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Mohamed Elzarka

Dr. Jason Blackard

January 20, 2016
Assignment #1
The Millennium Development Goals are eight international goals established for the
international community by the United Nations following that Millennium Summit that was held
at the turn of the century.1 The goals were rather ambitious, and included facing challenges like
extreme poverty and hunger, gender inequality, environmental sustainability, and diseases like
HIV/AIDS and malaria. Overall, all 189 United Nations member states at the timeand the
additional 4 that have since joined the bodyagreed to strive for the attainment of these goals by
2015, with rather mixed results.
In South Africa, in particular, progress that has been made is muted by the challenges that
still face the nation. For example, while the country has made significant progress in increasing
access to basic water supplies, there is still much work to be done in the effective and equitable
delivery of this and other public services. 2 Similarly, in the fight against poverty and hunger,
absolute poverty has been found to have declined since 2000, when the goals where first
authored and 34% of South Africans were living on less than US$2 per day. Much remains left to
achieve, however, especially with the nations relative reliance on social assistance programs
meant to evade the problems of high unemployment that the nation is facing.2
In similar goals, South Africa is still seeking improvements. Combatting HIV/AIDS, in
particular, has been a rather challenging proposition for the country. Even after the intensification
of governmental policies, HIV prevalence levels are still high in South Africa as compared to

countries in Northern, Western, and Middle Africa. 2 The UNDP attributes this relative
stagnation to the complexity of the health challenges that the nation is seeking to address, and
calls for more concerted efforts between the government, the countrys private sector, and
individuals in addressing the disease. Regardless, it is worrisome that the relative stabilization of
disease prevalence is being celebrated, as opposed to a declineif not eliminationin disease
that is real goal. This is especially worrisome when other aspects of health as related to the
MDGs have also found a considerable lack of success in South Africa. While the government
might be on track to have reached its 2015 MDGs to increased immunization levels for infants
and children, Pretorias investment in public health has done little to combat the high and
increasing level of maternal mortality in South Africa.
Conversely, the situation for Botswana and its progress to achieving Millennium
Development Goals has been relatively good. In particular, branches of the United Nations, such
as the World Health Organization, have been particularly impressed with the nations evidencebased approach to tackling the goals set out at the turn of the century. Releasing its first MDGs
status report in 2004, Botswana was among the first African nations to assess its progress, and in
turn to make significant positive developments that have improved the efficacy and effectiveness
of public service delivery.3 Particular strides that the nation has made include reducing poverty
by more than 16%, bringing the percentage of underweight children younger than the age of five
to under 5%, fully immunizing more than 93% of children, and more than having the maternal
mortality rate.3 These developments, as compared to South Africas, are significantly more
robust, and reflect the due diligence the Botswanan government has dedicated to meeting the
MDGs. Of particular relevance is Botswanas strong showing in addressing the issue of HIV that
is a major one in the country. Unlike in South Africa, Botswana has seen the prevalence of HIV

among young pregnant women drop by more than 10%, and among those women who are
pregnant, has seen a ten-fold drop in mother-to-child transmission.3 Overall, then, Botswana
seems to have been much more successful in its pursuit of the MDGs as compared to its neighbor
to the south
This bodes well for Botswanas aspirations for meeting the newly developed Sustainable
Development Goalswhich act as the successor to the MDGs that ended in 2015. Of the 17
newly-created goals 4, Botswana may be most prepared to address that that directly relates to the
good health and well-being of its populace. Of particular importance moving forward will be
the fact that Botswanas quest to achieve the MDGs has led it to develop robust national
infrastructure programs that have allowed for the effective distribution of resources and services,
and in turn, the development of important facets of the country in water, energy, education, and
health. In particular, the countrys significant advancements in expanding access to safe drinking
water has immensely positive repercussions on the future health of Botswanans. Indeed,
progress in access to safe drinking water and access to energy, especially electricity has
multiplier effects on nearly all of the MDGs as they leverage the potential of poor people
otherwise suppressed by such barriers as lack of information and poor health. 5 This great
advancement mirrors others that have ensured the health of the country in the future, especially
the Expanded Programme on Immunisation, which has successfully protected Botswanas
children from vaccine-preventable killer diseases. 6. With clean water, a 93% immunization rate
among children under five years of age, and the considerable improvements in other aspects of
health, Botswana looks to be on track to keep making considerable strides forward in furthering
the health of its country.

Conversely, it seems that South Africa may have more trouble in improving its success on
health-related measures with the new SDGs. As aforementioned, not only high, but increasing
levels of maternal mortality are troublesome in the country, especially when 90% of pregnant
women have access to antenatal care, and contraceptive prevalence levels have reached over
60%. With this in mind, the UNDPs categorization of health problems that South Africa is
facing as multidimensional may be an accurate one, as it definitely seems that other resources
and initiatives are needed beside those which have already been implemented to address this and
other health issues. In many ways, other key players in population health, like the private sector
and individuals, may need to take a more active role in furthering other aspects of the countrys
development, namely education, decent work, safety, clean water and sanitation, and adequate
transport facilities to truly realize a positive change towards health goals in the Sustainable
Development Goals plan.2 This is not to say, however, that the nation will be unable to make
significant strides moving forward in improving the health of its citizens, and preliminary
progress has already been seen in differential infection rates for diseases like HIV/AIDS and
tuberculosis. Overall, it would seem fit that South-Africa adopt the more evidence-based model
that Botswana has implemented in its fulfilment of developmental goals to make even further
progress. Given that evidence already points to a need in further development especially in rural
areas and that data might point out more effective solutions 2, it would only make sense that
South Africa act on this information to perform better on its goals by 2030 than it did by 2015.

Works Cited:
1. "About the MDGs." UN Millennium Project. N.p., 2006. Web. 19 Jan. 2016.
2. United Nations Development Programme. "Millennium Development Goals." UNDP in
South Africa. N.p., 2012. Web. 19 Jan. 2016.
3. World Health Organization. "Botswana." Analytical Summary - Progress on the HealthRelated MDGs. N.p., 2010. Web. 19 Jan. 2016.
4. "Countries Adopt Sustainable Development Goals at UN." N.p., 25 Sept.
2015. Web. 19 Jan. 2016.
5. Botswana National Report For The United Nations, Conference On Sustainable
Development (Rio+20), and By. SEANAMA CONSERVATION CONSULTANCY (Pvt)
Ltd. (n.d.): n. pag. Web. 19 Jan. 2016.
6. "Millennium Development Goal 4." UNDP in Botswana. N.p., n.d. Web. 19 Jan. 2016.