The Millennium Development goals fail poor children: The case for equity-adjusted measures

Abstract

The Millennium Declaration is a statement of principles about the kind of future that world governments seek; a future that they envisage to be more equitable and more responsive to the socially most vulnerable. The Millennium Development Goals represent the operational targets by which we may judge their actions. The reduction of the U5MR by two-thirds by 2015 is one of the Millennium Development Goals (MDG4). The reduction in U5MR can, however, be achieved through a diversity of policy interventions, some of which could leave the children of the poor worse off. A celebrated MDG4 success can, thus, be a Millennium Declaration failure. Health policy informed by composite outcome measures that take account of both the U5MR and the distribution of the burden of mortality across social groups would help to overcome this.