Health millennium goals neglected in Asia-Pacific region: UN report

Hunger, child mortality and maternal mortality remain high in the Asia-Pacific region, making it difficult for the countries in the region to achieve the Millennium Development Goals (MDGs) by 2015, says a UN report released on Friday in New Delhi.

Over three million children in the region died before their fifth birthday in 2010 alone, notes the report—Accelerating Equitable Achievements of the MDGs: Closing the Gaps in Health and Nutrition in Asia and Pacific. Public health experts who were present at the release of the report blame low public health spending as one of the reasons for unimpressive health indicators in India.

Low public spending

While launching the report, minister for rural development, drinking water and sanitation, Jairam Ramesh, too, said the health sector in the country is starved of funds. “Out of the seven per cent of GDP spent on health, less than two per cent comes from the government, rest is private spending. Public investment in health is critical,” he said. He added that health expenditure is one of the primary reasons for rural indebtedness. “Many suicides happen because of it, and it is loosely called farmer suicides,” Ramesh said.
 
Anuradha Rajivan, practice team leader with UNDP and one of the authors of the report, said more focus is needed on the primary health care system. “The policies ignore remote areas and that is one of the reasons why out-of-pocket expenditure on health is so high in India,” she said.

Stressing on increasing public spending on health, Jawaharlal Nehru University professor Jayati Ghosh pointed that it is absolutely necessary that the government recognises the work done by the Accredited Social Health Activists (ASHAs) and ground-level health workers and pay regular wages to them. 

Health indices linked to corruption

Another reason for slow progress on improving health indicators in the region is disparity within and between countries. “Women and children are dying of reasons that are preventable,” said Bindu Lohani, vice-president for knowledge management and sustainable development, Asian Development Bank (ADB). Linking the progress made in sectors other than health to better health indicators, he added that countries like Sri Lanka and Bangladesh are doing better because they have better access to basic infrastructure, energy, clean water and family planning services.

The report says that even fast-growing countries continue to lose shocking numbers of children before their fifth birthday and thousands of mothers die unnecessarily while giving birth.

The report notes that countries that have been able to control corruption have better health results. Also, women’s literacy and education levels play a crucial role in improving public health.

In India, the infant and maternal mortality rates are poor because the vaccines are only reaching 80 per cent of children and 24-hour emergency healthcare is missing in many parts of the country, explains Rajesh Mehta, medical officer for child and adolescent health, WHO.

The report warns that at the present rate of progress, the region as a whole is unlikely to meet MDGs for eradicating hunger, reducing child mortality and improving maternal health, among others. To raise the standards on health, the government will have to focus more on the needs of the poor and the vulnerable.

Positive news

The region, however, has made big advances in reducing poverty and has already achieved the MDG of halving the incidence of poverty, reducing the proportion of people living on less than $1.25 per day from 50 to 22 per cent between 1990 and 2009, notes the report.

The region has also achieved targets like promoting gender equality in education, reducing HIV prevalence, stopping the spread of tuberculosis, increasing forest cover, reducing consumption of ozone-depleting substances and halving the proportion of people without access to safe drinking water. The report has been published by the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP), the United Nations Development Programme (UNDP) and ADB.