High-level Sub-Regional Workshop
Accelerating Achievement of the Millennium Development Goals in South Asia
2-4 November 2011
New Delhi, India

Organized by ESCAP/ADB/UNDP

POSTPONED TO SECOND HALF OF JANUARY 2012

Less than 5 years remain to achieve the Millennium Development Goals (MDGs) and urgent action is necessary if the countries in South Asia are to achieve them. Although South Asia has made significant progress on some MDGs, it has fallen behind in several.

On the back of average growth rates of over 8.15 percent between 2003 and 2008, South Asia has made improvements in addressing issues related to reducing poverty, hunger and malnutrition, and child mortality, as well as improving maternal health and providing safe drinking water and sanitation facilities. However, such improvements are not sufficient enough to achieve the MDGs. Moreover, the global economic crisis and the food-fuel crises have placed substantial strain on the region ’ s progress towards the Millennium Development Goals (MDGs). Despite the economic crisis, South Asia grew by 4.8 percent in 2009 but regional trends and averages can be misleading due to India’s 8.0 percent growth, which accounts for three-fourths of the region’s population and produces roughly 80 percent of the GDP.

The resulting rise in income inequalities and regional disparities during the periods of rapid economic growth is another issue of concern. Recent reports have shown that South Asia’s progress in MDGs is lagging behind in areas of health, nutrition, education and sanitation. These regional concerns align closely with a refocus of global MDG priorities on health related issues resulting in new health initiatives.

Culminating in the UN Summit on the Millennium Development Goals (MDGs) in September 2010, United Nations Secretary-General Ban Ki-moon and Heads of State and Government, along with the private sector, international organizations and various stakeholders , confirmed their renewed commitment towards achieving the MDGs. For instance, t he Secretary-General's Global Strategy for Women's and Children's Health was seen as one of the main outcomes of the Summit which is designed to save the lives of more than 16 million women and children. The Secretary-General also remarked that “investing in women's and children's health has a multiplier effect across the MDGs. It is the best investment we can make.”

The MDG Outcome document, agreed to by all nations, expressed grave concern over slow progress on the MDGs, in particular health related goals such as reducing maternal mortality and maternal/ reproductive health. It was emphasized that “accelerating progress on the Millennium Development Goals related to health is essential for making headway also on the other Goals.”

The Asia-Pacific Regional MDG Report 2010/2011 , the annual product of the ESCAP/ADB/UNDP partnership on the MDGs, echoes the region’s challenges in health and nutrition related issues while highlighting the striking progress made towards the MDGs, particularly in poverty reduction. The region has reduced the number of extreme poor from 1.5 billion to 947 million between 1990 and 2008. Nevertheless, on present trends many countries are likely to miss several targets. The report shows South Asia as “off track” in several areas including underweight children, quality and completion rate of primary schooling, infant and under-5 mortality, TB incidence, and basic sanitation.

Regional challenges present an opportunity to refocus policy attention so that sufficient human and financial resources may be channeled to achieving the MDGs. In that context, the full potential of regional and sub-regional cooperation needs to be harnessed for achieving the MDGs.

The planned High-level Sub-regional Workshop will be organized as part of MDG related policy advocacy and knowledge dissemination activities under the ESCAP/ADB/UNDP regional partnership on MDGs which focuses on improv ing regional capacity to engage and promote MDGs at regional and sub-regional levels and provides the needed platform to share regional best practices. This calls for policy dialogue at highest possible levels, backed by solid research and analysis on the MDGs.

In this context, one of t he focus areas of the Workshop will be inter-country and intra-country disparities or gaps in achieving health-related MDGs, which is the main focus of the Regional MDG Report 2011/2012 expected to be available prior to the meeting. The Workshop will also highlight other health-related issues, particularly malnutrition and food security that remain some of the most intractable challenges facing the South Asia region.

The ESCAP/ADB/UNDP 2010/2011 Report states that while governments need to strengthen provision across the whole range of public services, many countries will need to pay special attention to health related goals—where progress has been particularly slow. Asia has alarming share of mortality and illnesses: more than 40 percent of the world’s under-five and maternal mortality , and 52 percent of unmet needs for family planning, 56 percent of new born deaths and 15 percent of those infected with HIV. Of the health targets, child mortality and maternal health were identified by the report as priority areas for action.

Aside from South-East Asia, the Asia-Pacific region is progressing far too slowly on child mortality, a priority area. Of the 47 countries for which trend data was available, 34 were off track including the majority of South Asian countries. Another major health concern is maternal mortality where mortality rates in the region’s least developed countries are close to Sub-Saharan Africa. In 11 countries out 43 in the region with available data, less than half of all births were attended by trained health professionals.

Asia Pacific’s large population size resulted in the greatest number of people affected across most indicators. For example, the region has more than 70 percent of the world’s population living without sanitation—which in 2008 numbered to almost 1.9 billion. Statistics in the area of health and nutrition also reflect a dire situation although showing an improvement. In 2008, there were 7 million people infected with TB, down from 11 million in 1990; 5 million living with HIV/AIDS, down from 6 million in 1990; and 96 million underweight children (under 5 years), down from 141 million.

South Asia has experienced average growth rates of 8.15 percent between 2003 and 2008, which is amongst the highest in Asia. South Asia has performed well on indicators such as economic growth, trade-to-GDP ratios, savings and investment rates, service sector growth, significant accumulation of foreign exchange, information technology and stock market development and is now considered as a major emerging economic power. While developments in India are clearly the predominant factor in the improved economic performance of South Asia, most other countries in the region have continued to experience upward positive trends. The result has been a reduction in income poverty levels (per capita income increases of approximately 6%) and improvements in food security, literacy, health and access to basic amenities. In spite of these positive developments, South Asia as stated above is still “off track” in 9 out of 21 MDG indicators measured, including underweight children, quality and completion rates of primary schooling, infant and under-5 mortality, TB incidence, forest cover, and basic sanitation.

A rise in income inequalities and regional disparities during the periods of rapid economic growth has been a concern for South Asia. Disparities in access and outcomes are important as MDG averages may hide vital inequalities resulting in inappropriate policy choices. As is well known, lower income and socially deprived groups have insufficient access to basic public services including health services. It is quite possible that MDG averages may be improving simply because of greater access of upper income groups to these vital services.

There are also well known geographical imbalances in South Asia. Rural and interior areas are often doing far worse than urban areas. In some cases urban areas may be slipping behind because of rapid urbanization that overwhelms planned expansions of service provision. There are sub-national geographical areas in many countries, whose MDG outcomes, if looked at individually, may be worse than sub-Saharan Africa. There are also socially excluded groups, such as women, lower castes and ethnic and religious minority communities who are typically bypassed by public service providers and thus less represented in the national averages.

Some of South Asia’s most disturbing MDG shortfalls concern hunger as one in six suffers from malnourishment and one in three children are underweight. South Asia has scarcely made any progress as the number of underweight children increased from 286 million in 1990 to 337 in 2006 . Food security has been threatened by deceleration in growth of agricultural output and productivity over the last decade. To some extent, this reflects declining levels of investment with government expenditure in agriculture dropping from 14 percent to less than 9 percent over two decades.

It has been argued that sector specific interventions are needed in order to achieve MDGs for health and nutrition. For example, a package consisting of expanded child and maternal immunization, antenatal care coverage, nutritional supplementation (including promotion of exclusive breast feeding) and home based neo-natal services is likely to bring about significant reduction in both infant mortality and child malnutrition. Expenditure on healthcare is alarmingly low at one per cent of GDP in the South Asian region. Low expenditures and ineffective implementation of programmes have resulted in vast majorities of the population not having access to public health services. Apart from the supply-side constraints, there are also several demand-side constraints emanating from the poverty and poor health-seeking behavior among the population. It shows that there is a need to not only increase public access to a decentralized public health system and better infrastructure, but to also make the existing healthcare system more equitable and accessible to the poor.

The situation is similar for sanitation with 8 of the 10 countries in South Asia being classified as off-track. Rural areas are particularly deprived with nearly half the countries considered off-track for providing their rural populations access to safe water and basic sanitation. Countries have made significantly more progress in urban areas, but in general it seems that early gains are fast disappearing as public service delivery systems struggle to keep pace with rapidly growing urban populations.

The principal objective of the Workshop is to share the key findings and policy recommendations from the Asia-Pacific MDG Report 2011/2012, discuss policy options and facilitate cross-country exchanges of knowledge and best practices for South Asia with a special focus on health-related MDGs, nutrition and food security in the region. The Workshop will highlight challenges of accelerating the progress of specific health and nutrition -related MDGs which are most pertinent to the countries in South Asia as part of their national economic and social development strategies. The Workshop will discuss and provide further insights into practical strategies and policy recommendations to accelerate the achievement of the MDGs by 2015.

The Workshop would bring together key stakeholders of the MDGs in South Asia, including senior Government officials, representatives of NGOs, media, private sector and professional experts, UN agencies and programmes, relevant regional organizations and other bilateral and multilateral development partners.

The Workshop is being organized in New Delhi as a part of the regional partnership of the United Nations Economic and Social Commission for Asia and the Pacific (ESCAP), the Asian Development Bank (ADB) and the United Nations Development Programme (UNDP).

The Workshop is expected to be inaugurated by a senior Minister from the Government of India and participated by the heads of partner organizations. Eminent experts from the partner organizations, including relevant UN agencies, as well as from the participating countries will lead the policy discussion, focusing on issues pertinent to South Asian countries in achieving MDG, such as health, nutrition, food security and sanitation. Senior officials, sectoral experts, MDG activists and eminent speakers will also be invited to be discussants.

Invitees from the 8 South Asian countries will comprise of senior policy-makers, business and NGO representatives, media and professional experts as well as UN organizations and programmes, inter-governmental organizations and multilateral funding organizations.

An Outcome Document will be produced which will serve as the basis for undertaking required actions in South Asia as well as an input for discussion in other sub-regional workshops to be organized under the partnership.

Related links:
	Outcome Document
	Information Note for Participants
	Tentative Programme
	Provisional List of Participants
	Papers and Presentations