Kaddar Miloud
Organisation mondiale de la santé FCH-IVB-EPI 20, avenue Appia 1211 Genève 27, Suisse.
Sante. 2009 Jul-Sep;19(3):111-9. doi: 10.1684/san.2009.0166.
The eight Millennium Development Goals (MDGs) are the expressed commitment by world leaders to combat the most obvious forms of social inequality in the world: poverty, illiteracy and disease. The MDGs set health priorities and serve as markers of the most fundamental problems to solve: the maternal and child health high mortality, and the fight against major endemic diseases. Thus, health appears in three of the eight goals, and plays a decisive role in achieving the other MDGs such as the eradication of poverty and hunger, promotion of education and gender equality. While progress has been made in various domains and in numerous countries, enormous gaps and lack of funding remain. This is the case for infant mortality and HIV/AIDS, and even more so in the area of maternal mortality reduction especially in sub-Saharan Africa and Southeast Asia. The recent proliferation of forums and international partnerships for health have put at the forefront the targeted health-related MDG, increased financial resources for the benefit of poor countries but have made the architecture of global health even more fragmented and complex. Attempts to align on country priorities, needs and national health plans, and also to harmonize donors and partners' actions and funding according to the 2005 Paris Declaration principles, were difficult to actually materialize. The revitalization of primary health care and the strengthening of health systems are now back on the international and national health agenda.
八项千年发展目标(MDGs)是世界各国领导人做出的明确承诺,旨在消除世界上最明显的社会不平等形式:贫困、文盲和疾病。千年发展目标确定了卫生领域的优先事项,并成为需要解决的最根本问题的标志:孕产妇和儿童健康方面的高死亡率,以及抗击主要的地方病。因此,健康问题出现在八项千年发展目标中的三项之中,并且在实现其他千年发展目标(如消除贫困与饥饿、促进教育和性别平等)方面发挥着决定性作用。尽管在各个领域以及众多国家都取得了进展,但巨大差距和资金短缺问题依然存在。婴儿死亡率和艾滋病毒/艾滋病情况如此,在降低孕产妇死亡率方面更是如此,特别是在撒哈拉以南非洲和东南亚地区。近期卫生领域论坛和国际伙伴关系的激增,使千年发展目标中与卫生相关的具体目标成为首要任务,为贫困国家增加了财政资源,但却使全球卫生架构变得更加分散和复杂。根据2005年《巴黎宣言》原则,在国家优先事项、需求和国家卫生计划方面保持一致,以及协调捐助方和合作伙伴的行动与资金,实际上很难实现。初级卫生保健的振兴和卫生系统的加强如今又重新回到国际和国家卫生议程上。