Millennium Development Goals, Real Experiences, Human Flourishing

In honor of International Women's Day and also because my Economic Development students are preparing for their midterm, some especially extended reflections on the importance and impact of the Millennium Development Goals...

The Millennium Development Goals are vital for focusing our efforts.  Fifty years previous to the articulation of the MDGs,  the United Nations put forth the Universal Declaration of Human Rights.  That declaration, while important, compelling, and the world’s clearest comprehensive statement of what is essential to a fully human experience, is also an aspiration sometimes too overwhelmingly broad to inspire clear action. The Millennium Development Goals boil down to eight concise concerns what next steps are necessary for the world’s progress.

In the scope of development history, the fundamental contribution of the MDGs is that they did clarify eight, actionable and measurable goals on a clear timeline. At times people argue that things like the Universal Declaration of Human Rights are too broad and too idealistic. The MDGs not only provide clear and measurable goals on a timeline, their last decade of history also shows us that progress can and will be made on the goals. I’m going to take a moment here to illustrate the goals through individual experiences, while also providing a bit broader background on the components and their connections.



Serious progress is underway for Goal 1: Eradicate Extreme Poverty and Hunger.  Based on current trends, approximately 15% of the world’s people will be living in poverty by 2015. That’s approximately 920 million people - still far too many people to be living in poverty,  but less than half the number of people living in poverty in 1990, only twenty years ago. While the global population has been growing, the number of people in absolute poverty has been dropping. There remains substantial variation in poverty around the world. It has fallen most dramatically in Asia, where state-led growth under authoritarian regimes has flourished. It has also fallen in sub-Saharan African and, most importantly, the proportion of people living on less than $1.25 per day has fallen from 46% to 27% throughout the developing world.



Extreme poverty, which is generally the reality for people living on less than that daily $1.25 amount, is debilitating. In situations of extreme poverty, people are so fundamentally lacking in basics - the possibility of education, the experience of general health sufficient to attend school or work regularly, or safe water and basic hygiene - that they arguably cannot be said to be living fully human lives. That may be too harsh, but the extreme deprivation calls attention to the question that development economists and human rights advocates regularly ask, and that is what are the basic conditions necessary for human flourishing. While people living in extreme poverty are obviously humans and they’re obviously living, it would be hard to say that they have  the opportunity for flourishing, and it would even be hard to suggest that they experience full human freedom. That’s part of what Amartya Sen emphasizes in his classic book Development as Freedom.



Sen argues that we cannot talk about development without consideration of how it expands human freedoms. He criticizes those state-led, authoritarian development efforts where economic gains may exist, but people are not free to make their own decisions within those gains or political systems. Development, for  Sen,  is the expansion of human freedoms. And he rightly points out that at least two of the primary building blocks of development - education and health care - are so human-resource-heavy that they are more affordable investments in developing countries where wages are lower. Sen’s Development as Freedom pulled together a long-standing human rights focus on civil and political rights with an emerging consensus on economic and social rights (e.g. health care and education) to make a case for focusing on the human effects and experience of economic development. Development that merely raises GDP,  but neither affects the poor nor expands political freedoms, is not sufficient for Sen.

I want to think about Millennium Development Goals in the context of these photos. These first three are homes in northwest Tanzania. When we talk about people living in extreme deprivation, we’re talking about homes that, as you can see, are often composed of sticks and mud,  with corrugated metal roofs. We’re frequently talking about people who have  no electricity, running water, or methods of personal transportation beyond walking. Sometimes this population has access to mobile phones,  sometimes not. The picture of poverty is made clearer through the relatively recent development of the Multidimensional Poverty Index at The University of Oxford.  That index, with its attention to household education (years of schooling,  child enrollment),  health (child mortality, nutrition),  and standard of living (access to electricity, drinking water, sanitation, flooring, cooking fuel, and a set of basic assets including a mobile phone or bicycle), provides researchers and policymakers with a sharper picture of the experience of individuals around the world. The MPI, already, has helped us understand that half of the world’s MPI poor people live in South Asia,  while just over a quarter are in Africa. The MPI also helps us understand more deeply than a raw income measure  can alone.  In Nigeria, for example, ⅔ of the population is income poor, but a whopping 93% are MPI Poor.   



In the photos,  the first  two homes are outside of town. There are no visible electric lines or other signs of communication network access.  The third photo, despite it still being an extremely basic home and now including a very young child carrying water, also demonstrates proximity to electric lines and tower for radio and cell signals. There’s a great deal of diversity in every bit of Africa, and around the world, and some of these more nuanced  measures, like the MPI, help policymakers better understand what they’re attempting to address. And the UN, in moving the MDGs forward, was trying to address the core issues that will bring the world closer to being a place where all people experience basic freedoms.

This forth photo I’m including to provide more context for what the region I’m talking about looks like and also to provide an image of an extraordinarily common site in East Africa: work. People work a great deal. As the UN reports in respect to progress on Goal 1: Eradicate Extreme Poverty and Hunger, approximately 77% of workers in Subsaharan Africa are in what the UN  calls “vulnerable employment.” They probably work alone, in family operations, or in small and informal local businesses.  They’re not likely to have any stability, benefits, or social protections.  They are most likely working in the informal economy and therefore are unlikely to either be paying into state coffers or to be registered with social safety nets such as the state social security administration.

The man in this photo is most likely selling water. In terms of household consumption, most of the household-level water providers in areas where water access is limited are women and children. Most of the time, if men are carrying water in large volume they’re doing so as part of a business effort and re-selling to local women at what many people would call extraordinarily high rates. They are businessmen operating in a completely unregulated market. The bicycle in this photo is almost certainly from China. Most of the bikes in the area have Chinese characters on them. Chinese trade with and extraction from Africa is soaring. I mention the work because it draws attention to a reality: people work hard in many places around the world,  but without basic social services they are unlikely to be working in a way that will lead to growth and growing opportunities.  I mention the connections to China because it is just one small reminder that the world today really and truly is a deep web of connections. All sorts of patterns and trends - environmental degradation, global disease epidemics, security and terrorism, trade, competition, and growth - are definitively global trends. Every community has global connections. Because of the global nature of threats and opportunities, our response to debilitating conditions of extreme poverty must be global in character too. Hence the MDGs.



I’ll come back around to vulnerable work later. I just alluded to the global challenges we face - environmental degradation, disease epidemics, and terrorism - that stand themselves as strong utilitarian justifications for investing in less developed countries, in an effort to strengthen global stability.  But there’s another reason to meet Millennium Development Goals, and that is the simple human appeal to common dignity and the notion of equal opportunity.  That is why the second goal is to Achieve Universal Primary Education. Kids ought to have opportunities.  And whatever you think the reasons for the developing world’s challenges are - whether you think they have to do with slavery, “Guns, Germs, and Steel,” corrupt dictators, neoliberalism, socialist experiments, or lack of transparent governance from aid agencies through local implementation - it’s nonetheless pretty clear that it’s not the children’s fault.

The UN has good news on this front too.  Tremendous strides have been made in the last ten years, moving the percentage of children in the developing world enrolled in primary education from 82 to 89. As you’ll note in this photo, in Tanzania school access usually means school uniforms.  

Families and aid agencies struggle to be sure the children can afford the single uniform, the pen or pencil they need for work, and the appropriate school materials. Governments have worked steadily to increase school buildings, school enrollments, and numbers of school teachers. As the UN notes, one of the challenges developing countries currently face is increasing the numbers of qualified teachers. Unfortunately, enrollment numbers only indicate the proportion of children who are actually inside school buildings on a regular basis. These numbers say nothing about the quality of the school 

or the ratio of children to qualified and concerned teachers in classrooms. 

This last photo features a set of West Virginia University-Amizade students working with Tanzanian students on some intensive English language instruction. The students and teachers appreciated the attention from people who spoke English as a first language,  and the teachers appreciated the break from their demanding experience of working with 50+ students at a time.

Just like with poverty measures, development researchers and policymakers have improved their understanding of how to think about and measure education in the last several years. First, there’s a relatively recent innovation in the development literature called Development as Human Rights. It suggests, quite similarly to Sen’s notion of development as freedom, that development should be defined as each individual’s opportunity to experience human rights. In respect to education, that would mean not asking whether there is a school, but whether each child has the opportunity to experience education.  That means each child has access to and interaction with good teachers.  It means each child has reading and writing materials.  It means each child has a holistic experience that provides them with real opportunity to learn. That’s a far cry farther than simply building schools.

The second important innovation that relates to education and, really, all development policy work, is Esther Duflo’s contribution of social experiments to fight poverty (For more on Duflo, check out this New Yorker article or her Ted Talk).

Duflo examines very specific policy intervention questions in similar environments that do and do not receive the intervention, then she measures very specific possible related outcomes. In one experiment, for example, she looked at whether incentivizing attendance for para-teachers seemed to be correlated with improved children’s test scores. Duflo’s contributions are important on several fronts.  First, she looks at interventions in quasi-controlled environments and therefore, for the first time in development history, can plausibly tell us if development dollars are having effects that wouldn’t otherwise exist in the community. Second, and equally importantly, she works and experiments very much in the context of development realities. Duflo does not visit once and then go back to her office to suggest broad development theories. She and her team of researchers are continuously considering very specific interventions very much in their empirical context. Due to this real commitment to serious empiricism, Duflo answers the objections often brought against conventional development economists, by people like “Barefoot Economics” advocate Manfreed Max Neef, who argue that economists’ supposed insights have little to do with what’s happening in real communities.

As the United Nations and countries continue to work to enroll all children in schooling, they must give policy attention to getting children and staff to attend school regularly. They must ensure children have the resources to succeed at school. And they must be sure well-trained teachers are in the classroom. That’s an awfully tall order, as the global brain drain regularly pulls top-performing people out of developing countries and rural communities with the promise of success and riches in the growing cities and regions at the heart of the global economy.

For women, leaving is often especially attractive.  If they can get out, they frequently have more opportunities in developed countries and major cities because of the better gender equality that typically exists there. Some have argued, most recently Nickolas Kristof and Sheryl WuDunn (in their brilliant book Half the Sky), that Goal 3: Promote Gender Equality, is the most important of development goals. 


I remember when I first read an assertion of that kind. It was in Foreign Policy magazine during the summer of 2007.  I was on a plane, returning to Tanzania for the second time. I thought, there must be a more important, all-encompassing goal: perhaps ending poverty, or promoting safe water access and hygiene for everyone. And then that summer I worked intensively with WOMEDA, The Women’s Emancipation and Development Agency, for the first time.

At WOMEDA's request, I worked with a group of students to do an analysis that determined the average distance women walked to receive services from WOMEDA was 26 miles. We worked with women who had been so completely abused, ignored, and marginalized by their spouses and communities that they had been nearly stripped of their humanity.  I say nearly because these were the women fighting back, one way or another.  They had their humanity, because they were asserting their dignity.  They knew their inherent worth. And in working with those women I understood on a visceral level why promoting gender equality is the most important development goal: because until we have gender equality roughly half the world – a bit less than half because gender equality is becoming a reality a few places – but nonetheless until we have gender equality roughly half the world is not part of the possibility.  We need gender equality because as it becomes a reality we add nearly 3 billion potential solution-makers, innovators, and leaders to the world. 3 billion, largely off-line at the moment.    

Vulnerable employment, that challenge named above in the discussion of Goal 1: End Poverty and Hunger, is a severe challenge particularly for women. These women completed a training program run by a local nongovernmental organization to become seamstresses. 

And indeed they are both eager to work and diligent at whatever work they get. They, like most people I’ve met in the developing world, don’t mind work at all. What would be ideal would be transparent government, good and strong public institutions and policies, and the rules and regulations necessary to recognize work, tax a small portion of it, and create some real social safety nets and public programs.

Taxation and public spending are necessary to help address Goals 4, 5, and 6: Reduce Child Mortality, Improve Maternal Health, and Combat HIV/AIDS, Malaria, and other diseases. Across the board, these goals relate to important, achievable expenditures in public health infrastructure to prevent unnecessary and untimely death or severe discomfort. The deprivation relating to these issues in rural Tanzania is often jarring: women regularly walk several miles to rural health clinics after their water breaks.  Through working with WOMEDA, I met a woman walking home several miles following a tubal ligation. She had opted for the procedure after her husband beat her for having too many children (return to Goal 3: Promote Gender Equality).

I’ve also had the good fortune to work with the extraordinarily dedicated nursing staff and doctor at Nyakahanga Hospital, in Omurushaka, Tanzania. Through that relationship and other connections through the global nonprofit organization Amizade,  I met Charl Kapp. Charl came to Tanzania through Amizade, an organization that arranges service-learning programs and volunteer vacations for people of all ages.  Charl is retired. She primarily serves as a deacon at her church in rural Northwest Pennsylvania. Charl found many things jarring in rural Tanzania. What she chose to do upon return was work with her church to start something called the milk project. Because of the shockingly low amount of resources available to the hospital in Omurushaka, children who are there only receive ugali as they recover. Ugali is a kind of porridge. It will fill the stomach but does little for nutrition. Charl noticed this. Through the milk project, monthly donations from a church in rural Northwest Pennsylvania provide children at the hospital with milk as they recover from whatever it is they’re addressing in the hospital. The children in the hospital now recover faster.  They gain weight faster.  They grow faster. When resources are shared responsibly, in this and many other examples, clear health gains are made.

Children and mothers now die needlessly.  As the UN Millennium Development Goals Report indicates:

On children: Four diseases – pneumonia, diarrhea, malaria, and AIDS – accounted for 43% of all deaths in children under 5 in 2008. Most of these lives could have been saved through low-cost prevention and treatment measures, including antibiotics for acute respiratory infections, oral rehydration for diarrhea, immunization, and the use of insecticide-treated mosquito nets and appropriate drugs for malaria.

And on mothers: The leading causes of maternal mortality in developing regions are hemorrhage and hypertension, which together account for half of all deaths in expectant or new mothers. …. The vast majority of these deaths are avoidable. Hemorrhage, for example,  which accounts for over one third of maternal deaths, can be prevented or managed through a range of interventions administered by a skilled health-care provider with adequate equipment and supplies.

Unfortunately, progress has stalled in reducing the number of teenage pregnancies and expanding the use of contraceptives among women,  particularly among poor and uneducated women. I call this unfortunate because when women have greater say in their timing and number of pregnancies they’re more likely to receive prenatal care and have the resources necessary to invest in the child’s growth and development once it’s here.  Women with this education and these choices, in other words, are more likely to have healthy, happy children. Progress may have stalled for many different plausible reasons, but one possibility is a drop in funding dedicated to family planning. The US is in an odd position in this story, particularly in relation to Goal 8: Develop a Global Partnership for Development.

I say the US is in an odd position because, even as it catches criticism for dedicating a relatively low portion of its national budget to international development spending, its especially large economy makes it one of the largest global givers.  And beyond that, as none other than Bono recognized (as he delivered the 2006 US National Prayer Breakfast), God’s politics in the US has had a decidedly inconsistent impact on international development policies. Left and right have come around to the importance of development assistance, for reasons ranging from utilitarian interest to charity to justice. President George W. Bush focused absolutely unprecedented attention on African development assistance, but domestic politics also required that he step away from anything approaching family planning.

As Nicholas Kristof has consistently reported in his New York Times columns and blog entries, as well as in the book he co-authored with his wife Sheryl WuDunn, US political dialogue has too frequently prevented common-sense education and family planning policies. Out of fear that talking openly about sex, condoms, and contraceptives will lead to promiscuity, less talk about any of the preceding leads to increasing numbers of unplanned and unwanted pregnancies. And all too often those lead to legal and illegal abortions. We do better when we get past left and right and look at the real effects of policy choices. If we give more attention to education, more women and girls will have choices, more babies will come to families prepared for children, and fewer girls will face the substantial set of challenges that come with unwanted pregnancy.


Left and right can also come together to achieve Goal 7: Ensure Environmental Stability. There are small signs of gains in environmental stability.  For example, the rate of deforestation is decreasing. Yet much more must be done. As the World Bank’s Changing the Climate for Development makes clear, environmental protection may be accomplished as much with the traditional left’s regulations as it will be with the traditional right’s market-based pricing. What is absolutely clear, according to the vast majority of the world’s scientists, is that environmental sustainability and protection needs urgent attention. The success of the Montreal Protocol on Ozone-depleting substances makes the possibility and importance of global agreements abundantly clear. Between 1986 and 2008 global consumption of ozone-depleting substances dropped 98 percent. This is a remarkable achievement made possible by global agreement of countries gathered through nothing less than enlightened self-interest. That single success story comes within a sea of concern: habitats are disappearing and species face extinction as global biodiversity decreases.

According to the Millennium Development Goals report,  the world is on track to meet the goal of halving the number of people without access to safe drinking water by 2015, but the goal relating to adequate sanitation will not be reached. According to the UN Development Program, access to safe water and sanitation are stronger development drivers than any other development intervention evaluated, including health and education. For every dollar invested in water access, economies witness a $4.5 return. Even more impressive, for every dollar invested in sanitation, economies witness a $9.1 return. Safe water access and functional sanitation systems are development drivers.  When people have access to safe water and sanitation systems, they avoid sickness far more easily. They’re more able to attend school and work. Water and sanitation are foundational.

Goal 8, finally, and as I’d mentioned before,  is to develop a global  partnership for development. What is meant by this in the simplest of terms is – there is far more than enough wealth in the world to achieve these goals.  Some relatively modest redistribution would provide the resources necessary to meet the MDGs. Development aid has increased, but the average level of assistance is well below the .7% goal agreed  to at the United Nations (That’s seven-tenths of one percent of each developed country’s annual budget).  The only countries to reach or exceed that target in 2008 were Denmark, Luxembourg, The Netherlands, Norway, and Sweden. The largest countries by volume, meanwhile, were The United States, France,  Germany, The United Kingdom, and Japan.

Beyond aid, developing countries are also eager to access developed country markets, and compete in a global trading system unfettered by high tariffs and without going up against extravagant subsidy systems in place in developed countries,  particularly in the agricultural sector. A few exciting things are happening on this front. First,  tariffs are dropping generally speaking,  though not as quickly as desired. Second, there are moves in several developed countries to chip away at these subsidies and to permit competition on an actual common playing field. One essential component in a truly competitive market is access to information, and with the growing global coverage of cell networks and access to cell phones,  we’re seeing developing country producers gain access to information about the markets that affect them. We’re seeing banking applications, which means better understanding of one’s own access to credit. Information access changes everything.

The 2009 data in the Millennium Development Goals report indicates 67% of the world’s people have access to mobile phones. Indeed, a recent National Geographic compilation of the world’s “typical person” declares that person is Asian, male, and a cell phone owner and operator. 

In this region in Tanzania I’ve mentioned a few  times, in 2006 there was very little cell network coverage. In 2007 there was some. By 2008 it was possible to use a laptop plug-in to access the internet through the regional cell coverage. That’s fortunate, but most of the world still does not have access to the abundance of information that the internet provides.

The Millennium Development Goals report provides much more reason for optimism than pessimism. Time-bound, specific targets have led to real gains in the specified areas. This means opportunity and empowerment for people all around the world. This means development as freedom and the opportunity for human flourishing. What’s interesting about Duflo is that she helps us know what specific interventions are supporting this effort. The MDGs report has less to say about that. For me,  I’m less interested in the grand theories and causal explanations – everyone seems to want to offer whether the culprit is capitalism or communism, slavery or selfishness – and far more interested in whether we’re working toward a world where more people have more access to more opportunity. Duflo’s work lets us get down into a level of detail about how that might be happening. And the MDGs give us goals to work toward and celebrate as we meet successes along the way.