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Have we achieved the millennium development goals?

As the deadline for the millennium development goals approaches, experts writing in The BMJ this week take stock of the successes, failures, and oversights, and look ahead to the next phase - the sustainable development goals.

The millennium development goals are eight aspirational targets set by the United Nations (UN) in New York in September 2000, explain Dr Mark Beattie and colleagues.

The progress made towards some of the goals has been remarkable, they write. For example, child mortality has effectively halved worldwide, from 90 per 1,000 births in 1990 to 46 in 2013, equivalent to 17,000 fewer children dying each day. Furthermore, HIV prevention and treatment is now a reality and there have been huge improvements in education.

In other areas, however, few inroads have been made, they say. For instance, newborn death rates remain stubbornly static, while gender empowerment, and undernutrition lag behind for complex, interconnected reasons.

Some argue that the goals have been over ambitious and that substantial changes would have occurred anyway, although a recent economic analysis estimated that 13.6 million extra children's lives have been saved since 2001.

But with shortfalls in so many areas, the UN has developed 17 new sustainable developmental goals to replace the millennium development goals in late 2015 with ambitious targets for 2030. These include the abolition of unnecessary neonatal deaths and ending AIDS, tuberculosis, malaria, and neglected tropical diseases.

The three targets of greatest importance remain women's education and empowerment, poverty, and warfare.

"As the new era dawns of the sustainable development goals, there remains much unfinished business, including persistent and substantial variations between countries and regions," write the authors. "Despite this, there are reasons for optimism - the progress made in Rwanda in only 20 years after the genocide shows what can be achieved with political and social will," they conclude.

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