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Paths to 2015: MDG Priorities in Asia and the Pacific

Report by ESCAP, ADB and UNDP, 2010

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Impending deadlines tend to focus the mind. Back in 2000 the year 2015, which is the target date for the Millennium Development Goals, seemed some way off. Now two thirds of the way towards the finishing line, it is beginning to look uncomfortably close. The year 2010 is therefore an appropriate point to take stock – to assess some of the likely outcomes on present trends, identify some of the weakest areas of performance,and identify priorities for action.This 2010/11 report refreshes the signals to reflect the latest information from the United Nations MDG database to assess which countries and subregions are likely to miss or achieve the Goals. But rather than addressing a new theme, this more concise report attempts to encapsulate and update the discussions and recommendations of the earlier reports. The report Paths to 2015 emphasises the inter relationships between MDGs by identifying some overall priorities and opportunities that countries can consider for achieving all the goals. Then it focuses specifically on three areas: hunger and food security; health and basic services – areas where the Asia-Pacific region as a whole appears to be falling short; and on improvement of basic infrastructure which is often neglected but is critical if the region is to achieve the MDGs.

Asia-Pacific MDG Report 2010/11




The Economic and Social Commission for Asia and the Pacific (ESCAP) promotes regional cooperation


for inclusive and sustainable economic and social development in Asia and the Pacific, a dynamic region


characterized by growing wealth, diversity and change, but also challenged with persistent poverty,


environmental degradation, inequality and insecurity. ESCAP supports member States with sound strategic


analysis, policy options and technical cooperation activities to address key development challenges and


to implement innovative solutions for region-wide economic prosperity, social progress and environmental


sustainability. ESCAP, through its conference structure, assists member States in forging a stronger,


coordinated regional voice on global issues by building capacities to dialogue, negotiate and shape


development agenda in an age of globalization, decentralization and problems that transcend borders.


A key modality for this strategy is the promotion of intraregional connectivity and regional integration.


ADB’s vision is an Asia and Pacific region free of poverty. Its mission is to help its developing member


countries substantially reduce poverty and improve the quality of life of their people. Despite the region’s


many successes, it remains home to two-thirds of the world’s poor: 1.8 billion people who live on less than


$2 a day, with 947 million struggling on less than $1.25 a day. ADB is committed to reducing poverty


through inclusive economic growth, environmentally sustainable growth, and regional integration. Based


in Manila, ADB is owned by 67 members, including 48 from the region. Its main instruments for helping


its developing member countries are policy dialogue, loans, equity investments, guarantees, grants, and


technical assistance.


UNDP is the UN’s global development network, an organization advocating for change and connecting


countries to knowledge, experience and resources to help people build a better life. UNDP is on the ground


in 166 counties, working with them on their own solutions to global and national development challenges.


UNDP’s network links and coordinates global and national efforts to achieve the Millennium Development


Goals, including the overarching goal of cutting poverty in half by 2015. UNDP helps developing countries


in building national capacities and sharing solutions to the challenges of: Democratic Governance,


Poverty Reduction, Crisis Prevention and Recovery, Environment and Energy, and HIV/AIDS. UNDP also


helps developing countries attract and use aid effectively.


Cover photographs: Courtesy of UN ESCAP and Kibae Park




Asia-Pacific MDG Report 2010/11


Paths to 2015
MDG Priorities in Asia and the Pacific






Contents


Foreword vii


Acknowledgements viii


Abbreviations ix


OVERVIEW

Paths to 2015 1
SevendriversforachievingtheMDGs 1
Reducinghungerandbuildingfoodsecurity 2
Improvinghealthandotherbasicservices 2
Priorities in health 3
Strengtheningbasicinfrastructure 3
Tiltingthebalance 3


CHAPTER I


MDGs in Asia and the Pacific – where we stand 4
Thescaleof deprivation 7
Impactof theglobaleconomiccrisis 8
Endnotes 8


CHAPTER II


Seven drivers for achieving the MDGs 9
Strengtheninggrowthbystimulatingdomesticdemandandintra-regionaltrade 9
Makingeconomicgrowthmoreinclusiveandsustainable 10
Strengtheningsocialprotection 10
Reducingpersistentgendergaps 11
Ensuringfinancialinclusion 12
Supportingleastdevelopedandstructurallydisadvantagedcountries 12
Exploitingthepotentialof regionaleconomicintegration 13
Towards2015 14
Endnotes 14


CHAPTER III


Reducing hunger and building food security 15
Creatingjobsandincreasingincomes 16
Boostingagriculturalproduction 17
Maintainingstableandreasonablefoodprices 18
Providingsafetynetsforthepoor 19
Implementingfeedingprogrammes 20
Releasedfromhunger 21
Endnotes 21




CHAPTER IV


Improving health and other basic services 22
Investingmoreinbasicservices 22
Improvinggovernance 23
Ensuringsocialinclusionandequalaccesstosocialservices 25
Diversifyingtherangeof serviceproviders 25
Prioritiesinhealth 26
Increasing public health expenditure and staffing levels 28
Achieving universal health care 29
Aneweraforpublicservices 31
Endnotes 31


CHAPTER V


Strengthening basic infrastructure 32
Mobilizingfinanceforbasicinfrastructureinvestment 34
Stimulatingtheprivatesector 34
Raisingstandardsof qualityandmaintenance 35
Buildinggreenerinfrastructure 36
Extendingregionalinfrastructure 37
Tiltingthebalance 37
Endnotes 37


STATISTICAl APPEnDIx 38


Comparisonof AsiaandthePacificwithotherdevelopingregions 38
Achievementsin$1.25/daypoverty 38
Achievementsinprimaryenrolment 38
Achievementsinbasicsanitation 41
Numberof peopleaffectedif targetsarereached 42
Impactof theglobaleconomicslowdown 42
SelectedMDGIndicators 46


REFEREnCES 54


FIGuRES


FigureI-1 – Asia-Pacificrankingongenderindicators 7
FigureI-2 –Asia-Pacific’sshareof thedevelopingworld’sdeprivedpeople 8
FigureII-1–NetODAreceiptsperpersonin2008,US$ 13
FigureIII-1–Agriculture’sshareof publicexpenditure,percentage. 18
FigureIV-1–Spendingonhealthandeducationasapercentageof GDP 23
FigureIV-2–Totalgovernmentrevenueasapercentageof GDP 24
FigureIV-3–Maternalmortalityratesandnumberof deaths 28
FigureA-1 –AsiaandthePacificcomparedwithSub-SaharanAfricaand
LatinAmericaandtheCaribbean 39
FigureA-2 –Progressinreducingextremeincomepoverty 40
FigureA-3 –Progressinexpandingaccesstoprimaryeducation 41
FigureA-4 –Progressinexpandingaccesstobasicsanitation 43




TAblES


TableI-1 – Countrygroupson-trackandoff-trackfortheMDGs 5
TableI-2 – Countrieson-trackandoff-trackfortheMDGs 6
TableIII-1 – UndernourishmentinAsiaandthePacificandotherglobalregions 15
TableIII-2–Underweightchildrenunderfive 16
TableIII-3–Progressrequiredforoff trackcountriestomeetthe
underweightchildrentarget 17
TableIII-4– Netimportersandexportersof food 19
TableIV-1 –Netenrolmentratioinprimaryeducation,percentage,2007 22
TableIV-2 –Progressrequiredforoff-trackcountriestomeetthe
under-5mortalitytarget 27
TableIV-3 – Healthpersonnel 29
TableV-1 –Positiveimpactsof basicinfrastructureonthepoorandMDGs 33
TableV-2 – Infrastructurecomparators,AsiaandRestof theWorld,2005 34
TableV-3 – Asia’sInfrastructureInvestmentneeds2010-2020
(US$millions,2008) 35
TableV-4 – InfrastructurequalityinAsia,ratedfrom0-7 36
TableA-1 – Progressrequiredforoff-trackcountriestomeetthe$1.25/day
povertytarget 40
TableA-2 – Progressrequiredforoff-trackcountriestomeettheprimary
enrolmenttarget 42
TableA-3 – Progressrequiredforoff-trackcountriestomeetthebasic
sanitationtarget 44
TableA-4 – Summaryof estimatedpopulationindeprivation,
alternativescenarios,thousands 44
TableA5 – Numberof peopleprojectedtobeindeprivationin2015 45
TableA-6 – Goal1:Eradicateextremepovertyandhunger 46
TableA-7 – Goal2:Achieveuniversalprimaryeducation 47
TableA-8 – Goal3:Promotegenderequalityandempowerwomen 48
TableA-9 – Goal4:Reducechildmortality 49
TableA-10 – Goal5:Improvematernalhealth 50
TableA-11 – Goal6:CombatHIVandAIDS,malariaandotherdiseases 51
TableA-12 – Goal7:Ensureenvironmentalsustainability 52
TableA-13 – Goal7:Ensureenvironmentalsustainability 53


bOxES


BoxIV-1 – Newestimatesonmaternalmortality 28
BoxV-1 – EnergyforAll 33






viiMDG PRIORITIES In ASIA AnD THE PACIFIC


Foreword


Impendingdeadlinestendtofocusthemind.Backin2000theyear2015,whichisthetargetdatefortheMillenniumDevelopmentGoals,seemedsomewayoff.Nowtwothirdsof thewaytowardsthefinishingline, it isbeginningto lookuncomfortablyclose.Theyear2010isthereforeanappropriatepointtotake
stock–toassesssomeof thelikelyoutcomesonpresenttrends,identifysomeof theweakestareasof performance,
andidentifyprioritiesforaction.


Since2004,anESCAP/ADB/UNDPpartnershiphasregularlyproducedreportscarefullytrackingprogressof
theAsiaandPacificregiontowardstheGoals.Theyhavedevelopedaconsistentmonitoringsystemforjudging
whethercountriesandsubregionsareon-trackoroff-tracktomeettheindicatorsforthe2015Goals–presenting
the results in a seriesof distinctive colour-coded ‘traffic-light’ charts.Eachof the reports has focusedon a
particulartheme,suchasMDGconsistentnationaldevelopmentpoliciesorinstitutionalreformstomakethe
developmentprocessfairerandmoreinclusive,ortheimpactof thefood,fuelandfinancialcrisesonthelikely
achievementof thegoals.


This2010/11reporttakesaslightlydifferentapproach.Asbefore, itrefreshesthesignalstoreflectthelatest
informationfromtheUnitedNationsMDGdatabasetoassesswhichcountriesandsubregionsarelikelytomiss
orachievetheGoals.Butratherthanaddressinganewtheme,thismoreconcisereportattemptstoencapsulate
andupdatethediscussionsandrecommendationsof theearlierreports.Whilethishasthemeritof brevity,italso
of coursehasthedisadvantageof excludingsomedetaileddiscussion.Readerswhowishtoconsidertheissues
morecloselyareencouragedtoconsultsomeof thepreviousAsia-PacificMDGreports.


ThereportPaths to 2015emphasisestheinter-relationshipsbetweenMDGsbyidentifyingsomeoverallpriorities
andopportunitiesthatcountriescanconsiderforachievingallthegoals.Thenitfocusesspecificallyonthree
areas:hungerandfoodsecurity;healthandbasicservices–areaswheretheAsia-Pacificregionasawholeappears
tobefallingshort;andon improvementof basic infrastructurewhich isoftenneglectedbut iscritical if the
regionistoachievetheMDGs.

Thereporthasbeenpreparedthroughwideconsultationsintheregionandbasedoninputsreceivedfromstaff of
allthethreepartnerorganizations,UNagencies,andcommunitiesof practice.Feedbackhasalsobeenreceived
fromcountryparticipantsatsub-regionalandregionalMDGconferencesheldinJulyandAugust2010.

ThisreportisbeingproducedtocoincidewiththeUnitedNationsHigh-levelPlenaryMeetingontheMDGsin
September2010inNewYork.TheAsia-Pacificregionishometomorethan60percentof humanity,sowhat
happensintheregionwillhaveacriticalbearingonglobalMDGachievement.AsiaandthePacifichasmuchto
beproudof,butneedstoredoubleeffortstoreducepovertyandvulnerabilityaffectinghundredsof millionsof
peoplelivingintheregion.Wehopethatthisreportwillcontributetoglobalandregionaldebatesandhelpspur
thenecessaryactionthatwillenableustoacceleratetowardsthefinishingline.


noeleen Heyzer
Under-Secretary-Generalof the


UnitedNationsand
ExecutiveSecretaryof ESCAP


ursula Schaefer-Preuss
Vice-President


AsianDevelopmentBank


Ajay Chhibber
UNAssistantSecretary-Generaland
UNDPAssistantAdministrator


andDirectorforAsiaandthePacific




viii PATHS TO 2015


Acknowledgements


ThisisthefifthreportthathasbeenpreparedundertheESCAP/ADB/UNDPregionalpartnershiponachievingtheMillenniumDevelopmentGoalsinAsiaandthePacificregion.IthasbeenpreparedasacontributionfromAsiaandthePacificregiontotheUnitedNationsSummitonMDGs2010.

The report has been prepared under the direct supervision and guidance of Dr. Noeleen Heyzer, Under-
Secretary-Generalof theUnitedNationsandExecutiveSecretaryof ESCAP,Dr.UrsulaSchaefer-Preuss,Vice-
President,AsianDevelopmentBankandDr.AjayChhibber,UNAssistantSecretary-General,UNDPAssistant
AdministratorandDirectorforAsiaandthePacific.


ESCAP/ADB/UNDPteam,whichcoordinatedandpreparedthereport,consistedof followingmembers:

ESCAP:NageshKumar,SyedNuruzzaman,JanSmit,YanhongZhangandHarumiShibata

ADB:ShiladityaChatterjeeandGuanghuaWan

UNDP:NicholasRosellini,ThangavelPalanivelandTaimurKhilji


The report teammet periodically to review the draft chapters and engaged inwider consultationswith the
membersof theUNDGandUNRegionalCoordinationMechanismbasedinBangkok.


The report team thanks the following for their support and technical inputs: JiwanAcharya, IanAnderson,
DipaBagai,ArminBauer,RadhikaBehuria,InduBhushan,ThomasBeloe,CarolineBorchard,AlainBorghijs,
BakhodirBurkhanov,RyceChanchai,BiploveChoudhary,DomingoCarolaDonner-Reichle,GerardDaly,Tyrrell
Duncan,Haishan Fu, JessicaGardner, FadzaiGwaradzimba, CherieHart, Imrana Jalal, Shanti Jagannathan,
Jacques Jeugmans,Kaushal Joshi,HiroyukiKonuma,HenrikLarsen, IosefaMaiava,RomanaMaryMargaret,
SarammaMathai,RoohiMetcalfe,KhajaMoinnuddin,K.A.MMorshed,AmitavaMukherjee,B.Murali,Tariq
Niazi,NubokoHoribe,ChellamPalanyandy,MaheshPatel,TamPham,MoniPizani,MudbharyPurushottam,
Anuradha Rajivan,Michael Sheinkman,Hiren Sarkar, Jouko Sarvi,Nashida Sattar, Sharad Saxena,Wolfgang
Schiefer,Michael Sheinkman,Kah Sin,David Smith, Sahba Sobhani, Alexandra Solovieva, Pauline Tamesis,
SonomiTanaka,NeschaTeckle,AnilTerway,MyoThant,GuyThijs,HansTroedsson,SachikoYamamotoand
YumikoYamamoto.


Theteam’sappreciationgoestotheUNAsiaPacificMDGsCommunitiesof PracticeandADBCommunitiesof
PracticeonEducation,Energy,Environment,Gender,GovernanceandPublicManagement,Health,Transport
andWaterwhomadesubstantivecontributionsforthepreparationof thisreport.


ThereportwaseditedbyPeterStalker.ItwasdesignedbySusannahDixionandNiphonPenplugsakul.Minyan
BaoandWannapornSridamaprovidedalladministrativesupport.




ixMDG PRIORITIES In ASIA AnD THE PACIFIC


Abbreviations


ADB AsianDevelopmentBank
ADBI AsianDevelopmentBankInstitute
AIDS acquiredimmunodeficiencysyndrome
ASEAN Associationof South-EastAsianNations
ASEAN+3 ASEAN+China,JapanandtheRepublicof Korea
BIMSTEC Bayof BengalInitiativeforMulti-SectoralTechnicalandEconomicCooperation
CIS Commonwealthof IndependentStates
CMI ChiangMaiInitiative
CO2 Carbondioxide
DAC DevelopmentAssistanceCommitteeof theOECD
EAS EastAsiaSummit
ESCAP EconomicandSocialCommissionforAsiaandthePacific
FAO FoodandAgricultureOrganization
FDI foreigndirectinvestment
FTA freetradeagreement
GDP grossdomesticproduct
HIV humanimmunodeficiencyvirus
ID identity
ILO InternationalLabourOrganization
IMF InternationalMonetaryFund
LAC LatinAmericaandtheCaribbean
LDCs leastdevelopedcountries
LLDCs landlockeddevelopingcountries
MDB multilateraldevelopmentbank
MDGs MillenniumDevelopmentGoals
NGO non-governmentalorganization
ODA officialdevelopmentassistance
OECD OrganisationforEconomicCooperationandDevelopment
PPP purchasingpowerparity
SAARC SouthAsianAssociationforRegionalCooperation
SIDS Smallislanddevelopingstates
SPC Secretariatof thePacificCommunity
TB Tuberculosis
UNDP UnitedNationsDevelopmentProgramme
UNESCO UnitedNationsEducational,ScientificandCulturalOrganization
UNFPA UnitedNationsPopulationFund
UNICEF UnitedNationsChildren’sFund
UNIFEM UnitedNationsDevelopmentFundforWomen
VAT valueaddedtax
WDI WorldDevelopmentIndicators
WFP WorldFoodProgramme
WHO WorldHealthOrganization
WTO WorldTradeOrganization






1MDG PRIORITIES In ASIA AnD THE PACIFIC


OVERVIEW


Oneof thegreatestMDGsuccessesinAsiaandthe Pacific has been on poverty reduction.Between1990and2008,thecountriesof the
region reduced the number of people living on less
than$1.25adayfrom1.5billionto947million,andthe
regionisontrackforthepovertygoal.Moreover,for
someotherindicatorstheAsia-Pacificregionasawhole
hasalreadyachievedthetargets–forreducinggender
disparitiesinprimary,secondaryandtertiaryeducation
enrolment,forexample,forpreventingarise inHIV
prevalence,forstoppingthespreadof tuberculosis,for
reducingconsumptionof ozone-depletingsubstances,
and for halving the proportion of people without
accesstosafedrinkingwater.


Ontheotherhand,theregionisstilllagginginsome
major areas. It has been slow in reducing the extent
of hunger, in ensuring that girls and boys reach the
last grade of primary education, in reducing child
mortality,inimprovingmaternalhealthprovisionand
inprovidingbasicsanitation.


Seven drivers for achieving the MDGs


EachcountryfocusingontheMDGshastoaddressits
ownspecificneedsandopportunities.Andeachof the
social sectors relevant for theMDGs, suchashealth
and education, also has its own specific issues. But
acrosstheregionandacrosssectorsthereareanumber
of common concerns and priorities. This report
singles out seven overall opportunities to strengthen
theenvironmentforachievingtheMDGs.


Strengthening growth by stimulating domestic demand
and intra-regional trade –Given the importance of
economic growth in MDG achievement, countries


affected by the crisis need to recover quickly and
expand theireconomies.But inanerawhenwestern
markets are likely to import fewer goods, countries
intheregionwillalsoneedtorebalancetheirgrowth,
basingitmoreondomesticconsumptionandgreater
levelsof intra-regionaltrade.Suchchangewouldalso
presentanopportunityforacceleratingMDGprogress
whichdependongreaterspendingonsocial services
andbasicinfrastructure.

Making economic growth more inclusive and sustainable
–Economicgrowthalsoneedstobeinclusive–derived
more from economic activities such as agriculture
that benefit the poor, and especially women. The
fruitsof growthalsoneedtobebetterallocatedsoasto
contributetoachievingtheMDGtargets.Governments
willwanttosettheirsightson‘greengrowth’thatcan
decoupleeconomicdevelopmentfromenvironmental
pressures.


Strengthening social protection – Countries will be
better placed to achieve the MDGs if they offer a
minimumsocialfloorthataddressesextremepoverty
andhunger and income insecurity.A comprehensive
social protection programme will help minimize the
risks and vulnerability from economic crises and
naturalcalamities.Itwillalsoactasa‘circuitbreaker’
for vicious inter-generational cycles of poverty and
hungeraswellasreducingwideningdisparitiesbetween
therichandpoor.Thisshouldinvolveatargetedand
gender-responsiveoutreachtotheinformalsector.


Reducing persistent gender gaps–Greaterinvestments
inwomen and girls havemultiplier effects across all
theGoals.Collection and analysis of gender-specific
data should be followed by the legislative and other
changes needed to ensure that women have greater


Paths to 2015


The Asia-Pacific region has made striking progress towards
achieving the Millennium Development Goals. Nevertheless, on
present trends many countries are likely to miss a number of the
targets. This report focuses on opportunities for making more rapid
progress – identifying some of the most promising paths to 2015.




2 PATHS TO 2015


OVERVIEW: Paths to 2015


control and ownership over assets, have equitable
accesstoemploymentandallpublicservices,andare
fullyrepresentedinpublicandpoliticallife.


Ensuring financial inclusion–Mostof thebillionor
sopoorpeopleinAsiaandthePacifichavelittleaccess
to financial services.Nowadays therearemanymore
opportunitiesforachievinggreaterfinancialinclusion
forthem.Governmentscanplaytheirpartbyimproving
infrastructure and the regulatory environment while
encouraging better service provision by NGOs,
community-basedgroupsandtheprivatesector.


Supporting least developed and structurally
disadvantaged countries–Whilemostof theresources
forachievingtheMDGsmustcomefromwithinthe
countries,manyof thepoorestcountrieswillcontinue
torelyonoverseasdevelopmentassistanceandSouth-
Southcooperation.


Exploiting the potential of regional economic integration
–Regionaleconomicintegrationcanmaketheregion
moreresilienttofurthercrisesandbolsterthecapacity
of the poorest countries to achieve the MDGs.
Agreements on economic integration, for example,
couldenablesmallercountriesinparticulartoextend
theirmarketsandreapefficiencygains.Opportunities
forfruitfulcooperationexistinfinanceandotherareas.


Thereportalsolooksmorecloselyatsomeof thekey
issues for goals onwhich the region is falling short:
reducinghungerandbuildingfoodsecurity,improving
basic services,andstrengtheningbasic infrastructure.
The report highlights the opportunities for building
food security, stronger basic services and improved
basicinfrastructures.


Reducing hunger and building
food security


Despite rapid economic growth and falling levels
of poverty,Asia and the Pacific still haswidespread
hunger and malnutrition. About one person in six
suffersfrommalnourishmentandonechildinthreeis
underweight.Toensurethatpoorpeoplehaveaccess
tothefoodtheyneedtoleadhealthyandproductive
lives,experienceacrosstheregionsuggestsfiveoverall
policypriorities.


Creating jobs and increasing incomes – The main
response should be to ensure that people have the
decent jobs and incomes that will enable them to
buy the food they need. Despite higher economic
growth,employmentgrowthhasslowedconsiderably.
Governmentswillwanttoensurethatgrowthismore


employment intensive while expanding employment
programmesforthepoorandvulnerable.


Boosting agricultural production – Over the years
therehasbeenadeclineinnationalpublicinvestment
in – and international support for – agriculture.
Consequently there has been a deceleration in the
growthof agriculturaloutputandproductivity.Asian
governments and the international community now
needthereforetoredirecttheirattentiontoagriculture
whichhasvastunexploitedpotentialforgrowth.


Maintaining stable and reasonable food prices –Food
pricesshouldbewithinrangeof poorconsumers,but
itisalsoimportanttohavepricesthatoffersufficient
incentivestofarmers.Atthesametimegovernments
mayneedtoaddressimbalancesinfoodmarketsthat
givegreaterpowertobuyersandretailersthantofood
producersandconsumers.


Providing safety nets for the poor–Governmentsshould
ensure foodsecurity for thepoorwhoareunable to
earn their livelihoods, through subsidies,public food
distributionsystems,orfood-for-workprogrammes.


Implementing feeding programmes – These can
include school feeding programmes, for example, or
programmesforpregnantwomen,babies,pre-school
children,ortheelderly,sickorinfirm.


Improving health and other
basic services


If the least developed countries are to achieve the
Millennium Development Goals they will need to
offer reliablebasic services, especially forhealth and
education.Most governments have been determined
toimproveprovisionof servicesbutstillfallshort in
termsof coverageandquality,particularlyinruralareas.


Investing more in basic services –Governmentshave
beenallocatingmoreresourcestoeducationthoughas
aproportionof GDPbut this is still lower than the
global average. Expenditure on health, however, has
stagnated.Whilemanygovernmentsmaybeconcerned
about deficits they probably havemore fiscal policy
spacethantheyrealizetoinvestinbetterservices.


Improving governance–Governmentswillbeconcerned
to ensure higher quality of services. At present the
quality of services is undermined by a number of
issues related to governance. These indicate the
need for effective decentralization, achieving greater
policy coherence, reducing corruption, strengthening
regulations, generating better data, increasing




3MDG PRIORITIES In ASIA AnD THE PACIFIC


OVERVIEW: Paths to 2015


accountabilityandstakeholderparticipation.


Ensuring social inclusion and equal access to social services –In
principle services are available to all, but in practice
certaingroupstendtobeexcludedongenderormany
other characteristics – for example, caste, creed,
ethnicity, sexual identity, socio-economic standing,
disability, age, HIV status, or geographical location.
Exclusion must therefore need to be tackled on a
broad front, including through greater community
mobilisation,andinsomecases,affirmativeactionor
decriminalization where certain laws could obstruct
thedeliveryof healthservices.


Diversifying the range of service providers – In the
pasttheprincipalprovidershavebeengovernments–
particularlyforhealth,education,waterandsanitation.
Moreservicesarenowbeingprovidedbycommunity
organizationsandtheprivatesector,butgovernments
stillneedtoensureaccessforthepoor.


Priorities in health


While governments need to strengthen provision
across thewhole rangeof public services,manywill
needtopayspecialattentiontothehealthgoals–where
progress has been particularly slow. Maternal health
needs special attention as an unacceptable number
of women perish from preventable and treatable
complications related to pregnancy. Despite the
stabilizingof HIVprevalenceintheregion,accessto
preventionandtreatmentservicesstillfallswellbelow
universal targets. This will require increasing public
healthexpenditure,whileseekingnewhealthinsurance
modelsandincreasingthenumberof primaryhealth
careworkers. In addition,health servicedelivery can
be improvedby involving communitygroupsof key
affectedpopulations.


Strengthening basic infrastructure


TheMDGframeworkhasfewspecificgoals,targetsor
indicatorsforinfrastructure–thusthefocushasbeen
on development outcomes while less attention has
beenpaidtosomeof thebasicconditionsforachieving
them. Asia and the Pacific region needs stronger
basic infrastructure,particularlyroadtransport,water
supplies,sanitation,electricity,informationtechnology,
telecommunications and urban low-income housing.
Amongtheprioritiesforimprovinginfrastructureare:


Mobilizing finance – For the period 2010-2020 the
requiredinfrastructureinvestmentwouldbe$7.7trillion
orabout$700billionperannum.Forthispurpose,some
countriesmaybeabletoaccesscapitalmarketsandtap


intoregionalsavings,thoughpoorercountrieswillhave
torelymoreonmultilateraldevelopmentinstitutions.


Stimulating the private investment –Overthepasttwo
decades,morethan70percentof Asia’sinvestmentin
infrastructurehasbeenmadebythepublicsector.Now
morespendingwillneedtocomefromprivatesources.
Governmentscould,forexample,offerfiscalincentives
while multilateral development institutions can help
guidenegotiationsforpublic-privatepartnerships.


Raising standards of quality and maintenance –
Except for railways, Asia also lags in the quality of
infrastructure, much of which suffers from a lack
of commitment to repairs andmaintenance.And in
a region prone to disasters another important factor
is the planning and implementationof measures for
risk reduction.Many of the problems are related to
governance, including corruption. Governments can
increase transparency by using competitive bidding
rules, for example, and automated e-billing systems.
They will also need to improve qualification and
certificationintheconstructionindustryandenforce
regulations more strictly. But one of the best ways
of improvingqualityandaccountability is toactively
involve local communities, and particularly women,
whocannotonlycontributeinputsbutalsofeelgreater
ownershipandbecommittedtomaintenance.


Building greener infrastructure – More attention
must be given to infrastructure that maximizes
equitable socio-economic benefits, while minimizing
environmental impactsandtheuseof resources.For
example,wellplannedandintegratedpublictransport
systemsreducecostsfortheurbanpoorwhileputting
citiesontrajectoriesof greengrowth.


Extending regional infrastructure – There is a clear
gaintopublicwelfarefromregionalinfrastructurethat
helpsenlargemarkets,reducesthecostsof tradeand
usesregionalresourcesmoreefficiently.Oneestimate
suggests that completing regional connectivity in
energy,transportandtelecommunicationswouldboost
Asia’snetincomeby$13trillionovertheperiod2010-
20andbeyond.


Tilting the balance


As theMDG target date 2015 approaches, it seems
likelythatthepictureacrossAsiaandthePacificwill
be mixed – with some disappointing failures, some
narrowmisses, and some striking successes. But the
finalMDGstory is yet tobe told.All countries still
have five years to choose themost promising paths
–andtiltthebalancedecisivelyonthesideof success.




4 PATHS TO 2015


CHAPTER I


Oneof thegreatestMDGsuccessesinAsiaandthePacifichasbeenwithpovertyreduction.Between 1990 and 2008, countries in Asia
andthePacificreducedthenumberof peoplelivingon
lessthan$1.25adayfrom1.5billionto947million–
allthemoreimpressivegiventhatoverthesameperiod
theregion’spopulationincreasedbysome800million.
Asaresulttheregionasawholeisontracktoachieve
thetargetof halvingtheproportionof peoplelivingin
extremepoverty.


Moreover, for some other indicators Asia and the
Pacifichasalreadyachievedthetargets–forreducing
gender disparities in primary, secondary and tertiary
education,forexample,forbeginningtoreduceHIV
prevalence,forstoppingthespreadof tuberculosis,for
reducingconsumptionof ozone-depletingsubstances,
and for halving the proportion of people without
accesstosafedrinkingwater.


Ontheotherhand,AsiaandthePacificregionisstill
lagging in some major areas. It has been slow, for
example,inreducingtheextentof hunger,inensuring
that girls and boys reach the last grade of primary
education, in reducing child mortality, in improving
maternalhealth,inprovidingbasicsanitation.


Table I-1 summarizes for 21 indicators the overall
status based on the most recent internationally
comparable data set, which covers the period up to
2008. For details of the classification method, see
http://www.unescap.org/stat/statpub/mdg-progress-
classification/.Forselectedindicators,basedontrends


of progresssince1990,thereportplaceseachcountry
orcountrygroupintooneof fourcategories:


Early achiever–Alreadyachievedthe2015target
On-track–Expectedtomeetthetargetby2015
Off-track: slow – Expected tomeet the target, but
after2015
Off-track: no progress/regressing–Stagnatingorslipping
backwards


AsTableI-1shows,theestimatesfortheAsia-Pacific
region as a whole inevitably mask considerable
variationsbetweencountrygroupingsandsubregions.
Theregion’s14leastdevelopedcountries,forexample,
havemadeslowornoprogressonmost indicators–
performingwellonlyongenderequalityinprimaryand
secondaryeducation,andstoppingthespreadof HIV
andTB.Itisamajorconcernthatinmostsubregions
progress is slow for reducing child mortality and
improvingprovisionformaternalhealth.


Therearesimilardifferencesbetweensubregions.The
greatestprogresshasbeeninSouth-EastAsiawhichhas
alreadyachievednineof the21assessedindicatorsand
isontrackforanotherthree.TheNorthandCentral-
Asian countries as a group have already achieved
eightof theindicators.Thesamegroupof countries,
excludingtheRussianFederation,haveachievedtenof
theindicators–thoughtheyareprogressingslowlyon
anotherthreeandmakingnoprogressonafurthersix,
includingthoserelatedtopoverty,HIVandTB.


TheAsia-Pacificregionincludestheworld’stwomost


MDGs in Asia and the Pacific –
where we stand


The Asia-Pacific region has made impressive gains in many MDG
indicators, especially in reducing poverty. But it is lagging on some
important targets, particularly on reducing hunger and in achieving
higher standards of health. To reach the goals, from now to 2015,
countries in Asia and the Pacific will need to step up their efforts
and focus on some key priorities.




5MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER I: MDGs in Asia and the Pacific – where we stand


Table I-1– Country groups on-track and off-track for the MDGs


Source: Staff calculations based on the United Nations MDG Database


populouscountries–ChinaandIndia–sotheregion’s
overallachievementonpoverty,asonotherindicators,
willbeswayedbytheirperformance.Toillustratethis,
Table I-1 also shows the performance of different
countrygroupingsthatexcludeAsia’stwogiants.Thus
‘Asia and the Pacific excluding China and India’ on
someindicatorshasperformedworsethantheregion
asawhole:ithasprogressedonlyslowlyinreducingthe
numberof peoplelivingwithlessthan$1.25perday,
andregressedonHIVprevalence.Startingfromalow
baseonmanyMDGindicators,SouthAsiahasmade
goodprogressonsevenindicatorsbut isprogressing
onlyslowlyonmanyothers.Giventheweightof India
insubregionalaggregates,itisalsousefultoconsider
‘SouthAsiawithoutIndia’.Thisgroupingisontrack
forpoverty,butprogressingslowlyontheprovisionof
cleanwatersupplies,andregressinginHIVprevalence
andforestcover.


As a group, the Pacific Island countries have been
successfulinindicatorsrelatedtotuberculosis,protected
areas and the consumption of ozone-depleting
substances.But theyhavebeenregressingormaking
no progress in eight indicators and advancing only
slowlyinanotherfive,thoseforinfantandunder-five
mortalityandprovidingaccesstoantenatalcare.Papua
NewGuinea is home to almost 70 per cent of the


Pacific Island countries’ population, so estimates for
thesubregionareinevitablyaffectedbythiscountry’s
performance. Table I-1 therefore presents estimates
forthePacificIslandcountriesexcludingPapuaNew
Guinea. This subgroup shows better progress on
gender equality in education and is also moving
forward,albeitslowly,onexpandingaccesstoimproved
sanitationfacilitiesandsafedrinkingwater.However,
itshouldbenotedthattheaccuracyof PacificIsland
aggregates for many indicators is hampered by a
shortageof data.

Disparitiesinprogressbetweengroupsof countriesin
theregionaremirroredatthecountrylevel(TableI-2).
Forexample,whereasSouth-EastAsiaasawholeison
track–orhasachievedthetarget–for12of the21
indicatorsconsideredinthisreport,Cambodiamanages
this for only ten indicators, and Lao PDR for only
nine – a result of insufficient progress in child
malnutrition and primary completion, for example.
At the other end of the spectrum, while South Asia
as awhole is on track for, or has achieved only nine
indicators, Sri Lanka is on track, or has achieved,
the targets, for 14 of the 19 indicators for which it
has data. More details on the variation in progress
towards achieving the MDGs are provided in the
Statisticalappendix.




PATHS TO 2015


CHAPTER I: MDGs in Asia and the Pacific – where we stand


Table I-2 – Countries on-track and off-track for the MDGs


Source: Staff calculations based on the United Nations MDG Database.




MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER I: MDGs in Asia and the Pacific – where we stand


Itshouldbenotedthattheseon-andoff-trackestimates
arebasedonaglobaldatabasecompiledbytheInter-
AgencyExpertGrouponMDGindicatorsledbythe
Department of Economic and SocialAffairs of the
UnitedNationsSecretariat.CountriesmeasuringMDG
progressusingdifferentdatasources,orusingdifferent
indicators, may arrive at different conclusions. Take
the goal of eradicating extreme poverty and hunger
forexample.Theassessmentof progressinthisreport
usestheinternationallydeterminedincomepovertyline
($1.25aday),whilemanynationalassessmentstendto
bebasedonnationallydeterminedpovertylines.Thus,
countriessuchasLaoPDR,NepalandTurkey,which
areshowninthereportassloworregressingonthe
goalof povertyreduction,wouldbeontrackonthe
basis of data estimated from nationally determined
povertylines.Similarly,countriessuchasMongoliaand
Pakistanareshownhereasearlyachieveron income
poverty,althoughtheywouldbeonsloworregressing
onthebasisof theirnationalpovertylinesdata.


Moreover,evenincountrieswheresignificantprogress
has been made towards the MDGs, there are often
disparities within the country – between urban and
ruralareas,betweenrichandpoor,betweenwomenand
men,andgirlsandboys.Althoughmanycountriesdo
notregularlyreportsex-disaggregateddatathatwould
helptrackthegenderdimensionsof MDGtargetsand


indicators, the available data on outcome indicators
of poverty, such as education, nutrition, health and
childmortality,andevidencefromcasestudiessuggest
gender disparities (Figure I-1). Close to 100 million
women inAsiaareestimated tobe ‘missing’because
of discriminatory treatment in access to health and
nutrition or through pure neglect – or because they
werenotallowedtobeborninthefirstplace.1


The scale of deprivation


Compared with other developing regions Asia and
the Pacific is generally ahead of Africa, but behind
LatinAmericaandtheCaribbean(Statisticalappendix,
FigureA-1).Butbecauseof itslargerpopulationsize,
on most indicators, the Asia-Pacific region has the
greatest numbers of people affected. In the case of
sanitation,forexample,theregionhasmorethan70per
centof thedevelopingworld’speoplewhoareaffected
–whichin2008amountedtoalmost1.9billion.This
is illustrated inFigure I-2 for thisandother selected
indicators. Indeedevenon indicators forwhichAsia
and the Pacific hasmade significant progress, it still
hasalargenumberof peoplewholiveindeprivation.
When it comes to providing people with access to
cleanwater,forexample,theregionisanearlyachiever
yetstillhas469millionpeopledeprived.


Figure I-1 – Asia-Pacific ranking on gender indicators


Source: Staff calculations based on data available at the World Bank Genderstat.


Lifeexpectancy Adultliteracy Secondary Adultlabourforce Proportionofseats
atbirth,2008 rate,2008 enrolment participation heldinnational
rate,2007 rate,2008 parliaments,2008


East Asia and the Pacific South Asia Sub-Saharan Africa World Gender parity


1.1
1.0
0.9
0.8
0.7
0.6
0.5
0.4
0.3
0.2
0.1
0


Ra
tio


o
ff


em
al


e
to


m
al


e
(F


/M
)




8 PATHS TO 2015


CHAPTER I: MDGs in Asia and the Pacific – where we stand


Impact of the global economic crisis


The most recent year for which internationally
comparable data are available in theUnitedNations
MDGdatabaseis2007or2008.Thiswaspriortothe
global economic slowdownwhich started in2008 so
the data do not yet register the effect of the crisis.
In theAsia-Pacific, for example, the economic, food
andfuelcrisesarebeingfeltthroughlowereconomic
growth, lower government revenues, higher debt
burdens,adeclineinthevalueof offshoreinvestments,
increasesinthecostof living,joblossesandreduced
remittances,2preventingsome21millionpeoplefrom
escapingpoverty.


Whilethereareinsufficientcurrentdata,itnevertheless
is possible tomake a rough estimate of the effects,
based on the impact of the crisis on economic
growth–whichisnowbecomingclearer.Thehistorical
relationshipbetweeneconomicgrowthandchangesin
MDGindicatorscanbeusedtoprojectthelikelyeffects
infuture.Themethodologyforthisissummarizedin
theStatisticalappendix.


Basedonthismodel,inAsiaandthePacificthecrisis
wouldresultby2015in:3
• Almost 35 million extra people in extreme
incomepoverty
• A cumulative number of almost 900,000 extra
childrensufferingfrommalnutritionfrom2008
to2015


• 1.7 million births not attended by skilled
professionals
• 70 more million people without access to
improvedsanitation


Note that these numbers are in addition to those
indicatedinFigureI-2forthenumberof peoplewho
would have beendeprived in any case had the crisis
not occurred. Compared with the overall levels of
deprivationtheimpactof thecrisismayappearsmall.
But they are nevertheless significant and add to the
challengeof achievingthegoals.


All of these estimates assume that historical trends
roughly continue. But history is not destiny. All
countries in the region still have the opportunity to
accelerate progress to 2015 and achievemanymore
of thegoals.Asaguidetohowtheymightdoso,the
following chapters highlight some of the paths they
cantake.


Figure I-2 – Asia-Pacific’s share of the developing world’s
deprived people


Source: Staff calculation based on the United Nations MDG Database.


Endnotes


1 UNDP,2010.
2 ESCAP/ADB/UNDP2010;PacificIslandForumSecretariat,
2010;ESCAP(2010a).
3 AlsoseeESCAP(2010a)andESCAP(2010b)forfurther
discussionof theimpactof theeconomiccrisis.


1990 Latest


1877 1873


141 96


1481 947


11 7


854 469


53 32


– 0.24


7 4


6 5


Without basic sanitation


Under-5 underweight


Living below $1.25/day


Infected with TB


Without safe drinking water


Outofprimaryschool


Maternaldeaths


Under-5 mortality


Living with HIV


0 10 20 30 40 50 60 70 80 90 100


Numberofpeople
deprived(inmillions)


Percent




9MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER II


Each country has to address its own specificneeds and opportunities. And each of thesocialsectorsrelevantfortheMDGs,suchas
healthandeducation,alsohasitsownspecificissues.
Butacrosstheregionthereareanumberof common
issues and priorities. Subsequent chapters will look
more closely at someof the key issues for goals on
whichtheregionisfallingshort:reducinghungerand
building food security, improving basic services, and
strengtheningbasicinfrastructure.


Allcountriesintheregionaccepttheirresponsibilities
asdevelopmentalstatesforachievingtheMDGs.This
chapterpresentssevenopportunitiesforstrengthening
the overall environment inwhich they can do so. It
should be noted that this and subsequent chapters
of thereportdrawheavilyontheprecedingregional
MDG reports – which can be consulted for the
analytical and empirical details that underpin the
sectionsthatfollow.1


Strengthening growth by
stimulating domestic demand and
intra-regional trade


Achieving all theMDGswill dependon accelerating
growth and making a strong recovery from the
economiccrisis.Manycountrieswillbeaimingtodo
thisbyrebalancingtheireconomiessoastobemore
resilient,basedlessonexportsandmoreonboosting
domestic demand and greater consumptionof Asia-
Pacificgoodsandservices.2FortheMDGsthispolicy
change presents amajor opportunity sincemany of
thepoliciesthatwillhelpachievetheMDGswillalso


boostlocaldemand.Theseincludeincreasingspending
onbasicsocialservicesandsocialprotectionandbasic
infrastructure,andboosting the incomeof thepoor,
who, comparedwithwealthier households, aremore
likelytospendextraincomethansaveit.

While increasing domestic demand, it will also be
important to boost South-South and intra-regional
trade and investment flows with more inclusive
patternsof regionalintegrationthatbenefittheLDCs.
Since1986, intra-regionalexportshaverisenfrom23
to41percentof developingAsiaexports,butmuch
of this is intheformof productionnetworking ina
limitednumberof partsandcomponentswiththefinal
goodsbeingdestinedforwesternmarkets.Infactonly
aroundone-fifthof exportsgotoEastandSouth-East
Asia; the remaining four-fifths go to the rest of the
world–nearly60percentof whichareheadedforthe
EU,theUSandJapan.Sotheslumpinimportsinthese
majormarkets, which is likely to continue for some
time,willdefinitelyaffecttheregion.Infuture,amore
diversifiedpatternof tradewouldhavetobebuiltup
includingongoodswhichhaveareadymarketinthe
regionandwhicharealsomorelikelytobeconsumed
bythepoor,suchasprocessedfood.


Greater intra-regional trade would require integrated
markets,lowertariff andnon-tariff barriers,concerted
investment in physical infrastructure, more robust
transportation networks and information platforms,
and better regulatory structures. Regional growth
wouldalsobenefitfromabalancedanddevelopment-
friendlyoutcomeof theDohaRound that corrected
existing asymmetries in global trade and enhanced
market access.LDCproducts shouldhaveduty- and
quota-freemarketaccessonalastingbasis.


Seven drivers for achieving the MDGs


Achieving the MDG would make a real difference to the lives of
millions of people across Asia and the Pacific. This chapter indicates
opportunities for strengthening the overall environment in which
the Goals can be achieved – enabling them to accelerate progress
towards 2015.




10 PATHS TO 2015


CHAPTER II: Seven drivers for achieving the MDGs


Making economic growth more
inclusive and sustainable


Economicgrowthnotonlyneedstobederivedmore
fromtheregion’sownconsumption,italsohastobe
more inclusive–with the fruits sharedmore equally
amongdifferentsocialandeconomicgroups.Thistoo
wouldrequireadeliberatechangeincourse–bothin
thegrowthpatternandingovernmentpolicies.Inthe
absence of countervailing policies, across the region
thenational incomeshareof the top20percentof
thepopulationhassteadilyincreasedwhilethatof the
bottom20percenthasdecreased.Similarly,formost
countries in Asia and the Pacific, the ‘Gini indices’,
whicharethestandard measures of inequality,


been increasing. 3



If inequalitycouldbereduced,oratleastheldconstant,
thentheMDGscouldbeachievedmorerapidly.4The
keyhereistoderivemoreof thegrowthfromeconomic
activitiesthatbenefitthepoor-especiallywomen.This
willrequire,forexample,greaterfocusonagriculture
which provides primary income to over 50 per cent
of Asia’s population.5 It will also mean promoting
productive employment in the informal sector – by
ensuring that small enterpriseshave the support and
credittheyneedtoexpandandprovidedecentwork.
Enabling greater female labour force participation
andbetteraccesstoeconomicassetshasshowngreat
benefit,especiallyinSouthAsia.6


It is also necessary that Governments act decisively
to ensure that growth offers greater opportunities
for the poor and deprived. This involves greater
employment generation andmore resources devoted
to investments in education, health and other basic
services. Governments must make more efforts to
raiseresourcesandreorientprioritizebudgetstowards
theMDGs.7


It isalsovitalthatgrowthbemoresustainable.Even
inclusive growth will eventually grind to a halt if it
undulystressestheregion’snaturalresources.Already,
unsustainable agricultural and industrial production
have been liquidating the natural resource base,
degradinglandandwaterquality,reducingbiodiversity,
anddestroying vital natural ecosystems.At the same
time,theregion’scitiesarecomingunderevergreater
strain as a result of rural-urbanmigration:Asia and
the Pacific already has fifteen of the world’s largest
cities and over the next ten years the region’s urban
populationwillgrowbyafurther1.1billion.8Ashortage
of availablelandinmanysmallislanddevelopingstates,
inparticular,isleadingtogreaterdensityinurbanareas
thatlackadequateinfrastructure.Addedtothisisthe
potentialadverseimpactof climatechangeonhuman


health,onfoodsecurity,oncoastalinfrastructure,and
on the livelihoods of communities that depend on
naturalresources.


Inresponse,governmentsacrossAsiaandthePacific
will need to progressively set their sights on amore
environmentally sustainable development that can
decouple economic growth from environmental
pressures– for example,by enhancing theefficiency
of natural resource use, reducing energy intensity,
preservingbiodiversity,cuttingthegenerationof waste
and adapting to the effects of climate change. This
neednot,however,necessarilymeanslowergrowthor
fewerjobs,sinceintegratingcleanenergyandclimate-
resilientpoliciesintodevelopmentplanningandfiscal
policieswillalsodrivetheeconomiesforwardandcreate
quality jobs. In this regard, it will be important that
governmentsalsodevelopsoundgreenjobspoliciesas
partof theshifttowardsalow-carbon,environmentally
friendly,climate-resilienteconomy.Manygovernments
havealreadysetoutonthispath.Thus,whilemitigating
the impactof theglobal economiccrisis, somehave
incorporatedenvironment-relatedelements into their
stimulus packages. The Republic of Korea’s ‘green
new deal’ package, for example, allocates over $38
billionforgreenprojectsthatwillcreateclosetoone
milliongreenjobsoverafouryearperiod,andChina
hasfocused20to30percentof itspackageonlow-
carbon production. China has also earmarked $440
billiontosupportwindandsolarenergy.9


Strengthening social protection


Countrieswill be in a better position to achieve the
MDGs if they can offer a minimum social floor
that addresses extreme poverty and hunger and
incomeinsecurity.Acomprehensivesocialprotection
programme will minimize the impact of economic
crises and natural calamities as well as consolidating
development gains, while also acting as a ‘circuit
breaker’forviciousinter-generationalcyclesof poverty
andhunger.


At present, acrossmost of Asia and the Pacific the
coverageof socialprotectionislow,typicallyconfined
toworkersingovernmentandtheformalsector.This
means that inmost countriesmore thanhalf of the
workforce is left without protection, and in most
countries this involves more women workers than
men.AccordingtoILO,inEastAsiamorethanhalf
theworkforce is inunstable ‘vulnerableemployment’
while in South-East Asia and the Pacific and South
Asia, the proportion rises to 60 per cent or more.
Only 30 per cent of Asia’s elderly receive pensions.
Only 20per centof theunemployedhave access to


have




11MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER II: Seven drivers for achieving the MDGs


unemploymentbenefitsorlabourmarketprogrammes.
AndhouseholdsinAsiahavetheworld’shighestrates
of out-of-pocket health care expenditure. In these
circumstances households try to protect themselves
bybuildingupsavings.10Particularattentionalsoneeds
tobepaidtohouseholdsimpactedbyHIVwhichare
amongthemostvulnerabletoexternalshocks.


To some extent social protection could be extended
intheshorttermbyimprovingthemanagementand
deliveryof existingprogrammes and ensuringbetter
targeting.Butmanycountrieswillneednewservices.
Across the region there are good examples of what
can be achieved, from Thailand’s universal health
careschemeto conditionalcashtransferschemes in
Cambodia and Indonesia, to well developed school
feedingprogrammesinIndiaandBangladesh.11



Reducing persistent gender gaps


Gender inequality isneither justandsustainable,nor
morallydefensible.Investinginwomenandgirlsisin
itself abreakthroughstrategyforachievingtheMDGs
andalmostany investmentmade inwomenandgirls
will have multiplier effects across all the Goals.12


Countries across Asia and the Pacific will therefore
needtoactonmultiplefrontstoensurethatwomen
canexercisetheirrightsandrealizetheirfullpotential.
This shouldbebasedonbetterdataoncriticalareas
suchasviolenceagainstwomen,onhowgendernorms
affectmenandwomen,andonthedifferentstatusof
menandwomeninhouseholds.Analysisof thesedata
should be accompanied by close monitoring, along
withthechangesinpolicyandlegislation–aswellas
in attitudes, perceptions and behaviour – needed to
ensurethatwomenhavegreatercontrolandownership
over assets and resources, have equitable access to
employment,andhaveaccessto,andbenefitfrom,all
publicservices.


Althoughtheregionhasprogressedonsomegender
indicators, it - particularly SouthAsia, still hasmany
disparities–inlifeexpectancy,educationalattainment
and labour force participation – which are being
passed relentlessly from one generation to the next.
In Bangladesh, for example, women earn only 50
per cent of whatmen earn for similarwork, and in
Mongolia only 80 per cent.13 Similar imbalances are
evident in agriculture. Inmost regionsof theworld,
womenhead20percentof farms,butinAsiaandthe
Pacifictheproportionisonly7percent,eventhough
agricultureaccountsforoverhalf of theregion’sfemale
employment.14 Furthermore, the share of women in
wage employment in the non-agricultural sector in


SouthAsia andWesternAsia is only around 20 per
cent,thelowestrateamongtheworld’sregions.Women
tendtobepredominantinmanyof theinformaland
insecurejobs.


Girls too have historically been less likely than boys
tobesenttoschool–insomecasesbecauseparents
considerthemalessworthwhileinvestment.Andwhile
educationaldisparitieshavebeenfallingattheprimary
level, they persist in a number of countries at the
secondarylevel.Parentsmayalsobereluctanttosend
girlstoschoolif theyareworriedabouttheirsecurity.
And inhouseholds affectedby theeconomic impact
of HIV,girlsaremorelikelythanboystodropoutof
school–asshownbystudiesfromChina,Cambodia
andIndonesia.15


Women’s persistent lack of power is also reflected
in low representation innational legislatures. InAsia
womenoccupyonly18percentof legislativeseatsand
inthePacificonly15percent.Similarly,theygenerally
havelessinfluenceoverlocalpoliciesandplans–on
food security, for example, and on health and other
basicservices.


Genderdiscriminationcostslives.Closeto100million
women inAsiaareestimated tobe ‘missing’because
of discriminatory treatment in access to health and
nutrition, pure neglect, or pre-birth sex selection.16
The region’s highest girl to boy under-fivemortality
ratiosarefoundinChina(1.41),India(1.10),Pakistan
(1.08),Micronesia,Nepal, and Tonga (1.07). And in
SouthAsiamorewomendie in childbirth – 500 for
every100,000 livebirths– than inanyotherpartof
theworldexceptSub-SaharanAfrica.Theproportion
of deliveriesattendedbyskilledstaff isstillaslowas
18percentinNepal,20percentinLaoPDR,39per
centinPakistan,and46percentinIndia–compared
with97percentinThailand.17



Many women are also subject to domestic violence,
especially when societies are under stress.18 In some
countriesinthePacific,forexample,aroundtwo-thirds
of women have been assaulted by male partners19


and theproportioncanalsobehigh inanumberof
countriesinSouthandSouth-EastAsia.20Nearlyhalf
thecountriesinSouthAsiaandmorethan60percent
of thoseinthePacificdonothavelawsondomestic
violence. Moreover, victims rarely report episodes
since enforcement is often slow and ineffective.
Gender-basedviolence is also associatedwithhigher
risksforHIVtransmissionandisakeydriverof the
epidemicinPapuaNewGuinea.InAsia,between1990
and2007thefemaleproportionof adultslivingwith
AIDSnearlydoubled–to29percent.21




12 PATHS TO 2015


CHAPTER II: Seven drivers for achieving the MDGs


Ensuring financial inclusion


Mostof thebillionorsopoorpeopleinAsiaandthe
Pacifichave littleaccess to financial services. Instead
they rely largely on cash or the informal economy,
andforcreditlooktofriends,familyormoneylenders.
Lacking insurance, they cannot protect theirmeagre
assets and incomes against shocks such as illness,
drought or theft. Andwithout transactional banking
services,theirfinancingisinsecureandexpensiveand
theycannotparticipatefullyintheeconomyeitheras
consumersorpotentialentrepreneurs.22


Nowadays,however,therearemanymoreopportunities
forwideningfinancialinclusion.Governmentscanplay
theirpartbyimprovinginfrastructureandtheregulatory
environment. But they can also encourage service
provisionbyNGOs,community-basedgroupsandthe
privatesector.Thisshouldenablemicro-insuranceand
micro-financeinstitutions,forexample,totailortheir
programmesbettertotheneedsof thepoor.


Serviceproviderscanalsotakeadvantageof advances
in information technology. They can, for example,
extendmobilephonebankingtoenablecustomersin
remoteareas tosendmoney, receiveremittancesand
payforpurchases.Theyshouldalsobeabletousepre-
paidsmartcardstopayforsuchservicesaselectricity.
The Reserve Bank of Fiji, for example, recently
announced that it will be working closely with two
mobile phone companies to provide ‘mobilemoney’
for all. And India is issuing a unique biometric ID
thatpoorfamiliescanusetoopenbankaccountsand
receivecashtransfers.


Offering financial services to the poor not only
allowthemtoescapefrompoverty. Itcanalsomake
good business sense. Companies that cater more
effectivelytopoorconsumerscanbeveryprofitable.
In the Philippines, for example, a company, which
providesprepaidphoneservicesmainlytolow-income
consumers, has become the most profitable of the
country’slargestcorporations.23


Supporting least developed and
structurally disadvantaged countries


Measures for faster MDG achievement should be
financedasmuchaspossiblefromdomesticresources.
However, poorer countries, particularly the least
developed countries, the landlocked developing
countries, and thesmall islanddevelopingstates,will
needtobeassistedthroughexternalresourcessuchas
officialdevelopmentassistance(ODA).


ODA, whether bilateral and multilateral, has played
a key role in supporting the economic development
and social progress of many developing countries
in the region and it continues tomake a significant
contribution to achieving theMDGs.With changing
circumstances,theroleof ODAisalsochangingand
it should now primarily be used for supporting the
developmenteffortsof theleastdevelopedcountries
(LDCs),thelandlockeddevelopingcountries(LLDCs)
andthesmallislanddevelopingStates(SIDS)–which
dependonexternalresourcesforfinancingagoodpart
of theirdevelopmentprocess.Inparticular,ODAfor
these structurally handicapped countries should be
usedtobuildtheireconomicandsocialinfrastructure,
especially for investing in basic services such as
water, sanitation, energy, transport, shelter, health
and education. ODA can also have a catalytic role
– in helping these countries expand their productive
capacities,promoteFDIandtrade,adapttechnological
inventions and innovations, foster gender equality,
ensurefoodsecurity,andreduceincomepoverty.


Atthesametime,itwillbeimportanttoimprovethe
qualityof ODAandincreaseitsdevelopmentimpact–
bybuildingonthefundamentalprinciplesof national
ownership, harmonization, andmanaging for results.
This includes especially aligning aid by sector with
internationallyagreeddevelopmentgoalsandcountry
priorities.


Although Asia and the Pacific has around 60 per
centof theworld’sdeprivedpeople, theregionfinds
it difficult to attract aid from the traditional donors,
particularlyforMDGsectors.Asiareceivesthelowest
per capita assistance of all regions – $12 compared
with$45forAfrica–whichcallsforbetterallocation
of flowsaccording toneeds (Figure II-1).Therefore
thereisaneedtore-focusODAflows–bothinterms
of regionalandsectoralpriorities.


Someof thegreatestconcernsareinthesmallisland
developing states of the Pacific.Here it can also be
misleading to consider ODA on a per capita basis
becauseof theirdiseconomiesof scaleandverysmall
populations.Geographically isolatedandwithlimited
resources they face high development costs and rely
stronglyonaidtoovercomevulnerabilitiestoexternal
shocks.Anyreduction in technicalassistance is likely
therefore to impede development progress. This
subregion in particular should be looking to boost
externalassistance.Infuture,technicalassistancewill
alsoneedtore-engagemorestronglywithagriculture
bothtobuildlongertermfoodsecurityandtosupport
theincomesof theruralpoor.




13MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER II: Seven drivers for achieving the MDGs


All these programmes would be more effective if
recipient countries improved their institutions and
governancestructures.Butthereisalsoaneedfordonors
toincreasethepredictabilityof theirsupport,reduce
fragmentationandinvestwithlong-termnationalgoals
inmind.For thispurpose, thedevelopmentpartners
shouldenablereceivingdevelopingcountriestotakethe
leadintheirowndevelopmentpoliciesanddeveloped
countries should align their technical assistance
programmes with national development plans to
harmonizetheiractivitiesandmakethemmoreopen
and accountable. For example, Pacific island leaders
and development partners have recently reaffirmed
their commitment through the Cairns Compact and
are working together to improve coordination and
accountability.24


South-South economic assistance – Most ODA still
comes from the DAC countries. Within the Asia-
Pacificregion,thelargestdevelopingcountrysources
includeChina,atabout$1.4billion,Indiaatabout$1.0
billion,theRussianFederationwitharound$0.2billion.
Southernornew sourcesof assistance in the region
are primarily helping their neighbours. For example,
ChinamostlyhelpsCambodia,DPRKorea,Indonesia,
Lao PDR, Myanmar, Pakistan, Philippines and Viet
Nam.Similarly,IndiaassistsAfghanistan,Bangladesh,
Bhutan,MyanmarandNepal,whileThailandprovides
assistancemostly toCambodia,LaoPDR,Myanmar,
MaldivesandVietNam.

Muchof thisaidthusgoestoLDCswhereitislikely
tobeusedinsupportof theMDGs–generallygoing
intosectorssuchasinfrastructure,energy,agriculture,
health, andeducation.For example,China and India


have helped in building roads, bridges, hospitals,
educational institutions and hydro-electric plants in
Cambodia, Lao PDR, Pakistan, Nepal and Bhutan.
Thailand has many cooperative programmes in the
areasof agricultureandhealthwithMalaysia,Indonesia
andTimor-Leste.Malaysiahasprovidedassistanceto
VietNamforresearchrelatingtorubber.Suchflows
canhelpestablishinstitutions,improvecapacitiesand
ultimatelyboosttheincomesof thepoor.25


Another priority has been health. Malaysia, for
example, has provided assistance for setting up
clinicsinCambodia,whileIndiahasbuilthospitalsin
Afghanistan,Nepal,Maldives and Lao PDR. South-
Southassistancealsofocusoneducationandtraining
– setting up educational institutions in the recipient
country, funding vocational programmes to develop
skills that help improve productivity and incomes,
andofferingscholarshipsforstudentsfromrecipient
countries to study in the assisting country. China,
India, Republic of Korea, Malaysia, Singapore and
Thailand all have several such programmes. These
instancesof cooperation, especially in social sectors,
are clearly positive examples of South-South and
regionalcooperation.



Exploiting the potential of regional
economic integration


Beyond South-South cooperation in sharing
developmentexperiencesandcapacitybuilding,regional
economicintegrationoffersmanyotheropportunities
– particularly for smaller economies – by enabling
themtoextendtheirmarketsandreapefficiencygains


Figure II-1 – net ODA receipts per person in 2008, uS$


Source: OECD-DAC, 2010.


0 20 40 60 80 100 120 140 160 180 200


Oceania 177
Africa 45
Europe 42
All developing countries 24


America 16
Asia 12
SouthandCentralAsia 10
FarEastAsia 4
LDCESCAP 39
LLDCESCAP 74
SIDSESCAP 135


US$




14 PATHS TO 2015


CHAPTER II: Seven drivers for achieving the MDGs


fromspecializationandeconomiesof scaleandscope.
This couldmake the regionmore resilient to future
crisesandbolsterthecapacityof manyof thepoorest
countries to achieve the Millennium Development
Goals.


Whenitcomestoexploitingthepotentialof regional
economicintegration,AsiaandthePacifichaslagged
behindotherregions.Thusfar,forhistorical,political
andtopographicalreasons,theregionhasbeenbetter
connected with Europe and North America than
withitself.Meanwhile,Europe,NorthAmerica,Latin
America andAfricahave allmoved todeeper forms
of regionalintegration,withcustomsunionsandeven
monetaryunions.AsiaandthePacificwhichhassome
of theworld’slargestandfastest-growingeconomies,
couldbeanevengreatereconomicpowerhouse if it
toodevelopedamoreintegratedregionalmarket.But
itwouldneedtodosousingadevelopmentparadigm
thatismoreinclusiveandsustainable.26


Theprocessof regionalcooperationintheAsia-Pacific
regionisledbysub-regionalgroupingssuchasASEAN
inSouth-EastAsia,SAARCinSouthAsia,BIMSTEC
inSouthandSouth-EastAsia,andthePacificIslands
Forum in the Pacific – which have evolved regional
tradingandinvestmentarrangements.Theregionhas
developedacomplexnetworkof overlappingregional
andbilateraltradingarrangements.Thetimehascome
toconsolidatetheseintoaunifiedAsia-Pacificmarket.
With growth poles such as China and India, along
withothereconomicpowerhouseslikeJapan,aunified
Asia-Pacificmarketcouldbethecentreof gravityof
theworldeconomy.27


For this purpose the countries of the region can
accelerate progress on two current proposals: the
EastAsiaFreeTradeAgreementthatbringstogether
the ASEAN+3 grouping, and the Comprehensive
EconomicPartnershipof EastAsiaunderEastAsia
Summit (EAS) frame work that, in addition to the
ASEAN+3 grouping, includes Australia, India, and
NewZealand.28


An integrated economic space needs to be
complemented, however, by improved physical
connectivityaswellasbybettertradeandinvestment
facilitation. Migration policy too could encourage
integration if source anddestination countries could
arriveatbilateralagreements.


Yetanotherareaforfruitfulregionalcooperationisin
developingaregionalfinancialarchitecture.Thiscould
provide more efficient intermediation between the
region’slargesavingsanditsunmetinvestmentneeds
for infrastructure and other developmental gaps.29


So far the cooperation in the area has been largely
limitedtotheChiangMaiInitiativethathasnowbeen
multilateralized as a reservepool of $120billion for
meetingthetemporary liquidityneedsof ASEAN+3
countries.30 At the 66th session held in Incheon in
May 2010, themember States of ESCAPmandated
theESCAPsecretariattoassistindevelopmentof the
elementsof aregionalfinancialarchitecture.31



Towards 2015


Theopportunitiesoutlined in this chapter arebyno
meansexhaustive,butif usedvigorously,theycanhelp
countries accelerate progress towards many of the
goals on which they are currently falling short. The
nextchapterlooksmorecloselyatoneof theregion’s
most vulnerable areas – hunger – and highlights
opportunitiesforbuildingfoodsecurity.


Endnotes


1 ESCAP/ADB/UNDP,2010.
2 Chhibber,GhoshandPalanivel,2009;ADB,2009;
ESCAP(2010a).
3 ADB,2007;ESCAP(2010b).
4 ESCAP(2010a);ESCAP(2010b).
5 WorldBank,2009;ESCAP(2010a).
6 UNDP,2010a;ESCAP(2010b).
7 ESCAP(2010b).
8 UnitedNationsPopulationDivision,2010.
9 ESCAP(2010a);ESCAP(2010b).
10ESCAP/ADB/UNDP,2010.
11UNDP,2008;UNDP(2010a);ESCAP/ADB/UNDP,2010.
12ESCAP/ADB/UNDP2006.
13UNDP,2010.
14FAO,2009.
15UNDP,2010.
16UNDP,2010.
17ESCAP/ADB/UNDP,2010.
18HeyzerandKhor,1999.
19SPC,2009.
20UnitedNations,2006.
21UNDP,2010.
22ESCAP(2010a);ESCAP(2010b).
23ESCAP(2010b).
24ESCAP/ADB/UNDP,2010.
25ESCAP/ADB/UNDP,2010;Kumar(2009).
26ESCAP(2010a).
27ESCAP(2010a).
28ESCAP(2010a).
29ESCAP(2010a,2010b).
30ADB,2008;ESCAP(2010a);ESCAP(2010b).
31ESCAPResolution66/5.




15MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER III


Some of the region’s most disturbing MDGshortfallsconcernhunger.Aroundonepersoninsixsuffersfrommalnourishment,andonechild
inthreeisunderweight.AsiaandthePacifichasabout
two-thirdsof theworld’shungrypeople.Thisfailurehas
ahugecost,primarilyinliveslostandinsicknessand
disease,butalsoinstiflingbothhumanandeconomic
potential.Lackof progressonchildnutrition,whichis
slowingchildren’sphysicalandmentaldevelopment,is
cripplingothercriticaldevelopmenteffortstocontrol
disease,boosteducationandspureconomicprogress.1


The two main MDG indicators on hunger and
malnutrition are the proportion of the population
undernourished and the proportion of under-five
children who are underweight. For the region as a


whole,between1990-92and2004-06,theproportion
of undernourished – those consuming less than the
dailyminimumenergyrequirement–fellonlyslightly.
Between 1990-92 and 1995-07 it fell from 20 to
17percentbutby2004-06haddroppedbyonlyone
percentage point, to 16 per cent (Table III-1). Even
thisreductionwaslargelyoffsetbypopulationincrease,
sothetotalnumberof hungrypeoplebarelychanged.
FAO’smostrecentestimatesputthenumberof hungry
peopleinAsiaandthePacificat642millionin2009–
anincreaseof about75millionduring2006-09.Thisis
thehighestnumberintherecentdecades.Forchildren
whoaremalnourished–weighinglessthantheyshould
fortheirage–thedropintheproportionwassomewhat
greater,from40to31percent,neverthelessthisstill
leftalmost100millionchildrenmalnourished.


Reducing hunger and building
food security


Despite rapid economic growth and falling levels of poverty, Asia and
the Pacific still suffers from widespread hunger and malnutrition. In
future, countries across the region will have to pay greater attention
to food security, and ensure that poor people have access to the food
they need to lead healthy and productive lives.


%ofpopulation Millions
1990-92 2004-06 1990-92 2004-06


AsiaandthePacific 20 16 585.7 566.2
EastAsia 15 10 183.3 136.3
South-EastAsia 24 15 105.7 84.7
SouthAsia 25 23 286.1 336.6
CentralAsia 8 10 4.0 5.8
WesternAsia 38 13 6.1 2.1
PacificIslands(a) 12 13 0.5 0.7
LatinAmericaandtheCaribbean 12 8 52.6 45.3
NearEastandNorthAfrica 6 8 19.1 33.8
Sub-SaharanAfrica 34 30 168.8 212.3
DevelopingWorld 20 16 826.2 857.7
World 16 13 845.3 872.9


Table III-1 – undernourishment in Asia and the Pacific and other global regions


Note: (a) Due to limited data, the Pacific Islands includes Papua New Guinea only.
Source: FAO. http://www.fao.org/economic/ess/food-security-statistics/en/ and Chatterjee, S., A. Mukherjee and R. Jha (2010).




1 PATHS TO 2015


CHAPTER III: Reducing hunger and building food security


For undernourishment the greatest advance was in
East and South-East Asia. SouthAsia, on the other
hand made scarcely any progress, and the number
of hungry people increased substantially, from 286
million to 337million. In several countries in South
Asia, more than one-fifth of the population are
undernourished. In thePacific Island states the level
of hungervariesfrom5percentinKiribatito9per
centintheSolomonIslands.2



Thesubregionalpatternissimilarforchildmalnutrition.
Theworst-performingsubregionisSouthAsiawhich
has an underweight prevalence of 41 per cent and
is home to half the world’s underweight children.
Several countries in the subregion have the world’s
highestnationalunderweightprevalence–worsethan
countries such as Ethiopia at 35 per cent.3 In this
region, theproblem is lessa lackof food thanpoor
food quality and food safety, along with inadequate
sanitationcausingenergy-drainingdiarrhoealdiseases
andwomen’slowsocialstatusandearlymarriagewhich
leadstolowbirthweights.Butitisstrikingthatdespite
rapideconomicgrowth,South-EastAsiastillhasone-
quarterof itschildrenmalnourished.

Childreninruralareasarenearlytwiceaslikelytobe
underweightasthoseinurbanareas.Insomecasesthis
ratiohasrisensharply: inEastAsia,for instance,the
ruraltourbanratiorosebetween1990and2008from
2.1to4.8.The2008ratiosforSouthAsiaandSouth-
EastAsia in2008were1.4 and1.2 respectively.The
incidenceof underweightchildrenisalsodramatically
higher among the poor: in SouthAsia, for example,
among the poor over 60 per cent of children are
underweight.4


AchievingtheMDGchildnutritiongoalwouldbring
significant dividends. If countries that are currently
off trackweretomeetthetargetby2015,thenumber
of underweightchildrenwouldfallbymorethanone-
third,from74million,onpresenttrends,to47million.
India andNepal are among the countries facing the
greatestchallenge: tomeet the target,bothcountries
need to accelerate progress about five-fold to over
2 percentage points per year. In response, India, for
example,hasbeenintroducinguniversalmid-daymeals
forchildren.ThechallengeisevengreaterforTimor-
Lestewhichwouldneed toreduce theprevalenceby
3.4percentagepointsperyear(TableIII-3).


Hungerisamultidimensionalproblemencompassing
many aspects of human development, including
poverty,health,education,rights,voice,security,dignity
anddecentwork.Inthelongerterm,asmostdeveloped
countries have shown, hunger fallswith rising levels
of economic development. Experience across the
regionsuggestsfiveoverallpolicyprioritiesfortackling
hunger: i) creating jobs and increasing incomes; ii)
boostingagriculturalproduction;iii)maintainingstable
andreasonableprices;iv)providingsafetynetsforthe
poor;andv)implementingfeedingprogrammes.


Creating jobs and increasing
incomes


Themainhunger response shouldbe to ensure that
poorpeoplehavethejobsandincomesthatwillenable
them to buy the food they need. In recent years,
however, employment growth has been slower than
economic growth and most of the poor have been


Proportion% Millions
1990-94 2003-07 1990-94 2003-07


AsiaandthePacific 40.0 31.0 127.0 98.0


EastAsia 19.0 7.0 17.0 6.0
South-EastAsia 34.0 24.0 17.0 12.0
SouthAsia 53.0 41.0 92.0 79.0
CentralandWestAsia 19.0 7.0 1.3 0.5
PacificIslands(a) 29.0 26.0 0.3 0.2


LatinAmericaandtheCaribbean 4.5
MiddleEastandNorthAfrica 12.2
Sub-SaharanAfrica 25.3
World 22.4


Table III-2 – underweight children under five


Note: (a) Due to limited data, the Pacific Islands includes Papua New Guinea only.
Source: FAO. http://www.fao.org/economic/ess/food-security-statistics/en/ and Chatterjee, S., A. Mukherjee and R. Jha (2010).




1MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER III: Reducing hunger and building food security


unabletogainfromthemoredynamicsectorsof the
region’s economies.To counter this trend and foster
decent employment governments can try to ensure
thatgrowthismoreemploymentintensive,particularly
where the poor work. This will mean, for example,
promoting employment-intensive sectors such as
agricultureandsmallandmediumenterprises.

At the same time they can establish or expand
employmentcreationprogrammesspecificallyforthe
poor and the vulnerable. Fortunately in recent years
many Asian governments have been adopting such
strategies. India, for example, as well as directing
investment into high employment sectors has also
implementedtargetedemploymentprogrammesforthe
poorandvulnerablesuchastheNationalEmployment
Guarantee Scheme, which provided employment to
46millionhouseholdsin2009.5Closetohalf of those
employedwerewomenandmorethanhalf werefrom
marginalizedgroups.6Otherwaysof raising incomes
of thepoorest,currentlybeingdevelopedinanumber
of countriesintheregion,areconditionalcashtransfer
programmesalongwithotherpovertyalleviationschemes.


Reducing poverty will make a vital contribution to
reducing hunger. But it will not be sufficient on its
own.ExceptinthePacificIslandgroupof countries,
the fall in poverty has generally been greater than
the fall in hunger. This underlines the importance
of tackling hunger on a broad frontwith additional
interventions specifically related to food production
andconsumption.


boosting agricultural production


Food insecurity depends to a large extent on food
productionandavailability.Aworryingtrendisthatover
thelastdecade,whilefoodoutputhasincreased,there
hasbeenadeceleration in thegrowthof agricultural
outputandproductivity.Tosomeextent this reflects
declininglevelsof investment.


Most capital investment in agriculture comes from
theprivatesector,especiallyfromfarmersthemselves.
Nevertheless public investment in agriculture is
important for attracting private-sector investment.
Governments can invest in irrigation, research and
rural infrastructure, technology generation and
dissemination, natural resource conservation and
standard setting and monitoring – which can help
increase productivity, reduce transaction costs and
improvethecompetitivenessof agriculture.7


In recent years, however, governments have been
spending less on agriculture and have directedmore
investmenttothemaingrowthsectors–manufacturing
and services (Figure III-1). The share of total
government expenditure in agriculture dropped
in almost all developing regions. The decline was,
however,verysignificantinAsia,fromover14percent
inthe1980stolessthan9percentin2002.8


India 51,987 -2.11 33,054
Pakistan 9,811 -1.35 5,265
Philippines 2,752 -0.90 1,846
Myanmar 1,569 -1.30 746
Nepal 1,551 -2.29 867
Cambodia 598 -1.57 360
Indonesia 3,542 -0.93 3,320
Afghanistan 1,596 -1.39 1,433
LaoPDR 284 -1.68 185
Timor-Leste 136 -3.41 51
Azerbaijan 67 -0.49 42
Turkmenistan 48 -0.50 32
Armenia 11 -0.20 5


Total 73,952 47,206


Table III-3 – Progress required for off-track countries to meet the underweight children target


Source: Staff calculations based on the United Nations MDG database.


Affectedpopulationin
2015oncurrenttrend


(thousands)


Averageannualchange
neededtoreachtarget
(percentagepoints)


Affectedpopulationin
2015iftargetreached


(thousands)Country




18 PATHS TO 2015


CHAPTER III: Reducing hunger and building food security


Similarly,theattentiontoagriculturehasbeendeclining
frominternationaldonors.Agriculture’sshareof ODA
declinedfrom18percent in1979to3.5percent in
2004.Italsodeclinedinabsolutetermsfallingbetween
1984and2004from$8billionto$3.4billion(in2004
dollars). In the late 1970s and early 1980s, the bulk
of agriculturalODAwenttoAsia,especiallyIndia,in
supportof thegreen revolution.9 It couldbeargued
thatdecliningaidflowsarelimitingagriculturalgrowth
andproductivity.


The firstpriority is therefore to redirect attention to
agriculture, since many Asian countries have vast
unexploitedpotentialforagriculturalgrowth.Oneof
theeasiestwaysof raisingfarmyieldsandaccelerating
growth is to adopt already available improved
technologies. Both public and private investments
in agricultural research and extension are necessary
to provide a continuous stream of yield-enhancing
technologiesthatcanbeprofitablyadoptedbyfarmers.
Thegreenrevolutionhasrunitscourse;newscientific
breakthroughs, such as those in biotechnology, are
nowrequiredtoraiseyieldpotentials.Thisisespecially
important because land and water are increasingly
scarce in Asia and future agricultural growth will
increasinglyhavetocomefromsustainableagriculture
technology.


Addressing the supply-side factors requires more
investment in irrigation and farm-to-market roads,
crop diversification, improved marketing, policies
to encourage larger farm sizes and mechanization,
increasedmarket access and trade in agriculture, and
greater incentives for food production. At the same
time it will be important that women are supported
fully todeveloptheircapacitiessincemorethanhalf
theregion’swomenworkinagriculture.10


Itwillalsobeimportanttooffersufficientincentivesto
farmers.Thisnotonlybenefitsfarminghouseholdsbut
alsootherruralhouseholdsbyencouraginginvestment
in agriculture and creating additional employment in
rural economies. For this purpose, governments in
theregionhaveusedavarietyof instruments–such
as fixing minimum support prices for food grains,
providing subsidies on key farm inputs such as
irrigationwater,fertilizers,seeds,andcredit.Theyhave
alsoheldbuffer stocksof foodgrains and regulated
thefoodgrainstrade.Somearguethatthesemeasures
distort incentives, but they are nevertheless critical
for ensuring food security in Asia and the Pacific.
Indonesia, for example, returned to self-sufficiency
in2009asaresultof activesupporttoagriculturein
recentyears.


Maintaining stable and reasonable
food prices


Countriesneedtostrikeabalance.Whilefoodprices
shouldbeatsuchalevelastoencourageproduction,
they also need to be within the range of the poor.
Highpriceshurtthevastmajorityof urbanandrural
households who purchase most of their food. The
people hit hardest are poor people who on average
spendabouttwothirdsof theirbudgetonfood.Rich
households,ontheotherhand,spendonlyaboutone
thirdof their incomeon food so theycan afford to
paymore.


To some extent domestic food prices will reflect
international prices, especially in countries that are
net food exporters. InAsia and thePacificwhile 13
countriesarenetexportersof cereals,pulses,meat,dairy,
vegetables and fruits, 31 countries are net importers


Figure III-1 – Agriculture’s share of public expenditure, percentage


Source: Fan and Saurkar, 2006.


Africa Asia Latin America Developing
&Carribean countries


1980
1990
2002


16
14
12
10
8
6
4
2
0


Pe
rc


en
t




19MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER III: Reducing hunger and building food security


(Table III- 4).FAOhas estimated that, as a resultof
the foodandenergy crises, the totalundernourished
populationintheregionincreasedfrom566millionin
2004-06to642millionin2009.11


During 2006-08, soaring cereal prices increased
household food costs substantially. On average, in
AsiaandthePacific, foodcostsforpoorhouseholds
increasedby43percent,butforrichhouseholdsonly
by18percent.Asaresult, thepurchasingpowerof
poor households decreased by 24 per cent, in Asia
andthePacific,whileforrichhouseholdsitdecreased
only by 4 per cent. Inthe Philippines and Pakistan,
forexample, ithasbeenestimatedthata30percent
increaseinfoodpricesledtoincreasesinthenumber
of people living below the national poverty lines of
about9millionand22millionrespectively.


12


Keepingfoodpriceslowandstablerequiresareliable
andconsistentsupplyof foodgrains.Forfood-deficient
countries, this will mean making efforts where
possibletoincreasedomesticproductionwhichcanbe
supplementedwith imports tobuild adequate stocks.
Toguardagainstfoodpricevolatilityandsuddenshortfalls,
somegovernmentsinAsiaandthePacifichavetraditionally
heldnationalstocksof riceandotherstaplefoods.


Itisalsoimportanttoensurethatfoodmarketswork
efficiently.Manycountries,particularlygeographically
largeoneswithinsufficientlydevelopedinfrastructure,
can face considerable variability in food prices. In
India, while the average monthly price of rice in
October2009wasRs.21perkilogram,thepriceacross
78consumptioncentresrangedfromRs.10toRs.31.


13




Anotherconcern is thatmuchof thepower in food
marketsrestswithbuyersandretailerswhocanpaylow
priceswhilecharginghighpricestoconsumers.Policy
makers will therefore need to promote competitive
yet equitablemarketmechanisms such as improving
transport,storage,andothernecessaryinfrastructure,
andencouragingtheprivatesectortodevelopefficient
foodmarkets.


Regionalcooperationcanhelppromotefoodsecurity,
forexamplethroughfoodreserves.Oneoptiontodeal
withsuchariskisaregionalricebank.Apermanent
EastAsianemergencyricereserve isbeingdiscussed
by the13countriesof ASEAN+3as a follow-up to
itsongoingEastAsiaEmergencyRiceReservePilot
Project – a system for sharing rice stocks. Another
positive initiative is the agreement, since 2007, to
establish the South Asian Association for Regional
Cooperation (SAARC) Food Bank which needs to
be strengthened and operationalized on an optimal
scaleandcouldalsofoster inter-countrypartnerships
and regional integration. Regional agreements to
avoidexportrestrictionsandcooperationtobuildup
productioncapacitiescanalsohelp.


14


Providing safety nets for the poor


When themarket fails to provide food of sufficient
quantityorqualityforthepoor,governmentscantake
responsibility to ensure food security for the poor
throughsubsidiesorpublicfooddistributionsystems.
In India, for example, thepublic distribution system
reaches 160 million families who can buy around


Netimporters Netexporters


EastAsia DPRKorea,RepublicofKorea,Mongolia China


South-WestAsia Afghanistan,Bangladesh,Maldives,Nepal,India, Pakistan,Turkey
SriLanka,Bhutan,Iran(IslamicRepof)


South-EastAsia Indonesia,Malaysia,Singapore,LaoPDR, VietNam,Thailand,Myanmar,
Cambodia Philippines


Centraland Armenia,Azerbaijan,Georgia,Tajikistan, Kazakhstan,Kyrgyzstan,Uzbekistan
NorthAsia Turkmenistan,Russia


Pacific Kiribati,Micronesia,CookIslands,Samoa,Nauru, Vanuatu,Tuvalu
PapuaNewGuinea,Palau,Fiji,SolomonIslands,
Tonga,MarshallIslands


Table III-4 – net importers and exporters of food


Note: The authors use the definition of food in a flexible manner.
Source: Francis and Akoy, 2008.


15




20 PATHS TO 2015


CHAPTER III: Reducing hunger and building food security


10 kilograms of grain per month at about half the
market price. These subsidies have made important
contributions but have often proved difficult to
operate successfully due to suffering from selection
bias, leakages and poor food quality. They are also
expensivetomaintainandoperate.Betweentheearly
1990sandthe2000sthecostof thepublicdistribution
systeminIndiarosefrom2.5toalmost6.0percentof
governmentexpenditure.


Costsforsuchprogrammesandthepriceof foodfor
thepoorcanbereduced,forexample,byonlyoffering
nutritious but lower cost cereals that the poor can
afford.When resources are very limited, however, it
mayalsobenecessarytohavemoreprecisetargeting
–while taking carenot to exclude thehomeless and
illiterate.Measuresalsoneedtobeinplacetoensure
wellmanaged storageanddistributionand to reduce
leakage, fraud and corruption. In addition, the
governmenthastohandleitsrelationshipwithfarmers
carefully by setting a purchase price that is fair for
producersaswellasconsumers.


Direct distribution of food is sometimes combined
withotherprogrammesinvolvingnutrition,education,
andhealthservices.Forexample,theVulnerableGroup
Development Programme in Bangladesh seeks to
integratefoodandnutritionsecuritywithdevelopment
andincomegeneration.Participantsreceiveamonthly
allocationof wheatinexchangeforattendingtraining
on income-generatingactivities,participating inbasic
literacy,numeracy,andnutritiontraining,andmaking
savingsdeposits.


Analternativetodistributingfoodistooffersubsidies
through‘foodstamps’–atermthatcancoverarange
of food-linkedincome-transferschemes.Theseinclude
tokensordiscountcardsorelectronic transfercards.
Foodstampprogrammeshavelowercoststhanfood
distributionsystems.Theycanalsobemoreefficientin
addressinghungerthancashtransfers,astheycanonly
bespentonfooditems.However,theseprogrammes
alsorequirestrongsupportingarchitecturewithinboth
thegovernmentandtheprivatesector.


Many governments also have targeted interventions
through food-for-work programmes. These schemes
too are self-selecting since only the poor are usually
willing to undertake the manual labour required.
Drought and conflict have led to shortages of food
andwaterinmanypartsof Afghanistanandinrecent
years, theWorld Food Programme (WFP) has been
providing food to people in rural areas in exchange
forworkonruralinfrastructure.In2009alone,WFP
assistedmorethan4.4millionpeopleinthisway,thus


providingfoodtovulnerableAfghansastheybuiltor
repaired community assets, including roads, bridges,
reservoirs and irrigation systems. These projects are
agreed upon in consultation with the government
and localcommunities.


16


Food-for-workprogrammes
suffer, however, from many of the same problems
associatedwithpublicdistributionsystems, including
leakage through corruption, and wastage from poor
storage,andcanbeevenmoreexpensive.



Implementing feeding programmes


Onereasonwhypovertyreductionmaynot translate
intobetterlevelsof nutritionisthatthepoordonot
necessarilyspendanyextraincomeonfood.Onestudy
of 13countriesfoundthattheextremepooralsospend
significant amounts on other items.


17


Moreover, as
incomesincrease,peoplebuygreatervarietiesof food
thatdonotnecessarilyoffermorecaloriesornutritional
benefits.Anotherissueisthat,evenif thehousehold
overallhassufficientfood,itmaynotbereachingthe
familymembers ingreatestneed,particularlywomen
andchildren.


In addition to policies on production, prices and
distribution, governments also have to consider
targeted interventions for especially vulnerable
population of society. These usually involve direct
feedingprogrammesforthreespecificgroups:women
of childbearing age, young infants and children, and
populations in need of emergency food assistance,
suchasrefugees.


In general, these programmes hinge on the delivery
of abasicpackageof servicesforenhancingnutrition
supported by necessary primary health care. The
essential nutrition components are breastfeeding,
growth monitoring, oral rehydration, immunization,
nutrition education, micronutrient supplementation,
and treatment and rehabilitation of the severely
malnourished.Inadditiontosupplementsforchildren,
such as Vitamin A, for example, governments have
alsointroducedfoodfortificationprogrammeslikesalt
iodization.


Schoolfeedingprogrammesdistributepreparedfood
tochildreninschool.Food-foreducationprogrammes
distribute free foodgrains to low-income families if
theirchildrenattendprimaryschool.Thegraincanbe
used to feed all familymembers or be sold tomeet
other expenses. Both school feeding and food-for-
educationprogrammesprovideimmediatesustenance
for thehungrywhile empowering future generations
byeducatingtoday’schildren.


18




21MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER III: Reducing hunger and building food security


As well as improving nutrition such programmes
bring many secondary benefits. School feeding
programmes can improve attendance, especially for
girls,reducedrop-outratesandevenimprovechildren’s
performance and behaviour. And programmes for
pregnantandlactatingmotherscanreducethenumber
of low birthweight babies and maternal mortality
ratesand,alongwithpre-schoolfeedingprogrammes,
help children develop normally both mentally and
physically.


Another vital contribution to good child nutrition
is exclusive breastfeeding along with other basic
health services like disease control, and safe water.
These programmes can also incorporate strong
communications components to empower families –
especiallywomenwith the information they need to
makebestuseof theavailablefood.


One of the best ways of addressing these issues is
througheducation,especiallyforwomen,sincebetter
educatedwomen are in a stronger position not only
tounderstandnutritionissuesbutwillalsohavemore
powerwithinthehouseholdtoensurethateveryoneis
fedadequately.


19




Released from hunger


Releasing people from hunger not only fulfils a
basic human right but also contributes towards the
achievementof all theotherMDGs.Well nourished
adultswill,forexample,bemoreproductiveandbetter
abletoworktheirownwayoutof poverty.Andwell
nourished children will grow up healthier and take
greateradvantageof opportunitiesto learnatschool
andfulfiltheiraspirations.


Atthesametime,reducinghungeralsodependstoa
largeextentonsimultaneouslyaddressingmostof the
otherGoals.Educatedwomen, for example,will get
betteremployment thatwillallowthemtobuymore
nutritiousfood.Andchildrenwhogrowupwithbetter
watersuppliesandsanitationwillbelessvulnerableto
diarrhoealandotherdiseasesthatpreventthemfrom
absorbingvitalnutrients.


Thisunderlinestheimportanceof takinganintegrated
approachthatconsiders theMDGsboth individually
andasawhole.Thenextchapterthereforebroadens
the discussion to consider how all the goals, and
particularly thoserelatedtohealth,canbesupported
bystrongerbasicservices.


Endnotes
1 SeeESCAP(2009)foradetaileddiscussion.
2 Chatteriee,MukherjeeandJha,2010.
3 WorldBank,2010.
4 UN,2010.
5 ESCAP(2010a).
6 ESCAP(2010a).
7 ESCAP(2009).
8 ESCAP(2009).
9 WorldBank,2008.
10FAO,2009b.
11FAO,2009a.


13 ADB,2008.
14 India,G.O.,2009.
15 ESCAP/ADB/UNDP,2010.
16 India,G.O.,2002.
17 WFP,2010.
18 BanerjeeandDuflo,2006.
19 Singh,2008.
20 MillerandRodgers,2009;MostueandHuttley,2007.


20


12UNDP,2008.




22 PATHS TO 2015


CHAPTER IV


The Asia-Pacific region has made strikingadvances in a number of social indicatorsbut has been making slow progress towards
thehealthgoals.Theregionasawholeisontrackto
achieve thegoalof stoppingthespreadof HIVand
tuberculosisby2015,butisoff trackformanyof the
otherhealthtargets–notablyreducinginfantandchild
mortalityandimprovingprovisionformaternalhealth.
AlthoughHIVprevalence is stabilizing, the region is
notontracktoachieveuniversalaccesstoprevention
andtreatmentforHIVinfectionforthosewhoneedit.


In education, the performance has been somewhat
better and many countries are close to achieving
universal primary enrolment (Table IV-1). Many are
alsoclosetogenderparityattheprimarylevel,andat
the secondary level girlsmaywell be aheadof boys.
Butwhilethequantityof educationhasincreased,the
quality is less impressive. School buildings are often
inadequate,books are scarce, teachers can frequently
absent,classsizesmaybelargeandthecurriculamay
fail tomeetchildren’sneeds.Discouraged,andunder


pressure towork,manychildrenattend irregularlyor
dropoutof school,andAsianstudentsoftengetlow
scoresininternationalstandardizedtests.


Despite advances in expanding access to primary
schooling,asmanyas14percentof primaryschoolage
childreninSouthandWestAsia–18million–were
notinschoolin2007.InthePacifictheproportionwas
16percent–overhalf amillioninthePacific.Girls
wereatadisadvantageinbothcases,butparticularlyin
SouthandWestAsia.(TableIV-1)


Investing more in basic services


Addressing shortfalls in social indicators will mean
investingmoreinpublicservices.FigureIV-1compares
spending on education and health in Asia and the
Pacific with that in other global regions. Despite
budgetpressures,governmentsshouldhavethefunds
to increase investment. Indeedcountrieshave largely
maintained or increased expenditure on health and


Improving health and other basic services


If the developing countries of Asia and the Pacific are to achieve
the MDGs they will need to offer reliable basic services such as
health and education to the people. Most have been determined to
improve their provision but many still fall short in terms of coverage
and quality, especially in rural areas.


Total Male Female


CentralAsia 92 93 91
EastAsiaandthePacific 94 94 93
EastAsia 94 94 94
Pacific 84 85 83
SouthandWestAsia 86 87 84


Table IV-1 – net enrolment ratio in primary education, percentage, 200


Source: UNESCO, 2010.




23MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER IV: Improving health and other basic services


Figure IV-1 – Spending on health and education as a percentage of GDP


Note: All health data – 2007; Education data: Excluding China and India – 2006, South-East Asia – 2007, South Asia – 2006, Excluding
India – 2008, North and Central Asia – 2006, Excluding Russia – 2007, LDCs Asia-Pacific – 2004, Latin America & Caribbean – 2007,
Sub-Saharan Africa – 2007.


Source: Staff calculations based on education data available at the website of UNESCO Institute for Statistics and health data
available at the website of the World Development Indicators of the World Bank.


education.Nevertheless,giventhatmanycountriesare
falling short onMDG achievement, theywill clearly
needtoinvestmore.


When public expenditure is low, households try to
makeupthedifferencethroughprivatespending.For
health services, for example, while people in richer
countriesareabletoarrangehealthinsuranceorother
formsof pre-paidplan,indevelopingcountriesinAsia
andthePacificahighproportionof privateexpenditure
is‘out-of-pocket’:around90percentinIndia,Nepal
andChina.About78millionpeople inAsia and the
Pacificendupwithlessthan$1adayaftertheyhave
paid for health care – and can suffer catastrophic
expenditureduringpregnancyandchildbirth.1



One reason why government expenditure on the
MDGsmightfallshortisaconcernaboutfiscaldeficits.
Asfiscalprudenceisessential,thenecessaryresponse
tothis ismaximizingrevenuesthrough improvedtax
collectionandothersourcesofrevenuebyimposing
newinnovativetaxesandthenbyincreasingallocations
tothesocialsectorsthatareessentialforachievingthe


2


MDGs.ForManycountriesintheregion,taxtoGDP
ratioisratherlowandmaybeincreased.


Improving governance


If they are to increase expenditure, however,
governmentswillbeconcernedaboutachievinghigher
service quality. At present the quality of services is
undermined by a number of issues, some related to
governance.Thesecouldbeaddressedby:


Improving efficiency – Governments can allocate
budgets wisely so as to spend more where services
are more urgently needed, such as on teachers in
rural areas, and on high productivity inputs such as
medicines and textbooks.3 Theymay also be able to
ensure that services bettermatch demand, especially
fromthepoor,bymovingawayfromoverly-centralized
systemsof bothfinancingandserviceprovision,and
decentralizingmorefunctionstolocaladministration.


Achieving greater policy coherence–MDGoutcomes
depend not just on expenditure through sectoral
ministries, such as health or education, but also
on broader policies on poverty alleviation, on
infrastructure, and on other services such as water
andsanitationwithwhichseveralotherministriesand
levelsof governmentmaybeinvolved.Governments


Asia-Pacific


Excluding China & India


South-East Asia


SouthAsia


Excluding India


Pacific Islands


Excluding Papua New Guinea


NorthandCentralAsia


Excluding Russia


Asia-Pacific LDCs


LatinAmerica&Caribbean


Sub-Saharan Africa


0 1 2 3 4 5 6
% of GDP


Education
Health




24 PATHS TO 2015


CHAPTER IV: Improving health and other basic services


will therefore want to consider ways of improving
coordination across sectors and ensuring policy
coherenceatdifferentlevelsof government.


Reducing corruption – At present a significant
proportion of social investment drains away in
corruption. Health and education personnel often
havehighabsenteerates,especially inruralareasand
therecanbekickbacksandbribestopublicofficialsin
procurementprocesseswhetherfornewconstruction
orsupplies.


Setting standards, strengthening regulations and
enforcement –Standardsof deliveryof servicessuch
as in education, health and water supply can fall if
standards are not set and enforced. Government
bodiesoftenhaveweakauthorityandpoorprocedures
for regulating the quality of private services and
supplies suchasof pharmaceuticals, for example,or
of medicalpractices.Weaknessesinlegalsystemsalso
make itdifficult toenforcecontractsorpursuecases
of medicalnegligence.


Increasing voice and accountability – In principle,
peopleinmanycountriesintheregionareentitledtofree
primaryeducationandprimaryhealthcare.Inpractice
theservicesareusuallymuchbetterfortheprivileged,
particularly intheurbanareas.This isbecausehealth


policies,forexample,aretypicallyconceived,directed
and implemented by a small group of professionals
inministriesof health–withinadequateinvolvement
of civil society including people living with HIV
and key affected populations, professional bodies,
consumer organizations, or members of parliament.
In addition teachers, doctors and healthworkers are
oftendiscouragedbypoorruralservicesfortransport,
housing,electricityandwater,andmaynotwishtolive
andworkinremoteareas.4


Ensuring better provision of decentralized services
– Basic services are generally provided by local and
provincial governments who often lack capacities.
While capacity development is essential, national
governmentsalsoneedtoensurethatqualitystandards
are maintained and set up adequate monitoring and
evaluationsystems.Regularfeedbackfrombeneficiaries
canhelp identifydeficiencies and spurbetter service
provision by encouraging such measures as the
BangaloreCitizenReportcardssystem.5


Generating better data–Improvingserviceswillalso
meangatheringdataforevidence-basedpolicymaking.
Nationaldatamaynotbedisaggregatedbyregionorby
genderorbycoverageof vulnerablegroups.Andsome
sensitivedatarelatedtoissuessuchasviolenceagainst
womenmaynotbecollectedatall.


Figure IV-2 – Total government revenue as a percentage of GDP


Source: ESCAP, 2010(b).


0 10 20 30 40 50 60


Myanmar
China
Bangladesh


India
Pakistan


Nepal
Philippines
Sri Lanka


Indonesia
Singapore


Kazakhstan


Thailand


Georgia


RepublicofKorea
Fiji
Australia
Bhutan


RussianFederation
Japan
Iran(IslamicRep.of)
Maldives


Percent




25MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER IV: Improving health and other basic services


Ensuring social inclusion and equal
access to social services


One reasonwhyachievement is low is that,while in
principleservicesareavailabletoall,inpracticecertain
groupsareexcluded.Discriminationmaybebasedon
gender or many other characteristics – caste, creed,
sexualidentity,ethnicity,disability,age,socio-economic
standing,geographicallocation,orevenmembershipof
stigmatizedgroupssuchassexworkersordrugusers.
And if the poor fail to register births their children
mayfinditmoredifficulttoaccessbasicservices.


Poor households –Evenwhenbasic services such as
education and health are free, poor households can
face out-of-pocket expenses, for schoolbooks for
example,orformedicines,orfamilymembersmaynot
beabletoaffordtotaketimeoff worktoattenddistant
facilities.Bangladesh,forexample,hasbeenaddressing
thisissuethroughastipendprogrammeforgirlsthat
hasimprovedtheirenrolmentinschoolingandreduced
drop-out rates. Demand-led approaches can also
offset the exclusionary impacts of user charges – as
isevidentfromtheexperienceof healthequityfunds
inCambodia.Poorfamiliesarealsogenerallyexcluded
fromformalbankingandfinancialtransactionsbecause
theylackcollateral.


Migrants–Facedwithmassiverural-urbanmigration
some countries in Asia and the Pacific region are
struggling tomaintain basic services in urban areas,
especiallyformigrantswhoareparticularlyvulnerable.
Whilesomecountriesstrictlyregulatesuchmigration,
othersdonothaveanypolicytomanagemigrationor
properlyprovideformigrants.6


Physically challenged people –Theymaybeconsidered
economicallyunproductiveandfacediscriminationin
employment.


People living with HIV –PeoplelivingwithHIVand
keyaffectedpopulations–suchassexworkers,people
whousedrugsormenhavingsexwithmen–maynot
have access topreventionandcare services.Or they
mayfearpoliceharassmentorbediscouragedbecause
theybelieve thathealth-careworkerswillnot respect
theirrightsandwilldiscriminateagainstthem.

Moreover, each form of exclusion compounds the
others and tends to sustain intergenerational cycles
of poverty. Poorer groups, for example, usually get
lowerthanaveragereturnsfromeducationasaresult
of discrimination in the job market. And unhealthy
workersare likely tobe lessproductiveandwillearn
less.Ontheotherhand,evencreatingmorejobswill


notboostpeople’sincomesif theylackthenecessary
education,strengthorskills.


Exclusion needs therefore to be tackled on a broad
front, addressing multiple deprivations and barriers,
whetherinaccesstopublicservices,orthedistribution
of assetsorof politicalpower.7Theseproblemswill
not be solved by markets alone, but will demand
government responses and communitymobilization,
includinginsomecasesaffirmativeactionandchanges
in laws that hamper access. The development of
effective partnerships between government and civil
societyorganizationsisalsocrucial.


One problem is that some social inequalities go
unobserved officially because of a lack of relevant
data and analysis. Good data can stimulate action.
India, for example established a commission on the
social,economicandeducationalstatusof theMuslim
community. The government has now published
the commission’s data and is implementing its
recommendations.8 Analysis should also respond to
qualitativefindings–suchastheneedforpoorwomen
inruralareastoconsultfemaledoctors.


Diversifying the range of service
providers


Users of services are also likely to have stronger
influenceif theycanchoosefromarangeof providers.
Inthepasttheprincipalproviders inmanycountries
have been governments – particularly for health,
education, water and sanitation. But increasingly, as
government budgets have become stretched, more
services are being provided by NGOs which, along
with the private sector and other civil society
organizations, have acquired greater knowledge and
expertise.Howevergovernmentsshouldensurethatthe
poorhaveaccesstoservicesfromtheseproviders.9


Communitybasedorganizationscanbebetterplaced
todeliverbasichealthandeducationservicestopoor
and vulnerable groups. Often they use microcredit
to link income-generating activities with health,
education and sanitation services. One of the best-
known models is that of the Grameen Bank in
Bangladeshwhichhasbeenwidelyreplicated.Another
innovation ispublic-privatepartnershipssuchas that
of ChiranjeeviYojanaininGujarat,Indiawhichoffers
poor and socially excluded women free maternity
services at private hospitals. There are also good
examplesof howpeer-ledcommunitygroupssuchas
thoseinvolvingsexworkersinSonagachi,WestBengal,
India, or drug user groups such asMit Samphan in




2 PATHS TO 2015


CHAPTER IV: Improving health and other basic services


Thailand,whichhavebeenabletoorganisethemselves
to do outreach and deliver health services to their
constituencies.Programmesarealsobeingsupported
bymanyinternationalfunders–includingtheGlobal
FundtoFightAIDS,TuberculosisandMalaria,theBill
andMelindaGatesFoundation, theGlobalFundfor
Children,andtheTurnerFoundation.Forthesekinds
of collaboration, governments have important roles
to play to ensure collaboration and harmonization,
setstandardsandestablishappropriateincentivesand
legalenvironments.


Priorities in health


While governments need to strengthen provision
across thewhole rangeof public services,manywill
needtopaycloseattentiontothehealthgoals–where
progress has been particularly slow.Asia has a large
share of global deaths and illnesses –more than 40
percentof theworld’sunder-fivedeathsandmaternal
deaths,and52percentof stuntedchildren.10Asia is
also responsible for55per centof unmetneeds for
familyplanning,56percentof newborndeathsand15
percentof thenumberof peoplelivingwithHIV.11


Of thehealthtargetsoneof thepriorityareasischild
mortality.South-EastAsiaisontrackforthis,butall
theothersubregionsareprogressingtooslowly.Thisis
mirroredatthecountrylevel:outof the47countries
forwhichtrenddataareavailable,34areoff track.The
recentfinancialcrisiswillhavehadanimpactanditis
proving difficult to reduce neonatalmortality, which
is intrinsically linked tomaternal survival andhealth.
Still,thepictureisnotallbleaksincemostcountriesare
makingsomeprogress.Of thecountrieswithunder-5
mortality rates in the early 1990sof around100per
1,000 livebirthsorhigher,quiteanumber, including
Azerbaijan, Bangladesh, Lao PDR, Mongolia and
Nepal,havemadeimpressiveprogress,andarecloseto
theirtargets,whiletheMaldiveshas,inthemeantime,
reacheditstarget.


A significant problem in the Pacific region is the
increase in incidenceof non-communicablediseases,
suchasdiabetes,highbloodpressureandcardiovascular
diseases.Many of these health problems are due to
preventablefactorssuchaspoordiet,physicalinactivity
andalcoholandtobaccouse.PacificIslandcountries
have carried out awareness-raising programmes but
still havemuchwork ahead if they are to encourage
widespread change towards healthier choices. In
addition to education, governments need to ensure
adequatetreatmentprogrammesandfacilitieswithout
cuttingservicestomeetotherhealthcareneeds.


WithrespecttoHIV,thepictureismixed.Therehas
been some success in bringing down incidence and
prevalence– as inCambodia,Thailand andpartsof
India.Buttheincidenceisincreasinginsomecountries
inSouth-EastAsiaaswellasacrosstheregionamong
men who have sex with men. Some countries have
scaledupanti-retroviraltreatmentbutregionalcoverage
is still lagging behind the global average. And even
whenHIVmedicineisfree,peoplemaystillfacehigh
feesfordiagnostictests,medicationforopportunistic
infections,andnutritionalsupplements.12


Anothermajor health concern ismaternalmortality.
Whenmothersdieduring childbirth, theirnewborns
are unlikely to survive and their young children
will also be at risk. Measuring maternal mortality is
challengingasitisoftenunderreportedormisreported.
NeverthelessitisclearthatmanycountriesinAsiaand
thePacificareunlikelytoreachthetargetof reducing
thematernalmortalityratiobythreequartersbetween
1990 and 2015 unless they can accelerate progress.
As indicated in Figure IV-3, the problems are most
severeintheleastdevelopedcountrieswherelevelsof
maternalmortality are close to those inSub-Saharan
Africa.Astudyof maternalmortalityratespublished
inThe Lancetin2010suggestedthatprogresshadbeen
somewhat more rapid than suggested by the MDG
database, but nevertheless even these numbers are
unacceptablyhigh(BoxIV-1).


Reflecting theurgencyof theproblem inApril2010
theUNSecretary-General announced a JointAction
Plan for accelerating progress on maternal and
newbornhealth.


A major determinant of a mother surviving is
whetherornotthebirthisattendedbyaskilledhealth
professional – doctor, nurse or midwife – who can
avertasignificantproportionof maternaldeaths.All
thewomenshouldhaveaccesstolifesavingemergency
obstetric care, including Caesarean sections though
poormothersarelesslikelytohavethisoption.


In11countriesoutof the43intheregionforwhich
data are available, less than half of all births were
attendedbytrainedhealthprofessionals.Thesituation
wasparticularly stark in countries suchasLaoPDR,
Timor-Leste, Nepal, Bangladesh and Afghanistan,
where less than one birth in five was attended by a
skilledprofessional.Inadditiontoashortageof such
workerstheyarealsopoorlydistributed.


Reducingmaternalmortality will also need adequate
antenatalcare,whichisparticularlyweakinSouthAsia.
Moreover the risks of dying during pregnancy and




2MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER IV: Improving health and other basic services


Table IV-2 – Progress required for off-track countries to meet the under-5 mortality target


Note: *Cumulative number of deaths from 2009 to 2015.
Source: Staff calculations based on the United Nations MDG database.


India 11,644 -4.33 9,310
Afghanistan 2,527 -24.33 1,435
Pakistan 3,195 -6.52 2,337
Myanmar 653 -8.29 427
China 2,424 -0.81 2,295
Cambodia 230 -7.29 153
DPRKorea 127 -5.24 71
PapuaNewGuinea 96 -5.52 66
Indonesia 973 -1.76 948
Philippines 415 -1.67 394
Uzbekistan 142 -1.90 120
RussianFederation 137 -0.57 116
Tajikistan 82 -3.57 69
Kazakhstan 56 -1.43 51
SriLanka 33 -0.76 29
RepublicofKorea 14 -0.29 12
Kyrgyzstan 28 -1.86 26
Timor-Leste 28 -4.52 26
Georgia 9 -2.05 7
Turkmenistan 32 -2.14 30
SolomonIslands 4 -3.33 2
Bhutan 7 -4.52 7
Vanuatu 2 -3.43 1
Fiji 2 -1.52 1
Micronesia(FederatedStatesof) 1 -2.81 0
Tonga 0 -1.62 0
BruneiDarussalam 0 -0.48 0
Samoa 1 -1.33 1
CookIslands 0 -1.29 0
Kiribati 0 -2.62 0
Nauru 0 -5.43 0
MarshallIslands 0 -2.81 0
Palau 0 -1.14 0
Tuvalu 0 -2.62 0


Total 22,862 17,934


childbirtharehigheramongadolescentmotherssoit
willbeimportanttoimproveadolescentreproductive
health. There are also high unmet needs for family
planning in countries such as Afghanistan, Timor-
Leste, and Papua New Guinea that have very high
fertilityrates.


Health outcomes are a function of many factors,
economicandpolitical, social andcultural.Generally


speaking, the richer countries will have higher
standardsof health as a result of improvedhousing
andoverall livingconditions.Manyof thedeathsof
young children, for example, can be prevented by
having better access to clean water and sanitation.
And better road infrastructure and public transport
wouldmake health facilitiesmore accessible. Indeed
economicgrowthmightbeexpectedtoimproveallthe
MDGindicators.ThishasbeenanalyzedforAsiaand


Affectedpopulationin
2015oncurrenttrend


(thousands)*


Averageannualchange
neededtoreachtarget
(per1,000livebirths)


Affectedpopulationin
2015iftargetreached


(thousands)*Country




28 PATHS TO 2015


CHAPTER IV: Improving health and other basic services


thePacificbycalculatingthepercentagechangeineach
MDGindicatorforeach1percentincreaseingrowth.
Thebeneficialeffectappearstobegreatestforpoverty,
withmorethan1percentdecreaseintheincidenceof
poverty.But thegrowtheffect is slower forhealth–
with a 1 per cent increase in growth only improves
health indicators by around half of a per cent.13 If
governments use the additional resources generated
by growth toprioritize spendingonurgentlyneeded
sectors suchashealth, risinggrowth levelscanbring
aboutbetterhealthoutcomesinthefuture.

While overall growth can thus lead to better health
outcomes,itisclearthatrelyingongrowthalonewill
notdo. Countriesacrosstheregionwillneedtopay


particularattentiontoimprovinghealthservicedelivery.
Thiswillinvolveestablishingabalancebetweenstateand
private-sectorprovision.Insomecases,particularlyfor
primaryhealthcare,thegovernmentwillbethemain
provider,but inothers thegovernment should serve
moreasthepolicycoordinatorandregulator–establishing
a framework within which the government services,
theprivatesectorandNGOscanoperateefficiently.


Increasing public health expenditure and
staffing levels


Generally health expenditure is higher in richer
countries–bothasaproportionof GDPandof total
governmentexpenditure.Butnationalwealthisclearly


Figure IV-3 – Maternal mortality rates and number of deaths


Source: Staff calculations based on the United Nations MDG database.


Astudyof maternalmortalityrates in181countriespublishedinThe Lancet inApril2010indicated
thatsignificantprogresshadbeenmadetowardsMDG5.Between1980and2008,worldwidematernal
deathsfellbynearly35percent,from526,300to342,900.Globally,however,only23countriesareon
tracktoachievea75percentdecreaseinmaternalmortalityrateby2015.InAsiaandthePacificthe
progresshasbeenuneven.Anumberof countriesincludingChinahavemaderapidprogress,andinthe
Maldivesbetween1980and2008thedeclineintheratewas8.8percentperyear.


Neverthelessaccordingtotheseestimations,unlesstheycanaccelerateprogressitisclearthatmany
countries inAsiaandthePacificareunlikely toreachthe2015target.If thesamemethodologyof
classificationwereapplied to thedata fromthisstudy,of the41countries forwhich trenddataare
available,4wouldberegressingormakingnoprogress,32wouldbeslowandonly3wouldbeontrack
–though2wouldbeearlyachievers.


Threeoutof thesixcountriesthataccountedformorethan50percentof allmaternaldeathsin2008
wereinAsiaandthePacific.


Source: Hogan M. et al. (2010) “Maternal Mortality for 181 countries 1980 – 2008” in The Lancet, April 12.


box IV-1 – new estimates on maternal mortality


Asia-Pacific


South-East Asia


SouthAsia


Pacific Islands


NorthandCentralAsia


Asia-Pacific LDCs


LatinAmerica&Caribbean


Sub-Saharan Africa


Numberof
deaths(in
thousands),2005


236


34


187


1


2


55


15


272


0 100 200 300 400 500 600 700 800 900 1,000
Maternalmortalityratio,per100,000livebirths




29MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER IV: Improving health and other basic services


nottheonlyfactorsincewithinAsiaandthePacificthere
arewidedifferencesevenamong the leastdeveloped
countries.BhutanandCambodia,forexample,devote
morethan10percent ofgovernmentexpenditureto


health,whileothersmaydevote4percentorless.
Clearly,muchdependsontheprioritiesand


Low public investment in health combined with a
highincidenceof diseasemeansthattoofewstaff are
havingtocopewiththeexpandingneeds–resultingin
overcrowdedgovernmenthospitalswithlongqueues,
and extended waiting times for specific treatments.
Countries such as Bangladesh, Bhutan, Cambodia,
Indonesia, Lao PDR and Nepal still have limited
physicians,andskilledhealthpersonneltoattendbirths
(TableIV-3).InthePacific,thePhilippinesandSouth
Asia in particular, these shortages are exacerbated
by the emigration of skilled health workers to


developedcountries.


Neverthelesstheprioritymaynotonlybetoincrease
the number of doctors – who often gravitate
to urban areas. More immediate problems may
derive from shortages of nurses, paramedics or
skilled birth attendants. Ensuring that staff, and
particularlyfemalestaff,canworkinruralareasandin
difficult locations will therefore require appropriate
systemsof incentives.


Achieving universal health care
Morecountriesintheregionarenowconsideringways
of offeringuniversalhealthcare.Thiscanbeachieved
inavarietyof waysandinmultiplecombinations.The
mostbasicrequirementistoguaranteehealthtreatment
forthepoorestthroughdifferentformsof socialsafety
netthatcanbefundedentirelyoutof generaltaxation–
asinThailand’suniversalhealthcarescheme.


SouthandSouth-WestAsia
Bangladesh 3 18
Bhutan <0.5 51
India 6 47
Iran(IslamicRepublicof) 9 97
Nepal 2 19
Pakistan 8 39
SriLanka 6 99
Turkey 15 83
South-EastAsia
Cambodia 2 44
Indonesia 1 73
LaoPDR 3 20
Malaysia 7 100
Myanmar 4 57
Philippines 12 62
Singapore 15 100
Thailand 3 99
VietNam 6 88
EastandNorth-EastAsia
China 14 98
Japan 21 100
Mongolia 26 99
RepublicofKorea 17 100
Developedcountries
USA 27 99


Table IV-3 – Health personnel


Source: Staff calculations based on the United Nations MDG database.


Physiciansper
10,000population


%ofbirthsattended
byskilledpersonnel


commitmentofgovernments.




30 PATHS TO 2015


CHAPTER IV: Improving health and other basic services


At the same time countries can also move towards
universalhealthschemesthatarebasedatleastpartly
onthepoolingof riskacrossthepopulationthrough
thepurchaseof insurance.ThuswhilesomeEuropean
countriesprovidehealthcarebasedonresidencerights,
others have much more pluralistic delivery systems
basedonobligatoryhealthinsurance,withcontribution
ratesrelatedtosalariesorincomes,andusuallyfunded
byemployersandbeneficiariesjointly.


In Asia, some countries have attempted to provide
suchauniversalhealthscheme:


Public health insurance – In the more advanced
countrieswhereahighproportionof workersare in
the formal sector, users of health services can pool
risksthroughpublichealthinsurance.

Private health insurance – Even in countries with
basic universal provision people with high incomes
oftenprefer touse theprivatesector in thehopeof
getting faster or better quality care. Private schemes
are becoming more popular in Asia and the Pacific
– particularly among middle- and high-income
households. A variant on this is a public-private
partnershipwhere thegovernment subsidizesprivate
healthinsurancepremiumsforthepoor.


Community-based health insurance – Rather than
havinganationalsystemtherecanalsobecommunity-
based health insurance schemes in which premiums
for thepoormightbepaidby the localauthority. In
2009, the State Government of Tamil Nadu (India)
introduced the Insurance Scheme called “Chief
MinisterKalaignar’sInsuranceSchemeforLifeSaving
Treatments” for the poor and children. In the first
half of 2010,over88,000peoplehadbenefittedfrom
thisschemeandthestategovernmenthadreleaseda
sumof Rs2500millionasclaimamount.14Ontopof
insuranceandsubsidies,however,usersarestill likely
tobepayingforsomeservices,andparticularlydrugs,
fromout-of-pocketexpenditure.


China for example, in 2005 introduced aNewRural
Co-operative Medical Care System which by 2007
covered around80per centof the rural population.
Of theannualcostof 50yuan($7)perperson,20yuan
isprovidedbythecentralgovernment,20yuanbythe
provincialgovernmentand10yuancomesintheform
of apatientcontribution.


Universalcoverageforhealthcareisusuallyattainedin
countrieswherepublicinvestmentinhealthisatleast
5percentof GDP.In2007,17developingcountriesin
Asiawerespendinglessthanthis.WHOhassuggested
appropriate percentages for the Asia-Pacific region:
totalpublichealthexpenditureshouldbeatleast4per
centof GDP;forprivateexpenditure,itrecommends
that over 90 per cent of the population should be
covered by some form of prepayment; and out-of-
pocket spending should not exceed 40 per cent of
totalhealthexpenditure.15 Inaddition, thevulnerable
sections of the population should be provided with
healthsafetynets.


Oneestimatesuggeststhattheessentialinterventions
should cost about $34 per person per year.16 While
someof thiscancomefromgeneraltaxationitmight
also be possible to earmark some tax collection
for health to ensure that the funds are used for this
purpose.AssumingthattheAsianLDCscouldmobilize
about 5 per cent of per capita income for health
spending, thiswould amount to $25.7, leaving a gap
of $8.3perpersonperyear,oratotalof $2.4billion,
thatmightneedtobemetfromoverseasdevelopment
assistanceorsouth-southcooperationwithincountries
of theregion.

The2008Reportof theCommissiononAIDSinAsia
statedthatacomprehensiveresponsetoAIDSinthe
regionwould cost about $6.4 billion per year. But a
targetedresponsewhichcanhaltandreversethespread
of theHIVepidemicmightneedonly$3.1billion–an
investmentof $0.50to$1.00percapitaperyear.17


While increasing expenditure on public health
services governments will also want to minimize
costs,particularlyfordrugs,whichshouldasmuchas
possible come in cheaper generic forms. Some
countries like India have been able to develop
capability to produce highly affordable generic
drugs through adapting intellectual property right
regimesandpriceregulations.


Theresponsibilityfortheseandothermeasuresrests
with national governments, but they should also be
able to take advantage of regional cooperation. In
somecases, thismight involve transferring resources
fromricher topoorercountries,butcountriesacross
the region can also learn from one another through
theexchangeof bestpracticeswhichreducecostsand
improvedeliveryof healthservices.




31MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER IV: Improving health and other basic services


Endnotes


1 WHO,2009.
2 ESCAP(2010b).
3 ESCAP/ADB/UNDP,2005.
4 WanandFrancisco,2009.
5 Ravindra,2004.
6 IOM,2005.
7 WanandFrancisco,2009.
8 Governmentof India,2008.
9 ESCAP/ADB/UNDP,2005.
10UNICEFandWHO,2010.
11WHO,2009.
12UNDP(2010b).
13ESCAP/ADB/UNDP,2010.
14Seehttp://www.newkerala.com/news/fullnews-104256.html
15WHO,2010.
16JungandTran,2008.
17CommissiononAIDSinAsia,2008.


A new era for public services


Improvingpublic serviceswill thus require a greater
commitmentnotjusttospendmorebuttospendwisely
–toincreasebothefficiencyandequity.Thiswillmean
openingupservices toawider rangeof providers–
andtogreaterpublicparticipationandscrutiny.


However, another important constraint on service
provision, particularly in the rural areas, is the lack
of adequate infrastructure, particularly transport
communicationsandpowersupplies.Thefinalchapter
turnsthereforetothisoftenneglectedsubjectwhose
development underpins the achievement of the
MDGs.




32 PATHS TO 2015


CHAPTER V


TheMDGframeworkonlyhasafewindicatorsfor infrastructure – for water and sanitationwhicharepartof MDG7andforinformation
and communications technology in MDG8. It thus
tendstofocusondevelopmentoutcomesratherthan
onsomeof thebasicconditionsforachieving them.
Even when governments responded to the global
economic crisiswith stimulus packages that invested
in infrastructure they did not generally link these
specificallywiththeMDGs.


Economicanalysishasestablishedacloserelationship
between investment in infrastructure and economic
growthbuthasnotexamined the impactonpoverty
or other MDG outcomes. However the linkage has
beenexploredinanumberof empiricalstudies.One
worldwidestudy,forexample,showsthatgrowthand
investmentare associatedwith reductions inpoverty,
infantmortality,incomeinequality,illiteracyandwater
pollution.1Butthisandsimilarstudiesdonotprovethe
directionof causality.Does infrastructure investment
generate economic growth and reduce poverty or
do higher growth and lower poverty create a larger
resourcespaceforinfrastructureinvestment?2Itseems
likelythatthecausalityrunsbothways.


Indeed the linkage between the two is intuitive.
Although all infrastructure would in some way help
inachievingtheMDGs,someformsaremoredirectly
connected, and these may be considered as ‘basic’
infrastructure.Betterruralroadtransport,forexample,
should expand access to markets for marginal and
smallfarmersandthusreduceruralpoverty,whilealso
allowing better access to schools and health centres.
Better power supplies would mean that households
wouldnotneed to rely somuchonunhealthywood
burningstoves (BoxV-1).SimilarMDGbenefitscan


be expected from other forms of infrastructure, as
summarizedinTableV-1.


Whichinvestmentswillbethemoreeffective,however,
willdependon localcircumstances.For remote rural
areastheprioritymightberoadsortelecomservices,
while in urban areas it might be water supply and
sanitation.


It is, however, clear that there is huge room for
improvement. For many forms of infrastructure,
Asia and the Pacific as a whole lags behind Latin
America (Table V-2). Some 930 million Asians are
withoutelectricity,only3Asiansin10haveaccesstoa
telephone,andhalf theregion’sroadsareunpaved.3



Even within Asia and the Pacific there are marked
disparities. Among the subregions, North-East Asia
is the most advanced while the landlocked Central
Asian republics and the Pacific Island countries
are some way behind. In fact, the lack of physical
infrastructureisconsideredamajorimpedimenttothe
growth of Pacific economies, where there is a clear
needtoimprovetransportfacilitiesandmaritimeand
aviationinfrastructure.Themostadvanceddeveloping
countriesintheAsia-PacificregionaretheRepublicof
Korea,China, Indiaand the faster-growingcountries
inSouth-EastAsia.


But disparities are also evident within countries.
Transport development, for example, tends to be
moreadvancedincoastalareasthatareintegratedinto
regional production networks, and less extensive in
remoteregionsthatarehometoindigenousgroupsand
othermarginalized populations. Andmore generally,
services and MDG outcomes are typically better in
urbanareas.


Strengthening basic infrastructure


Achieving the MDGs in Asia and the Pacific will require stronger
basic infrastructure, particularly better road transport, water supplies,
sanitation, electricity, information technology, telecommunications
and urban low-income housing.




33MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER V: Strengthening basic infrastructure


box V-1 – Energy for All


1 Note: Energy for All uses the IEA 2009 data that show that 809 million Asians lack access to electricity. This report
cites ADB’s Asian Development Outlook 2009 figure of 930 million so we use that here for consistency.
2 See www.energyforall.info


Modernenergyisanessentialinputforachievingallof theMDGs,somuchsothatincreasingaccessto
affordable,reliableenergyisnowwidelyconsideredthe“missingMDG”.YetintheAsia-Pacificregion
alone,some930millionpeopledonothaveaccesstoelectricity,andnearlytwicethatnumberdepend
onburningbiomassforcookingandheating.1


ADB’sEnergyforAllInitiativeisdevelopingnewapproachesforscalingupaccesstoclean,modern
energyamongthepoor.Thisincludesimprovingthedeliveryof energyservicestodeprivedcommunities
throughADBinvestments,extendingpolicysupporttogovernmentstodesignandimplementuniversal
electrificationprograms,andbuildingcapacityandpromotingknowledgeexchangeamongawiderange
of practitioners.ADBisalsopursuingregionalcooperationthroughtheEnergyforAllPartnership,
amulti-stakeholderplatform launched in2009.2TheEnergy forAllPartnershipbrings together the
privatesector,financialinstitutions,governmentsandcivilsocietytoshareintelligenceandcollaborate
onprojects,withatarget toexpandaccesstomodernenergyto100millionpeople inAsiaandthe
Pacificby2015.


Therearenowmanyprovenmethodsforextendingmuch-neededenergyservicestothepoor.ADB’s
EnergyforAllisfocusedonreplicatingeffectivemodelsandscalingupexistinginitiatives.InVietNam,
for example, anADB-supported credit facilitywill build on the country’s ongoing domestic biogas
programandenableanadditional40,000householdstoaccesscleanercookingfuelfromhousehold
biogasdigesters.Accesstocleanerfuelssuchasbiogascanreducediseaseburdenandimprovematernal
and child health which are among theMDGs.Where appropriate, targeting investment to expand
existinginitiativescanhastenprogresstowardenergyforall.


MoreinformationonADB’sEnergyforAllInitiativecanbefoundat:
http://www.adb.org/Clean-Energy/energyforall-initiative.asp


MDGsimpacted
Directimpact:MDG1
Indirectimpact:MDGs2,3,4,5


Directimpact:MDG1
Indirectimpact:MDGs2,4,5


Directimpact:MDG1
Indirectimpact:MDG7


Directimpact:MDGs1,8
Indirectimpact:MDGs2,3


Directimpact:MDGs4,5,6,7
Indirectimpact:MDG3
Directimpact:MDGs3,4,5,6,7


Table V-1 – Positive impacts of basic infrastructure on the poor and MDGs


Source: Adapted from ADB/JBIC/World Bank, 2005.


Sector
Electricity


Roads


Urban
mass
transit
ICT


Water
supply
Sanitation


Directimpactonpoor
Mainlyforlighting,TV,and
radioatlowlevelsofincome
Appliancesforself-employment


Accesstoemploymentand
marketsAccesstoservices
(health,education)


Accesstoemployment
opportunities


Bettercommunicationaccess,
aidingmigration,information
onopportunities,accessto
knowledgeandpotential
engagementinwidercommunities
Improvedhealthoutcomes;time
savings;lowercosts
Improvedhealthoutcomes


Indirectimpactsonpoor
Reducedenergycostsforenterprises,
encouragingemploymentcreationImproved
healthandotherservices(refrigeration,
lighting,etc)ImprovedICTaccess
Reducedtransportcostsandimproved
marketaccessforenterprisesandservice
providers,loweringcostsofservingremote
communities
Employmentcreationfrommoreefficient
labourmarkets


Employmentcreationthroughimproved
knowledgeofmarkets,reduced
managementsupervisioncosts,access
towiderknowledgebase


Limited


Improvedhealthoutcomes(e.g.reduced
pollutionbynon-poorhouseholdsandothers)




34 PATHS TO 2015


CHAPTER V: Strengthening basic infrastructure


Mobilizing finance for basic
infrastructure investment


Meeting infrastructure gapswouldbe expensive.For
the period 2010-2020 it has been estimated that the
required investment would be $7.7 trillion, or about
$700billionperannum–58percentof whichwould
be inEastAsiaandthePacific,36percent inSouth
Asiaand6percentinCentralAsia.Of thetotal,two-
thirdswouldbefornewinfrastructureandthebalance
for replacing existing facilities. More than half the
investmentwouldberequiredforenergy,and30per
cent for roads (Table V-3). Considering that much
of the investments would be needed to meet large
existing gaps – such as providing electricity to over
22percenthouseholdsintheregioncurrentlywithout
accessorexpandingthepavedroadnetworksforrural
populations–of the$7.7trillion,asignificantproportion
would be for basic infrastructure for supporting the
MDGs.Acrucialtaskfacingpolicymakersistomake
infrastructureinvestmentmoreMDG-supporting.


The key challenge is to mobilize finance. In the
short term it should be possible to include essential
low-cost rural infrastructure projects in ongoing
fiscal stimuluspackages. If suchprojects are labour-
intensive they can also provide employment safety
nets.For thispurpose,poorercountriesmayhave to
rely more on grants or concessional financing from
ODA or multilateral development institutions. But
othercountrieswillbeable toaccesscapitalmarkets


andtapintoregionalsavings.Withcombinedforeign
exchangereservesof nearly$5trillion,theregioncould
now develop an ambitious architecture for mutually
beneficial deployment of foreign exchange reserves.
This architecture could include an infrastructure
developmentfund.4If itmobilizedjust5percentof
theregion’sreservesitwouldhavestart-upcapitalof
$250 billion. The fund could also borrow from the
region’scentralbanks.Byco-financingviableprojects
withothersourcessuchanarchitecturecouldexpedite
investment in infrastructure development, especially
cross-border connectivity projects linking poorer
parts of the Asia-Pacific region with the region’s
growthcentres.5


Stimulating the private sector


Overthepasttwodecades,morethan70percentof
Asia’s investment in infrastructure has come from
thepublic sector.Thepublic sectorwill stillneed to
shoulder the main responsibility for improving the
delivery of basic infrastructure for areas that are
commercially unviable. But with rapidly increasing
demandif theregionistotakealeapininfrastructure
spending for basic infrastructure more finance will
needtocomefromprivatesources.Privateinvestment
does not usually focus on the needs of the poor,
particularly in rural areas where perceived risks are
high.Evenpublic-privatepartnershipsarerareinrural
areas,thoughtherehavebeensomepromisingresults,


North-EastAsia 13.72 0.49 99.34 88.11 64.97 5.96 0.366 32.97
CentralAsia 16.48 2.55 … 88.66 95.31 2.31 0.003 …
SouthAsia 12.78 0.51 61.03 88.06 32.83 1.20 0.010 40.10
South-EastAsia 10.51 0.27 71.69 86.39 67.50 3.53 0.031 34.15
PacificIslands 3.69 … … 46.19 48.74 0.77 0.043 …
Asia-Pacific 12.83 0.53 77.71 87.72 52.05 3.47 0.154 35.73
Industrialized 207.10 … … 99.58 99.85 13.76 1.553 …
countries
OECD 211.68 5.21 99.80 99.63 99.94 13.87 1.608 …
LatinAmerica 14.32 2.46 92.70 91.37 78.26 6.11 0.150 25.35
Africa … 0.95 28.50 58.38 30.83 1.42 0.003 62.72


Table V-2 – Infrastructure comparators, Asia and Rest of the World, 2005


Note: Paved roads indicator is derived from the indicator on paved roads (as % of total roads) and total road network (km).
Source: World Development Indicators, United Nations MDG Database and World Energy Outlook 2009.


Urban
slum


population
(%)


Country
grouping


Paved
roads
(km/


10,000
people)


Railways
(route
km/


10,000
people)


Household
electrification


rate,
2008
(%)


Accessto
improved


water
sources


(%oftotal)


Accessto
improved
sanitation


(%of
total)


Mobileand
telephone


subscribers
(per100
people)


Broadband
internet


subscribers
(per100
people)




35MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER V: Strengthening basic infrastructure


forexampleforfinancingmicro-andmini-hydropower
projects. Although the chief benefit of expanding
private sector involvement in infrastructure is likely
to be to releasemore public-sector funds forMDG
achievement, attempts to create more public-private
partnershipsinpromisingareasof basicinfrastructure
shouldcontinue.


Forthistohappen,itwillalsobeimportanttostimulate
the interest of the private sector by developing
appropriateregulatoryframeworks.Governmentsmay
alsoofferfiscalandotherincentivestoprivate-sector
investors, while multilateral development institutions
can help steer governments and private investors
through the difficult commercial and cost-sharing
negotiationsforpublic-privatepartnerships.Managing
thedebtcomponentof theseprojectscanbenefitfrom
swaparrangementstoalleviateforeignexchangerisk.


Raising standards of quality and
maintenance


Just as important as the extent of infrastructure is
its quality. Except for railways, Asia also lags in this
respect.Arecentstudy,basedontheWorldEconomic
Forum’s business survey, which rates infrastructure
giving amaximum score of 7 points, foundAsia to
be 1.9 points behind the G7 countries (Table V-4).
Asia’sweakestperformanceis inelectricityforwhich
itisfurthestbehindtheglobalaverage.AmongAsia’s
sub-regions, East Asia ranks the highest and South
Asia the lowest.Nevertheless, some countries in the
regionperformwell.Singapore’sratingsforportsand
airtransport,forexample,areclosetothemaximum
scoreof 7.6


The quality of infrastructure is also affected by the
commitment to repairs and maintenance. Older
infrastructure may decay and eventually fall into
disuse – and will be particularly vulnerable at times
of disaster. This is usually because governments are
more interested in building new infrastructure, for
whichtheycanclaimcredit,thaninmaintainingassets
createdbyprevious administrations.Moreover,while
new major infrastructure is typically created by the
centralgovernment,thetaskof maintenancegenerally
fallstolocaladministrationswhichhavefewerfinancial
orhumanresourcestofulfilthisresponsibility.High-
quality infrastructure does not necessarily require
sophisticated technology; more important is that it
shouldbesimpletomaintain.


Low-quality infrastructure will disproportionately
affectthepoor,whoare,forexample,themainvictims
of fatalitiesoccurringonpoorqualityroads.Also,there
isavastgapinqualitybetweenurbanandruralareas
–andtheresultingqualityof socialservices,including
watersupply,educationandhealth.Asaconsequence,
progressontheMDGshasslowedinruralareas.


Inmanycountries,mostof infrastructureinvestment
relatedtotheMDGsislikelytocomefromthepublic
sector.Butthiscanonlybeeffectiveif itisaccompanied
by reforms in governance and also by efforts to
increase capacity, especially in local government in
countriesthathaveachievedextensivedecentralization.
Anotherpriorityisfightingcorruption.Governments
canincreasetransparencybyusingcompetitivebidding
rules, widely publicizing project information, using
automatede-billingsystems,andsubjectingprojectsto
randomqualitychecks.Theywillalsoneedtoimprove
qualification and certification in the construction
industryandenforceregulationsmorestrictly.


Table V-3 – Asia’s Infrastructure Investment needs 2010-2020 (uS$ millions, 2008)


Source: Derived from ADBI/ADB, 2009.


Sector/Subsector New Capacity Replacement Total


Energe (Electricity) 3,176,437 912,202 4,088,639
Telecommunnications 325,353 730,304 1,055,657
Mobilephones 181,763 509,151 690,914
Landlines 143,590 221,153 364,743
Transport 1,704,858 674,313 2,378,161
Railways 2,692 35,947 38,639
Roads 1,702,166 638,366 2,340,532
Water and Sanitation 155,493 225,797 381,290
Sanitation 107,925 119,573 227,498
Water 47,568 106,224 153,792
Total 5,162,131 2,542,616 7,704,747




3 PATHS TO 2015


CHAPTER V: Strengthening basic infrastructure


Oneof thebestwaysof improvingqualityistoactively
involvelocalcommunities,andparticularlywomen.At
thehouseholdandcommunitylevel,womenoftenplay
aprimaryroleinmanagingenergyandwateruse.Their
participation in the development, implementation
and maintenance of infrastructure is more likely to
lead to sustainable solutions.7When local people are
engaged in planning water systems and other basic
infrastructure they can not only contribute inputs in
theformof labourorbuildingmaterialsbutalsofeel
greaterownershipandbecommittedtomaintenance.
Theycanalsoparticipateinappraisalsandauditsand
incollectingfeesandcharges.Insomecases,thiscan
beaccompaniedbyincreasinginvolvementof NGOs
– in such areas as developing water supplies, solid
wastedisposal, and school andhealth facilities.With
relatively lowoverheadsNGOsmaybeable towork
atlowercosts.


Infrastructure investment decisions also need to be
well coordinated – for example, planning rural road
networksalongwithmainarterialroads.Thiswillalso
mean investing simultaneously inbothhardware and


software–ensuring,forexample,thatawatersupply
facility will subsequently have operating staff. This
may be achieved through investment coordination
boards–whichcanalsoensurethatroadprojectsallow
adequately formaintenancecosts, and that electricity
schemesbuildmaintenancecostsintopowertariffs.


In order to track progress, it will be important to
establish appropriate indicators. Most of those
commonly used, such as the percentage of the
populationwithaccesstosafewater,measureoutcomes.
Trackinginvestment,however,willneedmoreandbetter
indicatorsof outputs, such as the lengthof water and
drainagepipesinstalled.


building greener infrastructure


It will also be important for future investment in
basic infrastructure to pay much closer attention to
the environmental impact – and the implications of
climatechange.FortheMDGsitwillbeimportant,for
example,toimprovepowersupplies,particularlyinthe


Regionorcountry Overallinfrastructure Roads Electricitysupply
Worldaverage 3.8 3.8 4.6
G7countriesaverage 5.7 5.7 6.4
AsiaAverage 3.8 3.7 4.1
CentralAsiaaverage 3.5 3.1 3.6
Azerbaijan 3.9 3.7 3.9
Georgia 3.2 3.5 4.4
Kazakhstan 3.5 2.5 4.3
Tajikistan 3.2 2.6 1.7
EastAsiaaverage 4.6 4.7 5.3
China,People’sRep.of 3.9 4.1 4.7
HongKong,China(SAR) 6.3 6.4 6.7
Korea,Rep.of 5.6 5.8 6.2
Mongolia 1.7 1.4 2.9
Taipei,China 5.5 5.6 5.9
SouthAsiaaverage 2.9 3.1 2.8
Bangladesh 2.2 2.8 1.9
India 2.9 2.9 3.2
Nepal 1.9 1.9 1.7
Pakistan 3.1 3.5 2.5
South-EastAsiaaverage 4.2 4.2 4.7
BruneiDarussalam 4.7 5.1 5.4
Cambodia 3.1 3.1 2.5
Indonesia 2.8 2.5 3.9
Malaysia 5.6 5.7 5.8
Philippines 2.9 2.8 4.2
Singapore 6.7 6.6 6.7
Thailand 4.8 5.0 5.5
VietNam 2.7 2.6 3.2


Table V-4 – Infrastructure quality in Asia, rated from 0-


Source: ADBI/ADB, 2009.




3MDG PRIORITIES In ASIA AnD THE PACIFIC


CHAPTER V: Strengthening basic infrastructure


ruralareas.Thiscanbringbenefitsnotjusttothelocal
economybutalsoforhealthandtheenvironmentby
reducingtheuseof woodburningstoves.Nevertheless
somepowersources,suchaslargehydropowerprojects,
have often had serious consequences both for the
environmentandforlocalcommunities.


Other formsof infrastructure canhave lessobvious
environmental implications.Thuspipedwater supply
inurbanareaswillhavetheenvironmentalbenefitof
reducinggroundwaterextractionbutwouldalsorequire
betterwastewatertreatmentasgreaterwaterflowsadd
topollutionthroughdrainagesystems.


More attention must be given to services that
maximize equitable socio-economic benefits, while
minimizing environmental impacts and the use of
resources. Governments will want to enhance the
complementarities between basic infrastructure
investmentandenvironmentalprotectionandminimize
the conflicts. Investment in low-incomehousing, for
example,willnotbeagreeninitiativewithoutadequate
watersuppliesandsanitation.Infact,therearemany
promisinggreenoptions.Forexample,publictransport
systemsthatarewellplannedandintegratedwithnon-
motorized transport can reduce costs for the urban
poorwhileestablishingcitiesontrajectoriesof green
growth.Thiswillalsomeanpromotingtheuseof green
energyandtechnologyalongwithenergyconservation
anddemandmanagement.


Extending regional infrastructure


While themost immediate gains for theMDGs are
likely to come from better infrastructure at national
levelstherearealsohugeopportunitiesforimproving
infrastructure at regional and subregional levels.
A study by ADB and ADBI has concluded that
completing regional connectivity in energy, transport
andtelecommunicationswouldboostAsia’snetincome
by$13trillionovertheperiod2010-2020andbeyond.8


Forpoor communities someof themost immediate
benefits of better connectivity will be degrees of
cross-national integration between neighbouring
border areas which in their respective countries are
often amongst themore remote andpoorer regions.
Adjacent areas of Thailand, Indonesia andMalaysia,
forexample,havebecomepartof a‘growthtriangle’.
Brunei Darussalam, Indonesia, Malaysia and the
PhilippineshavealsoformedanEastASEANGrowth
Area. Recently there has also been an attempt to
create a new growth triangle betweenEastern India,
Nepal, Bhutan and Bangladesh. Regional transport
infrastructure has also been developed in the form


of anEastWest Economic Corridor in theGreater
Mekongsubregionaswellasthrougharoadthatlinks
ChinawithKazakhstan,KyrgyzstanandUzbekistan.

It is also important however, that the physical links
betweencountriesareaccompaniedbyharmonization
of standards such as railway signalling systems or
customs codes. All these would contribute to faster
poverty reduction and progress on theMDGs.One
modelforKyrgyzstan,forexample,showsthatregional
cooperation on integration projects for transport,
transitandfacilitationwouldnearlydoubletheincomes
of thepoor.9



Attheregionallevel,governmentsshouldpressahead
withagreementsforpan-Asianconnectivity–through,
forexample,anAsianInfrastructureFundandother
aspectsof aregionalfinancialarchitecture,andapan-
AsianInfrastructureForumforsharingtheexperience
with cross-border projects. Cooperation between
countriesinexchangingknowledgeandbestpractices
can also play an important role in helping expand
accesstobasicinfrastructure.


Tilting the balance


Inrecentyearscountriesacrosstheregionhavemade
some progress in building new infrastructure. Seen
throughanMDGlens,however,theresultscanatbest
beconsideredpatchy–withfuturisticnewairportsand
smartprivatehospitalsononesideandpotholedrural
roadsandcrumblingvillagehealthclinicsontheother.
Thechallengenowistochangethecriteriaof success–
toachievehigherstandardsof basicinfrastructurethat
canunderpintheMillenniumDevelopmentGoals.

AstheMDGtargetdateof 2015approaches,itseems
likely that thepictureacrossAsiaand thePacific for
theGoals themselves is also likelybemixed– some
disappointingfailures,somenarrowmisses,andsome
strikingsuccesses.But the finalMDGstory isyet to
betold.Allcountriesstillhavefiveyearstochoosethe
mostpromisingpaths–andtiltthebalancedecisively
onthesideof success.


Endnotes


1 Thomas,2001.
2 Chatterjeeetal.,2004.
3 ADB,2009.
4 ESCAP(2010a),ESCAP(2010b);ADBI/ADB,2009.
5 ESCAP(2010a),ESCAP(2010b).
6 AlsoseeESCAP(2010a)foracompositeindexof
infrastructuredevelopment.
7 ADB/JBIC/WorldBank,2005.
8 ADBI/ADB,2009.
9 ADBI/ADB,2009.




38 PATHS TO 2015


Comparison of Asia and the Pacific
with other developing regions


The Asia-Pacific region as a whole has made more
progressthanSub-SaharanAfricabut less thanLatin
AmericaandtheCaribbean.Thecomparisonbetween
these three global regions is encapsulated in Figure
A-1forsixindicators.Inthesecharts,thesizeof the
bubbles is in proportion to the population currently
affected (on a logarithmic scale). The sloping line
divideseachchartintotwoparts:if thebubbleisabove
the line,since1990thevalueson that indicatorhave
increased; below the line they have decreased. The
colours correspond to those of the on- or off-track
progresssymbols.


Theremainderof thisappendixdiscussesforsomekey
indicatorswhereprogresssofarhasfallenshortforthe
targetstobemetby2015,andwhatisrequiredinterms
of deviationfromcurrenttrendstostilldoso.Itthen
provides estimates on the extent of reduced human
suffering resulting from theacceleratedprogress and
theachievementof thegoals.


Achievements in $1.25/day poverty


FigureA-2 illustrates the differences in the progress
amongcountriesinreducingextremeincomepoverty.
The arrows represent the percentage of population
livingbelow$1.25(PPP)perdayinthelatestyearfor
which data are available. The other end of the line
represents the data point for the earliest year since
1990.Dataontheseandotherindicatorsareprovided
inTablesA-6throughA-13inthisappendix.


Intheearly1990s,everysixtosevenoutof 10persons
inChina,Turkmenistan,VietNam,Pakistan,Bangladesh
and Nepal were living on less than $1.25 per day.
Whereasthefirstfourof thesecountriesmanagedto
reducetheprevalenceof povertytofewerthansixto
seven out of 10 persons, and have in themeantime
reachedthepovertyreductiontarget,Bangladeshand
Nepalprogressedmuchslowerandstillhavepoverty
ratesof around50percent.Ontheotherhand,countries
such as the Philippines, India and Lao PDR had
somewhatlowerpovertyratesintheearly1990s,have
madeevenslowerprogress.Thusextremepoverty in
thesecountriesremainsprevalent.Whereasatthesame


time,inanumberof CentralAsiancountriessuchas
GeorgiaandUzbekistanpovertyratesactuallyincreased.


ThegreatestchallengeisforUzbekistan,whichneeds
toreducepovertyby2.5percentagepointsperyearto
reach the target; this rate is lower than thehistorical
rateachievedbysixof the11earlyachieversandon
trackcountries.


Table A-1 also illustrates the scale of opportunity
to reduce human deprivation if currently off track
countries still manage to hit the target. On present
trends, the currently off track countries would be
hometo577millionpoorin2015.Thisfigurewould
be reduced by 163 million (or 28 per cent) if the
countriesmanagetoaccelerateprogresstotherequired
rate of progress (including reversing the trend for
the regressing countries). The contribution of 131
million to this reduction in regional total by India is
particularlynotable.


Achievements in primary enrolment


There were only four countries (out of the 32 with
data) in the early 1990s with net primary enrolment
rates of less than 70 per cent: Bhutan, Pakistan,
Solomon Islands and Timor-Leste; the progress on
currenttrendsof eachof thesecountriesistooslow
for the target to be reached by 2015. Perhaps even
moreworryingisthesituationintheMarshallIslands,
whichsawprimaryenrolmentratesregressfromwell
over80percenttobelow70percent.


ThesePacificIslandcountries,togetherwithPakistan,
face thegreatest challenge to stillmeet the targetby
2015,havingtoincreaseprimaryenrolmentbyatleast
threepercentagepointsperyear.


Oncurrent trends, almost 17million children inoff
trackcountrieswouldnotbeattendingschoolin2015;
thisnumberwouldbereducedtoalmostfourmillion,
a difference of 13million if the off track countries
manage to hit the target by 2015. The payoff of
Pakistan reaching the target would be tremendous.
Onpresenttrends,thecountrywouldhaveoverseven
millionchildrenoutof school in2015.Thisnumber
wouldbereducedby5.6millionif Pakistanisableto
achievethetarget.


Statistical appendix




39MDG PRIORITIES In ASIA AnD THE PACIFIC


STATISTICAl APPEnDIx


Figure A-1 – Asia and the Pacific compared with Sub-Saharan Africa and
latin America and the Caribbean


Source: Staff calculations based on the United Nations MDG database




40 PATHS TO 2015


STATISTICAl APPEnDIx


Figure A-2 – Progress in reducing extreme income poverty


Source: Staff calculations based on the United Nations MDG database


India 450,986 -1.69 319,665
Uzbekistan 22,834 -2.52 4,728
Bangladesh 65,359 -1.62 58,523
Georgia 2,207 -1.12 92
Philippines 17,055 -0.81 15,616
SriLanka 2,804 -0.50 1,587
Turkey 2,405 -0.07 1,599
Nepal 11,699 -1.90 11,116
LaoPDR 2,090 -1.24 1,957
Total 577,439 414,883


Table A-1 – Progress required for off-track countries to meet the $1.25/day poverty target


Source: Staff calculations based on the United Nations MDG database


Affectedpopulationin
2015oncurrenttrend


(thousands)Country


Affectedpopulationin
2015iftargetreached


(thousands)


Averageannualchange
neededtoreachtarget


(points)


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Malaysia
Turkey


RussianFederation
Iran(IslamicRep.of)


Kazakhstan
Georgia
Thailand
SriLanka
Azerbaijan
Armenia


Kyrgyzstan
Mongolia


Philippines
Uzbekistan
Tajikistan
Cambodia


India


LaoPDR
China


Turkmenistan
VietNam
Pakistan


Bangladesh
Nepal


0 10 20 30 40 50 60 70
Percentageofpopulationbelow$1.25perday(%)


Earlyachiever Slow Regressing/Noprogress
| Target


Timor-Leste


On-track




41MDG PRIORITIES In ASIA AnD THE PACIFIC


STATISTICAl APPEnDIx


Source: Staff calculations based on the United Nations MDG database


Achievements in basic sanitation


Thedifficulty that theAsia-Pacific regionasawhole
and – with the exception of South-East Asia – the
subregions within it have to reach the target for
sustainableaccesstobasicsanitationismirroredatthe
country level, as illustrated inFigureA-4.Thefigure
showsthatinagroupof 18countries–amongthe48
countries forwhich data is available – less than one
in two persons had access to basic sanitation in the
early1990s.Onlyfourof thesecountrieshaveeither
reached the target – Viet Nam and Myanmar – or
areontracktodoso–LaoPDRandTimor-Leste.It


shouldbenotedthat in the last twocountriesaccess
stoodataround50percent,whichislow.Allinall,30
countriesintheregionareoff trackonthistarget.


TableA-3indicateswhat isrequiredof theoff track
countries to still reach the basic sanitation target by
2015,andwhatthiswouldmeanintermsof reduced
deprivation. In order to reach the target, countries
suchasIndia,Afghanistan,Nepal,PapuaNewGuinea,
Cambodia, Azerbaijan, Mongolia and Micronesia
wouldhavetoreducetheproportionof thepopulation
without access to basic sanitation by aminimumof
3.5percentagepoints per year. In the caseof India,


Figure A-3 – Progress in expanding access to primary education


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Bhutan
Pakistan


SolomonIslands


LaoPDR
Macao,China


Cambodia
India


MarshallIslands
Tonga


Azerbaijan
Turkey


Bangladesh
Vanuatu
Georgia


Iran(IslamicRep.of)
Armenia


BruneiDarussalam
Samoa


Kyrgyzstan
Kazakhstan
Philippines
Mongolia
Tajikistan


HongKong,China
Indonesia
Malaysia
Maldives


RepublicofKorea
Fiji


Kiribati
SriLanka


0 20 40 60 80 100
Netenrolmentratioinprimaryeducation(%)


Earlyachiever O Slow Regressing/Noprogress
| Target


Timor-Leste


n-track




42 PATHS TO 2015


STATISTICAl APPEnDIx


Table A-2 – Progress required for off-track countries to meet the primary enrolment target


Source: Staff calculations based on the United Nations MDG database


Bangladesh 7,030 1.36 985
Pakistan 7,067 4.13 1,430
Philippines 1,830 0.41 741
LaoPDR 163 1.80 46
Cambodia 164 0.91 111
Turkey 491 0.04 456
Kyrgyzstan 55 0.57 27
Fiji 34 0.79 6
Timor-Leste 35 2.53 13
SolomonIslands 26 3.50 5
Armenia 15 0.26 11
Macao,China 2 1.25 1
Bhutan 6 1.10 6
MarshallIslands 0 3.56 0
Total 16,918 3,838


Affectedpopulationin
2015oncurrenttrend


(thousands)Country


Affectedpopulationin
2015iftargetreached


(thousands)


Averageannualchange
neededtoreachtarget


(points)


thiswouldmeanthat284millionmorepeoplewould
have access than if current trendswere to continue.
InAsia and thePacific as awhole 1.2 billionwould
remainwithoutaccessin2015,ratherthan1.7billion
oncurrenttrends,adifferenceof 516million.


number of people affected if
targets are reached


Table A-4 provides a summary of the estimated
deprived population in the above two scenarios –
current trends continue for the off-track countries
so the targetswill bemissed in 2015, or progress is
accelerated and these off-track countries reach the
targetin2015.Ascanbeseen,asmanyas892million
people in the Asian-Pacific region are projected to
remain in extreme income poverty if current trends
continue, including both countries that have made
progressand reached the target aswell as those that
are off track. Accelerated progress in the off track
countriesalonewouldreducethepovertyratesinthese
countriesbyasmuchas28percent,orasmuchas18
percentof allthepoorintheentireregion,compared
to the scenario of business as usual. Similarly, if
acceleratedprogresstakesplaceinexpandingprimary
enrolment in the off track countries, asmany as 13
million additional children in these countries would
have access to primary education, about half of the
childrenwhowouldremainoutof schoolinthewhole
regionif currenttrendscontinue.


Impact of the global economic
slowdown


As shown so far, unless accelerated progress takes
place,quiteanumberof countrieswillmissthetarget
in2015.Thegeneralviewisthatthechallengetoreach
thetargetsinthesecountrieshasbeencompoundedby
theglobaleconomiccrisis thatstarted in2008.Since
themostrecentyearforwhichdataareavailableinthe
globalMDG database is 2008, it is only possible to
project the likely impactof the economic slowdown
on the progress towards achieving theMDGs. Such
projections,however,havetheirowndifficulties.Chief
among such difficulties is an accurate understanding
of the determinants, including economic growth, of
thevariousMDGs.Humandevelopmentoutcomesare
influencedbyawiderangeof factors,includinginitial
socialandgeographicalconditions,policyinterventions
and,indeed,economicgrowth.


Despite such constraints, it is possible to explore
howprogresstowardsachievingtheMDGsmightbe
differentinthecontextof theglobaleconomiccrisis.
To the extent that economic growth can create
the necessary conditions for achieving the human
development outcomes, such projections can provide
anindicationof howtheprogresstowardsvariousgoals
mightbeimpacted.




43MDG PRIORITIES In ASIA AnD THE PACIFIC


STATISTICAl APPEnDIx


Figure A-4 –Progress in expanding access to basic sanitation


Source: Staff calculations based on the United Nations MDG database.


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Cambodia
Nepal
India


LaoPDR
Kiribati


Pakistan
Afghanistan


Micronesia(F.S.)
SolomonIslands


Indonesia
Bangladesh


Vanuatu
VietNam


China
PapuaNewGuinea


Myanmar
Mongolia


Azerbaijan
Philippines
DPRKorea


Bhutan
MarshallIslands


Maldives
Palau


SriLanka
Thailand
Tuvalu


Iran(IslamicRep.of)
Malaysia


NorthernMarianaI.
Turkey


Uzbekistan
RussianFederation


Armenia
Tajikistan


Kyrgyzstan
CookIslands


Georgia
Kazakhstan


Tonga
FrenchPolynesia


Turkmenistan
Samoa
Guam


Singapore
RepublicofKorea


Niue


0 20 40 60 80 100


Earlyachiever Slow Regressing/Noprogress
| Target


Timor-Leste


Proportionofthepopulationusingimprovedsanitationfacilities(%)


On-track




44 PATHS TO 2015


STATISTICAl APPEnDIx


Source: Staff calculations based on the United Nations MDG database.


Table A-4 – Summary of estimated population in deprivation, alternative scenarios, thousands


Note: * Cumulative number of deaths from 2009 to 2015.
Source: Staff calculations based on the United Nations MDG database.


Table A-3 – Progress required for off-track countries to meet the basic sanitation target


India 814,909 4.00 530,619
China 550,279 2.21 411,819
Pakistan 99,607 2.71 73,981
Indonesia 97,999 2.07 81,804
Bangladesh 68,900 2.00 57,822
RussianFederation 17,938 0.93 8,969
Afghanistan 19,995 3.93 12,157
Iran(IslamicRep.of) 13,507 0.57 6,754
DPRKorea 10,004 1.37 5,002
Nepal 18,099 3.50 14,464
PapuaNewGuinea 4,256 4.07 2,035
Cambodia 9,585 3.64 7,443
Azerbaijan 4,083 4.79 2,027
Mongolia 1,426 3.50 728
Turkey 6,689 0.29 6,397
Kyrgyzstan 411 0.50 206
SolomonIslands 395 3.30 209
Georgia 234 0.43 82
Armenia 294 0.57 188
Bhutan 249 2.29 146
Kazakhstan 408 0.14 326
Turkmenistan 110 0.14 55
Micronesia(F.S.) 88 3.95 40
Vanuatu 107 2.21 90
FrenchPolynesia 6 0.14 3
Tonga 4 0.29 2
Guam 2 0.07 1
Kiribati 0 2.80 0
MarshallIslands 0 1.29 0
Tuvalu 0 0.86 0
Total 1,739,584 1,223,369


Affectedpopulationin
2015oncurrenttrend


(thousands)Country


Affectedpopulationin
2015iftargetreached


(thousands)


Averageannualchange
neededtoreachtarget
(percentagepoints)


$1.25perdaypoverty 577,439 414,883 892,170
Underweightchildren 73,952 47,206 85,260
Primaryenrolment 16,918 3,838 26,556
Under-5mortality* 22,862 17,934 24,873
Skilledbirthattendance 20,157 7,305 20,806
Basicsanitation 1,739,584 1,223,369 1,786,637


Affectedpopulationin
2015oncurrenttrend


Off-trackcountries TotalAsia-Pacific


Indicator
Affectedpopulationin
2015oncurrenttrend


Affectedpopulationin
2015iftargetreached




45MDG PRIORITIES In ASIA AnD THE PACIFIC


STATISTICAl APPEnDIx


TableA-5summarizestheadditionalnumberof people
estimatedtobeindeprivationindevelopingcountries
in Asia and the Pacific in 2015 due to economic
slowdown.Theestimationwascarriedoutintwosteps.
Inthefirststep,thestatisticalrelationshipbetweeneach
of theindicatorsandGDPgrowthwasestimatedon
thebasisof developmentsthusfar.TheInternational
MonetaryFund (IMF) regularly provides projections
of anumberof economicindicators,includingGDP
growth,fortheworld.


ItsforecastspublishedinApril2008wereconsidered
to pre-date the global economic crisis. The most
recentupdateof suchforecastswasinApril2010.The
difference in the projected GDP for 2015 between
the two updates was considered as the impact of
the economic crisis. Thus in the second step, this
difference and the estimated statistical relationship
between GDP growth and development indicators
werecombinedtoarriveattheprojectedimpactof the
economicslowdownontheprogressasmeasuredby
theindicator.


Twopoints standoutwith regard to theseestimates.
First,theyarerelativelysmallincomparisontonumber
of estimated deprived population for the region if
current trends continue, as shown inTableA-5.For
instance,morethan892millionpeopleareestimated


toremaininextremeincomepovertyinAsiaandthe
Pacific in 2015 in the scenario of business as usual
and no accelerated progress takes place. In contrast,
theeconomicslowdownisestimatedtotrap35million
people in extreme income poverty, which is not
insignificant but relatively small. This number is just
one-fourth of the number of people who could be
liftedoutof povertyinthecurrentlyoff-trackcountries
if measures are taken and their countriesmanage to
achievethetargetin2015.


Second,theIMF’smostrecentforecastssuggestthat
quiteanumberof countriesintheregionwillescape
theeconomicslowdownorthattheslowdownisnot
asdeepasoriginallythought.Forinstance,of the41
countries for which GDP growth estimates are
available,for12themostrecentprojections(April2010)
for2008-2015areactuallyhigherthantheApril2008
projections. For 29 countries, the projections were
revisedupcomparedtothose inOctober2009.This
ispartlythereasonfortherelativelysmallnumberof
affectedpeopleduetotheeconomiccrisis.


Theseresultssuggestthatmuchcanbegainedinthe
region in reducing human deprivation if effective
policiesandprogrammesareputinplacesoastospeed
uptheprogressinreachingthevariousMDGtargets.


$1.25perdaypoverty 34,555
Underweightchildren 887
Under-5mortality* 1,352
Skilledbirthattendance 1,730
Basicsanitation 70,218


Table A-5 – number of people projected to be in deprivation in 2015


Note: * Commutative number of deaths from 2009 to 2015.
Source: Staff calculations based on the United Nations MDG database.


Additionalnumberofpeopleestimated
tobeindeprivationdue


toeconomicslowdown(thousands)Indicator




4 PATHS TO 2015


STATISTICAl APPEnDIx


Table A- – Goal 1: Eradicate extreme poverty and hunger


Note: The number in parenthesis is the year of the data point.
Source: United Nations MDG database.


Selected MDG Indicators


$1.25 per day poverty
(%)


Earliest Latest


Underweight children
(% under age 5)


Earliest Latest
East and North-East Asia
China
HongKong,China
Macao,China
DPRKorea
RepublicofKorea
Mongolia

South-East Asia
BruneiDarussalam
Cambodia
Indonesia
LaoPDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
VietNam

South and South-West Asia
Afghanistan
Bangladesh
Bhutan
India
Iran(IslamicRep.of)
Maldives
Nepal
Pakistan
SriLanka
Turkey

NorthandCentralAsia
Armenia
Azerbaijan
Georgia
Kazakhstan
Kyrgyzstan
RussianFederation
Tajikistan
Turkmenistan
Uzbekistan

Pacific
AmericanSamoa
CookIslands
Fiji
FrenchPolynesia
Guam
Kiribati
MarshallIslands
Micronesia(F.S.)
Nauru
NewCaledonia
Niue
NorthernMarianaI.
Palau
PapuaNewGuinea
Samoa
SolomonIslands
Tonga
Tuvalu
Vanuatu


60.2 (90)
...
...
...
...
18.8 (95)


...
48.6 (94)
21.4 (05)
55.7 (92)
2.0 (92)
...
30.7 (91)
...
5.5 (92)
52.9 (01)
63.7 (93)


...
66.8 (92)
...
49.4 (94)
3.9 (90)
...
68.4 (96)
64.7 (91)
15.0 (91)
2.1 (94)


17.5 (96)
15.6 (95)
4.5 (96)
4.2 (93)
18.6 (93)
2.8 (93)
44.5 (99)
63.5 (93)
32.1 (98)


...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...


15.9 (05)
...
...
...
...
2.2 (08)


...
25.8 (07)
29.4 (07)
44.0 (02)
2.0 (04)
...
22.6 (06)
...
2.0 (04)
37.2 (07)
21.5 (06)


...
49.6 (05)
26.2 (03)
41.6 (05)
2.0 (05)
...
55.1 (04)
22.6 (05)
14.0 (02)
2.6 (06)


3.7 (07)
2.0 (05)
13.4 (05)
2.0 (07)
3.4 (07)
2.0 (07)
21.5 (04)
24.8 (98)
46.3 (03)


...
...
...
...
...
...
...
...
...
...
...
...
...
35.8 (96)
...
...
...
...
...


19.1 (90)
...
...
60.0 (98)
...
12.3 (92)


...
39.8 (93)
34.0 (95)
44.0 (93)
23.3 (93)
32.4 (90)
33.5 (90)
...
18.6 (93)
42.6 (02)
44.9 (94)


48.0 (97)
67.4 (92)
...
53.4 (93)
15.7 (95)
38.9 (94)
48.7 (95)
40.4 (91)
37.7 (93)
10.4 (93)


3.9 (98)
10.1 (96)
3.1 (99)
8.3 (95)
11.0 (97)
...
17.4 (05)
12.0 (00)
18.8 (96)


...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...
...


6.9 (05)
...
...
23.4 (04)
...
6.3 (05)


...
35.6 (05)
28.2 (03)
37.1 (06)
8.1 (05)
31.8 (03)
27.6 (03)
3.4 (00)
9.3 (05)
48.6 (07)
20.2 (06)


39.3 (04)
46.3 (07)
18.7 (99)
47.8 (05)
5.2 (04)
30.4 (01)
45.0 (06)
37.8 (02)
29.4 (00)
2.8 (08)


4.0 (05)
9.5 (06)
2.1 (05)
4.0 (06)
3.4 (06)
3.0 (95)
17.6 (07)
11.0 (05)
5.1 (06)


...
10.0 (97)
7.9 (93)
...
...
13.0 (99)
...
15.0 (97)
...
...
...
...
...
26.4 (05)
...
...
...
...
15.9 (07)




4MDG PRIORITIES In ASIA AnD THE PACIFIC


STATISTICAl APPEnDIx


Table A- – Goal 2: Achieve universal primary education


Note: The number in parenthesis is the year of the data point.
Source: United Nations MDG database.


Primaryenrolmentratio
(%)


Earliest Latest


Reaching last grade
(%)


Earliest Latest
East and North-East Asia
China
HongKong,China
Macao,China
DPRKorea
RepublicofKorea
Mongolia

South-East Asia
BruneiDarussalam
Cambodia
Indonesia
LaoPDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
VietNam

South and South-West Asia
Afghanistan
Bangladesh
Bhutan
India
Iran(IslamicRep.of)
Maldives
Nepal
Pakistan
SriLanka
Turkey

NorthandCentralAsia
Armenia
Azerbaijan
Georgia
Kazakhstan
Kyrgyzstan
RussianFederation
Tajikistan
Turkmenistan
Uzbekistan

Pacific
AmericanSamoa
CookIslands
Fiji
FrenchPolynesia
Guam
Kiribati
MarshallIslands
Micronesia(F.S.)
Nauru
NewCaledonia
Niue
NorthernMarianaI.
Palau
PapuaNewGuinea
Samoa
SolomonIslands
Tonga
Tuvalu
Vanuatu


...
97.5 (01)
81.1 (91)
...
98.3 (99)
95.7 (99)


93.4 (91)
83.4 (99)
97.6 (91)
77.5 (99)
97.7 (99)
...
95.5 (91)
...
89.1 (08)
68.9 (05)
95.8 (99)


...
90.5 (05)
55.9 (99)
85.0 (00)
92.9 (99)
97.9 (99)
67.5 (99)
57.0 (01)
99.8 (01)
90.4 (91)


93.2 (01)
88.8 (91)
92.4 (04)
94.8 (00)
94.3 (99)
...
96.7 (00)
...
92.5 (07)


...
...
98.7 (99)
...
...
99.2 (99)
88.1 (01)
...
...
...
...
...
96.8 (99)
...
94.2 (99)
63.2 (03)
88.2 (99)
...
91.8 (99)


97.4 (91)
97.9 (05)
87.5 (09)
...
99.0 (08)
99.2 (08)


97.3 (08)
88.6 (08)
98.7 (08)
82.4 (08)
96.1 (07)
...
92.1 (08)
...
90.1 (09)
77.3 (08)
94.5 (01)


...
85.5 (08)
88.4 (09)
95.5 (07)
99.7 (04)
96.2 (08)
73.6 (00)
66.1 (08)
99.5 (08)
94.7 (08)


92.9 (07)
96.1 (08)
99.0 (08)
99.1 (08)
91.0 (08)
...
97.5 (08)
...
90.6 (08)


...
86.3 (99)
89.5 (08)
...
...
99.7 (02)
66.5 (07)
...
72.3 (07)
...
98.5 (99)
...
96.4 (00)
...
94.1 (09)
67.0 (07)
99.2 (06)
...
98.0 (05)


...
99.3 (02)
...
...
99.5 (99)
87.2 (99)


98.0 (03)
48.6 (99)
85.9 (01)
54.3 (99)
97.7 (02)
55.2 (00)
75.3 (01)
...
...
...
82.8 (99)


...
...
81.3 (99)
62.0 (99)
97.5 (00)
...
58.0 (99)
...
93.4 (05)
97.8 (03)


79.3 (01)
96.6 (99)
99.4 (99)
95.9 (00)
94.5 (99)
94.8 (99)
96.7 (99)
...
99.5 (99)


...
...
82.1 (99)
...
...
69.7 (01)
...
...
...
...
...
...
...
...
92.4 (99)
...
94.6 (00)
...
68.9 (99)


99.6(07)
100.0(07)
99.6(08)
...
98.4(07)
94.9(07)


98.4(07)
54.4(07)
80.1(07)
66.8(07)
92.2(06)
73.9(07)
73.2(06)
...
...
...
92.1(05)


...
54.8(05)
90.1(08)
65.8(05)
87.8(02)
...
61.6(07)
69.7(04)
98.0(07)
94.2(07)


97.7(06)
98.4(08)
95.1(07)
99.0(08)
98.3(07)
95.2(07)
99.5(07)
...
98.7(07)


...
...
94.6(07)
...
...
81.4(03)
...
...
25.4(01)
...
...
...
...
...
95.9(00)
...
90.9(05)
62.6(01)
73.4(06)


Primarycompletionrate
(%)


Earliest Latest


107.0(91)
102.2(91)
96.4(99)
...
99.4(91)
90.0(99)


100.0(91)
40.9(99)
93.5(91)
70.7(99)
91.0(91)
73.4(99)
87.5(99)
...
87.0(99)
70.5(07)
96.2(99)


...
59.5(00)
50.8(99)
69.9(99)
87.6(91)
148.1(03)
51.1(91)
60.8(05)
101.2(91)
90.1(91)


100.8(01)
92.2(99)
85.8(99)
94.4(00)
95.2(99)
96.0(99)
95.1(99)
...
96.2(99)


...
...
100.4(00)
...
...
107.3(99)
97.5(99)
...
90.4(01)
...
85.4(99)
...
99.4(99)
...
95.3(99)
...
98.9(91)
113.3 (99)
85.2(99)


96.0(08)
95.3(05)
98.8(09)
...
98.7(08)
93.3(08)


105.7(08)
79.5(08)
106.4(08)
74.7(08)
96.0(07)
99.1(08)
92.3(07)
...
87.5(07)
79.8(08)
102.3(01)


38.8(05)
54.5(08)
88.5(09)
93.6(07)
116.8 (07)
112.9 (08)
70.0(02)
60.3(08)
98.4(08)
93.4(08)


97.9(07)
121.1(08)
99.7(08)
106.1(09)
92.1(08)
95.2(08)
97.7(08)
...
94.7(08)


...
87.9(99)
91.8(08)
...
...
124.8(05)
90.7(07)
...
79.0(07)
...
96.7(05)
...
119.1(04)
46.5(91)
93.5(09)
72.1(91)
104.9(06)
105.3(06)
79.3(07)




48 PATHS TO 2015


STATISTICAl APPEnDIx


Table A-8 – Goal 3: Promote gender equality and empower women


Note: The number in parenthesis is the year of the data point.
Source: United Nations MDG database.


Gender parity index
inprimary


Earliest Latest


Gender parity index
insecondary


Earliest Latest
East and North-East Asia
China
HongKong,China
Macao,China
DPRKorea
RepublicofKorea
Mongolia

South-East Asia
BruneiDarussalam
Cambodia
Indonesia
LaoPDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
VietNam

South and South-West Asia
Afghanistan
Bangladesh
Bhutan
India
Iran(IslamicRep.of)
Maldives
Nepal
Pakistan
SriLanka
Turkey

NorthandCentralAsia
Armenia
Azerbaijan
Georgia
Kazakhstan
Kyrgyzstan
RussianFederation
Tajikistan
Turkmenistan
Uzbekistan

Pacific
AmericanSamoa
CookIslands
Fiji
FrenchPolynesia
Guam
Kiribati
MarshallIslands
Micronesia(F.S.)
Nauru
NewCaledonia
Niue
NorthernMarianaI.
Palau
PapuaNewGuinea
Samoa
SolomonIslands
Tonga
Tuvalu
Vanuatu


0.92 (91)
1.01 (91)
0.96 (91)
...
1.01 (91)
1.02 (91)


0.94 (91)
0.87 (99)
0.98 (91)
0.79 (91)
0.99 (91)
0.95 (91)
0.99 (91)
...
0.98 (91)
0.93 (04)
0.93 (99)


0.55 (91)
1.04 (05)
0.85 (99)
0.76 (91)
0.90 (91)
1.00 (99)
0.63 (91)
0.68 (00)
0.96 (91)
0.93 (91)


1.01 (01)
0.99 (91)
1.00 (91)
1.01 (99)
0.99 (99)
1.00 (91)
0.98 (91)
...
0.98 (91)


...
... (...)
1.00 (91)
...
...
1.01 (99)
0.98 (99)
0.99 (04)
1.16 (00)
...
1.00 (99)
...
0.93 (99)
0.85 (91)
0.98 (99)
0.87 (91)
0.98 (91)
1.02 (99)
0.96 (91)


1.04 (08)
0.98 (05)
0.95 (09)
...
0.98 (08)
0.99 (08)


1.00 (08)
0.94 (08)
0.97 (08)
0.91 (08)
1.00 (07)
0.99 (08)
0.98 (08)
...
0.98 (09)
0.94 (08)
0.95 (01)


0.66 (08)
1.06 (08)
1.01 (09)
0.97 (07)
1.40 (08)
0.94 (08)
0.86 (02)
0.83 (08)
1.00 (08)
0.97 (08)


1.02 (08)
0.99 (08)
0.98 (08)
1.00 (09)
0.99 (08)
1.00 (08)
0.96 (08)
...
0.98 (08)


...
0.95 (99)
0.99 (08)
...
...
1.02 (07)
0.97 (07)
1.01 (07)
1.06 (08)
...
0.95 (05)
...
1.02 (07)
0.84 (06)
0.98 (09)
0.97 (07)
0.97 (06)
0.99 (06)
0.96 (07)


0.75 (91)
1.05 (91)
1.11 (91)
...
0.96 (91)
1.14 (91)


1.09 (91)
0.53 (99)
0.83 (91)
0.69 (99)
1.05 (91)
0.97 (91)
1.09 (99)
...
0.99 (91)
0.99 (04)
0.90 (99)


0.51 (91)
0.98 (99)
0.81 (99)
0.70 (99)
0.75 (91)
1.09 (99)
0.46 (91)
0.48 (91)
1.09 (91)
0.62 (91)


1.12 (91)
1.01 (91)
0.97 (91)
1.00 (99)
1.02 (91)
1.00 (03)
0.86 (99)
... (...)
0.98 (99)


...
... (...)
0.97 (91)
...
...
1.18 (99)
1.06 (99)
1.05 (04)
1.21 (00)
...
1.10 (99)
...
1.07 (99)
... (...)
1.10 (99)
0.61 (91)
1.03 (91)
... (...)
0.80 (91)


Gender parity index
intertiary


Earliest Latest


1.05 (08)
1.02 (08)
0.96 (09)
...
0.96 (08)
1.08 (08)


1.02 (08)
0.82 (07)
0.99 (08)
0.81 (08)
1.07 (07)
1.01 (07)
1.09 (08)
...
1.09 (09)
1.00 (05)
0.92 (01)


0.38 (07)
1.05 (07)
0.99 (09)
0.86 (07)
0.98 (08)
1.05 (06)
0.89 (06)
0.76 (08)
1.02 (04)
0.89 (08)


1.05 (08)
0.98 (08)
0.96 (08)
0.98 (09)
1.01 (08)
0.97 (08)
0.87 (08)
1.02 (91)
0.98 (08)


...
1.08 (99)
1.07 (08)
...
...
1.20 (07)
1.02 (07)
1.07 (05)
1.23 (08)
...
1.07 (05)
...
0.97 (07)
0.62 (91)
1.13 (09)
0.84 (07)
1.03 (06)
0.93 (01)
0.86 (04)


0.83 (03)
0.96 (03)
0.48 (91)
...
0.49 (91)
1.89 (91)


1.04 (91)
0.34 (00)
0.76 (01)
0.49 (99)
1.02 (99)
... (...)
1.26 (99)
...
0.94 (91)
1.27 (02)
0.76 (99)


0.28 (03)
0.49 (99)
0.58 (99)
0.54 (91)
0.40 (91)
2.41 (03)
0.33 (91)
0.81 (02)
... (...)
0.53 (91)


1.05 (91)
0.67 (91)
0.91 (91)
1.15 (99)
1.04 (99)
1.27 (91)
0.35 (99)
... (...)
0.82 (99)


...
...
1.20 (03)
...
...
...
1.29 (01)
...
...
...
...
...
2.35 (00)
... (...)
1.04 (99)
...
1.30 (99)
...
0.57 (02)


1.04 (08)
1.02 (07)
0.91 (08)
...
0.69 (08)
1.57 (08)


1.99 (08)
0.54 (08)
0.92 (08)
0.78 (08)
1.29 (07)
1.37 (07)
1.24 (08)
...
1.24 (09)
0.71 (09)
0.73 (01)


0.28 (04)
0.55 (07)
0.59 (08)
0.70 (07)
1.14 (08)
2.40 (04)
0.40 (04)
0.85 (08)
0.48 (91)
0.78 (08)


1.20 (07)
0.83 (08)
1.19 (08)
1.45 (09)
1.36 (08)
1.36 (08)
0.40 (08)
1.15 (91)
0.68 (08)


...
...
1.20 (05)
...
...
...
1.30 (03)
...
...
...
...
...
2.15 (02)
0.55 (99)
0.93 (01)
...
1.62 (04)
...
0.59 (04)




49MDG PRIORITIES In ASIA AnD THE PACIFIC


STATISTICAl APPEnDIx


Table A-9 – Goal 4: Reduce child mortality


Note: The number in parenthesis is the year of the data point.
Source: United Nations MDG database.


Under-5 mortality rate
(per1,000livebirths)


1990 2008


Infantmortalityrate
(per1,000livebirths)


1990 2008
East and North-East Asia
China
HongKong,China
Macao,China
DPRKorea
RepublicofKorea
Mongolia

South-East Asia
BruneiDarussalam
Cambodia
Indonesia
LaoPDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
VietNam

South and South-West Asia
Afghanistan
Bangladesh
Bhutan
India
Iran(IslamicRep.of)
Maldives
Nepal
Pakistan
SriLanka
Turkey

NorthandCentralAsia
Armenia
Azerbaijan
Georgia
Kazakhstan
Kyrgyzstan
RussianFederation
Tajikistan
Turkmenistan
Uzbekistan

Pacific
AmericanSamoa
CookIslands
Fiji
FrenchPolynesia
Guam
Kiribati
MarshallIslands
Micronesia(F.S.)
Nauru
NewCaledonia
Niue
NorthernMarianaI.
Palau
PapuaNewGuinea
Samoa
SolomonIslands
Tonga
Tuvalu
Vanuatu


46
...
...
55
9
98


11
117
86
157
18
120
61
7
32
184
56


260
149
148
116
73
111
142
130
29
84


56
98
47
60
75
27
117
99
74


...
18
22
...
...
89
49
58
21 (95)
...
...
...
21
91
50
38
23
53
27


21
...
...
55
5
41


7
90
41
61
6
98
32
3
14
93
14


257
54
81
69
32
28
51
89
15
22


23
36
30
30
38
13
64
48
38


...
15
18
...
...
48
36
39
45
...
...
...
15
69
26
36
19
36
33


37
...
...
42
8
71


9
85
56
108
16
85
42
6
26
138
39


168
103
91
83
55
79
99
101
23
69


48
78
41
51
63
23
91
81
61


...
16
19
...
...
65
39
45
19 (95)
...
...
...
18
67
40
31
19
42
23


18
...
...
42
5
34


6
69
31
48
6
71
26
2
13
75
12


165
43
54
52
27
24
41
72
13
20


21
32
26
27
33
12
54
43
34


...
14
16
...
...
38
30
32
36
...
...
...
13
53
22
30
17
30
27




50 PATHS TO 2015


STATISTICAl APPEnDIx


Table A-10 – Goal 5: Improve maternal health


Note: The number in parenthesis is the year of the data point.
Source: United Nations MDG database.


Skilled birth attendance
(%)


Earliest Latest


Antenatal care (≥ 1 visit)
(%)


Earliest Latest
East and North-East Asia
China
HongKong,China
Macao,China
DPRKorea
RepublicofKorea
Mongolia

South-East Asia
BruneiDarussalam
Cambodia
Indonesia
LaoPDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
VietNam

South and South-West Asia
Afghanistan
Bangladesh
Bhutan
India
Iran(IslamicRep.of)
Maldives
Nepal
Pakistan
SriLanka
Turkey

NorthandCentralAsia
Armenia
Azerbaijan
Georgia
Kazakhstan
Kyrgyzstan
RussianFederation
Tajikistan
Turkmenistan
Uzbekistan

Pacific
AmericanSamoa
CookIslands
Fiji
FrenchPolynesia
Guam
Kiribati
MarshallIslands
Micronesia(F.S.)
Nauru
NewCaledonia
Niue
NorthernMarianaI.
Palau
PapuaNewGuinea
Samoa
SolomonIslands
Tonga
Tuvalu
Vanuatu


94.0(90)
...
...
98.0(90)
...
93.6(98)


98.0(94)
34.0(98)
40.7(90)
19.4(01)
92.8(90)
46.3(91)
52.8(93)
...
99.3(00)
25.8(97)
77.1(97)


12.4(00)
9.5(94)
14.9(94)
34.2(93)
86.1(97)
90.0(94)
7.4(91)
18.8(91)
94.1(93)
75.9(93)


96.4(97)
99.8(98)
96.6(90)
99.6(95)
98.1(97)
99.2(90)
79.0(96)
95.8(96)
97.5(96)


...
99.0(91)
100.0(98)
...
...
72.0(94)
94.9(98)
92.8(99)
...
...
99.0(90)
...
99.0(90)
53.2(96)
76.0(90)
85.0(94)
92.0(91)
100.0(90)
87.0(94)


98.4(07)
...
...
97.1(04)
100.0(97)
99.2(06)


99.0(99)
43.8(05)
79.4(07)
20.3(06)
98.0(05)
57.0(01)
61.8(08)
100.0(98)
97.3(06)
18.4(03)
87.7(06)


14.3(03)
18.0(07)
71.4(07)
46.6(06)
97.3(05)
84.0(04)
18.7(06)
38.8(07)
98.5(07)
91.3(08)


99.9(07)
88.0(06)
98.3(05)
99.8(06)
97.6(06)
99.5(06)
88.4(07)
99.5(06)
99.9(06)


...
98.0(01)
99.0(00)
...
...
63.0(05)
86.2(07)
87.7(01)
97.4(07)
...
100.0(06)
...
100.0(02)
53.0(06)
100.0(98)
70.1(07)
95.0(01)
97.9(07)
74.0(07)


78.7 (95)
...
...
...
...
89.8 (98)


...
34.3 (98)
76.3 (91)
26.5 (01)
73.6 (03)
75.8 (97)
83.1 (93)
...
85.9 (96)
70.9 (97)
70.6 (97)


36.9 (00)
25.7 (94)
51.0 (00)
61.9 (93)
76.5 (97)
...
15.4 (91)
25.6 (91)
80.2 (93)
62.3 (93)


82.0 (97)
98.3 (97)
74.0 (97)
92.5 (95)
97.3 (97)
...
71.3 (00)
98.1 (00)
94.9 (96)


...
...
...
...
...
...
...
...
...
...
...
...
...
77.5 (96)
...
...
...
...
...


90.9(07)
...
...
...
...
98.9(05)


100.0(94)
69.3(05)
93.3(07)
35.1(06)
78.8(05)
75.6(01)
91.0(08)
...
97.8(06)
60.5(03)
90.8(06)


16.1(03)
51.2(07)
88.0(07)
74.2(06)
98.3(05)
81.0(01)
43.7(06)
60.9(07)
99.4(07)
92.0(08)


93.0(05)
76.6(06)
94.3(05)
99.9(06)
96.9(06)
...
88.8(07)
99.1(06)
99.0(06)


...
...
...
...
...
88.0(94)
81.2(07)
...
94.5(07)
...
...
...
...
78.8(06)
...
73.9(07)
...
97.4(07)
84.3(07)




51MDG PRIORITIES In ASIA AnD THE PACIFIC


STATISTICAl APPEnDIx


Table A-11 – Goal : Combat HIV and AIDS, malaria and other diseases


Note: The number in parenthesis is the year of the data point.
Source: United Nations MDG database.


HIV prevalence
(% ages 15-49)


2001 2007


TB incidence rate
(per100,000)


1990 2008
East and North-East Asia
China
HongKong,China
Macao,China
DPRKorea
RepublicofKorea
Mongolia

South-East Asia
BruneiDarussalam
Cambodia
Indonesia
LaoPDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
VietNam

South and South-West Asia
Afghanistan
Bangladesh
Bhutan
India
Iran(IslamicRep.of)
Maldives
Nepal
Pakistan
SriLanka
Turkey

NorthandCentralAsia
Armenia
Azerbaijan
Georgia
Kazakhstan
Kyrgyzstan
RussianFederation
Tajikistan
Turkmenistan
Uzbekistan

Pacific
AmericanSamoa
CookIslands
Fiji
FrenchPolynesia
Guam
Kiribati
MarshallIslands
Micronesia(F.S.)
Nauru
NewCaledonia
Niue
NorthernMarianaI.
Palau
PapuaNewGuinea
Samoa
SolomonIslands
Tonga
Tuvalu
Vanuatu


0.1
...
...
0.1
0.1
0.1


...
1.8
0.1
0.1
0.3
0.9
0.1
0.1
1.7
...
0.3


...
0.1
0.1
0.5
0.1
0.1
0.5
0.1
0.1
...


0.1
0.1
0.1
...
0.1
0.5
0.1
...
0.1


...
...
0.1
...
...
...
...
...
...
...
...
...
...
0.3
...
...
...
...
...


0.1
...
...
0.1
0.1
0.1


...
0.8
0.2
0.2
0.5
0.7
0.1
0.2
1.4
...
0.5


...
0.1
0.1
0.3
0.2
0.1
0.5
0.1
0.1
...


0.1
0.2
0.1
...
0.1
1.1
0.3
...
0.1


...
...
0.1
...
...
...
...
...
...
...
...
...
...
1.5
...
...
...
...
...


120
140
120
340
190
210


70
590
190
180
120
400
390
66
140
500
200


190
220
310
170
36
150
160
230
66
58


33
110
110
140
140
110
92
64
130


21
0
51
38
52 (92)
510
300
190
85
100
59
80
64
250
32
310
34
300
140


TB prevalence rate
(per100,000)


1990 2008


97
91
78
340
88
210


65
490
190
150
100
400
280
39
140
500
200


190
220
160
170
20
42
160
230
66
30


73
110
110
180
160
110
200
68
130


3
20
20
22
58
360
210
93
12
21
0
38
63
250
18
120
24
160
74


260
120
100
890
170
410


55
1,400
460
410
180
1,100
1,000
43
180
620
380


280
550
380
340
48
270
350
660
96
53


47
230
240
230
270
230
160
20
260


29
1
59
38
11
1,200
750
94
44
88
180
64
83
550
21
630
39
76
82


88
58
49
270
50
140


43
680
210
260
120
470
550
27
160
660
280


270
410
96
190
23
13
170
310
73
22


67
140
42
98
140
69
330
18
190


1
32
25
6
61
110
59
34
10
10
0
11
110
130
36
150
22
44
88




52 PATHS TO 2015


STATISTICAl APPEnDIx


Table A-12 – Goal : Ensure environmental sustainability


Note: The number in parenthesis is the year of the data point.
Source: United Nations MDG database.


Forestcover
(%landarea)


1990 2005


Protectedarea
(%territorialarea)


1990 2009
East and North-East Asia
China
HongKong,China
Macao,China
DPRKorea
RepublicofKorea
Mongolia

South-East Asia
BruneiDarussalam
Cambodia
Indonesia
LaoPDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
VietNam

South and South-West Asia
Afghanistan
Bangladesh
Bhutan
India
Iran(IslamicRep.of)
Maldives
Nepal
Pakistan
SriLanka
Turkey

NorthandCentralAsia
Armenia
Azerbaijan
Georgia
Kazakhstan
Kyrgyzstan
RussianFederation
Tajikistan
Turkmenistan
Uzbekistan

Pacific
AmericanSamoa
CookIslands
Fiji
FrenchPolynesia
Guam
Kiribati
MarshallIslands
Micronesia(F.S.)
Nauru
NewCaledonia
Niue
NorthernMarianaI.
Palau
PapuaNewGuinea
Samoa
SolomonIslands
Tonga
Tuvalu
Vanuatu


16.8 a
...
...
68.1
64.5
7.3


59.4
73.3
64.3
75.0
68.1
59.6
35.5
3.4
31.2
65.0
28.8


2.0
6.8
64.6
21.5
6.8
3.0
33.7
3.3
36.4
12.6


12.3
11.3
39.7
1.3
4.4
47.9
2.9
8.8
7.4


91.9
63.9
53.6
28.7
47.1
3.0
...
90.6
...
39.2
66.2
75.3
82.9
69.6
45.9
98.9
5.0
33.3
36.1


21.2 a
...
...
51.4
63.5
6.5


52.8
59.2
48.8
69.9
63.6
49.0
24.0
3.4
28.4
53.7
39.7


1.3
6.7
68.0
22.8
6.8
3.0
25.4
2.5
29.9
13.2


10.0
11.3
39.7
1.2
4.5
47.9
2.9
8.8
8.0


89.4
66.5
54.7
28.7
47.1
3.0
...
90.6
...
39.2
54.2
72.4
87.6
65.0
60.4
77.6
5.0
33.3
36.1


13.07
41.09
...
2.71
3.29
4.10


23.57
0.03
3.96
0.84
13.57
2.58
1.86
2.59
12.45
0.00
3.12


0.43
1.28
14.25
4.79
5.06
...
7.69
9.99
13.35
1.78


6.93
6.18
2.55
2.40
6.36
7.82
1.94
2.99
2.12


2.02
0.00
0.15
0.01
3.29
0.34
0.00
0.06
...
1.06
0.00
0.03
0.45
0.93
0.94
0.01
0.01
0.00
0.39


CO2emissions
(metrictonspercapita)


1990 2007


16.06
41.79
...
2.73
3.54
13.39


28.39
22.16
6.39
16.32
14.50
5.20
3.29
3.55
16.92
6.36
4.85


0.43
1.46
28.35
5.12
6.84
...
17.00
10.00
14.48
1.94


7.99
7.15
3.39
2.52
6.94
9.02
4.14
2.99
2.26


2.03
0.05
0.18
0.07
3.56
20.21
0.62
0.09
...
1.10
1.86
0.08
4.80
1.37
1.18
0.12
2.53
0.19
0.47


2.15
4.85
2.78
12.15
5.62
4.53


24.98
0.05
0.84
0.06
3.13
0.10
0.71
15.56
1.69
0.19(02)
0.32


0.21
0.13
0.23
0.80
4.00
0.71
0.03
0.59
0.22
2.69


1.07(92)
5.93(92)
2.87(92)
15.90(92)
2.47(92)
13.96(92)
3.86(92)
7.23(92)
5.30(92)


...
1.24
1.13
3.23
...
0.31
1.02
0.51(99)
14.43
9.49
1.74
...
15.74
0.52
0.77
0.51
0.81
...
0.47


4.92
5.75
3.03
2.98
10.49
4.05


19.76
0.31
1.77
0.25
7.32
0.27
0.80
12.08
4.14
0.17
1.29


0.03
0.28
0.86
1.38
6.85
2.99
0.12
0.90
0.62
3.95


1.65
3.68
1.38
14.76
1.14
10.83
1.07
9.20
4.32


...
3.38
1.74
3.08
...
0.35
1.67
0.56
14.09
11.75
2.57
...
10.49
0.52
0.90
0.40
1.71
...
0.45




53MDG PRIORITIES In ASIA AnD THE PACIFIC


STATISTICAl APPEnDIx


Table A-13 – Goal : Ensure environmental sustainability


Note: The number in parenthesis is the year of the data point.
Source: United Nations MDG database.


ODPsubstanceconsumption
(ODPmetrictons)


Earliest 2008


Safe drinking water
(%population)


1990 2008
East and North-East Asia
China
HongKong,China
Macao,China
DPRKorea
RepublicofKorea
Mongolia

South-East Asia
BruneiDarussalam
Cambodia
Indonesia
LaoPDR
Malaysia
Myanmar
Philippines
Singapore
Thailand
Timor-Leste
VietNam

South and South-West Asia
Afghanistan
Bangladesh
Bhutan
India
Iran(IslamicRep.of)
Maldives
Nepal
Pakistan
SriLanka
Turkey

NorthandCentralAsia
Armenia
Azerbaijan
Georgia
Kazakhstan
Kyrgyzstan
RussianFederation
Tajikistan
Turkmenistan
Uzbekistan

Pacific
AmericanSamoa
CookIslands
Fiji
FrenchPolynesia
Guam
Kiribati
MarshallIslands
Micronesia(F.S.)
Nauru
NewCaledonia
Niue
NorthernMarianaI.
Palau
PapuaNewGuinea
Samoa
SolomonIslands
Tonga
Tuvalu
Vanuatu


59,674.0 (90)
...
...
192.0 (91)
0.0 (91)
0.0 (91)


0.0 (91)
0.0 (91)
80.8 (91)
0.0 (90)
4,193.7 (90)
16.6 (92)
3,477.2 (90)
4,855.2 (90)
6,984.2 (90)
0.3 (91)
430.0 (91)


0.0 (91)
202.1 (90)
0.0 (91)
0.0 (90)
1,393.9 (90)
4.5 (90)
25.0 (91)
1,455.8 (90)
218.2 (90)
4,361.0 (90)


0.0 (91)
2.8 (91)
94.8 (91)
2,355.9 (90)
133.5 (91)
130,578.5 (90)
93.3 (91)
145.2 (90)
4.4 (91)


...
0.1 (91)
41.8 (90)
...
...
0.0 (91)
1.2 (90)
0.0 (91)
0.0 (91)
...
0.0 (91)
...
0.0 (91)
28.5 (91)
4.0 (91)
2.1 (90)
0.4 (91)
0.0 (91)
0.0 (91)


67
...
...
100
90 (95)
58


...
35
71
44 (95)
88
57
84
100
91
52 (00)
58


3 (95)
78
91 (00)
72
91
90
76
86
67
85


92 (95)
70
81
96
78 (95)
93
58 (95)
83 (95)
90


...
94
...
100
100
48
95
89
...
...
100
98
81
41
91
69 (95)
100 (95)
90
57


Basic sanitation
(%population)


1990 2008


89
...
...
100
98
76


...
61
80
57
100
71
91
100
98
69
94


48
80
92
88
93 (00)
91
88
90
90
99


96
80
98
95
90
96
70
84 (05)
87


...
95 (05)
...
100
100
64 (05)
94
94 (05)
...
...
100
98
84 (05)
40
88 (05)
70 (05)
100
97
83


41
...
...
59(95)
100
49(95)


...
9
33
18(95)
84
49(95)
58
99
80
32(00)
35


29(95)
34
62(00)
18
83
69
11
28
70
84


88(95)
57(95)
96
96
93(95)
87
89(95)
98
84


...
96
...
98
99
26
64
29
...
...
100
84
69
47
98
30(95)
96
80
35(95)


55
...
...
59 (00)
100
50


...
29
52
53
96
81
76
100
96
50
75


37
53
65
31
83 (00)
98
31
45
91
90


90
45
95
97
93
87
94
98
100


...
100
...
98
99
35 (05)
73
25 (05)
...
...
100
94 (05)
83 (05)
45
100
32 (05)
96
84
52


17,386.3
...
...
91.2
4,050.2
2.6


7.6
9.3
299.9
3.6
571.2
2.0
397.4
149.5
1,197.5
2.7(07)
277.5


47.9
223.1
0.1
2,904.9
508.6
3.7
1.4
356.9
10.3
762.5


18.4
0.8
5.9
128.8
12.4
1,457.6
3.9
10.1
2.3


...
0.0
4.8
...
...
0.2
0.2
0.2
0.0(07)
...
0.0
...
0.1
1.5
0.1
1.2
0.2
0.0
1.0




54 PATHS TO 2015


ADB(2009).Asian Development Outlook 2009: Rebalancing
Asia’s Growth.Manila,ADB.


ADB(2007).Inequality in Asia, Key Indicators 2007,Vol
38,Manila,ADB.


ADB (2008). The emerging Asian Regionalism, Manila,
ADB.


ADB/JBIC/WorldBank (2005).Connecting East Asia:
A New Framework for Infrastructure.Manila,ADB.


ADBI/ADB (2009). Infrastructure for a seamless Asia.
Tokyo,ADBI/ADB.


Banerjee,A.andE.Duflo. (2006).The Economic Lives
of the Poor.MITDepartmentof EconomicsWorking
PaperSeries.No.06-29.


Chand, R. (2008). “The State of Indian Agriculture
andProspectsfortheFuture”,inKanchanChopraand
C.H.HanumanthaRao(Ed)Growth Equity, Environment
and Population,NewDelhi,SagePublicationsIndia.


Chatterjee, S., A. Mukherjee and R. Jha (2010).
Approaches to Combat Hunger in Asia and the Pacific,
SustainableDevelopmentWorking Paper Series. No.
11,August.Manila,ADB.


Chatterjee, S. et.al. (2004) Scaling up Poverty Reduction
Potential of Infrastructure Projects: Lessons From the Asia
Pacific Region,Manila,ADB.


Chhibber,A., J.Ghosh andT.Palanivel (2009).Asia
Rebounds But Lasting Recovery Needs New Paradigm: A
Synthesis Study Incorporating Evidence from Country Case
Studies.Bangkok,UNDPRegionalCentreinAsiaand
thePacific.


CommissiononAIDSinAsia(2008).Redefining AIDS
in Asia: Crafting an Effective Response,NewDelhi,Oxford
UniversityPress.


ESCAP (2009).Sustainable Agriculture and Food Security
in Asia and the Pacific(UnitedNationspublication,Sales
No.E.09.II.F.12).


ESCAP(2010a).Economic and Social Survey of Asia and
the Pacific 2010.


ESCAP(2010b).Financing an Inclusive and Green Future. A
Supportive Financial System and Green Growth for Achieving
the Millennium Development Goals in Asia and the Pacific,
Bangkok,UnitedNations.


ESCAP/ADB/UNDP(2005).A Future Within Reach:
Reshaping institutions in a region of disparities to meet the
MDGs.Bangkok,UnitedNations.


ESCAP/ADB/UNDP(2006).Pursuing Gender Equality
through the Millennium Development Goals in Asia and the
Pacific.Manila,ADB.


ESCAP/ADB/UNDP (2010).Achieving the MDGs in
an Era of Global Uncertainty.Bangkok,UnitedNations.


Fan,S.andA.Saurkar.(2006).Public Spending in Developing
Countries: Trends, Determination and Impact(mimeo).


FAO (2009a).The State of Food Insecurity in the World.
Rome,FAO.


FAO (2009b). Women, Agriculture and Food Security.
Rome,FAO.


Francis,N.G.andM.A.Akoy(2008).Who Are the Net
Food Importing Countries,PolicyResearchWorkingPaper
4457,WashingtonDC,WorldBank.


Heyzer, N. andM. Khor (1999) “Globalization and
thewayforward”,DevelopmentOutreach“Speaker’s
Corner”Washington,D.C.:WorldBank.


HoganM. et al. (2010) “MaternalMortality for 181
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India,G.O.(2002).The Tenth Five Year Plan, 2002-2007.
NewDelhi,Governmentof India.


India, G. O. (2009). Government of India, Labour
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International Organization for Migration (2005).
Migration, Development and Poverty Reduction in Asia.
Geneva,IOM.


Jung, J. and C. Tran (2008). The Macroeconomics of
Health Savings Accounts, CAEPR Working Paper
No.2007-023.


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Printed in Bangkok
September 2010


United Nations publication
Sales No. E.10.II.F.20
Copyright © United Nations 2010
ISBN: 978-92-120618-0




www.unescap.org www.undp.orgwww.adb.org


There are only five years left to reach 2015 in achieving the MDGs. World leaders are once again gathering at


the United Nations High-level Plenary Meeting on the MDGs in September 2010 in New York to assess some


of the likely outcomes on present trends, identify some of the weakest areas of performance, and identify


priorities for accelerated action.


This report on Paths to 2015 is the Asia-Pacific region’s contribution to that assessment. It uses the latest


information from the United Nations MDG database to assess which countries and subregions are likely to


miss or achieve the Goals. It attempts to encapsulate and update the discussions and recommendations of


the earlier reports on MDGs, jointly published by ESCAP, ADB and UNDP since 2004. It looks at some of


the key drivers which have propelled MDG achievement in the region, and which are likely to remain as


important as before in the region’s quest for reaching the Goals by 2015. It focuses specifically on three areas


where increased and sustained policy attention would be required: hunger and food security; health and


basic services; and basic infrastructure – areas where many of the countries in the region appear to be


facing significant challenges.


This report is the fifth in the series published by ESCAP, ADB and UNDP on MDG achievement. It is a resource


which policy makers, development practitioners and other stakeholders should find useful in addressing


the remaining challenges in achieving the MDGs.




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