Saturday, March 6, 2010
FRONTLINE - The Age of Aids
http://www.pbs.org/wgbh/pages/frontline/aids/view/?utm_campaign=viewpage&utm_medium=grid&utm_source=grid
Friday, March 5, 2010
Thursday, March 4, 2010
Economic effects of HIV/AIDS
Time for a lesson from the other subject I teach, economics. To begin, every country has what is known as a production possibilities curve. A production possibilities curve (PPC) is a graphical representation of different rates of production of two goods and services (in this case, capital and consumer goods) that an economy can produce efficiently at a given time period, at a given level of technology and with finite factors of production (land, labor, capital and enterprise). Let's look at one.
In this PPC, point A represents a corresponding level of capital goods and consumer goods, whereas point E is currently unattainable given this country's current state of technology and store of factors of production. If the output increases to point B, there has been actual growth, and any point on the curve (C or D) would indicate the country is producing at its maximum level using all land, labor, capital and enterprise contained therein. A shift out in the PPC illustrates economic growth, or the increase in the value of the goods and services produced in an economy over a given time period. This suggests an increase in the potential growth of the economy, and occurs when there is an increase in the quality and/or quantity of a country's factors of production.
How do factors of production relate to the HIV/AIDS epidemic? This disease kills the most productive workers in society, people from the ages of 15 to 49. This essentially obliterates labor as a factor of production through sheer reduction in numbers and diversion of attention of the uninfected away from work and towards child/elder (= dependent) care. Moreover, human capital, which is the education and training that makes people more productive workers, is also obviously repressed by countries with high HIV/AIDS adult infection rates. It's difficult to invest in workers' futures when they either have or are at significant risk of catching the disease. We could show these affects on the graph above by shifting the PPC inwards (a rare event) like we would with a major natural disaster (i.e. Haiti 2010) or war (Rwanda, 1994). Please watch Professor Emily Oster's economic explaining in the post above...it's great!
HIV and UNDP - Economic Effects of HIV (scholarly article)
In this PPC, point A represents a corresponding level of capital goods and consumer goods, whereas point E is currently unattainable given this country's current state of technology and store of factors of production. If the output increases to point B, there has been actual growth, and any point on the curve (C or D) would indicate the country is producing at its maximum level using all land, labor, capital and enterprise contained therein. A shift out in the PPC illustrates economic growth, or the increase in the value of the goods and services produced in an economy over a given time period. This suggests an increase in the potential growth of the economy, and occurs when there is an increase in the quality and/or quantity of a country's factors of production.
How do factors of production relate to the HIV/AIDS epidemic? This disease kills the most productive workers in society, people from the ages of 15 to 49. This essentially obliterates labor as a factor of production through sheer reduction in numbers and diversion of attention of the uninfected away from work and towards child/elder (= dependent) care. Moreover, human capital, which is the education and training that makes people more productive workers, is also obviously repressed by countries with high HIV/AIDS adult infection rates. It's difficult to invest in workers' futures when they either have or are at significant risk of catching the disease. We could show these affects on the graph above by shifting the PPC inwards (a rare event) like we would with a major natural disaster (i.e. Haiti 2010) or war (Rwanda, 1994). Please watch Professor Emily Oster's economic explaining in the post above...it's great!
HIV and UNDP - Economic Effects of HIV (scholarly article)
Wednesday, March 3, 2010
All about HIV/AIDS as an illness
HIV is transferred through unprotected sexual intercourse (semen, vaginal fluids, pre-ejaculate); drug use or transfusion contamination (blood); or from mother-to-child (blood, milk). HIV is NOT transferred through hugging or kissing, sharing a cup or sitting on a toilet seat. It is critical to understand legitimate risks of transmission and to reject non-legitimate suggestions.
From Wikipedia: Estimated per-act risk for acquisition of HIV by exposure route (***note that risk rates may change due to other factors such as commercial sex exposure, phase of HIV infection, presence or history of genital ulcers, and national income levels.)
Exposure Route Estimated infections per 10,000
exposures to an infected source
Blood transfusion 9,000
Child birth 2,500
Needle-sharing 67
injection drug use
Percutaneous needle 30
stick
Receptive anal 170 ("best guess")
intercourse (2010) 143 (no condom)
Insertive anal 62 (uncircumsized)
intercourse (2010) 11 (circumsized)
Low-income country 38 ("best guess")
female-to-male
Low-income country 30 ("best guess")
male-to-female
Receptive penile- 10
vaginal intercourse
Insertive penile- 5
vaginal intercourse
Receptive oral 1
intercourse
Insertive oral 0.5
intercourse
Where did HIV/AIDS originate?
Although some alternative theories exist, the most widely accepted view of the origin of HIV/AIDS is transfer from primates to humans in the late 19th/early 20th century in sub-Saharan central Africa. Please read the following article (bolding added by me) to understand this predominate view.
ARTICLE - HIV origin 'found in wild chimps' from the BBC - 25 May 2006
The origin of HIV has been found in wild chimpanzees living in southern Cameroon, researchers report.
A virus called SIVcpz (Simian Immunodeficiency Virus from chimps) was thought to be the source, but had only been found in a few captive animals.
Now, an international team of scientists has identified a natural reservoir of SIVcpz in animals living in the wild.
The findings are to be published in Science magazine.
It is thought that people hunting chimpanzees first contracted the virus - and that cases were first seen in Kinshasa, in the Democratic Republic of Congo - the nearest urban area - in 1930.
Scientists believe the rareness of cases - and the fact that symptoms of Aids differ significantly between individuals - explains why it was another 50 years before the virus was named.
This team of researchers, including experts from the universities of Nottingham, Montpellier and Alabama, have been working for a decade to identify the source of HIV.
While SIVcpz was only identified in captive animals, the possibility remained that yet another species could be the natural reservoir of both HIV and SIVcpz.
Gene tests
It had only been possible to detect SIVcpz using blood test - which meant that only captive animals could be studied.
This study, carried out alongside experts from the Project Prevention du Sida au Cameroun (PRESICA) in Cameroon, involved analysing chimpanzee faeces, collected from the forest floor in remote jungle areas.
This was useful because University of Alabama at Birmingham researchers had been able to determine the genetic sequences of the chimpanzee viruses - which could then be searched for in the faecal samples.
Lab tests detected SIVcpz specific antibodies and genetic information linked to the virus in up to 35% of chimpanzees in some groups.
All of the data were then sent to the University of Nottingham for analysis, which revealed the extremely close genetic relationship between some of the samples and strains of HIV.
Chimpanzees in south-east Cameroon were found to have the viruses most similar to the form of HIV that has spread throughout the world.
The researchers say that, as well as solving the mystery about the origin of the virus, the findings open up avenues for future research.
But SIVcpz has not been found to cause any Aids-like illnesses in chimpanzees, so researchers are investigating why the animals do not suffer any symptoms, when humans - who are so genetically similar - do.
Close relation
Paul Sharp, professor of genetics at the University of Nottingham said: "It is likely that the jump between chimps and humans occurred in south-east Cameroon - and that virus then spread across the world.
"When you consider that HIV probably originated more than 75 years ago, it is most unlikely that there are any viruses out there that will prove to be more closely related to the human virus."
He said the team were currently working to understand if the genetic differences between SIVcpz and HIV evolved as a response to the species jump.
Keith Alcorn of Aidsmap said: "The researchers have pinned down a very specific location where they believe the precursor of HIV came from.
"But there are vast areas of west Africa where other forms of SIVcpz lineages exist, and the possibility remains for human infection.
Yusef Azad, policy director of the National Aids Trust said: "This research is interesting as all discoveries which relate to the history and origins of HIV could be of value to the vital work being carried out by scientists in developing a HIV vaccine."
According to Merriam-Webster online, zoonosis is "a disease communicable from animals to humans under natural conditions" like HIV coming from mutated primate SIV. For this to occur, six conditions must be met (citation - Wikipedia):
1. a human population;
2. a nearby population of a host animal;
3. an infectious pathogen in the host animal that can spread from animal to human;
4. interaction between the species to transmit enough of the pathogen to humans to establish a human foothold, which could have taken millions of individual exposures;
5. ability of the pathogen to spread from human to human (perhaps acquired by mutation);
6. some method allowing the pathogen to disperse widely, preventing the infection from "burning out" by either killing off its human hosts or provoking immunity in a local population of humans.
These condition were met for the SIV jump to humans (HIV) and also explains new animal-to-human illness like H1N1 and avian flu.
Treatment for HIV/AIDS -
One of the world's preeminent hospitals, the Mayo Clinic in Rochester, Minnesota, U.S.A. provides information on diseases including HIV/AIDS. Regarding treatment of HIV/AIDS, their web sites says:
"According to current guidelines, treatment should focus on achieving the maximum suppression of symptoms for as long as possible. This aggressive approach is known as highly active anti-retroviral therapy (HAART). The aim of HAART is to reduce the amount of virus in [the] blood to very low or even nondetectable levels, although this doesn't mean the virus is gone. This is usually accomplished with a combination of three or more drugs."
HAART (video here) is a combination of antiretroviral drugs given at different levels and doses depending on the specific needs of the patient. Although some people in MEDCs have difficulty affording such treatment (i.e. health care debate in the U.S.), the vast majority of infected individuals in LEDCs do not have access to this truly beneficial treatment which has extended and improved the lives of many since the end of the 1990s. Getting drugs to those without access physically or financially is a significant goal/challenge of UNAIDS and the UN in general.Video - occupational PEP
Tuesday, March 2, 2010
Infectious Diseases and Initial Application of MDGs
To better understand the workings of the Millennium Development Goals, we will start an initial examination and evaluation with reference to the MDG framework to the problem of infectious diseases (specifically HIV/AIDS).
What is an infectious disease?
An infectious disease is an illness infected plants, animals and humans from a pathogenic agent like bacteria, viruses, fungi, parasites, and protozoa. Transmission of infectious diseases may occur in several ways, including through insect bites (i.e. malarial mosquitoes), bodily fluids (HIV, hepatitis), food and water (i.e. many diarrheal diseases, e. coli in ground meat) and contaminated surfaces (i.e. noroviruses on cruise ships).
What are the most deadly infectious diseases?
According to the World Health Organization (WHO), in 2002, the five most deadly infectious diseases were lower respiratory diseases like pneumonia and influenzas (3.9 million), HIV/AIDS (2.8 million), diarrheal diseases caused by bacteria like cholera and e. coli (1.8 million), tuberculosis - TB (1.6 million), and malaria (1.3 million).
Why does it seem that HIV/AIDS and, to a lesser extent, malaria are discussed far more frequently than these other microbial killers?
There is not a straight-forward, universally-accepted answer to this question. Simply stated, the pathogens that cause lower respiratory diseases, diarrheal diseases and tuberculosis thrive in areas with poverty and underdevelopment (specific connection to poor health care, infrastructure and education regarding transmission). Furthermore, in MEDCs, the latter two have essentially been eradicated in the former doesn't lead to many deaths which, unfortunately, leads to less discussion of these diseases.
HIV/AIDS, a "new" epidemic in the course of human epidemiology, exists in rich and poor country alike, affecting men, women, children of every race, religion and socioeconomic position. Moreover, the means of transmission (specifically the sexual route) can be, culturally and religiously, a very difficult subject which leads to a stigmatization of the disease not seen with the other infections. Lastly, its wildfire-like spread through and subsequent humanistic and economic attack on sub-Saharan Africa in the late 1990s to today has brought much attention to HIV/AIDS awareness and prevention. These are a few major reasons why HIV/AIDS has become a focal point of international discussion, but certainly is not an exhaustive list.
As for malaria, the pathogen which is transmitted from mosquito to human follows the same sort of pattern described above for lower respiratory diseases, diarrheal diseases and tuberculosis. Perhaps the absolute cheapness of mosquito nets and other malaria prevention methods has led to "more" global attention to this infectious disease?!
What is the connection between MDG6 and infectious disease?
MDG6 reads:
GOAL 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES
Target 7. Have halted by 2015 and begun to reverse the spread of HIV/AIDS
Indicators
18. HIV prevalence among pregnant women aged 15-24 years (UNAIDS-WHO-UNICEF)
19. Condom use rate of the contraceptive prevalence rate (UN Population Division)
19a. Condom use at last high-risk sex (UNICEF-WHO)
19b. Percentage of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS (UNICEF-WHO)
19c. Contraceptive prevalence rate (UN Population Division)
20. Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years (UNICEF-UNAIDS-WHO)
Target 8. Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
Indicators
21. Prevalence and death rates associated with malaria (WHO)
22. Proportion of population in malaria-risk areas using effective malaria prevention and treatment measures (UNICEF-WHO)
23. Prevalence and death rates associated with tuberculosis (WHO)
24. Proportion of tuberculosis cases detected and cured under DOTS (internationally recommended TB control strategy) (WHO)
Clearly, the world believes the prevention and eventual eradication of preventable diseases like HIV/AIDS and malaria is an important goal for humanity. MDG6 delineated the major goal, its two sub-targets and their measurable indicators (with the charged organization in parentheses). Look at and consider them!
Videos - infectious disease and modern transportation, infectious diseases caused by bacteria, understanding infectious diseases
What is an infectious disease?
An infectious disease is an illness infected plants, animals and humans from a pathogenic agent like bacteria, viruses, fungi, parasites, and protozoa. Transmission of infectious diseases may occur in several ways, including through insect bites (i.e. malarial mosquitoes), bodily fluids (HIV, hepatitis), food and water (i.e. many diarrheal diseases, e. coli in ground meat) and contaminated surfaces (i.e. noroviruses on cruise ships).
What are the most deadly infectious diseases?
According to the World Health Organization (WHO), in 2002, the five most deadly infectious diseases were lower respiratory diseases like pneumonia and influenzas (3.9 million), HIV/AIDS (2.8 million), diarrheal diseases caused by bacteria like cholera and e. coli (1.8 million), tuberculosis - TB (1.6 million), and malaria (1.3 million).
Why does it seem that HIV/AIDS and, to a lesser extent, malaria are discussed far more frequently than these other microbial killers?
There is not a straight-forward, universally-accepted answer to this question. Simply stated, the pathogens that cause lower respiratory diseases, diarrheal diseases and tuberculosis thrive in areas with poverty and underdevelopment (specific connection to poor health care, infrastructure and education regarding transmission). Furthermore, in MEDCs, the latter two have essentially been eradicated in the former doesn't lead to many deaths which, unfortunately, leads to less discussion of these diseases.
HIV/AIDS, a "new" epidemic in the course of human epidemiology, exists in rich and poor country alike, affecting men, women, children of every race, religion and socioeconomic position. Moreover, the means of transmission (specifically the sexual route) can be, culturally and religiously, a very difficult subject which leads to a stigmatization of the disease not seen with the other infections. Lastly, its wildfire-like spread through and subsequent humanistic and economic attack on sub-Saharan Africa in the late 1990s to today has brought much attention to HIV/AIDS awareness and prevention. These are a few major reasons why HIV/AIDS has become a focal point of international discussion, but certainly is not an exhaustive list.
As for malaria, the pathogen which is transmitted from mosquito to human follows the same sort of pattern described above for lower respiratory diseases, diarrheal diseases and tuberculosis. Perhaps the absolute cheapness of mosquito nets and other malaria prevention methods has led to "more" global attention to this infectious disease?!
What is the connection between MDG6 and infectious disease?
MDG6 reads:
GOAL 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES
Target 7. Have halted by 2015 and begun to reverse the spread of HIV/AIDS
Indicators
18. HIV prevalence among pregnant women aged 15-24 years (UNAIDS-WHO-UNICEF)
19. Condom use rate of the contraceptive prevalence rate (UN Population Division)
19a. Condom use at last high-risk sex (UNICEF-WHO)
19b. Percentage of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS (UNICEF-WHO)
19c. Contraceptive prevalence rate (UN Population Division)
20. Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years (UNICEF-UNAIDS-WHO)
Target 8. Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
Indicators
21. Prevalence and death rates associated with malaria (WHO)
22. Proportion of population in malaria-risk areas using effective malaria prevention and treatment measures (UNICEF-WHO)
23. Prevalence and death rates associated with tuberculosis (WHO)
24. Proportion of tuberculosis cases detected and cured under DOTS (internationally recommended TB control strategy) (WHO)
Clearly, the world believes the prevention and eventual eradication of preventable diseases like HIV/AIDS and malaria is an important goal for humanity. MDG6 delineated the major goal, its two sub-targets and their measurable indicators (with the charged organization in parentheses). Look at and consider them!
Videos - infectious disease and modern transportation, infectious diseases caused by bacteria, understanding infectious diseases
Monday, March 1, 2010
UN Millennium Development Goals (MDGs)
With eight goals, 18 targets and 48 measurable indicators, the UN Millennium Goals are "the world's time-bound and quantified targets for addressing extreme poverty in its many dimensions - income poverty, hunger, disease, lack of adequate shelter, and exclusion - while promoting gender equality, education, and environmental sustainability". Meant to be achieved by 2015 by the 192 UN Member-states with the assistance of 23 UN-affiliated organizations, the MDGs "are also basic human rights-the rights of each person on the planet to health, education, shelter, and security"(from the Millennium Project). Because of the urgency of the issues contained within this living document, it is important we examine and connect to the MDGs while studying international relations. The UN Millennium Development Goals, their targets and indicators are displayed below in full:
GOAL 1: ERADICATE EXTREME HUNGER AND POVERTY
Target 1. Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day
Indicators
1. Proportion of population below $1 (1993 PPP) per day (World Bank)
2. Poverty gap ratio [incidence x depth of poverty] (World Bank)
3. Share of poorest quintile in national consumption (World Bank)
Target 2. Halve, between 1990 and 2015, the proportion of people who suffer from hunger
Indicators
4. Prevalence of underweight children under five years of age (UNICEF-WHO)
5. Proportion of population below minimum level of dietary energy consumption (FAO)
GOAL 2: ACHIEVE UNIVERSAL PRIMARY EDUCATION
Target 3. Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
Indicators
6. Net enrolment ratio in primary education (UNESCO)
7. Proportion of pupils starting grade 1 who reach grade 5 (UNESCO)
8. Literacy rate of 15-24 year-olds (UNESCO)
GOAL 3: PROMOTE GENDER EQUALITY AND EMPOWER WOMEN
Target 4. Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015
Indicators
9. Ratio of girls to boys in primary, secondary and tertiary education (UNESCO)
10. Ratio of literate women to men, 15-24 years old (UNESCO)
11. Share of women in wage employment in the non-agricultural sector (ILO)
12. Proportion of seats held by women in national parliament (IPU)
GOAL 4: REDUCE CHILD MORTALITY
Target 5. Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
Indicators
13. Under-five mortality rate (UNICEF-WHO)
14. Infant mortality rate (UNICEF-WHO)
15. Proportion of 1 year-old children immunized against measles (UNICEF-WHO)
GOAL 5: IMPROVE MATERNAL HEALTH
Target 6. Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio
Indicators
16. Maternal mortality ratio (UNICEF-WHO)
17. Proportion of births attended by skilled health personnel (UNICEF-WHO)
GOAL 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES
Target 7. Have halted by 2015 and begun to reverse the spread of HIV/AIDS
Indicators
18. HIV prevalence among pregnant women aged 15-24 years (UNAIDS-WHO-UNICEF)
19. Condom use rate of the contraceptive prevalence rate (UN Population Division)
19a. Condom use at last high-risk sex (UNICEF-WHO)
19b. Percentage of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS (UNICEF-WHO)
19c. Contraceptive prevalence rate (UN Population Division)
20. Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years (UNICEF-UNAIDS-WHO)
Target 8. Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
Indicators
21. Prevalence and death rates associated with malaria (WHO)
22. Proportion of population in malaria-risk areas using effective malaria prevention and treatment measures (UNICEF-WHO)
23. Prevalence and death rates associated with tuberculosis (WHO)
24. Proportion of tuberculosis cases detected and cured under DOTS (internationally recommended TB control strategy) (WHO)
GOAL 7: ENSURE ENVIRONMENTAL SUSTAINABILITY
Target 9. Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources
Indicators
25. Proportion of land area covered by forest (FAO)
26. Ratio of area protected to maintain biological diversity to surface area (UNEP-WCMC)
27. Energy use (kg oil equivalent) per $1 GDP (PPP) (IEA, World Bank)
28. Carbon dioxide emissions per capita (UNFCCC, UNSD) and consumption of ozone-depleting CFCs (ODP tons) (UNEP-Ozone Secretariat)
29. Proportion of population using solid fuels (WHO)
Target 10. Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation
Indicators
30. Proportion of population with sustainable access to an improved water source, urban and rural (UNICEF-WHO)
31. Proportion of population with access to improved sanitation, urban and rural (UNICEF-WHO)
Target 11. Have achieved by 2020 a significant improvement in the lives of at least 100 million slum dwellers
Indicators
32. Proportion of households with access to secure tenure (UN-HABITAT)
GOAL 8: DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT
Target 12. Develop further an open, rule-based, predictable, nondiscriminatory trading and financial system (includes a commitment to good governance, development, and poverty reduction - both nationally and internationally)
Target 13. Address the special needs of the Least Developed Countries (includes tariff- and quota-free access for Least Developed Countries? exports, enhanced program of debt relief for heavily indebted poor countries [HIPCs] and cancellation of official bilateral debt, and more generous official development assistance for countries committed to poverty reduction)
Target 14. Address the special needs of landlocked developing countries and small island developing states (through the Program of Action for the Sustainable Development of Small Island Developing States and 22nd General Assembly provisions)
Target 15. Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term
Indicators
Official development assistance (ODA)
33. Net ODA, total and to LDCs, as percentage of OECD/Development Assistance Committee (DAC) donors' gross national income (GNI)(OECD)
34. Proportion of total bilateral, sector-allocable ODA of OECD/DAC donors to basic social services (basic education, primary health care, nutrition, safe water and sanitation) (OECD)
35. Proportion of bilateral ODA of OECD/DAC donors that is untied (OECD)
36. ODA received in landlocked developing countries as a proportion of their GNIs (OECD)
37. ODA received in small island developing States as proportion of their GNIs (OECD)
Market access
38. Proportion of total developed country imports (by value and excluding arms) from developing countries and from LDCs, admitted free of duty (UNCTAD, WTO, WB)
39. Average tariffs imposed by developed countries on agricultural products and textiles and clothing from developing countries (UNCTAD, WTO, WB)
40. Agricultural support estimate for OECD countries as percentage of their GDP (OECD)
41. Proportion of ODA provided to help build trade capacity (OECD, WTO)
Debt sustainability
42. Total number of countries that have reached their Heavily Indebted Poor Countries Initiative (HIPC) decision points and number that have reached their HIPC completion points (cumulative) (IMF - World Bank)
43. Debt relief committed under HIPC initiative (IMF-World Bank)
44. Debt service as a percentage of exports of goods and services (IMF-World Bank)
Some of the indicators listed below are monitored separately for the least developed countries, Africa, landlocked developing countries, and small island developing states
Target 16. In cooperation with developing countries, develop and implement strategies for decent and productive work for youth
Indicators
45. Unemployment rate of young people aged 15-24 years, each sex and total (ILO)
Target 17. In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries
Indicators
46. Proportion of population with access to affordable essential drugs on a sustainable basis (WHO)
Target 18. In cooperation with the private sector, make available the benefits of new technologies, especially information and communications technologies
Indicators
47. Telephone lines and cellular subscribers per 100 population (ITU)
48. Personal computers in use per 100 population and Internet users per 100 population (ITU)
GOAL 1: ERADICATE EXTREME HUNGER AND POVERTY
Target 1. Halve, between 1990 and 2015, the proportion of people whose income is less than $1 a day
Indicators
1. Proportion of population below $1 (1993 PPP) per day (World Bank)
2. Poverty gap ratio [incidence x depth of poverty] (World Bank)
3. Share of poorest quintile in national consumption (World Bank)
Target 2. Halve, between 1990 and 2015, the proportion of people who suffer from hunger
Indicators
4. Prevalence of underweight children under five years of age (UNICEF-WHO)
5. Proportion of population below minimum level of dietary energy consumption (FAO)
GOAL 2: ACHIEVE UNIVERSAL PRIMARY EDUCATION
Target 3. Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling
Indicators
6. Net enrolment ratio in primary education (UNESCO)
7. Proportion of pupils starting grade 1 who reach grade 5 (UNESCO)
8. Literacy rate of 15-24 year-olds (UNESCO)
GOAL 3: PROMOTE GENDER EQUALITY AND EMPOWER WOMEN
Target 4. Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015
Indicators
9. Ratio of girls to boys in primary, secondary and tertiary education (UNESCO)
10. Ratio of literate women to men, 15-24 years old (UNESCO)
11. Share of women in wage employment in the non-agricultural sector (ILO)
12. Proportion of seats held by women in national parliament (IPU)
GOAL 4: REDUCE CHILD MORTALITY
Target 5. Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
Indicators
13. Under-five mortality rate (UNICEF-WHO)
14. Infant mortality rate (UNICEF-WHO)
15. Proportion of 1 year-old children immunized against measles (UNICEF-WHO)
GOAL 5: IMPROVE MATERNAL HEALTH
Target 6. Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio
Indicators
16. Maternal mortality ratio (UNICEF-WHO)
17. Proportion of births attended by skilled health personnel (UNICEF-WHO)
GOAL 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES
Target 7. Have halted by 2015 and begun to reverse the spread of HIV/AIDS
Indicators
18. HIV prevalence among pregnant women aged 15-24 years (UNAIDS-WHO-UNICEF)
19. Condom use rate of the contraceptive prevalence rate (UN Population Division)
19a. Condom use at last high-risk sex (UNICEF-WHO)
19b. Percentage of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS (UNICEF-WHO)
19c. Contraceptive prevalence rate (UN Population Division)
20. Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years (UNICEF-UNAIDS-WHO)
Target 8. Have halted by 2015 and begun to reverse the incidence of malaria and other major diseases
Indicators
21. Prevalence and death rates associated with malaria (WHO)
22. Proportion of population in malaria-risk areas using effective malaria prevention and treatment measures (UNICEF-WHO)
23. Prevalence and death rates associated with tuberculosis (WHO)
24. Proportion of tuberculosis cases detected and cured under DOTS (internationally recommended TB control strategy) (WHO)
GOAL 7: ENSURE ENVIRONMENTAL SUSTAINABILITY
Target 9. Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources
Indicators
25. Proportion of land area covered by forest (FAO)
26. Ratio of area protected to maintain biological diversity to surface area (UNEP-WCMC)
27. Energy use (kg oil equivalent) per $1 GDP (PPP) (IEA, World Bank)
28. Carbon dioxide emissions per capita (UNFCCC, UNSD) and consumption of ozone-depleting CFCs (ODP tons) (UNEP-Ozone Secretariat)
29. Proportion of population using solid fuels (WHO)
Target 10. Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation
Indicators
30. Proportion of population with sustainable access to an improved water source, urban and rural (UNICEF-WHO)
31. Proportion of population with access to improved sanitation, urban and rural (UNICEF-WHO)
Target 11. Have achieved by 2020 a significant improvement in the lives of at least 100 million slum dwellers
Indicators
32. Proportion of households with access to secure tenure (UN-HABITAT)
GOAL 8: DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT
Target 12. Develop further an open, rule-based, predictable, nondiscriminatory trading and financial system (includes a commitment to good governance, development, and poverty reduction - both nationally and internationally)
Target 13. Address the special needs of the Least Developed Countries (includes tariff- and quota-free access for Least Developed Countries? exports, enhanced program of debt relief for heavily indebted poor countries [HIPCs] and cancellation of official bilateral debt, and more generous official development assistance for countries committed to poverty reduction)
Target 14. Address the special needs of landlocked developing countries and small island developing states (through the Program of Action for the Sustainable Development of Small Island Developing States and 22nd General Assembly provisions)
Target 15. Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term
Indicators
Official development assistance (ODA)
33. Net ODA, total and to LDCs, as percentage of OECD/Development Assistance Committee (DAC) donors' gross national income (GNI)(OECD)
34. Proportion of total bilateral, sector-allocable ODA of OECD/DAC donors to basic social services (basic education, primary health care, nutrition, safe water and sanitation) (OECD)
35. Proportion of bilateral ODA of OECD/DAC donors that is untied (OECD)
36. ODA received in landlocked developing countries as a proportion of their GNIs (OECD)
37. ODA received in small island developing States as proportion of their GNIs (OECD)
Market access
38. Proportion of total developed country imports (by value and excluding arms) from developing countries and from LDCs, admitted free of duty (UNCTAD, WTO, WB)
39. Average tariffs imposed by developed countries on agricultural products and textiles and clothing from developing countries (UNCTAD, WTO, WB)
40. Agricultural support estimate for OECD countries as percentage of their GDP (OECD)
41. Proportion of ODA provided to help build trade capacity (OECD, WTO)
Debt sustainability
42. Total number of countries that have reached their Heavily Indebted Poor Countries Initiative (HIPC) decision points and number that have reached their HIPC completion points (cumulative) (IMF - World Bank)
43. Debt relief committed under HIPC initiative (IMF-World Bank)
44. Debt service as a percentage of exports of goods and services (IMF-World Bank)
Some of the indicators listed below are monitored separately for the least developed countries, Africa, landlocked developing countries, and small island developing states
Target 16. In cooperation with developing countries, develop and implement strategies for decent and productive work for youth
Indicators
45. Unemployment rate of young people aged 15-24 years, each sex and total (ILO)
Target 17. In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries
Indicators
46. Proportion of population with access to affordable essential drugs on a sustainable basis (WHO)
Target 18. In cooperation with the private sector, make available the benefits of new technologies, especially information and communications technologies
Indicators
47. Telephone lines and cellular subscribers per 100 population (ITU)
48. Personal computers in use per 100 population and Internet users per 100 population (ITU)
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