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The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6. The Global Burden of Disease 2013 study provides a consistent and comprehensive approach to disease estimation for between 1990 and 2013, and an opportunity to assess whether accelerated progress has occured since the Millennium Declaration. To estimate incidence and mortality for HIV, we used the UNAIDS Spectrum model appropriately modified based on a systematic review of available studies of mortality with and without antiretroviral therapy (ART). For concentrated epidemics, we calibrated Spectrum models to fit vital registration data corrected for misclassification of HIV deaths. In generalised epidemics, we minimised a loss function to select epidemic curves most consistent with prevalence data and demographic data for all-cause mortality. We analysed counterfactual scenarios for HIV to assess years of life saved through prevention of mother-to-child transmission (PMTCT) and ART. For tuberculosis, we analysed vital registration and verbal autopsy data to estimate mortality using cause of death ensemble modelling. We analysed data for corrected case-notifications, expert opinions on the case-detection rate, prevalence surveys, and estimated cause-specific mortality using Bayesian meta-regression to generate consistent trends in all parameters. We analysed malaria mortality and incidence using an updated cause of death database, a systematic analysis of verbal autopsy validation studies for malaria, and recent studies (2010–13) of incidence, drug resistance, and coverage of insecticide-treated bednets. Globally in 2013, there were 1·8 million new HIV infections (95% uncertainty interval 1·7 million to 2·1 million), 29·2 million prevalent HIV cases (28·1 to 31·7), and 1·3 million HIV deaths (1·3 to 1·5). At the peak of the epidemic in 2005, HIV caused 1·7 million deaths (1·6 million to 1·9 million). Concentrated epidemics in Latin America and eastern Europe are substantially smaller than previously estimated. Through interventions including PMTCT and ART, 19·1 million life-years (16·6 million to 21·5 million) have been saved, 70·3% (65·4 to 76·1) in developing countries. From 2000 to 2011, the ratio of development assistance for health for HIV to years of life saved through intervention was US$4498 in developing countries. Including in HIV-positive individuals, all-form tuberculosis incidence was 7·5 million (7·4 million to 7·7 million), prevalence was 11·9 million (11·6 million to 12·2 million), and number of deaths was 1·4 million (1·3 million to 1·5 million) in 2013. In the same year and in only individuals who were HIV-negative, all-form tuberculosis incidence was 7·1 million (6·9 million to 7·3 million), prevalence was 11·2 million (10·8 million to 11·6 million), and number of deaths was 1·3 million (1·2 million to 1·4 million). Annualised rates of change (ARC) for incidence, prevalence, and death became negative after 2000. Tuberculosis in HIV-negative individuals disproportionately occurs in men and boys (versus women and girls); 64·0% of cases (63·6 to 64·3) and 64·7% of deaths (60·8 to 70·3). Globally, malaria cases and deaths grew rapidly from 1990 reaching a peak of 232 million cases (143 million to 387 million) in 2003 and 1·2 million deaths (1·1 million to 1·4 million) in 2004. Since 2004, child deaths from malaria in sub-Saharan Africa have decreased by 31·5% (15·7 to 44·1). Outside of Africa, malaria mortality has been steadily decreasing since 1990. Our estimates of the number of people living with HIV are 18·7% smaller than UNAIDS's estimates in 2012. The number of people living with malaria is larger than estimated by WHO. Incidence rates for HIV, tuberculosis, and malaria have all decreased since 2000. At the global level, upward trends for malaria and HIV deaths have been reversed and declines in tuberculosis deaths have accelerated. 101 countries (74 of which are developing) still have increasing HIV incidence. Substantial progress since the Millennium Declaration is an encouraging sign of the effect of global action. Bill & Melinda Gates Foundation.

\"The global economic crisis of 2008-2009 exposed systemic failings at the core of economic policy making worldwide. The crisis came on top of several other crises, including skyrocketing and highly volatile world food and energy prices and climate change. This book argues that new policy approaches are needed to address such devastating global development challenges and to avoid the potentially catastrophic consequences to livelihoods worldwide that are likely to result from present approaches. The contributors to the book are independent development experts, brought together by the UN Commiittee for Development Policy, an advisory body of the Economic and Social Council, to identify a development strategy capable of promoting a broad-based economic recovery and at the same time guaranteeing social equity and environmental sustainability both within countries and internationally. This new development approach seeks to promote the reforms needed to improve global governance, providing a more equitable distribution of global public goods. The contributors offer a critical evaluation of past development experiences and report on their creative search for new and well-thought out answers for the future. They suggest that economic progress, fairer societies and environmental sustainability can be compatible objectives, but only when pursued simultaneously by all.\"--Page 4 of cover.

A Development Emergency: the title of this year's Global Monitoring Report, the sixth in an annual series, could not be more apt. The global economic crisis, the most severe since the Great Depression, is rapidly turning into a human and development crisis. No region is immune. The poor countries are especially vulnerable, as they have the least cushion to withstand events. The crisis, coming on the heels of the food and fuel crises, poses serious threats to their hard-won gains in boosting economic growth and reducing poverty. It is pushing millions back into poverty and putting at risk the very survival of many. The prospect of reaching the Millennium Development Goals (MDGs) by 2015, already a cause for serious concern, now looks even more distant. A global crisis must be met with a global response. The crisis began in the financial markets of developed countries, so the first order of business must be to stabilize these markets and counter the recession that the financial turmoil has triggered. At the same time, strong and urgent actions are needed to counter the impact of the crisis on developing countries and help them restore strong growth while protecting the poor. Global Monitoring Report 2009, prepared jointly by the staff of the World Bank and the International Monetary Fund, provides a development perspective on the global economic crisis. It assesses the impact on developing countries, their growth, poverty reduction, and other MDGs. And it sets out priorities for policy response, both by developing countries themselves and by the international community. This report also focuses on the ways in which the private sector can be better mobilized in support of development goals, especially in the aftermath of the crisis.

This unique work by the Centre for Conflict Resolution (CCR), Cape Town, South Africa, tracks the progress Africa has made in achieving the United Nations' Millennium Development Goals (MDGs) since 2000. Thirteen analytical chapters written by scholars and practitioners with expertise in the various areas covered by the eight MDGs are organized around the larger themes of political economy, structural issues, sustainable goals, and human development goals. They critically assess the progress that Africa has made towards the achievement of the MDGs, discuss how to accelerate that progress, and offer alternatives and recommendations in support of institutions in Africa that are engaged in promoting the achievement of sustainable development. Throughout, they examine the role of various actors (including the African Union; Africa's regional economic communities, the United Nations, the European Union, etc.), civil society, and other external development partners in light of their contributions, shortfalls, and viable options in shaping the continent's development agenda. Together they provide a unique assessment from experts on the ground of whether the goals were a success and what remains to be done to achieve sustainable economic and human development in Africa.

Equality of opportunity is about leveling the playing field so that circumstances such as gender, ethnicity, place of birth, or family background do not influence a person's life chances. Success in life should depend on people's choices, effort and talents, not to their circumstances at birth. 'Measuring Inequality of Opportunities in Latin America and the Caribbean' introduces new methods for measuring inequality of opportunities and makes an assessment of its evolution in Latin America over a decade. An innovative Human Opportunity Index and other parametric and non-parametric techniques are presented for quantifying inequality based on circumstances exogenous to individual efforts. These methods are applied to gauge inequality of opportunities in access to basic services for children, learning achievement for youth, and income and consumption for adults.

Target 7c of the Millennium Development Goals (MDG 7c) aimed to halve the population that had no sustainable access to water and basic sanitation before 2015. According to the data collected by the Joint Monitoring Programme in charge of measuring progress towards MDG 7c, 2.6 billion people gained access to safe water and 2.3 billion people to basic sanitation. Despite these optimistic figures, many academics have criticised MDG 7c. We provide an overview of this critique by performing a systematic literature review of 62 studies conducted over the MDG implementation period (2002–2015) and shortly after. Our objective is to contribute to the debate on the operationalisation of the Sustainable Development Goal on water and sanitation (SDG 6). The academic debate on MDG 7c mainly focused on the effectiveness of the indicators for safe water and sanitation and on the political dynamics underlying the selection of these indicators. SDG 6 addresses some of the concerns raised on the indicators for safe water and sanitation but fails to acknowledge the politics of indicator setting. We are proposing additional indicators and reflect on the limitations of using only quantitative indicators to measure progress towards SDG 6.

To assess various causes of maternal mortality over a ten year period. Retrospective audit of hospital case records. Tertiary care hospital. Pregnant women who expired in the premises of GTB Hospital. A retrospective audit of case records of maternal deaths was conducted for a ten year period (January 2005 to December 2014). There were a total of 647 maternal deaths out of 1,16,641 live births. Sixty-eight percent (n = 445) of women were aged 21-30 years, while 10.5% (n = 68) were <20 years of age. The most common direct causes of maternal mortality were preeclampsia/eclampsia in 24.4% (n = 158), obstetric hemorrhage in 19.1% (n = 124) and puerperal sepsis in 14.5% (n = 94). With regards to indirect causes, anemia accounted for 15.3% (n = 99) mortality. There was only 1 (0.1%) mortality because of HIV/AIDS. Other notable causes of maternal mortality were infective hepatitis in 7.1% (n = 46). Tuberculosis, that is a disease of tropical countries, accounted for 3.0% (n = 20) of the total deaths. High maternal mortality in GTB hospital can be due to it being a tertiary hospital with referrals from all neighbouring states. Accessible antenatal care can help prevent these maternal deaths. Female education can be of immense help in dealing with the problem and improving the utilization of public health facilities. Preeclampsia/eclampsia and obstetric hemorrhage have been the main causes of maternal mortality for ages. Regular antenatal visits and the judicious training of grassroot level workers to pick-up complications early on in the pregnancy can be an effective way to deal the morbidity and mortality associated with these problems. The Janani Suraksha Yojana (JSY) and Janani Shishu Suraksha Karyakaram (JSSK) in India are pioneer steps in this direction.

Remarkable financial and political efforts have been focused on the reduction of child mortality during the past few decades. Timely measurements of levels and trends in under-5 mortality are important to assess progress towards the Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015, and to identify models of success. We generated updated estimates of child mortality in early neonatal (age 0–6 days), late neonatal (7–28 days), postneonatal (29–364 days), childhood (1–4 years), and under-5 (0–4 years) age groups for 188 countries from 1970 to 2013, with more than 29 000 survey, census, vital registration, and sample registration datapoints. We used Gaussian process regression with adjustments for bias and non-sampling error to synthesise the data for under-5 mortality for each country, and a separate model to estimate mortality for more detailed age groups. We used explanatory mixed effects regression models to assess the association between under-5 mortality and income per person, maternal education, HIV child death rates, secular shifts, and other factors. To quantify the contribution of these different factors and birth numbers to the change in numbers of deaths in under-5 age groups from 1990 to 2013, we used Shapley decomposition. We used estimated rates of change between 2000 and 2013 to construct under-5 mortality rate scenarios out to 2030. We estimated that 6·3 million (95% UI 6·0–6·6) children under-5 died in 2013, a 64% reduction from 17·6 million (17·1–18·1) in 1970. In 2013, child mortality rates ranged from 152·5 per 1000 livebirths (130·6–177·4) in Guinea-Bissau to 2·3 (1·8–2·9) per 1000 in Singapore. The annualised rates of change from 1990 to 2013 ranged from −6·8% to 0·1%. 99 of 188 countries, including 43 of 48 countries in sub-Saharan Africa, had faster decreases in child mortality during 2000–13 than during 1990–2000. In 2013, neonatal deaths accounted for 41·6% of under-5 deaths compared with 37·4% in 1990. Compared with 1990, in 2013, rising numbers of births, especially in sub-Saharan Africa, led to 1·4 million more child deaths, and rising income per person and maternal education led to 0·9 million and 2·2 million fewer deaths, respectively. Changes in secular trends led to 4·2 million fewer deaths. Unexplained factors accounted for only −1% of the change in child deaths. In 30 developing countries, decreases since 2000 have been faster than predicted attributable to income, education, and secular shift alone. Only 27 developing countries are expected to achieve MDG 4. Decreases since 2000 in under-5 mortality rates are accelerating in many developing countries, especially in sub-Saharan Africa. The Millennium Declaration and increased development assistance for health might have been a factor in faster decreases in some developing countries. Without further accelerated progress, many countries in west and central Africa will still have high levels of under-5 mortality in 2030. Bill & Melinda Gates Foundation, US Agency for International Development.