Meeting the health MDGs in fragile states

The MDGs are unlikely to be met in fragile states, where factors such as poor governance, poverty, lack of funding, failed health systems and policy neglect pose considerable constraints. The UK Government’s Department for International Development (DFID) calculates that while they are home to only 14 per cent of the world’s population, fragile states contain a third of the world’s poor, a third of the world’s maternal and under-5 mortality cases and a third of those living with HIV/AIDS in developing countries.

On average, one in three people living in fragile states is undernourished; this proportion is twice as high as in other developing countries. Child mortality in fragile states is five times that of middle income countries, and almost twice that of low income countries. Measles immunisation is 25 per cent below that of other low income countries, and malaria death rates are significantly higher than in neighboring lower income countries. DFID estimates that the malarial death rate is nearly 13 times higher in fragile states than elsewhere in the developing world. If the MDGs are ever to be met at a global level, there is a need to support and engage in fragile states to draw them out of their cycle of fragility.