Dream with a Deadline: The Millennium Development Goals

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By Bill Gates


Although it was several years ago, I still remember how Melinda and I felt when we learned about the Millennium Development Goals. We were hopeful, but we had reservations.

We were hopeful because the goals—eight specific targets for improvements in health, education, and other areas—shone a light on issues we were passionate about. We had been learning a lot about poverty, and about diseases that disproportionately affect the poor. We learned that millions of children die of preventable causes every year, and yet much of the world didn’t seem to be paying attention. So we were glad to see that three of the MDGs were specifically about global health, including reducing childhood deaths.

But as I said, we also had reservations. The MDGs were hardly the first time someone had declared that children shouldn’t die. And the U.N. had passed many resolutions calling for things that never came to pass. Why would this time be different?


It’s hard to pinpoint exactly when it happened, but over time Melinda and I moved from cautious optimists to full-throated fans. I think the MDGs are the best idea for focusing the world on fighting global poverty that I’ve ever seen. Next week in New York City, I will attend the U.N. General Assembly, where I’ll be meeting with a number of partners to talk about the progress of the MDGs and what comes next.

First, unlike so many vaguely worded international resolutions, the MDGs came with concrete numbers. You can use the goals to measure progress around the world and in specific countries. (This site lists all the targets and shows the progress toward them.) And the measures apply to things that everyone can rally around, like saving children’s lives and preventing maternal mortality. I’ve been writing about measurement a lot this year, because I’ve found that measuring progress is the only way to drive lasting success.

Second, the MDGs quickly got on the global agenda, even if they’re not that well-known here in the United States. I would visit a country like Ghana, and the leaders would be eager to discuss how they were doing on the MDGs. (Quite well, in Ghana’s case: They cut hunger by 75 percent between 1990 and 2004, for example.) I remember going to the World Economic Forum in Davos, Switzerland, and seeing for the first time a series of sessions on health and development. I doubt that would have happened without the MDGs. And Melinda and I never would have expected that in 2008, one of our daughters would come home from school with an assignment to learn about the Millennium Development Goals.

Third, the MDGs show how we can solve problems that might seem intractable. Sometimes people look at poverty or childhood deaths and say, “I feel bad about that, but there’s no way we can make progress on that in my lifetime. It’s just too depressing and complex.”

The MDGs cut through that complexity. The results prove that success is possible and real. Fewer children are dying and fewer people are living in poverty. The death rate from malaria has fallen by more than 25 percent since 2000. The proportion of people in extreme poverty has been cut by more than half, meeting MDG 1 five years early.

The success has been infectious. When donors see that their money is having an impact, they want to do more. Net foreign aid has gone up since 2000, and a large part of the increase has gone to global health.

How much credit do the MDGs get for this progress? There’s no way to put a precise number on it, but they probably had a bigger impact on health and education than on poverty. About three quarters of the drop in extreme poverty is due to China’s economic growth, which would have happened with or without the MDGs. But without the goals, it’s unlikely the world would have focused as much as it did on malaria, HIV/AIDS, maternal mortality, or childhood diseases.


We have to acknowledge that we’re not going to meet all the goals.

Some people point to this fact and say, “Oh no, we’re failing.”

But I don’t look at it that way.

The MDGs aren’t a test that the world will either pass or fail. They’re more like a report card. Some country is getting an A in every subject. The ones that aren’t doing as well can go learn from the ones that are. Without the MDGs, we wouldn’t have any idea who was acing the test and who was struggling to get by.

In some cases, we’ll miss an MDG because the goals were unrealistically high to begin with. For example, MDG 4 is to reduce childhood deaths by two thirds. We won’t hit that number by 2015. But we have achieved the largest reduction in child deaths ever recorded. Millions of children’s lives have been saved. I dare anyone to call that a failure.


We can’t be satisfied with this progress. We have to double down on it. Various groups under the auspices of the U.N. are now talking about the new round of goals that will be adopted after the current ones expire in 2015. I don’t have a position on what the new goals should be, but I do think they should build on what made the current goals so successful—starting with the fact that there were only eight MDGs, which let the world zero in on the most important areas.

Next week in New York, I’ll be making the case for four other qualities that I hope the new MDGs will also reflect:

Focused on extreme poverty, including childhood deaths in the poorest countries. We can cut the number of childhood deaths by more than half—to well below 3 million—by 2030. In addition, the next round should focus on the poorest of the poor. Much of the progress in fighting poverty over the past 15 years has been among people who lived just below $1.25 a day. Those living on far less have largely been left behind. They are harder to reach, but just as deserving of the chance to make the most of their lives.

Measurable. The MDGs create a positive feedback loop by setting clear, specific targets and measuring the progress toward them. If the new goals are going to have lasting impact, they too need to have concrete targets that can be measured.

Actionable. The MDGs are focused on areas where we have the tools that will drive progress, like vaccines to stop childhood diseases and bednets to prevent malaria. The new goals should meet this same test. For example, improving governance is a worthy end, but do we have the tools to make it happen? It’s not clear.

Built on consensus. I hope people stay focused on goals that will get unanimous support. Otherwise, the U.N. could get bogged down in endless debate that could sap our momentum. No one can object to saving children and mothers.


Let’s remember what the MDGs have accomplished. They saved lives, and they helped rich and poor countries come together to make measurable progress on reducing inequity. That had never happened before. It is a wild success. It should inspire us and guide our actions in the years ahead.