Inside Millennium Development Goal 4

Abstract

* Abbreviations: MDG — : Millennium Development Goal U5MR — : under-5 mortality rate UN — : United Nations This Pediatrics Perspectives column traces the origins of the promises and commitments made to decrease global under-5 mortality. The disparities that exist worldwide are extraordinarily large, although significant progress has been made since the establishment of the Millennium Development Goals (MDGs). Dr Spector traces the origins and challenges of Goal 4 (of 8) that relate specifically to this issue. Although overall survival rates are improving, outcome gaps in under-5 mortality have widened between rich and poor nations. Clearly, the MDGs must be looked at as a large package. There are specific measurements for each goal, but success in 1 area influences the outcomes in the others. Our advocacy efforts should focus on improving the lives of the world's poorest people broadly. World leaders have committed to achieving the MDGs by 2015. We all need to use our influence and personal resources to push the international community to succeed in eliminating extreme poverty and hunger everywhere, ultimately allowing for elimination of the growing health disparities among the affluent and poorest nations . —Jay E. Berkelhamer, MD Editor, Global Health Perspectives The Millennium Development Goals (MDGs) have been dubbed the “world's biggest promise.”1 At the turn of the 21st century, 189 (now 192) United Nations (UN) member states agreed to support the most comprehensive poverty reduction objectives ever established (Table 1).2,3 Child mortality is addressed through Goal 4: reduction of the global under-5 mortality rate (U5MR) by two-thirds between 1990 and 2015, equivalent to an annual drop rate of 4.3% (Table 2).4 In 1990, the U5MR was estimated at 84 of 1000 live births, and 11.9 million largely preventable child deaths took place. If MDG 4 could be achieved, 30 million children would be saved by 2015.2 Since their launch, the MDGs have been … Address correspondence to Jonathan M. Spector, MD, MPH, Harvard School of Public Health, Department of Health Policy and Management, 4th Floor, 677 Huntington Ave, Boston, MA 02115. E-mail: jspector{at}hsph.harvard.edu