To MDG or not to MDG?

Which is the title of a presentation I’ve just given at a conference on global health and the MDGs in Copenhagen.   The powerpoint’s not up yet, but the main points were:

1. The MDGs should not be confused with an ‘8 commandments of development’.  They’re criticised for not saying everything there is to say about development, but this is missing the point.  They represent an international agreement on some joint actions and responsibilities which reflect an understanding of what the main problems were in the late 1990s and where international cooperation could usefully be part of the solution. A post-2015 agreement should do the same, for a different era of development.

2. The MDGs have created a new incentive structure for donor governments in particular, and so have distorted behaviour. Some would argue, for example, that the focus on increasing the numbers of children in school has been at the cost of the quality of education – but numbers were the MDG target, so that’s where the money and the attention went (to be fair, it’s not just the MDGs that focused on quantity over quality – just about every other education campaign and report did the same).  Any post-2015 agreement would do this too – that’s the point of it.  The question is what actions, and by who, we want to incentivise.

3. A post-2015 agreement will be delivered through different aid architecture.  The world can’t be divided into rich donor countries and poor recipient countries any more – most poor people live in countries that are both donor and recipient, or neither.  So the politics of agreeing it, and the structure for implementing it, would have to be different. 

4. And the problems we face are different.  To take just two examples, poverty is increasingly urban, so development’s rural bias will have to go, and diseases are increasingly of the non-communicable kind  (heart disease, diabetes and the like), rather than the infectious diseases that were the focus of the MDGs (not that these have gone away).

5. And our understanding of what ‘development’ is and how to measure it has changed, informed by the ideas of ‘wellbeing’ or of ‘multidimensional poverty’, among others.  We have new ideas about instruments to help bring it about – with social protection perhaps the most current example.  The importance of politics looms much larger in development thinking than in the 1990s – though we probably still don’t quite know what to do with that insight. 

So it’s complicated. It was always complicated, but the more we know the more complicated it seems. Out of this tangle (hence the string – I’m feeling  rather literal today), a post-2015 agreement would need to have the same simplicity and political power as the MDGs, if it’s to be an agreement that governments can use with electorates, NGOs with governments, journalists to their editors and so on.

A tough call.  What are the choices?
– keep the MDGs with an extended timeline (not appealing – rather a missed opportunity to reframe the ideas and incentives for a different world)
– keep the structure, but with (some) different targets and a new timeline (this would all depend on keeping the targets within manageable limits – a shopping list approach wouldn’t work for anyone)
– a new structure – possibly framed around global public goods or some other principle (the least likely politically, though in some ways the most apprppriate)

Or of course, nothing at all.  It’s perfectly likely that attempts to reach international consensus around shared responsiblity for a set of defined poverty problems will be too difficult and will be quitely dropped.  Before we get too deeply into a technical discussion on the what and the how of any new agreement, maybe we should remember that any agreement at all may well be the real prize.