Inter Press Service - September 6, 2005
Marty Logan

Other improvements are underway, in a nation where the bleeding sometimes never seems to stop, according to the world body. "It seems baffling," says Sriram Raj Pande, who heads the UNDP's pro-poor policies initiative in Nepal. "Yet the (results) are based on the national statistical surveys - they do show there has been improvement in many areas," he told IPS.

The child death target is one of eight Millennium Development Goals (MDGs) set by the global community in 2000. Later this month, world leaders will meet in New York to gauge their progress towards meeting them.

A UN report released here Monday documents Nepal's steps in reaching those targets.

"Nepal has made significant progress over the past 15 years in reducing poverty, improving access to education, health services and drinking water...however, some serious challenges remain in addressing inequality and exclusion, which is a critical factor hindering the equitable distribution of the results of development efforts across all geographical regions and social groups," says the foreword.

Even a massive drop in the country's poverty rate in the past eight years (by 11 percent), reported earlier this year, was tempered by the finding that the gap between reach and poor is widening.

The report outlines steps the government has taken to achieve the MDGs -- such as incorporating the goals into its five-year national plans, developing a poverty-monitoring system and initiating fiscal reforms like privatising public banks.

But, concludes the introduction, "intensifying violence and political instability have been hampering the effective utilisation of aid. Restoring peace and democracy in the country, therefore, is of utmost priority to put development efforts back on track".

According to the report, by 2015 Nepal is likely to meet the MDG goal of halving the proportion of people living below the national poverty line. Cutting in half the fraction of people who do not have access to safe drinking water is another target "likely" to be met, it adds.

"Some extra efforts from the side of the government and the donor partners may help in achieving three goals: gender and equality , improving maternal health and ensuring environmental sustainability ," says a statement released by the UN Development Programme (UNDP) in Nepal.

But "the report strongly states that the goal of achieving universal primary education is unlikely to be met". Similarly, efforts will likely fail to halt and reverse the spread of HIV/AIDS by 2015, despite some improvements.

Development in Nepal, one of South Asia's poorest countries where nearly four out of 10 people lives on less than a dollar a day, has been stunted by a Maoist uprising that has spread across most of the countryside. In the past decade, 12,000 people have died, thousands more have crossed into southern neighbour India for security and countless others have been displaced within the tiny country.

On Feb. 1 King Gyanendra fired the government for failing to defeat the Maoists, who say they aim to establish a system that will guarantee justice for the country's disadvantaged groups, especially Dalits (so- called untouchables) and indigenous people, who together make up more than half of Nepal's 25 million people.

On Saturday, the Maoists declared a unilateral three-month ceasefire, coinciding with the festival season in this officially Hindu nation; the government said Monday it is "too early" to embrace the move. Others see it as the rebels' attempt to further woo political parties -- that have reluctantly joined hands to fight the king and restore parliament -- into an alliance.

While Nepal graduated in 2002 to being classified a country of "medium" development, that progress has been limited by many "constraints", the MDG report says. These include: rugged terrain and inadequate infrastructure, high transport and investment costs, weak governance and high population growth.

But for children, developments such as better control of diarrhoea, improved immunisation, nation-wide Vitamin A supplements and better management of acute respiratory illnesses, especially pneumonia, are likely causes for the "remarkable reduction" in Nepal's child mortality in the last 30 years, says the report.

If that progress continues, the country will probably attain the MDG child mortality goal despite the conflict's destructive impact on rural life.

With an HIV/AIDS prevalence rate of 0.5 percent in the 15-49 age group, the disease would not seem to be a big health threat. However, "data suggests that Nepal has entered the stage of a concentrated epidemic," says the report. "This means that HIV/AIDS prevalence consistently exceeds five percent in some sub-populations such as female sex workers and injecting drug users."

If the disease follows trends elsewhere it will move from those sub- groups to the general population, warns the report. This "has the potential to cause an explosive epidemic".

One study estimates AIDS could be the leading cause of death in the 15- 49 age group by the end of the decade. "The alarm bells have started ringing," says Pande, adding, "not enough has been done".

"Over the next 10 years this will be a priority - that is an area where we anticipate more aid coming in and we are going to continue pushing for that."

Asked to summarise the report's results, Pande responded: "The trend so far looks good. Progress is on track but there is uncertainty - if things improve and we can upscale development to include disadvantaged groups, this will also contribute to the peace process."

*****

+MDG Report

(http://www.undp.org.np/publications/mdg/index.html)

050906
IP050903

Always watch for outdated information. This article first appeared in 2005. This material is designed to support, not replace, the relationship that exists between you and your doctor.

AEGiS presents published material, reprinted with permission and neither endorses nor opposes any material. All information contained on this website, including information relating to health conditions, products, and treatments, is for informational purposes only. It is often presented in summary or aggregate form. It is not meant to be a substitute for the advice provided by your own physician or other medical professionals. Always discuss treatment options with a doctor who specializes in treating HIV.

Copyright ©1980, 2005. AEGiS. All materials appearing on AEGiS are protected by copyright as a collective work or compilation under U.S. copyright and other laws and are the property of AEGiS, or the party credited as the provider of the content. .