Mittwoch, 28. September 2016

Millennium Development Goals (MDG) vs. Steven Pinker

In "The Better Angels of Our Nature: Why Violence Has Declined" Steven Pinker chronicles an unprecedented decline in violence and war over the last decades and centuries (c.f. [4]). After having read this book one has to wonder if the same trajectory applies to public health goals? Although, the answer is obvious to me I don't think it is evident from media reporting or even common knowledge that the world today is better than ever in almost all regards.

One key question is not just whether there is progress at all, but also the rate of change. Is progress accelerating leading to a singularity? Is progress constant, e.g. a fixed decrease in deaths per year or a fixed fraction? If the latter is true the total amount of suffering may be increasing while the incidence of suffering decreases, not exacly the best outcome.
Or is progress even slowing down because the last bit is the hardest, the remaining challenges being exponentially more complex - as has been suggested for biomedical research?

Can we expect a world without bloody internecine struggle in 2100? Will we live long enough to see a world without poverty, gender inequality and HIV? Will we eradicate cancer and solve aging one day in the far future?  How ridiculous are these questions and aspirations?

If we want to look at high level progress towards a better, utopian world, it seems prudent and most convenient to look at those who need the most help: poor, developing nations. The United Nation's "Millennium Development Goals Report" (1) provides a handy source documenting progress across the board with notable exceptions. In this post, I will discuss what we have achieved so far with some added commentary on biomedicine and Pinker's book and at some later point I plan to write a post focusing on the situation in developed nations.

The goals
Goal 1: Eradicate Extreme Hunger and Poverty
Goal 2: Achieve Universal Primary Education
Goal 3: Promote Gender Equality and Empower Women
Goal 4: Reduce Child Mortality
Goal 5: Improve Maternal Health
Goal 6: Combat HIV/AIDS, Malaria and other diseases
Goal 7: Ensure Environmental Sustainability
Goal 8: Develop a Global Partnership for Development