Putting It Together: AIDS and the Millennium Development Goals

One of the most important and visionary global actions of recent years was the September 2000 commitment by 189 governments worldwide to " [make] the right to development a reality for everyone and to [free] the entire human race from want " [1]. The movement to achieve sustainable reductions across all dimensions of extreme poverty has reached an unprecedented level, with efforts primarily focused on and measured against the Millennium Development Goals (MDGs; see http:⁄⁄www.un.org/ millenniumgoals/goals.html) [2]. To date, progress toward achieving these goals has been mixed: in some regions such as East Asia, most countries have made important gains across the board and are thus " on track, " or better, for reaching many MDG targets. But in other regions, most notably in sub-Saharan Africa, a large number of countries are far behind and appear unlikely to reach, or even come close to reaching, their goals for 2015 [2]. The reasons for this are complex and often interlinked, but one stands out as a major overarching threat to development: HIV/AIDS, which kills more people than any other infectious disease and is the fourth-leading cause of death worldwide [3]. The severe health impacts of AIDS are well documented. But AIDS also affects countries' fundamental economic and social development performance, and exerts detrimental effects on many of the other MDGs. AIDS will make it diffi cult if not impossible for many countries to achieve their MDG targets [4]. This Policy Forum reviews the literature on the impact of AIDS on selected MDGs, and explores the links between fi ghting AIDS and improving other development outcomes. It also considers the implications for developing country and donor investment strategies, arguing that expanded investment in HIV prevention—especially in new prevention tools including AIDS vaccines—is essential for attaining and upholding the MDGs. Methodology We examine how HIV/AIDS impedes progress toward several of the MDGs, beyond the direct target dedicated to reducing the HIV epidemic itself. Based on availability of data, we focus on the following MDGs: (1) eradicating extreme poverty and hunger; (2) achieving universal primary education; (3) reducing child mortality; (4) improving maternal health; and (5) combating malaria and tuberculosis (TB). Our analysis draws on primary sources published over the past fi ve years (2000–2005). The literature search, conducted between January and November 2005, relied on general searches of the PubMed database, in addition to consultations with experts from the respective fi elds to …