London School of Hygiene & Tropical Medicine

Professor Oona Campbell, Professor Peter Godfrey-Faussett, Professor Anne Mills, Professor Kim Mulholland and Piya Hanvoravongchai have all contributed to a new health report, with a focus on maternal and child mortality, and HIV/AIDS.

The unique interdisciplinary study suggests principles for goal development, including equity and sustainability, after 2015 - the target date for the MDGs. Its conclusions are based on a cross-cutting analysis of the challenges facing the implementation of the MDGs - a set of eight goals to reduce global poverty which emerged from the UN Millennium Declaration in 2000.

The Commission is a collaboration between The Lancet - the world’s leading general medical journal—and the London International Development Centre (LIDC) - a consortium of six University of London colleges, including LSHTM, dedicated to interdisciplinary approaches to international development.

Professor Jeff Waage, Director of LIDC, is the lead author of the Commission. He said: "The MDGs have made a significant contribution to development, but more could have been achieved if they were better integrated. From our cross-sectoral analysis, we conclude that future goals should be built on a shared vision of development, and not on the bundling together of a set of independent development targets."

Nineteen academic authors representing numerous sectors (including agriculture, health, education, and gender) and based in seven countries (including India, South Africa, Thailand, and the UK) were involved in producing the study entitledThe Millennium Development Goals: a cross-sectoral analysis and principles for goal setting after 2015. The joint Commission illustrates the fragmentation and lack of synergy between the MDGs, particularly the division of the health MDGs concerning reducing child mortality (MDG4), maternal health (MDG5), and combating HIV/AIDS, malaria, and other diseases (MDG6). The lost opportunities created by limited goals are also explored, especially with reference to universal primary education (MDG2). The focus on primary education means secondary and tertiary education, which is essential for improving future incomes and training health-care professionals to help achieve certain other MDGs, remains underdeveloped.
The authors continue by adopting a definition of development as "a dynamic process involving sustainable and equitable access to improved wellbeing." Working with this definition and the cross-sectoral analysis of the strengths and weaknesses of the MDGs, the authors suggest five principles to create synergies between sectors. These are:

• Holism - avoiding gaps in a development agenda and exploiting the inter-connected nature of different elements of wellbeing, such as health and learning 
• Equity - developing targets that do not increase inequity but take a pro-poor approach to improve equity of opportunity and outcome
• Sustainability - ensuring development is sustainable, not only in terms of use of resources, but continuity of supporting institutions and appropriate productivity growth
• Ownership - a need for greater ownership of the process of goal development both nationally and internationally
• Global obligation - the need for the development agenda to be a global framework, such that all countries, rich and poor, have obligations and subscribe to targets for which they are accountable.

The implications of each of these principles is then explored, particularly in relation to its impact upon health, where it is suggested that future health development goals focus on sustainable health systems built around delivering health objectives across the lifecourse.

The UN summit to discuss how to accelerate progress towards the MDGs is taking place in New York from 20-22 September.