ethics
Can the UN Heal the World by
+
2015?
policy
T
o help bridge the gap in quality of life between
developed and underdeveloped nations, leaders
from several countries in the United Nations (UN)
created the Millennium Development Goals in
September 2000—eight goals aimed at reducing worldwide
hunger, poverty, disease and mortality, and promoting
childhood education, gender equality and environmental
sustainability. The UN set a target for meeting these goals
by 2015.
The progress of some of these efforts and their
implications for members of the international community
were discussed on October 7, 2006, at a conference entitled
“Can the United Nations heal the world?” hosted by Stanford
School of Medicine. Several Stanford professors spoke at the
conference, including Dr. Yvonne Maldonado, Associate
Professor of Pediatrics in Infectious Diseases, who focused
on development goals to reduce childhood mortality and
increase maternal health.
Closing the Health Gap
Childhood and infant mortality are the greatest indicators
of disparity between children in the developed world and
those in underdeveloped regions. For this reason, the fourth
UN Millennium Development Goal is to reduce the mortality
rate of children under age five by two-thirds. Along similar
lines, the fifth goal is to improve maternal health by reducing
the maternal mortality ratio by three-quarters.
Since the inception of these goals, there have been
improvements in countries in Latin America, the Caribbean,
Eastern Asia and Northern Africa. However, some regions
have only seen modest progress. In 2003, Sub-Saharan
Childhood and infant mortality are the greatest indicators of disparity between
children in the developed world and those in underdeveloped regions.
Background Photo Credit: ©UNICEF/94-1393/Shehzad Noorani
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74 stanford scientific
Stanford Medical School Hosts
Conference on UN Goals
by Victoria Parente
Africa, with only 20% of the world’s young, accounted for
half of the deaths of children under age five. Also in this
region, maternal mortality fell on average by 1.6% a year
compared to the annual target rate of 5.4%.
The World Bank, a group of organizations that provide
finance and advice for economic development and elimination
of poverty, states that the main obstacle in meeting the
UN goals is the inefficient use of existing interventions.
In 2003, the World Bank estimated that the number of
childhood deaths worldwide could fall by as much as 63% if
all the effective preventive and treatment interventions for
childhood illness were practiced.
The Case for Vaccines
Immunization is one such intervention for preventing
disease. Vaccines are arguably the greatest achievement in
public health, increasing life expectancy in the U.S. by 29.2
years during the 20th century. They have eliminated small
pox and diminished the cases of infectious diseases such as
polio, tetanus, measles and hepatitis B. Maldonado notes
that pediatric vaccines “have had the most profound impact
of any intervention on increasing global child survival,
accounting for three million children’s lives saved annually.”
According to Maldonado, 30.4% of deaths in children under
age five in 1990 were due to infectious diseases. Today, that
percentage is 1.4%, due in large part to increased access
to vaccinations. However, close to 30 million children
worldwide still have no access to immunization.
In addition to the health benefits of vaccines, Maldonado
adds that “Immunization reduces the social and financial
costs of treating diseases, offering opportunities for poverty
 ethics
reduction and greater social and economic development.” +
policy
For example, the eradication of smallpox in 1979 led to direct
savings of $275 million per year in the U.S.

Preventing HIV Transmission

Reducing childhood mortality in the developing world has
also faced the more recent challenge of the spread of HIV/
AIDS. In the U.S., a single dose of an anti-HIV drug called
nevirapine is given to mothers with HIV at the onset of labor
and to the baby after delivery. This procedure roughly halves
the rate of HIV transmission from mother to newborn. As
nevirapine is only given once to the mother and her child, it
is relatively easy and inexpensive.
Photo Credit: ©sxc.hu/Nick Winchester
However, as with immunization, not everyone is using
this preventative measure. U.S. law requires that a pregnant Vaccinations not only save lives, but they also save money and allow
woman be tested for HIV to ensure that nevirapine is for greater economic prosperity.
administered if she is positive. However, in other countries
where HIV tests are not available, women may not know they
are HIV positive and thus do not seek this intervention.
VICTORIA PARENTE is a senior majoring in Biology, with an emphasis on
Maldonado has participated in research that measures
Neuroscience and Psychology. In her spare time she enjoys running,
the frequency, timing and risk factors of HIV transmission
swimming, and reading the New York Times.
through breast milk in Zimbabwe. Her work has had
significant impact on studies concerning mother-to-
child transmission. Although formula feeding prevents
To Learn More
contraction of the virus, it also increases mortality rates
in African infants under seven months old, due to factors Visit the UN Millennium Development Goals website: http://
including lack of transmission of antibodies from mother to www.un.org/millenniumgoals
child. Maldonado focuses on giving pharmaceuticals or HIV
drugs such as nevirapine to those children at risk, so that
they can continue nursing.

Bringing UN Goals to Fruition

Despite the existence of technology that can be applied
toward reaching the UN’s goals, political effort has been
lacking for this initiative. According to one UN speaker, the
U.S. spent 0.2% of its budget for international development
in 2005, making it the second lowest country out of 22
surveyed. To effect change, political will is needed. The scale
of the problems is too large for non-government aid-relief
organizations to solve alone. S

^Two children scavenge through remains of garbage in their village.

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