An Immeasurable Crisis? A Criticism of the Millennium Development Goals and Why They Cannot Be Measured
PLoS Medicine: An Immeasurable Crisis? A Criticism of the Millennium Development Goals and Why They Cannot Be Measured
Amir Attaran
In September 2000, 147 heads of state met at the United Nations (UN) headquarters—the largest such gathering ever—to resolve action on the most pressing problems of humanity and nature [1]. To underscore their commitment, they set numerical targets and deadlines to measure performance. These are the Millennium Development Goals (MDGs), and they span a large range of topics, including poverty, infectious disease, education, and gender equality (Box 1).
This September, the heads of state will gather again for the Millennium +5 Summit to assess the five-year progress of the MDGs. They will find that the MDGs have become all-important, not just within the UN, but also as the zeitgeist of the global development enterprise. As Professor Jeffrey Sachs, Director of the UN's Millennium Project, has declared, “To the extent that there are any international goals, they are the Millennium Development Goals”[2].
But is it wise to elevate the MDGs to the pedestal where they now sit? Could it be, despite an appearance of firm targets, deadlines, and focused urgency, that the MDGs are actually imprecise and possibly ineffective agents for development progress?
In this article, I argue that many of the most important MDGs, including those to reduce malaria, maternal mortality, or tuberculosis (TB), suffer from a worrying lack of scientifically valid data. While progress on each of these goals is portrayed in time-limited and measurable terms, often the subject matter is so immeasurable, or the measurements are so inadequate, that one cannot know the baseline condition before the MDGs, or know if the desired trend of improvement is actually occurring. Although UN scientists know about these troubles, the necessary corrective steps are being held up by political interference, including by the organisation's senior leadership, who have ordered delays to amendments that could repair the MDGs [3]. In short, five years into the MDG project, in too many cases, one cannot know if true progress towards these very important goals is occurring. Often, one has to guess./.../
Amir Attaran
In September 2000, 147 heads of state met at the United Nations (UN) headquarters—the largest such gathering ever—to resolve action on the most pressing problems of humanity and nature [1]. To underscore their commitment, they set numerical targets and deadlines to measure performance. These are the Millennium Development Goals (MDGs), and they span a large range of topics, including poverty, infectious disease, education, and gender equality (Box 1).
This September, the heads of state will gather again for the Millennium +5 Summit to assess the five-year progress of the MDGs. They will find that the MDGs have become all-important, not just within the UN, but also as the zeitgeist of the global development enterprise. As Professor Jeffrey Sachs, Director of the UN's Millennium Project, has declared, “To the extent that there are any international goals, they are the Millennium Development Goals”[2].
But is it wise to elevate the MDGs to the pedestal where they now sit? Could it be, despite an appearance of firm targets, deadlines, and focused urgency, that the MDGs are actually imprecise and possibly ineffective agents for development progress?
In this article, I argue that many of the most important MDGs, including those to reduce malaria, maternal mortality, or tuberculosis (TB), suffer from a worrying lack of scientifically valid data. While progress on each of these goals is portrayed in time-limited and measurable terms, often the subject matter is so immeasurable, or the measurements are so inadequate, that one cannot know the baseline condition before the MDGs, or know if the desired trend of improvement is actually occurring. Although UN scientists know about these troubles, the necessary corrective steps are being held up by political interference, including by the organisation's senior leadership, who have ordered delays to amendments that could repair the MDGs [3]. In short, five years into the MDG project, in too many cases, one cannot know if true progress towards these very important goals is occurring. Often, one has to guess./.../
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