Issue 4/10 AFGHANISTAN - Social Well-Being The Millennium Development Goals October 2010

5 October 2010

Erin Foster Humanitarian Assistance and Social Well-Being Knowledge Manager (erin.foster@cimicweb.org) (www.cimicweb.org)

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The purpose of this paper is to provide a brief examination of the Millennium Development Goals (MDGs), how the MDGs relate to Afghanistan and their current progress. More comprehensive information is available at www.cimicweb.org.1 Hyperlinks to original source material are highlighted in blue and underlined in the embedded text.
ON, Introduction to the MDGs

The Millennium Development Goals (MDGs) are a set of eight global priorities (see Table 1) agreed upon by all 189 member states of the UN General Assembly in September 2000 at the United Nations. The UN Millennium Declaration clearly states the role of the MDGs to reduce poverty and increase gender equality, access to education and environmental protection. A deadline was set to achieve all 8 goals and corresponding targets no later than September 2015.

Table 1. Millennium Development Goals

Eradicate Extreme Hunger and Poverty
Target 1: Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day. Target 2: Achieve full and productive employment and decent work for all, including women and young people. Target 3: Halve, between 1990 and 2015, the proportion of people who suffer from hunger.

Achieve Universal Primary Education

Target 1: Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling.

Promote Gender Equality and Empower Women

Target 1: Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015.

Reduce Child Mortality

Target 1: Reduce by two thirds, between 1990 and 2015, the under-five mortality rate.

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Improve Maternal Health

Target 1: Reduce by three quarters the maternal mortality ratio. Target 2: Achieve universal access to reproductive health care.

Combat HIV/AIDS, Malaria and other diseases

Target 1: Have halted by 2015 and begun to reverse the spread of HIV/AIDS. Target 2: Achieve, by 2010, universal access to treatment for HIVA/AIDS for all those who need it. Target 3: Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases.

Ensure Environmental Sustainability

Target 1: Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources. Target 2: Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss. Target 3: Halve, by 2015, the proportion of the population without sustainable access to safe drinking water and basic sanitation. Target 4: By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers.

Develop a Global Partnership for Development

Target 1: Develop further an open, rule-based, predictable, non-discriminatory trading and financial system. Target 2: Address the special needs of least developed countries, landlocked countries and small island developing states. Target 3: Deal comprehensively with developing countries debt. Target 4: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries. Target 5: In cooperation with the private sector, make available benefits of new technologies, especially information and communications.

Following the global commitment to achieve the MDGs, the UN Secretary General established the Millennium Project in 2002 to serve in an advisory capacity to countries engaged in meeting their targets. Countries faced their first barometer reading at the 2005 World Summit for heads of state and then again at the 2008 High-level Event for governments, foundations, businesses and civil society groups. These periodic sessions were intended to evaluate where participating countries were in achieving their goals as well as to address any common obstacles. The most recent review of the MDGs was held on 20-22 September 2010 at the United Nations headquarters in New York City. With only five years remaining until the deadline, member states produced a summit outcome document renewing their commitment to achieving the MDGs by 2015. Findings from the recent MDG summit indicate mixed results in member countries progress towards achieving the eight goals. An action agenda was posed for achieving the MDGs in the next five years with the first recommendation being to promote and strengthen national ownership and leadership of development, in addition to promoting international trade and finance measures for positive growth. The Millennium Development Goals Report 2010 released prior to the summit cites challenges of natural disasters, armed conflict, undernourishment, global financial crisis and gender inequity as gaps that must be overcome to meet the MDGs. Positive gains were found worldwide in the areas of poverty reduction (anticipated to reach 15% by 2015), increased school enrolment, reduced child mortality (12.5 million in 1990 to 8.8 million in 2008) and an increase from 400,000 to 4 million individuals receiving anti-retroviral therapy (2003 and 2008, respectively). As the MDG summit concluded, social inequality emerged as a new theme, with many participants considering it the major stumbling block nations must confront in the coming five years. The MDGs and Afghanistan: How do the MDGs relate to Afghanistan and what is the outlook in it attaining these goals? Afghanistan was not one of the original signatories to the Millennium Declaration as it took place during Taliban rule. The Declaration was signed by Afghanistan in March 2004, making it the 191st country to join. While the global deadline set for achieving the MDGs is September 2015, Afghanistans deadline was

extended to 2020 to form a more realistic timeframe based on the country experiencing several decades of conflict as well as an overall lack of information pertaining to the state of its people. Baseline data gathered between 2002 and 2005 was used to set the indicators of success. Afghanistan also forged a ninth goal to enhance security, stating on the MDG Afghan website: Despite extreme poverty, ill health, and hunger, Afghans define the lack of security as their greatest problem. In an effort to support the Afghan government in achieving its development goals as outlined in the Afghanistan National Development Strategy (ANDS), United Nations agencies provide support through the UN Development Assistance Framework. The United Nations Development programme (UNDP), in particular, provides three key areas of service, including MDG-based diagnostics and investment planning, policy reform guidance and national capacity building at the national and local levels. Afghanistan used the MDGs as the basis for establishing the ANDS and therefore any achievements made towards this national strategy is another step closer to attaining the MDGs in Afghanistan (Table 2 lays out the MDGs as tailored to Afghanistan).

Eradicate Extreme Hunger and Poverty (difficult)

Table 2. Afghanistan Millennium Development Goals

In Afghanistan, nearly 20% of rural households are chronically food insecure and nearly 75% of their diet consists of cereals, especially wheat. Target 1: The proportion of people whose income is less than US $1 a day decreases by 3% per annum until the year 2020. Target 2: The proportion of people who suffer from hunger decreases by 5% per annum until the year 2020.

Achieve Universal Primary Education (achievable)

Afghanistan has the highest proportion of school-age children in the world (1 in 5 Afghans) and the lowest participation rate for education. Target 1: Ensure that, by 2020, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling.

Promote Gender Equality and Empower Women (difficult)

Considerable gaps exist for women to obtain parity with men in education, economics and political representation. Target 1: Eliminate gender disparity in all levels of education no later than 2020. Target 2: Reduce gender disparity in economic areas by 2020. Target 3: Increase female participation in elected bodies at all levels of governance to 30% by 2020. Target 4: Reduce gender disparity in access to justice by 50% by 2015 and completely (100%) by 2020.

Reduce Child Mortality (on-track)

Infectious diseases and lack of access to clean water are challenges to this MDG; however successful immunization campaigns are seeing positive results. Target 1: Reduce by 50%, between 2003 and 2015, the under-5 mortality rate, and further reduce it to 1/3 of the 2003 level by 2020.

Improve Maternal Health (achievable)

Afghan women lack access to health care due to an insufficient number of female health workers as well as the majority of births taking place inside the home. Target 1: Reduce by 50% between 2002 and 2015 the maternal mortality ratio, and further reduce the MMR to 25% of the 2002 level by 2020.

Combat HIV/AIDS, Malaria and other diseases (on-track)

Lack of information about the prevention of HIV/AIDS, especially for injecting drug users and the majority of women, make Afghanistan a potential high-risk country for the spread of HIV/AIDS. The prevalence of Malaria and TB are attributed to high population movements, lack of health care, substandard medicines and malnourishment, among other factors. Target 1: Have halted by 2020 and begun to reverse the spread of HIV/AIDS. Target 2: Have halted by 2020 and begun to reverse the incidence of malaria and other major diseases.

Ensure Environmental Sustainability (achievable)

Environmental degradation in Afghanistan is particularly evident due to the destruction of forests for fuel leading to soil erosion, poor waste management and air pollution, which contributes to poor health and water contamination. An estimated 4 out of 5 Afghans in rural areas drink contaminated water. Target 1: Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources. Target 2: Halve, by 2020, the proportion of people without sustainable access to safe drinking water and sanitation. Target 3: By 2020, to have achieved a significant improvement in the lives of all slum dwellers.

Develop a Global Partnership for Development (achievable)

Donor commitments to Afghanistan need more untied aid that maintains security, transport, infrastructure and social sectors. Target 1: Deal comprehensively and influence the provision of foreign aid through appropriate measures to enable Afghanistan to develop sustainably in the long-term. Target 2: Develop an open, rule-based, predictable, non-discriminatory trading and financial system including a commitment to good governance, development and poverty reduction. Target 3: In cooperation with developing countries, develop and implement strategies for decent and productive work for youth. Target 4: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries. Target 5: In cooperation with the private sector, make available the benefits of new technologies, especially information and communications.

Enhance Security (on-track)

A stable security situation is key for Afghanistan to achieve all the Millennium Development Goals set for 2020. Target 1: Reform and professionalise the Afghan National Army by 2010. Target 2: Reform and professionalise the Afghan National Police by 2010. Target 3: Reduce the misuse of weapons and the proportion of illegally-held weapons by 2010. Target 4: All emplaced antipersonnel mines destroyed by 2013. All other explosive contaminants destroyed by 2015. Target 5: All stockpiled antipersonnel mines destroyed by 2007. All other abandoned or unwanted explosive stocks destroyed by 2020. Target 6: Reduce the contribution of opium to the total (illicit and illicit) GDP to less than 5% by 2015 and less than 1% by 2020.

Afghan Progress in Attaining the MDGs In 2005, Afghanistan submitted a country report on the MDGs providing some of the baseline information available regarding the challenges in achieving the set targets referenced in Table 2. UNDP produced a summary sheet containing the major points of the report. Some points of progress indicated in the report included a back-to-school campaign that resulted in the doubling of the Afghan school attendance rate from 27% to 54% in 2003. Girls school attendance rose from 13% to 40% in the same year and the literacy rate increased to one-third of 15 to 24-year-olds. The final point of progress noted in the 2005 report was the country-wide immunization campaigns that resulted in 75% of children under 12-monthsold being immunized. The Afghanistan Human Development Report 2007 carried many of the same findings expressed in the 2005 MDG report with emphasis on the need to reinforce the goals in the national budget. Within the 2007 report, there was also a brief update by the Minister of Education on the Afghan National Education Strategic Plan, including details on improvements in primary education, teacher education, education infrastructure development, curriculum development, Islamic education, technical/vocational education, literacy, education administration reform and development. The new strategic plan for 2010 emphasises the five year benchmark towards universal education and the ministrys achievement of 60% and 75% net primary school enrolment for girls and boys respectively by the end of 2010. The 2008 Annual Progress Report on Afghanistans MDGs (the last publicly available annual report) created a colour-coded system showing which goals were on track, achievable, difficult, or off track.

According to the Afghan government, three goals were on track in 2008; reducing child mortality (Goal 4), combating the spread of diseases (Goal 6) and enhancing security (Goal 9). Four other goals were listed as achievable with mixed progress over time; these included achieving universal primary education (Goal 2), improving maternal health (Goal 5), ensuring environmental sustainability (Goal 7) and enhancing global partnership for development (Goal 8). The benchmarks set for reducing poverty (Goal 1) and reaching gender equality and womens empowerment (Goal 3) were listed as difficult to achieve by the 2020 deadline; stressing the need to achieve peace and security and reduce cultural constraints that hinder equality for women. UNDP provides a detailed table of the MDG status in Afghanistan compiled with the results of the 2008 report. The World Bank also hosts a development indicators database. The database query on Afghanistan produces a statistical chart (see Annex 1) showing progress in the country as of 2008, though many of the goals exhibit little change over time. The Government of Afghanistan, World Health Organization (WHO) and United Nations Childrens Fund (UNICEF) issued new estimates at the MDG summit for child and maternal mortality in Afghanistan, MDG 4 and 5 respectively. Maternal mortality has decreased from 1,600 annual deaths per 100,000 live births in 2001 to 1,400 in 2010 and child mortality for children under the age of five has decreased from 257 annual deaths per 1,000 live births in 2001 to 161 in 2010.2 Acting Minister of Public Health Dr. Suraya Dalil has attributed the decrease in mortality rates to expanded health services and concerted child immunization Women collect potatoes in Bamyan province. campaigns. In spite of the decrease, Afghanistan Fardin Waezi /UNAMA 2010 still has a long road towards bridging the gaps in access to health care and disease prevention, reports the Integrated Regional Information Network (IRIN). UNICEF ranks Afghanistan the worst country out of 202 listed for maternal, infant and child mortality in 2009. Afghanistan is committed to reducing maternal mortality to 800 per 100,000 live births by 2015 and 400 by 2020 to achieve MDG 5 and reduce under-five mortality to 127 per 1,000 live births in 2015 to meet MDG 4. Afghan Foreign Minister Dr. Zalmai Rassoul presented Afghanistans current situation in terms of achieving their nine goals during a speech at the MDG Summit 2010. Minister Rassoul stressed the need to attain peace and security in the country to fully meet the MDGs. He went on to add that the country is experiencing 40% unemployment, 36% of the population is living in poverty and an ongoing gender gap in education persists. He also mentioned that Afghanistan relies solely on foreign aid for development projects and will need continued support to fully realize their nine MDGs. Afghanistan, at the five-year mark for attaining the MDGs, still has many obstacles to overcome. The question remains if peace and stability (Goal 9) will be achieved in sufficient time for the MDGs to make a significant difference in the lives of the Afghan people, particularly women and children.
2

It should be noted that WHO and UNICEF statistics for the MDGs available on-line still place the official child mortality figure for children under the age of five at 257 annual deaths per 1,000 in 2008. The 2010 figures have not yet been added to any official data charts publicly available.

ANNEX 1: World Bank Development Indicators: Afghanistans Millennium Development Goals

Millennium Development Goals 1990 Goal 1: Eradicate extreme poverty and hunger Employment to population ratio, 15+, total (%) Employment to population ratio, ages 15-24, total (%) GDP per person employed (constant 1990 PPP $) Income share held by lowest 20% Malnutrition prevalence, weight for age (% of children under 5) Poverty gap at $1.25 a day (PPP) (%) Poverty headcount ratio at $1.25 a day (PPP) (% of population) Vulnerable employment, total (% of total employment) Goal 2: Achieve universal primary education Literacy rate, youth female (% of females ages 15-24) Literacy rate, youth male (% of males ages 15-24) Persistence to last grade of primary, total (% of cohort) Primary completion rate, total (% of relevant age group) Total enrollment, primary (% net) Goal 3: Promote gender equality and empower women Proportion of seats held by women in national parliaments (%) Ratio of female to male primary enrollment (%) Ratio of female to male secondary enrollment (%) Ratio of female to male tertiary enrollment (%) Share of women employed in the nonagricultural sector (% of total nonagricultural employment) Goal 4: Reduce child mortality Immunization, measles (% of children ages 12-23 months) Mortality rate, infant (per 1,000 live births) Mortality rate, under-5 (per 1,000) Goal 5: Improve maternal health Adolescent fertility rate (births per 1,000 women ages 15-19) Births attended by skilled health staff (% of total) Contraceptive prevalence (% of women ages 15-49) Maternal mortality ratio (modeled estimate, per 100,000 live births) Pregnant women receiving prenatal care (%) Unmet need for contraception (% of married women ages 15-49) Goal 6: Combat HIV/AIDS, malaria, and other diseases Children with fever receiving antimalarial drugs (% of children under age 5 with fever) Condom use, population ages 15-24, female (% of females ages 15-24) Condom use, population ages 15-24, male (% of males ages 15-24) Incidence of tuberculosis (per 100,000 people) Prevalence of HIV, female (% ages 15-24) .. .. .. 1,700 .. .. .. .. .. 19 0 .. .. .. .. 1,800 .. .. .. .. .. 19 0 .. 14 6 12 5 1,800 37 .. .. .. .. 19 0 .. 13 1 19 15 1,500 30 .. .. .. .. 19 0 .. 12 0 24 15 1,400 36 .. .. .. .. 19 0 .. 20 16 7 25 0 41 15 7 23 5 35 14 8 22 2 64 14 0 20 8 75 13 5 20 1 4 55 51 48 17.8 .. 51 37 .. .. .. 0 0 .. .. 27 59 33 28 .. 28 66 38 .. .. .. .. .. .. .. .. .. .. 28 28 .. .. .. .. .. .. .. .. 39 .. .. .. .. .. .. 54 45 .. .. .. .. .. .. 54 45 .. .. .. .. .. .. 54 45 .. .. .. .. .. .. 54 46 .. .. 33 .. .. .. 55 47 .. .. .. .. .. .. 1995 2000 2005 2008

Prevalence of HIV, male (% ages 15-24) Prevalence of HIV, total (% of population ages 15-49) Tuberculosis case detection rate (all forms) Goal 7: Ensure environmental sustainability CO2 emissions (kg per PPP $ of GDP) CO2 emissions (metric tons per capita) Forest area (% of land area) Improved sanitation facilities (% of population with access) Improved water source (% of population with access) Marine protected areas (% of total surface area) Terrestrial protected areas (% of total surface area) Goal 8: Develop a global partnership for development Net ODA received per capita (current US$) Debt service (PPG and IMF only, % of exports, excluding workers' remittances) Internet users (per 100 people) Mobile cellular subscriptions (per 100 people) Telephone lines (per 100 people) Source: World Development Indicators

.. .. 18 .. 0 2.0 .. .. .. .. 7 .. 0.0 0 0

.. .. 4 .. 0 1.8 29 3 .. .. 10 .. .. 0 0

.. .. 18 0 0 1.6 32 21 .. .. 6 .. 0.0 0 0

.. .. 47 0 0 1.3 35 41 .. .. 10 5 4 1.1 4 0

.. .. 55 0 0 1.2 37 48 0 0 16 8 1 1.7 27 0

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