Jamra primary scholl for children affected by HIV/AIDS, drugs or poverty, Senegal (c) Nell Freeman/Alliance Participants in the Photovioce project, Ecuador © Marcela Nievas for the Alliance
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MDG Countdown: Finish the job!


MDG countdown

“Before we focus on the next set of goals we must remember to deliver on existing ones,” said Justine Greening, UK Secretary of State for International Development, speaking at the Millennium Development Goal (MDG) Countdown event on 26th September, co-hosted by the UK and US governments.

With only three years to go to meet the MDG targets, and health goals off track, it’s encouraging to hear this from Greening in her new role. To achieve MDG 6 (combat HIV/AIDS, malaria and other diseases) it’s going to take a big push, which is also the name of a new campaign by the Global Fund to Fight AIDS, Tuberculosis and Malaria. It shares our sentiment that we must keep going in order to build on progress made over the past decade and not allow this to slip back.

While new HIV infections have declined overall, more is needed to reach the 2015 goal of halting the spread of HIV, and some regions and key populations have a disproportional burden. Sub-Saharan Africa accounted for 70% of new infections in 2010, while it is home to just 12% of the global population†.

There’s also been progress for the number of people on treatment, with 6.5 million people in developing regions receiving ART at the end of 2010, but with 13.7 million people estimated to need treatment the universal access target by 2010 was largely missed†.

The MDG Countdown 2012 event, held during the UN General Assembly in New York, aimed to showcase innovative projects and programmes to highlight how coordinated development work can make a real difference.

Lucia Mvula, Advocacy Officer at Alliance for Community Action on HIV and AIDS in Zambia (Alliance Zambia) was the first to present. Alliance Zambia’s work was selected by the UK’s Department for International Development and the U.S. Agency for International Development to highlight progress made on maternal health, in particular prevention of HIV transmission from mother to child (PMTCT), which links MDGs 4, 5 and 6; to reduce child mortality, maternal mortality and HIV.  

Mvula explained how Alliance Zambia has seen an increase in the uptake of PMTCT services, but also the scale of the issue: “Around one in five pregnant women in Zambia are HIV positive” said Mvula, “with a large investment in PMTCT services in Zambia over the past few years, many HIV positive mothers are giving birth to HIV negative babies.”

With PMTCT intervention the risk of mother to child transmission can be less than 1%, without it this increases to 20-45%. Yet despite the scientific advances and the availability of medicines Mvula brought home the challenges  that women face by asking: “Would you want to walk for hours while in labour? Not surprisingly many Zambian women don’t want to either.”

Alliance Zambia’s experiences go some way to explain the barriers to achieving the maternal mortality goal (MDG 5) which is far from the 2015 target of reducing deaths by three quarters. As the region with the highest maternal mortality rate, Sub-Saharan Africa also has the lowest coverage of births attended by skilled health personnel†.

Mvula highlighted how working with communities has been key for Alliance Zambia in overcoming barriers. “We believe that [communities] stand on the frontline of the HIV response and their involvement is critical if we want to prevent HIV infections and meet the targets around MDG 6.”

Without community involvement, Alliance Zambia may not have identified the  transport issue facing many women and also the huge influence that traditional birth attendants have on women’s decisions, particularly in rural areas.

Alliance Zambia has used that information garnered from communities to inform programme delivery. Last year under a UK aid funded programme, work with traditional birth attendants led to more women delivering safely at health centres, and where necessary, being provided with transport to get there.

“Projects such as this demonstrate that science alone is not enough” states Mvula, “understanding why people act as they do must not be left out of the equation.”

You can read more from Mvula in her blog for Impatient Optimists here.

Initiatives like this coupled with major scientific breakthroughs offer a real possibility of achieving the goals, but there’s also worrying signs that the international donor community could be taking its foot off the pedal right at the time when it’s possible to achieve significant progress.

We welcome the US and UK’s commitment to make a big push on the MDGs. As we look ahead to a post-MDG environment, which Raj Shah, Administrator, U.S. Agency for International Development, described as “an opportunity to accelerate our efforts”, it is vital that we first meet the current targets, and we must continue to learn from our experiences involving affected communities in the response for progress on HIV to have a chance to accelerate now. That’s why our mantra, which developed over 2011 and continues to be relevant, is: Don’t Stop Now: Finish the job!

† The UN’s Millennium Development Goals Report 2012

Related links:

Watch: MDG Countdown video.

Blogs: Report on the MDG Countdown 2012 event and Looking to the future: HIV in a post-MDG world