millennium(development(goals ... · 7 | presentation title | 2013...

Presentation title | 2013 1 |

Millennium Development Goals: Progress made and lessons learned in the La8n American and Caribbean Region

Dr Jon Andrus PAHO/WHO Deputy Director

20th Canadian Conference on Global Health, Canada, October 27, 2013


Content

•  Health related MDGs – MDG 4: Reduce Child Mortality – MDG 5: Improve Maternal Health – MDG 6: Combat HIV/aids, malaria, TB, other – MDG 7: Ensure environmental sustainability

•  Lessons learn •  Final words


MDGs and Health Target in the Region of the Americas

MDG 4: Reduce Child Mortality by 2/3 MDG 5: Improve Maternal Health reduce maternal morbidity by 3/4 MDG 6: Combat HIV/aids, malaria, TB, other MDG 7: Ensure environmental sustainability


0

20

40

60

80

100

Infant mortality rate

1990 1995 2000 2005 2010

Year

Even with descending trends, some countries who are outliers clearly will not reach the goal by 2015

Source: United NaJons Children’s Fund; World Health OrganizaJon; The World Bank; United NaJons PopulaJon Division. Levels & Trends in Child Mortality, Report 2012. New York: UNICEF; 2012 (EsJmates developed by the UN Inter-‐agency Group for Child Mortality EsJmaJon).

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1990: Average IMR was 42 per 1,000 live births 2011: Average IMR was 16, represen8ng a 62.0% reduc8on.

MDG 4 -‐ Distribu8on of Child Mortality Under One Year of Age in the LAC, 1990-‐2013


Maternal Mortality in the Americas, 1990 -‐ 2010

Rates show great varia8on, few countries will reach the goal by 2015

World Health Organiza8on. Trends in maternal mortality: 1990 to 2010. WHO, UNICEF, UNFPA and World Bank es8mates [Internet]. Geneva, (Switzerland): OMS; 2012 [cited 2013 Feb 15].

0

50

100

150

200

300

400

600

Maternal mortality rate

1990 1995 2000 2005 2010

Year

1990: Average MMR in LAC was 140 per 100,000 live births and 80 in 2010 (9,726 deaths in Region); a 41% reduc8on, with an annual average decline of 2.6%.


MDG 6: Combat HIV/aids, malaria, TB & other


MDG Target 6.A. Epidemic halted by 2015 and Reversed Spread of HIV/AIDS

68% 73%

78%

0%

20%

40%

60%

80%

100%

2010 2011 2012

% an8

retrovira

l the

rapy

coverage

0

30,000

60,000

90,000

120,000

150,000

180,000

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012

No o

f new

HIV infec8on

s

Target 6.B. Achieve universal access to treatment for HIV/AIDS for all those who need it

Trends in new HIV infec8ons in LAC

Decreased from 120,000 in 2001 to 97,000 in 2012

(19% decrease)

People eligible who are receiving an8retroviral therapy in LAC

MDG 6: “Halt and begin to reverse the incidence of Malaria...”

ü  Currently, six countries are in pre-‐elimina8on phase (Argen8na, Costa Rica, Ecuador, El Salvador, Mexico and Paraguay); other endemic countries are in control phase .

ü  In 2012*, the region reported 492,085 confirmed malaria cases and 114 malaria deaths (58% decline in cases and a 70% decline in deaths since 2000)

ü  In the Americas, between 2000 and 2012 malaria: –  Incidence declined in 18 of 21

endemic countries –  Cases declined over 75% in 12

countries, 50-‐75% in four countries, and less than 50% in two countries

–  Cases increased In three countries—the Guyana, HaiJ

Source: Annual Country Report. PAHO/WHO.


MDG 6: “Halt and begin to reverse the incidence of Malaria...”

Source: Annual Country Reports to PAHO/WHO

Percentage reduc8on in confirmed malaria cases, Region of the Americas 2000-‐2012

MDG 6: Tuberculosis 1990 – 2012 Incidence

Prevalence Mortality

Es8mated incidence

Reported incidence

Es8mated Mortality

Es8mated Prevalence

Reported Prevalence

The incidence of TB in the Americas is declining at a rate of 4% annually, the fastest rate of decline in the world.

The Region has reached and surpassed the goals of reducing prevalence and mortality by 50%.


In 2011, data reported on sustainable access to safe water, access to improved water sources was 94% in the Americas: •  98% in urban areas and •  81% in rural areas

MDG 7: Ensure environmental sustainability


38 million people in the Americas do not have access to water 26 million of them live in rural areas

Trends in WATER coverage in the Americas, 1990-‐2011

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Source: 2011 WHO/UNICEF Joint Monitoring Programme for Water and SanitaJon.

Trends in SANITATION coverage in the Americas, 1990-‐2011

30.4 million people in the Americas defecate in the open 27 million of them live in rural areas

Source: 2011 WHO/UNICEF Joint Monitoring Programme for Water and SanitaJon.


Lessons Learned in Malaria

•  Ongoing monitoring and evalua8on: Periodically review and update malaria policies and strategic frameworks to reflect work carried out in the Region, appropriately award good work

•  Cri8cal role of surveillance: Sustain and strengthen surveillance at all levels of the health system to detect malaria threats and trigger appropriate responses to evolving challenges including: –  Quality assurance and universal access to malaria diagnosis and treatment –  Resistance to anJmalarial medicines –  Judicious use of epidemiologic informaJon and other relevant data in

decision-‐making and program management –  InsecJcide resistance –  Addressing key knowledge gap

•  Poli8cal commitment: Galvanize stronger, sustained commitment of countries (endemic and non-‐endemic) and various sectors in efforts against the disease


Lessons Learned •  The LAC Region is changing and

must face new challenges •  Complex problems require beker

coordinated solu8ons -‐ New integrated, all of society responses

•  Role of UHC and maternal mortality •  Rapid urbaniza8on -‐ There is a need

to strengthen urban and industrial development planning

•  To increase fiscal space and promote sustainable development, other efforts are required, especially inclusion of other non-‐health stakeholders

•  Beker metrics to measure the achievements of poten8al post 2015 MDGs will be required


Final Words

Paving the Future




•  La8n America and the Caribbean

have achieved important advances to fulfill the MDGs, health related, par8cularly those who have increased coverage of pre-‐natal care, comple8on of primary educa8on, reduc8on of maternal mortality and access to drinking water.

millennium(development(goals ... · 7 | presentation title | 2013...

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