The Millennium Development Goals Fail Poor Children: The Case for Equity-Adjusted Measures

Daniel D. Reidpath1*, Chantal M. Morel2, Jeffrey W. Mecaskey3, Pascale Allotey1
1 Centre for Public Health Research, Brunel University, Uxbridge, United Kingdom,
2 LSE Health, London School of Economics, London, United Kingdom,
3 Save the Children UK, London, United Kingdom
PLoS Med 6(4): e1000062. doi:10.1371/journal.pmed.1000062 - April 28, 2009

Available online at: http://www.plosmedicine.org/article/info%3Adoi%2F10.1371%2Fjournal.pmed.1000062

“………..of the Millennium Declaration is to address the health and development needs of society's most vulnerable and least served [1]. Issues of equity form a key principle:

We recognize that, in addition to our separate responsibilities to our individual societies, we have a collective responsibility to uphold the principles of human dignity, equality and equity at the global level. As leaders we have a duty therefore to all the world's people, especially the most vulnerable and, in particular, the children of the world, to whom the future belongs [1]….”

Summary Points
The Millennium Declaration is a statement of principles about the kind of future that world governments seek; a future that they envisage to be more equitable and more responsive to the socially most vulnerable.

The Millennium Development Goals represent the operational targets by which we may judge their actions.

The reduction of the U5MR by two-thirds by 2015 is one of the Millennium Development Goals (MDG4).

The reduction in U5MR can, however, be achieved through a diversity of policy interventions, some of which could leave the children of the poor worse off. A celebrated MDG4 success can, thus, be a Millennium Declaration failure.

Health policy informed by composite outcome measures that take account of both the U5MR and the distribution of the burden of mortality across social groups would help to overcome this.

Introduction
Exploring Equity, Equality, and U5MR
An Equity-Adjusted Measure
Conclusion
References