President Truong Tan Sang speaks at the Summit of the United Nations in New York (USA), in September 2015. Photo: VNA
According to the 2015 Statistic Report of the World Health Organization (WHO) on 13 May, 2015, though encouraging progress has been made in implementing the Millennium Development Goal (MDG) on health in 194 countries there are gaps between countries and in each country as well as remaining issues to be settled. While several countries can not fulfill MDGs against deadline Viet Nam has stood out as a bright spot in achieving these goals.
Challenges in the implementation of MDGs in the world
The United Nations stated that some MDGs have been achieved worldwide. They are prevention of malaria and tuberculosis, access to improved drinking water by 2.3 billion people, inequality in primary school enrolment between boys and girls removed, increasing representation of women in political field, restored official development assistance, trade system’s facilitation to developing countries and low level of loans.
Nevertheless, big gaps among countries (some are left behind) and challenges to the implementation of MDGs remain. Greater efforts are needed despite reduction in poverty; chronicle child malnutrition decreases but one fourth of the children are still affected; strong actions should be taken to lower maternal and child mortality rates; anti-virus therapy has saved lives but should be scaled up; more than a quarter of the world population have had access to improved sanitation since 1990 but one billion people are living in poor hygienic conditions.
Among the 49 least developed countries, six have poverty rate below 30% and fail to meet the deadlines in all goals namely malnutrition, child mortality rate, epidemic, among others. As Chairman of the UN General Assembly put it the causes were they have met with “structural problems” and these difficulties and weaknesses have become extremely serious after the world monetary-financial, food and energy crisis in addition to negative impacts of climate change.
One of the biggest challenges in the current stage is humanitarian issue. There are currently about 1.1 billion people living on less than $ 1/day, of which 30% are children, even in rich countries, 1 out of 6 children live below the national poverty line. Worldwide, each year, nearly 11 million under-five children die. More than 500 million of the 884 million children do not have access to clean water; 140 million children in developing countries have not been to school; and 15 million children die of HIV/AIDS.
In most countries of sub-Saharan region, only few women, especially adolescents have had access to knowledge about reproductive health. In most of the least developed countries in Latin America and South Asia, the birth rate in adolescents remains high. The dangers related to reproductive health have led to high mortality among pregnant adolescents globally.
At the MDG Summit held in New York (USA) recently, UN Secretary General Ban Ki-moon stressed: "The MDGs are still achievable by 2015 if world leaders provide more money and have a stronger political will.” It is estimated that $ 120 billion are needed to implement the eight MDGs, however, the European leaders’ commitment to finance $ 1.3 billion for the target for eliminating pauperism and malnutrition is still a promise.
Viet Nam-a bright spot in MDGs implementation
On the way to implement the MDGs, Viet Nam has achieved significant results highly appreciated by the international community, especially in poverty reduction, gender equality and education. Positive results have been recorded in the implementation of other objectives; many health indicators are close to the targets; environmental indicators have received more concern and are integrated in State programs and policies; progress has been made in partnerships for development confirming the position of the country in the international arena.
Viet Nam early reached MDG1 on eradication of extreme poverty and food shortage since 2002, fulfilled universalization of primary education in 2010 and higher goals in universalization of secondary education. Viet Nam has basically completed the goals of gender equality and woman empowerment; succeeded in controlling malaria, some dangerous diseases, initially preventing the spread of HIV and almost fulfilling the goal of child mortality reduction. Although there are still many challenges and obstacles to fulfill all the MDGs by 2015, the achievements that Viet Nam has made so far are very important and very remarkable.
First, poverty reduction has made outstanding progress with rapid reduction rate. The poverty rate fell from 58.1% in 1993 to 9.6% in 2012 and 6% 2014. The success is conducive to Viet Nam’s rapid economic growth and efforts of the entire political system considering poverty reduction as a national primary goal in the past two decades.
Second, Viet Nam has achieved universalization of primary education (according to national standards). Primary school enrollment rate has steadily increased over the years, reaching 97.7% by 2012. Along with achieving the goal of universalization of primary education, Viet Nam is trying to work towards universalization of primary education and lower secondary school at the right ages; education universalization programme continues to be scaled up at the local level.
Third, Viet Nam has achieved much progress on gender equality, particularly in the fields of education, employment and political activities. Viet Nam has eliminated gender disparities in access to primary education and boast relatively high percentage of women's participation in workforce and National Assembly. Viet Nam has higher gender indicators than other countries in the world of the same level of development.
Fourth, the under-one mortality rate fell from 44.4 ‰ in 1990 to 15‰ in 2012, and 15.2‰ in 2014. The under-five mortality has declined by more than half in the past two decades, dropping from 58‰ in 1990 to 23.2‰ in 2012 and 22.9‰ in 2014. However, to achieve the goal by 2015, more efforts are needed to prevent all major causes of killers among children under 5 years old.
Fifth, maternal mortality ratio during pregnancy have continued to decline in the past two decades. From 1990 to 2012, the ratio had dropped by more than two thirds from 233 per 100,000 live births to 60 per 100,000 live births in 2014. However, this ratio tends to slow down from 2006, thus achieving the target of 58.3 per 100,000 live births is a significant challenge, requiring more and strong efforts.
Sixth, Viet Nam has controlled HIV infection rates below 0.3%, lower than the target set in the National Strategy for the period of 2004-2010. The National Program on the prevention of malaria has achieved positive results, reducing malaria cases and deaths due to malaria, completing targets related to TB control and making progress in the control of other dangerous diseases.
Seventh, sustainable development becomes a fundamental goal of the socio-economic development strategy. Viet Nam has set a goal of environmental protection in parallel with economic development objectives for more than 20 years, constantly linking economic development with environmental protection. The state budget for environmental protection has increased significantly, more than 1% of the total State budget expenditure.
Eighth, since joining the World Trade Organization (WTO), Viet Nam has established trade relations with nearly 230 countries and territories, investment relations with 84 countries and regions, and signed more than 90 bilateral trade agreements. Viet Nam is an active member of over 70 international and regional organizations, has successfully attracted a large amount of official development assistance (ODA) for development. Foreign direct investment (FDI) has played the role of a key driving force in developing economy, thus FDI is always one of the primary focus.
However, besides the achievements, there are difficulties and problems in the implementation of the MDGs, namely:
First, the increase in inequality and chronic poverty of vulnerable groups. Slow pace of poverty reduction and poverty remain widespread in rural, mountainous and remote and ethnic minority regions. The number of poor ethnic minority households accounts for 50% of the country's poor households; and the average income of households of ethnic minorities equals to only one six of the average income of households in the country. The achievement of poverty reduction is not really sustainable, many families which got out of poverty, face high risk of falling back to poverty and some non-poor families have become poor. The rapid urbanization with the influx of migrants from rural to urban areas is a challenge for efforts to increase living standards and socio-economic development in urban areas. The urban poor are facing many difficulties, while the State policies have not really supported this group of people.
Second, although Viet Nam has achieved universalization of primary education and elimination of gender disparity in lower secondary education level, the female enrollment rate in higher education in rural, remote and ethnic minority areas is often much lower than male. Male workers have participated more in the labor market and better accessed to decent work. A large proportion of women still do vulnerable jobs, especially in the non-formal sector. Domestic violence is becoming a growing problem in Viet Nam society, creating obstacles to the development of family and society. The practice of respect for men and disregard of women is still common, leading to men being more respectful and privileged than women in families and society. Son preference still exists in many Vietnamese families, especially in rural, and ethnic minority areas. As a result, there is a big gap in sex ratio at birth and the situation is worsening in recent years.
Third, there remain differences in the health status of various groups of women, especially those living in rural, remote and far away areas, those of low levels of education, poor households and ethnic minority groups. Family planning services have not fully met requirements; the unmet rate remains relatively high. Social and cultural barriers have hampered access to family planning measures in Viet Nam. The misconceptions about reproductive health remains widespread in society. In addition, family planning is still considered as woman's responsibility; men’s unwillingness has caused many obstacles and shifted the burden on women. Information about reproductive health is still insufficient, especially for young people.
Fourth, difficulties in ensuring environmental sustainability are still common, requiring constant efforts. The number of infringement upon environment, depletion of resources is growing and is increasingly serious. Many loopholes exist in the environmental legal system. Investment in the environment protection is small and not adequate. The State budget allocation for environmental protection in our country is still relatively low compared with other countries in the region and the world.
Fifth, the growing challenges of trade barriers, especially non-tariff trade barriers. FDI inflows has declined steadily; mobilization of FDI in key sectors becomes difficult. Viet Nam's public debt tends to rise, creating concern and makes the economy facing high risks. Foreign debts account for a largest proportion of public debts which makes Viet Nam vulnerable to world economic shocks and exchange rate risks.
Sixth, the development of an institutional framework for international goals committed by Viet Nam is difficult due to certain differences between national and international criteria, measurement and standards. Therefore, it takes a lot of time to identify solutions to harmonize international criteria with national criteria, and methods for conversion with international regulations.
Seventh, one of the remarkable achievements over the past decade is Viet Nam has become a low middle-income developing country in 2010. This achievement reflects the efforts of Viet Nam in economic development, and in improvement of people's lives. But in parallel with that process, ODA, preferential resources from the international community, tends to decrease. Viet Nam has transited to a new stage of cooperation with partners and loans are less concessional. This creates a lot of difficulties in mobilizing resources to implement the objectives of social sectors and poverty reduction.
Another important issue is that more attention must be given to raise awareness of the whole society, and enhance capacity to monitor and supervise, especially regular and systematic monitoring.
First, Viet Nam has made commitment and high political will. With the adoption of the Millennium Declaration in 2000, Viet Nam commits to achieve the MDGs, build a sustainable society, in which economic growth goes hand in hand with progress, social justice and environmental protection.
Second, Viet Nam has a good governance system and strong state institutions. Good governance is one of the most important factors to help Viet Nam achieve great achievements in implementing the MDGs. Viet Nam's experience shows that good governance should include such factors as clear, efficient and highly effective system of policy and mechanism, strong management apparatus executing the implementation of social objectives in general and the MDGs in particular established from the central to local levels, the ability to mobilize and use resources effectively, close and effective coordination among government agencies and other stakeholders and strengthened capacity to monitor and evaluate to ensure successful implementation of the MDGs.
Third, innovative and relevant approaches in the process of implementing the MDGs. Many approaches have become creative experience of Viet Nam on the path to achieve the MDGs. Some important ones include the “nationalization” and mainstreaming the MDGs have helped Viet Nam to rapidly and sustainably reached its goals; Viet Nam has eradicated hunger and reduced poverty based on high economic growth, focusing on the development of rural areas and the agricultural sector.
Fourth, national ownership is enhanced, while active participation of stakeholders have been encouraged. In order to promote people’s engagement in the process of planning and implementing the MDGs, Viet Nam has implemented a number of principles, such as ensuring best information provision, sufficient resources for identified priority targets and best mechanism for feedback from citizens and stakeholders.
Fifth, focus on using and diversifying advocacy for the successful implementation of the MDGs. Policy advocacy is to provide accurate, appropriate and objective information on objectives, requirements, content and the results of policies. Advocacy has always been attached importance to by the Government and stakeholders and used as a tool, even a “resource” to be mobilized to the maximum to achieve the MDGs.
Viet Nam's experience shows that the MDGs can be achieved even in conditions of limited resources, although the availability of resources has always been considered an indispensable condition to ensure the successful implementation of the MDGs. Also, it needs strong commitment and political will, creative approaches suitable to specific conditions of the country, high sense of ownership and active engagement of the stakeholders. In addition, the successful implementation of the MDGs also requires improved efficiency of the management apparatus and other state institutions to ensure the vital role of leading agencies, ministries, branches and localities concerned, and strengthened capacity to mobilize, promote and encourage actions of the actors at both central and local levels. An effective and efficient system of policy which meets the needs of the people, coupled with the active support of international organizations, non-governmental organizations and other development partners is a factor contributing significantly to achieving the MDGs.
The article was published on Communist Review No. 875 (September 2015)