Millennium development goals: whose goals and for whom?
http://www.100md.com
《英国医生杂志》
EDITOR—Millennium development goals are the most recent statement of commitment towards narrowing gaps between the developed and developing regions of the world.1 But how realistic are these goals?
Although goals help in making assessments of progress, they should not be blind to existing potentials for progress, which is conditioned by the existing status as well as the motivation of nations and states towards realising them. Unfortunately, millennium development goals are considered to be a tool for assessing accountability and highlight a need for urgency that could violate the autonomy of nations and states. This raises the question of whose goals they are.
Often such initiatives are seen as global priorities, overriding local concerns. The best example is the vaccination initiative, which has consistently reflected failures by countries without the required infrastructure. In other circumstances, such externally aided initiatives are never integrated into the local health system to make the most of such intervention. In terms of measuring the extent of achievement of such goals, caution is advised in assessing progress conditioned by local realities that may not always be conducive to making the expected progress.
Finally, who benefits from the achievement of such goals needs to be made clear. Would there be any space to account for inequities resulting in achievement of such goals? If yes, the assessment of progress in achieving these goals needs to make adjustments for this to have a realistic evaluation of progress.
Udaya S Mishra, Takemi fellow
Department of Population and International Health, Harvard School of Public Health, 665, Huntington Avenue, Boston MA 02115, USA umishra@hsph.harvard.edu
Competing interests: None declared.
References
Haines A, Cassels A. Can the millennium development goals be attained? BMJ 2004;329: 394-7. (14 August.)
Although goals help in making assessments of progress, they should not be blind to existing potentials for progress, which is conditioned by the existing status as well as the motivation of nations and states towards realising them. Unfortunately, millennium development goals are considered to be a tool for assessing accountability and highlight a need for urgency that could violate the autonomy of nations and states. This raises the question of whose goals they are.
Often such initiatives are seen as global priorities, overriding local concerns. The best example is the vaccination initiative, which has consistently reflected failures by countries without the required infrastructure. In other circumstances, such externally aided initiatives are never integrated into the local health system to make the most of such intervention. In terms of measuring the extent of achievement of such goals, caution is advised in assessing progress conditioned by local realities that may not always be conducive to making the expected progress.
Finally, who benefits from the achievement of such goals needs to be made clear. Would there be any space to account for inequities resulting in achievement of such goals? If yes, the assessment of progress in achieving these goals needs to make adjustments for this to have a realistic evaluation of progress.
Udaya S Mishra, Takemi fellow
Department of Population and International Health, Harvard School of Public Health, 665, Huntington Avenue, Boston MA 02115, USA umishra@hsph.harvard.edu
Competing interests: None declared.
References
Haines A, Cassels A. Can the millennium development goals be attained? BMJ 2004;329: 394-7. (14 August.)