a future within reach: gender and the millennium development goals

1. As we approach the mid-term review next year, it is timely for us to take a closer look at where we are and what needs to be done to achieve MDGs by 2015. The purpose of my presentation is therefore to give you, first a brief account of trends in achieving MDGs in South Asia, second, institutional changes required for service delivery and third, regional cooperation mechanisms for achieving MDGs. As we approach the mid-term review next year, it is timely for us to take a closer look at where we are and what needs to be done to achieve MDGs by 2015. The purpose of my presentation is therefore to give you, first a brief account of trends in achieving MDGs in South Asia, second, institutional changes required for service delivery and third, regional cooperation mechanisms for achieving MDGs.

2. Before I go into details, let me give you a snapshot of progress towards achieving MDGs in the Asia-Pacific region. The Asia-Pacific region as a whole continues to make progress towards achieving the MDGs. In particular its progress in reducing poverty is remarkable. The number of poor people in the region fell from 931 million in 1990 to 679 million in 2001. No country in the region is performing badly on all 18 MDG targets However, on the negative side, not a single country in the region is expected to achieve all MDG targets 5 countries in the region may not meet any of the targets on high-priority indicators including poverty. Before I go into details, let me give you a snapshot of progress towards achieving MDGs in the Asia-Pacific region. The Asia-Pacific region as a whole continues to make progress towards achieving the MDGs. In particular its progress in reducing poverty is remarkable. The number of poor people in the region fell from 931 million in 1990 to 679 million in 2001. No country in the region is performing badly on all 18 MDG targets However, on the negative side, not a single country in the region is expected to achieve all MDG targets 5 countries in the region may not meet any of the targets on high-priority indicators including poverty.

3. In contrast, the South Asian subregion experienced mix fortunes. Overall, six out of nine countries in South-Asia including Iran are off-track for more than one-third of the MDG indicators. These countries are either slow or slipping backwards in achieving MDG targets. While some countries are catching up and making a good progress, some others are falling further behind. This has made South Asia the poorest performer in the Asia-Pacific region.In contrast, the South Asian subregion experienced mix fortunes. Overall, six out of nine countries in South-Asia including Iran are off-track for more than one-third of the MDG indicators. These countries are either slow or slipping backwards in achieving MDG targets. While some countries are catching up and making a good progress, some others are falling further behind. This has made South Asia the poorest performer in the Asia-Pacific region.

4. Let me now elaborate on the achievements of countries in South Asia in each goal/target Latest available data indicate that all countries in the South Asian subregion are �on track� in achieving the income poverty target. For example, Pakistan is an early achiever and India has made substantial progress by reducing the number of people earning less than $1 a day from 381 million in 1993 to 354 million in 1999. The main reason behind this substantial poverty reduction in the subregion is the rapid economic growth. However, the progress in reducing hunger is slow in Bangladesh, India and Pakistan.Let me now elaborate on the achievements of countries in South Asia in each goal/target Latest available data indicate that all countries in the South Asian subregion are �on track� in achieving the income poverty target. For example, Pakistan is an early achiever and India has made substantial progress by reducing the number of people earning less than $1 a day from 381 million in 1993 to 354 million in 1999. The main reason behind this substantial poverty reduction in the subregion is the rapid economic growth. However, the progress in reducing hunger is slow in Bangladesh, India and Pakistan.

5. With respect to Goal 2 All countries in South Asia, except Maldives are generally �on track� on primary enrolment, although countries such as Pakistan has by far the lowest primary enrolment rates in the whole Asia-Pacific region. The subregion is however, slow in targets relating to reaching grade 5 and completion of primary schooling. School dropout is a serious concern in some countries. For example, in India, only less than two-thirds of school entrants reach grade 5.With respect to Goal 2 All countries in South Asia, except Maldives are generally �on track� on primary enrolment, although countries such as Pakistan has by far the lowest primary enrolment rates in the whole Asia-Pacific region. The subregion is however, slow in targets relating to reaching grade 5 and completion of primary schooling. School dropout is a serious concern in some countries. For example, in India, only less than two-thirds of school entrants reach grade 5.

6. Rapid progress in gender equality and women empowerment Impressive progress in South Asia, in particular in Bangladesh, India and Nepal Afghanistan regressing and outlook not good for Pakistan Let us turn to Goal 3. The Asia-Pacific region has made remarkable progress in achieving Goal 3, which is promoting gender equality. The performance of South Asia is equally impressive. Bangladesh, India and Nepal, in particular, have made rapid progress in gender equality and women empowerment since 1990. However, the situation in Afghanistan is not so good as the ratio between girls and boys enrolment declined significantly. The outlook does not appear good in Pakistan, as it�s girls to boys ratio at primary and secondary level is amongst the lowest in the Asia-Pacific region. Let us turn to Goal 3. The Asia-Pacific region has made remarkable progress in achieving Goal 3, which is promoting gender equality. The performance of South Asia is equally impressive. Bangladesh, India and Nepal, in particular, have made rapid progress in gender equality and women empowerment since 1990. However, the situation in Afghanistan is not so good as the ratio between girls and boys enrolment declined significantly. The outlook does not appear good in Pakistan, as it�s girls to boys ratio at primary and secondary level is amongst the lowest in the Asia-Pacific region.

7. Next goal is reducing child mortality. In achieving Goal 4 South Asia has done better. However, despite the progress made by all subregions, nearly 5 million children across the Asia-Pacific region die before reaching their fifth birthday. Out of this, South Asian subregion accounts for 3.5 million child deaths. While Afghanistan, India and Pakistan are likely to miss the under 5 mortality target, these countries along with Bhutan and Nepal continue to have high infant mortality rates too. India has the largest number of child deaths in the world. For example, total child deaths in India was an alarming 2.3 million in 2003, almost half of the world total. In Afghanistan one in every four children die before reaching the age of 5.Next goal is reducing child mortality. In achieving Goal 4 South Asia has done better. However, despite the progress made by all subregions, nearly 5 million children across the Asia-Pacific region die before reaching their fifth birthday. Out of this, South Asian subregion accounts for 3.5 million child deaths. While Afghanistan, India and Pakistan are likely to miss the under 5 mortality target, these countries along with Bhutan and Nepal continue to have high infant mortality rates too. India has the largest number of child deaths in the world. For example, total child deaths in India was an alarming 2.3 million in 2003, almost half of the world total. In Afghanistan one in every four children die before reaching the age of 5.

8. Still low priority accorded to maternal health Nearly 250,000 mothers in the Asia-Pacific die every year during pregnancy and child birth Around two-thirds of this takes place in India and Pakistan Little access to antenatal or primary health care in some countries Progress towards Goal 5 is a matter of concern for whole Asia-Pacific region. Nearly 250,000 mothers in Asia and the Pacific die every year during pregnancy and child birth. Around two-thirds (or 164,000) of these deaths take place in India and Pakistan which are among the off-track countries for this goal. This indicates that maternal health has been given very low priority in South Asia. These deaths can be avoided if mothers have access to emergency health care. In South Asia, we have good performers too. For example, Bangladesh has made considerable progress in reducing maternal mortality partly by taking health care closer to mothers in rural communities, which can be a good practice for other countries to replicate. Progress towards Goal 5 is a matter of concern for whole Asia-Pacific region. Nearly 250,000 mothers in Asia and the Pacific die every year during pregnancy and child birth. Around two-thirds (or 164,000) of these deaths take place in India and Pakistan which are among the off-track countries for this goal. This indicates that maternal health has been given very low priority in South Asia. These deaths can be avoided if mothers have access to emergency health care. In South Asia, we have good performers too. For example, Bangladesh has made considerable progress in reducing maternal mortality partly by taking health care closer to mothers in rural communities, which can be a good practice for other countries to replicate.

9. The region�s performance in achieving Goal 6 is mixed. For example, although South Asia has a low HIV infection rate, and progressing well to achieve the target, India has 5 million HIV infected people, the highest number in Asia and the Pacific Malaria and Tuberculosis (TB) remain serious problems in South Asia despite the progress made in combating these diseases in recent years. For example, India has the largest number of malaria related deaths in the Asia-Pacific. 3.1 million people in India are infected with TB, the second highest after China. South Asia can draw lessons from other countries in Asia in particular from Thailand where strong political commitment and public health campaigns have worked very well in containing the spread of HIV.The region�s performance in achieving Goal 6 is mixed. For example, although South Asia has a low HIV infection rate, and progressing well to achieve the target, India has 5 million HIV infected people, the highest number in Asia and the Pacific Malaria and Tuberculosis (TB) remain serious problems in South Asia despite the progress made in combating these diseases in recent years. For example, India has the largest number of malaria related deaths in the Asia-Pacific. 3.1 million people in India are infected with TB, the second highest after China. South Asia can draw lessons from other countries in Asia in particular from Thailand where strong political commitment and public health campaigns have worked very well in containing the spread of HIV.

10. Moving to Goal 7, one of the significant developments in South Asia is its good record on protected land area, including national parks, and providing access to water and sanitation. Concerns remain however in CO2 emissions, forest cover and implementation of national sustainable development strategies. For example: All countries in the South Asian subregion are off-track in reducing CO2 emissions. Forest cover, particularly in Nepal, Pakistan and Sri Lanka is declining at a rapid rate and Implementation of national sustainable development strategies is slow, particularly in Afghanistan, Bangladesh and Pakistan.Moving to Goal 7, one of the significant developments in South Asia is its good record on protected land area, including national parks, and providing access to water and sanitation. Concerns remain however in CO2 emissions, forest cover and implementation of national sustainable development strategies. For example: All countries in the South Asian subregion are off-track in reducing CO2 emissions. Forest cover, particularly in Nepal, Pakistan and Sri Lanka is declining at a rapid rate and Implementation of national sustainable development strategies is slow, particularly in Afghanistan, Bangladesh and Pakistan.

11. Home to 40% of world�s poor despite high growth due to widening income disparity Poor service delivery in some areas Weak governance and institutional structure With this background, let me now highlight some of the key challenges for South Asia in achieving MDGs. South Asia has one of the highest growth rates in the world; more than 6 per cent per annum during the last decade. Despite this high growth, South Asia accounts for 431 million (40%) of the world�s poor. A large number of people in the subregion are also malnourished. The region also faces the challenge of basic service delivery, services are not available to the poor. Governance continues to be a major problem for South Asia, many countries ranking at the bottom of the corruption perception index published by Transparency International. The region also has to confront weaknesses in the institutional set-up, both formal and informal, which have an impact on the delivery of basic services.With this background, let me now highlight some of the key challenges for South Asia in achieving MDGs. South Asia has one of the highest growth rates in the world; more than 6 per cent per annum during the last decade. Despite this high growth, South Asia accounts for 431 million (40%) of the world�s poor. A large number of people in the subregion are also malnourished. The region also faces the challenge of basic service delivery, services are not available to the poor. Governance continues to be a major problem for South Asia, many countries ranking at the bottom of the corruption perception index published by Transparency International. The region also has to confront weaknesses in the institutional set-up, both formal and informal, which have an impact on the delivery of basic services.

12. How can we meet these challenges? To achieve MDGs, countries need financial resources, economic growth, as well as pro-MDG policies and poverty reduction strategies. But they alone are not sufficient. These must be complemented by appropriate institutions. A fundamental change in the way we do things will be necessary to meet these challenges. For example: Growth policies have to be more pro-poor, Institutions have to change to the need of the hour, Services have to be accessible and affordable. Let me focus on service delivery, as the second regional MDG report focuses specially on this issue.How can we meet these challenges? To achieve MDGs, countries need financial resources, economic growth, as well as pro-MDG policies and poverty reduction strategies. But they alone are not sufficient. These must be complemented by appropriate institutions. A fundamental change in the way we do things will be necessary to meet these challenges. For example: Growth policies have to be more pro-poor, Institutions have to change to the need of the hour, Services have to be accessible and affordable. Let me focus on service delivery, as the second regional MDG report focuses specially on this issue.

13. As I mentioned earlier, failure in the service delivery is the main cause of the slow progress in achieving some of the MDG targets. The report identifies 3 major bottlenecks in service delivery. First is supply constraints that relate to the availability and quality of services; The second constraint is access barriers that are financial, legal, socio-cultural and political in nature and The third is institutional constraints that make service delivery difficult.  As I mentioned earlier, failure in the service delivery is the main cause of the slow progress in achieving some of the MDG targets. The report identifies 3 major bottlenecks in service delivery. First is supply constraints that relate to the availability and quality of services; The second constraint is access barriers that are financial, legal, socio-cultural and political in nature and The third is institutional constraints that make service delivery difficult.

14. Let me now discuss briefly supply constraints Basic services are not equally available to all. In some countries, governments cannot provide these services due to various reasons including financial constraints. Often services cannot be accessed by those who need them most, particularly women, old and the disabled. The quality of services is another key challenge; schools are there, but no books or sometimes teachers; health clinics are there, but no nurses sometimes, doctors and supplies. Let me now discuss briefly supply constraints Basic services are not equally available to all. In some countries, governments cannot provide these services due to various reasons including financial constraints. Often services cannot be accessed by those who need them most, particularly women, old and the disabled. The quality of services is another key challenge; schools are there, but no books or sometimes teachers; health clinics are there, but no nurses sometimes, doctors and supplies.

15. The second constraint is that people cannot use services due to various barriers. There are 4 types of access barriers The first type is financial barriers which mostly affect the poor. People often cannot afford to purchase services provided by the private sector due to high charges. Even free public services can be costly to the poor due to supplementary charges (such as uniforms and books) hidden costs (such as tips to health workers) and opportunity costs such as walking long distances or waiting in a queue for long hours to access services The second barrier relates to discrimination and exclusion. This is a serious issue for socially vulnerable groups in South Asia. For example, women face discrimination, people belonging to lower castes face social exclusion and people infected by HIV are discriminated. The second constraint is that people cannot use services due to various barriers. There are 4 types of access barriers The first type is financial barriers which mostly affect the poor. People often cannot afford to purchase services provided by the private sector due to high charges. Even free public services can be costly to the poor due to supplementary charges (such as uniforms and books) hidden costs (such as tips to health workers) and opportunity costs such as walking long distances or waiting in a queue for long hours to access services The second barrier relates to discrimination and exclusion. This is a serious issue for socially vulnerable groups in South Asia. For example, women face discrimination, people belonging to lower castes face social exclusion and people infected by HIV are discriminated.

16. The third type is legal barriers. One area where Governments in South Asia could act soon is removing legal barriers to access. For example: Poorest families are sometimes excluded from schooling in the absence of birth certificates. Absence of titles to land can deprive access to water, sanitation, credit and food from the public distribution system. The final barrier that I want to highlight is a political one. Those with a voice tend to benefit more from services. Those without a voice tend to be neglected.The third type is legal barriers. One area where Governments in South Asia could act soon is removing legal barriers to access. For example: Poorest families are sometimes excluded from schooling in the absence of birth certificates. Absence of titles to land can deprive access to water, sanitation, credit and food from the public distribution system. The final barrier that I want to highlight is a political one. Those with a voice tend to benefit more from services. Those without a voice tend to be neglected.

17. Governments can also play a critical role in removing barriers to access services. There are a range of options available for Governments to choose from. For example: Governments can charge small or lower fees in certain situations (for example water supply) so that the poor also can access public services Governments can also use Variable subsidies whereby charges are based on the volume of of services used. Since the poor normally use lower volumes of utilities such as electricity, water etc, with the subsidies they pay less Another one is giving Vouchers to entitle the poor to free or reduced rates for services. Governments can also play a critical role in removing barriers to access services. There are a range of options available for Governments to choose from. For example: Governments can charge small or lower fees in certain situations (for example water supply) so that the poor also can access public services Governments can also use Variable subsidies whereby charges are based on the volume of of services used. Since the poor normally use lower volumes of utilities such as electricity, water etc, with the subsidies they pay less Another one is giving Vouchers to entitle the poor to free or reduced rates for services.

18. Women�s Human Rights Instruments Declaration on the Elimination of Violence Against Women Declaration on the Elimination of Discrimination Against Women Convention on the Elimination of All Forms of Discrimination Against Women Optional Protocol to CEDAW Declaration on the Protection of Women and Children in Emergency and Armed Conflict Regional Human Rights Instruments, ie Africa Protocol on the Rights of Women, 2003

19. Gender Equality and MD/MDGs

20. MDs/MDGs, Beijing + CEDAW The MD and its Goals as a global expression of commitment to certain minimum outcomes by 2015 The MDG and their Targets MUST be applied and implemented within their context of the MILLENIUM DECLARATION. Gender Equality, women�s human rights and CEDAW are specifically included in the commitments of the Declaration CEDAW, and the Beijing + must therefore be the comprehensive starting points and framework for analysis and implementation of the MDGs

21. Let us now examine some institutional changes that we use to improve basic services delivery such as health and education. Governments are the main provider of basic services. However, Governments also should facilitate the participation of other stakeholders in service delivery, including the private sector and communities. Public-private partnerships is another way for efficient service delivery. This requires institutional changes, particularly legal and regulatory changes, to create the enabling environment for such partnerships. Provision of services need to go beyond governments; private sector and NGOs could play an important role in the delivery of services.Let us now examine some institutional changes that we use to improve basic services delivery such as health and education. Governments are the main provider of basic services. However, Governments also should facilitate the participation of other stakeholders in service delivery, including the private sector and communities. Public-private partnerships is another way for efficient service delivery. This requires institutional changes, particularly legal and regulatory changes, to create the enabling environment for such partnerships. Provision of services need to go beyond governments; private sector and NGOs could play an important role in the delivery of services.

22. Thank you!Thank you!