NAIROBI: Just what should the world focus on with the expiry of the Millennium Development Goals?
As the world meets in September in New York to deliberate and ratify 169 targets that have been identified, as Sustainable Development Goals, voices are rising with divergent opinion over the number of targets and which among them could give the world the best results – the argument by the Copenhagen Consensus is that 169 is ‘too many’.
In his book, the smartest targets for the world, Dr Bjorn Lomborg argues that if the world were to spend 2.5 trillion dollars on the 169 targets that have been set to drive world development over the next 15 years then only seven dollars of good will be achieved for every dollar spent. He heads the Copenhagen Consensus, a global think tank.
Lomborg writes, “But if the same 2.5 trillion dollars were spent more focused on the top most efficient targets, we could do 50 trillion dollars of extra social, environmental and economic good for the world. Simply by focusing more on the best targets, we could do extra 35 trillion dollars of good – equivalent of making everyone in the developing world an extra annual income.”
In the Kenyans context Lomborg’s argument would be that for every shilling spent in the next 15 years under the SDGs, there would only be seven shillings of gain while the better option would be to focus on less targets to make a gain of Sh50 or Sh35 for every shilling spent.
Using hindsight, Lomborg believes that just like the UN has in the past years given failed promises, there was a likelihood that the 169 targets will fail.
“Showing which targets are great, fair and poor is an obvious step to making the next global targets smarter, but surprisingly that has never been done systematically before,” says Lomborg.
Picking some of the key indicators that Kenya has been struggling with since independence, what Lomborg says could mean that in the next 15 years developing countries might still end up mark timing without anything to show for it, but because of the targets that would not allow for maximum benefit for each shilling spent.
Maternal and child health, for instance is a problem that the Kenya is still trying to battle. The UN notes that 18 million children under the age of five died in 1970 while in 2013, the number dropped to six million – which Lomborg argues is still high.
He argues that if the world can focus on reducing maternal and child deaths then it has to be by building more clinics, training more doctors and nurses – and paying them well. If this is done, then the world can gain nine shillings for every shilling spent.
In Kenya currently, the shortage of doctors and nurses is biting. The World Bank reports that Kenya has one physician for every 5,000 people. While over the past few years the government has embarked on building health facilities, these facilities go without staffing thus are left standing as monuments. Therefore Lomborg alludes that developing one aspect of the health sector must be accompanied by another aspect for better results to be achieved.
Some of the ways that Lomborg argues could reduce infant mortality is by investing in family planning so that women only have children when they are ready for them.
He states, “Reducing infant mortality is not the only good target, of course. One which gets a lot of attention is access to contraception, which enables women to have children when the time is right for them, gives them better employment prospects and enables them to invest more in their children’s future. A dollar spent on this could pay back perhaps 120-fold,” notes Lomborg.
Yet further argues that to reduce death of mothers, more focus needs to be made on dealing with diseases such as cervical cancer which is foten caused by viral infection that can easily be controlled through vaccination.
He writes, “Vaccinating 70 per cent of girls in one cohort throughout most of the developing world would cost about 400 million dollars, and would save 274,000 women from dying, often in prime of their lives, from cervical cancer. For each dollar spent, we would do more than three dollars worth of good.”
According to a World Bank Report under five deaths in Kenya increased in 2013 to 105,859 from 96,060 in 1990. Note has to be taken in comparing the two figures because there was population increase in over the years, so the percentage increase might have actually gone down but it is a target that these deaths will be cut to 95,437 by 2030.
According to the latest Kenya Demographic and Health Survey 2014, about 30 out of 50 women in Kenya deliver under skilled care. This marks an increase of about 16 per cent comparing to the last KDHS report of 2008-2009 which indicated only 22 out of 50 women gave birth under skilled care. This was thanks to the inception of the free maternity care.
Lomborg therefore states that if the world will not reset more achievable targets, then it will be the same scenario at the expiry of the next 15 years that will mark post 2015.