With less than a decade left to meet its development targets, the United Nations said on Monday there were "staggering" obstacles to succeeding and conditions in many poor countries were actually worsening.
The eight Millennium Development Goals include targets on health, poverty and the environment - such as halving the number of people living on less than $1 a day and stopping the spread of AIDS and tuberculosis.
The UN progress report on the goals, set in 2000, found that while global incidence of extreme poverty has declined, some 140 million more people have entered that category in sub-Saharan Africa.
More people are also going hungry in the region, which has seen only modest improvements in child mortality and maternity rates in the past six years, according to the study.
"The challenges the (Millennium Development) Goals represent are staggering," Jose Antonio Ocampo, the UN under-secretary for economic and social affairs, said in its introduction.
"Disparities in progress, both among and within countries, are vast and ... the poorest among us, mostly those in remote rural areas, are being left behind."
Still, Ocampo stressed that "some progress has been made" towards achieving the sweeping targets agreed by 189 countries and meant to be reached by 2015. While many goals seemed hard to reach, the UN noted some improvement in access to primary education and other areas.
It said big leaps in Indian school enrolment had helped boost net enrolment ratios to 86 percent across the developing world, with the highest rates in Latin America where 95 percent of children are going to school.
But rates were lagging in sub-Saharan Africa and needed to rise in Oceania and Western Asia to meet the universal education goal, it said, noting that fewer than half of children in Burkina Faso, Djibouti, Eritrea, Ethiopia, Mali and Niger get primary school education.
Although several countries have successfully reduced HIV infection rates, in line with the goal to halt and begin to reverse the spread of the disease that causes AIDS by 2015, infection rates are rising globally and the number of people living with the disease continues to increase.
The report said that distribution of insecticide-treated mosquito nets to combat malaria has increased 10-fold in sub-Saharan Africa, but their use varied between richer and poorer populations and city and rural dwellers.
The report also highlighted wide inequalities between countries on ensuring children are vaccinated for measles, which still kills nearly 500,000 children each year.
Two thirds of the world's children unprotected against measles live in six countries - China, the Democratic Republic of Congo, India, Indonesia, Nigeria and Pakistan.
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