Attaining Millennium Development Goals in Health: Isn't Economic Growth Enough?

Abstract

The UN Millennium Declaration, agreed to by 189 countries in 2000, exemplifies an unprecedented commitment on the part of both rich and poor countries to attain improvements in human development by the year 2015. This commitment is summarized in the eight Millennium Development Goals (MDGs) that set targets in areas of poverty reduction, health improvements, education attainment, gender equality, environmental sustainability and fostering global partnerships (UNDP 2003).

This focus on MDGs has triggered (healthy) debates on several issues ranging from concerns regarding the lack of availability and reliability of data for monitoring MDG outcomes to those relating to choice of policy options for attaining the MDGs. For health and other social-sector MDGs, it is not clear what the exact policy options are to ensure that the goals are met by 2015. Some argue for a massive scaling up of public health and other socialsector expenditure (Sachs 2004).

A second school of thought favors a more multisectoral approach: emphasizing cross sector synergies, general investments in infrastructure, and improved governance for achieving better social-sector outcomes (Leipziger et al. 2003). Others focus on economic growth as the primary driver of social outcomes. Implicitly, in the latter approach, the focus on social-sector MDGs is considered to be superfluous. Instead, emphasis is placed on policies that target generalized macroeconomic growth more than anything else.