. Notably, however, the indicators analysed are highly sensitive to relatively minor changes in the number of individuals infected in very small populations, as could be the case in most Caribbean countries. 53

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 6.4 Latin America and the Caribbean: incidence, prevalence and mortality associated with tuberculosis, 1990, 2002 and 2013 (Number per 100,000 persons)

MORTALITY

8.3

4.9

2.7

160 140

PREVALENCE

137

120 100 80

INCIDENCE

76 84

60 56

20 0 1990

2002

2013

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, on the basis of information from the World Health Organization (WHO).

Tuberculosis control programmes are crucial in the treatment of infected patients and the prevention of related deaths. Significant challenges remain for Latin America in this regard: in 2013, only 77% of cases were detected with directly observed treatment short course (DOTS) and 74% of diagnosed cases were treated successfully. The region must continue progressing in this direction in order to meet the global target of 85%. On one hand, the region must continue making efforts to eradicate preventable contagious diseases such as malaria and tuberculosis, and, on the other, it must tackle chronic non-communicable diseases, which carry a high mortality rate and create heavy burdens on health services through recurring acute episodes and growing disabilities. Latin America and the Caribbean should also focus its efforts on the prevention and treatment of diseases caused by external causes and aggravated by rapid urbanization processes (ECLAC, 2013).

MDG 6

Combat HIV/AIDS, malaria and other diseases

Figure 6.5 Latin America and the Caribbean (41 countries): tuberculosis prevalence and percentage reduction in tuberculosis prevalence and related mortality, 1990 and 2013 (Number of cases per 100,000 persons and percentages)

Tuberculosis prevalence rate

Percentage reduction in tuberculosis prevalence and tuberculosis-related mortality between 1990 and 2013 Montserrat Saint Kitts and Nevis Puerto Rico Barbados British Virgin Islands Dominica Grenada Saint Lucia Jamaica Bahamas United States Virgin Islands Cayman Islands Cuba Costa Rica Aruba Chile Antigua and Barbuda Turks and Caicos Islands Trinidad and Tobago Mexico Argentina Uruguay Belize Saint Vincent and the Grenadines Colombia El Salvador Venezuela (Bol. Rep. of) Suriname Anguilla Brazil Paraguay Panama Nicaragua Honduras Dominican Rep. Ecuador Guatemala Guyana Peru Bolivia (Plur. State of) Haiti Latin America and the Caribbean

400

350

300

250

200

150

100

1990

2013

-40 -20 0 20 40 50 60 Tuberculosis prevalence Tuberculosis-related mortality

100

Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, on the basis of information from the World Health Organization (WHO).

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Infographic 6.1 Latin America and the Caribbean: VIH/AIDS, malaria and tuberculosis and the Millennium Development Goals

Target 6A: Have halted by 2015 and begun to reverse the spread of HIV/AIDS NEW INFECTIONS OF HIV AND AIDS-RELATED DEATHS HAVE COME DOWN SLIGHTLY IN THE REGION: THE EPIDEMIC REMAINS CONCENTRATED IN SPECIFIC POPULATION GROUPS THAT ENCOUNTER DIFFICULTY IN ACCESSING ADEQUATE MEDICAL CARE

PERSONS LIVING WITH HIV IN 2014

280,000

1.7 MILLION

THE CARIBBEAN

LATIN AMERICA

PEOPLE

IN THE CARIBBEAN, THE EPIDEMIC AFFECTS MEN AND WOMEN EQUALLY

PEOPLE

IN LATIN AMERICA THERE ARE 11 MEN INFECTED WITH HIV FOR EVERY 5 WOMEN INFECTED

THE CARIBBEAN IS THE SUBREGION WITH THE SECOND HIGHEST PREVALENCE OF HIV IN THE WORLD, AFTER SUB-SAHARAN AFRICA

LATIN AMERICA AND THE CARIBBEAN IS A

Target 6B: Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it

WORLD LEADER THE SUPPLY AND EXPANSION OF ANTIRETROVIRAL TREATMENT

THE REGION HAS MADE PROGRESS IN CONTROLLING PREVENTABLE CONTAGIOUS DISEASES SUCH AS MALARIA AND TUBERCULOSIS

Target 6C: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases

MORTALITY 8.3 PREVALENCE 137

MALARIA HAS BEEN SIGNIFICANTLY REDUCED IN THE REGION, BUT ALMOST HALF A MILLION CASES ARE STILL REPORTED EVERY YEAR, MOSTLY IN A SMALL GROUP OF COUNTRIES

Cumulative number of cases

4.9

INCIDENCE 84 New cases

58 2.7 44

1.2 million

427,000

2000

2013

Per 100 000 persons

1990

2002

2013

INCIDENCE, PREVALENCE AND DEATH RATES ASSOCIATED WITH TUBERCULOSIS HAVE ALL FALLEN

CONFIRMED MALARIA CASES

IN LATIN AMERICA AND THE CARIBBEAN THE EPIDEMIOLOGICAL PROFILE IS CHARACTERIZED BY A TRIPLE DISEASE BURDEN

Infectious diseases

Morbidity due to external causes

TRIPLE DISEASE BURDEN

Life styles, unhe althy c o nsumption a

izati o n R a pid u rban

UNIVERSAL ACCESS TO GOOD-QUALITY HEALTH SERVICES

abit s ing h

Non-communicable chronic diseases

CONTROL OF NON-COMMUNICABLE CHRONIC DISEASES

Goal 7

Ensure environmental sustainability

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 7.1 Latin America and the Caribbean: official indicators for Millennium Development Goal 7 Target 7A: Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources Indicator 7.2 Total carbon dioxide emissions (Millions of tons)

Indicator 7.1 Proportion of land area covered by forest. Variation 1990-2010 (Percentage points) 20

35 000

30 000 25 000

10 5 0 -5

World Developed countries Developing countries Latin America and the Caribbean

Latin America Developing and the Latin World countries Caribbean America The Developed Caribbean countries

20 000 15 000 10 000 5 000

-10

-15

1990

Indicator 7.3 Consumption of ozone-depleting substances (Tons of ozone-depleting potential (ODP)) 2 000

Developing countries World Latin America and the Caribbean

1 600

800

400

20 0 1990

2000

2010

100

1986

2005

Indicator 7.5 Proportion of total water resources used (Percentages)

1 200

2000

Latin Developed America countries

2013

World Developing The countries Caribbean

Target 7.B: Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss Indicator 7.6 Proportion of terrestrial and marine areas protected (Percentages)

Indicator 7.7 Proportion of species threatened with extinction (Percentage of species not expected to become extinct in the near future) 96

1990

2014

Latin America

2000

2012

Developed Latin America Developing and countries countries the Caribbean

World

92 90

Developed countries

Developing countries

4 2

The Caribbean

0 0

1990

MDG 7

Target 7C: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation Indicator 7.8 Proportion of population using an improved drinking water source (Percentages) 1990

2015

Target 7D: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers

Indicator 7.9 Proportion of population using an improved sanitation facility (Percentages) 1990

Target

2015

Target

Indicator 7.10 Proportion of urban population living in slums (Percentages) 50

100

Developed Latin America countries and the Caribbean

World

Developing countries

Developed Latin America countries and the Caribbean

Ensure environmental sustainability

World

Developing countries

Developing countries Latin America and the Caribbean 1990

2000

2014

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of United Nations, The Millennium Development Goals Report 2015, statistical annex, New York, 2015.

In the past decade, several countries of the region have made significant progress in developing environmental legislation and creating institutions to oversee and manage environmental issues. However, the efforts made by Latin America and the Caribbean have not been sufficient to ensure environmental sustainability and the region faces significant challenges to achieving the proposedÂ targets. Environmental considerations have still not been mainstreamed into sectoral policies and the work of institutions not specifically dedicated to such matters. The impact of environmental policy is often cancelled out by the effects of industrial, urban development, energy and infrastructure development policies, as well as a system of incentives which are the result of a combination of fiscal policy and industrial development initiatives that fail to take the environmental externalities of economic activity properly into account. In addition, budget allocations do not cover the full cost of implementing measures set out in these policies and laws.

Biodiversity and environmental resources Thus, while the countries of the region have invested in reducing biodiversity loss and damage to ecosystems (for example by expanding protected areas), with some notable successes (particularly with regard to ozone-depleting emissions), they still struggle with high deforestation rates, loss of habitat and biodiversity, and increasing carbon dioxide emissions, among other environmentally harmful issues. The consumption of ozone-depleting substances, measured in tons of ozone-depleting potential, dropped by 95% between 1990 and 2013, with most countries in the region achieving a decrease ofÂ over 90%.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 7.2 Latin America and the Caribbean: consumption of ozone-depleting substances, 2000-2014 (Tons of ozone-depleting potential (ODP) and percentage of global consumption in 2014)

Tons o f ozo ne-

(OD ential g pot letin dep

2000

of Latin America and the Car ibbe Share an i n

glo bal co

tion mp nsu

29 435

3 752 99

Latin America The Caribbean

ting substances (ODS) -deple zone of o

2013

13.2%

1 669

The consumption of ozone-depleting substances actually increased in some countries in the early 1990s, but this trend that was reversed at the beginning of 2000-2014, when consumption was reduced considerably. With the exception of Anguilla, Aruba, Barbados, Dominica, Guadeloupe, Haiti, Martinique, Saint Kitts and Nevis, and Saint Vincent and the Grenadines, all the countries increased their proportion of protected terrestrial and marine areas by more than 5% between 1990 and 2014, according to the data available on the United Nations official website for monitoring the Millennium Development Goals. In fact, some countries have more than doubled the proportion of protected areas with respect to 1990 (Antigua and Barbuda, the Bahamas, Brazil, Chile, Cuba, the Dominican Republic, El Salvador, Guyana, Jamaica, Mexico, Montserrat, Nicaragua, Paraguay, Peru, the Plurinational State of Bolivia, and Suriname). The region as a whole saw a 171% increase, with the proportion of protected areas rising from 4.9% in 1990 to 13.3% in 2014.

MDG 7

Ensure environmental sustainability

Figure 7.3 Latin America and the Caribbean (41 countries and territories): proportion of terrestrial and marine areas protected, 1990-2014 (Percentages)

Bahamas

Turks and Caicos Islands

Mexico

Saint Kitts and Nevis Antigua and Barbuda

Montserrat Belize

Cuba Guadalupe

Haiti Dominican Rep.

El Salvador

Guatemala

British Virgin Islands

Honduras

Cayman Islands

Martinique

Dominica Jamaica

United States Virgin Islands Puerto Rico

Costa Rica

Saint Vincent and the Grenadines

Saint Lucia

Grenada

Trinidad and Tobago

Aruba Guyana

Nicaragua Panama

Suriname

Venezuela (Bol. Rep. of) Colombia

Ecuador

Brazil

Bolivia (Plur. State of) Peru

1990

13.3

2014

Paraguay

5.2 Chile

2.9

Uruguay

0.9 The Caribbean

Latin America

Argentina

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Management failures in these protected areas combined with the need for additional conservation measures has led to the further loss of habitat and much of the regionâ&#x20AC;&#x2122;s biodiversity. Millions of hectares of tropical forest are cleared every year to make way for agriculture and unsustainable forest plantations. The region as a whole saw a 9% reduction in the proportion of its land area covered by forest, with only Chile, Costa Rica, Cuba, Saint Lucia, Saint Vincent and the Grenadines, and Uruguay showing clear signs of increasing their wooded areas, according to available data for 1990 and 2010. This situation is compounded by the regionâ&#x20AC;&#x2122;s increasing carbon dioxide emissions as a result of human activities in sectors such as energy, industry, agriculture and waste treatment (excluding CO2 removed by carbon sinks). This is evidenced in both total and per capita emissions, which reached 2.9Â tons of CO2 per capita per year for the region as a whole in 2010. This represents a 27% increase on 1990 per capita emissions. Aruba, the Bahamas, Colombia, Jamaica and Suriname are the only countries in the region to have reduced per capita emissions between 1990 and 2011. The smallest yearly per capita consumptions were registered by Guatemala, Haiti, Nicaragua and Paraguay, at under 1 ton. In 2012, total greenhouse gas emissions for the region, including emissions from energy use, land use change and deforestation, and other gases besides CO2 , amounted to 7.7 tons per capita, compared to a global average of 6.7 tons per capita. The long-term trend in emissions shows that developed countries are making structural changes to patterns of energy production and consumption and are relocating highly polluting segments of their industries, mainly to China and other Asian countries. Emission patterns in Latin America and the Caribbean do not, however, reflect clear signs of structural change in patterns of energy production and consumption or land use changes.

MDG 7

Ensure environmental sustainability

Figure 7.4 Latin America and the Caribbean (33 countries and territories): proportion of land area covered by forest and total and per capita carbon dioxide emissions (Percentages, thousands of tons of CO2 and tons per capita)

5 4 3

Mexico

2 1 0

Colombia

Belize

1 2

Guatemala

Honduras

El Salvador

0 1

4 3

Venezuela (Bol. Rep. of)

2 1

Nicaragua

Costa Rica

Guyana

2 1

0 5

Panama

Suriname

3 2

Ecuador

2 0

0 3

Peru

2 1

Brazil 2

Bolivia (Plur. State of)

1 0

Paraguay 5 4

Uruguay

3 2

0 3 1

Chile

0 5

4 3

Argentina

2 1 0

Percentage of surface area covered by forest, 2010 CO2 emissions

0-19

20-39

Thousands of tons, 2011

40-59

60-79

80-100

=10,000

Tons per capita, 1990, 2000, 2011

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 7.4 (concluded) 38

25 8 7

6 5

Dominican Rep.

3 1

Cuba

Bahamas

Antigua and Barbuda

1 0

Haiti

Jamaica

1 0

Guadeloupe Martinique

2 0

Saint Lucia 0 Saint Vincent and the Grenadines

3 1

Barbados

Grenada

Trinidad and Tobago

Drinking water and sanitation facilities The region as a whole has halved the proportion of people without sustainable access to safe drinking water, with coverage increasing from 85% in 1990 to 95%, according to 2015 estimates by the World Health Organization (WHO)/United Nations Childrenâ&#x20AC;&#x2122;s Fund (UNICEF) Joint Monitoring Programme for Water Supply and Sanitation. The regional picture is quite mixed, however: 27 countries have met the target, while 11 have not. Nevertheless, the Latin American and Caribbean region has high levels of access to safe drinking water. Most countries have high access rates, with over 90% coverage. The

MDG 7

Ensure environmental sustainability

Dominican Republic, Ecuador, Nicaragua and Peru have between 80% and 90% coverage; while the situation is worst in Haiti, where only 58% of the population has access to safe drinking water. People living in rural areas face even greater difficulties, given that 80% of the rural population in the Bolivarian Republic of Venezuela, Colombia, Ecuador, Haiti, Nicaragua, Peru and the Plurinational State of Bolivia lack sustainable access to drinking water. Inequality is also evident in the differences between income quintiles, with regard to both access to drinking water and the quality of water considered safe to drink.

Figure 7.5 Latin America and the Caribbean: proportion of population using an improved drinking water source, 1990-2015 (Percentages)

100

90 80

95 85

70 60

50 40 30 20 10 National

Urban

Rural

0 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Source: Economic Commission for Latin America and the Caribbean (ECLAC), CEPALSTAT database, on the basis of United Nations, Millennium Development Goals indicators database [online] http://mdgs.un.org/unsd/mdg/Default.aspx.

With regard to the use of improved sanitation facilities, the outlook is not so bright. In 2015, the Latin American and Caribbean region overall was very close to achieving the target of halving the proportion of the population without access to such services compared to 1990 levels, with around 17% of the population not covered. Most countries are close to the regional average: 19 countries have failed to reduce their 1990 levels by half or more, while 17 have met the target. Although in a number of countries much of the population has access to sanitation facilities, significant challenges remain in this regard in El Salvador, Guatemala, Nicaragua, Panama, Peru, Saint Vincent and the Grenadines, and Suriname, where the proportion is between 60% and 80%, and in Haiti and the Plurinational State of Bolivia, where it is less than 50%. As with sustainable access to safe drinking water, fewer people from rural areas and the lower income quintiles have access to improved sanitation facilities. Only 64% of those living in rural areas of Latin America had access to such facilities in 2015, and the figure is less than 50% in Guatemala, Haiti and the Plurinational State of Bolivia.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 7.6 Latin America and the Caribbean (36 countries and territories): proportion of population using an improved sanitation facility, 1990-2015 (Percentages and percentage points of progress toward the target)

Target

1990

2015

Paraguay

Honduras

Ecuador

Nicaragua

El Salvador

Peru

Bolivia (Plur. State of)

Mexico

Antigua and Barbuda

Guatemala

Barbados

Brazil

Panama

Belize

Chile

Venezuela (Bol. Rep. of)

Saint Lucia

Colombia

Cuba

Dominican Rep.

Haiti

Argentina

Guyana

Anguilla

Costa Rica

Uruguay

Bahamas

Jamaica

Trinidad and Tobago

Cayman Islands

Puerto Rico

United States Virgin Islands

British Virgin Islands

Grenada

Aruba

Suriname

Latin America and the Caribbean

83 Percentage points short of the target

Starting point in 1990 Progress achieved by 2015

20 Slipped back

10 Virtually unchanged

Percentage points past the target 10 Progress made but still short of the target

30 Target achieved

MDG 7

Ensure environmental sustainability

Infographic 7.1 Latin America and the Caribbean: environmental sustainability and the Millennium Development Goals Target 7A: Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources THE REGION’S ECONOMY HAS BECOME MORE CARBON-INTENSIVE AND ITS CLIMATE VULNERABILITY HAS INCREASED LATIN AMERICA AND THE CARIBBEAN

Per capita greenhouse gas emissions are higher than the global average

Land use change and deforestation account for a fifth (21%) of all greenhouse gas emissions in the region, compared with around 5% for the planet overall

WORLD AVERAGE

7.6

6.6

TONS PER CAPITA

The region overall has seen a 9% reduction in the proportion of its land area covered by forest and its CO2 emissions are rising

21%

1 800 000

1 600 000

Emissions from land use change and deforestation

1 400 000 1 200 000

1 000 000

800 000 600 000

400 000

200 000

1990

2000

2010

Proportion of land area covered by forest

THE PROPORTION OF TERRESTRIAL AND MARINE AREAS PROTECTED HAS RISEN

Lat in

Share of

3 752

Latin America

The Caribbean

13.2%

in g lob

1990

2000

ces stan sub

29 435

the Caribbean

tion of ozone-dep ump leti ng ons al c

2013

a and eric Am

MANAGEMENT FAILURES IN PROTECTED AREAS AND THE NEED FOR ADDITIONAL CONSERVATION MEASURES HAVE LED TO FURTHER LOSS OF HABITAT AND MUCH OF THE REGION’S BIODIVERSITY

6.2%

9.9%

12.7%

9.0%

14.5%

21.1%

Proportion of protected terrestrial areas

THE REGION HAS REDUCED ITS CONSUMPTION OF OZONE-DEPLETING SUBSTANCES

Proportion of protected marine areas

tial poten ting ple

Tons of ozo ne-d e 2000

Target 7B: Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss

CO2 emissions (thousands of tons)

2012

1 669

Target 7C: Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation Proportion of population using an improved drinking water source 1990 1990

2015

95%

Target 2015

Proportion of population using an improved sanitation facility

83%

64%

Only of people living in rural areas have improved sanitation facilities

33.7%

Target

THE REGION HAS ALMOST REACHED THE TARGET FOR USE OF IMPROVED SANITATION FACILITIES

THE REGION HAS REACHED THE TARGET FOR SUSTAINABLE ACCESS TO DRINKING WATER

THE PROPORTION OF THE POPULATION LIVING IN SLUMS IN THE REGION HAS FALLEN BY 40%

Target 7D: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers

20.5%

Proportion of the urban population living in slums 1990

2014

Goal 8 Develop a global partnership for development

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Progress towards the targets Figure 8.1 Official indicators for Millennium Development Goal 8 Target 8A: Develop further an open, rule-based, predictable, non-discriminatory trading and financial system. Includes a commitment to good governance, development and poverty reduction —both nationally and internationally. Target 8B: Address the special needs of the least developed countries. Includes: tariff and quota free access for the least developed countries’ exports; enhanced programme of debt relief for heavily indebted poor countries (HIPC) and cancellation of official bilateral debt; and more generous ODA for countries committed to poverty reduction. Target 8C: Address the special needs of landlocked developing countries and small island developing States (through the Programme of Action for the Sustainable Development of Small Island Developing States and the outcome of the twenty-second special session of the General Assembly). Target 8D: Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term.

2014

2010

2000

2013

0 1996

2011

2 2014

2010

2005

2000

1996

Developing countries Latin America and the Caribbean Least developed countries

20 15

Latin America Developing countries The Caribbean

2013

Agricultural products Clothing Textiles

12 10

Indicator 8.12 Debt service as a percentage of exports of goods and services (Percentages)

2009 2010

Indicator 8.7 Average tariffs imposed by developed countries on agricultural products and textiles and clothing from Latin America and the Caribbean (Percentages)

2009

2007

2005

20 2013

2000

100

1990

Indicator 8.6 Proportion of total developed-country imports (by value and excluding arms) from developing and least developed countries, admitted free of duty (Percentages)

2011

2005 2007 2009 2011 2013 2014

2000

1990

2009

2007

Percentage of bilateral ODA that is untied Billions of dollars

100

2005

120

Indicator 8.3 Proportion of bilateral official development assistance of OECD/DAC donors that is untied

Percentage of bilateral ODA Billions of dollars

2003

All developing countries Least developed countries

2001

160

Indicator 8.2 Proportion of total bilateral, sector-allocable ODA of OECD/DAC donors to basic social services

2003

Indicator 8.1 AOD Net ODA of OECD/DAC donors to all developing countries and the least developed countries (Billions of current dollars)

MDG 8

Develop a global partnership for development

Target 8E: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries. Target 8F: In cooperation with the private sector, make available the benefits of new technologies, especially information and communications. Indicator 8.15 Mobile-cellular subscriptions per 100 inhabitants

Indicator 8.14 Fixed-telephone subscriptions per 100 inhabitants 50 45 40 35 30 25 20 15 10 5 0

2000

2013

120

2000

2013

80 60

40 30

20 0

Developed countries Latin America World The Caribbean Developing countries

100

Developed Latin Latin America World Developing The countries America and the countries Caribbean Caribbean

Indicator 8.16 Internet users per 100 inhabitants

10 Developed Latin Latin America World Developing The countries America and the countries Caribbean Caribbean

1995

2000

2013

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of United Nations, The Millennium Development Goals Report 2015, statistical annex, New York, 2015.

Millennium Development Goal 8 covers several dimensions relating to the creation of a global partnership for development, such as official development assistance and increased tariff-free access for least developed countries’ exports, attending to the special needs of landlocked and island countries, debt sustainability and cooperation with the private sector to facilitate access to essential drugs and new information and communications technologies.

Official development assistance (ODA) In 2014, net official development assistance (ODA) provided to the world by the countries of the Development Assistance Committee (DAC) of the Organization for Economic Cooperation and Development (OECD) averaged just 0.29% of their gross national income (GNI), broadly in line with the average figure posted between 2000 and 2014, and significantly lower than the target of 0.7% agreed at the International Conference on Financing for Development, held in Monterrey, Mexico in 2002. In Latin America and the Caribbean, net ODA inflows in 2013 amounted to US$ 10.2 billion, or 0.18% of regional GNI. In keeping with the historical trend, most of these inflows (60%) came from DAC member countries in the form of bilateral ODA, with the United States traditionally the largest donor; the remainder was channelled through multilateral institutions (mainly the European Union, the Fund for Special Operations of the Inter-American Development Bank (IDB) —whose contributions have surged since 2010— and the International Development Association of the World Bank). Measured at current prices, total ODA received by the region has seen an uptrend which steepened in the late 2000s; however, relative to the region’s average GNI total ODA has fallen from over 1% in the early 1960s to less than 0.2% in the present decade.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 8.2 Net official development assistance received by Latin America and the Caribbean, 1990-2013 (Millions of current dollars and percentages of the region’s gross national income)

0.5

14 000

Bilateral (other countries)

12 000 10 000

0.4

8 000 0.3 6 000 0.2

Millions of current dollars

Bilateral (Development Assistance Committee countries) Multilateral Percentage of Latin American and Caribbean gross national income

4 000

0.1

2 000

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

1995

1994

1993

1992

1991

0 1990

Percentage of Latin American and Caribbean gross national income

0.6

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of figures provided by the Development Assistance Committee (DAC) of the Organization for Economic Cooperation and Development (OECD).

Compared with other developing regions, the Latin American and Caribbean share of ODA inflows diminished from 14% to 7.6% of the world total between 1960 and the start of the present decade. This region’s declining share may be explained by donor countries’ prioritization of low-income and least developed countries, to the detriment of middle-income economies —the majority classification in Latin America and the Caribbean. The pattern of allocating ODA on the basis of income level, with a bias towards lower-income countries, was further entrenched by the international cooperation system’s collective impetus in pursuit of the MDGs (ECLAC, 2012). A similar shift has been observed in the sectoral focus of ODA in the region, with reduced emphasis on production sectors and increased priority for social sectors. Compared with other external flows, and irrespective of their importance in qualitative terms, ODA inflows have been much smaller than those of foreign direct investment (FDI), remittances and portfolio investment. The relative size of ODA flows differs greatly from one country to the next: ODA and remittances together make up almost 100% of external financial flows into countries such as Haiti, but are dwarfed by FDI and portfolio flows in upper-middle-income countries such as Brazil.

MDG 8

Develop a global partnership for development

Figure 8.3 World regions: share of official development assistance disbursements, 1990-2013 (Moving five-year averages, percentages)

Percentages, 2013

Moving five-year averages, 1990-2013 50 45

Europe (5)

Others (19)

Africa (37)

35 30

Oceania (1)

25 20 15 10

Asia (29)

5 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013

Europe

Africa

Latin America and the Caribbean

Asia

Latin America and the Caribbean (9)

Oceania

Figure 8.4 Latin America and the Caribbean: official development assistance (ODA) inflows, 1990-2013 (Percentages)

A. External financial flows as a percentage of regional GDP 7 6 5 4 3 2 1

Net ODA inflows

Personal remittance inflows

Net direct investment flows

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

1995

1994

1993

1992

1991

-1

1990

Net portfolio flows

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Figure 8.4 (concluded)

B. Distribution of total regional ODA inflows by country income level 90 80 70 60 50 40 30 20 10

Least developed, low-income and lower-middle-income countries

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

1995

1994

1993

1992

1991

1990

0 Upper-middle-income countries

There is clearly some connection between countries’ income levels and their main type of external financing. For example, portfolio and FDI flows are much more abundant in the case of higher-income countries, while lower-income countries receive a much greater proportion of financing from ODA and migrant workers’ remittances. For that reason, ODA continues to be substantial for many Latin American and Caribbean countries, particularly those with the lowest income levels (such as Guyana, Haiti, Honduras and Nicaragua) and the smallest economies (such as Dominica, Grenada, Saint Kitts and Nevis and Saint Vincent and the Grenadines). It also warrants recalling that some of the region’s middle-income and upper-middle-income countries receive very little ODA but still have to deal with high levels of poverty and inequality in certain population segments, while other countries are extremely vulnerable to recurring natural disasters that hamper their development, or simply do not have the same access to external sources of financing. Not all these circumstances are contingent on income levels, so that classifying development level on the basis of income alone does not fully reflect the different countries’ needs, challenges and constraints. Latin America and the Caribbean therefore needs a new criterion for ODA allocation, focusing more on its countries’ specific requirements.

Duty-free imports In 2014, almost 94% of exports (in value terms) from Latin America and the Caribbean to developed countries enjoyed tariff-free access to those markets, a proportion considerably larger than that of exports from developing countries overall (79%) and even that of the least developed countries (84%). This is due to a combination of factors: (i) the region’s exports to industrialized countries are dominated by minerals, metals and fuels, whose tariffs in developed country markets are usually low or non-existent; (ii) the various unilateral preferential tariff schemes in industrialized countries, from which some of the region’s countries still benefit; and (iii) the entry into force of free trade agreements between several of the region’s countries and industrialized partners such as the United States, the European Union, Canada and Japan. Accordingly, the region’s exports to industrialized countries are, on average, subject to a preferential tariff of just 3%, similar to that paid on the least developed countries’ exports. 74

MDG 8

Develop a global partnership for development

Figure 8.5 Developed countries: proportion of total imports (by value) from selected country groupings, admitted free of duty, 1996-2014a

Developing countries

Latin America and the Caribbean

2014

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

100 90 80 70 60 50 40 30 20 10 0

1996

(Percentages)

Least developed countries

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of figures from the International Trade Centre database on the measurement of indicators 8.6 and 8.7 of the United Nations Conference on Trade and Development (UNCTAD) and World Trade Organization (WTO) [online] http://www.mdg-trade.org. a Excluding arms and oil.

Figure 8.6 Developed countries: average tariffs (most favoured nation and preferential) imposed on imports from selected country groupings, 1996-2014a (Percentages)

12 10 8 6 4 2

Developing countries (MFN) Developing countries (preferential)

Least developed countries (MFN) Least developed countries (preferential)

2014

2013

2012

2011

2010

2009

2008

2007

2006

2005

2004

2003

2002

2001

2000

1999

1998

1997

1996

0 Latin America and the Caribbean (MFN) Latin America and the Caribbean (preferential)

Although Latin American and Caribbean exports enjoy generally favourable access to industrializedcountry markets, they still have to contend with high levels of tariff protection in areas of trade interest to the region, especially the agricultural and agro-industrial sectors. Moreover, non-tariff barriers such as strict rules of origin and tough sanitary, technical and environmental standards may often prevent the regionâ&#x20AC;&#x2122;s exporters from taking full advantage of tariff-free access. 75

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Closely related to Millennium Development Goal 8, although not specifically included in its indicators, is the matter of progress in establishing new multilateral rules applicable to world trade. Notable progress was achieved in that connection in December 2013, with the new Trade Facilitation Agreement of the World Trade Organization (WTO), the first multilateral agreement concluded under the auspices of WTO since it commenced work in 1995. The agreement aims to expedite the movement of goods across borders, which is crucial in todayâ&#x20AC;&#x2122;s context of regional and global value chains, and is currently in the process of domestic ratification by member countries of WTO. A recent survey of customs services in 19 countries in the region, conducted by ECLAC, found that they were relatively well prepared for the agreementâ&#x20AC;&#x2122;s entry into force.1

Figure 8.7 Latin America and the Caribbean (19 countries): score obtained in the Global Survey on Trade Facilitation and Paperless Trade Implementation, 2015 (Percentages)

Preparedness for the entry into force of the new Trade Facilitation Agreement of the World Trade Organization

Transit facilitation

Institutional aspects Paperless trade Transparency

Importing and exporting

Bolivia (Plur. State of)

Latin America and the Caribbean

Suriname

Barbados

Trinidad and Tobago

Honduras

Nicaragua

Uruguay

Paraguay

Dominican Rep.

Brazil

Peru

Panama

Guatemala

Costa Rica

Chile

El Salvador

Ecuador

Colombia

Mexico

90 80 70 60 50 40 30 20 10 0

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of tabulation of the results of the Global Survey on Trade Facilitation and Paperless Trade Implementation 2014-2015, conducted by the five United Nations regional commissions.

Information and communications technologies In recent years, the countries of the region have taken large strides in access to information and communications technologies (ICTs), albeit with major differences depending on the type of indicator used for measurement purposes. In developing countries, fixed telephony posted sustained growth until peaking around 2005, before beginning to decline with the boom in mobile telephony. Although fixed telephone lines appeared to be a suitable indicator at the time when the development goals and targets were established, another 1

The survey evaluates aspects such as transparency, institutions, import and export formalities, paperless trade and transit facilitation.

MDG 8

Develop a global partnership for development

type of indicator may now be more appropriate for measuring access to and use of ICTs. Access to mobile telephony has increased exponentially and, with cheaper devices and communication plans, by 2014 penetration levels had drawn level with those of developed countries. However, Internet access continues to present a challenge for the region and despite significant recent progress (the penetration rate stood at 50.1% in 2014), sustained efforts are needed to improve accessibility and to narrow the wide gaps that exist between and within countries. The number of Internet users (as a proportion of the total population) in Latin American and Caribbean countries is shown below, along with their average annual growth rate between 2006 and 2014. While Internet user numbers have surged in many countries, this momentum has not sufficed to close gaps in relation to access, so that the regionâ&#x20AC;&#x2122;s hallmark heterogeneity is in evidence here, too. The small size of Caribbean countries has allowed them to achieve usage rates of about 70%, while larger Latin American countries posted figures in the region of 50%. In most Central American countries, only about 20% of inhabitants have Internet access.

Figure 8.8 Latin America and the Caribbean (37 countries and territories): Internet users and their average annual growth rate, 2006-2014 (Number of users per 100 inhabitants and percentages)

90 80 70

60 50

15 40 30

Average annual growth rate, 2006-2014

Number of Internet users per 100 inhabitants

20 5

Aruba Puerto Rico Bahamas Barbados Cayman Islands Chile Anguilla Saint Kitts and Nevis Trinidad and Tobago Argentina Antigua and Barbuda Dominica Uruguay Brazil Venezuela (Bol. Rep. of) Saint Vincent and the Grenadines Colombia Saint Lucia United States Virgin Islands Dominican Rep. Costa Rica Panama Mexico Ecuador Paraguay Jamaica Peru Suriname Bolivia (Plur. State of) Belize Grenada Cuba El Salvador Guatemala Honduras Nicaragua Haiti

10 0

2006 2014 Average annual growth rate

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of data from International Telecommunication Union (ITU), World Telecommunications Indicators Database, 2014.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

New technologies constantly open windows of opportunity for people and businesses to improve their economic and social situation. To harness these new technologies fully and productively, however, bandwidth â&#x20AC;&#x201D;and particularly the penetration of fixed and mobile broadbandâ&#x20AC;&#x201D; is a key consideration. Although the region has made great progress in increasing access to fixed broadband and, especially, mobile broadband services, significant gaps still exist between countries, leaving plenty of areas for improvement.

Figure 8.9 Latin America (18 countries): penetration of fixed and mobile broadband, 2013 (Number of active subscriptions per 100 inhabitants)

Costa Rica Brazil Uruguay Venezuela (Bol. Rep. of) Chile Argentina Ecuador Dominican Rep. Panama Colombia Bolivia (Plur. State of) Mexico Honduras El Salvador Paraguay Guatemala Peru Nicaragua

Mobile broadband

Fixed broadband

Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of data from International Telecommunication Union (ITU), World Telecommunications Indicators Database, 2014.

MDG 8

Develop a global partnership for development

Infographic 8.1 Latin America and the Caribbean: global partnership for development and the Millennium Development Goals

Target 8A: Develop further an open, rule-based, predictable, non-discriminatory trading and financial system Target 8B: Address the special needs of the least developed countries TOTAL ODA RECEIVED BY LATIN AMERICA AND THE CARIBBEAN HAS FALLEN RELATIVE TO AVERAGE REGIONAL GNI

The region’s share in total flows of official development assistance (ODA) has fallen 1960s

0.48%

of regional GNI

US$ 10.2

billion in net ODA

1990

14%

2000

Shift in the destination of ODA Social sectors Least developed countries Production sectors

2013

REGIONAL EXPORTS ENJOY FAVOURABLE CONDITIONS OF ACCESS TO INDUSTRIALIZED COUNTRIES, BUT THERE ARE BARRIERS PREVENTING EXPORTERS FROM TAKING FULL ADVANTAGE OF TARIFF-FREE ACCESS High levels of tariff protection in areas of export interest to the region

95% of the population of Latin America and the Caribbean live in middle-income countries

Middle-income countries

Non-tariff barriers

100 80

Receipts by Latin America and the Caribbean

7.6%

0.18% of regional GNI

Net ODA disbursements in percentages of the region’s gross national income (GNI)

Total ODA

CURRENT DECADE

Target 8D: Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term

The Caribbean

60 40

THE PUBLIC DEBT BURDEN IS MODERATE OVERALL IN LATIN AMERICA, WITH DIFFERENT PATTERNS BETWEEN COUNTRIES, BUT IS HIGH IN MOST OF THE CARIBBEAN

Latin America

20 0 Public debt with respect to GDP (percentages) 1990

2014

Target 8F: In cooperation with the private sector, make available the benefits of new technologies, especially information and communications THE COUNTRIES OF THE REGION HAVE ACHIEVED SUBSTANTIAL PROGRESS IN ACCESS TO INFORMATION AND 96.3 COMMUNICATIONS TECHNOLOGIES (ICTs) Mobile-cellular subscriptions per 100 inhabitants Internet users per 100 inhabitants

0.8 1995

0.1

12.1

34.7

2000

2010

3.9

1% 4G

ONLY OF CONNECTIONS ARE

2.6%

114.6

Mobile telephone subscriptions

50.1 Internet users 2014

ONLY OF FIXED CONNECTIONS ARE VIA FIBRE OPTIC TECHNOLOGY

World’s top user of social networks for socialization and work

DIGITAL GAPS PERSIST GENDER GAP IN INTERNET USE GAPS BETWEEN SOCIOECONOMIC LEVELS GAPS BETWEEN COUNTRIES

Conclusion Final reflections In recent years ECLAC has called on the region to shift its development approach towards closing structural gaps and securing environmental sustainability in pursuit of greater equality, which is seen as the underlying ethical principle of development, in the framework of entitlement to rights. To that end, ECLAC recommends that countries undertake a structural change in their production matrices by incorporating an environmental dimension into their production and consumption patterns. The idea is to move towards more knowledge-intensive sectors that generate good-quality jobs, as part of a new equation between the State, the market and society built on long-term political and policy agreements and social compacts that imbue the regionâ&#x20AC;&#x2122;s development with political, social, economic and environmental sustainability. The 2030 Agenda for Sustainable Development and the Sustainable Development Goals constitute a fundamental step in the right direction and require a paradigm shift in implementation modalities. The goals and targets of the 2030 Agenda for Sustainable Development are broader with respect to some elements of development than the Millennium Development Goals and include new, essential elements related to economic, production, social and environmental change. They address central issues linked to education, housing, provision of basic services and social protection and disaster risk management, for example, and also fully embrace the notion of providing collective goods, such as protection of the oceans, the atmosphere and biodiversity. By way of example, for the first time in history, the Agenda sets out to eradicate extreme poverty by 2030 (a target which Latin America and the Caribbean should achieve if measured using the established global standard).1 At the same time, it provides scope for a multidimensional perspective on welfare challenges, which calls for a broader spectrum of policies that goes beyond poverty and strives towards equality by applying a rights-based approach, in terms of both its human dimensions (such as gender and ethnic equality) and welfare dimensions. The labour sector is another interesting example. Whereas an inadequate target on employment was included in the Millennium Development Goals well after they were launched, the 2030 Agenda explicitly incorporates the topic of employment with rights. Along with economic growth, industrialization and technological innovation, employment with rights boosts productivity, fosters development policies geared towards innovative production, and improves efficiency in resource utilization. As ECLAC has stated in the past, good-quality, decent work is the master key to overcoming inequality and eradicating poverty. The 2030 Agenda is more inclusive, incorporating womenâ&#x20AC;&#x2122;s autonomy and the emancipation of young people, especially those at high risk of marginalization. Other targets include eliminating child labour and putting an end to discrimination against indigenous and Afro-descendent peoples. Lastly, the new Agenda seeks to promote the rights of workers and achieve universal social protection and job security.

Target 1.1: By 2030, eradicate extreme poverty for all people everywhere, currently measured as people living on less than US$ 1.25 a day.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Box 1 The Sustainable Development Goals The Sustainable Development Goals were proposed by the Open Working Group of the General Assembly on Sustainable Development Goals following the consultations held in the Group’s 13 sessions with Member States, civil society, academics, the private sector and other stakeholders between March 2013 and July 2014. The 17 proposed goals were subsequently included in the 2030 Agenda for Sustainable Development. Goal 1. End poverty in all its forms everywhere. Goal 2. End hunger, achieve food security and improved nutrition and promote sustainable agriculture. Goal 3. Ensure healthy lives and promote well-being for all at all ages. Goal 4. Ensure inclusive and equitable quality education and promote lifelong learning opportunities for all. Goal 5. Achieve gender equality and empower all women and girls. Goal 6. Ensure availability and sustainable management of water and sanitation for all. Goal 7. Ensure access to affordable, reliable, sustainable and modern energy for all. Goal 8. Promote sustained, inclusive and sustainable economic growth, full and productive employment and decent work for all. Goal 9. Build resilient infrastructure, promote inclusive and sustainable industrialization and foster innovation. Goal 10. Reduce inequality within and among countries. Goal 11. Make cities and human settlements inclusive, safe, resilient and sustainable. Goal 12. Ensure sustainable consumption and production patterns. Goal 13. Take urgent action to combat climate change and its impacts.a Goal 14. Conserve and sustainably use the oceans, seas and marine resources for sustainable development. Goal 15. Protect, restore and promote sustainable use of terrestrial ecosystems, sustainably manage forests, combat desertification, and halt and reverse land degradation and halt biodiversity loss. Goal 16. Promote peaceful and inclusive societies for sustainable development, provide access to justice for all and build effective, accountable and inclusive institutions at all levels. Goal 17. Strengthen the means of implementation and revitalize the global partnership for sustainable development. Source: Economic Commission for Latin America and the Caribbean (ECLAC), on the basis of United Nations, Report of the Open Working Group of the General Assembly on Sustainable Development Goals (A/68/970), New York, 2014. a Acknowledging that the United Nations Framework Convention on Climate Change is the primary international, intergovernmental forum for negotiating the global response to climate change.

Unlike the Millennium Development Goals, the 2030 Agenda addresses inequality in all its dimensions. Latin America and the Caribbean, the most unequal region in the world, has seen some progress —albeit very uneven among countries— in reducing the most basic inequalities implicitly covered in the Millennium Development Goals. It has made progress, for example, as regards reducing extreme poverty and achieving universal access to primary education. However, much remains to be done in terms of economic, social and political inclusion and rights-based equality is still far from a reality. The 2030 Agenda also addresses inequalities and deep asymmetries between countries, especially between developing and developed countries. In particular, it highlights the importance of including developing countries in the decision-making process in global institutions. In terms of gender equality, the Millennium Development Goals focused mostly on access to education, leaving major gaps in the goals and indicators with respect to other important issues, such as violence.

MDG

Conclusion

The new Agenda seeks to fill those gaps and incorporates new topics such as recognizing and assigning value to unpaid care work, including domestic work. It addresses the empowerment of women and girls, and mainstreams gender equality in other goals too. Furthermore, the Agenda covers access to and control over natural and production resources and credit, the vulnerability of certain groups of women to climate change and natural disasters, violence against women and girls and efforts to eradicate all forms of discrimination. Little progress was made in the region during the implementation period of the Millennium Development Goals on the goals and targets relating to health, especially sexual and reproductive health, as reflected, for example, in the still very high incidence of maternal mortality. The 2030 Agenda must tackle these outstanding priority matters, while also addressing new challenges, such as the worrying rise in adolescent pregnancy rates associated with poorer households. In this area of development, the region must carry forward its efforts under the 2030 Agenda to eradicate preventable communicable diseases, such as malaria and tuberculosis. Furthermore, with respect to universal access to good-quality health-care services, Latin America and the Caribbean must also deal with chronic non-communicable diseases which carry a high mortality rate and create heavy burdens on health services through recurring acute episodes and growing disabilities. Without doubt, the least progress was seen on the environmental targets of the Millennium Development Goals. The new 2030 Agenda emphasizes solidarity with future generations by recognizing that, today more than ever, as a result of climate change and the systematic degradation of ecosystems and biodiversity, an inclusive strategy for economic and social development must consider the implementation of public policies and programmes to meet present human needs without destroying the environment’s capacity to meet those same needs in the future (Brundtland, 1986). Although this is a global concern, the problem is particularly pressing in the Latin American and Caribbean region because its economies are so closely connected with the environment —the extraction of non-renewable resources being a clear example. The Sustainable Development Goals promote the protection of critical ecosystems and biodiversity, as well as a transition to lower-carbon, less fossilfuel-intensive economies, which is a fundamental pillar of sustainable development (ECLAC, 2010). This new development paradigm should be at the heart of the development with equality agenda, since what is at issue is not just the intrinsic value of ecosystems and biodiversity, but also their importance to the other components of human welfare. While the new Agenda addresses a similar topic to Millennium Development Goal 8 (“Develop a global partnership for development”), it takes the idea further by recognizing from the start that the success of the new Agenda will depend on having the means of implementation required in terms of financial, commercial, technological and institutional resources. Furthermore, the means of implementation are clearly specified in the text of each goal. The new Agenda also recognizes the importance of domestic resource mobilization in developing countries between now and 2030, and hence the need to strengthen capacity to raise more revenues using better methods. It also stresses the need to respect the freedom of each country to establish and implement its own poverty reduction and sustainable development policies. Nevertheless, a greater commitment is required at the global level in terms of fiscal and financial regulations and institutions. This point was made forcefully at the Third International Conference on Financing for Development held in Addis Ababa, and a number of agreements were reached in this regard, such as a commitment to further governance reform in the International Monetary Fund (IMF), the World Bank and other main international regulatory standard-setting bodies to adapt to changes in the global economy and to continue efforts to increase the voice of developing countries in normsetting processes to ensure that their concerns are taken into consideration.2 However, no specific 2

See United Nations (2015e), para. 106.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

plan was adopted to achieve these aims. The Addis Ababa outcome also reaffirms the commitment by developed countries to allocate 0.7% of their gross national income (GNI) to developing countries as official development assistance (ODA).3 During the implementation period of the Millennium Development Goals, between 2000 and 2014, net ODA provided worldwide by the member countries of the Development Assistance Committee of the Organization for Economic Cooperation and Development (OECD) was just 0.29% of GNI, despite the pledge that countries made in the Monterrey Consensus (2002) to achieve an allocation of 0.7% of GNI. It is vital to insist on meeting that target in order to make faster progress on reducing development gaps. The regional focus of the new Agenda highlights the fundamental importance of mobilizing public and private resources, including from non-traditional sources and innovative financing mechanisms, and acknowledges different development styles. Access to developed countries’ markets for developing countries’ goods and services, technology transfer and South-South cooperation are other elements crucial to ensuring the implementation of the Agenda.

The regional dimension and the role of ECLAC The regional dimension of the 2030 Agenda for Sustainable Development and the role of the regional commissions in monitoring its implementation were widely recognized in the drafting process, starting with the outcome document of the United Nations Conference on Sustainable Development (Rio+20), which led to their specific inclusion as part of the follow-up and review mechanism of the new Agenda. The regional commissions have been instrumental in helping to establish regional positions, convening regional consultations on financing for development and accountability under the new Agenda, and giving voice to regional perspectives in global discussions and negotiations. The establishment of regional forums on sustainable development in most regions, in response to the Rio+20 outcome document, will further amplify regional voices on the implementation, followup and review of the 2030 Agenda for Sustainable Development, ensure the inclusion of the three dimensions of sustainable development and facilitate the forging of direct linkages with the High-level Political Forum on Sustainable Development, the Economic and Social Council and the United Nations General Assembly. ECLAC will focus on the following priorities to support countries of Latin America and the Caribbean in implementing the new Agenda and in monitoring and following up on the sustainable development goals in the region (United Nations, 2015d): Placing equality front and centre Diversifying the production matrix and consumption patterns by incorporating an environmental dimension Pursuing technological innovation and developing the information and knowledge society Ensuring access to information and citizen participation Redefining the equation between the State, the market and society Institution-building Forging regional voices on the global agenda and in regional forums Promoting a balanced integration of the economic, social and environmental dimensions of sustainable development in the formulation and implementation of national strategies and policies on sustainable development

Ibid., para. 51.

MDG

Conclusion

Supporting South-South cooperation and sustaining the rise of middle-income countries Helping to create a solid follow-up and review architecture for the 2030 Agenda for Sustainable Development Strengthening national capacities with respect to statistics and data Promoting multi-stakeholder dialogue and forums to build policy coherence Coordinating the United Nations system at the regional level Through its subsidiary bodies, ECLAC provides a platform for experts and decision makers from the region to meet and share experiences, best practices, lessons learned and innovative policy proposals. The architecture of the Commission’s subsidiary bodies represents a regional commons and an essential resource for coordinating follow-up and monitoring of the new Agenda. The subsidiary bodies of ECLAC are the following: Caribbean Development and Cooperation Committee Committee on South-South Cooperation Conference on Science, Innovation and Information and Communications Technologies Committee of the Whole of ECLAC Regional Conference on Population and Development in Latin America and the Caribbean Regional Conference on Social Development in Latin America and the Caribbean Regional Conference on Women in Latin America and the Caribbean Regional Council for Planning of the Latin American and Caribbean Institute for Economic and Social Planning Statistical Conference of the Americas of ECLAC The wealth of experience and forums for discussion and action built up through this regional architecture will stand the countries of Latin America and the Caribbean and ECLAC in good stead for continuing their traditional technical cooperation, now with a view to review, follow-up and feedback for the goals and targets established under the 2030 Agenda for Sustainable Development.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Box 2 Statistical challenges Effective measurement of the goals and targets of the 2030 Agenda for Sustainable Development calls for the strengthening of national statistical systems and mechanisms for effective coordination between their component institutions, which will mean: (i) Promoting the preparation of national statistical development strategies. (ii) Fostering the creation of a national inter-institutional and intersectoral architecture at the highest level to help build the platforms required for setting up national monitoring mechanisms and ensuring they interact with relevant regional and international forums. (iii) Strengthening technical capacity in all national agencies involved in producing official statistics. (iv) Ensuring that sufficient technological and financial resources are available to promote the modernization of the offices that produce official statistics. (v) Consolidating, through the national budget, the sustainability of the production of statistical information (data gathering, systematization, processing, analysis and dissemination). (vi) Supporting the production of statistical information for deeper analysis of existing inequality gaps in the region. (vii) Building national capacity to tap the data revolution in order to obtain good-quality data —traditional and non-traditional— for reliable review and follow-up of the sustainable development goals. (viii) Strengthening targets on statistical capacity-building for monitoring the 2030 Agenda. (ix) Measuring the effective capacity of national statistical systems to meet the demands of the Agenda. Although much work remains to be done, the region will be able to capitalize on the advantages it has accrued and the experience it has gained with regard to measuring development objectives. Indeed, existing intergovernmental mechanisms, such as the Statistical Conference of the Americas of ECLAC, already help to harness synergies in respect of standardizing measurements and intraregional cooperation. Furthermore, the region’s relatively well (though somewhat unevenly) developed national statistical systems stand the countries in good stead for tackling many of the challenges involved in meeting the information demands arising from the 2030 Agenda. Nevertheless, the region faces several measurement challenges regarding the ambitious 2030 Agenda for Sustainable Development, especially with respect to closing existing gaps in the statistical capacity of some countries whose statistical systems are less developed and have less installed capacity. There are also gaps between Latin America and the Caribbean in terms of statistical capacity and data comparability at the regional level. Significant short- and long-term challenges are posed by the need, first, to generate statistics on emerging issues for which the region’s countries lack the instruments required to collect even basic data and, second, to sustain the essential processes of national statistical systems with a view to ensuring the accurate and reliable measurement of countries’ progress on the 2030 Agenda over the long run. From a thematic point of view, a comparative approach to measuring and monitoring poverty is essential. The Commission’s work provides valuable information to countries on issues including the monetary measurement of poverty, multidimensional measurements of critical childhood deprivation and key gender indicators, such as the percentage of women without an income of their own and the femininity index of poverty. Analysing gender and ethnic inequalities is key to building a comprehensive approach since these two structural inequalities have a specific impact on other inequalities. This approach must be applied consistently to the 2030 Agenda for Sustainable Development to ensure that the goals and targets provide for both men and women and no one is left behind.

MDG

Conclusion

Box 2 (concluded)

This means that the indicators used must reflect gender inequalities and be consistent with the region’s overall vision of sustainable development. The region’s ongoing efforts to improve gender statistics will serve to capture progress in the areas established. Countries must build further their capacity to generate information on the environment and environmental sustainability, facilitate public access to that information, adopt environmentally aware development measures and educate the general public, the public sector and the for-profit and non-profit private sector on interpreting and using this information correctly and to their best advantage. Lastly, the countries of Latin America and the Caribbean need stronger national statistical systems with long-term national statistical development strategies that dovetail efforts to meet national challenges with the demands arising from the 2030 Agenda. Such strategies should be underpinned by inter-institutional arrangements that serve to rank priorities and to plan and implement mechanisms for monitoring the Sustainable Development Goals. The 2030 Agenda will provide an opportunity to develop accountability systems and provide citizens with ready access to information on environmental issues. Recent developments in information and communications technology offer innovative platforms to boost citizen participation. There is also potential for developing an innovative agenda with the private sector. Latin America and the Caribbean offers fertile ground for successes in these areas. Source: Economic Commission for Latin America and the Caribbean (ECLAC).

ECLAC sees the Sustainable Development Goals as forming a bridge between the short and the long terms, particularly from the perspective of achieving equal rights and sustainable development. Now approaching its seventieth anniversary, the Commission has gained a wealth of experience on its quest to open avenues for economic, social and environmental development in Latin America and the Caribbean. On the basis of Raul Prebisch’s premise that accurate observation of reality must precede consideration of action, we cannot fail to see that the scourge of inequality continues to be the region’s most prominent feature. And, as society’s greatest problems demand our commitment to act upon them —as Celso Furtado enjoined us—, our every effort must be directed towards making a change for the better. Today, in the framework of the 2030 Agenda, new and better tools are available for the task.

ECLAC

Latin America and the Caribbean: looking ahead after the Millennium Development Goals

Bibliography Brundtland, Gro Harlem (ed.) (1987), Our Common Future, World Commission on Environment and Development, Oxford, Oxford University Press. ECLAC (Economic Commission for Latin America and the Caribbean) (2015), Regional review and appraisal of implementation of the Beijing Declaration and Platform for Action and the outcome of the twenty-third special session of the General Assembly (2000) in Latin American and Caribbean countries (LC/L.3951) Santiago. (2014a), Social Panorama of Latin America, 2014 (LC/G.2635-P), Santiago. (2014b), Compacts for Equality: Towards a sustainable future (LC/G.2586(SES.35/3)), Santiago. (2013), Sustainable Development in Latin America and the Caribbean. Follow-up to the United Nations development agenda beyond 2015 and to Rio+20 (LC/G.2577), Santiago. (2012), Structural Change for Equality: An integrated approach to development (LC/G.2524(SES.34/3)), Santiago. (2010), Achieving the Millennium Development Goals with Equality in Latin America and the Caribbean: Progress and challenges (LC/G.2460), Santiago, United Nations. IGME (Inter-agency Group for Child Mortality Estimation) (2014), Levels and Trends in Child Mortality. Report 2014, New York, United Nations. Martínez, Rodrigo and Amalia Palma (2015) “Cerrando la brecha: modelo para estimar el costo de erradicar la desnutrición crónica y las deficiencias de micronutrientes”, Manuales series, No. 84 (LC/L.4019), Santiago, Economic Commission for Latin America and the Caribbean (ECLAC). PAHO (Pan American Health Organization) (2015), Databases [online] http://www.paho.org/hq/index. php?option=com_content&view=category&layout=blog&id=2391&Itemid=2392&lang=en. (2014), Situación de la malaria en la región de las Américas, 2000-2013 [online] http://www.paho.org/hq/ index.php?option=com_docman&task=doc_view&gid=31043+&Itemid=999999&lang=es. (2013a), “Antiretroviral Treatment under the Spotlight: A public health analysis in Latin America and the Caribbean” [online] http://www.paho.org/hq/index.php?option=com_docman&task=doc_ view&gid=23710&Itemid. (2013b), “Tuberculosis in the Americas. Regional report 2012: Epidemiology, Control and Financing” [online] http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=22953&Itemid=. UNAIDS (Joint United Nations Programme on HIV/AIDS) (2015), “How AIDS changed everything. MDG 6: 15 years, 15 lesson” [online] http://www.unaids.org/sites/default/files/media_asset/MDG6Report_en.pdf. United Nations (2015a), The Millennium Development Goals Report 2015, New York. (2015b), The Millennium Development Goals Report. Statistical Annex 2015, New York. (2015c), Millennium Development Goals Indicators [online database] http://mdgs.un.org/unsd/mdg/ Default.aspx. (2015d), “The United Nations regional commissions and the post-2015 development agenda: moving to deliver on a transformative and ambitious agenda” [online] http://repositorio.cepal.org/bitstream/ handle/11362/38543/S1500614_en.pdf?sequence=1. (2015e), Addis Ababa Action Agenda of the Third International Conference on Financing for Development (Addis Ababa Action Agenda) (A/RES/69/313), New York. (2014), Report of the Open Working Group of the General Assembly on Sustainable Development Goals (A/68/970), New York. WHO (World Health Organization) (2014), “Children: reducing mortality”, Factsheet, No. 178, September [online] http://www.who.int/mediacentre/factsheets/fs178/en/.

This document affords a concise descriptive overview of the progress achieved by Latin America and the Caribbean in respect of the Millennium Development Goals. This new contribution by the Economic Commission for Latin America and the Caribbean (ECLAC) uses infographics, tables, figures and descriptive statistics, along with short explanatory texts, to convey in a nutshell the region’s achievements and remaining challenges with respect to the Goals. In recent years ECLAC has called on the region to shift its development approach towards closing structural gaps in pursuit of greater equality, in the framework of entitlement to rights. To this end, countries are urged to work towards a structural change in their production matrices by integrating an environmental dimension into their production and consumption patterns. The idea is to move towards more knowledge-intensive sectors that generate good-quality jobs, as part of a new equation between the State, the market and society built on longterm political and policy agreements and social compacts that imbue the region’s development with political, social, economic and environmental sustainability. The 2030 Agenda for Sustainable Development and the Sustainable Development Goals, which succeed the Millennium Development Goals, constitute a fundamental step in this direction and require a paradigm shift. In this regard, ECLAC sees the Sustainable Development Goals as forming a bridge between the short and the long terms. Now approaching its seventieth anniversary, the Commission has gained a wealth of experience on its quest to open avenues for economic, social and environmental development in Latin America and the Caribbean. On the basis of Raul Prebisch’s premise that accurate observation of reality must precede consideration of action, we cannot fail to see that the scourge of inequality continues to be the region’s most prominent feature. And, as society’s greatest problems demand our commitment to act upon them —as Celso Furtado enjoined us—, our efforts are directed towards bringing about a change for the better. Today, in the framework of the 2030 Agenda, new and better tools are available for the task.