Salvaging MDG commitments

It goes to the credit of the present government to frankly admit in its latest report PMDGR 2010 that out of 34 indicators, it is lagging or slow in 24 indicators. In other words, based on past 10 years of 'business as usual' scenario, as well as the difficult economic environment it will face in the next 5 years, it is unlikely to achieve or miss the committed targets for 2015.
One can go into a whole set of discussion and blame game on the weaknesses in the process ( administrative, financial, capacity) of target setting, when these commitments were made in the years prior to 2004 but at the UN level it, was a commitment by the government and this understanding is not a function of the type of the government.
Similarly, whichever political party will be in power in 2015, will have to suffer the embarrassment of not achieving these targets. Instead of delving into the past, this article looks ahead and explores ways or options to salvage the MDGs and face the world body with some sense of achievement by 2015.
One of the conventional face-saving option is to go back to the drawing board and re-examine the likelihood of achieving these 34 targets in the light of new realities. This exercise in all probability will end up with downward revision of all the targets (as we are prone to do it in case of economic, including budgetary targets) for 2015.
A case would have to be made for taking the revised targets for documentation to the world body. Probably this will be even more embarrassing than not achieving the original targets. As we may be the only country in the world to take such a step, the UN may not encourage it as it may set precedence and a chain reaction from other countries. Secondly, what is the guarantee that we will even achieve the lower targets?
At a more conceptual level, these commitments are owned by the governments and were not undertaken for showcasing it to the world or wining a race rather a sincere gift for the nationals of each respective country. Ultimately the looser is the country itself (although it lowers the average marginally for the world) whether it fails to achieve the original target or achieves the lower targets.
Thirdly, by revising the benchmark targets for 2015, we may further slacken our efforts and political will, allocation of domestic resources and weaken development partnerships, thereby further reducing any chance of achieving the revised lower targets.
A much more feasible option is to adopt a prioritization strategy for salvaging the MDGs. Given the fact that government has explicitly admitted that it will miss the targets for 24 indicators, it is best to prioritise and concentrate on achieving only a few of the targets.
This is easier said than done as selecting from 24 indicators with multiple constraints and cost functions can become a challenging linear programming exercise. Instead a stylistic approach would start by focusing on two or at the most three goals out of the seven. What should be the criteria for selecting those? Should it be the number of indicators in each one of them, or the probability of achieving those with minimum allocations or having biggest bang for the buck?
At a broader level, each goal is inter-related with the other and some stage of social and economic development can only be reached through achieving all the targets, but more realistically for Pakistan, such a scenario is out of question by 2015. At the risk of offending certain lobbies and interest groups, I would suggest that the GOP should just concentrate on 3 goals, ie, 1) achieving universal primary education, 2) reducing child mortality and 3) improving maternal health.
Undoubtedly, the achievement of these 3 goals in the context of Pakistan is very challenging as the GOP has consistently admitted even 5 years ago that they are most likely to be missed. But in the short and long-run the improvement in these 3 goals have the most widespread linkages to the well-being of the society and utilising its potentials.
The strategy to salvage the MDGs does not end here as the above 3 goals contain 11 indicators, which are lagging or slow. Given the resource constraints, further prioritization is needed among these 11 indicators to focus on a war-footing to achieve the targets or at least to come near them by 2015. What should be the criteria to select a few (at most 3 or 4) among the 11 indicators? One can adopt the same criteria for selecting a few indicators as suggested above for the selection of goals, or they could be different.
From the above 3 goals, we now discuss each separately and prioritise the indicators within them. The goal for achieving universal primary education contains 3 indicators. Among the 3 indicators, adult literacy rate has the smallest gap, while the gap in the other two indicators is large and almost similar. One criterion is to pick the indicator with the smallest gap between now and 2015.
Under the criterion of biggest bang for the buck and largest spillovers over the longer term, I am biased towards picking one from the two with larger gaps. One can refer to the MDG costing exercise and based on comparative investments needed for each of them, arrive at a decision.
However, achieving 100 % completion rate in primary schooling is more difficult administratively as it involves investment and monitoring in quality and quantity, while the NPER indicator is biased towards quantity and may be easier to achieve. This will also be inline with our long cherished goal of last 50 years of achieving UPE.
Coming to the second goal of reducing child mortality, out of 6 indicators, three will be missed. The biggest gap between now and 2015 is in 2 indicators, ie, under-five mortality rate and infant mortality rate. The gap between the current position and target is equally big for both indicators.
A priori, I would think that achieving the target for reducing infant mortality is administratively more capital intensive than for under-5. Moreover, the human capital loss is greater in under-5 mortality, and parents may be eager to contribute in achieving this indicator.
All the 5 indicators of improving maternal health lag behind the targets and will be missed. The gaps are pretty large in case of 2 indicators, ie, maternal mortality rate (MMR) and fertility rate. These are far more difficult to achieve as they depend on complex set of factors as well are capital intensive.
Among the remaining 3 indicators, the government can easily prioritise between indicators (a) proportion of skilled birth attendants and (b) consultation for antenatal care. The gaps are also challenging here, but both are provision intensive and can improve on a war footing.
There is now a 3rd stage of prioritization and that relates to spatial prioritization. Health and education are provincial subjects and it has been clearly recognised that MDG targets will not be achieved unless MDGs are localised. The committed targets are national averages and averages are influenced by extreme values.
Thus districts (their number ranging from 20-40 country wide) in each province that lag far behind even from the provincial averages need to be selected for prioritization. The rapid improvement in those districts can dramatically improve the averages for 2015. The CWIQ surveys of 2004-05 and 2008-09 can be used to identify the districts' current ranking as well as those with potential for rapid improvements.
Lastly, the above prioritization strategy for achieving MDGs will remain a number game, unless again backed by political willingness and administrative machinery from federal to local level. Provinces, NGOs and donors would have to be taken on board on this prioritization strategy. In the absence of local governments being nurtured and nudged by the provincial governments to achieve the targets, the route of actively involving the NGOs would need to be taken by the Centre.
Secondly, just as there is a war-room near the office of the highest authority in times of war, so a cell or a sub-secretariat needs to be created in the Prime Minister's secretariat to achieve these targets on a war-footing. Similar cells need to be created under the direct supervision of the CM secretariats in the provinces. These kinds of cells were established in many countries soon after the commitments made in 2000 that have finally paid off in rapid movement towards the targets and demonstrating to the world about government commitment to MDGs and attracting development partners in the process.
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