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ethics + policy

Can the UN Heal the World by

2015?

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o help bridge the gap in quality of life between developed and underdeveloped nations, leaders from several countries in the United Nations (UN) created the Millennium Development Goals in September 2000—eight goals aimed at reducing worldwide hunger, poverty, disease and mortality, and promoting childhood education, gender equality and environmental sustainability. The UN set a target for meeting these goals by 2015. The progress of some of these efforts and their implications for members of the international community were discussed on October 7, 2006, at a conference entitled “Can the United Nations heal the world?” hosted by Stanford School of Medicine. Several Stanford professors spoke at the conference, including Dr. Yvonne Maldonado, Associate Professor of Pediatrics in Infectious Diseases, who focused on development goals to reduce childhood mortality and increase maternal health.

Closing the Health Gap Childhood and infant mortality are the greatest indicators of disparity between children in the developed world and those in underdeveloped regions. For this reason, the fourth UN Millennium Development Goal is to reduce the mortality rate of children under age five by two-thirds. Along similar lines, the fifth goal is to improve maternal health by reducing the maternal mortality ratio by three-quarters. Since the inception of these goals, there have been improvements in countries in Latin America, the Caribbean, Eastern Asia and Northern Africa. However, some regions have only seen modest progress. In 2003, Sub-Saharan

Stanford Medical School Hosts Conference on UN Goals by Victoria Parente

Africa, with only 20% of the world’s young, accounted for half of the deaths of children under age five. Also in this region, maternal mortality fell on average by 1.6% a year compared to the annual target rate of 5.4%. The World Bank, a group of organizations that provide finance and advice for economic development and elimination of poverty, states that the main obstacle in meeting the UN goals is the inefficient use of existing interventions. In 2003, the World Bank estimated that the number of childhood deaths worldwide could fall by as much as 63% if all the effective preventive and treatment interventions for childhood illness were practiced.

The Case for Vaccines Immunization is one such intervention for preventing disease. Vaccines are arguably the greatest achievement in public health, increasing life expectancy in the U.S. by 29.2 years during the 20th century. They have eliminated small pox and diminished the cases of infectious diseases such as polio, tetanus, measles and hepatitis B. Maldonado notes that pediatric vaccines “have had the most profound impact of any intervention on increasing global child survival, accounting for three million children’s lives saved annually.” According to Maldonado, 30.4% of deaths in children under age five in 1990 were due to infectious diseases. Today, that percentage is 1.4%, due in large part to increased access to vaccinations. However, close to 30 million children worldwide still have no access to immunization. In addition to the health benefits of vaccines, Maldonado adds that “Immunization reduces the social and financial costs of treating diseases, offering opportunities for poverty

Childhood and infant mortality are the greatest indicators of disparity between children in the developed world and those in underdeveloped regions.

Background Photo Credit: ©UNICEF/94-1393/Shehzad Noorani

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reduction and greater social and economic development.” For example, the eradication of smallpox in 1979 led to direct savings of $275 million per year in the U.S.

Preventing HIV Transmission Reducing childhood mortality in the developing world has also faced the more recent challenge of the spread of HIV/ AIDS. In the U.S., a single dose of an anti-HIV drug called nevirapine is given to mothers with HIV at the onset of labor and to the baby after delivery. This procedure roughly halves the rate of HIV transmission from mother to newborn. As nevirapine is only given once to the mother and her child, it is relatively easy and inexpensive. However, as with immunization, not everyone is using this preventative measure. U.S. law requires that a pregnant woman be tested for HIV to ensure that nevirapine is administered if she is positive. However, in other countries where HIV tests are not available, women may not know they are HIV positive and thus do not seek this intervention. Maldonado has participated in research that measures the frequency, timing and risk factors of HIV transmission through breast milk in Zimbabwe. Her work has had significant impact on studies concerning mother-tochild transmission. Although formula feeding prevents contraction of the virus, it also increases mortality rates in African infants under seven months old, due to factors including lack of transmission of antibodies from mother to child. Maldonado focuses on giving pharmaceuticals or HIV drugs such as nevirapine to those children at risk, so that they can continue nursing.

Photo Credit: ©sxc.hu/Nick Winchester

Vaccinations not only save lives, but they also save money and allow for greater economic prosperity.

VICTORIA PARENTE is a senior majoring in Biology, with an emphasis on Neuroscience and Psychology. In her spare time she enjoys running, swimming, and reading the New York Times. To Learn More Visit the UN Millennium Development Goals website: http:// www.un.org/millenniumgoals

Bringing UN Goals to Fruition Despite the existence of technology that can be applied toward reaching the UN’s goals, political effort has been lacking for this initiative. According to one UN speaker, the U.S. spent 0.2% of its budget for international development in 2005, making it the second lowest country out of 22 surveyed. To effect change, political will is needed. The scale of the problems is too large for non-government aid-relief organizations to solve alone. S

^Two children scavenge through remains of garbage in their village. layout layout design: design: Anita Verma

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