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UNITED NATIONS
This report is based on a master set of data that has been compiled by the Inter-Agency and Expert
Group on MDG Indicators led by the Department of Economic and Social Affairs of the United Nations
Secretariat, in response to the wishes of the General Assembly for periodic assessment of progress
towards the MDGs. The Group comprises representatives of the international organizations whose
activities include the preparation of one or more of the series of statistical indicators that were identified as
appropriate for monitoring progress towards the MDGs, as reflected in the list below. A number of national
statisticians and outside expert advisers also contributed.
INTER-PARLIAMENTARY UNION
UNITED NATIONS ENTITY FOR GENDER EQUALITY AND THE EMPOWERMENT OF WOMEN - UN WOMEN
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United Nations
New York, 2015
Foreword |3
Foreword
The global mobilization behind the Millennium Experiences and evidence from the efforts to achieve
Development Goals has produced the most successful the MDGs demonstrate that we know what to do. But
anti-poverty movement in history. The landmark further progress will require an unswerving political
commitment entered into by world leaders in the year will, and collective, long-term effort. We need to tackle
2000to spare no effort to free our fellow men, root causes and do more to integrate the economic,
women and children from the abject and dehumanizing social and environmental dimensions of sustainable
conditions of extreme povertywas translated into development. The emerging post-2015 development
an inspiring framework of eight goals and, then, into agenda, including the set of Sustainable Development
wide-ranging practical steps that have enabled people Goals, strives to reflect these lessons, build on our
across the world to improve their lives and their future successes and put all countries, together, firmly on track
prospects. The MDGs helped to lift more than one billion towards a more prosperous, sustainable and equitable
people out of extreme poverty, to make inroads against world.
hunger, to enable more girls to attend school than ever
before and to protect our planet. They generated new Reflecting on the MDGs and looking ahead to the next
and innovative partnerships, galvanized public opinion fifteen years, there is no question that we can deliver on
and showed the immense value of setting ambitious our shared responsibility to put an end to poverty, leave
goals. By putting people and their immediate needs at no one behind and create a world of dignity for all.
the forefront, the MDGs reshaped decision-making in
developed and developing countries alike.
Overview
At the beginning of the new millennium, world leaders have saved the lives of millions and improved conditions
gathered at the United Nations to shape a broad vision to for many more. The data and analysis presented in
fight poverty in its many dimensions. That vision, which this report prove that, with targeted interventions,
was translated into eight Millennium Development Goals sound strategies, adequate resources and political will,
(MDGs), has remained the overarching development even the poorest countries can make dramatic and
framework for the world for the past 15 years. unprecedented progress. The report also acknowledges
uneven achievements and shortfalls in many areas. The
As we reach the end of the MDG period, the world
work is not complete, and it must continue in the new
community has reason to celebrate. Thanks to concerted
development era.
global, regional, national and local efforts, the MDGs
20142016.
60%
60% The literacy rate among youth aged 15 to 24 has increased globally from 83 per
52%
80% cent to 91 per cent between 1990 and 2015. The gap between women and men has
80%
40% narrowed.
60%
60% 52%
20%
40%
0
1990 2000 2015
20%
0
1990 2000 2015
Overview |5
Primary school enrolment Many more girls are now in school compared to 15 years ago. The developing
ratio in Southern Asia regions as a whole have achieved the target to eliminate gender disparity in
primary, secondary and tertiary education.
74 103
74 103
100
In Southern Asia, only 74 girls were enrolled in primary school for every 100 boys in
100 100
100 1990. Today, 103 girls are enrolled for every 100 boys.
1990 2015
1990 2015
Women now make up 41 per cent of paid workers outside the agricultural sector, an
increase from 35 per cent in 1990.
90% of countries have more
women in parliament since Between 1991 and 2015, the proportion of women in vulnerable employment as a
1995 share of total female employment has declined 13 percentage points. In contrast,
vulnerable employment among men fell by 9 percentage points.
Global number of deaths The global under-five mortality rate has declined by more than half, dropping from
of children under five
1990
12.7 90 to 43 deaths per 1,000 live births between 1990 and 2015.
million
1990
12.7
6 Despite population growth in the developing regions, the number of deaths of
2015 million
million children under five has declined from 12.7 million in 1990 to almost 6 million in
6 2015 globally.
2015 million
Since the early 1990s, the rate of reduction of under-five mortality has more than
Global measles vaccine tripled globally.
coverage
100% In sub-Saharan Africa, the annual rate of reduction of under-five mortality was over
84% five times faster during 20052013 than it was during 19901995.
80% 73%
100%
60% 84% Measles vaccination helped prevent nearly 15.6 million deaths between 2000 and
80% 73% 2013. The number of globally reported measles cases declined by 67 per cent for
40%
60% the same period.
20%
40%
About 84 per cent of children worldwide received at least one dose of measles-
0
20% 2000 2013 containing vaccine in 2013, up from 73 per cent in 2000.
0
2000 2013
6 | The Millennium Development Goals Report 2015
Global maternal mortality Since 1990, the maternal mortality ratio has declined by 45 per cent worldwide,
ratio (deaths per 100,000 and most of the reduction has occurred since 2000.
live births)
In Southern Asia, the maternal mortality ratio declined by 64 per cent between
1990 and 2013, and in sub-Saharan Africa it fell by 49 per cent.
More than 71 per cent of births were assisted by skilled health personnel globally in
380
330 2014, an increase from 59 per cent in 1990.
380 210
330
In Northern Africa, the proportion of pregnant women who received four or more
210
antenatal visits increased from 50 per cent to 89 percent between 1990 and 2014.
1990 2000 2013
Global1990
births2000
attended by
2013 Contraceptive prevalence among women aged 15 to 49, married or in a union,
skilled
80% health personnel increased from 55 per cent in 1990 worldwide to 64 per cent in 2015.
80%
70%
71%
70%
71%
60%
59%
60%
50% 59%
1990 2015
50%
1990 2014
Global antiretroviral therapy New HIV infections fell by approximately 40 per cent between 2000 and 2013,
treatment from an estimated 3.5 million cases to 2.1 million.
13.6
million By June 2014, 13.6 million people living with HIV were receiving antiretroviral
therapy (ART) globally, an immense increase from just 800,000 in 2003. ART
averted 7.6 million deaths from AIDS between 1995 and 2013.
0.8 13.6
million ART million Over 6.2 million malaria deaths have been averted between 2000 and 2015,
primarily of children under five years of age in sub-Saharan Africa. The global
ART
malaria incidence rate has fallen by an estimated 37 per cent and the mortality rate
2003 2014 by 58 per cent.
0.8
million
Number of insecticide- ART More than 900 million insecticide-treated mosquito nets were delivered to
treated mosquito nets
ART malaria-endemic countries in sub-Saharan Africa between 2004 and 2014.
delivered2003
in sub-Saharan
2014
Africa, 20042014 Between 2000 and 2013, tuberculosis prevention, diagnosis and treatment
interventions saved an estimated 37 million lives. The tuberculosis mortality rate
fell by 45 per cent and the prevalence rate by 41 per cent between 1990 and 2013.
900 million
900 million
Overview |7
1.9 billion people have gained Ozone-depleting substances have been virtually eliminated since 1990, and the
access to piped drinking ozone layer is expected to recover by the middle of this century.
water since 1990
Terrestrial and marine protected areas in many regions have increased substantially
2.3 billion 4.2 billion
since 1990. In Latin America and the Caribbean, coverage of terrestrial protected
areas rose from 8.8 per cent to 23.4 per cent between 1990 and 2014.
2.3 billion 4.2 billion
In 2015, 91 per cent of the global population is using an improved drinking water
source, compared to 76 per cent in 1990.
1990 2015 Of the 2.6 billion people who have gained access to improved drinking water since
1990, 1.9 billion gained access to piped drinking water on premises. Over half of the
global population (58 per cent) now enjoys this higher level of service.
98% of ozone-depleting2015
1990
substances eliminated since Globally, 147 countries have met the drinking water target, 95 countries have met
1990 the sanitation target and 77 countries have met both.
Worldwide, 2.1 billion people have gained access to improved sanitation. The
proportion of people practicing open defecation has fallen almost by half since
1990.
The proportion of urban population living in slums in the developing regions fell
from approximately 39.4 per cent in 2000 to 29.7 per cent in 2014.
Official development Official development assistance from developed countries increased by 66 per cent
assistance in real terms between 2000 and 2014, reaching $135.2 billion.
$135 billion
In 2014, Denmark, Luxembourg, Norway, Sweden and the United Kingdom
$81 billion $135 billion continued to exceed the United Nations official development assistance target of
$81 billion 0.7 per cent of gross national income.
$ $
$
In 2014, 79 per cent of imports from developing to developed countries were
$
2000 2014
admitted duty free, up from 65 per cent in 2000.
The number of mobile-cellular subscriptions has grown almost tenfold in the last 15
6%
years, from 738 million in 2000 to over 7 billion in 2015.
6%
Internet penetration has grown from just over 6 per cent of the worlds population
2000 2015 in 2000 to 43 per cent in 2015. As a result, 3.2 billion people are linked to a global
2000 2015 network of content and applications.
8 | The Millennium Development Goals Report 2015
Despite many successes, the poorest and most vulnerable people are being left behind
Although significant achievements have been made on XX Climate change and environmental degradation
many of the MDG targets worldwide, progress has been undermine progress achieved, and poor people
uneven across regions and countries, leaving significant suffer the most
gaps. Millions of people are being left behind, especially
the poorest and those disadvantaged because of their Global emissions of carbon dioxide have increased by
sex, age, disability, ethnicity or geographic location. over 50 per cent since 1990. Addressing the unabated
Targeted efforts will be needed to reach the most rise in greenhouse gas emissions and the resulting likely
vulnerable people. impacts of climate change, such as altered ecosystems,
weather extremes and risks to society, remains an
XX Gender inequality persists urgent, critical challenge for the global community.
Women continue to face discrimination in access to An estimated 5.2 million hectares of forest were
work, economic assets and participation in private lost in 2010, an area about the size of Costa Rica.
and public decision-making. Women are also more Overexploitation of marine fish stocks led to declines
likely to live in poverty than men. In Latin America in the percentage of stocks within safe biological limits,
and the Caribbean, the ratio of women to men in poor down from 90 per cent in 1974 to 71percent in 2011.
households increased from 108 women for every 100 Species are declining overall in numbers and distribution.
men in 1997 to 117 women for every 100 men in 2012, This means they are increasingly threatened with
despite declining poverty rates for the whole region. extinction. Water scarcity affects 40 per cent of people
in the world and is projected to increase. Poor peoples
Women remain at a disadvantage in the labour market. livelihoods are more directly tied to natural resources,
Globally, about three quarters of working-age men and as they often live in the most vulnerable areas, they
participate in the labour force, compared to only half of suffer the most from environmental degradation.
working-age women. Women earn 24 per cent less than
men globally. In 85 per cent of the 92 countries with XX Conflicts remain the biggest threat to human
data on unemployment rates by level of education for development
the years 20122013, women with advanced education
have higher rates of unemployment than men with By the end of 2014, conflicts had forced almost
similar levels of education. Despite continuous progress, 60million people to abandon their homesthe highest
today the world still has far to go towards equal gender level recorded since the Second World War. If these
representation in private and public decision-making. people were a nation, they would make up the twenty-
fourth largest country in the world. Every day, 42,000
XX Big gaps exist between the poorest and richest people on average are forcibly displaced and compelled
households, and between rural and urban areas to seek protection due to conflicts, almost four times the
2010 number of 11,000. Children accounted for half of
In the developing regions, children from the poorest the global refugee population under the responsibility
20per cent of households are more than twice as likely of the United Nations High Commissioner for Refugees
to be stunted as those from the wealthiest 20per cent. in 2014. In countries affected by conflict, the proportion
Children in the poorest households are four times of out-of-school children increased from 30 per cent in
as likely to be out of school as those in the richest 1999 to 36 per cent in 2012. Fragile and conflict-affected
households. Under-ve mortality rates are almost twice countries typically have the highest poverty rates.
as high for children in the poorest households as for
children in the richest. In rural areas, only 56percent XX Millions of poor people still live in poverty and
of births are attended by skilled health personnel, hunger, without access to basic services
compared with 87 per cent in urban areas. About
16percent of the rural population do not use improved Despite enormous progress, even today, about 800
drinking water sources, compared to 4 per cent of the million people still live in extreme poverty and suffer
urban population. About 50 per cent of people living in from hunger. Over 160 million children under age five
rural areas lack improved sanitation facilities, compared have inadequate height for their age due to insufficient
to only 18 per cent of people in urban areas. food. Currently, 57 million children of primary school
age are not in school. Almost half of global workers are
still working in vulnerable conditions, rarely enjoying
the benefits associated with decent work. About
16,000 children die each day before celebrating their
Overview |9
fifth birthday, mostly from preventable causes. The ART in 2013. In 2015, one in three people (2.4 billion)
maternal mortality ratio in the developing regions is 14 still use unimproved sanitation facilities, including 946
times higher than in the developed regions. Just half of million people who still practise open defecation. Today
pregnant women in the developing regions receive the over 880 million people are estimated to be living in
recommended minimum of four antenatal care visits. slum-like conditions in the developing worlds cities.
Only an estimated 36 per cent of the 31.5 million people
living with HIV in the developing regions were receiving With global action, these numbers can be turned around.
The successes of the MDG agenda prove that global action works. It is the only path to
ensure that the new development agenda leaves no one behind
The global community stands at a historic crossroads This is the final MDG report. It documents the
in 2015. As the MDGs are coming to their deadline, the 15-year effort to achieve the aspirational goals set out
world has the opportunity to build on their successes in the Millennium Declaration and highlights the many
and momentum, while also embracing new ambitions successes across the globe, but acknowledges the
for the future we want. A bold new agenda is emerging gaps that remain. The experience of the MDGs offers
to transform the world to better meet human needs and numerous lessons, and they will serve as the springboard
the requirements of economic transformation, while for our next steps. Leaders and stakeholders in every
protecting the environment, ensuring peace and realizing nation will work together, redoubling efforts to achieve
human rights. At the core of this agenda is sustainable a truly universal and transformative agenda. This is the
development, which must become a living reality for only way to ensure a sustainable future and a dignified
every person on the planet. life for all people everywhere.
Wu Hongbo
Under-Secretary-General for Economic and Social Affairs
10 | The Millennium Development Goals Report 2015
Proportion of countries and territories in the developing Better data are needed for the post-2015
regions with at least two data points for 22 selected development agenda
MDG indicators, 2003, 2006 and 2014 (percentage)
100
XX Only by counting the uncounted can we reach the
90 unreached
79
80
70 High-quality data disaggregated by key dimensions
64
beyond the basics of age and sex, including migrant status,
60
48
indigenous status, ethnicity and disability among others, are
50
key to making decisions and monitoring progress towards
40 achieving sustainable development for all. Estimating the
30
30 size and exploring the attributes of small population groups
19 19 requires large sample sizes or full population counts.
20
12 13
6 6
National population and housing censuses provide an
10
2 2 important data source and sampling frame for estimating
0
2003 2006 2014
the size of vulnerable minority groups.
A World Bank study shows that about half of the 155 Births attended by skilled personnel in Mexico
countries lack adequate data to monitor poverty and, as a and Peru, by indigenous status, selected years
result, the poorest people in these countries often remain (percentage)
invisible. During the 10-year period between 2002 and 2011, 99
100 95
as many as 57 countries (37 per cent) had none or only one 92
poverty rate estimate. In sub-Saharan Africa, where poverty 90
81 83
is most severe, 61 per cent of countries have no adequate 80
data to monitor poverty trends. 70 67
60 57
Lack of well-functioning civil registration systems with
50
national coverage also results in serious data gaps,
especially for vital statistics. According to the UN Inter- 40
agency Group for Child Mortality Estimation, only around 30
22
60 countries have such systems; the others rely mostly on 20
household surveys or censuses to estimate child mortality. 10
0
2003 2012 2000 2012
Mexico Peru
Indigenous women
Non-indigenous women
12 | The Millennium Development Goals Report 2015
XX Real-time data are needed to deliver better Strong political commitment and significantly
decisions faster increased resources will be needed to meet the
data demand for the new development agenda
In todays rapidly changing world, real-time information
is needed to prepare and respond to economic, political,
natural and health crises. However, most development data XX Strengthening statistical capacity is the foundation
have a time lag of two to three years. Recent innovations are for monitoring progress of the new development
helping to circumvent this problem. For example, UNICEF agenda
and partners have used text messaging (SMS) technology
to facilitate real-time collection and sharing of information To improve the availability, reliability, timeliness and
about the Ebola outbreak. In Liberia, hundreds of health accessibility of data to support the post-2015 development
workers have used mHero (Health Worker Electronic agenda, sustainable investments are needed in statistical
Response and Outreach) and in Guinea and Sierra Leone, capacity at all levels, especially the national level. The
thousands of young people are using U-Report. This real- scaling-up of national statistical capacities and the
time information has helped rapidly locate new cases, strengthening and modernization of statistical systems
determined what supplies are needed and disseminated will require ensuring effective institutional arrangements
lifesaving messages. and internal coordination, sustainable human resources,
sustainable financial resources (internal and external) and
XX Geospatial data can support monitoring in many technical cooperation. National statistical offices should
aspects of development, from health care to natural have a clear mandate to lead the coordination among
resource management national agencies involved and to become the data hub for
monitoring.
Knowing where people and things are and their relationship
to each other is essential for informed decision-making. For instance, improving a countrys civil registration and
Comprehensive location-based information is helping vital statistics system requires strong commitment from
Governments to develop strategic priorities, make decisions, the government and long-term efforts in strengthening
and measure and monitor outcomes. Once the geospatial administrative infrastructure. Progress in the past 20 years
data are created, they can be used many times to support has been very slow, but a few countries have made great
a multiplicity of applications. A geodetic reference frame strides. In South Africa, for example, 85 per cent of births
allows precise observations and positioning of anything on in 2012 were registered compared to 56 per cent of births
the Earth and can be used for many social, economic and in 2003. In Thailand, thanks to efforts begun in 1996, more
environmental purposes, such as precision agriculture and than 95 per cent of births and deaths are now registered.
monitoring changes in sea level rise.
XX New technology is changing the way data are
For example, geospatial information was used to support collected and disseminated
health care and design social intervention measures during
the chikungunya virus (chick-V) outbreak across the New information and communication technologies provide
Caribbean. In Trinidad and Tobago, geospatial applications unprecedented opportunities for data collection, analysis
for smart phones assisted the Ministry of Health to identify and dissemination. Today, 95 per cent of the global
the location of infected persons and use the information to population is covered by a cellular network, while mobile-
contain the outbreak. cellular subscriptions have grown to over 7 billion. Internet
penetration has increased to 43 per cent of the worlds
population, linking 3.2 billion people to a global network of
content and applications. New data collection technologies,
such as Computer-Assisted Personal Interviewing (CAPI)
and mobile text surveys (SMS), and new data sources, such
as social media posts, online search records and mobile
phone call records, allow faster data collection and provide
near real-time information.
To cover difficult-to-reach populations, Brazil also used XX Promoting open, easily accessible data and
Internet data collection as a complementary system. data literacy is key for effective use of data for
development decision-making
However, new data sources and new data collection
technologies must be carefully applied to avoid a reporting Data for development are public goods and should be made
bias favouring people who are wealthier, more educated, available to the public in open formats. Open data supports
young and male. The use of these innovative tools might government transparency and accountability, enables
also favour those who have greater means to access the use of collective intelligence to make smarter policy
technology, thus widening the gap between the data poor decisions, increases citizen engagement and promotes
and the data rich. government efficiency and effectiveness. Besides data,
information on definitions, data quality, methods used in
XX Global standards and an integrated statistics system collecting data and other importantmetadata also need to
are key elements for effective monitoring be made widely available. In addition to opening up data,
great efforts need to be made to release data in machine-
International standards are important for building national readable formats and to provide free visualization and
statistical capacity. One of the Fundamental Principles of analysis tools.
Official Statistics states that the use by statistical agencies
in each country of international concepts, classifications With an increasing volume of data available, people will
and methods promotes the consistency and efficiency of also need the skills to use and interpret them correctly.
statistical systems at all official levels. The Secretary- Governments, international organizations and other
Generals Independent Expert Advisory Group on the Data stakeholders should support implementation of data
Revolution for Sustainable Development also highlighted literacy programmes, provide e-learning opportunities and
in its report the need for a Global consensus on data include data literacy as a part of school curriculum.
to adopt principles concerning legal, technical, privacy,
geospatial and statistical standards that facilitate openness XX Together we can measure what we treasure
and information exchange while promoting and protecting
human rights. Data, as the basis for evidence-based decision-making
and accountability, are a crucial pillar of the post-2015
Measuring sustainability is a highly technical task that development agenda. The necessary data revolution is
requires capturing complex economic, societal and a joint responsibility of governments, international and
environmental interactions. Therefore, an integrated regional organizations, the private sector and civil society.
framework of indicators is needed to cover these three Building a new partnership will be essential to ensure that
dimensions cohesively. Integration benefits not only data data are available to inform the post-2015 development
users, but also data producers and providers by reducing the agenda and support development decision-making for the
respondents burden, the likelihood of errors and the long- next 15 years.
term costs. Harnessing the benefits of statistical integration
requires investment in the adoption of statistical standards,
developing and re-engineering of statistical production
processes, and changing institutional arrangements.
14 | The Millennium Development Goals Report 2015
Target 1.A
hunger
Sub-Saharan Africa
57
47 28%
41
Southern Asia
52
23 66%
17
Southern Asia (excluding India)
53
20 73%
14
South-Eastern Asia
46
12 84%
7
Eastern Asia (China only)
61
Key facts 6 94%
4
Latin America and the Caribbean
XX More than 1 billion people have 13
been lifted out of extreme 5 66%
4
poverty since 1990.
Caucasus and Central Asia
8
XX Despite progress, almost half 4 77%
2
of the worlds employed people
work in vulnerable conditions. Western Asia
5
2 46%
XX The proportion of 3
undernourished people in the Northern Africa
5
developing regions has fallen by 2 81%
almost half since 1990. 1
Developing regions (excluding China)
XX One in seven children worldwide 41
22 57%
are underweight, down from one 18
in four in 1990. Developing regions
47
XX By the end of 2014, conflicts had 18 69%
14
forced almost 60 million people
World
to abandon their homes. 36
15 68%
12
0 10 20 30 40 50 60 70 80 90 100
1990 2011 2015 projection
Global poverty has declined significantly over the past The number of people living in extreme
two decades. The MDG target of reducing by half the poverty has declined by more than half
proportion of people living in extreme poverty was
achieved five years ago, ahead of the 2015 deadline. The
since 1990
latest estimates show that the proportion of people living
on less than $1.25 a day globally fell from 36 per cent Number of people living on less than $1.25 a day
in 1990 to 15 per cent in 2011. Projections indicate that worldwide, 19902015 (millions)
the global extreme poverty rate has fallen further, to 12 2,000
per cent, as of 2015. The poverty rate in the developing
1,939
1,926
regions has plummeted, from 47 per cent in 1990 to 14 1,800
per cent in 2015, a drop of more than two thirds.
1,754
1,751
1,600
1,632
By 2011, all developing regions except sub-Saharan Africa 1,400
had met the target of halving the proportion of people
1,371
who live in extreme poverty (Oceania has insufficient 1,200
1,255
data). The worlds most populous countries, China and
India, played a central role in the global reduction of 1,000
1,011
poverty. As a result of progress in China, the extreme
800
poverty rate in Eastern Asia has dropped from 61 per
836
cent in 1990 to only 4 per cent in 2015. Southern Asias 600
progress is almost as impressivea decline from 52 per
cent to 17 per cent for the same periodand its rate of 400
reduction has accelerated since 2008.
200
Ratio of women to men of working age (20 to 59) in the lowest wealth quintile of all households, selected developing
countries, 20002013
In 41 countries, women are In 17 countries, women are In 17 countries, women are
more likely than men equally likely as men less likely than men
to live in poor households to live in poor households to live in poor households
130
120
110
100
90
80
70
0 15 30 45 60 75
Notes: This indicator is weighted by the ratio of females to males aged 2059 in all households to reflect the fact that women may be overrepresented in the
entire population. It uses the wealth asset index in the Demographic and Health Surveys and Multiple Indicator Cluster Surveys as a proxy measure for poverty.
Values above 103 indicate that women are overrepresented in the lowest wealth quintile while values below 97 indicate that men are overrepresented in the
lowest wealth quintile. Values between 97 and 103 indicate parity.
Among the 1 billion people who were still living in Using conventional national poverty lines, another study
extreme poverty worldwide in 2011, it is unknown how found that in Latin America and the Caribbean, the ratio
many were women and girls. In part this is because of women to men in poor households increased from
measures of poverty rely on income or consumption 108 women for every 100 men in 1997 to 117 women
data collected at the household level, rather than at the to every 100 men in 2012. This upward trend is all the
individual level. This makes it difficult to differentiate more concerning because it took place in the context of
poverty rates within households, and hence to declining poverty rates for the whole region.
understand gender differences in the incidence, severity
and impact of poverty. Many factors contribute to womens heightened
vulnerability to poverty. These include unequal access to
A recent study used a wealth asset index as a proxy for paid work, lower earnings, lack of social protection and
household poverty to compare the percentage of women limited access to assets, including land and property.
and men aged 2059 who live in the lowest wealth Even where women are equally as likely to live in poor
quintile of all households. Using this measure, the study households as men, they are more likely to be deprived in
found that women are more likely to live in poverty in 41 other important areas of well-being, such as education.
out of 75 countries with data. Further analysis indicates
that in countries where women are overrepresented in Understanding the characteristics of the worlds poorest
the lowest wealth quintile of households, the households people and the reasons for their deprivation is crucial in
are more likely to be headed by women or to have no determining how best to target and eradicate poverty. It
male adults. This suggests a greater risk of poverty is clear that greater efforts are needed to produce high-
among separated women, widows and single mothers, quality poverty and gender statistics if we are to monitor
including self-reported heads of household without a progress effectively in eradicating extreme poverty for all
male partner. people everywhere.
Goal 1: Eradicate extreme poverty and hunger |17
Developed regions
57
56
0 10 20 30 40 50 60 70 80 90 100
The proportion of workers living The working middle class makes up almost
inextreme poverty has fallen sharply half the workforce in the developing world
Proportion of employed people living on less than Employment by economic class in the developing regions,
$1.25 a day, 1991 and 2015 (percentage) 1991 and 2015 (percentage of total employment)
Sub-Saharan Africa 100
5
57 13
36 13
Oceania 80
51 14
18 35
Southern Asia
53 60 19
17
South-Eastern Asia
50 40 25
7
Eastern Asia
68 49
20 16
3
Despite progress, almost half of the worlds employed people are still working
invulnerable conditions
Number and proportion of own-account and contributing family workers in total employment, 19912015
Millions Percentage
1,500 60
58
1,450
56
54
1,400
52
1,350 50
48
1,300
46
44
1,250
42
1,200 40
1991 1995 1999 2003 2007 2011 2015
(projection)
Left axis: number of workers in vulnerable employment Right axis: proportion of workers in vulnerable employment
The proportion of workers in vulnerable employment decent work. Sub-Saharan Africa and Southern Asia
defined as the share of own-account work and account for more than half of the worlds vulnerable
contributing family employment in total employment employment, with three out of four workers falling in
has continued to decline in all regions. The most this category. The number of workers in vulnerable
significant progress has been made in Eastern employment has increased by 25 million since 2008,
Asia, where the proportion of people in vulnerable because of the increasing number of people entering
employment has dropped from 71.2 per cent in 1991 to the labour market and limited opportunities for paid
39.6 per cent in 2015. Globally, however, 45 per cent employment. Currently there are 1.45 billion workers in
of all workers are still working in vulnerable conditions. vulnerable employment worldwide.
These workers rarely have the benefits associated with
20 | The Millennium Development Goals Report 2015
Target 1.C
Halve, between 1990 and 2015, the proportion of people who suffer from hunger
0
8
2
95
ct 6
3
n)
0
0
9
1
9
je 1
1
io
08
05
ro 14
99
02
90
11
96
93
20
(p 20
20
20
19
20
19
19
19
Marked differences in hunger prevalence The rate of hunger reduction varies widely by region. The
persist across regions Caucasus and Central Asia, Eastern Asia, Latin America
and South-Eastern Asia have reached the hunger target,
due mainly to rapid economic growth in the past two
Proportion of undernourished people, decades. China alone accounts for almost two thirds
19901992 and 20142016 (percentage) of the total reduction in the number of undernourished
Sub-Saharan Africa people in the developing regions since 1990. Northern
33 Africa is close to eradicating severe food insecurity,
23 having attained an overall level below 5 per cent.
Caribbean
27 In contrast, the pace of reduction in the Caribbean,
20 Oceania, Southern Asia and sub-Saharan Africa has
Southern Asia been too slow to achieve the target. Southern Asia faces
24 the greatest hunger burden, with about 281 million
16
undernourished people. Progress in Oceania has been
Oceania slow because of heavy dependence on food imports
16
by the small islands that constitute the majority of
14
countries in that region. Food security in this region is
Eastern Asia
23
also hampered by natural and human-caused disasters,
10 which often result in volatile prices and sudden and
South-Eastern Asia
unpredictable changes in the availability of important
31 staple foods.
10
Western Asia In sub-Saharan Africa, projections for the 20142016
6 period indicate a rate of undernourishment of almost 23
8 per cent. While the hunger rate has fallen, the number of
Caucasus and Central Asia undernourished people has increased by 44 million since
14 1990, reflecting the regions high population growth
7 rate. The situation varies widely across the subregions.
Latin America Northern, Southern and Western Africa have already
14 met or are close to meeting the target. But in Central
<5 Africa progress has been hampered by rapid population
Northern Africa growth and environmental fragility as well as economic
<5
and political upheaval. The number of undernourished
<5
people in the subregion has doubled since 1990.
Developing regions
23
13
In Western Asia, a starkly different pattern emerges.
Despite a relatively low number of undernourished
0 5 10 15 20 25 30 35 40 people and fast progress in reducing food insecurity
in several countries, projections indicate that the
199092 201416 projection
prevalence of undernourishment will rise by 32 per cent
2015 target between 19901992 and 20142016 due to war, civil
unrest and a rapidly growing number of refugees.
22 | The Millennium Development Goals Report 2015
Conflicts have forced almost 60 million Nine out of ten refugees under the UNHCR mandate
people from their homes are located in the developing regions. This compares
to seven out of ten a decade ago. The top three source
countries of refugees at the end of 2014 were the Syrian
Number of forcibly displaced persons, 20002014
Arab Republic (3.9 million), Afghanistan (2.6 million)
(millions)
and Somalia (1.1 million). Together they accounted for
60 60 more than half of all refugees under the responsibility of
UNHCR.
50
45 Based on available evidence, children accounted for
44
41
42 half of the global refugee population under the UNHCR
38 40 39
40
mandate in 2014, the highest proportion in 10 years.
Over the past decade, the number of refugee children
has been growing intermittently, from a low of 41 per
30 cent in 2009. This increase is principally driven by the
growing number of Afghan, Somali and Syrian refugee
children.
20
0
2000 2002 2004 2006 2008 2010 2012 2014
Although the MDG targets of halving the proportion of
people living in extreme poverty and hunger have been
Refugees and asylum seekers met or almost met, the world is still far from reaching the
Internally displaced persons MDG goal of eradicating extreme poverty and hunger.
Total number of forcibly displaced persons In 2015, an estimated 825 million people still live in
extreme poverty and 800 million still suffer from hunger.
In 2014, the world witnessed conflicts, violence and Eradicating poverty and hunger remains at the core of
human rights violations that resulted in the massive the post-2015 development agenda.
displacement of people, either within or outside their
home countries. During the year, an average of 42,000 Eliminating the remaining extreme poverty and hunger
people each day were forced to abandon their homes and will be challenging. Many of the people suffering the
seek protection due to conflicts, such as those in Iraq, most live in fragile contexts and remote areas. Access
Nigeria, Pakistan, South Sudan, the Democratic Republic to good schools, health care, electricity, safe water and
of the Congo, the Syrian Arab Republic and Ukraine. This other critical services remains elusive for many people,
is almost four times the figure of 11,000 people only four and it is frequently determined by socioeconomic status,
years earlier. gender, ethnicity or geography. For those who have been
able to climb out of poverty, progress is often fragile and
By the end of 2014, almost 60 million people had been temporary; economic shocks, food insecurity and climate
forcibly displaced worldwide, the highest level recorded change threaten to rob them of their hard-won gains.
since the Second World War. If these people were a
nation, they would make up the twenty-fourth largest The post-2015 development agenda will pick up where
country in the world. Roughly one third of them were the MDGs left off. The remaining gaps must be filled
refugees or asylum seekers, including 14.4 million in order to eradicate poverty and hunger and promote
individuals under the responsibility of the United sustained and inclusive economic growth, allowing
Nations High Commissioner for Refugees (UNHCR) people everywhere to thrive.
and 5.1 million Palestinian refugees registered with
the United Nations Relief and Works Agency for
Palestine Refugees in the Near East. In addition, close
to 1.8 million individuals were waiting for a decision
on asylum applications by the end of 2014. The global
figure of displaced people also includes more than 38
million people displaced within the borders of their own
countries.
24 | The Millennium Development Goals Report 2015
Target 2.A
Achieve
Across the world, tremendous progress
universal has been made since 2000 in enrolling children
primary in primary school
Considerable progress has been made in expanding The number of out-of-school children has
primary education enrolment since 1990, particularly been cut almost in half since 2000
since the adoption of the MDGs in 2000. Yet in some
developing countries many children of primary education
age do not attend school, and many children who begin Number of out-of-school children of primary school age,
primary school do not complete it. selected regions, 19902015 (millions)
120
of conflict. For example, in Western Asia the ongoing More children are completing primary
conflict in the Syrian Arab Republic has had a devastating school in lower-income countries
impact on childrens education. Data from the Syrian
Ministry of Education indicate that enrolment rates fell
by 34 percentage points for grades 1 to 12 in the school Completion rate in primary education, low- and
year ending in 2013. Among Syrian refugee children of middle-income countries, 19922015 (percentage)
primary and lower secondary school age (6 to 14 years) 100 96 96
95
in Lebanon, the enrolment rate is estimated to be around 89
12 per cent. 90
85
82
80 77 84
70 81
Large disparities remain in primary school 70
73 64
enrolment, and the poorest and most 65 57
60
disadvantaged children bear the heaviest
burden 50
43
47
40
Household wealth remains an important determinant
of a childs likelihood of attending school. For instance, 30
20082012 survey data from 63 developing countries
show that children in the poorest households were four 20
The gender gap in youth literacy has fallen Since the 1990s, global progress in youth and adult
since 1990, and a greater proportion of all literacy has been slow but steady, and the gap between
women and men has narrowed. The literacy rate among
youth can read and write youth aged 15 to 24 increased globally from 83 per cent
in 1990 to 89 per cent in 2010. This improvement was
Literacy rate among youth aged 15 to 24 by sex and region, largely a result of increasing attendance in primary and
1990, 2000 and 2015 (percentage) secondary school among younger generations.
Sub-Saharan Africa
According to projections based on historical trends,
91 per cent of youth are expected to be able to read
and write by the end of 2015. Youth literacy rates
Oceania
are estimated to be 93 per cent for young men and
90percent for young women. This still leaves an
estimated 103 million illiterate youth in 2015, which is
Southern Asia
22 million fewer than in 2010.
Eastern Asia
40 50 60 70 80 90 100
Female Male
The unfinished work on education must rank high on the post-2015 development agenda
Despite enormous progress during the past 15 years, and ensuring a sustainable source of funding are also
achieving universal primary education will require essential.
renewed attention in the post-2015 era, just as the
global community seeks to extend the scope to universal Stagnation in education progress has profound
secondary education. Drawing on lessons learned from consequences for the children and adolescents who
the MDGs, interventions will have to be tailored to cannot go to school. As the world looks beyond 2015,
the needs of specific groups of childrenparticularly it is crucial to reflect on and address the root causes of
girls, children belonging to minorities and nomadic limited progress in youth literacy in some parts of the
communities, children engaged in child labour and world. It is also necessary to explore new approaches to
children living with disabilities, in conflict situations or directly assess whether children have mastered the skills
in urban slums. Investing in the quality of education they are taught and whether they are being taught the
skills they need in the twenty-first century.
28 | The Millennium Development Goals Report 2015
Target 3.A
2000
2015
Sub-Saharan Africa
1990
2000
2015
Western Asia
1990
2000
2015
Northern Africa
Key facts 1990
2000
2015
The education of women and girls has a positive secondary education had been achieved in 36 per cent
multiplier effect on progress across all development of countries with available data in the developing regions
areas. Driven by national and international efforts and in 2012.
the MDG campaign, many more girls are now in school
compared with 15 years ago. Gender disparity has The largest gender disparities in enrolment ratios are
narrowed substantially at all levels of education since found in tertiary education, with only one developing
2000. The developing regions as a whole have achieved region, Western Asia, achieving the target. The most
the target to eliminate gender disparity at all levels of extreme disparities are those at the expense of women
education, with a gender parity index of 0.98 in primary in sub-Saharan Africa and Southern Asia and at the
and secondary education and 1.01 in tertiary education in expense of men in Eastern Asia, Northern Africa and
2015 (the accepted measure of gender parity is between Latin America and the Caribbean. Only 4 per cent of
0.97 and 1.03). However, significant differences remain countries with available data in the developing regions
across regions and countries, as disparities favouring had achieved the target for tertiary education in 2012.
either sex can cancel each other out when aggregated.
Distribution of countries* in the developing regions
The greatest improvements have been made in primary
by status of gender parity target achievement in primary,
education. Today, five of the nine developing regions have
secondary and tertiary education, 2000 and 2012
achieved parity: the Caucasus and Central Asia, Eastern
(percentage)
Asia, Latin America and the Caribbean, South-Eastern Primary education
Asia and Southern Asia. The most substantial progress 2000 45 52 4
has been made in Southern Asia, where the gender parity 2012 29 64 7
index has increased from 0.74the lowest starting point
Secondary education
of all regions in 1990to 1.03 in 2015. The gap between
2000 35 26 39
girls and boys has also narrowed considerably in North 2012 30 36 34
Africa, sub-Saharan Africa and Western Asia. Overall, 64
Tertiary education
per cent of countries in the developing regions reporting
2000 40 3 57
data by sex had achieved gender parity in primary
2012 31 4 65
education in 2012. More than half of the countries with
gender disparity in primary education in 2012 (56 per 0 20 40 60 80 100
cent) were in sub-Saharan Africa.
Target not reached (disparities against females)
In secondary education, gender parity has been achieved Target reached
in 2015 in the Caucasus and Central Asia, Eastern Asia, Target not reached (disparities against males)
Northern Africa, South-Eastern Asia and Southern Asia.
In Oceania, sub-Saharan Africa and Western Asia, girls * Based on available data for 164 countries or territories for primary
education, 148 countries or territories for secondary education,
remain at a disadvantage, while in Latin America and the and 122 countries or territories for tertiary education.
Caribbean, boys are at a disadvantage. Gender parity in
30 | The Millennium Development Goals Report 2015
Womens political representation from 1 to 13. In January 2015, there were four countries
has increased, but parity remains with more than 50 per cent of parliamentary seats held
by women, and in Rwanda, women hold more than 60
a distant goal per cent of such posts.
Proportion of seats held by women in single or lower These successes are also now shared more evenly across
houses of national parliament, 2000 and 2015 regions. In 1995, Europe dominated the top 10 spots in
(percentage) world rankings of women in parliament. As of January
Oceania 2015, 4 of the top 10 countries are in sub-Saharan Africa,
3.6 while the Americas and Europe each have 3 countries in
4.4 the top 10. The biggest gains in womens representation
Western Asia during the last 20 years have been made in Rwanda,
4 with an increase of 60 percentage points; Andorra, 46
12
percentage points; and Bolivia, 42 percentage points.
Southern Asia The number of male-only parliaments has also dropped,
7
from 10 to 5.
18
South-Eastern Asia
Electoral quotas in more than 120 countries have
12
18
underpinned this success. However, a significant
slowdown in progress since 2014 could be an indicator
Caucasus and Central Asia
7 that the fast-track impact of gender quotas has reached
18 its peak. This calls for additional measures to advance
Eastern Asia womens political empowerment.
20
22 Progress in leadership positions has been slow. Just
Sub-Saharan Africa 16 per cent of parliamentary leaders (speakers of
13 parliament) are women, while women represent
23 18percent of all government ministers in the world, an
Northern Africa increase of only 4 percentage points since 2005.
4
25
Latin America and the Caribbean The fundamental causes of inequality
15
27 between women and men must be
Developed regions rectified
16
26
While much progress has been made towards womens
Developing regions
12
and girls equality in education, employment and political
21 representation over the last two decades, many gaps
World
remain, particularly in areas that were not addressed in
14 the MDGs. To achieve universal realization of gender
22 equality and empowerment of women, it is critical to
address the key areas of gender inequality, including
0 5 10 15 20 25 30 gender-based discrimination in law and in practice;
2000 2015 projection violence against women and girls; womens and mens
unequal opportunities in the labour market; the unequal
division of unpaid care and domestic work; womens
Since 1995, when the Beijing Platform for Action on limited control over assets and property; and womens
womens empowerment was adopted, the global average unequal participation in private and public decision-
proportion of women in parliament has nearly doubled, making. Gender perspectives should be integrated fully
growing from 11 per cent in 1995 to 22 per cent in into all goals of the post-2015 development agenda.
January 2015. Women in parliament have gained ground
in nearly 90 per cent of the 174 countries for which data
are available for 19952015. The number of single or
lower houses of parliament where women occupy more
than 30 per cent of the seats has increased from 5 to 42,
while those with more than 40 per cent have jumped
32 | The Millennium Development Goals Report 2015
Target 4.A
Southern Asia
126
60%
50
Caucasus and Central Asia
73
55%
33
South-Eastern Asia
Key facts 71
62%
27
XX The global under-five mortality Northern Africa
rate has declined by more than 73
67%
half, dropping from 90 to 43 24
deaths per 1,000 live births Western Asia
between 1990 and 2015. 65
65%
23
XX The rate of reduction in under-
Latin America and the Caribbean
five mortality has more than 54
69%
tripled globally since the early 17
1990s.
Eastern Asia
53
XX Measles vaccination helped 78%
11
prevent nearly 15.6 million deaths
Developed regions
between 2000 and 2013.
15
61%
6
XX About 84 per cent of children
worldwide received at least one Developing regions
100
dose of measles-containing 53%
47
vaccine in 2013.
World
90
XX Every day in 2015, 16,000 53%
43
children under five continue to
die, mostly from preventable
0 50 100 150 200
causes. Child survival must
remain the focus of the post-2015 1990 2015 projection 2015 target
development agenda. Percentage change between 1990 and 2015
The dramatic decline in preventable child deaths over the Focusing on newborns is critical to further
past quarter of a century is one of the most significant accelerating progress in child survival
achievements in human history. According to preliminary
estimates, the global under-five mortality rate has
declined by more than half, dropping from 90 to 43 Number of deaths by day in the first 28 days of life,
deaths per 1,000 live births between 1990 and 2015. 2013 (thousands)
This translates into almost 6 million deaths of children 1,000
under five in 2015, a decline from 12.7 million in 1990.
The under-five mortality rate has fallen by 50 per cent or
800
more in every region except Oceania.
h
y2
y4
y6
y8
Da 2
Da 4
Da 6
Da 18
Da 0
Da 2
4
7
malaria.
irt
y2
y1
y2
y2
y1
y1
y1
y2
y
Da
Da
Da
Da
fb
Da
Da
Da
yo
Da
Though sub-Saharan Africa has the worlds highest child 1 million deaths on the first day of life = 36% of neonatal deaths
2 million deaths in the first week = 73% of neonatal deaths
mortality rate, the absolute decline in child mortality
has been the largest over the past two decades. The
under-five mortality rate has fallen from 179 deaths per The first day, week and month of life are the most critical
1,000 live births in 1990 to 86 in 2015. Yet the region still for the survival of children. Of the almost 6 million
faces an urgent need to accelerate progress. Not only children who die before their fifth birthday in 2015, about
does sub-Saharan Africa carry about half of the burden 1 million will take their first and final breath on the day
of the worlds under-five deaths3 million in 2015but they are born. An additional 1 million will die in the first
it is also the only region where both the number of live week, and around 2.8 million will die during their first
births and the under-five population are expected to rise 28 days of life (the neonatal period).
substantially over the next decades. This means that the
number of under-five deaths will increase unless progress Between 1990 and 2015, the worldwide neonatal
in reducing the under-five mortality rate is enough to mortality rate has fallen from 33 deaths to 19 deaths per
outpace population growth. 1,000 live births. As the decline in neonatal mortality
has been slower than the decline in mortality for children
Southern Asia also continues to have both a high rate of aged 159 months, neonatal deaths now represent a
under-five mortality, at 50 deaths per 1,000 live births in larger share of total under-five deaths. Every region of
2015, and a large number of total deaths, at 1.8 million. the world is experiencing an increase in the proportion of
under-five deaths that occur in the neonatal period.
Child mortality rates are falling Under-five mortality is declining faster than at any other
faster than ever time during the past two decades. The global annual
rate of reduction has more than tripled since the early
Annual rate of reduction in the under-five mortality rate 1990s. In sub-Saharan Africa, despite the relatively high
in developing regions, 19902013 (percentage) rate of under-five mortality, the rate of decline was over
five times faster during 20052013 than it was during
Oceania 19901995, accelerating from 0.8 per cent per year to
1.4 4.2 per cent per year.
0.7
1.0
2.1 The annual rate of reduction in under-five mortality has
South-Eastern Asia accelerated since 1995 in countries of all income levels
4.0 except in high-income countries. Although there is a
3.8 link between a countrys level of income and its child
4.3
3.7
mortality, the strong reductions in under-five mortality
rates in a number of low-income countriesnotably,
Latin America and the Caribbean
Bangladesh, Cambodia, Eritrea, Ethiopia, Liberia,
4.7
5.6 Madagascar, Malawi, Mozambique, Nepal, Niger,
5.1 Rwanda, Uganda and United Republic of Tanzania
4.1
prove that low income need not be an impediment to
Southern Asia saving childrens lives.
2.9
3.4
3.9
4.1
Northern Africa
4.8
5.0
4.9
4.1
Sub-Saharan Africa
0.8
1.9
3.8
4.2
Western Asia
4.0
4.5
4.1
4.4
Eastern Asia
2.7
4.7
8.7
7.7
-1 0 1 2 3 4 5 6 7 8 9 10
Measles immunization has saved millions Measles deaths have declined rapidly since 2000, from
of childrens lives, but progress towards 544,200 deaths to 145,700 deaths in 2013, mostly
among children under five years of age. Compared
eliminating measles has stalled with estimated mortality in the absence of a measles
vaccination programme, nearly 15.6 million deaths were
Estimated child deaths due to measles (thousands) and averted by measles vaccination between 2000 and 2013.
proportion of children in the appropriate age group who Measles deaths in sub-Saharan Africa (96,000) and
received at least one dose of measles-containing vaccine Southern Asia (39,800) accounted for 93 per cent of the
(percentage), 19902013 estimated measles deaths worldwide during 2013.
Thousands Percentage
700 100 Also, between 2000 and 2013, the number of annual
reported measles cases globally declined by 67 per cent,
from more than 853,000 in 2000 to under 279,000 in
600 95
2013. However, the number of measles cases in 2013
increased from the 2012 level of 227,700. Unfortunately,
500 90 continued outbreaksdue to weak routine immunization
systems and delayed implementation of accelerated
400 85
disease controlhave stalled momentum towards
achievement of regional and global targets for measles
control and elimination.
300 80
Measles can be prevented with two doses of a safe,
200 75 effective and inexpensive vaccine. Between 2000 and
2009, global coverage with the first dose of measles-
containing vaccine (MCV1) increased from 73 per cent
100 70
to 83 per cent, but it stagnated at 8384 per cent from
2010 to 2013. The most impressive progress was made
0 65 in sub-Saharan Africa, where coverage increased from
1990 1995 2000 2005 2010 2013 53per cent in 2000 to 74 per cent in 2013. Between
Left axis: Child deaths in sub-Saharan Africa 2000 and 2013, the number of countries providing a
second dose of the vaccine (MCV2) increased from
Child deaths in Southern Asia
96 to 148, and global coverage of MCV2 increased from
Child deaths in other regions
15 to 53 per cent.
Right axis: Global proportion of children who received vaccine
Impressive as these gains are, progress has stalled
since 2010 and remains fragile. An estimated 21.6
million infants did not receive MCV1 in 2013. Many
of them are from the poorest and most marginalized
communities, residing in especially hard-to-reach areas.
Ramping up progress will require countries and the
international community to continue to campaign for
measles elimination. Achieving equitable increases in
immunization coverage will also require substantial and
sustained investments in strengthening health systems.
Goal 4: Reduce child mortality |37
Child survival must remain at the heart of the post-2015 global development agenda
Reducing under-five mortality requires political will, Achievement of Goal 4 by a significant number of
sound strategies and adequate resources. The MDGs countries, even very poor countries, shows that it can be
have led to dramatic and unprecedented progress done. With millions of women and children still at risk
in reducing child deaths. Effective and affordable of dying of preventable causes, maternal, newborn and
treatments, improved service delivery and political child survival must remain at the heart of the post-2015
commitment have all contributed. Yet every minute global development agenda.
around the world, 11 children die before celebrating their
fifth birthday, mostly from preventable causes. More
work is needed to improve child survival rates.
38 | The Millennium Development Goals Report 2015
Target 5.A
Maternal survival has significantly improved since the Proportion of deliveries attended by skilled health
adoption of the MDGs. The maternal mortality ratio personnel, 1990, 2000 and 2014 (percentage)
dropped by 45 per cent worldwide between 1990 and
Southern Asia
2013, from 380 maternal deaths per 100,000 live births 32
to 210. Many developing regions have made steady 38
progress in improving maternal health, including the 52
40
42
40 38
30 33
32
20
10
0
Central Eastern North Southern West Sub-Saharan Southern Western Latin South- Eastern Developing
Africa* Africa* Africa* Africa* Africa* Africa Asia Asia America Eastern Asia regions
and the Asia
Caribbean
Rural Urban
*The composition of the subregions of Africa is shown on page 71.
Profound inequalities in access to and use of of inequalities among regions. The largest difference
reproductive health services persist within and between rural and urban coverage is found in Central
across regions. In the developing regions, there is a Africa, at 52 percentage points. In contrast, Eastern
31percentage-point gap between urban and rural areas Asia has no gap100 per cent of births are attended by
in the coverage of births attended by skilled health skilled health personnel in both urban and rural settings.
personnel, but even this large disparity masks the range
Goal 5: Improve maternal health |41
Nine in ten contraceptive users were using effective Number of births to women aged 1519,
methods, including female and male sterilization, 1990, 2000 and 2015 (per 1,000 women)
oral hormonal pills, intrauterine devices, condoms, Sub-Saharan Africa
injectables or an implant. Yet even in 2015, 12 per cent 123
of married or in-union women of reproductive age 121
116
worldwide want to delay or avoid pregnancy but are
Latin America and the Caribbean
not using any method of contraception. Women who 86
are sexually active but not married or in a union are not 86
included in this indicator, but they also need access to 73
Western Asia
63
Adolescent childbearing can have harmful consequences 51
for the health of both adolescent girls and the children 45
0 30 60 90 120 150
Lack of basic data on births, deaths and health hampers effective policymaking
Oceania
Sub-Saharan Africa
Eastern Asia
Caribbean
Northern Africa
South-Eastern Asia
Western Asia
Latin America
Southern Asia
Developed regions
Developing regions
World
0 20 40 60 80 100
The MDGs helped spur improvements in the availability countries in Latin America have nationally representative
and accessibility of basic data on births, deaths, cause data on maternal cause of death compared to less than
of death and health service coverage. Yet inequalities in 20 per cent of sub-Saharan African countries.
data availability on maternal health hamper efforts to
guide establishment of priorities on national, regional The disparity among countries in the production of
and global health. Globally, only 51 per cent of countries maternal cause-of-death statistics extends to data
have some data on maternal causes of death. In the on all causes of death for all people. While high-
developed regions these data are primarily from civil income countries have been routinely generating such
registration, while in the developing regions data information for many years, the majority of low- and
primarily come from other sources. The availability of middle-income countries continue to struggle to produce
data varies widely by region. More than 90 per cent of high-quality statistics on cause of death.
Improving maternal health is part of the unfinished agenda for the post-2015 period
Goal 5 brought a concentrated focus on efforts to education, place of residence, economic status or age.
reduce maternal deaths and ensure universal access to Large inequities remain in maternal health, along with
reproductive health. Significant progress has been made, gaps in access to and use of sexual and reproductive
but it fell far short of the global goal and targets. This health services that must be consistently addressed
leaves an unfinished agenda to ensure that all people and monitored. In addition, country capacity needs to
receive comprehensive sexual and reproductive health be strengthened to help reduce inequalities in both the
services. In-depth analyses reveal insufficient and greatly availability and the quality of health-related data, as well
uneven progress. as registration of births and deaths. This information
is crucial for establishing informed policy priorities,
Averages at the global, regional and even country level targeting resources more efficiently and measuring
mask what can be profound health disparities among improvements in maternal health and universal access to
subgroups that are vulnerable, because of their level of sexual and reproductive health care.
44 | The Millennium Development Goals Report 2015
Target 6.A
other diseases
Southern Africa*
1,370
700
Eastern Africa*
650
400
West Africa*
550
290
Central Africa*
140
74
North Africa*
8
13
Key facts Southern Asia
310
160
XX New HIV infections fell by
South-Eastern Asia and Oceania
approximately 40 per cent 120
between 2000 and 2013, from 120
an estimated 3.5 million cases to Latin America
2.1million. 96
94
XX By June 2014, 13.6 million people Eastern Asia
living with HIV were receiving 63
antiretroviral therapy globally, an 70
increase from just 800,000 in Caribbean
2003. 27
12
XX In sub-Saharan Africa still less Caucasus and Central Asia
10
than 40 per cent of youth aged 15
8.3
to 24 years had comprehensive
correct knowledge of HIV in 2014. Western Asia
0.9
1.9
XX Thanks to the expansion of anti-
Developed regions
malaria interventions, over 6.2 170
million malaria deaths have been 190
averted between 2000 and 2015, Developing regions
primarily of children under five 3,340
years of age in sub-Saharan Africa. 1,940
Globally, new HIV (human immunodeficiency virus) Knowledge of HIV and HIV prevention
infections declined by about 40 per cent between 2000 remains low among young people
and 2013, falling from an estimated 3.5 million new
infections to 2.1 million. Among countries with sufficient
Proportion of women and men aged 1524 in sub-Saharan
data, 10 countries had a decline of more than 75 per cent
Africa with comprehensive correct knowledge of HIV
in new HIV infections between 2000 and 2013,
transmission and reporting condom use at last higher-risk
and another 27 countries had a decline of more than
sex,* around 2000 and 2014 (percentage)
50 per cent.
60
59
More than 75 per cent of the new infections in 2013
50
occurred in 15 countries. Sub-Saharan Africa remains
the region most severely affected by the HIV epidemic,
40
with 1.5 million new infections in 2013. Of these, almost 40
42
half occurred in only three countries: Nigeria, South 37
Africa and Uganda. However, it is encouraging that 30
30
South Africa, the country with the largest number of 28
people living with HIV, recorded the largest decline in the 20 23
21
absolute number of new infections, with 98,000 fewer
new infections in 2013 than in 2010. In addition, the 10
number of new infections among young people aged 15
to 24 in the region has declined by 45 per cent between 0
Women Men Women Men
2000 and 2013. Comprehensive correct knowledge of HIV Condom use
Around 2000 Around 2014
New HIV infections fell most rapidly in the Caribbeana * Higher-risk sex refers to sex with a non-marital, non-cohabiting partner.
decline of 56 per centfollowed by Southern Asia and Note: The values in the chart represent the regional aggregate for those
Southern Africa, both with a decrease of 49 per cent. In sub-Saharan African countries that have survey data in both periods
contrast, Latin America and South-Eastern Asia showed around 2000 and around 2014. Around 2000 data refer to a survey
conducted during 19962006. Around 2014 data refer to a survey
either a slow decline or stagnation in the number of new
conducted during 20072014.
infections. In Eastern Asia, North Africa and Western
Asia estimates suggest an increase. Since 2000, there has been moderate progress in HIV
prevention efforts targeting young people aged 15 to
AIDS-related deaths also showed a downward trend in 24. However, risky sexual behaviour and insufficient
2013, with an estimated 1.5 million people dying of AIDS- knowledge about HIV remain at high levels among youth
related illnesses. This represents a 35 per cent decline in many countries.
since the peak of 2.4 million deaths, recorded in 2005. In
just three years, from 2010 to 2013, deaths from AIDS- In sub-Saharan African countries with available data,
related illnesses fell by 19 per cent. AIDS-related deaths, only 30 per cent of young women and 37 per cent of
however, have not decreased among adolescents aged 10 young men had comprehensive correct knowledge of
to 19. This could be due to lack of access to testing and HIV in 2014. This represents an increase of less than
treatment for this age group. AIDS remains the number 10 percentage points since 2000 for both groups. Data
one killer of adolescents in sub-Saharan Africa. indicate modest progress between 2000 and 2014
in condom use with higher-risk sex among the same
Globally, an estimated 35 million people were still living populations. The 19 percentage-point gap in condom
with HIV in 2013. This number is rising as more people use between young women and young men highlights
live longer due to increased use of antiretroviral therapy the inadequacy of prevention efforts in addressing the
(ART) and as the number of new HIV infections remains unique vulnerability of young women.
high. Worldwide, an estimated 0.8 per cent of adults
Furthermore, disparities in the level of comprehensive
aged 15 to 49 were living with HIV in 2013, although the
correct knowledge about HIV among women and men
burden of the epidemic continues to vary considerably
aged 15 to 24 persist by income and location. The
across regions and countries.
disparity in knowledge between those living in the
poorest and those in the richest households is 17 per cent
versus 35 per cent for young women, and 25 per cent
versus 48 per cent for young men. Similarly, the disparity
in knowledge between those living in rural and urban
areas is 23 per cent versus 36 per cent for young women
and 32 per cent versus 46 per cent for young men.
46 | The Millennium Development Goals Report 2015
14 16
13.2 14
12 12
10
10.5
10 8
2000 2002 2004 2006 2008 2010 2013
6
10
Goal 6: Combat HIV/AIDS, malaria and other diseases |47
Since 1995, ART has averted 7.6 million deaths globally, also home to 78 per cent of the people living with HIV in
including 4.8 million deaths in sub-Saharan Africa. While developing regions who are not receiving ART.
this is good news, only an estimated 36 per cent of the
31.5 million people living with HIV in developing regions The overall number of people receiving ART masks
were receiving ART in 2013, with coverage varying important disparities in access across populations.
significantly across regions. For example, sub-Saharan Expanded programmes are necessary to adequately
Africa had both the largest share of people living with reach all groups of the population, including children
HIV and the largest increase in the number of people and adolescents, as well as high-risk groups such as sex
receiving ART. Yet despite this progress, the region is workers, people who inject drugs and men who have sex
with men.
Target 6.C
Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
Estimated change in malaria incidence rate (cases per in children under five years of age in sub-Saharan Africa.
1,000 population at risk) and malaria mortality rate The estimated 69 per cent reduction in malaria mortality
(deaths per 100,000 persons at risk), 20002015 in the under-five age group in this region also helped
improve child survival rates, directly contributing to
200
MDG4, the reduction of child mortality by two-thirds.
Proportion of children under age five sleeping under insecticide-treated mosquito nets for selected countries
in sub-Saharan Africa, around 2001 and 2013 (percentage)
100
75
74
72
70
66
62
56
50 54
49
46 47
43
41 41
37
25
20 15
17 9
7
3 4
1 1 1 1 2 2 2 1 1 2
0
0
Nigeria Niger Cte Zambia Comoros Togo Senegal Gambia Sierra Burundi Dem. Mada- Malawi Benin United Rwanda
d'Ivoire Leone Rep. gascar Republic
of the Congo of Tanzania
Around 2001 Around 2013
Note: Around 2001 refers to a survey conducted during 19992003. Around 2013 refers to a survey conducted during 20122014.
Between 2004 and 2014, more than 900 million the treatment of choice, and they have been critical in
insecticide-treated nets were delivered to endemic preventing deaths. In addition, preventive treatments,
countries in sub-Saharan Africa, significantly increasing such as intermittent preventive therapy in pregnancy
household use of mosquito nets. Indoor residual spraying to reduce the risk of malaria infection, are highly
programmes were also expanded significantly across the cost-effective and have the potential to save tens of
region, but progress slowed between 2011 and 2013 due thousands of lives each year.
to funding constraints.
The past 15 years have shown how effective public health
Access to prompt diagnosis has increased appreciably interventions can be in reducing malaria cases and
since 2000, contributing to more rational use of saving lives. However, the roll-out of some interventions,
antimalarial medicines. Nonetheless, only approximately such as diagnostic testing and treatment, has been
20 per cent of children with fever in sub-Saharan Africa slower than expected, and robust efforts will be needed
receive a malaria diagnostic test, according to household to scale up measures in the post-2015 period. Sustained
surveys from 2012 to 2014. political commitment, predictable financing and strategic
investments in health systems, disease surveillance and
Artemisinin-based combination therapies have new tools are necessary to reduce resurgences and the
progressively replaced other antimalarial medicines as malaria disease burden in the years ahead.
Goal 6: Combat HIV/AIDS, malaria and other diseases |49
Tuberculosis incidence, mortality and prevalence rates, 19902015 (estimated numbers per 100,000 population)
200 300
250
150
200
100 150
100
50
50
0 0
1990 1995 2000 2005 2010 2015 1990 1995 2000 2005 2010 2015
Note: In both panels, the green box marks the Stop TB target of a 50 per cent reduction by 2015 compared with 1990. Incidence rate refers to new cases
per 100,000 population including people who are HIV-positive. Mortality rate refers to deaths due to tuberculosis per 100,000 population excluding people
who are HIV-positive.
The tuberculosis (TB) incidence rate has been falling in were HIV-positive. Current projections suggest the rate
all regions since 2000, declining by about 1.5 per cent of decline in both mortality and prevalence rates is close
per year on average. This corresponds to an estimated to reaching the global Stop TB Partnership target of a 50
9 million new cases in 2013. The rate of decline is slow, per cent reduction by 2015 compared with 1990.
but based on current trends, all regions are expected
to achieve the MDG target of halting the spread and Reductions in disease burden follow 20 years
reversing the incidence of TB by 2015. The slow decline (19952005) of intensive efforts to implement the
is due in part to lack of effective strategies (such as DOTS strategy and its successor, the Stop TB Strategy
a post-exposure vaccine or treatment for latent TB (20062015). Between 2000 and 2013, an estimated 37
infection) to prevent the reactivation of disease in the million lives were saved by TB prevention, diagnosis and
2 billion-plus people who are estimated to have been treatment interventions.
infected by mycobacterium tuberculosis. This limits the
impact of current efforts to control TB incidence. Also in 2013, 6.1 million people diagnosed with TB were
officially reported to public health authorities. Of these,
Globally, the TB mortality rate fell by 45 per cent 5.7 million were people newly diagnosed, equivalent to
between 1990 and 2013. In 2013, there were 1.1 million approximately 64 per cent of estimated incident cases,
deaths from TB among HIV-negative people, and an and 400,000 were people already on treatment. China
additional estimated 360,000 deaths among HIV- and India accounted for 35 per cent of those notified
positive people. At the same time, 11 million people cases.
were living with the disease, representing a 41 per cent
decline in prevalence since 1990. Of those, 13 per cent
50 | The Millennium Development Goals Report 2015
70
65
60
55
50
1995 1997 1999 2001 2003 2005 2007 2009 2012
Developed regions
Developing regions
Target
Note: The green line denotes an 85 per cent success rate target.
A new Ebola outbreak teaches many lessons for health and development
Over the past 40 years, sporadic outbreaks of Ebola The outbreak has affected many aspects
virus disease across equatorial Africa have resulted ofdevelopment beyond health
in a few hundred deaths on average, with the virus
primarily confined to rural areas and contained Closed schools, threats to past health gains and
within a few weeks or months. In total between economic declines are among the many impacts of
1976 and 2012, Ebola outbreaks infected about the Ebola outbreak. According to UNICEF, 5 million
2,400 people and caused around 1,600 deaths. In children were deprived of education in the three
December 2013, another outbreak began in rural high-transmission countries, where schools were
Guinea, near the border with Sierra Leone and closed for months.
Liberia. Formal identification of the disease followed
in March 2014, at which point cases were already Health facilities and services collapsed under the
occurring in neighbouring countries. strain of the crisis, and patients avoided health
services for fear of Ebola contagion. Sierra Leone
This latest outbreak has been the most severe, reported a 39 per cent decline in the number of
largest and longest lasting of any outbreak of the under-five children receiving treatment for malaria
virus since its discovery. It has affected thousands between May and September 2014. A report from
more than all previous outbreaks combined and Liberia indicated that the proportion of women
still continues in some of the affected countries delivering babies with a skilled health care provider
over a year later. As of late May 2015, over 27,000 declined from 52 per cent in 2013 to only 37 per
confirmed, probable and suspected cases and over cent between May and August 2014.
11,000 deaths had been reported, according to
WHO. UNICEF estimates that more than 5,000 According to the World Bank, the high-transmission
children had been infected and 16,000 children had countries felt a total fiscal impact of over $500
lost one or both parents or their primary caregiver. million in 2014, nearly 5 per cent of their combined
gross domestic product (GDP). For 2015, lost output
is estimated to be more than 12 per cent of GDP. In
Rapid, intense transmission of the disease has addition, the countries have suffered from reduced
raised risks beyond Africa agricultural production, possible food insecurity,
reduced wages and pauses in investment plans by
Unlike during past outbreaks, in 2014 Ebola spread international companies, among other losses.
to urban areas and cities, causing rapid, intense
transmission in Guinea, Liberia and Sierra Leone.
High transmission of the disease rested on multiple The Ebola outbreak provides global lessons
factors, including unfamiliarity with the disease, forstopping future epidemics
poor health infrastructure, the rapid spread to urban
centres, high population mobility and cultural beliefs The Ebola crisis showed the vulnerability of countries
and behavioural practices. Additional countries that lack basic health services and the capacity for
dealt with cases or localized transmission. This was early detection, comprehensive reporting and a
the first time the disease was carried abroad by air rapid response system for public health outbreaks.
travellers, highlighting the potential global risk of the For countries without these basic health provisions,
disease. In late 2014, Ebola was declared a public shocks created by emerging or re-emerging diseases
health emergency of international concern. or other events, such as climate change, can lead to
even bigger crises. As the outbreak demonstrated,
effective future responses will require country and
global preparedness to avoid the reversal of gains in
many aspects of development.
52 | The Millennium Development Goals Report 2015
Target 7.A
In recent years, the net loss of forest area has slowed, due to both
a slight decrease in deforestation and an increase in afforestation,
as well as the natural expansion of forests in some countries and
regions. Net loss in forest area declined from 8.3 million hectares
annually in the 1990s to an estimated 5.2 million hectares (an area
Key facts about the size of Costa Rica) each year from 2000 to 2010. In
spite of this improvement, deforestation remains alarmingly high
XX Ozone-depleting substances in many countries.
have been virtually eliminated,
and the ozone layer is expected South America and Africa experienced the largest net losses of
to recover by the middle of this forest area in the first decade of the new millennium. Oceania
century. also reported a net loss, largely due to severe drought and forest
fires in Australia. Asia, on the other hand, registered a net gain
XX Global emissions of carbon of around 2.2 million hectares annually between 2000 and 2010
dioxide have increased by over following a net loss in the 1990s. This gain, mostly due to large-
50 per cent since 1990. scale afforestation programmes in China, offsets continued high
rates of net loss in many countries in Southern and South-Eastern
XX In 2015, 91 per cent of the global Asia.
population uses an improved
drinking water source, compared Deforestation, forest degradation and poor forest management
to 76 per cent in 1990. release carbon into the atmosphere, contributing to climate
change. Since 1990, global forests have lost carbon stored in their
XX Since 1990, 2.1 billion people biomass in almost all regions, adding to global carbon emissions.
have gained access to improved The total carbon stock held in forest biomass fell by an estimated
sanitation, and the proportion 0.5 gigatonnes annually from 2005 to 2010, primarily due to a
of people practising open reduction in global forest area. Stemming these damaging releases
defecation globally has fallen of carbon requires sustainable forest management worldwide to
almost by half. limit deforestation and allow forests to maintain their crucial role
in ecosystem health.
XX The proportion of urban
population living in slums in the
developing regions fell from
39.4 per cent to 29.7 per cent
between 2000 and 2014.
Goal 7: Ensure environmental sustainability |53
Global greenhouse gas emissions continue to rise and are now more than 50 per cent
higher than their 1990 level
Emissions of carbon dioxide, 1990, 2000 and 2012* A continual rise in greenhouse gas emissions is projected
(billions of metric tons) to further warm the planet and cause long-lasting
changes in the climate system, threatening severe and
Eastern Asia
3.0 irreversible consequences for people and ecosystems.
4.0 Impacts on natural and human systems are projected
10.3
to span the globe, with varying effects region to
Southern Asia region. They include altered ecosystems and habitats;
1.0
1.7
detrimental impacts on agriculture, potentially leading
3.1 to food shortages; and more and longer lasting weather
Latin America and the Caribbean extremes and natural disasters, along with numerous
1.0 risks to society.
1.3
1.8
Between 1990 and 2012, global emissions of carbon
Africa
0.7
dioxide increased by over 50 per cent. Data collected
0.9 over two decades show that the growth in global
1.2 emissions has accelerated, rising 10 per cent from 1990
Developed regions to 2000 and 38 per cent from 2000 to 2012, driven
14.9 mostly by growth in the developing regions.
13.9
13.1
Developing regions
Average rates of emissions differ considerably between
6.7 the developed and the developing regions. In 2012,
9.9 average emissions from the developed regions were
19.8
about 10 metric tons of carbon dioxide per person per
World year, compared to about 3 metric tons in the developing
21.6
23.8 regions. Emissions per unit of economic output were
33.0 slightly higher in the developing regions (0.4 kilograms of
carbon dioxide per dollar of economic output) compared
0 5 10 15 20 25 30 35
to developed regions (0.3 kilograms).
1990 2000 2012
* Data for 2012 are preliminary estimates and the breakdown for some Addressing the unabated rise in greenhouse gas
MDG regions is not available. Therefore, the regional estimates do not emissions and the resulting likely impacts of climate
add up to the total. change remains an urgent, critical challenge for the
global community. At the United Nations Framework
Convention on Climate Change conference in Paris
in December 2015, participants will work to forge an
agreement on a protocol, another legal instrument
or an agreed outcome with legal force that will apply
to all Parties to the Convention. This would provide a
framework for strengthening international action to
mitigate climate change.
54 | The Millennium Development Goals Report 2015
The ozone layer is expected to recover One of the foremost remaining challenges is phasing
bymid-century, thanks to concerted out the last of the ozone-depleting chemicals,
hydrochlorofluorocarbons, while avoiding the use of
global efforts to eliminate ozone-depleting alternatives with high potential for global warming, such
substances as hydrofluorocarbons. Other important continuing
issues include prevention of illegal trade in ozone-
Consumption of ozone-depleting substances, 19862013 depleting substances and the sound management of
(thousands of metric tons) those substances still in use, such as in refrigerators,
1,600
air conditioners and firefighting equipment. Continuing
momentum and funding for the final phase-out is crucial
to maintaining this unprecedented international success
1,400
story.
1,200
0 90 90
1986 1992 1996 2000 2004 2008 2013
Developed regions
80 80
World
70 70
The virtual elimination of ozone-depleting substances
represents an unequivocal success of an
intergovernmental effort. It reflects achievements in 60 60
both integrating sustainable development principles into
national policies and developing global partnerships for
50 50
development.
1970 1975 1980 1985 1990 1995 2000 2005 2013
Left axis: fish landings (catch that is brought ashore)
The Montreal Protocol on Substances that Deplete
Right axis: fish stock within their safe biological limits
the Ozone Layer, agreed in 1987, has been universally
ratified. Under the Protocol, all signatories are required
to develop management policies for ozone-depleting The worlds fisheries make significant contributions
substances and licensing systems to control their to global food security, livelihoods and economies.
consumption and production. To date, 197 parties have However, depletion of fish stocks below sustainable-yield
phased out 98 per cent of all major ozone-depleting levels is also a major driver of ecological and evolutionary
substances globally compared to 1990 levels. The harm to marine ecosystems. The percentage of
remaining substances will be phased out over the next 15 overfished stocks that remain within safe biological
years. As a result, the ozone layer is projected to recover limits has been falling over time.
by the middle of this century. Between 1974 and 2011, the proportion of marine fish
stocks within safe biological limits fell 19 percentage
Another potential benefit of this achievement is the points, from 90 per cent in 1974 to 71 per cent. As a
prevention of up to 2 million cases of skin cancer result of this 40-year deterioration in the condition of
annually by 2030. In addition, because many ozone- global fisheries, fish stocks are now below the level
depleting substances are also potent greenhouse gases, at which they can produce maximum sustainable
ozone protection efforts have significantly helped to yields. This is taking place despite fisheries policy and
mitigate climate change by averting more than 135 billion management actions taken by coastal States and the
tonnes of carbon dioxide equivalent emissions.
Goal 7: Ensure environmental sustainability |55
international community. On the other hand, numerous and economic development. The total marine catch
successes have been reported in rebuilding overfished brought ashore globally has fallen from a peak of 88
stocks, most notably in Europe, North America and million metric tons in 1996 to approximately 82 million
Oceania. metric tons in 2013. This demonstrates the impact of
overfishing, among other factors, on fish production.
Overfishing not only reduces the productivity of fish
Turning this situation around calls for strong political will
stocks but also impairs ecosystem functions and
and strict management plans to restore the sustainability
biological diversity. Ultimately, this will hinder social
and productivity of global fisheries.
Water scarcity affects more than 40 per cent of the global population
andisprojected to rise
Proportion of renewable water resources withdrawn, The proportion of water resources a country uses is
around 2011 (percentage) affected by national water policies and water scarcity.
Northern Africa Scarcity can be physical (lack of water of sufficient
78 quality), economic (lack of adequate infrastructure,
Western Asia due to financial, technical or other constraints) or
54
institutional (lack of institutions for a reliable, secure and
Caucasus and Central Asia equitable supply of water). Major sectors that withdraw
50
water include agriculture (irrigation, livestock and
Southern Asia
aquaculture), industries and municipalities. At present,
48
municipalities account for 12 per cent of total freshwater
Eastern Asia
20 withdrawal globally and industries for 19 per cent, while
South-Eastern Asia
agriculture takes up the remaining 69 per cent, mostly
8 through irrigation.
Sub-Saharan Africa
3 Worldwide, only 9 per cent of renewable freshwater
Latin America and the Caribbean resources are withdrawn for use by agriculture,
2 municipalities and industries. This is below the 25 per
Oceania cent withdrawal threshold that defines the start of
0.06 physical water stress, but this global figure masks large
Developed regions differences between regions and within countries. In
7 2011, 41 countries experienced water stress, up from
Developing regions 36 in 1998. Of these, 10 countriesfrom the Arabian
9
Peninsula, Northern Africa and Central Asiawithdrew
World
more than 100 per cent of renewable freshwater
9
resources. Once a country reaches a withdrawal level
0 10 20 30 40 50 60 70 80 90 100 above 100 per cent, it starts depleting its renewable
At 25 per cent: Abundant water resources groundwater resources, relying on non-renewable fossil
25 per cent to 60 per cent: Water stressed groundwater or non-conventional sources of water,
60 per cent to 75 per cent: Water scarcity such as desalinated water, wastewater and agricultural
Above 75 per cent: Severe water scarcity drainage water.
Target 7.B
Reduce biodiversity loss, achieving, by 2010, asignificant reduction in the rate of loss
Latin America and the Caribbean, Oceania and Western Asia lead the way in protecting
land andmarine areas
Terrestrial areas protected, 1990, 2000 and 2014 Terrestrial and marine protected areas help to prevent
(percentage) loss of biodiversity, maintain food security and water
Caucasus and Central Asia supplies, strengthen climate resilience and improve
2.7
3.5
human health and well-being. Protecting these areas
4.6 aims to conserve and nurture biological diversity,
Oceania ensuring areas are safeguarded and maintained for
2.0 future generations.
3.16
5.0
Southern Asia
In 2014, 15.2 per cent of terrestrial and inland water
5.4 areas and 8.4 per cent of coastal marine areas (up
6.1 to 200 nautical miles from shore) were protected.
6.8
Only 0.25 per cent of marine areas beyond national
Northern Africa
2.7
jurisdiction (extending beyond 200 nautical miles) were
3.4 protected, which highlights the urgent need for action in
7.7 this area.
South-Eastern Asia
8.4
12.6 Many regions have substantially increased their
14.0 terrestrial protected areas since 1990. In Latin America
Sub-Saharan Africa and the Caribbean, coverage of terrestrial protected
10.6
areas rose from 8.8 per cent to 23.4 per cent between
11.3
15.3 1990 and 2014. In Western Asia, the terrestrial area
Western Asia under protection has more than quadrupled, from 3.7 per
3.7 cent in 1990 to 15.4 per cent in 2014.
15.2
15.4
Some regions of the world have also increased their
Eastern Asia
12.0 protected marine areas substantially. In Oceania, there
14.9 were no coastal or marine protected areas in 1990, but
16.8
7.4 per cent of such areas were protected in 2014.
Latin America and the Caribbean
8.8
14.4 Global coverage of protected areas has expanded
23.4 since 1990, and protected areas are projected to
Developed regions reach at least 17 per cent of terrestrial and inland
9.1
12.2
waters and 10 per cent of marine and coastal areas by
14.4 2020. However, other aspects of protection also need
Developing regions improvement. These include effective and equitable
8.4 management and connectivity, and protection of areas
11.4
15.7 important for biodiversity and ecosystem services,
World especially ecologically representative protected area
8.7 networks. Monitoring progress in protected areas will be
11.8
fundamental to assessing progress towards achievement
15.2
of the post-2015 development agenda and its goals and
0 5 10 15 20 25
targets.
1990 2000 2014
Goal 7: Ensure environmental sustainability |57
Conservation efforts are in a race against Cycads, the first major plant group for which a Red
time to save animals and plants from List Index has been produced, are the oldest living
plants on earth. Unchanged for millions of years, they
extinction are particularly vulnerable to extinction from habitat
loss and trade that targets specimens harvested in the
IUCN Red List Index* of species survival for birds, wild. Cycads continue to decline across all regions, and
19882012, mammals, 19962008, corals, 19962008, nearly two-thirds are documented as threatened with
amphibians, 19802004, and cycads, 20032014 extinction.
1.0
As past experience has shown, species can recover.
Concerted conservation interventions can make a vital
difference in biodiversity trends. An estimated 16 bird
0.9
species would have gone extinct between 1994 and
Better
0.6
0.5
1980 1985 1990 1995 2000 2005 2010 2015
Birds Amphibians
Mammals Cycads
Corals
* The Red List Index, compiled by the International Union for Conservation
of Nature and 10 Red List Partner institutions, measures trends in species
risk of extinction based on genuine changes in risk.
Note: A Red List Index value of 1.0 means that all species are categorized
as Least Concern, and hence none are expected to go extinct in the near
future. A value of zero indicates that all species have gone Extinct.
Proportion of population using an improved drinking Since 1990, the proportion of the population without
water source, 1990 and 2015 (percentage) access to improved drinking water has been cut in
half in Eastern Asia, Latin America and the Caribbean,
Oceania South-Eastern Asia, Southern Asia and Western Asia.
50
Sub-Saharan Africa fell short of the MDG target but
56
still achieved a 20 percentage point increase in the
Sub-Saharan Africa
use of improved sources of drinking water. In 2015, it
48
68
is estimated that 663 million people worldwide still
use unimproved drinking water sources, including
Caucasus and Central Asia
87
unprotected wells and springs and surface water. Nearly
89 half of all people using unimproved sources live in sub-
Saharan Africa, while one-fifth live in South Asia.
South-Eastern Asia
72
90
Northern Africa
Since 1990, 2.1 billion people have gained
87 access to improved sanitation, but the
93
world has missed the MDG target
Southern Asia
73
93 Between 1990 and 2015, the proportion of the global
Latin America and the Caribbean population using an improved sanitation facility has
85 increased from 54 per cent to 68 per cent. This means
95 that 2.1 billion people have gained access to improved
Western Asia sanitation since 1990, and the proportion of people
85 practising open defecation globally has fallen almost by
95 half, from 24 per cent to 13 per cent. However, in 2015,
Eastern Asia 2.4 billion people are still using unimproved sanitation
68 facilities, including 946 million people who are still
96
practising open defecation.
Developed regions
98
Caucasus and Central Asia, Eastern Asia, Northern
99
Africa and Western Asia have cut in half the proportion
Developing regions of the population without access to improved sanitation.
70
Southern Asia had the lowest baseline coverage in 1990,
89
at 22 per cent, and recorded the largest increase in the
World
proportion using improved sanitation, reaching 47 per
76
91
cent in 2015.
1990
1990
1990
1990
1990
2015
2015
2015
2015
2015
2015
80
94 Urban Rural World Urban Rural World
Caucasus and Central Asia
Surface water Open defecation
90
96 Unimproved Unimproved
Target 7.D
By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers
Fewer urban residents are living in slums The lives of those living in slums have improved
in almost all regions significantly in the last 15 years. Between 2000 and
2014, more than 320 million people gained access to
either improved water, improved sanitation, durable
Proportion of urban population living in slums, housing or less crowded housing conditions, which
2000 and 2014 (percentage) means that the MDG target was largely surpassed. The
Sub-Saharan Africa proportion of urban population living in slums in the
65 developing regions fell from approximately 39 per cent
55 in 2000 to 30 per cent in 2014. Although the target was
Southern Asia
met, absolute numbers of urban residents living in slums
46 continue to grow, partly due to accelerating urbanization,
31 population growth and the lack of appropriate land and
South-Eastern Asia
housing policies. Over 880 million urban residents are
40 estimated to live in slum conditions today, compared to
27 792 million reported in 2000 and 689 million in 1990.
Eastern Asia
37 The proportion of urban population living in slums has
25 fallen significantly in almost all regions. The largest
Western Asia
declines have taken place in Eastern Asia, South-Eastern
21 Asia and Southern Asia (at least a 12 percentage point
25 drop). In 2015, the regions with the lowest prevalence
of slum conditions are Latin America and the Caribbean
Oceania
24 and Northern Africa. In Northern Africa the proportion of
24 urban slum population declined almost by half, to 11 per
cent in 2014 from 20 per cent in 2000. In Latin America
Latin America and the Caribbean
29 and the Caribbean it fell to 20 per cent in 2014 from 29
20 per cent in 2000.
Northern Africa
20
Sub-Saharan Africa continues to have the highest
11 prevalence of slum conditions of all regions, estimated at
55 per cent in 2014. However, this represents a decline
Developing regions
39
of almost 10 percentage points in prevalence since
30 2000. On the other hand, the proportion of the urban
population living in slums continues to grow in countries
0 10 20 30 40 50 60 70 80 affected by or emerging from conflict. Iraq, for example,
experienced an increase of more than 60 per cent
2000 2014
between 2000 and 2014.
Goal 7: Ensure environmental sustainability |61
Urban population living in slums (millions) Efforts to ensure global environmental sustainability
and proportion of urban population living in slums have shown mixed results throughout the last 15 years.
(percentage), developing regions, 19902014 Much work remains for the post-2015 period, particularly
Millions Percentage given the acute environmental challenges the world
1000 50 is facing, such as climate change, food and water
46.2 insecurity, and natural disasters.
42.9
900
800
39.4
40 One theme emerging from the debate on the
35.6 successor agenda to the MDGs is the importance
34.3
700 32.6 32.7 of true integration of environment into development
29.7 ambitions. Environmental sustainability is a core pillar
600 30
of the post-2015 agenda and a prerequisite for lasting
500 socioeconomic development and poverty eradication.
923
830 845 872 881 Healthy, well-managed and diverse ecosystems and
400 792 20
749 resources can play a strong role in mitigating future
689
300 environmental challenges and improving livelihoods
everywhere. Therefore, it is crucial to ensure that
200 10
the development agenda for the future reflects the
100 links between socioeconomic and environmental
sustainability and protects and reinforces the
0 0 environmental pillar.
1990 1995 2000 2005 2007 2010 2012 2014
a global 150
development
90
60
30
0
2000 2002 2004 2006 2008 2010 2012 2014
Key facts (preliminary)
Net debt relief grants Multilateral ODA
XX Official development assistance Humanitarian aid Bilateral development projects,
from developed countries programmes and technical cooperation
increased by 66 per cent in real
terms between 2000 and 2014. A decline in aid flows during the last years of the 20th century
reversed early in the new millennium. Net official development
XX In 2014, 79 per cent of imports assistance (ODA) from member countries of the Development
from developing to developed Assistance Committee (DAC) of the Organisation for Economic
countries were admitted duty Co-operation and Development (OECD) increased by 66 per cent
free. between 2000 and 2014. However, after reaching an all-time high
in 2013, net ODA flows from DAC members totalled $135.2 billion
XX The proportion of external debt in 2014, marking a slight decline, of 0.5 per cent, in real terms.
service to export revenue in
developing countries fell from 12 ODA in the form of net aid for core bilateral projects and
per cent in 2000 to 3 per cent in programmes, which represents about 60 per cent of the total,
2013. remained virtually unchanged between 2013 and 2014. In contrast,
debt relief grants fell by 87 per cent in real terms, from $3.6 billion
XX As of 2015, 95 per cent of the to $476 million. Humanitarian aid rose by 22 per cent in real terms,
worlds population is covered by from $11 billion to $13 billion.
a mobile-cellular signal.
Total ODA from DAC member countries represented 0.29 per cent
XX Only one third of the population of their gross national income (GNI) in 2014. The top five donor
in the developing regions use the countries by volume were the United States, the United Kingdom,
Internet, compared to 82 per cent Germany, France and Japan. Denmark, Luxembourg, Norway,
in the developed regions. Sweden and the United Kingdom continued to exceed the United
Nations ODA target of 0.7 per cent of GNI. In 2014, the Group of
7 industrialized countries provided 71 per cent of all the net ODA
from DAC members, while European Union countries provided 55
per cent.
Goal 8: Develop a global partnership for development |63
Aid has also increased from non-DAC countries. In 2014, bilateral aid to least developed countries (LDCs)
Although precise figures are not yet available for all fell 16 per cent in real terms, reaching $25 billion at
countries for 2014, preliminary data show that the United constant prices of the previous year. However, much of
Arab Emirates reached the highest ratio of ODA to GNI this decrease can be attributed to a relatively high level
of any country, at 1.17 per cent. Hungary, Estonia and of debt relief assistance granted to Myanmar in 2013.
Turkey increased their aid in real terms with respect to
the previous year by 24.4 per cent, 19.2 per cent and 8.2 Preliminary data for 2014 show that bilateral ODA to
per cent, respectively. sub-Saharan Africa (where the majority of LDCs are
located) decreased by 5 per cent in real terms from the
On average, aid focusing on the achievement of the goal previous year, reaching $25 billion at constant 2013
of gender equality and womens empowerment in 2012 prices. However, the decrease was only 2 per cent if debt
and 2013 was approximately 26 per cent of all aid that relief is excluded.
could be allocated by sector.
Preliminary results from the 2015 DAC Survey on
Donors Forward Spending Plans project a 2.5 per cent
real increase in country programmable aid in 2015. This
Targets 8.B and 8.C will come mainly through disbursements by multilateral
Address the special needs of the least agencies. Least developed and other low-income
developed countries, landlocked developing countries will benefit most from this increase; their aid
countries and small island developing States levels are expected to grow by 5.7 per cent in real terms.
The report also projects that allocations for the least
developed countries will continue to increase through
Official development assistance to 2018. Allocations to lower-middle-income and upper-
least developed countries increased middle-income countries are expected to remain at
current levels.
significantly over the MDG period
0.35
0.30
0.25
0.20
0.15
0.10
0.05
0.00
1990 1994 1998 2002 2006 2010 2014
(preliminary)
Total ODA
ODA to least developed countries
64 | The Millennium Development Goals Report 2015
100
4
95
90 2
85
0
80 Developing LDCs Developing LDCs Developing LDCs
countries countries countries
75 Agricultural Clothing Textiles
products
70
1996 2000 2005 2010 2014
65
Note: Based on a fixed 19992001 export structure.
60
Within each product category, the average tariffs
55
imposed by developed countries on imports from
50 developing countries declined rapidly between 1996
1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 and 2005. The decline was slower after 2005, and in a
Developing countries few categories, the trend reversed. Agricultural tariffs
LDCs
imposed on LDCs, however, continued their sharply
decreasing trend well into 2010 in most developed
countries.
The proportion of developed country imports (excluding
oil and arms) originating from developing countries that
are admitted duty free has significantly increased over
the last 15 years. Despite a slight decrease from 2013 to
2014, 84 per cent of imports from LDCs were admitted
duty free in 2014, along with 79 per cent of imports from
developing countries. The share of exports from LDCs
that received preferential treatment (beyond most-
favoured-nation status) reached approximately 60 per
cent in 2014, up from 53 per cent in 2011.
Goal 8: Develop a global partnership for development |65
The margin of trade preference varies widely across exporting developing regions
0 2 4 6 8 10 12
Smartphones continue to become cheaper and more Greater funding and innovation are crucial
widespread. Their growing processing power supports to the implementation of the post-2015
the seamless delivery of services to an increasing
number of people in every imaginable sector, including
development agenda
banking, retail trade, transport, health and education.
As the post-2015 development agenda is being prepared
for launching, its breadth and ambition need to be
ICT access and use are unequally matched by adequate funding and renewed efforts
distributed within and between countries to mobilize innovation, science and technology for
sustainable development.
Number of Internet users per 100 inhabitants, 20002015 ODA remains critically important for countries with
100 limited capacity to raise public resources domestically.
It is important to pay greater attention to the potential of
80
ODA to attract other financial flows, both by blending it
with non-concessional public finance and by leveraging
private finance and investments. Such market-like
60
instruments may play an important role in financing the
post-2015 development agenda.
40
The changing trade landscape will also demand
20 innovative ways to improve market access and address
non-tariff barriers, particularly as trade in services
0 expands. Also, it will be crucial to strengthen the
2000 2003 2006 2009 2012 2015 integration of developing countries into the multilateral
(preliminary) trade system, as measured by their trade diversification
Developed regions Developing regions and share in value-added.
World Least developed countries
Similarly, it will be essential to address the widening
digital divide. Only then will the transformative power
The digital divide is particularly pronounced with respect of ICTs and the data revolution be harnessed to deliver
to Internet use and quality of access. For instance, just sustainable development for all.
over one third of the population in developing countries
uses the Internet, compared to 82 per cent in developed
countries. The contrast is even more dramatic in
sub-Saharan Africa, where less than 21 per cent of the
population uses the Internet, and in LDCs, where the
figure is less than 10 per cent.
Progress towards the eight Millennium Development Regional and subregional figures presented in this report
Goals is measured through 21 targets and 60 official are compiled by members of the United Nations Inter-
indicators.1 This report presents an accounting to date Agency and Expert Group on MDG Indicators (IAEG).
of how far the world has come in meeting the goals using In general, the figures are weighted averages of country
data available as of June 2015. 2 data, using the population of reference as a weight. For
each indicator, individual agencies were designated as
Most of the MDG targets have a deadline of 2015, using official providers of data and as leaders in developing
1990 as the baseline against which progress is gauged. methodologies for data collection and analysis (see
Country data are aggregated at the subregional and page 72 for a list of contributing organizations).Data
regional levels to show overall advances over time. The are typically drawn from official statistics provided by
composition of MDG regions and subregions is based governments to the international agencies responsible
on UN geographical divisions, with some modifications for the indicator. To fill data gaps, data for many of the
necessary to createto the extent possiblegroups indicators are supplemented by or derived exclusively
of countries for which a meaningful analysis can be from data collected through surveys sponsored and
carried out. In addition to the MDG regional groupings, carried out by international agencies.
the report also shows data for subregions in Africa,
based on the classification adopted by the United These include many of the health indicators, which are
Nations Economic Commission for Africa. 3 Although the compiled, for the most part, from Multiple Indicator
aggregate figures are a convenient way to track progress, Cluster Surveys (MICS) and Demographic and Health
the situation of individual countries within a given region Surveys (DHS). In some cases, countries may have
may vary significantly from regional averages. Data for more recent data that have not yet become available
individual countries, along with the composition of all to the relevant specialized agency. In other cases,
regions and subregions, are available at http://mdgs. countries do not produce the data required to compile
un.org. the indicator, and the responsible international agencies
estimate the missing values. Even when national data
are available, adjustments are often needed to ensure
international comparability. Data from international
sources, therefore, often differ from those available
within countries. The United Nations Statistics Division
1 The complete list of goals, targets and indicators is available maintains the official website of the IAEG and its
at http://mdgs.un.org. database (http://mdgs.un.org). In an effort to improve
2 Given the time lag between collecting data and analysing
transparency, the country data series in the database are
them, few indicators can be compiled for the current year.
given colour codes to indicate whether the figures are
In this report, 2015 projections are used for most indicators.
Other indicators are based on data from earlier years estimated or provided by national agencies; they are also
generally up to 2013 or 2014. accompanied by metadata with a detailed description of
3 The composition of these subregions is shown in the next how the indicators are produced and the methodologies
section Regional groupings. used for regional aggregations.
Regional Groupings |71
Regional groupings
Developed regions
Northern Africa
Sub-Saharan Africa
South-Eastern Asia
Eastern Asia
Southern Asia
Western Asia
Caucasus and Central Asia
Oceania
Latin America and the Caribbean
Goal 1: Eradicate extreme poverty and hunger Visit the UN Millennium Campaign Office website at
Target 1.A: World Bank and UN-Women www.endpoverty2015.org.
Target 1.B: ILO
Target 1.C: FAO and UNICEF
Additional contribution: UNHCR Photo credits:
Goal 2: Achieve universal primary education Cover UNICEF/Syed Altaf Ahmad
Target 2.A: UNESCO Page 2 Virginia Hooper
Page 15 UNICEF/Bindra
Goal 3: Promote gender equality and empower
Page 19 Nonie Reyes / World Bank
women
Target 3.A: ILO, IPU, UNESCO and UN-Women Page 20 Curt Carnemark / World Bank
Page 25 UNICEF/Richter
Goal 4: Reduce child mortality Page 29 Nafise Motlaq /World Bank
Target 4.A: UNICEF, United Nations Population Division,
Page 34 UNICEF/Bindra
World Bank and WHO
Page 35 UNICEF/Esiebo
Goal 5: Improve maternal health Page 37 UNICEF/Romenzi
Target 5.A: UNFPA, UNICEF, United Nations Page 40 UNICEF/Biswas
Population Division, World Bank and WHO Page 50 UNICEF/Irwin
Target 5.B: UNFPA, UNICEF and United Nations Page 53 John Hogg/World Bank
Population Division Page 57 UN Photo/Ky Chung
Goal 6: Combat HIV/AIDS, malaria and other Page 61 Boris Balabanov / World Bank
diseases Page 63 Chhor Sokunthea/ World Bank
Target 6.A: UNAIDS, UNICEF and WHO Page 65 Scott Wallace / World Bank
Target 6.B: UNAIDS and WHO Page 69 UNICEF/Esteve
Target 6.C: UNICEF and WHO
ISBN 978-92-1-101320-7
15-04513