TOWARDS REACHING THE HEALTH-RELATED MILLENNIUM DEVELOPMENT GOALS: PROGRESS REPORT AND THE WAY FORWARD REPORT OF THE REGIONAL DIRECTOR

TOWARDS REACHING THE HEALTH-RELATED MILLENNIUM DEVELOPMENT GOALS: PROGRESS REPORT AND THE WAY FORWARD REPORT OF THE REGIONAL DIRECTOR i

AFRO Library Cataloguing-in-Publication Data Title: Towards reaching the health-related millennium development goals: progress report and the way forward: Report of the Regional Director 1. Millennium development goals 2. Delivery of health care 3. Achievement 4. Health priorities 5. Socioeconomic factors I. World Health Organization. Regional Office for Africa. ISBN : 978 929 023 1776 (NLM Classification: W 84.1) WHO Regional Office for Africa, 10 Publications of the World Health Organization enjoy copyright protection in accordance with the provisions of Protocol 2 of the Universal Copyright Convention. All rights reserved. Copies of this publication may be obtained from the Publication and Language Services Unit, WHO Regional Office for Africa, P.O. Box 6, Brazzaville, Republic of Congo (Tel: +47 241 39100; Fax: +47 241 39507; E-mail: afrobooks@afro.who.int). Requests for permission to reproduce or translate this publication whether for sale or for non-commercial distribution should be sent to the same address. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization or its Regional Office for Africa be liable for damages arising from its use. Printed in the Republic of Congo ii

CONTENTS 1. BACKGROUND......1 2. PROGRESS MADE... 2 3. CHALLENGES... 4 4. THE WAY FORWARD... 5 ANNEXES A: OFFICIAL LIST OF MDG INDICATORS... 7 B: GRAPHS OF MDG TRENDS... 14 C: LATEST ON MDGS PROVIDED BY MEMBER STATES COMPARED WITH UN... 24 iii

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1. BACKGROUND In 00, world leaders adopted the United Nations Millennium Declaration and the millennium development goals (MDGs), setting the year 15 as the date for reaching the targets. The MDGs constituted an unprecedented commitment by world leaders to comprehensively address peace, security, development, human rights and fundamental freedoms. Three of the eight MDGs are health goals: they are Goal 4, Reduce child mortality; Goal 5, Improve maternal health; and Goal 6, Combat HIV/AIDS, malaria and other diseases. Several other MDGs are monitored through health-related indicators; they include Goal 1, Eradicate poverty and hunger; Goal 7, Ensure environmental sustainability; and Goal 8, Develop a global partnership for development (see the table in Annex A for an updated list). Significant commitments to the MDGs have been demonstrated by countries of the WHO African Region. Examples of these commitments include the Abuja Declaration of 01 requesting countries to allocate 15% of public expenditures to the health sector; the 05 WHO Regional Committee for Africa resolution on achieving the millennium development goals; 1 and the 08 Ouagadougou Declaration on Primary Health Care and Health Systems in Africa 2. Similar commitments have been demonstrated by development partners through the United Nations Secretary-General s MDGs Africa Initiative and the Harmonization for Health in Africa mechanism. This report provides an update on the progress made towards the achievement of the health and health-related MDGs; it further identifies the main challenges and proposes the way forward. 1. Resolution AFR/RC55/R2, Achieving the health millennium development goals: situation analysis and perspectives in the African Region. In: Fifty-fifth Session of the WHO Regional Committee for Africa, Maputo, Mozambique, 22 26 August 05, Final report, Brazzaville, World Health Organization, Regional Office for Africa, 05 (AFR/RC55/), pp. 7 9. 2. Resolution AFR/RC58/R3, The Ouagadougou Declaration on Primary Health Care and Health Systems in Africa: achieving better health for Africa in the new millennium. In: Fifty-eighth Session of the WHO Regional Committee for Africa, Yaounde, Republic of Cameroon, 1 5 September 08, Final report, Brazzaville, World Health Organization, Regional Office for Africa, 08 (AFR/RC58/), pp. 13 15. 1

2. PROGRESS MADE The analysis of progress is based on data from the UN Statistical Division (UNSD) and data from World Health Statistics 08 and 09 when not available in UNSD. It focuses on agreed MDG targets and indicators. Trends are assessed on the basis of data between 1990 and the most recent year for which information was available as of July 09. 3 UN Member States earlier agreed to use the UNSD statistical database to monitor country progress towards reaching the MDGs. However the latest data on MDGs submitted by Member States are presented in Annex. Health MDGs Target 4A: Reduce by two thirds, between 1990 and 15, the under-five mortality rate. Six countries are on track to achieve this target (Algeria, Cape Verde, Eritrea, Malawi, Mauritius and Seychelles); 23 countries are making progress, although it is insufficient; and 16 countries have made no progress. In 06, the mortality rate varied between 16 and 262 per 1000 live births (Annex B: Figure 2). Target 5A: Reduce by three quarters, between 1990 and 15, the maternal mortality ratio. MMR estimates for 05 show that the Region has made no progress towards achieving this target. 4 A total of 13 countries 5 had maternal mortality ratios less than 550 deaths per 100 000 live births; 31 countries had very high MMRs of 550 or higher; and 12 countries had ratios of 1000 or higher. MMR estimates were not available for two countries (Annex B: Figure 3). Target 5B: Achieve, by 15, universal access to reproductive health. Between 1990 and 07, there was a 30% increase in access to contraceptives in the Region among currently married women. The prevalence of contraceptive use among currently married women (15 49 years old) varied from 75% to 5% in 07. Only five countries had contraceptive use rates higher than 50% (Algeria, Cape Verde, Mauritius, South Africa and Zimbabwe), while 27 countries had usage rates less than 33%. Trend data were not available for nine countries (Annex B: Figure 4). Target 6A: Halt and begin to reverse, by 15, the spread of HIV/AIDS. Among the 13 countries that have complete trend data, 11 have started to observe declines or stabilization 3. Although the MDGs were adopted in 00, the baseline year for the targets was set from 1990. 4. WHO, Maternal mortality in 05: Estimates developed by WHO, UNICEF, UNFPA and the World Bank, Geneva, World Health Organization, 07; also see http://www.who.int/reproductive-health/publications/maternal_mortality_05/index.html (accessed 29 October 08). 5. Algeria, Botswana, Cape Verde, Comoros, Eritrea, Gabon, Madagascar, Mauritius, Mozambique, Namibia, South Africa, Swaziland and Togo. 2

in HIV prevalence trends among pregnant women aged 15 24; 6 HIV/AIDS prevalence has increased in two countries (Burundi and Malawi). The most recent prevalence estimates in the 13 countries ranged between 1.7% and 27.1% (Annex B: Figure 5). Target 6B: Achieve, by 10, universal access to treatment for HIV/AIDS for all those who need it. Only a third of the population with advanced HIV infection in the Region had access to antiretroviral medicines in 07. Three countries had coverage rates of more than 70% (Botswana, Namibia and Rwanda), while 39 countries had coverage rates below 50%. Trend data were not available for four countries (Annex B: Figure 6). Target 6C: Halt and begin to reverse, by 15, the incidence of malaria and other major diseases. Interpretation of the trends in malaria incidence and deaths using available data is difficult in the African Region due to incomplete reports, non-standardized reporting and reliance mostly on clinical diagnosis. Indicators of ITN and antimalarial coverage are preferred to measure progress toward the MDG targets. There were increases in the proportions of children under five sleeping under insecticide-treated bednets between 1999 and 06 in all 18 countries with trend data, although coverage rates were lower than 50% (Annex B: Figure 7a). The use of antimalarial medicines for treating children with fever decreased between 1996 and 06 in 14 countries out of 19 with complete trend data (Annex B: Figure 7b). This decrease is due to the shift from chloroquine treatment to the implementation of artemisinin-based combination therapy policy. Five countries (Angola, Comoros, Eritrea, Seychelles and Zambia) are on track to achieve the target for tuberculosis, while eight countries 7 have shown insufficient progress (Annex B: Figure 8). Of the 33 countries that are making no progress, 14 have prevalence of 500 or more per 100 000 population; between 1990 and 07, estimated prevalence increased in 27 countries due to the HIV pandemic. The prevalence ranged between 39 and 941 per 100 000 population per year (Annex B: Figure 8). Health-related MDGs Target 1C: Halve, between 1990 and 15, the proportion of people who suffer from hunger. Only eight countries are on track to achieve this target. 8 Although 18 countries 6. Benin, Botswana, Eritrea, Ethiopia, Ghana, Lesotho, Namibia, Rwanda, Swaziland, Zambia and Zimbabwe. 7. Cape Verde, Ghana, Guinea-Bissau, Mali, Mauritius, Namibia, Sao Tome and Principe, and South Africa. 3

3. CHALLENGES are making progress, their progress is insufficient; 12 countries have made no progress. The proportion of malnourished children in these 38 countries varies from 3% to 44%. Trend data were not available in eight countries (Annex B: Figure 1). Target 7C: Halve, by 15, the proportion of people without sustainable access to safe drinking water and basic sanitation. Nine countries 9 are on track to achieve the safe water target. Six countries are making progress although it is insufficient, while 19 countries have made no progress (Annex B: Figure 9). The proportions of population using improved drinking water sources varied between 42% and 100% in 06. Trend data were not available for 12 countries. Of the 36 countries with trend data, 34 countries have made no progress to achieve the target for basic sanitation while two countries are on track (Algeria and Mauritius) (Annex B: Figure 10). The few countries that are on track to achieve some of the targets represent between 5% and 15% of the total population of the African Region. Target 8E: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries. The indicator for this target is the proportion of population with access to affordable essential medicines on a sustainable basis. The method for collecting data on this indicator was introduced only recently (see Annex A). Thus, adequate trend data were not yet available to assess countries progress on this target. CHALLENGES The available evidence indicates that most of the countries in the African Region have not made sufficient progress towards the MDG targets. A number of key challenges need to be addressed effectively if countries are to attain the goals by 15. These challenges include: (a) (b) (c) inadequate internal and external resources devoted to the achievement of the MDGs; external resources which are unpredictable, non-sustainable, and not aligned to or in harmony with country priorities; existing resources which are inefficiently utilized; weak health systems, particularly inadequate access to, and quality of, health 8. Algeria, Botswana, Republic of Congo, Ghana, Guinea-Bissau, Malawi, Mauritania, and Sao Tome and Principe. 9. Botswana, Burkina Faso, Cote d Ivoire, Ghana, Guinea, Malawi, Mauritius, Namibia and South Africa. 4

4. THE WAY FORWARD (d) (e) (f) (g) services; weak human and institutional capacity; persisting inequities in access to proven interventions, particularly against maternal mortality, but also against child mortality, HIV/AIDS, tuberculosis and malaria; low priority accorded to health in national economic and development policies; weak multisectoral response, and the poor progress in achieving the other MDGs; inadequate trend data for a number of indicators, global reporting often being based on imputations and estimations using statistical techniques rather than on empirical and timely data collection. THE WAY FORWARD Progress on the goals of the health-related MDGs is mostly very slow in the African Region. Countries and their development partners should increase resources significantly and explore new and innovative ways to ensure progress. Countries should allocate at least 15% of public expenditure to the health sector as set out in the 01 Abuja Declaration. 10 In addition, they need to strengthen existing structures and mechanisms for sustainable, effective and efficient mobilization and utilization of internal and external resources. Countries can strengthen health systems by fully implementing the 08 Ouagadougou Declaration on Primary Health Care and Health Systems in Africa to ensure better access to, and quality of, health services; a strong health workforce; an effective health information system; equitable access to essential medical products, vaccines and technologies; a functioning health financing system; and a robust leadership and governance structure. It is necessary for countries to increase their attention to areas where progress has been limited, particularly to improve maternal health, by providing sufficient financing to strengthen maternal and other reproductive health services. Both countries and partners should build international partnerships, sustain the gains 10. Recent estimates show that only five countries Botswana, Burkina Faso, Liberia, Malawi and Rwanda have achieved the 05 Abuja target of at least 15% of public expenditure to the health sector. 5

achieved and scale up interventions to achieve the necessary reductions in under-five mortality as well as combat HIV/AIDS, malaria and tuberculosis. Countries should strengthen leadership and institutional capacity within ministries of health, especially in macroeconomic analysis and strategic planning and budgeting. There is a need to increase dialogue between health and oversight ministries such as finance and planning. National efforts should follow the Three Ones principle of one national plan, one coordination mechanism and one monitoring and evaluation plan while striving to achieve the MDGs. Countries can improve the monitoring of progress towards the MDGs in collaboration with all stakeholders and international partners by: (a) improving the frequency, quality and efficiency of national health surveys; (b) strengthening birth and death registration; (c) improving the availability of demographic data by completing the 10 census round; (d) improving surveillance and service statistics; (e) enhancing monitoring of health systems strengthening; and (f) strengthening the analysis, evaluation and use of data for decision-making. 11 Unless current trends are drastically changed, most countries of the African Region are unlikely to achieve any of the health or health-related MDGs. However, progress is possible if Member States work with development partners to devote more resources, strengthen health systems, including the data sources for monitoring MDG progress, and improve access to proven interventions. The Regional Committee is requested to take note of this progress report and encourage countries to adopt the proposed actions as the way forward for reaching the targets of the millennium development goals. 11. WHO, Strengthening the monitoring of progress on the health-related MDGs in the African Region. Report submitted to the HHA Regional Directors Meeting, Nairobi, 11 14 November 08, Brazzaville, World Health Organization, Regional Office for Africa, 08. 6

ANNEX A MILLENNIUM DEVELOPMENT GOALS Of icial list of MDG indicators MDG monitoring framework revised to include new targets and indicators, as noted by the 62nd UN General Assembly. Health targets and indicators are in orange. All indicators shouldbe disaggregated by sex and urban/rural as far as possible. Effective 15 January 08 Goals and targets (from the Millennium Declaration) Indicators for monitoring progress Goal 1: Eradicate extreme poverty and hunger Target 1.A: Halve between 1990 and 15, the proportion of people whose income is less than one dollar a day 1.1 Proportion of population below $1 (PPP) per day i. 1.2 Poverty gap ratio. 1.3 Share of poorest quintile in national consumption. Target 1.B: Achieve full and productive employment and decent work for all, including women and young people 1.4 Growth rate of GDP per person employed. 1.5 Employment-to-population ratio. 1.6 Proportion of employed people living below $ 1 (PPP) per day. 1.7 Proportion of own-account and contributing family workers in total employment. Target 1.C: Halve, between 1990 and 15, the proportion of people who suffer from hunger 1.8 Prevalence of underweight children under-five years of age. 1.9 Proportion of population below minimum level of dietary energy consumption. 7

MILLENNIUM DEVELOPMENT GOALS Goals and targets (from the Millennium Declaration) Indicators for monitoring progress Goal 2: Achieve universal primary education Target 2.A: Ensure that, by 15, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling. 2.1 Net enrolment ratio in primary education. 2.2 Proportion of pupils starting grade 1 who reach last grade of primary. 2.3 Literacy rate of 15-24 year-olds, women and men. Goal 3: Promote gender equity and empower women Target 3.A: Eliminate gender disparity in primary and secondary education, preferably by 05, and in all levels of education no later than 15 3.1 Ratios of girls to boys in primary, secondary and tertiary education 3.2 Share of women in wage employment in the nonagricultural sector 3.3 Proportion of seats held by women in national parliament Goal 4: Reduce child mortality 8

MILLENNIUM DEVELOPMENT GOALS Goals and targets (from the Millennium Declaration) Indicators for monitoring progress Target 4.A: Reduce by two-thirds, between 1990 and 15, the under-five mortality rate 4.1 Under-five mortality rate 4.2 Infant mortality rate 4.3 Proportion of 1 year-old children immunized against measles Goal 5 : Improve maternal health Target 5.A: Reduce by three quarters, between 19990 and 15, the maternal mortality ratio Target 5.B: Achieve, by 15, universal access to reproductive health 5.1 Maternal mo 5.2 Proportion of births attended by skilled health personnel 5.3 Contraceptive prevalence rate 5.4 Adolescent birth rate 5.5 Antenatal care coverage (at least one visit and at least four visits) 5.6 Unmet need for family planning 9

MILLENNIUM DEVELOPMENT GOALS Goals and targets (from the Millennium Declaration) Indicators for monitoring progress Goal 6: Combat HIV/AIDS, malaria and other diseases Target 6.A: Have halted by 15 and begun to reverse the spread of HIV/AIDS Target 6.B: Achieve, by 10, universal access to treatment for HIV/AIDS for all those who need it. 6.1 HIV prevalence among population aged 15-24 years 6.2 Condom use at last high-risk sex 6.3 Proportion of population aged 15-24 years with comprehensive correct knowledge of HIV/AIDS 6.4 Ratio of school attendance of orphans to school attendance of non-orphans aged 10-14 years 6.5 Proportion of population with advanced HIV infection with access to antiretroviral drugs Target 6.C: Have halted by 15 and begun to reverse the incidence of malaria and other major diseases 6.6 Incidence and death rates associated with malaria 6.7 Proportion of children under 5 sleeping under insecticide-treated bednets 6.8 Proportion of children under 5 with fever who are treated with appropriate anti-malaria drugs 6.9 Incidence, prevalence and death rates associated with tuberculosis 6.10 Proportion of tuberculosis cases detected and cured under directly observed treatment short course 10

MILLENNIUM DEVELOPMENT GOALS Goals and targets (from the Millennium Declaration) Indicators for monitoring progress Goal 7: Ensure environmental sustainability Target 7.A: Target 7.B: Integrate the principles of sustainable development into country policies and programmes and reverse the loss of environmental resources Reduce biodiversity loss, achieving, by 10, a significant reduction in the rate loss. 7.1 Proportion of land area covered by forest 7.2 CO2 emissions, total per capita and per $ 1 GDP (PPP) 7.3 Consumption of ozone-depleting substances 7.4 Proportion of fish stocks within safe biological limits 7.5 Proportion of total water resources used 7.6 Proportion of terrestrial and marine areas protected 7.7 Proportion of species threatened with extinction Target 7.C: Halve, by 15, the proportion of people without sustainable access to safe drinking water and basic sanitation. Target 7.D: By, to have achieved a significant improvement in the lives of at least 100 million slum dwellers. 7.8 Proportion of population using an improved drinking water source 7.9 Proportion of population using an improved sanitation facility 7.10 Proportion of urban population living in slums ii 11

MILLENNIUM DEVELOPMENT GOALS Goals and targets (from the Millennium Declaration) Indicators for monitoring progress Goal 8: Develop a global partnership for development Target 8. A Develop further an open, rule-based, predictable, non-discriminatory trading and financial system. Includes a commitment to good governance, development and poverty reduction both nationally and internationally. Target 8.B: Address the special needs of the least developed countries. Includes: tariff and quota free access for the least developed countries export, enhanced programme of debt relief for heavily indebted poor countries (HIPC) and cancellation of official bilateral debt, and more generous ODA for countries committed to poverty reduction. Target 8.C: Address the special needs of landlocked developing countries and small island developing States (through the Programme of Action for the Sustainable Development of Small Island Developing States and the outcome of the twenty-second special session of the General Assembly). Some of the indicators listed below are monitored separately for the least developed countries (LDCs). Africa, landlocked developing countries and small islands developing States. OFFICIAL DEVELOPMENT ASSISTANCE (ODA) 8.1 Net ODA, total and to the least developed countries, as percentage of OECD/DAC donors gross national income. 8.2 Proportion of total bilateral, sector-allocable ODA of OECD/DAC donors to basic social services (basic education, primary health care, nutrition, safe water and sanitation). 8.3 Proportion of bilateral official development assistance of OECD/DAC donors that is untied. 8.4 ODA received in landlocked developing countries as a proportion of their gross national incomes. 8.5 ODA received in small island developing States as a proportion of their gross national incomes. MARKET ACCESS 8.6 Proportion of total developed country imports (by value and excluding arms) from developing countriesimports (by value and excluding arms) from developing countries and least developed countries, admitted free of duty. 12

MILLENNIUM DEVELOPMENT GOALS Goals and targets (from the Millennium Declaration) Indicators for monitoring progress Target 8.D: Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term Target 8.E: Target 8.F: In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries. In cooperation with the private sector, make available the benefits of new technologies, especially information and communications. 8.7 Average tariffs imposed by devel-oped countries on agricultural products and textiles and clothing from developing countries. 8.8 Agricultural support estimate for OECD countries as a percentage of their gross domestic product. 8.9 Proportion of ODA provided to help trade capacity. DEBT SUSTAINABILITY 8.10 Total number of countries that have reached their HIPC decision points and number that have reached their HIPC completion points (cumulative). 8.11 Debt relief committed under HIPC and MDRI Initiatives. 8.12 Debt service as a percentage of exports of goods and services. 8.13 Proportion of population with access to affordable essential drugs on a sustainable basis. 8.14 Telephone lines per 100 population. 8.15 Cellular subscribers per 100 population. 8.16 Internet users per 100 population. The Millennium Development Goals and targets come from the Millennium Declaration, signed by 189 countries, including 147 Heads of State and Government in September 00 (http//www.un.org/millennium/declaration/ares552e.htm) and from further agreement by Member States at the 05 World Summit (Resolution adopted by the General Assembly A/RES/60/1, http//www.un.org/docs/journal/asp/ws.asp?m=a/res/60/1. The goals and targets are interrelated and should be seen as a whole. They represent a partnership between the developed countries and the developing countries to create an environment at the national and global levels alike which is conducive to development and the elimination of poverty. i ii For monitoring country poverty trends, indicators based on national poverty lines should be used, where available. The actual proportion of people living in slums measured by a proxy, represented by the urban population living in households with at least one of the four characteristics (a) lack of access to improved water supply; (b) lack of access to improved sanitation; (c) overcrowding (3 or more persons per room); and (d) dwellings made of non-durable material. 13

ANNEX B GRAPHS OF MDG TRENDS Figure 1: Percentage of under-five children with moderate or severe malnutrition in 01-06 (lighter bars) and the MDG target* rate in the African Region Countries with insufficient progress Countries showing no progress towards the target** 0 0 10 23 11.5 4.6 4.6 16.6 MDG 19.3 target 6.8 (15)19.8 Lesotho 19.3 Lesotho Comoros 7.9 19.8 Comoros 01-06Senegal Zambia 10.8 Kenya Cote d'ivoire11.2 7.9 6.8 24.9 9.3 24.9 Togo 9.3 26 Togo Gambia Uganda Rwanda U R Tanzania Rwanda Benin Mozambique Benin 28.5 Mozambique Namibia 28.5 30.4 Sierra Leone 13.7 Burkina Faso Burkina Faso Burundi 13.6 30.4 Sierra Leone 13.6 Madagascar Niger Mali 22.6 Madagascar 19.6 Niger 21.3 19.6 41.9 21.3 44.4.2 11.9 12.4.2 11.9 Chad 41.9 Mali Chad Eritrea 14.4.4 12.8 21.8 14.6 14.4 Eritrea MDG 21.8 target (15) 22.5 22.6 22.5 14.6 14.6 (15).4.3 12.8 23.7 22.6 24 23.7 0 13.1 13.5 24 31.1.0 33.2.0 19.4 36.7 23.8 38.4 23.8.5.5 39.6 36.7 39.6 Ghana Guinea-Bissau 50 14.4 ` 17.7 13.7 ` 17.7 13.7 19.4 19.4 12.5 12.5 Malawi Mauritania Mauritania 50 7.0 14.4 Ghana Malawi 12.5 7.0 Guinea-Bissau 38.4 30 30 8.6 Congo Congo 33.2 9.2 6.5 9.2 Sao Tome and Principe Botswana 6.5 12.5 Botswana 8.6 28.7 17.9 17.2 31.1 10 Algeria 3.7 11.6 28.7 3.7 4.6 Algeria Sao Tome and Principe 4.6 25.8 25.8 10 0 13.5 14.6 19.4 Ethiopia Ethiopia 44.4.3 01-06 MDG target 13.2 13.2 17.9 39.2 22.6 01-06 12.4 17.2 39.2 Burundi 50 50 19.9 Nigeria D R Congo 19.9 30 17.3 D R Congo 37.4 16.437.4 16.4 11.2 Namibia Guinea 13.1 Guinea Nigeria 11.6 13.7 Central African Republic Uganda U R Tanzania 26 9.5 Central African Republic9.5 Cote d'ivoire 30 10.8 50 (15) 7.8 17.3 10 Kenya Zambia Gambia 01-06 16.6 MDG target Zimbabwe11.5 Zimbabwe Cameroon 7.8 Cameroon 10 Senegal 0 30 11.2 South Africa South Africa 50 11.2 10 African Region 23 African Region 0 30 Countries on track to achieve the target 19.4 19.4 13.6 13.6 31.8 23.8 31.8 23.8 Note: *MDG Target 1.C: Halve, between 1990 and 15, the proportion of people who suffer from hunger ** Countries and regions are classified according to the following thresholds: On track: Average annual rate of reduction (AARR) is greater than or equal to 2.6 per cent, or latest available estimate of underweight prevalence (00 or later) is less than or equal to 5 per cent, regardless of AARR. Insufficient progress: AARR is between 0.6 per cent and 2.5 per cent. No progress: AARR is less than or equal to 0.5 per cent. Data was not available for eight countries: Angola, Cape Verde, Equatorial Guinea, Gabon, Liberia, Mauritius, Seychelles and Swaziland. Source for country data UNSD - accessed 7 July 09. Source for data for the average of the African Region: WHO, World health statistics 08, Geneva, World Health Organization, 08. 14

GRAPHS OF MDG TRENDS Figure 2: Under-five mortality (per 1000 live births) in 07 (lighter bars) and the MDG target* rate in the African Region Countries showing no progress towards the target** Countries with insufficient progress Note: 0 50 100 150 0 250 300 African Region 145 61 Rate in 07 MDG 4 - target rate for 15 0 50 100 150 0 250 300 Sierra Leone 262 96 Chad 0 50 100 150 0 9250 300 67 African Burkina Region Faso 145 191 69 61 Rwanda 181 58 Sierra Burundi Leone 180 262 63 96 Central African Republic Chad 172 9 5767 Burkina Zambia Faso 170 191 6069 Equatorial Guinea Rwanda 150 181 5758 Cameroon Burundi 148 180 46 63 Central African Republic Congo 125 172 34 57 Zambia Kenya 121 170 32 60 0 50 100 Mauritania 118 150 0 250 300 Equatorial Guinea 44 57 African Cameroon Ghana Region 115 148145 46 61 Sao Tome and Principe Congo 99 125 334 Sierra Gabon Kenya Leone 91 121 262 3132 96 Zimbabwe Mauritania Chad 90 118 9 25 44 67 South Burkina Africa Ghana Faso 59 115 191 69 Sao Tome and Principe Rwanda 99 181 33 58 Gabon Burundi 91 180 31 63 Central African Zimbabwe Republic 90 172 25 57 South Africa Zambia 59 170 60 Equatorial Guinea 150 57 Cameroon 148 46 Congo 125 34 Kenya 121 32 Mauritania 118 44 Ghana 115 114 *MDG Target Sao Tome 4.A: and Principe Reduce by two-thirds, 99 between 1990 and 15, Senegal the under five 50 mortality rate. 33 Madagascar 112 **Country and regional Gabon assessments 91 of progress towards MDG 4 are based on 56 31 average annual rates of reduction (AARR) in U5MR Gambia 109 51 observed for 1990 07 Zimbabwe 90 and 25 required during 08 15 in order to reach the MDG target of reducing U5MR by two thirds by 15, Togo 100 49 according to the South following Africa 59 thresholds: On track: U5MR is less than Swaziland, or U5MR is 91 or more and AARR observed for 1990 07 is 37 4.0 per cent or more. Insufficient progress: U5MR is or more and Lesotho AARR observed 84 34 for 1990 07 is between 1.0 per cent and 3.9 per 68 cent. No progress: U5MR is or more and AARR observed for 1990 07 Namibia 29 is less than 1.0 per cent. Source: WHO, World health statistics 09, Geneva, World Health Organization, 09. Guinea - Bissau 198 80 Mali 196 83 189 Rate in Nigeria 07 MDG 4 - target 77 rate for 15 Niger 176 0 50 100 107 150 0 250 300 0 50 100 150 0 250 300 Mozambique 168 78 Guinea - Bissau 198 110 80 Malawi Democratic Republic of Congo 161 74 68 Mali 196 83 Angola 158 Eritrea 70 87 49 Nigeria 189 77 Guinea 150 Algeria 37 78 Niger 176 23 107 Liberia 133 78 32 Mozambique 168 Cape Verde 78 Uganda 131 53 17 Democratic Republic of Congo 161 Mauritius 68 Côte d'ivoire 127 Countries 8 on track to 51 Angola 158 87 16 Benin 123 Seychelles 62 6 150 achieve the target Guinea 78 Ethiopia 119 68 Liberia 133 78 United Republic of Tanzania 116 Rate 54 Uganda in 07 MDG 4 - target rate 131 for 15 53 Senegal 114 50 Côte d'ivoire 0 50 100 127 150 0 250 300 0 50 100 150 0 250 300 51 Madagascar 112 56 123 Guinea Benin - Bissau 198 110 62 Gambia 80 109 Malawi 74 51 Ethiopia 119 Mali 68 196 Togo 100 83 Eritrea 70 49 United Republic of Tanzania 116 49 54 Swaziland Nigeria 189 9177 37 37 Senegal 114 Algeria 23 50 Lesotho Niger 176 84 107 34 Madagascar 112 32 Mozambique 168 Cape Verde 56 Namibia 68 78 29 Gambia 109 17 Democratic Republic of Congo 161 51 Comoros 66 Mauritius 68 8 Togo 100 158 Botswana Angola 49 87 Seychelles 16 19 Swaziland 91 6 Guinea 150 37 78 Lesotho 84 Liberia 34 133 78 Namibia 68 Uganda 131 29 53 Comoros 66 Côte d'ivoire 127 51 Botswana Benin 123 19 62 Ethiopia 119 68 United Republic of Tanzania 116 54 Comoros Botswana 19 66 15

GRAPHS OF MDG TRENDS Figure 3: Estimates of maternal mortality ratio (per 100 000 live births) in 05 (lighter bar) and the MDG target* ratio in the African Region Countries with MMR less than 550** Countries with MMR between 550 and 980 Countries with MMR between 1000 or higher 0 500 1000 1500 00 African Region 228 900 Mauritius Algeria Cape Verde Namibia Botswana Swaziland South Africa Comoros Eritrea Madagascar Togo Gabon Mozambique 0 500 1000 1500 00 15 30 180 210 48 210 93 380 63 390 1 0 58 0 238 450 350 510 123 510 160 5 125 5 375 Year 05 MDG target (15) Uganda Kenya Ghana Equatorial Gambia Burkina Faso Ethiopia Congo Côte d'ivoire Mauritania Zambia Benin Zimbabwe Guinea U R Tanzania Lesotho Mali Central Senegal 550 300 560 163 560 185 680 5 690 275 700 233 7 350 7 223 810 3 8 233 830 235 8 248 880 143 910 0 950 193 960 153 970 300 980 175 300 980 Cameroon Malawi Guinea-Bissau D R Congo Nigeria Burundi Liberia Rwanda Angola Chad Niger Sierra Leone 0 500 1000 1500 00 138 1 228 235 250 325 1 325 375 375 300 450 1000 1100 1100 1100 1100 1100 10 1300 10 1500 1800 2100 Note: *MDG Target 5.A: Reduce by three quarters, between 1990 and 15, the maternal mortality ratio. **Due to the large margins of uncertainty around these estimates, country-level trend analysis is problematic. Progress towards this MDG is therefore assessed based on the latest available estimates and is classified according to the following thresholds: Very high: MMR of 550 or more; High: MMR of 300 549; Moderate: MMR of 100 299; Low: MMR below 100. Data was not available for San Tome and Principe and Seychelles. Source: Maternal mortality in 05: Estimates developed by WHO, UNICEF, UNFPA and the World Bank, WHO, 07. http://www.who. int/reproductive-health/publications/maternal_mortality_05/index.html (accessed on 29/10/08) and WHO, World health statistics 09, Geneva, World Health Organization 09. 16

GRAPHS OF MDG TRENDS Figure 4: Prevalence of contraceptive use (per cent) among currently married women 15 49 years old, in 00 07 (lighter bars) and 1990 1999 (darker bars) in the African Region* Countries with prevalence less than 33% 0 10 30 50 60 70 80 African Region 21.3 16.4 Sierra Leone Chad Angola Eritrea Mauritania Mal Guinea i Ethiopia Senegal Niger Nigeria Cote d'ivoire Gambia Burkina Faso Rwanda Mozambique Benin Ghana Togo Uganda Madagascar Central African Republic Comoros D R Congo Cameroon U R Tanzania Malawi 4.8 2.6 5.4 4.1 6.2 8.1 8.0 8.0 8.0 4.1 8.2 6.7 9.1 4.0 11.4 4.1 11.8 10.5 12.6 8.2 12.6 10.7 12.9 13.2 13.6 11.8 13.8 9.9 15.3 17.5 16.5 5.6 17.8 16.4 21.0 21.2 21.3 23.5 22.8 14.8 23.0 19.4 23.5 14.8 25.7 21.0 26.0 7.7 26.0 17.7 27.3 19.4 32.5 17.5 00-07 1990-1999 Zambia Lesotho Kenya Namibia Botswana Zimbabwe South Africa Cape Verde Algeria Mauritius Countries with prevalence of 33% or more** 0 10 30 50 60 70 80 22.0 23.2 28.9 34.2 34.3 35.9 39.3 43.7 44.447.6 50.8 52.9 53.9 56.3 60.2 60.3 61.3 61.4 75.9 74.7 Note: *MDG Target 5.B: Achieve, by 15, universal access to reproductive health. **Trend data is incomplete for nine countries: Burundi, Congo, Equatorial Guinea, Gabon, Liberia, Guinea-Bissau, Sao Tome and Principe, Seychelles, and Swaziland. Source: UNSD - accessed 7 July 09. 17

GRAPHS OF MDG TRENDS Figure 5: HIV prevalence in pregnant women aged 15 24 years in 04 07 (lighter bars) and in 00 03 (darker bars) for 13 countries with trend data in the African Region* Botswana Swaziland Lesotho Zimbabwe Zambia Namibia Ethiopia Rwanda Ghana Eritrea Benin Burundi Malawi 5.6 4.0 4.6 2.5 3.0 1.8 2.1 1.7 1.7 5.5 10.4 15.3 14.9 16.2 14.7 17.9 15.5 14.3 13.3 16.8 24.2 25.9 25.2 27.1 33.2 34.4 04-07 00-03 For these two countries the prevalence has increased between 00 and 07 0 10 30 50 Note: *MDG Target 6.A: Have halted by 15 and begun to reverse the spread of HIV/AIDS. Source: WHO-AFRO dataset 7 July 09. 18

GRAPHS OF MDG TRENDS Figure 6: Percentage of population with advanced HIV infection with access to antiretroviral medicines in 07 (lighter bars) and in 06 (darker bars) in the African Region* Countries with coverage rate of 31% or more Countries with coverage rate of 21 30% Countries with coverage rate of % or less** 0 0 0 4 3 10 8 13 11 13 12 15 12 17 12 17 10 17 11 18 19 19 18 14 9 12 Madagascar 34 4 Madagascar 60 3 80 Niger 10 60 100 8 0 10 13 Niger Chad 8 11 Madagascar 34 07 13 Chad Eritrea 13 11 10 12 Niger 07 138 06 Eritrea 12 13 1215 Chad Ghana 11 15 17 Ghana Congo 12 13 Eritrea 12 17 15 Congo Liberia 12 Ghana 12 17 12 10 17 17 Liberia Congo 10 12 11 17 Zimbabwe 17 17 18 Zimbabwe LiberiaGambia 11 10 19 Zimbabwe Gambia Togo 181911 17 19 18 18 Gambia Togo Algeria1819 19 14 19 Togo Algeria 14 189 Guinea-Bissau Algeria 14 Guinea-Bissau 9 Sierra Leone 12 Guinea-Bissau 9 Sierra Leone 12 Sierra Leone 12 60 80 80 100 100 0 Central African Republic 21 Central African Republic 6 0 Mauritius 6 21 60 60 80 80 100 100 0 0 African Region 21 60 31 60 80 80 100 100 22 60 African80 Region 100 21 31 0 24 0 60 80 100 0 31 22 Equatorial Guinea 60 80 100 Mauritius 14 Burundi 246 17 23 21 Republic 07 06 07Central 06 AfricanCentral African Region 21 31 31 31 African23Republic 6 21 Equatorial Guinea UR Tanzania 14 14 African Region 23 22 Burundi 07 06 06 Mauritius Mauritania17Mauritius 22 8 24 31 33 UR Tanzania 24 Uganda 14 27 23 24 23 Equatorial Guinea 31 1 Mauritania 8 Burundi DR Congo 23 35 Guinea 14 15 17 Burundi Uganda Malawi 27 33 Equatorial 21 07 06 17 31 UR Tanzania 24 1 23 24 DR Congo UR 35 14 35 Tanzania Mauritania 23 15Mauritania Mozambique 812 Malawi Burkina Faso 21 31 8 33 Uganda 24 Uganda 27 25 24 Mozambique 24 DR Congo 12 DR Congo Angola Burkina Faso Kenya 3135 27 38 1615 Malawi 21 35 15 38 41 Malawi 25 24 25 24 Angola Kenya Mali 27 Mozambique 35 43 16 Cameroon 12 Burkina Mozambique 12 16 Burkina Faso Faso 31 41 42 25 25 38 Mali Gabon 25 43 26 39 Angola Cameroon Kenya Angola 16 Kenya 27 Lesotho16 16 22 42 42 41 Gabon 25 Swaziland 26 39 35 25 Mali Mali 26 Cameroon 43 Lesotho NigeriaCameroon 22 13 16 16 42 46 42 Swaziland Zambia 35 Gabon 26 26 Gabon 26 39 26 Lesotho 2722 Nigeria Guinea 22 49 13 Lesotho 42 26 Zambia Benin 26 46 Swaziland Swaziland 42 35 26 26 27Nigeria Nigeria 28 49 4 56 Guinea 13 Cote d'ivoire 26 13 Benin Zambia Zambia Senegal 42 26 19 57 27 27 28 Guinea 56 71 Guinea 28 26 26 Cote d'ivoire 42 Senegal Rwanda 57 South Africa19 52Benin Benin 21 28 28 71Senegal 79 Cote28d'Ivoire Cote 19 Senegal 29 Botswan Rwanda 19 Southd'Ivoire AfricaEthiopia 52 76 21 18 28 79 88 Rwanda Rwanda 68 South AfricaSouth29 Africa21 28 21 Botswana Namibia 76 Ethiopia 18 29 Botswan 88 29 18 Botswan a Namibia 68 Ethiopia Ethiopia 18 a Namibia a Namibia Note: *MDG Target 6.B: Achieve, by 10, universal access to treatment for HIV/AIDS for all those who need it. **Trend data not available for four countries: Cape Verde, Comoros, Sao Tome and Principe and Seychelles. Source for country data UNSD - accessed 7 July 09. Source for data for the average of the African Region: WHO/UNAIDS/UNICEF--Towards Universal Access: Scaling up priority HIV/ AIDS interventions in the health sector--progress report 08. 19

GRAPHS OF MDG TRENDS Figure 7a: Percentage of under five children sleeping under insecticide-treated bednets* in 03 06 (lighter bars) and 1999 02 (darker bars) in the African Region** Figure 7b: Percentage of under five children with fever being treated with anti-malarial medicines in 02 06 (lighter bars) and 1993 01 (darker bars) in the African Region*** These five countries have shown an increasing trend in coverage between 1999 and 06 0 10 30 50 60 Kenya Cote d'ivoire Sierra Leone Cameroon Senegal Niger 4,6 2,9 4,9 1,1 5,3 1,5 7,0 1,3 7,1 1,7 7,4 1,0 03-06 1999-02 Rwanda Gambia Ghana U R Tanzania Burkina Faso 0 60 12,3 9,2 62,6 55,2 61,8 60,7 58,2 53,4 48,8 31,5 Burundi Uganda Rwanda 1,3 0,2 4,3 8,3 9,7 13,0 Ethiopia Sao Tome and Principe Malawi 3,0 3,0 24,7 26,2 27,0 61,2 Central African Republic U R Tanzania Malawi Benin Zambia Togo Guinea-Bissau Sao Tome and Principe Gambia 1,5 2,1 2,8 7,4 3,8 2,0 7,4 15,1 16,0 18,9,2 22,8 22,5 14,7 38,4 39,0 46,0 49,0 Senegal Burundi Niger Madagascar Cote d'ivoire Guinea-Bissau Togo Sierra Leone Zambia Cameroon Central African Republic 26,8 36,2 30,0 31,3 33,0 34,2 36,0 48,1 60,7 57,5 45,7 58,4 47,7 60,0 51,9 60,7 54,9 58,0 55,5 66,1 57,0 68,8 Note: *MDG Target 6.C: Have halted by 15 and begun to reverse the incidence of malaria and other major diseases. **Trend data on ITN overage is not available for 28 countries. ***Trend data on treatment overage is not available for 27 countries. Source for country data UNSD - accessed 7 July 09.

GRAPHS OF MDG TRENDS Figure 8: Prevalence of tuberculosis (/100 000 pop) in 07 (lighter bars) and the MDG target* rates (darker bars) in the African Region ** Countries showing no progress toward the target (Prevalence of 500 or more in 07) Countries showing no progress toward the target (Prevalence less than 500 in 07) Countries on track (Angola, Comoros, Eritrea, Seychelles and Zambia) and countries with insufficient progress (the rest) 0 0 0 600 800 1000 African Region Sierra Leone Swaziland Togo Zimbabwe D R Congo Burundi Botswana Rwanda Côte d'ivoire Ethiopia Lesotho Mauritania Nigeria Mozambique 123 133 166.5 153. 5 147 100. 5 165 153. 5 127 139 149 245. 5 288 332. 5 387.5 475 521 504 666 647 622 590 582 579 568 559 750 714 812 941 Chad Congo Equatorial Guinea Senegal Guinea Uganda Central African Republic Madagascar Gambia Burkina Faso Liberia Gabon U R Tanzania Kenya Malawi Niger Cameroon Benin Algeria 0 0 0 600 800 1000 10 88 337 319 305 292 157. 5 195 96. 5 135 70 56 22 127 125. 5 127 66. 5 148 189 168 182. 5 173. 5 168. 5 166. 5 135 191. 5 160. 5 497 485 469 468 448 426 425 417 4 3 398 379 Year 07 MDG target ( 15 ) South Africa Mali Namibia Zambia Ghana Angola Cape Verde Guinea - Bissau Sao Tome and Principe Eritrea Comoros Seychelles Mauritius 0 0 0 600 800 55 56. 5 39 25 387 318 353 266 294 257 280 6. 5 276 1. 5 2 172. 5 134 115. 5 83 93 387 357. 5 337 532 599 692 Note: *MDG Target 6.C: Have halted by 15 and begun to reverse the incidence of malaria and other major diseases. ** Countries are classified as: On track: If average annual rate of reduction (AARR) is greater than or equal to 2.6 per cent; Insufficient progress: AARR is between 0.6 per cent and 2.5 per cent. No progress: AARR is less than or equal to 0.5 per cent. Source: WHO, World health statistics 09, Geneva, World Health Organization, 09. 21

GRAPHS OF MDG TRENDS Figure 9: Percentage of the population using improved drinking water sources in 06 (lighter bars) and MDG target* (darker bars) in the African Region Countries showing no progress towards the target** 0 10 30 50 60 70 80 90 100 African Region Ethiopi a Niger D R Congo Madagascar Nigeria Angola U R Tanzania Kenya Zambia Togo Eritrea Liberia Benin Rwanda Central African Republic Burundi Algeria Comoros 59 75 42 57 42 71 43 72 46 72 47 70 47 75 51 70 55 75 57 71 58 75 59 75 60 72 64 79 65 82 65 83 66 71 85 85 85 97 97 Mali Mauritania Uganda Cameroon Senegal Zimbabwe Countries with insufficient progress 0 10 30 50 60 70 80 90 100 60 67 60 69 64 72 70 75 77 84 81 89 MDG Target (15) Burkina Faso Guinea Guinea Burkina Faso Malawi Ghana Cote d'ivoire Namibia South Africa Botswana Mauritius Countries on track to achieve the target Guinea 0 10 30 50 60 70 80 90 100 70 73 72 67 76 71 80 78 81 84 93 79 93 91 96 97 100 100 Note: *MDG Target 7.C: Halve, by 15, the proportion of people without sustainable access to safe drinking water and basic sanitation. ** Countries were classified according to the following thresholds: On track: Use of improved sources of drinking water in 06 was less than 5 per cent below the rate needed for the country/region to reach the MDG target, or use was 95 per cent or higher. Insufficient progress: Use of improved sources of drinking water in 06 was 5 per cent to 10 per cent below the rate needed for the country/region to reach the MDG target. No progress: Use of improved sources of drinking water in 06 was more than 10 per cent below the rate needed for the country/region to reach the MDG target, or the 1990 06 trend shows unchanged or decreasing use. Trend data was not available for 12 countries: Cape Verde, Chad, Congo, Gabon, Gambia, Guinea-Bissau, Lesotho, Mozambique, Sao Tome and Principe, Seychelles, Sierra Leone and Swaziland. Source: UNSD - accessed 7 July 09. 22

GRAPHS OF MDG TRENDS Figure 10: Percentage of the population using improved sanitation facilities in 06 (lighter bars) and MDG target* (darker bars) in the African Region (All countries (except Algeria and Mauritius) have made no progress** towards achieving the target) Year 06 MDG target (15) 0 10 30 50 60 70 80 90 100 African Region 33 65 Eritrea Niger Chad Ghana Ethiopia Togo Madagascar Burkina Faso Guinea Rwanda Cote d'ivoire Mauritania Senegal Benin Nigeria D R Congo Central African Republic Liberia Uganda U R Tanzania Namibia Comoros Burundi Kenya Mali Zimbabwe Botswana Angola Equatorial Guinea Cameroon Zambia South Africa Malawi Algeria Mauritius 5 7 9 10 11 12 12 13 1 9 23 24 24 28 30 30 31 31 32 33 33 35 35 52 52 53 53 5 2 57 54 53 57 65 60 60 63 56 63 5 5 8 6 70 65 68 63 59 4 72 142 70 45 68 46 72 47 69 50 63 51 76 51 70 5 71 2 59 78 60 7 3 94 94 94 97 Note: *MDG Target 7.C: Halve, by 15, the proportion of people without sustainable access to safe drinking water and basic sanitation. ** Countries were classified according to the following thresholds: On track: Use of improved sanitation facilities in 06 was less than 5 per cent below the rate needed for the country/region to reach the MDG target, or use was 95 per cent or higher. Insufficient progress: Use of improved sanitation facilities in 06 was 5 per cent to 10 per cent below the rate needed for the country/region to reach the MDG target. No progress: Use of improved sanitation facilities in 06 was more than 10 per cent below the rate needed for the country/region to reach the MDG target, or the 1990 06 trend shows unchanged or decreasing use. Trend data was not available for eleven countries: Cape Verde, Congo, Gabon, Gambia, Guinea-Bissau, Lesotho, Mozambique, Sao Tome and Principe, Seychelles, Sierra Leone and Swaziland. Source: UNSD - accessed 7 July 09. 23

ANNEX C LATEST ON MDGS PROVIDED BY MEMBER STATES COMPARED WITH UN MDG1; TARGET 1C: PERCENTAGE OF UNDER-FIVE CHILDREN WITH MODERATE OR SEVERE MALNUTRITION MDG 4: UNDER-FIVE MORTALITY (PER 1,000 LIVE BIRTHS) MDG 5: MATERNAL MORTALITY RATIO (PER 100,000 LIVE BIRTHS) MEMBER STATES MOST RECENT UN MOST RECENT MEMBER STATE MOST RECENT UN MOST RECENT MEMBER STATE MOST RECENT UN MOST RECENT MEMBER STATE 01-07 YEAR SOURCE* 07 YEAR SOURCE* 05 YEAR SOURCE* ALGERIA 3.7 3.7 06 MICS ANGOLA 8.2 07 MOH BENIN 22.6 38 06 MOH BOTSWANA 12.5 6.3 01 06 MOH BURKINA FASO 37.4 37.4 06 MICS BURUNDI 39.2 5.6 07 UNICEF CAMEROON 19.3 19.3 CAPE VERDE 8 06 QUIBB CENTRAL AFRICAN REPUBLIC 28.5 CHAD 36.7 14 01-06 MOH COMOROS 24.9 27.3 UNICEF CONGO 14.4 CÔTE D IVOIRE.2 4.3 06 MOH DEMOCRATIC REPUBLIC OF CONGO 31.1 45.5 07 DHS EQUATORIAL GUINEA 09 MOH ERITREA 39.6 VALID ETHIOPIA 38.4 8.1 08 MOH GABON GAMBIA.3.3 06 MICS GHANA 17.7 13.9 08 08GHDS GUINEA 25.8 21 08 MICS Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey Data not available. Blank cells: Data not provided 37 158 123 191 180 148 32 172 9 66 125 127 161 150 70 119 91 109 115 150 31.4 06 MICS 180 92.6 06 MICS 260 01 MICS 10 10 05 MICS 125 06 MOH 8 397 06 MOH 76 06 DHS 380 157 05 MOH 141.9 06 CENSUS 700 307.3 06 CENSUS 176 05 MICS 1100 615 05 MICS 144 09 MOH 1000 669 09 MOH 28.6 07 MOH 210 41.9 06 MOH 176 06 MICS 980 1355 06 MICS 9 VALID 1500 VALID 113 03 CENSUS 0 380 03 CENSUS 117 06 MOH 7 781 05 MOH 84 05 MOH 810 543 05 MOH 148 07 DHS 1100 549 07 DHS 93 01 MOH 680 VALID 450 VALID 123 05 EDHS 7 673 05 EDHS 60 05 MOH 5 519 05 MOH 131 06 MICS 05/06 690 VALID 80 08 08GHDS 560 451 07 MOH 163 05 EDS 910 980 05 EDS 24

LATEST ON MDGS PROVIDED BY MEMBER STATES COMPARED WITH UN MDG1: TARGET 1C: PERCENTAGE OF UNDER- FIVE CHILDREN WITH MODERATE OR SEVERE MALNUTRITION MDG 4: UNDER-FIVE MORTALITY (PER 1,000 LIVE BIRTHS) MDG 5: MATERNAL MORTALITY RATIO(PER 100,000 LIVE BIRTHS) MEMBER STATES MOST RECENT UN MOST RECENT MEMBER STATE MOST RECENT UN MOST RECENT MEMBER STATE MOST RECENT UN MOST RECENT MEMBER STATE 01-07 YEAR SOURCE* 07 YEAR SOURCE* 05 YEAR SOURCE* GUINEA BISSAU 19.4 5.6 06 MICS 198 223 06 MICS 1100 818 06 MOH KENYA 19.9 19.9 01 07 MOH 121 74 08-09 DHS 560 560 05 MOH LESOTHO 19.8 14.4 07 LNNS 84 113 04 LHDS 960 762 04 LDHS LIBERIA 19 07 LDHS 133 110 07 LDHS 10 994 07 LDHS MADAGASCAR 41.9 112 94 03-04 MSPF 510 469 03-04 DHS MALAWI 19.4.5 06 MICS 110 122 06 MICS 1100 MALI 33.2 32 MOH 196 96 MOH 970 464 MOH MAURITANIA 31.8 29.8 07 MICS 118 122 07 MICS 8 686 07 MICS MAURITIUS 17 16.4 08 MOH 15 0.38 08 MOH MOZAMBIQUE 23.7 168 5 NAMIBIA 24 29 06 DHS 68 69 06 DHS 210 449 06 DHS NIGER 44.4 44.4 06 EDSIM 176 198 06 EDSIM 1800 648 06 EDSIM NIGERIA 28.7 27.1 08 DHS 189 157 08 DHS 1100 800 03 MOH RWANDA 22.5 22 05 DHS 181 103 07 DHS 1300 750 05 DHS SAO TOME & PRINCIPE 9.2 9.2 06 MOH 99 52 06 MOH SENEGAL 17.3 17.3 05 DHS 114 121 05 DHS 980 1 05 DHS SEYCHELLES 16 14.8 08 MOH 1 MATERNAL DEATH 08 MOH SIERRA LEONE 30.4 262 1 08 SLDHS 2100 857 08 SLDHS SOUTH AFRICA 11.5 30 082 CASES 05 MOH 59 57.6 03 DHS 0 124 02 STATS, SA SWAZILAND 7.5 07 MOH 91 1 06 MOH 390 589 07 DHS TOGO 26 100 123 06 MICS06 510 478 05 DHS UGANDA.4 16 08 MOH 131 137 06 UDHS 550 435 05 MOH UNITED REP. OF TANZANIA 21.8 22 04-05 DHS 116 91 07-08 950 578 04-05 DHS ZAMBIA 14 07 ZDHS 170 119 07 ZDHS 830 591 07 DHS ZIMBABWE 16.6 90 82 06 ZDHS 880 555 05 DHS Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey Data not available. Blank cells: Data not provided 25

LATEST ON MDGS PROVIDED BY MEMBER STATES COMPARED WITH UN MDG5B: PREV OF CONTRACEPTIVE USE MDG6A: HIV PREVALENCE IN PREGNANT WOMEN 15-24 (%) MDG6B: PROP OF POP WITH ADVANCED HIV INFECTION WITH ACCESS TO ARV (%) MEMBER STATES UN (MEDIAN) MOST RECENT MEMBER STATE 00-07 YEAR SOURCE* AFRO (MEDIAN) MOST RECENT MEMBER STATE 04-07 YEAR SOURCE* MOST RECENT UN MOST RECENT MEMBER STATE 07 YEAR SOURCE* ALGERIA 61.4 61.4 06 MICS ANGOLA 6.2 5 07 MoH 2 07 MoH 25 16 07 MoH BENIN 17.8 6.2 06 MoH 1.7 2.0 06 MoH 49 98.8 07 MoH BOTSWANA 44.4 42.5 06 DHS 27.1 24.6 07 MoH 79 BURKINA FASO 13.8 17.4 06 MICS 35 35 BURUNDI 8.4 08 MoH 15.5 15.5 04-07 MoH 23 30 07 MoH CAMEROON 26.0 26.0 4.8 04 DHS 25 25 CAPE VERDE 61.3 34.1 CENTRAL AFRICAN REPUBLIC 00-07 MoH 23.5 19 06 MICS 6.3 06 MoH 21 CHAD 5.4 3 00-07 MoH 13 COMOROS 25.7 19.4 04 MoH 100 08 MoH CONGO 2.6 17 CÔTE D IVOIRE 12.9 4.3 05 MoH 28 0.1 06 MoH DEMOCRATIC REP. OF CONGO 26.0 6 07 DHS 3.4 07 MoH 24 5 07 MoH EQUATORIAL GUINEA 31 1.7 08 MoH ERITREA 8.0 Valid 1.8 0.9 08 MoH 13 58 08 MoH ETHIOPIA 11.4 13.9 05 EDHS 5.6 5.6 08 UNGAS 29 68 09 MoH GABON 37.7 06 WHS09 5.6 UNGAS 42 47.8 08 MoH GAMBIA 13.6 18 18 GHANA 21.0 17 08 08 GHDS 2.5 15 31 08 08 GHDS GUINEA 9.1 9 05 EDS 3.4 08 ENSS 27 52 08 MoH Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey Data not available. Blank cells: Data not provided 26

LATEST ON MDGS PROVIDED BY MEMBER STATES COMPARED WITH UN MDG5B: PREVALENCE OF CONTRACEPTIVE USE (%) MDG6A: HIV PREVALENCE IN PREGNANT WOMEN 15-24 (%) MDG6B: PROP OF POP WITH ADVANCED HIV INFECTION WITH ACCESS TO ARV (%) MEMBER STATES UN (MEDIAN) MOST RECENT MEMBER STATE 00-07 YEAR SOURCE* AFRO (MEDIAN) MOST RECENT MEMBER STATE 04-07 YEAR SOURCE* MOST RECENT UN MOST RECENT MEMBER STATE SOURCE* 07 YEAR GUINEA BISSAU 10.3 06 MICS 08 MOH KENYA 39.3 46 08-09 DHS 38 38 07 MOH LESOTHO 34.3 37.3 04 LDHS 16.8 18.7 07 MOH 26 25 07 MOH LIBERIA 11 07 LDHS 5.3 07 MOH 17 VALID MADAGASCAR 23.0 24 06 MOH 4 MALAWI 32.5 14.3 14.0 07 MOH 35 MALI 8.2 8 00 07 MOH 41 MAURITANIA 8.0 9.3 07 MICS 0.8 07 MICS 23-30 07 MOH MAURITIUS 75.9 0.5 08 MOH 22 27.4 07 MOH MOZAMBIQUE 16.5 24 NAMIBIA 43.7 46 06 NDHS 14.7 14.2 06 NDHS 88 66 07 NDHS NIGER 12.6 11.7 06 EDSIM 10 26.6 07 MOH NIGERIA 12.6 9.7 08 DHS 4.2 08 FMOH 26 27.7 08 FMOH RWANDA 15.3 27 07 DHS 4.0 4.3 07 MOH 71 SAO TOME & PRINCIPE 83 (ADULT > 15 YRS) 07 UNGASS 24.7 07 MOH SENEGAL 11.8 11.8 05 EDS4 56 64.01 07 UNGASS SEYCHELLES 44.1 (15-49 AGE) 08 MOH 27.9 PER 10 000 04 07 MOH 100 08 MOH SIERRA LEONE 4.8 6.7 08 SLDHS 65 08 SLDHS 28 SOUTH AFRICA 60.3 (-24 06 MOH 28 YRS) SWAZILAND 51 07 MOH 25.9 38.0 08 MOH 42 52 08 MOH TOGO 21.3 3.4 06-07 MOH 19 32 07 MOH UGANDA 22.8 19.6 06 UDHS 6.4 06 UDHS 33 39 07 MOH UNITED REP. OF TANZANIA 27.3 28 04-05 TDHS 7.4 6.8 JUN-05 NACP 31 46.8 JUN- 05 MOH ZAMBIA 34.2.8 07 ZDHS 14.9 16.0 06 MOH 46 60 07 MOH ZIMBABWE 60.2 60.2 06 ZDHS 15.3 17 Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey Data not available. Blank cells: Data not provided 27

LATEST ON MDGS PROVIDED BY MEMBER STATES COMPARED WITH UN MDG6C: PERCENTAGE OF CHILDREN UNDER FIVE SLEEPING UNDER ITN MDG6C: PERCENTAGE OF UNDER-FIVE CHILDREN WITH FEVER TREATED WITH ANTIMALARIA DRUG MDG6C: PREVALENCE OF TUBERCULOSIS(PER 100 000 POPULATION) MEMBER STATES UN (MEDIAN) MOST RECENT MEMBER STATE 03-06 YEAR MOST RECENT UN MOST RECENT MEMBER STATE 02- SOURCE* 06 YEAR MOST RECENT UN MOST RECENT MEMBER STATE SOURCE* 07 YEAR SOURCE* ALGERIA ANGOLA 17.7 06-07 DHS-MIS 29.3 06-07 DHS-MIS 56 INCIDENCE 60.9 06 MOH 294 285 07 MOH BENIN.2 06 MOH 54.0 135 135 07 WHS09 BOTSWANA 622 511 06 MOH BURKINA FASO 5.6 9.6 06 MICS 48.8 48.0 06 MICS 3 BURUNDI 8.3 8 05 MICS 30.0 30.0 05 MICS 647 780 06 MOH CAMEROON 7.0 7.0 55.5 55.5 195 195 07 WHS09 CAPE VERDE CENTRAL AFRICAN REPUBLIC 15.1 57.0 280 57 06 MOH 425 CHAD 497 COMOROS 26.4 08 MOH 83 08 MOH CONGO 6.1 48.0 485 CÔTE D IVOIRE 4.9 3 06 MICS 36.0 25.9 06 MICS 582 DEMOCATIC REP. OF CONGO 6 07 MOH 17 07 MOH 666 666 07 WHS09 EQUATORIAL GUINEA ERITREA 48.3 03-06 MOH ETHIOPIA 1.5 42 07 MIS GABON 55 08 MOH GAMBIA 49.0 49.0 62.6 GHANA 12.7 28.2 08 3.0 08 GHDS 61.8 7.5 02-06 MOH 44.0 08 MOH 62.6 43.0 08 469 576 09 MOH 134 50 05 MOH 579 543 09 MOH 379 379 07 WHS09 4 4 07 WHS09 08 GHDS 353 353 07 WHS09 GUINEA 0.3 4.5 08 MICS 43.5 74.0 08 MICS 448 448 07 WHS09 Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey Data not available. Blank cells: Data not provided 28

LATEST ON MDGS PROVIDED BY MEMBER STATES COMPARED WITH UN MDG6C: PERCENTAGE OF CHILDREN UNDER FIVE SLEEPING UNDER ITN MDG6C: PERCENTAGE OF UNDER-FIVE CHILDREN WITH FEVER TREATED WITH ANTIMALARIA DRUG MDG6C: PREVALENCE OF TUBERCULOSIS(PER 100 000 POPULATION) MEMBER STATES UN (MEDIAN) MOST RECENT MEMBER STATE MOST RECENT UN MOST RECENT MEMBER STATE MOST RECENT UN MOST RECENT MEMBER STATE GUINEA BISSAU KENYA LESOTHO LIBERIA MADAGASCAR MALAWI MALI MAURITANIA MAURITIUS MOZAMBIQUE NAMIBIA NIGER NIGERIA RWANDA SAO TOME & PRINCIPE SENEGAL SEYCHELLES SIERRA LEONE SOUTH AFRICA SWAZILAND TOGO UGANDA UNITED REP. OF TANZANIA ZAMBIA ZIMBABWE 03-06 YEAR SOURCE* 39.0 74.8 05 MOH 4.6 46.1 08-09 DHS-PR 2.6 2.6 07 LDHS 36 18.9 2.1 50.9 04-05 03-06 DHS MOH 11 06 DHS 7.4 54.93 06 ENCM 1.2 5.5 08 DHS 13.0 60 07 DHS 46.0 53.3 07 MOH 7.1 16.4 06 ENP N/A N/A MOH 5.3 25.8 08 SLDHS 44 08 MOH 38.4 9.7 10.5 06 UDHS 16.0 36 07-08 THMIS 22.8 27 06 MIS 2.9 02-06 YEAR 45.7 34.2 26.2 33.4 14.9 33.0 33.9 12.3 SOURCE* 07 YEAR SOURCE* 70.0 05 MOH 276 139.3 07 MOH 23.2 08-09 DHS-PR 319 319 07 MOH 568 59.0 07 LDHS 398 VALID 417 97 06 MOH 305 599 9.5 07 MICS 559 1 06 MOH 39 504 10 06 DHS 532 556 06 DHS 292 292 07 WHS 09 33.3 08 DHS 521 650 08 FMOH 21.4 07 DHS 590 241 06 MOH 24.7 2 22.0 06 ENP 468 504 07 26.8 N/A N/A MOH 6.9 08 MOH 55 30.1 08 SLDHS 941 08 SLDHS 51.9 692 66.0 07 MOH 812 812 07 GTR 750 47.7 426 426 09 GTC 61.8 58.2 54.9 4.7 57.0 07-08 THMIS 337 176 06 MOHSW 58.0 06 MIS 387 568 07 MOH 714 Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey Data not available. Blank cells: Data not provided 29

LATEST ON MDGS PROVIDED BY MEMBER STATES COMPARED WITH UN MDG7C: PERCENTAGE OF THE POPULATION USING IMPROVED DRINKING WATER (%) MDG7C: PERCENTAGE OF THE POPULATION USING IMPROVED SANITATION FACILITIES (%) MEMBER STATES MOST RECENT UN MOST RECENT MEMBER STATE MOST RECENT UN MOST RECENT MEMBER STATE 06 YEAR SOURCE* 06 YEAR SOURCE* ALGERIA 85.0 ANGOLA 51.0 62 02 MICS BENIN 65.0 M66.3 06 MOH BOTSWANA 96.0 VALID BURKINA FASO 72.0 77.3 06 ICS BURUNDI 71.0 64 05 MICS CAMEROON 70.0 VALID CAPE VERDE 84.9 06 QUIBB 94.0 50.0 30.0 47.0 13.0 41.0 51.0 59 02 MICS 37.0 06 MOH VALID 36.9 06 MICS 32.0 05 MICS VALID 30.4 06 QUIBB CENTRAL AFRICAN 66.0 31.0 52.5 06 MICS REPUBLIC CHAD 48.0 9.0 COMOROS 85.0 42.7 03 CENSUS 35.0 CONGO 71.0.0 CÔTE D IVOIRE 81.0 76 06 MICS 48.8 06 MICS 24.0 DEMOCRATIC REP. 46.0 48.2 07 DHS 18.0 07 DHS OF CONGO 31.0 EQUATORIAL GUINEA 43.0 44 09 MOH 21.1 09 MOH 51.0 ERITREA 60.0 VALID 9.0 06 MOH 5.0 ETHIOPIA 42.0 59 07-08 MWR GABON 87.0 65 06 SEEG GAMBIA 86.0 85.1 06 MICS05/6 GHANA 80.0 GUINEA 70.0 70 06 UN 11.0 36.0 52.0 10.0 19.0 47.0 07-08 MOH 84.0 06 MICS05/6 19.0 06 UN Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey Data not available. Blank cells: Data not provided 30

LATEST ON MDGS PROVIDED BY MEMBER STATES COMPARED WITH UN MDG7C: PERCENTAGE OF THE POPULATION USING IMPROVED DRINKING WATER (%) MDG7C: PERCENTAGE OF THE POPULATION USING IMPROVED SANITATION FACILITIES (%) MEMBER STATES MOST RECENT UN MOST RECENT MEMBER STATE MOST RECENT UN MOST RECENT MEMBER STATE 06 YEAR SOURCE* 06 YEAR SOURCE* GUINEA BISSAU 57.0 60 06 MICS 33.0 23.0 06 RAMRN KENYA 57.0 57.0 06 MOH 42.0 42.0 06 MOH LESOTHO 78.0 64 04 LDHS 36.0 23.6 04 LDHS LIBERIA 64.0 65 07 LDHS 32.0 10.0 07 LDHS MADAGASCAR 47.0 12.0 MALAWI 76.0 60.0 MALI 60.0 45.0 MAURITANIA 60.0 50.5 07 MICS 24.0 32.2 07 MICS MAURITIUS 100.0 94.0 MOZAMBIQUE 42.0 31.0 NAMIBIA 93.0 90 06 DHS 35.0 33 06 DHS NIGER 42.0 41.4 06 DHS 7.0 8.4 06 DHS NIGERIA 47.0 46.4 07 MICS 30.0 39.0 07 MICS RWANDA 65.0 69 07 EICV 23.0 38 05 DHS SAO TOME & PRINCIPE 86.0 38 06 MOH 24.0 30.0 06 MOH SENEGAL 77.0 28.0 SEYCHELLES 87 02 94 02 SIERRA LEONE 53.0 50.3 08 SLDHS 11.0 SOUTH AFRICA 93.0 84.7 07 59.0 71 06 SWAZILAND 60.0 51 06 MOH 50.0 72.0 06 MOH TOGO 59.0 12.0 31.7 06 MICS UGANDA 64.0 67.1 08 MOH 33.0 21.0 08 MOH UNITED REPUBLIC OF TANZANIA 55.0 54 / 77 06, RURAL / URBAN MOHSW 33.0 47.0 07 PHDR ZAMBIA 58.0 59 06 LCMS 52.0 68.3 06 LCMS ZIMBABWE 81.0 46.0 Data source* MoH: Ministry of Health; DHS: Demographic and Health survey; MICS: Multiple Indicators Cluster Survey Data not available. Blank cells: Data not provided 31