Department of Economic and Social Affairs
Progress towards the Millennium Development Goals,1990-2005
Goal 8 - Develop a global partnership for development
The Millennium Declaration embodies partnership between developed and developing countries.
Millennium Goal 8 calls for more official development assistance; measures to ensure debt
sustainability in the long term; an open, equitable, rule-based, predictable and non-discriminatory
multilateral trading and financial system; and measures to address the special needs of least
developed, landlocked and small island developing states. A meaningful partnership between rich
and poor countries must also address developing countries access to technology, medicines and
jobs for their growing populations.
How the indicators are calculated
Charting the ebbs and flows of official
development assistance
Indicators of official development assistance
Provision by donor countries of official development
The Monterrey Conference on Financing for
assistance is monitored on the basis of the following
Development in 2002 came at a critical time. In
indicators: the total ODA to all developing countries
1970, the United Nations General Assembly
as a percentage of donors’ national income, the
proposed a target for ODA of 0.7 per cent of
ODA to least developed countries as a percentage
1
donors’ national income. For many years
of donors’ national income, the share of ODA that is
afterwards, the collective contributions of members
allocated to basic social services and the share of
of the Development Assistance Committee (DAC)
ODA that is untied.
of the Organisation for Economic Co-operation and
Development (OECD) hovered around half this
level. But during the 1990s, it fell by about one third, reaching an all time low of 0.22 per cent in
2001. From 2002, however, aid flows began to recover as donors started to deliver on
commitments made in connection with the Monterrey Conference. The ratio of ODA to donors’
national income rose to 0.23 per cent in 2002 and to 0.25 per cent in 2003. In 2004, it reached a
record high of $79 billion. Full delivery of Monterrey-related commitments would result in an
increase in ODA by a further $20 billion, corresponding to 0.29 per cent of donors’ national
income by 2006. Only five donors have achieved the longstanding United Nations aid target of
0.7 per cent of their gross national income (see Table 1), although six more have indicated that
they intend to do so before 2015. If these pledges are honoured, ODA will exceed $100 billion in
2010.
Within their total aid packages, developed countries agreed to provide at least 0.15–0.20 per cent
of their gross national income to assist the 50 “least developed countries” (these are countries
designated as having acute development challenges.) Even though they account for only 14 per
cent of the developing world’s population, the least developed countries now receive about one
third of all aid flows. But this is still not enough. Aid to least developed countries fell from about
0.09 per cent of donors’ national income a decade ago to about 0.05 per cent in 2001, but slightly
increased in 2002 to 0.06 per cent and in 2003 to 0.08 per cent of donors’ income.
Most of the recent increase in foreign aid has been used to cancel debts and meet humanitarian
and reconstruction needs in the aftermath of emergencies. Debt relief, while welcome, often goes
to countries that have already ceased debt repayments, and does not necessarily provide a new
source of financing for social services or poverty reduction. Similarly, emergency and disaster
relief, although essential, do not address long-term development needs.
1
Fully delivering on these commitments will be a challenge for many donors, particularly given
recent increases in budget deficits. More recent announcements, such as pledges to boost AIDS
funding, also reflect renewed international commitment to meet the Millennium Development
Goals. Nevertheless, total ODA will still be well short of the amount estimated to be required to
ensure that the Millennium Development Goals are achieved.
Figure 1. Official development assistance from developed countries, 1990–2003 (constant
US dollars and as a proportion of donor country gross national income)
Table 1. In 2004, only five countries reached the overall level
of 0.7 per cent of their gross national income for official
development assistance
Net ODA as percentage of OECD/DAC donors' gross national
income
Norway
0.87 Finland
0.35
Luxembourg
0.85 Germany
0.28
Denmark
0.84 Canada
0.26
Sweden
0.77 Spain
0.26
Netherlands
0.74 Australia
0.25
Portugal
0.63 Austria
0.24
France
0.42 New Zealand
0.23
Belgium
0.41 Greece
0.23
Ireland
0.39 Japan
0.19
Switzerland
0.37 United States
0.16
United Kingdom
0.36 Italy
0.15
Source: OECD, 11 April 2005.
The proportion of ODA to basic social services
The World Summit on Social Development at Copenhagen in 1995 proposed a mutual
commitment between interested developed and developing country partners to allocate, on
average, 20 per cent of ODA and 20 per cent of the national budget, respectively, to social
programmes such as basic education, health, population, and poverty-focused water and
sanitation projects. The share of bilateral aid that can be allocated to sectors and directed
towards these basic social services has risen regularly from 8.8 per cent in 1996-97 to 12.3 per
cent in 1998-99, 14.6 per cent in 2000-2001, and almost 17 per cent in 2002-03.2
2
Figure 2. Gross bilateral ODA (in 2000 US$ billions).
12.6
2.0
10.4
30
5.4
14.0
9.4
20
2.7
2.5
10.5
14.8
10
17.6
17.2
7.0
5.8
3.3
5.2
0
3.2
4.1
4.5
2002-03
4.6
1995-96
5.3
1990-91
40
50
60
70
Gross Bilateral ODA (US$ 2002 billions)
Education
Health and Water Supply
Other government services
Programme and other assistance
Production and infrastructure
Emergency and reconstruction aid
Debt relief
Some of the recovery in aid since the mid-1990s has gone to health, water and government
capacity-building. About half of the assistance going to basic education, health, and water and
sanitation is to promote gender equality and women’s empowerment. What’s worrying is that the
share devoted to agriculture and physical infrastructure has diminished. This trend needs to be
reversed if the poorest countries are to achieve the MDGs. Emergency and reconstruction aid
has doubled as crises have multiplied – and will rise further with the additional aid following the
Asian tsunami. Debt relief is also up, but releases new money for development only if the debt
was being repaid.
Proportion of bilateral ODA that is untied
It is widely recognized that tying aid to procurement from suppliers in a donor country reduces the
cost-effectiveness of aid and its flexibility in implementation. Acknowledging this, members of
OECD’s Development Assistance Committee have raised the share of their aid that is untied from
about 68 per cent in 1990 to 92 per cent in 2003. 3
However, the share of untied aid to the least developed countries has not risen at the same rate.
In 2001, the Development Assistance Committee adopted a recommendation on untying aid to
the least developed countries, intended to spur progress in this area. 4
Addressing the special needs of landlocked countries and small island
developing states
Landlocked developing countries present special
challenges. They are often far from markets and the
cost of exporting goods is higher than for other
countries. Most have recorded disappointing economic
results.
Small island developing states also face unique
constraints. They have a narrow resource base and
high costs for energy, small domestic markets and
heavy dependence on a few external and remote
3
Indicators on development assistance to
landlocked countries and small island
developing states
Progress made to address the special needs of
landlocked developing countries and small island
developing states is assessed on the basis of the
ODA received as a percentage of the recipient
countries’ gross national income.
markets. They also have little resilience to cope with natural disasters or resources to protect
fragile natural environments.
Despite their special needs, aid to landlocked countries as a percentage of their national income
rose slightly at the beginning of the 1990s, but fell in 1996 and then stayed at around 6 per cent
during the late 1990s until 2001. Figures for 2002, however, show an increase of the ratio to 7.6
per cent, equivalent to $8.8 billion. Figures for 2003 show a decrease in the ratio to 7.4 per cent,
although, in absolute terms, the amount increased to $9.9 billion.
Official development assistance received by the small island developing states as a percentage
of their gross national income (GNI) fell between 1990 and 2003, from 2.8 per cent to 1.1 per
cent, totalling $1.7 billion in 2003. It should be kept in mind, however, that the small island
developing states include countries with very diverse incomes per capita (ranging from least
developed to high-income countries) and thus have diverse ODA/GNI ratios; within the group, a
number of small island developing states now need less aid, having successfully diversified their
economies by developing tourism, offshore banking, or clothing or other light industries.
Achieving the MDG on poverty in the least developed countries, landlocked developing countries
and small island developing states remains a daunting challenge. Extreme poverty, structural
handicaps, such as high international transport costs and isolation from world markets, poor
infrastructure, lack of access to information and technology, and weak human capacity make
them extremely vulnerable to external shocks, natural and man-made disasters, and
communicable diseases. Despite the efforts of their governments to mobilize meaningful
domestic resources and attract foreign investment, ODA will remain a critical source of external
financing for poverty reduction and sustainable development in these countries in the years to
come.
Opening markets to developing countries
If developing countries are to realize the potential
of international trade to enhance economic growth,
the main barriers to their exports need to be
removed. These include tariffs (taxes) imposed by
developed countries on imports from developing
countries and the subsidies that developed
countries provide to domestic agricultural
producers.
Indicators on market access
International efforts to remove barriers to trade from
developing countries are monitored on the basis of
the share of exports from developing and from the
least developed countries that enter developed
countries free of duty, and on the basis of trends in
average tariffs imposed on exports from developing
countries of agricultural products, textiles and
clothing.
Some improvements in removing trade barriers for
developing countries have been made in recent
years. Initiatives in 2001 by the world’s two largest markets, the European Union’s “Everything
but Arms” arrangement for the LDCs and the United States African Growth and Opportunities Act,
provided increased trading opportunities for the poorest countries. Other developed countries
such as Australia, Canada, Japan, Norway and Switzerland have also opened up their markets to
goods from least developed countries.
The Doha round of multilateral trade talks, under the aegis of the World Trade Organization
(WTO), was promoted as a development round because it was expected to deliver long-sought
trade reforms that would help developing countries to export their goods to richer nations, thereby
spurring their economic growth. These efforts were seriously compromised by the collapse of
negotiations in Cancún in September 2003.
The goal of improving market access is monitored by four indicators that reflect the level and
structure of tariffs imposed on exports from developing countries and the domestic subsidies
provided by developed countries. Both sets of policies distort trade and restrict growth in
developing countries.
Duty-free access
The share of exports, excluding arms, from developing countries that entered developed
countries free of duty has, in 2000-2003, risen for developing countries and improved modestly
4
for least developed countries. In 2000, the proportion of developing country exports eligible to
enter duty free into developed country markets was 63 per cent. In 2003, the figure was 70 per
cent. The figures for exports from LDCs were 77 per cent and 80 per cent in 2000 and 2003,
respectively. When both arms and oil are excluded, the proportion of duty-free exports from
developing countries increased from 61 per cent in 2000 to 64 per cent in 2003, and from 70 per
cent to 72 per cent in LDCs over the same period.
Table 2. Proportion of total developed country imports (by value and excluding arms) from developing
countries and least developed countries, admitted free of duty
Percentage of total developed country imports
1996
2000
2001
2002
2003
Excluding arms:
Developing countries
48.2
63.0
62.6
64.8
69.7
Least developed countries
70.3
76.9
77.5
78.0
80.5
Excluding arms and oil:
Developing countries
44.7
61.3
60.2
63.4
63.9
Least developed countries
77.4
69.7
70.4
69.2
72.1
Source: United Nations Statistics Division, Millennium Indicators Database, http://millenniumindicators.un.org (accessed June 2005);
based on data provided by the World Trade Organization (WTO).
Almost two thirds of exports from developing countries now enter developed countries duty-free.
When looking at the period from 1996 to 2003, the proportion of duty-free imports from both
developing countries and LDCs has increased noticeably. However, when both arms and oil are
excluded from duty-free imports from LDCs, the proportion has decreased.
These different trends can be explained by two developments. First, the bias on the part of
developed countries in protecting products of export interest to developing countries is still
prevalent, despite the reductions in tariffs arising from the implementation of the WTO Uruguay
Round commitments. As the growth and volume of exports from some developing countries
continue to expand, the share of these exports entering duty free will either decrease or remain
constant. An improvement in this indicator, therefore, requires a change in the structure of
developed country protection, or a shift in the composition of developing country exports to
include a greater share of products that are not tariff constrained in developed country markets.
Second, the effect of initiatives specifically in favour of LDCs are now more noticeable. Of these,
of particular note is the Africa Growth and Opportunity Act of the United States. The European
Union also enacted a scheme to benefit LDCs, but this has not had a significant impact on the
figures since the scheme augmented an already extensive set of duty-free and quota-free market
access arrangement in favour of LDCs.
Figure 3. Proportion of imports from developing countries (excluding arms and oil)
admitted to developed countries duty-free, 1996-2003 (Percentage of value)
5
Tariffs on agriculture, textiles and clothing
Developed countries’ tariffs remain high on goods that are strategically important to developing
economies, such as textiles and farm products. Tariffs imposed by developed countries on
imports of agricultural and textile products from developing countries declined marginally over the
period 1996-2003. Some of the reductions are an outcome of the Uruguay Round of negotiations,
which has resulted in a reduction in overall tariffs; the remaining are due to preferential trading
agreements. Ongoing multilateral trade negotiations provide an opportunity to make the markets
of all countries more accessible to exports from the developing world.
Figure 4. Developed countries’ average tariffs on imports of key products from developing
countries, 1996–2003 (percentage)
Support and protection for domestic agriculture in developed countries
Tariffs are not the only impediment to exports from
Indicators on other policies and interventions to
developing countries. Subsidies to producers in
facilitate market access
developed countries enable them to sell their
Efforts by developed countries to create an open
output at a lower price than would otherwise be the
and non-discriminatory trading system for
case – to the disadvantage of producers from
developing and least developed countries are
developing countries. This is particularly important
assessed on the basis of domestic agricultural
for agricultural products, since they represent a
subsidies measured as a percentage of total gross
large part of developing countries’ trade. It is
domestic product in OECD countries and on the
estimated that trade in agricultural products
basis of the support provided to developing
without these subsidies would benefit developing
countries to help them build their trade capacity.
countries by some $20 billion per year. Annual
agricultural support by OECD countries remains at
around $350 billion, but has fallen as a share of their growing gross domestic product (GDP). The
nature of support is also changing. Support that distorts prices and production has declined from
60 per cent to 46 per cent of total support. Yet it still accounts for a third of farmers’ incomes. And
prices paid to rich world farmers are some 31 per cent higher than world market prices.
6
Figure 5. Value of agricultural subsidies in developed countries, 1990–2003 (billions of US
dollars and as a proportion of gross domestic product)
Building capacity in trade
At Doha, donors committed to providing increased support to help developing countries,
especially LDCs, build the capacity to trade and to integrate into world markets. The World Trade
Organization and the OECD have compiled the Doha Development Agenda Trade Capacity
Building Database that lists and quantifies such activities by bilateral and multilateral donors from
2001 onwards. Table 3 below presents the latest available data for the proportion of ODA
provided to build trade capacity.
Table 3. Proportion of ODA provided to help build trade capacity (trade-related technical
assistance/capacity-building)
Trade-related technical assistance/capacity-building
as a percent of total sector-allocable ODA
2001
2002
2003
Africa
4.2
4.3
5.6
Americas
5.6
3.9
9.2
Asia
2.3
2.9
2.5
Europe
3.0
6.1
6.5
Oceania
3.3
3.7
3.7
Global programmes
9.0
4.0
4.2
World
4.0
3.8
4.5
Source: United Nations Statistics Division, Millennium Indicators Database, http://millenniumindicators.un.org (accessed June 2005); based
on data provided by the OECD.
Easing the debt burdens of the poorest countries
Over the years, developing countries have borrowed extensively from official lenders and
commercial banks to finance their development. But interest charges and repayment of these
loans present difficulties, especially when the amounts involved become large in relation to the
funds a country has available, principally through its export earnings. Recent weakening prices
for commodity exports from the poorest countries have made the problem more acute.
The major current international effort targeted specifically at improving developing countries’ debt
sustainability is the Heavily Indebted Poor Countries (HIPC) Initiative.
There are 38 countries considered likely to be eligible for assistance under the enhanced HIPC
Initiative. Almost all are in sub-Saharan Africa. By April 2005, twenty-seven countries were
receiving debt relief under the Initiative. Eighteen of these countries had reached "completion
point" and were receiving irrevocable debt relief (see table 4). These 18 countries will benefit
from an agreement reached by the major developed countries in June 2005 to provide for the full
cancellation of the $40 billion they owe to the World Bank, the International Monetary Fund and
7
the African Development Bank. As many as 20 other countries could be eligible if they satisfy
criteria for good governance and tackling corruption. This would eventually boost the total
additional debt relief to more than $55 billion. Among these 20 additional countries, nine are
between the "decision point" and "completion point" and are already receiving interim debt
service relief. The remaining 11 countries are potentially eligible for the Initiative but have been
beset by such persistent difficulties as internal civil strife, cross-border armed conflict, governance
challenges and substantial arrears on debt payments. A few of them, however, have made
progress towards establishing a track record of sound macroeconomic performance which is a
requirement for qualifying for debt relief.
Table 4. Enhanced HIPC Initiative: status as of April 2005
Countries that have reached
Countries between Decision and
Decision and Completion Points (18) Completion Points (9)
Benin
Cameroon
Bolivia
Chad
Burkina Faso
Democratic Republic of Congo,
Ethiopia
Gambia
Ghana
Guinea
Guyana
Guinea-Bissau
Honduras
Malawi
Madagascar
Sao Tome and Principe
Mali
Sierra Leone
Mauritania
Mozambique
Nicaragua
Niger
Rwanda
Senegal
Tanzania, United Rep. of
Uganda
Zambia
Countries still to be considered for Decision
Points (11)
Burundi
Central African Republic
Comoros
Congo
Côte d’Ivoire1
Lao PDR
Liberia
Myanmar
Somalia
Sudan
Togo
* Côte d’Ivoire reached the decision point under the original HIPC Initiative, but has not yet reached the decision point under the enhanced HIPC Initiative.
Source: International Monetary Fund and World Bank (accessed June 2005).
The ratio of debt service to exports averaged around 23 per cent in low-income economies over
the period 1990 to 2000. For the 27 countries that reached their decision point under the
Enhanced HIPC Initiative, the ratio of debt service to exports is expected to fall from an average
of 16 per cent in 1998-1999 to 10 per cent in 2001-2005.
Small, open economies may have relatively high levels of exports (and imports) and yet may face
problems in meeting debt service obligations, particularly when debt service payments due on
public debt are high relative to government revenue. A large economy may have proportionately
smaller exports and still find its debt payments sustainable. In addition, countries that depend on
one or two commodities for the bulk of their export revenues may be particularly vulnerable when
prices for commodities fall.
For this reason, in forming a picture of debt sustainability, it is necessary to look at other
indicators, such as the ratio of total debt to gross national income, the size of international
reserves relative to total debt, and debt maturing within a year’s time.
8
Table 5. Debt service as a percentage of exports of goods and services
Ratio of debt service to exports
1990
1995
2003
11.0
10.0
6.5
20.6
18.6
19.6
4.7
4.5
1.9
17.7
26.9
13.4
14.0
7.8
6.9
6.0
7.4
6.2
7.5
4.3
6.5
9.4
11.7
9.8
Northern Africa
Sub-Saharan Africa
Latin America and the Caribbean
Eastern Asia
Southern Asia
South-Eastern Asia
Western Asia
Oceania
Commonwealth of Independent States
CIS, Europe
CIS, Asia
Transition countries of South-Eastern Europe
Source: United Nations Statistics Division, “World and regional trends”, Millennium Indicators Database, http://millenniumindicators.un.org (accessed June 2005);
based on data provided by the World Bank.
Target 16 - In cooperation with developing countries, develop and
implement strategies for decent and productive work for youth
Globalization is being driven by technological
Indicators on youth unemployment
advancements and improvements in labour
Efforts to provide decent and productive work for
productivity throughout the developed and
youth are monitored on the basis of the youth
developing world. But despite the many benefits of
unemployment rate, defined as the percentage of
globalization, nearly half the world’s 2.8 billion
unemployed people aged 15 to 24 in the labour
workers still earn less than $2 a day. More than
force of the same age group.
500 million of these workers live on half that much.
Reducing poverty among them requires growth in employment as well as growth in the
productivity of employment.
Employment challenges remain particularly worrisome for young people. Of the 184.7 million
people unemployed in the world, 82.5 million are between the ages of 15 and 24. Youth in
developing regions are three times more likely than adults to be unemployed and more than twice
as likely to be unemployed in the developed regions. The total number of youths has increased
by over 115 million since 1990, to nearly 1.2 billion in 2004, and this figure is expected to grow by
an additional 64 million by 2015. Whether this demographic trend represents an asset or liability
very much depends on society’s ability to increase the availability of decent and productive work.
Overall, young people continue to suffer from marked disadvantages in the labour market when
compared with older adults. Youth unemployment rates exceed adult unemployment rates in all
regions (see Table 6). The ratio shows that youth unemployment rates are two to six times the
rates for unemployment adults. The greatest disadvantage for young people relative to adults is in
Southern and South-Eastern Asia, where young workers are six and five times, respectively,
more likely to be unemployed than older workers.
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Table 6. Ratio of youth unemployment rate to adult unemployment rate, 1993-2003
1993
2000
Developed regions
2.4
2.4
Commonwealth of Independent States
3.1
2.4
Northern Africa
3.2
2.9
Sub-Saharan Africa
3.6
3.5
Latin America and the Caribbean
2.8
2.7
Eastern Asia
3.1
3.0
Southern Asia
5.6
5.8
South-Eastern Asia
3.9
5.0
Western Asia
3.4
3.3
Oceania
3.1
3.3
2003
2.3
2.5
3.0
3.5
3.1
2.9
5.8
4.8
3.0
3.3
Source: United Nations Statistics Division, “World and regional trends”, Millennium Indicators Database,
http://millenniumindicators.un.org (accessed June 2005); based on data provided by the International Labour Organization (ILO).
The youth unemployment rate increased over the decade 1993-2003 in South-Eastern Asia, the
Commonwealth of Independent States, Latin America and the Caribbean, and Eastern Asia, and
decreased slightly in Northern Africa and sub-Saharan Africa (see Table 7).
Table 7. Youth unemployment rate (percentage), 1993-2003
1993
Total Women
Men
Total
1998
Women
Men
Total
2003
Women
Men
16.7
16.5
16.8
14.5
14.6
14.3
14.6
14.2
15.0
9.4
9.0
9.7
17.1
17.2
16.9
14.6
14.7
14.5
Northern Africa
30.7
39.7
27.1
32.7
41.8
28.9
29.4
39.1
25.5
Sub-Saharan Africa
21.9
19.5
23.7
20.8
18.3
22.8
21.1
18.6
23.0
Latin America and the Caribbean
12.4
15.5
10.7
16.0
20.4
13.2
16.6
20.8
14.0
Eastern Asia
4.8
4.1
5.5
7.0
5.7
8.1
7.0
5.8
8.1
Southern Asia
13.3
14.6
12.7
14.1
15.6
13.4
14.6
17.1
13.5
8.8
9.3
8.4
12.0
12.8
11.4
16.5
17.7
15.6
19.0
19.6
18.7
17.7
19.1
17.2
20.8
22.5
20.1
7.5
7.8
7.3
9.5
9.9
9.1
8.7
9.2
8.4
Developed regions
CIS
South-Eastern Asia
Western Asia
Oceania
Source: United Nations Statistics Division, “World and regional trends”, Millennium Indicators Database, http://millenniumindicators.un.org (accessed June 2005) based
on data provided by the ILO.
;
10
Table 8. Share of youth unemployment in total unemployment, 1993-2003
1993
2000
Developed regions
30.1
27.6
Commonwealth of Independent States
38.1
28.0
Northern Africa
51.5
48.8
Sub-Saharan Africa
62.0
62.3
Latin America and the Caribbean
49.7
44.8
Eastern Asia
52.6
41.6
Southern Asia
64.3
64.0
South-Eastern Asia
58.2
55.4
Western Asia
55.9
52.3
Oceania
59.2
56.5
2003
26.2
29.6
46.8
62.8
48.6
41.0
62.1
58.2
48.3
55.6
Source: United Nations Statistics Division, “World and regional trends”, Millennium Indicators Database,
http://millenniumindicators.un.org (accessed June 2005), based on data provided by ILO.
The gender dimension of youth unemployment
Unemployment among young women is significantly higher than that among young men in almost
all regions. The gender gap is particularly evident in Northern Africa and Southern Asia, where,
rather than closing, the gap has widened during the decade 1993-2003. Only in sub-Saharan
Africa and Eastern Asia do data indicate higher unemployment for young men than young
women. However, the relatively lower rates for women do not always reflect the availability of
productive work opportunities. In sub-Saharan Africa, a larger number of women cannot afford to
be unemployed and thus work in subsistence agriculture, low-income jobs in smallholdings, or in
other forms of unpaid and informal work.
Figure 6. Growth in value added per worker, total economy (1990-the last year for
which data are available)
Harnessing the energy of youth
There is a need for cooperation among policymakers, civil society and international organizations
to address the multitude of challenges facing young people. High and persistent unemployment
among youths represents a waste of the world’s most valuable resource – our young people.
Moreover, the absence of hope and promise for youth is a potential source of unrest, conflict and
violence.
11
Target 17 - In cooperation with pharmaceutical companies, provide access
to affordable essential drugs in developing countries
An issue that has polarized international trade negotiations and highlighted the growing rift
between poor and rich countries is access to medicines. Target 17 stresses the need to make
essential drugs available and affordable to those who need them.
Millions of people die prematurely or suffer unnecessarily each year from diseases or conditions
for which effective medicines or vaccines exist. Essential drugs save lives and improve health,
but their potential can only be realized if they are accessible, rationally used and of good quality.
Providing access to essential drugs is an integral part of a national health system.
Progress continues to be made in increasing the availability of essential drugs to developing
regions, as a result of efforts by national Governments, donors, the private sector and others. In
2001, the World Trade Organization ruled that the TRIPS (Trade-related Aspects of Intellectual
Property Rights) Agreement, which, among other things, protects patents on drugs, should be
interpreted so as to support countries’ rights to safeguard public health and promote access to
medicines for all. This was followed by a decision of the General Council of the World Trade
Organization taken in 2003 to ease restrictions on the importation of generic drugs by the poorest
countries for the treatment of rapidly spreading “high-cost” diseases, such as AIDS, malaria and
tuberculosis.
Growing access to HIV drugs
It is estimated that 39 million adults and children were living with HIV at the end of 2004 and in
need of care, including antiretroviral drugs. Access to antiretroviral therapy is still very limited in
developing countries. However, various initiatives to improve access are now being undertaken
by international agencies, governments, non-governmental organizations and private entities.
In 2004, the number of people receiving antiretroviral drugs for the treatment of HIV and AIDS
doubled in sub-Saharan Africa and Asia. But there are another 6 million people –
about three quarters of whom are in sub-Saharan Africa – who could benefit from treatment.
Though the price of generic versions has dropped sharply as a result of collaboration between the
public and private sectors, the cost of these drugs for the poorest countries is still high.
Moreover, these countries face challenges in making these drugs widely available because of
their weak health systems and limited capacity to reach those in need, factors that remain the
biggest obstacles to treatment.
In 2002, ten antiretroviral compounds recommended for the combination treatment of HIV
infection in adults and children were included in the WHO’s Model List of Essential Drugs.
Essential ingredient for combating malaria is in short supply
New combinations of drugs — especially those that contain a compound derived from the
Artemisia annua plant — are proving effective in controlling malaria. But access to this natural
substance remains difficult owing to the high cost and limited supply. As the plant has a six- to
eight-month growing season, accurate forecasting of demand is a critical factor in maintaining the
supply of artemisinin-based combination therapy, or ACT. Production and financing of ACT
remain the major challenges to meeting the projected needs of 132 million people in 2005.
Insufficient drug supplies and inadequate drug policies limit progress
against tuberculosis
If taken as prescribed, a combination of drugs is generally effective in treating tuberculosis.
Though these drugs are relatively inexpensive in their generic forms, the cost is still too high for
many of the poorest countries. In these countries and elsewhere, the effectiveness of treatment
strategies — including the internationally recommended protocol called DOTS (see Goal 6) —
and the prospect of expanding them are limited by insufficient drug supplies and inadequate drug
policies.
12
Target 18 - In cooperation with the private sector, make available the
benefits of new technologies, especially information and communications
Technology enhances people’s lives and can spur national economic growth. Yet access to such
Indicators on access to new technologies
technology is unevenly distributed. Only 11 per cent of
the world’s population had access to the Internet in
The indicators used to track progress in the
2003, and over 70 per cent of these people lived in
availability of new technologies measure
5
developed countries.
the number of telephone and cellular phone line
subscribers, the number of personal computers and
The use of information and communications
the number of Internet users.
technology (ICT), for example, can make
governments more transparent and therefore reduce
corruption and lead to better governance. It can help people in rural areas find out about market
prices and sell their products at a better value. It can also overcome traditional barriers to better
education by making books available online and opening the door to “e-learning”.
Mobile phone and Internet services have grown tremendously over the past decade. Yet, the gap
between rich and poor in access to communications services must be reduced if the benefits of
the global information society are to be shared. Bridging this “digital divide” has risen to the top of
the development agenda. Recent data are encouraging: use of the Internet in developing
countries is rising rapidly.
Telephone access has more than quadrupled
Access to telephone networks has more than quadrupled – from 10.1 subscribers per 100
inhabitants in 1990 to 40.5 subscribers in 2003 (see Table 9). The most rapid growth occurred in
the use of mobile phones – from less than 0.3 mobile phone subscribers per 100 population in
1990, to 23 in 2003. This mobile boom has dramatically increased total (fixed and mobile)
telephone access in the developing world, from 2 per cent in 1991 to 25 per cent in 2003.
Mobile phone service is often the first area where competition has been introduced and private
investment allowed. Competition has led to a drop in prices and market innovation. The
introduction of prepaid cards for mobile networks has also driven growth, particularly in
developing countries where many citizens would not qualify for conventional subscriptions. One in
five people around the world now has a mobile phone, up from one in 339 in 1991. In 2003, the
number of mobile telephone subscribers surpassed fixed ones, and there was strong growth in
developing regions in particular. China, for instance, surpassed the United States to emerge as
the largest mobile phone market in the
Table 9. Telephone lines and cellular phones per 100
world. Growth has been robust in Africa,
population, 1990 and 2003
where almost all countries now have
more mobile than fixed telephone
1990
2003
subscribers.
World
10.1
40.5
As a whole, developing countries now
account for 45 per cent of all telephone
subscribers in the world, up from just 19
per cent in 1990.
Developed regions
CIS
Transition countries South-Eastern Europe
Developing regions
Northern Africa
Sub-Saharan Africa
Latin America and the Caribbean
Eastern Asia
Southern Asia
South-Eastern Asia
Western Asia
Oceania
45.4
12.5
13.8
2.3
2.9
1.0
6.4
2.4
0.7
1.4
10.0
3.4
120.7
29.4
57.7
25.0
21.0
6.0
40.4
47.3
7.1
20.9
45.8
10.1
Source: United Nations Statistics Division, “World and regional trends”,
Millennium Indicators Database, http://millenniumindicators.un.org (accessed
June 2005); based on data provided by the International Telecommunications
Union (ITU).
13
Personal computers and access to the Internet also on the rise
The number of personal computers (PCs) rose from around 120 million in 1990 to 691 million in
2003. Worldwide, PCs per 100 people stood at about 10 per cent at the end of 2003. Between
1990 and 2000, developing countries increased their share of PCs by about 10 percentage
points. While they had some 20 per cent of the total PC stock in the early 1990s, they now own
about 30 per cent of all PCs. Growing
Figure 7. ICT users worldwide
investment in information technology, falling
Total number of telephone subscribers, Internet
prices through technological improvement
users and personal computers, as a percentage of
and reductions in trade barriers, domestic
world population, 1990–2003
production, and greater functionality have
driven PC sales.
Another major factor in the rise of PC
penetration has been the use of the PC as
the leading access device to the Internet.
Internet usage has grown at an astounding
pace. Just 27 countries had a direct
connection to the global network in 1990.
Today, practically every country in the world
is online. It is estimated that 11 per cent of
the world’s population was online at the end
of 2003. Over half the adult population is
online in most developed countries. Internet
usage has grown fastest in developing
countries, which accounted for 30 per cent
of all Internet users in 2003 – a dramatic
increase from the 2 per cent share in 1991.
25
Mobile
20
15
Fixed-line
10
Personal
computer
5
Internet
users
0
1990
92
94
96
98
2000
02
Source: ITU World Telecommunication Indicators Database.
A key development is the growing use of wireless technologies to access the Internet. In some
countries, third-generation mobile services have been launched that provide Internet access via
mobile networks at speeds higher than a dial-up telephone line. At the same time, there are a
growing number of locations around the world providing high-speed wireless Internet access for
suitably equipped laptop PCs at special locations (so-called “hotspots”).
Existing data suggest that proportionally fewer women than men use the Internet in the
developed world. In the developing world this gap is further aggravated by lower female school
enrolment rates and wages.
14
Table 10. Personal computers and internet users per 100 population, 1990 and 2003
Personal
computers in use
per 100 population
1990
2003
2.5
10.1
11.1
44.9
0.3
6.8
0.2
6.5
0.3
3.4
0.1
2.0
0.3
1.2
0.6
6.8
0.3
5.6
0.0
1.1
0.3
2.8
1.2
5.6
0.0
6.1
World
Developed regions
CIS
Transition countries South-Eastern Europe
Developing regions
Northern Africa
Sub-Saharan Africa
Latin America and the Caribbean
Eastern Asia
South Asia
South-Eastern Asia
Western Asia
Oceania
Internet
users per
100 population
1990
2003
0.05
11.1
0.3
44.8
0.0
3.6
0.0
13.5
0.0
5.1
0.0
3.4
0.0
1.1
0.0
9.0
0.0
8.9
0.0
1.7
0.0
6.1
0.0
7.2
0.0
3.8
Source: United Nations Statistics Division, “World and regional trends”, Millennium Indicators Database,
http://millenniumindicators.un.org (accessed June 2005); based on data provided by the ITU.
Outlook for the future
The telecommunications industry has undergone a major transformation over the last two
decades. For most of the period since World War II, the industry has moved along gradually with
network growth rates of between 5 per cent and 7 per cent a year. This changed in the mid1990s, when growth rates started to rise, peaking at a heady 28 per cent in 2000. Underlying
these statistics is a period of high and sustained investment.
What happened in the late 1990s was the sort of radical shift that usually only happens every 50
years or so. Such a shift is generally caused by the confluence of rapid technological change
with a shift in market expectations, in this particular case associated with mobile networks
overtaking fixed-line networks, and with data overtaking voice.
In an effort to boost productivity, global spending on information technology products averaged
around 9 per cent growth a year between 1997 and 2001. Today’s entry level PC costs are
roughly the same as they were 10 years ago, even though the equipment is about 40 times more
powerful. The World Trade Organization’s Ministerial Declaration on Trade in Information
Technology Products, concluded in December 1996, stipulates that participants should
completely eliminate duties on information technology products covered under the Agreement by
1 January 2000. Signatories cover 90 per cent of the market in such products.
As the ICT industry enters the 21st century, the equation has changed for many developing
countries. Since computers are now readily available all over the world, the concern has shifted
from scarce supply of hardware to affordability and skills to use computer technology effectively.
Notes
United Nations General Assembly Resolution 2626 (XXV) of 24 October 1970. Switzerland and the United States
have not committed to the 0.7 per cent target.
2 These figures for aid to basic social services may be underestimated, since some assistance within wider sector
programmes and multisector programmes is not captured by the reporting system.
1
15
Data exclude technical cooperation and administrative costs and ODA from Austria, Luxembourg, New Zealand and
the United States, since these countries do not report on whether their ODA is tied.
4 OECD, DAC recommendation on untying official development assistance to the least developed countries (2001),
available at http://www.oecd.org/dataoecd/14/56/1885476.pdf.
3
ITU, Telecom World 2003, “Reaching the Unreached”, available at
http://www.itu.int/WORLD2003/media/features/devbackgrounder.html.
5
How the indicators are calculated
Trade-related technical assistance/capacity-building
Only a proportion of aid can be allocated to sectors. In order to avoid the implicit assumption that
none of the aid unallocable by sector is for trade-related technical assistance or capacity-building,
the denominator used is “sector-allocable aid”, that is, aid excluding categories such as general
programme assistance (structural adjustment, budget and balance-of-payments support), debt
reorganization and administrative costs of donors.
Market Access
Goods admitted free of duties are exports of goods (excluding arms) received from developing
countries and admitted without tariffs to developed countries.
Average tariffs are the simple average of all applied ad valorem tariffs (tariffs based on the value
of the import) applicable to the bilateral imports of developed countries. Agricultural products
comprise plant and animal products, including tree crops but excluding timber and fish products.
Clothing and textiles include natural and synthetic fibers and fabrics and articles of clothing made
from them.
Debt relief under the HIPC Initiative
Launched in 1996, the Heavily Indebted Poor Countries Initiative marked the first time that
multilateral, official bilateral, and commercial creditors united in a joint effort to reduce to
sustainable levels the external debt of the world’s most debt-laden countries. Once a heavily
indebted poor country has established an appropriate track record of good performance, made a
commitment to continue to implement sound macroeconomic policies within the context of an
IMF-supported programme, and developed an Interim Poverty Reduction Strategy Paper (IPRSP) or a full PRSP, the country can reach its decision point. At this stage, the country’s
eligibility and the amount of debt relief are determined by the IMF and World Bank Executive
Boards on the basis of a loan-by-loan analysis of the country’s debt situation and according to
HIPC rules. Debt relief and other assistance begin flowing on an interim basis as soon as the
decision point is reached. Approximately one to three years after the decision point, the country
reaches its “completion p point”, when the remainder of the debt relief is delivered unconditionally
and irrevocably. The actual time period between a country’s decision and completion points
varies, depending on how quickly the country can make satisfactory progress toward
implementing its full PRSP and establishing its track record by implementing the specific
macroeconomic and structural measures that were identified at its decision point.
Youth unemployment
The youth unemployment rate (youth unemployment as a percentage of the youth labour force) is
a general measure of the utilization of the labour force of young people, defined as persons aged
15 to 24 years old. Unemployment, however, is only one dimension of the employment problem
faced by young people: a disproportionately large number of them are underemployed in many
countries. Some are working fewer hours than they would like to and others are working long
hours with little economic gain. Stagnation and decline of employment opportunities in the formal
sectors of most developing countries has intensified the problem in recent years, with young
women bearing a disproportionate burden. Supplementary indicators to understand the
employment problem should include measures of underemployment, the informal sector,
educational access and labour force participation, among others.
16
The youth unemployment rate gives the percentage of persons aged 15 to 24 years who are
actively seeking, but unable to find employment. It is important to note that the youth
unemployment rate alone cannot fully gauge the ability of youth to meet their full-productive
capacity. The International Labour Organization (ILO) is currently exploring the development of
an additional indicator – the youth non-employment rate, which is a measure of the youth who are
neither in education nor in employment as a proportion of the total youth population. It would
represent a narrower construct of youth idleness by isolating from the equation youth who are still
participating in the education system. The indicator takes in consideration those discouraged
youths who have dropped out of the labour market.
Access to essential drugs
The World Health Organization regularly monitors access to a minimum of 20 of the most
essential drugs in countries on the basis of their being continuously available and affordable at
public or private health facilities or drug outlets that are within one hour’s walk.* Essential
medicines fall into a number of categories, including well-known anesthetics, analgesics,
antibacterials and antimalarials. The information is generated through interviews with relevant
experts on the pharmaceutical situation in each country. Countries are categorized as having low,
middle, high, very high coverage where:




Low means that less than 50 per cent of the population have regular access.
Middle means that 50-80 per cent of the population have regular access.
High means that 81-95 per cent of the population have regular access.
Very high means that more than 95 per cent of the population have regular access.
The access framework covers a number of criteria, including: (a) the rational selection of drugs
appropriate for the population and the setting, (b) sustainable financing and procurement, (c)
affordability, and (d) a reliable supply system. It is therefore complex to measure accurately.
* World Health Organization, Model List April 2003, available from
http://www.who.int/medicines/organization/par/edl/expertcomm13.shtml
Telephone lines, personal computers and Internet users
Data on telephone subscribers come from administrative records compiled by national regulatory
authorities or telecommunication operators and tend to be timely and complete. However there
are issues related to the practice of some countries including a “virtual” number of telephone lines
for high-speed data services. There are also comparability issues for mobile subscribers due to
the prevalence of pre-paid subscriptions. This arises from differences in the time period chosen
for considering when to consider a pre-paid subscription no longer active.
The precise number of personal computers is available only in few countries. The International
Telecommunications Union (ITU) uses industry sales data to derive the stock of PCs for most
developed and major developing countries. In cases where these data are not available, the ITU
also uses PC import data to make estimates. Neither sales nor import data are available for
many, mainly smaller developing countries. Another limitation of the PC data is that it is quite
recent, so longitudinal time series only exist for developed nations and major developing ones.
Finally, there are growing methodological issues in measuring the number of Internet users.
These include wide variations in the definition of an Internet user in terms of the user’s age and
frequency of use and age. Another emerging issue is how to treat Internet access from mobile
phones. While many developed nations now carry out Internet use surveys conducted by national
statistical offices or industry associations, hardly any developing countries do so. In the case of
most developing countries, Internet users are calculated based on a multiplier factor of the
number of subscribers. This could be misleading since many users in developing countries are
not subscribers and obtain access through public facilities such as libraries, Internet cafés and
schools.
17