Of all the Millennium Development Goals agreed by world leaders in the year 2000, the sixth goal has had arguably the most dramatic results. It aims to halt and reverse the spread of HIV/AIDS, achieve universal access to AIDS treatment, and halt malaria and other serious diseases like tuberculosis. Fifteen yeas later, the world has done exactly that, and more.
New HIV infections fell from about 3.5 million cases in 2000 to 2.1 million cases in 2013–a drop of about 40%. By 2014, 13.6 million people living with HIV were receiving antiretroviral therapy, up from about 800,000 in 2003. Interventions like insecticide-treated bed nets prevented an estimated 6.2 million deaths from malaria between 2000 and 2015. And, because of better diagnosis and prevention, a staggering 37 million people didn’t become infected with TB, according to U.N. figures.
Global health experts like Peter Hotez at Baylor College of Medicine praise the work of groups like the President’s Emergency Plan for AIDS Relief (PEPFAR) and The Global Fund in distributing drugs and interventions in developing countries.
“I think we are making great progress on the malaria component with a 30% reduction in the number people infected and malaria deaths,” says Hotez in an email. “Also remember the ‘other diseases’ component. [There’s been] a 30-35% reduction in neglected tropical diseases targeted by mass drug administration.”
These include trachoma, an eye disease, and lymphatic filariasis, which attacks the lymphatic system. Indeed, the success of MDG 6 shows where international development really works (unlike, say, MDG 1 where it’s arguable whether international goal-setting in itself has had much impact on poverty and hunger).
However, critics argue the focus on HIV, malaria, and TB has left other health issues in the shade. “The downside of spotlighting is that things get left in the shadows and they’re not necessarily the priorities for governments in the Global South,” says Alicia Yamin, a lecturer on global health at Harvard.
The MDGs have “led to quite narrow and technocratic approaches to health issues” and “haven’t emphasized the social or institutional changes that are really needed to sustain better population health,” Yamin argues. The narrow focus on lowering specific disease numbers might not have set up good systems for more holistic changes to health care in the developing world. And other, less notable diseases, were left out of the targets. For example, the MDGs have done little address respiratory infections, non-communicable diseases like heart disease, and sanitation-related risks.
The post-2015 Sustainable Development Goals have a wider remit. Goal 3 calls for ending the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases, universal health coverage and 11 other health steps. If achieved, the agenda would certainly address the complaints about MDG 6.