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UN 2030 Agenda

Data look harder than they are

by Hans Dembowski

In brief

Bill and Melinda Gates with former US President Barack Obama promoting the new report in New York in September

Bill and Melinda Gates with former US President Barack Obama promoting the new report in New York in September

Bill and Melinda Gates have launched a new annual report series to promote the Sustainable Development Goals (SDGs). This year’s edition focuses on health issues.

“We are launching this report this year and will publish it every year until 2030 because we want to accelerate progress in the fight against poverty,” Bill and Melinda Gates state in the introduction. They want policymakers to be guided by the SDGs, which were adopted by the UN in the 2030 Agenda two years ago.  

The philanthropist couple has a history of promoting development programmes. The Gates Foundation is involved in the Global Fund to Fight Aids, Tuberculosis and Malaria, the Alliance for a Green Revolution in Africa and the ONE Campaign, which lobbies donor governments to keep their promises. In view of plans to slice the official development assistance (ODA) of the USA and “a similar mood of retrenchment” in other donor countries, Bill and Melinda Gates now intend to add yet more pressure.

The Gates Foundation asked experts to assess recent trends for 18 of 232 SDG indicators. It reports that, because of “insufficient data”, no precise assessment could be made of the quality of primary education, gender equity and labour productivity in agriculture. The Institute of Health Metrics and Evaluation (IHME) at the Seattle-based University of Washington provided most of the analyses included in the publication.

Its graphs show that, while global development has been moving in the right direction in recent decades, humankind is generally not on track to meet the targets set for 2030. The IHME graphs also indicate what results are likely if global development efforts are increased or reduced. The report warns, for example, that the incidence of malaria can rise from currently 29 to 39 new cases per 1,000 people by 2030 “if we regress”. On the other hand, they may sink to a mere five per thousand “if we progress”.

The publication makes a similar case in regard to HIV/AIDS. The rate of new infections has declined considerably, but this healthy trend became slower as “the sense of crisis dissipated”. The Gates Foundation warns that the infection rates may double again by 2030 “if we regress”.

The graphs look impressively precise. Unfortunately, the IHME remains vague what exactly it would take to “make progress” or what “regressing” would mean. The IHME experts do not offer any estimates concerning how much money needs to be spent to achieve the best results possible, or precisely who would have to take what kind of action. Without such information, the data are not as “hard” as they appear to be.

The publication includes several brief essays that elaborate some issues in more detail. Moussé Fall, an imam from Senegal, explains why family planning is consistent with the Muslim faith, for example. According to him, “the Prophet of Islam encourages women to space births because they have a duty to breastfeed for two full years”. Fall argues that it is okay to use technologies that were unknown in Prophet Muhammad’s time, provided they are used in line with Koranic principles.

Kesete Admasu, a former health minister of Ethiopia, has contributed an essay on his country’s approach to improving maternal and child health. He convincingly points out that awareness raising and community involvement are essential. However, his insistence that all women should give birth in “health facilities” is unconvincingly vague. He probably does not mean full-blown hospitals, but that is not elaborated. In Bangladesh and India, experts warn that, especially in rural areas, there are not enough hospitals to accommodate all women who give birth, so only difficult cases should be referred to hospitals. Given that Bangladesh’s track record on maternal health is impressive and that the country is more prosperous and much more densely populated than Ethiopia, it is hard to see why its rural health infrastructure should be worse than Ethiopia’s.  

The new Gates Foundation series serves a worthy cause, and its first edition offers some interesting information. In order to contribute substantially to rigorous development debate, however, the next editions must become far more detailed.



Bill & Melinda Gates Foundation, 2017: Goalkeepers – The stories behind the data 2017.

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