Progress in achieving the Millennium Development Goals (MDGs) in the Asian and Pacific region is uneven. We achieved success in some, but faltered in others. Even in areas of success, in-country and intra-country disparities persist. The pace of progress is too slow. Unless we act and accelerate it, 641 million people will continue to live on less than $1 a day; some 97 million children will remain underweight and 4 million will die before reaching the age of five; 400 million people in urban areas will have no access to basic sanitation; and 566 million in rural areas will live without access to clean water.
The destiny of Asia-Pacific is not to be poor. The region has the strengths, resources, knowledge and expertise to achieve the MDGs by 2015. It can provide the leadership to address the implementation shortcomings and financial gaps by harnessing the power of partnerships to make a difference. But time is running out and we must act now. Our research on tracking the countries' progress towards achieving the MDGs enables us to quantitatively rank the extent of "off-trackness" by indicators. We find that the three priority off-track areas are maternal and child health, water and sanitation, and the environment.
Despite some success in reducing income poverty, the region is still home to approximately 65 per cent of the world's poor. Many countries in South and South-East Asia are off track in achieving the targets for underweight children. Similarly, despite many more children surviving beyond their fifth birthday, and South-East Asia as a whole being on track, several countries are advancing too slowly. In fact, children's health, measured by the proportion of underweight children, is one of the region's biggest failures: 28 per cent of under-fives are underweight. This high rate is linked to other key challenges faced by the Asian and Pacific region, which is off track for 2015: poor health and low social status of women.
With 250,000 maternal deaths a year, the situation is simply not acceptable. These preventable deaths are caused by events as natural as pregnancy and childbirth. The region's overall maternal mortality ratio, at more than 300 per 100,000 live births, is over 30 per cent higher than that of Latin America and the Caribbean. Maternal deaths in Asia and the Pacific account for almost half the global total -- and there is no indication that the ratio is declining significantly. This certainly is a result of persistent gender inequality. Maternal mortality is high when women have limited access to health care, and cultural restrictions can exacerbate the problem. Cultural practices, for example, can forbid male physicians from coming in direct contact with female patients, placing pregnant women at a greater risk. Moreover, malnutrition among girls, often as a result of gender discrimination, leads to high maternal and child mortality. In poor households, the mother will feed her husband and sons first, leaving inadequate or poor quality food for herself. While poverty is the key factor, gender discrimination has a significant negative impact on reducing the number of underweight, wasted and stunted children.
Around 6 million people are living with HIV in the region, of which over a million have been infected during the past two years. The prevalence of, and the death rates from, tuberculosis have fallen across the region, but are rising throughout Central Asia. Many countries are off track in improving urban water supplies, while sanitation coverage in most of the region, especially in rural areas, is poor. Many are still losing forest cover at alarming rates, particularly the least developed countries in South-East Asia and the Pacific.
Economic growth has been recognized as a necessary but in sufficient condition for achieving the MDGs. Growth also needs to be pro-poor. Our research supports the observation that high economic growth improves major MDG indicators, but the extent of improvement differs accordingly. In the Asia-Pacific countries, we find that income poverty goes down significantly due to high economic growth, but education and health indicators are less affected. Moreover, the ESCAP quantitative analysis shows that the "growth gaps", which indicate the additional growth rates required to achieve the MDGs, are huge. At the very least, even to achieve the income poverty target, off-track countries have to grow by an additional 3 to 5 per cent a year. It is, therefore, not possible for them to reach the MDGs by 2015 by relying on economic growth alone. Much more attention needs to be paid to pro-MDG economic and social policies and to improving the quality of institutions. Addressing social exclusion and delivery of basic services. The impact of social policies on development is not often explicitly considered in development strategies. Measures to address social exclusion, as well as a rights-based approach to development, need to be promoted as vigorously as economic growth policies. This can enhance the participation and empowerment of excluded groups and individuals, and brighten the prospects for achieving the MDGs.
Asia-Pacific countries also need to change their approaches. They need to develop the skills and capacity of national and local institutions to deliver services they are expected to provide. Governments have a central role in reforming domestic institutions so that they can better meet their responsibilities and ensure delivery of adequate basic services. They can provide these directly or create a framework that enables the private sector and civil society to participate as equals in delivering those services. These are all part of a bigger challenge of addressing the implementation gap faced by all partners to achieve the MDGs.
The road map for achieving the MDGs in the region -- developed by ESCAP in cooperation with the United Nations Development Programme (UNDP) and the Asian Development Bank (ADB) -- includes some of the following features:
On tracking the off-track countries . A major focus of the regional road map is the consideration of a sequential graduation process for off-track countries, so that they can attain on-track status. Thus, it is possible to envisage one third of off-track countries, such as those making slow progress or regressing in only one or two indicators, attaining on-track status by 2009. This is followed by another one third, categorized as slow or regressing with respect to three or four indicators, becoming on track by 2011. The remainder will be on track by 2013, so that all countries achieve the MDGs by 2015.
A holistic approach in synergizing the modalities and delivering as "one" . Achieving the MDGs is a shared endeavour in which the wider international community, including the multilateral institutions of the region -- ESCAP, UNDP and ADB and other UN agencies -- join hands in a regional partnership to assist individual countries in achieving the Goals. Subregional organizations, such as the Association of Southeast Asian Countries (ASEAN), the South Asian Association for Regional Cooperation (SAARC) and the Pacific Islands Forum, are also invited to participate in the regional road map. The partnership will deliver five sets of products and services: knowledge and capacity development; expertise; resources; advocacy for the MDGs; and regional cooperation in delivering public goods (see chart). All combined, these regional partnerships should enable off-track countries to successfully navigate their journey to 2015.
Monitoring and evaluation of assistance. The success of the regional road map will depend ultimately on the efficient functioning of a system to monitor and evaluate the outcomes on a regular basis. We propose to evaluate the impact of assistance to member countries through the Annual Ministerial Review of the UN Economic and Social Council, the Commission's sessions and subregional consultation processes. The outcome of the evaluation will be used to make necessary changes to the strategy.
ESCAP facilitates the regional process . As the Chair of the Regional Coordination Meeting, ESCAP will promote coherence and greater effectiveness in delivering all MDG-related products and services as "One UN" at the regional level. At the country level, the Commission will contribute to the Common Country Assessment/UN Development Assistance Framework and the Poverty Reduction Strategy Papers processes, and support the UN country teams. We are confident that we will be able to fully operationalize the regional MDG road map with the cooperation of UN agencies, regional development banks, subregional organizations and other partners.
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