Do the Millennium Development Goals Limit How We See Global Health?

Is it possible that by focusing so explicitly on certain diseases, the Millennium Development Goals are actually stymieing overall progress on health?

Yesterday, I wrote here about how the Millennium Development Goals have succeeded in emphasizing public health issues -- child mortality, maternal health and combating diseases like malaria and HIV/AIDS, malaria -- even though countries are falling short of their targets.

I still stand by that argument. But simultaneously, I think such a narrow focus is pushing health programs to overlook other key, chronic illnesses.

A report released yesterday in the Public Library of Science (PLoS) Medicine journal concludes that programs geared toward public health MDGs "must consider all the diseases and factors that can trap households in vicious cycles of illness and poverty." That means looking beyond the diseases explicitly identified by the MDGs -- HIV/AIDS, malaria and tuberculosis -- to also confront chronic health issues, such as heart disease, diabetes and health issues caused by poor diet and smoking. (The latter which, as we noted last week, could kill some 1 billion people in the next century alone.)

In fact, if countries were to focus on chronic health issues as well as infectious diseases, they might actually be further along in achieving the health-specific MDGs. As one of the study's researchers tells Reuters, it's important to examine the "entire health experience of individuals and families, and not focus on just one or a few diseases."

For instance, when it comes to the MDG goal of halving tuberculosis prevalence, the study notes that either a 1% reduction in the number of HIV infections or a 10% reduction in deaths from chronic diseases might have a similar impact.

Should we continue to laud the MDGs for raising awareness and helping set clear targets for critical public health goals? Absolutely. But as this latest report emphasizes, achieving those targets means considering the whole spectrum of factors that influence public health -- from HIV infections to heart disease.

I know I gave U.N. Secretary-General Ban Ki-moon a lot to do yesterday: stop preaching about the threat of failure, and start talking about what success means in countries falling short of the MDGs. But still, I might add one more thing: That the MDGs shouldn't be treated as a checklist, but instead as a guide to help craft a broad-based public health strategy -- one with a vision that extends beyond the specifics of the Goals.

Photo Credit: Korean Resource Center