Research Article: Drivers of Inequality in Millennium Development Goal Progress: A Statistical Analysis

Date Published: March 2, 2010

Publisher: Public Library of Science

Author(s): David Stuckler, Sanjay Basu, Martin McKee, Simon Hales

Abstract: David Stuckler and colleagues examine the impact of the HIV and noncommunicable disease epidemics on low-income countries’ progress toward the Millennium Development Goals for health.

Partial Text: Remarkable efforts have been made towards meeting the health MDGs over the past 8 years (Box 1), yet many of the poorest countries are falling behind. As noted in the Report of the Secretariat to the World Health Assembly, “At the mid-point in the countdown to 2015, the target date set by the United Nations Millennium Declaration, there are several examples of success. However, great inequalities still exist within and between countries, and current trends suggest that many low-income countries will not reach the Millennium Development Goal targets” [1].

Our results indicate that progress in achieving the health MDGs for infant and child mortality and tuberculosis is associated significantly with the burden of adult NCDs and HIV prevalence among adults aged 15–49. The evidence emerging from these models is consistent with a growing body of research finding that high burdens of NCDs contribute to worse child health and poorer tuberculosis outcomes, both as a result of biological risks from comorbidities and as a consequence of reduced household resources (in both human and financial terms) when faced with multiple comorbidities (Table 1). An abundance of evidence indicates that poor households face the greatest burdens of both HIV and NCDs (though the diagnostic infrastructure for the latter is focused on higher income groups), and are also the households most affected by child mortality and tuberculosis.



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