Lancet understates Millennium pledges

Millennium Declaration, 2000:

"We resolve…by the year 2015…to have reduced maternal mortality by three quarters,
and under-five child mortality by two thirds, of their current rates."

The Lancet:

"explicit health goals elaborated in 2000 were: to reduce child mortality by two-thirds relative to 1990...maternal mortality by three-quarters relative to 1990…"

"In 2000, 189 governments committed to eight [?] development goals for 2015. The target of Millennium Development Goal (MDG) 4 was to reduce mortality in children younger than 5 years by two-thirds between 1990 and 2015, and the target for MDG5 was to reduce the maternal mortality ratio by three-quarters during the same period."

"eight [?] goals for development in the Millennium Declaration (… [MDG] 5). The target for MDG 5 is to reduce the maternal mortality ratio (MMR) by three-quarters from 1990 to 2015."

"(MDGs) for 2015, adopted actively by governments in 2000... targets…MDG4 (reduce under-5 mortality from 1990 to 2015 by two-thirds) and MDG5 (reduce maternal mortality from 1990 to 2015 by three-quarters)."

"During the United Nations (UN) Millennium Summit in 2000, 147 heads of state gathered and adopted the Millennium Development Goals [!] (MDGs, panel 1)"
Panel 1
Millennium Development Goals
1 Reduce extreme poverty and hunger by half relative to 1990...
4 Reduce child mortality by two-thirds relative to 1990
5 Improve maternal health, including reducing maternal mortality by three-quarters relative to 1990"

The Lancet has given a misleading impression of Millennium Declaration commitments for many years.

The material includes flatly false statements about what leaders pledged.

The articles include material from the current editor-in-chief, editorial articles and the Lancet ombudsman.

Matt Berkley

This version 19 September 2015
millenniumdeclaration.org/lancet.htm

………………………………………………………………………………………………………………………

Bold emphasis added later to correspondence:

Date: 16 September 2015 at 07:31
Subject: Re: FW: Lancet error: Millennium Summit made pledges with a 2000 baseline
To: "Turner, Richard (ELS-CAM)" <richard.turner@lancet.com>, audrey.ceschia@lancet.com, The Lancet Peer Review Team <eesTheLancet@lancet.com>, Richard Horton <richard.horton@lancet.com>, Malcolm Molyneux <mmolyneux999@gmail.com>, ombudsman@lancet.com

Dear Dr Turner,

Thank you for dealing with this case.

I am afraid your email of 15 September thanking me for my appeal of 2 August to the ombudsman also does not mention the phone call to Dr Ceschia or the email to Dr Horton and Dr Ceschia with further details, both of 15 September. I append the email below.

I hope we can all agree that statements or text implying UN agreement to particular targets are only acceptable if they have support from specific words in UN resolutions.

Yours sincerely,

Matt Berkley

---------- Forwarded message ----------

Date: 15 September 2015 at 16:08
Subject: Millennium Summit pledges have 2000 baseline, not 1990
To: Richard Horton <richard.horton@lancet.com>, audrey.ceschia@lancet.com, The Lancet Peer Review Team <eesTheLancet@lancet.com>

Dear Dr Horton and Dr Ceschia,

Thank you, Dr Ceschia, for your time on the phone just now.

As I said, there is an opportunity for The Lancet to correct this error before the UN Summit at the end of next week.

In my first letter, the chart does not make clear that "the commitments in the Declaration were strictly speaking not at the country level". A note should be added if it is to be published.

Also, any letter from me should reference the work of Thomas Pogge of Yale, so a footnote would be in order:

Thomas Pogge, Millions Killed by Clever Dilution of Our Promise, 2010

http://www.crop.org/viewfile.aspx?id=218 .

The evidence for the Lancet's errors and other problematic material is at:

poorscience.org .

Dr Horton might have a conflict of interest from his IERG or other role.

I think there is a clear argument for publishing the truth about the Millennium pledge before the Summit.

Thank you.

Yours sincerely,

Matt Berkley.

On 16 September 2015 at 07:00

Dear Dr Turner,

The situation is unusual in that both the ombudsman and the editor-in-chief have made the error being complained of.

It is not clear from your email that you understand that.

It may be appropriate for other people to carry out the investigation on behalf of the journal.

An appropriate remedy might include The Lancet proposing to doctors that they tell people what their governments pledged.

Your email thanking me for my email of 2 August to the ombudsman omits the email of 18 August, appended below.

I have heard nothing from Professor Murray or Mr Chambers, to whom as I understand it The Lancet has written with a proposal that they write to me.

Their publicity for a Lancet article still flatly contradicts the text of the Declaration:

"The Millennium Declaration in 2000 set an ambitious goal of reducing the death rate in children under 5 by two-thirds in each country between 1990 and 2015"

http://www.sciencedaily.com/releases/2015/07/150703072652.htm

Yours sincerely,

Matt Berkley.

---------- Forwarded message ----------

Date: 18 August 2015 at 17:24
Subject: Re: Lancet error: Millennium Summit made pledges with a 2000 baseline
To: ombudsman@lancet.com, mmolyneux999@gmail.com

Dear Professor Molyneux,

Please reply to my complaint, and/or pass it to a suitable independent adjudicator.

In 2000 leaders pledged, in effect, under 3.6 million deaths of children under five in 2015.

The Lancet has implied the figure is 4.3 million.

Yours sincerely,

On 15 September 2015 at 17:42, Matt Berkley wrote:

Dear Dr Turner,

Thank you. I was assured by Dr Ceschia that the editor-in-chief would consider this in view of the urgency before the Summit.

I am afraid it is not disputable that The Lancet has made a significant error, and so I propose that the editor-in-chief begin a reappraisal at the same time.

Yours sincerely,

Matt Berkley.

On 15 September 2015 at 17:31, Turner, Richard (ELS-CAM) <richard.turner@lancet.com> wrote:

Dear Dr [?] Berkley,

Thank you very much for your letter, with apologies for the slow response.

Your letter has been passed on to Prof Molyneux, who I’m sure will be in touch with you in due course.

Sincerely,

Richard Turner PhD

Executive editor, The Lancet

Richard.turner@lancet.com

Sent: Sunday, August 02, 2015 13:50
To: Ombudsman (ELS)
Subject: Lancet error: Millennium Summit made pledges with a 2000 baseline

Dear Professor Molyneux,

I am aware that what I write here is unusual; it may be hard to believe or shocking.

I am afraid that both other contributors to the Lancet and yourself have made a significant error.

Contrary to a common belief, the Millennium Declaration includes resolutions to reduce child and maternal mortality from "current rates", not 1990.

Leaders only mentioned the generally easier Millennium Development Goal framework in 2005, while reaffirming the Declaration - which they affirmed again in 2013.

It is not clear to me who might be independent enough to decide what The Lancet should do: perhaps you would think it appropriate to suggest an alternate who could act as ombudsman - or inform the publisher.

In my view The Lancet has failed to take reasonable account of representations about both the reasons to publish two letters, and the factual error which caused them to be written.

It seems clear that the editor-in-chief has a conflict of interest. Whether Professor Murray's statements or those of his institution, or of another author, amount to author misconduct is not something I would claim expertise about. But I find it astonishing that he, or Jeffrey Sachs, might not have known what is in the Millennium Declaration.

As I stated in my first letter to The Lancet, Professor Sachs' co-author has since written that the Declaration did not set 1990 baselines. I do not know if it is accepted practice not to correct such errors by writing to the journal which published them.

The evidence is at

millenniumdeclaration.org/lancet.htm .

Yours sincerely,

Matt Berkley

---------- Forwarded message ----------

From: Matt Berkley <mattberkley@gmail.com>
Date: 30 July 2015 at 21:01
Subject: Re: Your submission to The Lancet
To: The Lancet Peer Review Team <eesTheLancet@lancet.com>

Dear Dr Ceschia,

It is not clear to me that you have understood. For whatever reasons, The Lancet has misled over a period of years.

It is not good for poor people's health to be told the wrong government commitments.

The evidence is at:

www.millenniumdeclaration.org/lancet.htm .

The letter you mention refers to errors in two papers, not one. The letter of 12 June refers to others.

Yesterday I found that the Lancet's ombudsman made the same mistake. Today I found Morton Jerven did likewise in February 2014. Both mistakes are in the Lancet.

The Lancet published two misleading articles after you stated to me that you had discussed my letter with the editor and that editorial staff had considered it carefully.

Yours sincerely,

Matt Berkley

Update 29 July 2015: The Lancet’s ombudsman has himself made the error:

"In 2000, global heads of state reached agreement on the Millennium Development Goals"

[The MDG framework has a 1990 baseline, but heads of state agreed a 2000 baseline.]

Grace Malenga, Malcolm Molyneux
The Lancet
Vol 379 June 9, 2012
Published online

May 8, 2012

DOI:10.1016/S0140-6736(12)60369-9

The Millennium Declaration makes no reference to 1990.

“We, heads of State and Government...have a duty therefore to...in particular, the children…

We resolve…

- To halve, by the year 2015, the proportion of the world’s people….one dollar a day...who suffer from hunger...reach or to afford safe drinking water. …

- By the same date, to have reduced maternal mortality by three quarters, and under-five child mortality by two thirds, of their current rates. .…

We request the General Assembly to review on a regular basis the progress made in implementing the provisions of this Declaration, and ask the Secretary-General to issue periodic reports for consideration by the General Assembly and as a basis for further action. …

We solemnly reaffirm, on this historic occasion, that the United Nations is the indispensable common house of the entire human family, through which we will seek to realize our universal aspirations for peace, cooperation and development. We therefore pledge our unstinting support for these common objectives and our determination to achieve them."

8 September 2000
http://www.un.org/millennium/declaration/ares552e.htm

Two mortality errors and two misstated pledges

On 27 March 2000, the UN Secretary-General published his Millennium Report, calling for a halving of the current proportions of people on under a dollar a day and without safe water.

On 5 July 2000 at Church House, London, the UK Department for International Development organised a Development Forum. A participant at a Trade and Poverty workshop at the Forum stated to a senior Department economist and those present that if a child dies, average income rises.

On 3 August 2000, Professor Jonathan Morduch of Princeton, later the chairman of the UN expert committee on poverty statistics, received an email: “people look at "reducing poverty" without looking at how many people die in the interim. This seems to me the worst flaw in simple economic analysis...if the poorest die, the income figures look better.”

The same point was put to other experts.

On 8 September 2000 leaders adopted the Millennium Declaration. According to the 2011 book "The Unfinished Revolution" by the chairman in 2000 of the committee of UN development funds and programmes, Mark Malloch Brown, the Assembly adopted "wholesale" the Secretary-General's recommendation document, which urged a 2000 baseline for water and money goals. The USA issued a press release strongly supporting the Secretary-General's document. Reuters, the New York Times, the Economist and the Guardian all reported the Summit using a 2000 baseline.

After the leaders resolved to achieve targets using a 2000 baseline, the IMF, World Bank, OECD and the British government strangely referred to - instead of the Declaration's pledges - the seven “International Development Goals” or “International Development Targets”. These were devised by the OECD in 1996 with 1990 baselines.

The Secretary-General had endorsed these 1990-baseline targets in June 2000 with civil servants from the OECD, the IMF and World Bank despite having himself in March proposed 2000 baselines for the Millennium Summit in September. The June 2000 UN/OECD/IMF/World Bank document made clear that UN member states' governments had not agreed these four civil servants' targets.

On 19-20 March 2001 there was a meeting of intergovernmental agencies and government representatives organised by the World Bank: “From consensus to action: a seminar on the international development goals”. The meeting discussed merging the two sets of goals.

The representative from the UN Food and Agriculture Organization stated, “my primary concern is the omission in the International Development Goals of the goal that was established by the heads of state of all the governments that are represented here today to halve the number of persons hungry in the world by 2015. That goal is not in the International Development Goals; it is in the Millennium Goals, although it is a less aggressive goal there - it is the proportion, as it is with respect to poverty, instead of the number.”

The FAO representative was referring to the 1996 World Food Summit pledge to halve the number of hungry people from “its present level” by 2015.

In order to monitor progress on the pledge, the FAO distributed a form for countries to fill in. Fo the baseline number of undernourished people, the form had a space for “number in 1996”. Pakistan, Bangladesh and other countries filled in the form. The United States developed an “action plan” stating that the WFS had a 1996 baseline – as did the director-general of the FAO.

Later, the FAO began stating that the goal was something “less aggressive”: “World Food summit goal: halve between 1990-02 and 2015, the number…”. Governments did not officially endorse this change.

At the World Bank meeting on the International Development Goals, the United Kingdom was represented by the Chief Social Development Adviser at the Department for International Development.

In late March or early April, the Adviser received a telephone call informing him of a problem: statistics would look better if the worst-off died. There was a discussion.

Frances Harper of the Statistics Department received a similar telephone call.

The World Bank head of media relations, Caroline Anstey, later Managing Director of the World Bank, received a related email.

The speechwriter for the President of the World Bank received a related telephone call, in which he stated that he understood the problem, and email.

Jeffrey Hammer, lead economist at the World Bank, received a related telephone call, and his co-author at Johns Hopkins University an email.

On 29 March 2001 the chairman of the relevant OECD committee wrote to heads of UN agencies. He proposed:

"agreement on the alignment of the international and millennium development goals and the timing and role of BWA in regular reporting to the General Assembly on development progress."

BWA - "Better world for all" - was the four civil servants' agreement with the 1990 baseline.

Around 4 April 2001, the OECD representative for the negotiations on what would become the MDGs received a telephone call informing him of a problem: statistics would look better if more of the worst-off died. There was a discussion.

On 11 April 2001, the World Bank representative received a similar call. There was a discussion.

On 11 April 2001 an email was sent.
Subj: Economics of survival
To: jeffrey_sachs@harvard.edu
“Most of the goals [later correction: many indicators - 21 for the Millennium Goals] are susceptible to the problem that if the worst-off die, we are closer to the target. ….
If the poorest die, the average income of those alive at the end of the period will be higher than the average when the group included the poorest, even if none of the survivors' income has gone up. ….
My suggestion is this: For any outcome measure - reducing poverty, achieving 100% schooling - account needs to be taken of those within the relevant group who did not achieve the target, whether through death or any other path.
...To me, no outcome measure is humane unless it takes into account what happened to people who started the period but didn't make it to the end.”

On 18 April and 2 May 2001 Ravi Kanbur of Cornell University received a telephone call on the same subject. There were discussions.

“Subj: Economics and mortality rates
Date: 20/04/01
To: Arrow@stanford.edu …
Can average welfare measures give valid conclusions about what is good for the poor without taking account of mortality rates?
In studying poor countries, economists ask, for example, “was x or y good for the poor?” on the basis of average income for the bottom quintile of those living in a country at various times. And yet, if the poorest die at a disproportionate rate, 1) the average income of those living will automatically be higher - even if none of those in the group at the end of the period increased their incomes during the period; and 2) the average at the end is not affected by anyone’s decline in income over the period, as long as they die before the end.
My question is this: can a researcher credibly claim that there has been benefit to “the poor” without knowing how many died, and at what level of income?”

UN, World Bank, OECD and IMF civil servants met on 21 June 2001. In subsequent correspondence they agreed the 1990-baseline Millennium Development Goal targets.

The Secretary-General, who had been asked to report on implementing the Declaration's pledges, instead presented the easier targets on 6 September 2001. The structure of 8 MDGs goals with targets and the baseline were from the seven IDGs. 20 of 21 IDG targets were kept.

The OECD Secretariat on 17 September 2001 stated that although the targets had a standard 1990 baseline, the drinking-water target had a 2000 baseline because it had been agreed at a UN conference.

This is odd for two reasons: 1) the baseline was never or extremely rarely mentioned again; 2) the Declaration was a UN conference which agreed, both explicitly and by implication from the acceptance of the Secretary-General's recommendation document, a standard baseline of 2000 – and yet this factor was only honoured by the civil servants in the case of the water target (though not for long).

Letter sent to the Economist newspaper, 10/10/01

Sir,

“This year the average size of fish in the pond is higher. This confirms that, on average, the fish grew”. Later, we realised big fish lived longer than small fish. ….

Growth falls if the poor live longer…

Growth rises if inequality of life length between rich and poor rises. ...

Many people think the following two inferences are obviously valid.
“Average income among the poorest fifth alive now is 1% higher than for the poorest fifth alive last year. Therefore, poor people’s incomes rose on average by 1%.”.
“The proportion of poor people went down. Therefore, poor people’s incomes rose.”
Maybe it is time to find out. Survival data, like cohort data, never give rise to the “fish” mistake.”

“Subj: Statistics and survival
Date: 10/10/01
To: sudhir.anand@economics.ox.ac.uk
Dear Professor Anand
Thank you for listening to me the other day.
I have sent a letter to the Economist, which I attach here.
I believe that I am raising a fundamental issue for social science about the validity of using statistical averages to infer benefit to individuals, in populations with variable mortality…
I have discussed differential mortality with a DFID statistician, the head of statistics at the OECD and the head of statistics at the World Bank. None of them can provide any data on possible effects on average income statistics, or on poverty reduction....”

“Subj: Re: Life tables
Date: 05/10/01
To: carl_e@ifs.org.uk
Dear Carl
Thanks very much for these and your time yesterday - it was good to talk to you.
I have wondered whether commercial (pensions and insurance) actuaries may have information that is relevant as regards differential mortality and income in industrialised countries…
What I am attempting overall is to examine rigorously the process by which conclusions are drawn as to increases or decreases in welfare, from data collected on people living at different times, in any population where survival rates are highly variable....
I believe that it is possible for social science to come to more reliable conclusions about aggregate trends in welfare in poor countries, and to narrow the gap between statistical methods and observational methods; I also believe that this cannot be done without rethinking some aspects of methodology from first principles.”

“An influential World Bank paper on growth and poverty, accepted by DFID, claims that “incomes of the poor rise one for one with overall growth”. This is widely stated, yet is a mistaken inference from the data. The study only looked at averages for living people at different times.
What it ignored was the fact that poor people in some countries live longer than in others. If the poor live longer, the average, logically, will be reduced. If the poorest die earlier, the average will rise: a country which is more unequal in income, life length or both will look better…

Many economists think this is a minor technical issue. It is not: it is a fundamental question of what is acceptable social science. …
The logical fallacy that in poor countries (populations with unknown differential mortality rates) “average income went up” is the same as “people’s incomes went up”.…

The same applies to poverty reduction - no-one knows how much this is due to raised income, and how much to excess mortality among the poor due to AIDS, hunger or bad government. The assumption is made that people’s incomes are raised, but this is just an assumption.
We need mortality data or cohort data to ensure that incomes are being raised...”

- From document 16 October 2001 written as reminder of contents of email sent to Andrew Smith MP, Chief Secretary to the UK Treasury on 15 October 2001, forwarded to and answered by Clare Short MP, Secretary of State for International Development and UK Governor of the World Bank.

Heads of four UN agencies sent the framework with the generally easier baselines on 6 November 2001 to UN country representatives. The stated aim was to help countries report progress. They had no authority from the General Assembly for changing the baseline from what it pledged a year before.

Following the announcement of the MDG framework, the agencies diluted targets again.

First, they began using 1990 for the drinking-water target, which baseline was not included in the official lists of 2001, 2003 or 2008. While for some countries this may have been harder, overall it was easier.

Second, they reported statistics on “developing regions” as if these were the MDG or Declaration targets. Due to total population growth, these targets are easier than the global pledges of 2000 or the civil servants' fudge of 2001.

Details are at:

www.millenniumdeclaration.org .

Note: Mentions of statistics in this document do not imply acceptance as sound of targets, statistical methods or results. Applying the same targets to different countries may not be fair. Statistics especially on maternal mortality may not be reliable.

On 12 June 2015 I sent a letter to the editor of the Lancet stating that the journal had repeatedly misled readers on the Millennium Declaration pledges.

On 2 July 2015 a Lancet article again referred readers to a non-existent 1990 baseline. It directed readers to a source already shown to the editorial team on 12 June as unreliable. The press release from the institution of one of the authors contains a flatly false statement contradicting the Declaration.

A July Lancet Global Health article appeared to overstate global "achievement" on survival rates in a related confusion. This article contributed to the general misconception by referring to "the MDG summit in 2000". The MDG framework was devised in summer 2001 and sent by UN civil servants in November 2001 to country offices on no formal authority from member states. It has some easier baselines than the leaders' pledges.

12 June 2015: Letter to the editor of the Lancet correcting confusion of 1990 baseline with Declaration's "current rates".

As the covering letter stated, the author learned of the discrepancy from the work of Thomas Pogge - for example "Millions Killed by Clever Dilution of Our Promise", 2010:
http://www.crop.org/viewfile.aspx?id=218 .

29 June 2015: Letter rejected but "considered carefully" and "discussed with the editor".

29 June 2015: Email to editor: "perhaps...some mistake...significant error”…
”authors, readers and those most affected deserve the truth".

No response.

2 July 2015: Lancet article by Murray and Chambers again encourages citizens to hold governments to account for the wrong pledges.

http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2815%2961171-0.pdf

It refers to the Millennium Declaration but directs readers to information relating to the MDG target with an easier 1990 baseline.

Murray's institution issues press release with false statement on leaders' pledge of 2000:

"The Millennium Declaration in 2000 set an ambitious goal of reducing the death rate in children under 5 by two-thirds in each country between 1990 and 2015."

An article by Arregoces and colleagues in Lancet Global Health, July 2015 refers to "the MDG summit in 2000".

The letter of 12 June stated,

"There are some implications for both international and national
accountability."

Murray and Chambers' article of 2 July is titled,

"Keeping score: fostering
accountability for children’s lives".

The letter of 12 June pointed out the error in a Millennium Project article in the Lancet from 2005, and showed that one of the authors published an article stating the truth in 2013.

Murray and Chambers' article of 2 July mentions the Millennium Declaration but directs readers to information on something else: information from 2006 on the MDG targets from the
Millennium Project,
whose website misleads on the pledge.

The University of Washington false statement in a press release for the Murray and Chambers article may be more widely read than the article itself:

"Institute for Health Metrics and Evaluation ...The Millennium Declaration in 2000 set an ambitious goal of reducing the death rate in children under 5 by two-thirds in each country between 1990 and 2015."

http://morocco.shafaqna.com/EN/MA/206183
http://www.eurekalert.org/pub_releases/2015-07/ifhm-moc070215.php
http://www.sciencedaily.com/releases/2015/07/150703072652.htm
http://www.healthdata.org/news-release/millions-children%E2%80%99s-lives-saved-through-low-cost-investments
http://www.theglobalfund.org/en/mediacenter/announcements/2015-03-07_Global_Health_Partners_Have_Saved_34_Million_Children_Since_2000/
http://medicalxpress.com/news/2015-07-millions-children-low-cost-investments.html
http://globalhealth.washington.edu/department-news/children-saved
http://www.news-medical.net/news/20150703/More-than-34-million-childrens-lives-saved-since-2000-through-low-cost-investments-in-health-programs.aspx
http://www.sciencecodex.com/millions_of_childrens_lives_saved_through_lowcost_investments-160703
http://m.sciencenewsline.com/news/2015070311270027
http://globalhealth.washington.edu/department-news
http://www.saluteh24.com/il_weblog_di_antonio/2015/07/millions-of-children-s-lives-saved-through-low-cost-investments-.html

In the July 2015 edition of Lancet Global Health an article stated:

"Introduction
With only 6 months remaining to reach the 2015 deadline of the Millennium Development Goals (MDGs), progress on the targets for child survival (MDG 4) and maternal and reproductive health (MDG 5) has been uneven.
Achievements include almost halving child and maternal mortality since 2000"

Countdown to 2015: changes in official development assistance to reproductive, maternal, newborn, and child health, and assessment of progress between 2003 and 2012

Leonardo Arregoces, Felicity Daly, Catherine Pitt, Justine Hsu, Melisa Martinez-Alvarez, Giulia Greco, Anne Mills, Peter Berman, Josephine Borghi
Lancet Glob Health 2015; 3: e410–22
http://www.thelancet.com/pdfs/journals/langlo/PIIS2214-109X(15)00057-1.pdf

The official figures in the MDG Report Statistical Annex are:

Under-5 mortality
2000: 76
2013: 45

The Millennium pledge is 25.

Maternal mortality
2000: 330
2013: 210

The Millennium pledge is 82.

Perhaps the authors meant "since 1990", or perhaps they were extrapolating.

Elsewhere in the article they write:

"There has been growing attention to resource tracking and assessment of whether commitments are honoured, with initiatives undertaken by the Institute for Health Metrics and Evaluation (IHME), 9 the Partnership for Maternal, Newborn and Child Health (PMNCH), 6 and the Resource Flows project of the United Nations Population Fund (UNFPA) and the Netherlands Interdisciplinary Demographic Institute (NIDI). This paper contributes to these accountability efforts..."

The article refers incorrectly to "the MDG summit in 2000", which adds to the misleading impression given by the Lancet over the years. The summit of 2000 did not mention, to my knowledge, anything about "MDGs" or eight goals - in any of the 200 or so speeches made. The MDG structure with generally easier baselines of 2015 was not mentioned by a summit at the UN until 2005, when leaders reaffirmed the Declaration - as they did in 2013.

So when the authors state

"There has been growing attention to resource tracking and assessment of whether commitments are honoured"

they may have done so while contributing to diverting public attention from actual government commitments.

In any case it was in the context of the Lancet, alongside many other sources, giving the wrong impression over many years.

The 12 June 2015 letter to the editor of the Lancet showed that several articles confused the pledge with the later MDGs. The generally easier 1990-baseline Millennium Development Goal targets were set by civil servants between June and September 2001. Four UN agencies sent the framework on 6 November 2001 to UN country representatives to help countries report, with no formal authority from member states.

The letter to the editor quoted the official MDG list, which states that the targets with 1990 baselines are "from the Millennium Declaration". The reader may wish to read that last sentence again.

The letter contained this chart, which, like the UNICEF chart it is based on, is restricted to countries estimated as having achieved 50% of the target by 2012.

The Lancet’s stated policy is to correct all significant errors.

It is clear that the Lancet has given a misleading impression of Millennium Declaration commitments for many years.

The articles include material from the current editor-in-chief, and editorials.

It would seem that any editorial staff who have been involved in publication or review of misleading material in the past, or who might be inappropriately influenced by institutional factors – including links with other organisations which have issued misleading material – may, like the editor, have a conflict of interest in relation to assessment of my letter of 12 June and consideration of whether to correct the misinformation.

Further examples are at the end of this document.

A 2 July online article for the 4 July edition of the Lancet directs readers to information on the wrong baseline for the Millennium pledges.

"Keeping score: fostering accountability for children’s lives"

Lancet, Volume 386, No. 9988, p3–5

Murray and Chambers write, "The Millennium Declaration set an ambitious goal of reducing [under-five mortality] by two-thirds in each country."

The footnote to that sentence reads, "United Nations Millennium Project. Goals, targets and indicators. New York: United Nations, 2006".

I had informed the Lancet editorial team on 12 June that the Millennium Project had misled in the Lancet in 2005 and that one of its key employees stated the truth in 2013.

The relevant Millennium Project web page does not relate to the Declaration. It gives details of the MDGs with the generally easier 1990 baseline.

http://www.unmillenniumproject.org/goals/gti.htm.

The project's ".../goals" page wrongly states:

"At the Millennium Summit in September 2000 the largest gathering of world leaders in history adopted the UN Millennium Declaration...setting out a series of time-bound targets, with a deadline of 2015, that have become known as the Millennium Development Goals."

http://www.unmillenniumproject.org/goals

As the Lancet had been told on 12 June, one of the Millennium Project authors for a Lancet article with the same error - its deputy director - had since written that it was a “myth” that the Declaration established the 1990 baselines of the MDGs.

………………………………………………………………..

Letter to the Lancet

18 July 2015

Wrong Millennium pledge

The Millennium Declaration pledge on under-five mortality is, by 2015, to reduce it by two-thirds from "current rates".

Murray and Chambers' footnote to their sentence about the Declaration (Lancet 386, 9988, 3–5) wrongly directs readers to "United Nations Millennium Project. Goals, targets and indicators. New York: United Nations, 2006".

The Millennium Project page relates not to the Millennium Declaration but to the generally easier MDG target proposed a year later:

"Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate".

On 2 July the institution which Professor Murray directs, the Institute for Health Metrics and Evaluation at the University of Washington, issued a press release announcing the Lancet's publication of the Murray and Chambers article. The release states,

"The Millennium Declaration in 2000 set an ambitious goal of reducing the death rate in children under 5 by two-thirds in each country between 1990 and 2015."

This error is rife among academics, civil servants, journalists and others. I learned of it from the work of Thomas Pogge.

I note that Arregoces and colleagues refer to an "MDG summit in 2000"

On 12 June I had written a letter to the Lancet for publication,. pointing out several relevant instances in the journal of misleading content, including from the Millennium Project. It is not difficult to see that related errors in the Lancet are common. On 29 June, after the letter was rejected, I wrote again: "I think it is clear that authors, readers and those most affected deserve the truth.".

References

http://www.un.org/millennium/declaration/ares552e.htm

Thomas Pogge, Millions Killed by Clever Dilution of our Promise, 2010
http://www.crop.org/viewfile.aspx?id=218

www.unmillenniumproject.org/goals/gti.htm

http://www.eurekalert.org/pub_releases/2015-07/ifhm-moc070215.php

www.millenniumdeclaration.org

…...........................……………

3 July 2015

Staff member took a telephone message for senior editor, Audrey Ceschia asking her to call me, following lack of response to email of 29 June to the editor and to her. No response.

29 June 2015

Fwd: Your correspondence to The Lancet

To: richard.horton@lancet.com, audrey.ceschia@lancet.com

Dear Dr Horton,

Perhaps there has been some mistake.

I have informed The Lancet of a significant error in its own editorial coverage as well as in contributions from others.

World leaders at the Millennium Summit did not adopt the generally easier 1990 baseline or "proportions of people in developing regions".

I realise this may be difficult for you.

I think it is clear that authors, readers and those most affected deserve the truth.

Yours sincerely

Matt Berkley

From: The Lancet Peer Review Team <eesTheLancet@lancet.com>
Date: 29 June 2015 at 15:31
Subject: Your correspondence to The Lancet

Manuscript reference number: THELANCET-D-15-04476
Title: Error on commitments in Millennium Declaration

Dear Mr. Berkley,

… Having discussed your Letter with the Editor, and weighing it up against other submissions we have under consideration, I am sorry to say that we are unable to accept it at this time. Please be reassured that your Letter has been carefully read and discussed by the Editors. …

Yours sincerely

Audrey Ceschia
Senior Editor

…………………………………………

Letter to The Lancet 12 June 2015

Error on commitments in Millennium Declaration

Like many people - including me in the past, and Lancet staff and other contributors - Norheim and colleagues make an error. Millennium Development Goals targeting reductions by 2015 were not "adopted in 2000" (1).

Similarly, Gates says "the persistence of maternal mortality motivated world leaders in 2000 to include it in the Millennium Development Goals" (2).

Official MDG list based on Secretary-General's proposals of 2001:
"Goals and Targets (from the Millennium Declaration) ...
- Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate...
- Reduce by three quarters, between 1990 and 2015, the maternal mortality ratio ...". (3)

Millennium Declaration:
"We resolve...by the year 2015...to have reduced maternal mortality by three quarters, and under-five child mortality by two thirds, of their current rates." (4).

There are some implications for both international and national accountability.

Yours sincerely,

Matt Berkley

Notes

"During the...Millennium Summit in 2000, 147 heads of state gathered and adopted the Millennium Development Goals...with quantitative targets set for the year 2015." (5)

A co-author of a 2005 article published by The Lancet containing the error:

"During the...Millennium Summit in 2000, 147 heads of state gathered and adopted the Millennium Development Goals...relative to 1990" (6)

later published the correct position:

"Myth 4: The Millennium Declaration established 1990 baselines" (7).

The MDG framework was proposed by the Secretary-General on 6 September 2001 in a "Road Map towards the Implementation of the United Nations Millennium Declaration". (8)

On 6 November 2001 the heads of UNDP, UNICEF, WFP and UNFPA announced to UN country representatives, "The International Development Goals (IDGs) and the development goals contained in the Millennium Declaration have recently been merged under the designation of "Millennium Development Goals" (MDGs). They have been agreed by the United Nations system, World Bank, International Monetary Fund, and OECD/DAC." (9)

[They] attached a guidance note for country reporting. This stated that the text of the Declaration "would imply" a baseline of 2000 for both the mortality and other relevant pledges. (10).

It was only after civil servants changed the baseline that the General Assembly passed a resolution on the "road map" containing the change.

In December 2001 the General Assembly did not say it "adopted" the new targets but recommended "that the "road map" be considered as a useful guide in the implementation of the Millennium Declaration".

Even then it requested

"the Secretary-General to prepare an annual report and a comprehensive report every five years on progress...towards implementing the Millennium Declaration, drawing upon the "road map"...while the quinquennial comprehensive reports examine progress achieved towards implementing all the commitments made in the Declaration".

It looks like member states were asking the Secretary-General to report not just on the generally easier MDG4 and MDG5 but on their pledges of 2000.

This interpretation is boosted by the fact that they at the same time invited "specific measures to give widespread publicity to the Millennium Declaration".

http://mdgs.un.org/unsd/mdg/Resources/Static/Products/GAResolutions/56_95/a_res56_95e.pdf

National leaders did not make any explicit statement at the UN on MDGs until September 2005 (11).

The USA's position earlier in 2005 emphasised that the MDG framework was "solely a Secretariat product" and not formally endorsed by the UN membership (12).

The leaders reaffirmed the Declaration in 2005 (13) and 2013 (14).

References

(1) Volume 385, No. 9983, p2148–2149, 30 May 2015

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2961017-0/abstract

(2) DOI: http://dx.doi.org/10.1016/S0140-6736(15)60940-0

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960940-

0/fulltext?rss=yes

(3) http://mdgs.un.org/unsd/mdg/Host.aspx?Content=indicators/officiallist.htm

(4) http://www.un.org/millennium/declaration/ares552e.htm

(5) http://www.thelancet.com/series/millennium-development-goals

(6) http://dx.doi.org/10.1016/S0140-6736(05)17791-5

(7) http://johnmcarthur.com/2015/01/origins-of-mdgs/

(8) http://mdgs.un.org/unsd/mdg/Resources/Static/Products/SGReports/56_326/a_56_326e.pdf

(9) http://www.undg.org/archive_docs/1607-MDGs_-_letter_-_MDGs_-_letter.pdf

(10) http://www.undg.org/archive_docs/2356-English.doc

(11) http://mdgs.un.org/unsd/mdg/Host.aspx?Content=/Products/GAResolutions.htm

(12) pdf.usaid.gov/pdf_docs/PCAAB560.pdf

(13) http://mdgs.un.org/unsd/mdg/Resources/Static/Products/GAResolutions/60_1/a_res_60_1e.pdf

(14) http://www.un.org/millenniumgoals/pdf/Outcome%20documentMDG.pdf

[End of letter to the Lancet 12 June 2015]

……………………………………………………

Further details:

Lancet material possibly contributing to misleading impression of Millennium Summit baseline or otherwise possibly relevant

"In 2000, governments worldwide committed to improving the health and nutrition of children by adopting the Millennium Declaration, with its ten Millennium Development Goals (MDGs)…
MDG 4 calls for a two-thirds' reduction in deaths of children younger than five years between 1990 and 2015."

Child Survival Symposium: Urgent action needed to reduce child mortality worldwide by 2015
Press release from The Lancet
17 September 2006
http://www.eurekalert.org/pub_releases/2006-09/l-css090806.php

“In 2000, governments worldwide committed to improving the health and nutrition of children by adopting the Millennium Declaration. Within the ten Millennium Development Goals (MDGs),

[footnote: "United Nations Millennium Declaration. http://www.un.org/millennium/declaration/ares552e.htm"]

child survival is the focus of the fourth MDG, that calls for a reduction of two-thirds in under-5 deaths from the 1990 baseline. "

Countdown to 2015: tracking intervention coverage for child survival
Vol 368 1067
September 23, 2006
Jennifer Bryce, Nancy Terreri, Cesar G Victora, Elizabeth Mason, Bernadette Daelmans, Zulfi qar A Bhutta, Flavia Bustreo, Francisco Songane, Peter Salama, Tessa Wardlaw
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(06)69339-2/fulltext
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2806%2969339-2.pdf

"Millennium Declaration, signed by 189 countries and translated into eight Millennium Development Goals (MDGs) to be accomplished by the year 2015. ...The three explicit health goals elaborated in 2000 were: to reduce child mortality by two-thirds relative to 1990; to improve maternal health, including reducing maternal mortality by three-quarters relative to 1990…"

Volume 366, No. 9496, p1512–1514, 29 October 2005
Comment
MDGs: chronic diseases are not on the agenda
Valentin Fuster, Janet Voûte
http://dx.doi.org/10.1016/S0140-6736(05)67610-6
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)67610-6/abstract

"This year marks a pivotal moment in international efforts to fight extreme poverty. During the United Nations (UN) Millennium Summit in 2000, 147 heads of state gathered and adopted the Millennium Development Goals [!] (MDGs, panel 1)"
Panel 1
Millennium Development Goals
1 Reduce extreme poverty and hunger by half relative to 1990 [!]
2 Achieve universal primary education
3 Promote gender equality and empowerment of women
4 Reduce child mortality by two-thirds relative to 1990
5 Improve maternal health, including reducing maternal mortality by three-quarters relative to 1990"

The Millennium Project: a plan for meeting the Millennium Development Goals
Prof JD Sachs, PhD, JW McArthur, MPhil
http://dx.doi.org/10.1016/S0140-6736(05)17791-5
Published online January 12, 2005
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)17791-5/fulltext

"It is 5 years since the member states of the UN adopted the Millennium Development Goals (MDGs). Progress towards achieving the goals by the target date of 2015 will be reviewed at a meeting of the UN General Assembly on September 14–16. Of the eight MDGs, three relate—to a greater or lesser extent—to infectious diseases: goal 4, reduce the under-5 mortality rate by two-thirds from its 1990 level; goal 5, reduce by three-quarters from its 1990 level the maternal mortality ratio…"

Volume 5, Issue 9, September 2005, Pages 529
Leading Edge
Poor shooting at the Millennium Development Goals
The Lancet Infectious Diseases
http://www.thelancet.com/journals/laninf/article/PIIS1473-3099(05)70196-1/fulltext
Jim Yong Kim - WHO HIV/AIDS Director

"Maternal and child mortality is an important indicator of a country's health and development. In 2000, 189 governments committed to eight development goals for 2015.1 The target of Millennium Development Goal (MDG) 4 was to reduce mortality in children younger than 5 years by two-thirds between 1990 and 2015, and the target for MDG5 was to reduce the maternal mortality ratio by three-quarters during the same period. "

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60481-5/fulltext
Maternal and child mortality in China
Correspondence
Lancet 383, 953-4
March 15, 2014
Bo Xi, Chengchao Zhou, Min Zhang, Yan Wang, Lingzhong Xu
Department of Maternal and Child Health, School of Public Health, Shandong University, Jinan 250012, China (BX, MZ); Department of Social Medicine and Health Management Care, School of Public Health, Shandong University, Jinan, China (CZ, LX); and Department of Child Health, National Center for Women and Children’s Health, Chinese Center for Disease Control and Prevention, Beijing, China (YW)

"During the United Nations (UN) Millennium Summit in 2000, 147 heads of state gathered and adopted the Millennium Development Goals"

http://www.thelancet.com/series/millennium-development-goals

"The Millennium Development Goals (MDGs) for health, adopted in 2000, targeted substantial reductions by 2015 in a few MDG-selected causes: mortality in children younger than 5 years, maternal mortality…"

The Lancet
Volume 385, Issue 9983, 30 May–5 June 2015, Pages 2148–2149
Correspondence
A premature mortality target for the SDG for health is ageist – Authors' reply
Ole Frithjof Norheim, Prabhat Jha,Kesetebirhan Admasu, Dean T Jamison, Richard Peto
Available online 28 May 2015
doi:10.1016/S0140-6736(15)61017-0
The Lancet, Volume 385, Issue 9964, 17–23 January 2015, Pages 239-252

"maternal mortality became one of eight goals for development in the Millennium Declaration (Millennium Development Goal [MDG] 5). The target for MDG 5 is to reduce the maternal mortality ratio (MMR) by three-quarters from 1990 to 2015."

Maternal mortality for 181 countries, 1980–2008: a systematic analysis of progress towards Millennium Development Goal 5 - The Lancet
Volume 375, No. 9726, p1609–1623, 8 May 2010
Margaret C Hogan, MSc, Kyle J Foreman, AB, Mohsen Naghavi, MD, Stephanie Y Ahn, BA, Mengru Wang, BA, Susanna M Makela, BS, Prof Alan D Lopez, PhD, Prof Rafael Lozano, MD, Prof Christopher JL Murray, MD
Published online:
12 April 2010
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60518-1/fulltext

"Introduction
The Millennium Development Goals (MDGs) for 2015, adopted actively by governments in 2000, have mobilised action on development issues.1, 2, 3 During 2015, the UN will formulate 2016–30 Sustainable Development Goals, of which one (SDG3) will relate to health.1 Some MDGs defined quantifiable targets that allowed progress to be assessed within regions and countries, such as MDG4 (reduce under-5 mortality from 1990 to 2015 by two-thirds) and MDG5 (reduce maternal mortality from 1990 to 2015 by three-quarters)."

Avoiding 40% of the premature deaths in each country, 2010–30: review of national mortality trends to help quantify the UN Sustainable Development Goal for health
Ole F Norheim, Prabhat Jha, Kesetebirhan Admasu, Tore Godal, Ryan J Hum, Margaret E Kruk, Octavio Gómez-Dantés, Colin D Mathers, Hongchao Pan, Jaime Sepúlveda, Wilson Suraweera, Stéphane Verguet, Addis T Woldemariam, Gavin Yamey, Dean T Jamison, Richard Peto
The Lancet
2015; 385: 239–52
Published online
September 19, 2014
http://dx.doi.org/10.1016/S0140-6736(14)61591-9
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)61591-9/fulltext

"Perhaps the most visible public commitment to results-based policy and evidence-driven policy was the adoption of the Millennium Development Goals (MDGs) in 2000 when UN members pledged to commit policy and funds towards reaching the eight goals, measured by 18 targets and 48 indicators."

Poor numbers and what to do about them
Morton Jerven
Volume 383, No. 9917, p594–595, 15 February 2014
Published online: 13 February 2014
DOI: http://dx.doi.org/10.1016/S0140-6736(14)60209-9
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60209-9/fulltext

"In 2000, 189 heads of state signed the Millennium Declaration committing themselves to achieve eight goals for development.1 The target for Millennium Development Goal (MDG) 4 was to reduce the under-5 mortality rate by two-thirds between 1990 and 2015 and the target for MDG 5 was to reduce the maternal mortality ratio by three-quarters during the same period..."

http://www.sciencedirect.com/science/article/pii/S0140673611613378
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2811%2961337-8/abstract
Progress towards Millennium Development Goals 4 and 5 on maternal and child mortality: an updated systematic analysis
Rafael Lozano, Haidong Wang, Kyle J Foreman, Julie Knoll Rajaratnam, Mohsen Naghavi, Jake R Marcus, Laura Dwyer-Lindgren, Katherine T Lofgren, David Phillips, Charles Atkinson, Alan D Lopez, Christopher J L Murray
Volume 378, Issue 9797, 24–30 September 2011, Pages 1139–1165

"14 years ago, the leaders of 189 nations signed the Millennium Declaration, committing their countries to fight poverty and promote development by 2015. The Declaration included eight Millennium Development Goals (MDGs) that have since shaped development policies around the globe. Much has been achieved during these years:...Worldwide, the mortality rate for children younger than 5 years decreased by 41% from 1990 to 2011, and the maternal mortality ratio similarly declined by 47% between 1990 and 2010. "

Universal health coverage and the post-2015 agenda
www.thelancet.com/pdfs/journals/lancet/PIIS0140673614614197.pdf
M Touraine et al
27 Sep 2014

"The second revolution in global health has been more recent—a revolution in accountability. Thanks to the specific targets of the MDGs, partners want proof that their investments are making a difference. The international community wants to be sure that the promises made by those partners are being delivered. A 2011 Commission on Information and Accountability for the first time explicitly linked metrics to politics. Accountability is not only about measuring and monitoring. It is about creating the right political conditions for data to have an impact on health and health policy—those political conditions mean reviewing data transparently and acting on those data collectively. Accountability carries risks. It exposes those who burnish their international credentials with fine words to the cold light of truth. This fear of truth is why there is an intense struggle to ensure that the accountability revolution of the past decade is not extinguished after 2015."

The third revolution in global health
Richard Horton
10 May 2014
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)60769-8/fulltext

Accountability Brunch
21 September 2014 - For the third time, PMNCH will co-host a traditional brunch event with Countdown to 2015, iERG and WHO. The event will mark the launch of three new report and will discuss priority actions and processes essential to developing robust accountability structures which will also be relevant in the post 2015 era.

http://www.who.int/woman_child_accountability/ierg/en/

"Introduction
At the UN Millennium Summit in September, 2000, world leaders adopted the Millennium Declaration, committing their nations to a new global partnership to reduce extreme poverty and address a series of time-bound health and development targets.1 Among these Millennium Development Goals (MDG) was a pledge to reduce child mortality by two-thirds between 1990 and 2015."

The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment"
"1 UN General Assembly. United Nations Millennium Declaration. http://www.un.org/millennium/declaration/ares552e.htm "

The effect of an integrated multisector model for achieving the Millennium Development Goals and improving child survival in rural sub-Saharan Africa: a non-randomised controlled assessment
Paul M Pronyk, Maria Muniz, Ben Nemser, Marie-Andrée Somers, Lucy McClellan, Cheryl A Palm, Uyen Kim Huynh, Yanis Ben Amor, Belay Begashaw, John W McArthur, Amadou Niang, Sonia Ehrlich Sachs, Prabhjot Singh, Awash Teklehaimanot, Jeffrey D Sachs, for the Millennium Villages Study Group
The Lancet
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60207-4/fulltext
2012; 379: 2179–88
Published online May 8, 2012
DOI:10.1016/S0140-6736(12)60207-4

"The unacceptable persistence of maternal mortality and its association with poverty prompted the global community to dedicate one of the eight Millennium Development Goals (MDG 5) to its reduction, committing to reducing maternal mortality by two-thirds by 2015. 6"

Footnote 6 is,

"UN Millennium Development Goals United Nations, New York (2000) http://www.un.org/millenniumgoals/bkgd.shtml ..."

http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2815%2960497-4/fulltext
Published online
June 5, 2015
Lancet Commissions: Women and Health
http://dx.doi.org/10.1016/S0140-6736(15)60497-4

"the persistence of maternal mortality motivated world leaders in 2000 to include it in the Millennium Development Goals (MDGs). MDG 5 was dedicated to reducing the maternal mortality ratio by three-quarters by 2015. Although that target will not be achieved by the time the MDGs expire later this year, important progress has been made. Between 1990 and 2013, the worldwide maternal mortality ratio declined by 45%"

Melinda Gates
June 5, 2015
http://dx.doi.org/10.1016/S0140-6736(15)60940-0
http://press.thelancet.com/WomenCommissionCMT2.pdf

"The United Nations Millennium Declaration 1 in 2000, when the world agreed to the Millennium Development Goals (MDGs), 2...the health MDGs (MDG 4, to reduce child mortality; MDG 5, to improve maternal health; and MDG 6, to combat HIV/AIDS, malaria, and other diseases), the reported figures show impressive achievements overall…

By providing detailed information on key data sources, key adjustments to data, modelling strategies, and uncertainty analyses, Murray and colleagues have pushed the boundaries of reporting in global health to levels expected of other disciplines and areas of health research—an important step in the right direction.

Writing in The Lancet, Richard Horton has identified three revolutions in global health: the first in metrics, the second in accountability, and the third in quality of health care. 18 The time is right for the fourth revolution: new global standards to make available the data, methods, and models used in global health estimates of incidence, prevalence, mortality, and morbidity to enable replication, setting in motion a new era in global health research. Only then will we ensure transparency, intensify scrutiny, and create accountability in global health.

Rifat Atun
Harvard School of Public Health"

The footnotes to "Declaration" and "MDGs" are both to "United Nations Millennium Declaration. UN General Assembly Resolution A/RES/55/2. Sept 8, 2000".

Time for a revolution in reporting of global health data
Rifat Atun
Published online
July 22, 2014
http://dx.doi.org/10.1016/S0140-6736(14)61062-X

"When world leaders signed the UN Millennium Declaration in 2000, they were united around one common agenda—to eradicate poverty. The leaders agreed to meet eight Millennium Development Goals (MDGs) by 2015"

Tuberculosis control is crucial to achieve the MDGs
Rifat Atun, Mario Raviglione, Ben Marais, Alimuddin Zumla
18 September 2010
http://www.thel ancet.com/journals/lancet/article/PIIS0140673610614286/fulltext

"As described by Bill Gates, the MDGs have become a type of global report card for the fight against poverty for the 15 years from 2000 to 2015."

From Millennium Development Goals to Sustainable Development Goals
Jeffrey Sachs
Viewpoint
Vol 379 June 9, 2012
Lancet
379: 2206
http://www.the lancet.com/pdfs/journals/lancet/PIIS0140-6736(12)60685-0.pdf

"The Millennium Declaration in 2000 brought special global attention to HIV, tuberculosis, and malaria through the formulation of Millennium Development Goal (MDG) 6."

Global, regional, and national incidence and mortality for HIV, tuberculosis, and malaria during 1990-2013: A systematic analysis for the Global Burden of Disease Study 2013
Murray CJL., Ortblad KF., Guinovart C., Lim SS., Wolock TM., Roberts DA., Dansereau EA., Graetz N., Barber RM., Brown JC., Wang H., Duber HC., Naghavi M., Dicker D., Dandona L., Dandona L., Salomon JA., Heuton KR., Foreman K., Phillips DE., Fleming TD., Flaxman AD., Phillips BK., Johnson EK., Coggeshall MS., Abd-Allah F., Abera SF., Abraham JP., Abubakar I., Abu-Raddad LJ., Abu-Rmeileh NM., Achoki T., Adeyemo AO., Adou AK., Adsuar JC., Agardh EE., Akena D., Al Kahbouri MJ., Alasfoor D., Albittar MI., Alcalá-Cerra G., Alegretti MA., Alemu ZA., Alfonso-Cristancho R., Alhabib S., Ali R., Alla F., Allen PJ., Alsharif U., Alvarez E., Alvis-Guzman N., Amankwaa AA., Amare AT., Amare AT., Amini H., Ammar W., Anderson BO., Antonio CAT., Anwari P., Ärnlöv J., Arsic Arsenijevic VS., Artaman A., Asghar RJ., Assadi R., Atkins LS., Badawi A., Balakrishnan K., Banerjee A., Basu S., Beardsley J., Bekele T., Bell ML., Bernabe E., Beyene TJ., Bhala N., Bhalla A., Bhutta ZA., Bin Abdulhak A., Binagwaho A., Blore JD., Bora Basara B., Bose D., Brainin M., Breitborde N., Castañeda-Orjuela CA., Catalá-López F., Chadha VK., Chang JC., Chiang PPC., Chuang TW., Chuang TW., Colomar M., Cooper LT., Cooper C., Courville KJ., Cowie BC., Criqui MH., Dandona R., Dayama A., De Leo D.
The Lancet
01/01/2014 384 1005 – 1070
http://www.neuroscience.ox.ac.uk/publications/486663
http://www.ncbi.nlm.nih.gov/pubmed/25059949

"The UN Millennium Declaration has eight goals and 18 targets including the reduction of maternal mortality by three-quarters by 2015. …"

Volume 363, No. 9402, p67–68, 3 January 2004
The right to count
Wendy Graham
www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(03)15174-4.pdf

"In September, 2000, an unprecedented gathering of world leaders attended the UN Millennium Summit in New York, NY, USA, and adopted the UN Millennium Declaration committing their nations to a new global partnership to halve the number of people living in poverty by 2015.1
Several development targets and goals were set, including several in health that are collectively known as the Millennium Development Goals (MDGs). 2
These goals are at the heart of achieving sustainable development through poverty eradication. MDGs 4, 5, and 6 cover the main health priorities in development: child survival, maternal and reproductive health, HIV, tuberculosis, and malaria.
With only 5 years left until the 2015 deadline to achieve the MDGs, UN Secretary-General Ban Ki-moon has called on world leaders to attend a summit in New York, on 20–22 Sept, 2010, to review progress towards the MDGs, renew the international commitment of 10 years ago…"
References
1.United Nations. Millennium Assembly. 55th session, New York.
http://www.un.org/millennium/assembly.htm; September, 2000. ….
2.The UN Millennium Project. http://www.unmillenniumproject.org/goals/index.htm; 2006. ...
3.UN Secretary-General's report on the MDGs. Keeping the Promise: a forward-looking review to promote an agreed action agenda to achieve the MDGs by 2015. http://www.un.org/ga/search/view_doc.asp?symbol=A/64/665; 2010. ...

Volume 375, No. 9719, p967, 20 March 2010
Comment
The health-related MDGs—an urgent call for papers
Pam Das, Richard Horton
http://dx.doi.org/10.1016/S0140-6736(10)60414-X

"During the United Nations (UN) Millennium Summit in 2000, 147 heads of state gathered and adopted the Millennium Development Goals to address extreme poverty in its many dimensions—income poverty, hunger, disease, lack of adequate shelter, and exclusion—while promoting education, gender equality, and environmental sustainability, with quantitative targets set for the year 2015. The UN committed to reviewing progress towards the goals in 2005"

http://www.thelancet.com/series/millennium-development-goals
Published: January 22, 2005
Executive Summary

"...the fifth Millennium Development Goal to reduce maternal mortality by 75% between 1990 and 2015. ... Targeting of interventions to the most vulnerable—rural populations and poor people—is essential if substantial progress is to be achieved by 2015.
At the turn of this century, 189 countries endorsed the Millennium Declaration and signed up to meeting eight goals. One of these (Millennium Development Goal [MDG] 5) is to “improve maternal health”.1
...Here we focus on maternal mortality explicitly because it has been selected by 189 countries as the target for substantial reduction by 2015.
...The target set for MDG-5 is a 75% reduction in the maternal mortality ratio between 1990 and 2015."

Published online
September 28, 2006
DOI:10.1016/S0140-6736(06)69380-X

"Jeffrey Sachs…argued that unless his investment recommendations were heeded, the Millennium Development Goals laid down by world leaders would never be met. His case is mixed with moral and political urgency: "with globalisation on trial as never before, the world must succeed in achieving its solemn commitments to reduce poverty and improve health" "
"Conflict of interest statement - An important objective for The Lancet is to publish the best work in international health. To this end, we receive and commission many papers co-authored by WHO staff. I take part in making decisions about the progress of these papers within the journal."

Richard Horton
The Lancet, 359, 1605-11
May 4, 2002
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(02)08523-9/fulltext
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2802%2908523-9.pdf

MB note: The MDGs were not "laid down by world leaders", but by a few civil servants with no formal consultation with UN members. There were no "solemn commitments" on the easier MDG targets - only Resolution 56/95 of December 2001 welcoming the Road Map containing them as a "useful guide" to implementing the Declaration. There were solemn commitments in the World Food Summit Declaration of 1996 to halve the number of hungry people from its "present level", and the Millennium Declaration to halve the easier "proportion". The MDG target on hunger proposed in 2001 was even easier due to the baseline change, and the UN's reporting on "developing countries" diluted the global target further due to total-population growth rates. There was a "solemn commitment" to monitor the harder Millennium pledges.

"The Lancet, UNICEF, and the Norwegian Government will host a key meeting in New York on September 18th to assess the progress being made to reduce child deaths by two-thirds by 2015--the fourth Millennium Development Goal (MDG 4). …
The meeting will coincide with the publication of a special issue of The Lancet devoted to child survival. …
Millennium Development Goals
In 2000, governments worldwide committed to improving the health and nutrition of children by adopting the Millennium Declaration, with its ten Millennium Development Goals (MDGs)…
MDG 4 calls for a two-thirds' reduction in deaths of children younger than five years between 1990 and 2015. "

Child Survival Symposium: Urgent action needed to reduce child mortality worldwide by 2015
Press release from The Lancet
17 September 2006
http://www.eurekalert.org/pub_releases/2006-09/l-css090806.php

"...despite maternal mortality reduction being awarded its own Millennium Development Goal (MDG-5) in 2000"

Maternal mortality: surprise, hope, and urgent action
Richard Horton
http://dx.doi.org/10.1016/S0140-6736(10)60547-8
Published online: 12 April 2010
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(10)60547-8/fulltext

"During the United Nations (UN) Millennium Summit in 2000, 147 heads of state gathered and adopted the Millennium Development Goals [!] to address extreme poverty in its many dimensions, with quantitative targets set for the year 2015. The UN is reviewing progress this year, starting with the Jan 17 publication of the report of the Millennium Project, directed by Professor Jeffrey Sachs of Columbia University, USA. As Sachs and McArthur point out in this week's issue, 2005 will contain many opportunities to address this vital goal…"

Volume 365, No. 9456, p267–268, 22 January 2005
Editorial
Health and poverty: a new Marshall plan?
The Lancet
http://dx.doi.org/10.1016/S0140-6736(05)17795-2
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)17795-2/fulltext

The editorial page refers to this article:

MB note: It is generally true that leaders later reaffirmed commitments to the Declaration:

"On health, the G8 reaffirmed their commitment to goals set by the Millennium Summit and at the World Summit on Sustainable Development."
Volume 361, No. 9373, p1962, 7 June 2003
Global security takes priority over health at G8 summit
Haroon Ashraf
http://dx.doi.org/10.1016/S0140-6736(03)13605-7
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)13605-7/fulltext

"the seven Millennium Development Goals (MDGs) agreed by world leaders at the Millennium Summit in 2000"
"In his first annual report on implementation of the MDGs in July, 2002, UN Secretary-General Kofi Annan acknowledged that current progress is far too slow to meet the targets for education and health by 2015…"

Volume 361, No. 9365, p1235, 12 April 2003
Editorial
Lessons must be learned for good health
The Lancet
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(03)13025-5/fulltext
http://dx.doi.org/10.1016/S0140-6736(03)13025-5

"The Millennium Development Goals of eradicating extreme poverty and hunger, reducing child mortality, improving maternal health, and combating diseases such as HIV/AIDS and malaria by 2015 …
Heads of state committed themselves to the Millennium Development Goals at a summit in 2000. UNICEF estimated that it would need around US$60 billion to achieve the targets by 2015."

Volume 362, No. 9400, p1986, 13 December 2003
UNICEF gloomy on child development goals
Clare Kapp
http://dx.doi.org/10.1016/S0140-6736(03)15087-8

"The Millennium Development Goal 4 (MDG 4) target of reduction of child mortality by two thirds from 1990 to 2015…
"huge strides since the declaration of the MDG goals"
"The MDG declaration.…"

Global, regional, and national levels of neonatal, infant, and under-5 mortality during 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013

Haidong Wang, Chelsea A Liddell, Matthew M Coates, Meghan D Mooney, Carly E Levitz, Austin E Schumacher, Henry Apfel, Marissa Iannarone, Bryan Phillips, Katherine T Lofgren, Logan Sandar, Rob E Dorrington, Ivo Rakovac, Troy A Jacobs, Xiaofeng Liang, Maigeng Zhou, Jun Zhu, Gonghuan Yang, Yanping Wang, Shiwei Liu, Yichong Li, Ayse Abbasoglu Ozgoren, Semaw Ferede Abera, Ibrahim Abubakar, Tom Achoki, Ademola Adelekan, Zanﬁna Ademi, Zewdie Aderaw Alemu, Peter J Allen, Mohammad AbdulAziz AlMazroa, Elena Alvarez, Adansi A Amankwaa, Azmeraw T Amare, Walid Ammar, Palwasha Anwari, Solveig Argeseanu Cunningham, Majed Masoud Asad, Reza Assadi, Amitava Banerjee, Sanjay Basu, Neeraj Bedi, Tolesa Bekele, Michelle L Bell, Zulﬁqar Bhutta, Jed D Blore, Berrak Bora Basara, Souﬁane Boufous, Nicholas Breitborde, Nigel G Bruce, Linh Ngoc Bui, Jonathan R Carapetis, Rosario Cárdenas, David O Carpenter, Valeria Caso, Ruben Estanislao Castro, Ferrán Catalá-Lopéz, Alanur Cavlin, Xuan Che, Peggy Pei-Chia Chiang, Rajiv Chowdhury, Costas A Christophi, Ting-Wu Chuang, Massimo Cirillo, Iuri da Costa Leite, Karen J Courville, Lalit Dandona, Rakhi Dandona, Adrian Davis, Anand Dayama, Kebede Deribe, Samath D Dharmaratne, Mukesh K Dherani, Uğur Dilmen, Eric L Ding, Karen M Edmond, Sergei Petrovich Ermakov, Farshad Farzadfar, Seyed-Mohammad Fereshtehnejad, Daniel Obadare Fijabi, Nataliya Foigt, Mohammad H Forouzanfar, Ana C Garcia, Johanna M Geleijnse, Bradford D Gessner, Ketevan Goginashvili, Philimon Gona, Atsushi Goto, Hebe N Gouda, Mark A Green, Karen Fern Greenwell, Harish Chander Gugnani, Rahul Gupta, Randah Ribhi Hamadeh, Mouhanad Hammami, Hilda L Harb, Simon Hay, Mohammad T Hedayati, H Dean Hosgood, Damian G Hoy, Bulat T Idrisov, Farhad Islami, Samaya Ismayilova, Vivekanand Jha, Guohong Jiang, Jost B Jonas, Knud Juel, Edmond Kato Kabagambe, Dhruv S Kazi, Andre Pascal Kengne, Maia Kereselidze, Yousef Saleh Khader, Shams Eldin Ali Hassan Khalifa, Young-Ho Khang, Daniel Kim, Yohannes Kinfu, Jonas M Kinge, Yoshihiro Kokubo, Soewarta Kosen, Barthelemy Kuate Defo, G Anil Kumar, Kaushalendra Kumar, Ravi B Kumar, Taavi Lai, Qing Lan, Anders Larsson, Jong-Tae Lee, Mall Leinsalu, Stephen S Lim, Steven E Lipshultz, Giancarlo Logroscino, Paulo A Lotufo, Raimundas Lunevicius, Ronan Anthony Lyons, Stefan Ma, Abbas Ali Mahdi, Melvin Barrientos Marzan, Mohammad Tauﬁq Mashal, Tasara T Mazorodze, John J McGrath, Ziad A Memish, Walter Mendoza, George A Mensah, Atte Meretoja, Ted R Miller, Edward J Mills, Karzan Abdulmuhsin Mohammad, Ali H Mokdad, Lorenzo Monasta, Marcella Montico, Ami R Moore, Joanna Moschandreas, William T Msemburi, Ulrich O Mueller, Magdalena M Muszynska, Mohsen Naghavi, Kovin S Naidoo, KM Venkat Narayan, Chakib Nejjari, Marie Ng, Jean de Dieu Ngirabega, Mark J Nieuwenhuijsen, Luke Nyakarahuka, Takayoshi Ohkubo, Saad B Omer, Angel J Paternina Caicedo, Victoria Pillay-van Wyk, Dan Pope, Farshad Pourmalek, Dorairaj Prabhakaran, Sajjad UR Rahman, Saleem M Rana, Robert Quentin Reilly, David Rojas-Rueda, Luca Ronfani, Lesley Rushton, Mohammad Yahya Saeedi, Joshua A Salomon, Uchechukwu Sampson, Itamar S Santos, Monika Sawhney, Jürgen C Schmidt, Marina Shakh-Nazarova, Jun She, Sara Sheikhbahaei, Kenji Shibuya, Hwashin Hyun Shin, Kawkab Shishani, Ivy Shiue, Inga Dora Sigfusdottir, Jasvinder A Singh, Vegard Skirbekk, Karen Sliwa, Sergey S Soshnikov, Luciano A Sposato, Vasiliki Kalliopi Stathopoulou, Konstantinos Stroumpoulis, Karen M Tabb, Roberto Tchio Talongwa, Carolina Maria Teixeira, Abdullah Sulieman Terkawi, Alan J Thomson, Andrew L Thorne-Lyman, Hideaki Toyoshima, Zacharie Tsala Dimbuene, Parfait Uwaliraye, Selen Begüm Uzun, Tommi J Vasankari, Ana Maria Nogales Vasconcelos, Vasiliy Victorovich Vlassov, Stein Emil Vollset, Stephen Waller, Xia Wan, Scott Weichenthal, Elisabete Weiderpass, Robert G Weintraub, Ronny Westerman, James D Wilkinson, Hywel C Williams, Yang C Yang, Gokalp Kadri Yentur, Paul Yip, Naohiro Yonemoto, Mustafa Younis, Chuanhua Yu, Kim Yun Jin, Maysaa El Sayed Zaki, Shankuan Zhu, Theo Vos, Alan D Lopez, Christopher J L Murray

Lancet 2014; 384: 957–79
Published online
May 2, 2014
http://dx.doi.org/10.1016/S0140-6736(14)60497-9

"(MDGs), targets that the world's governments signed up to at the Millennium Summit 2 years ago."

Volume 360, No. 9338, p960–961, 28 September 2002
Commentary
WHO'S mandate: a damaging reinterpretation is taking place
Richard Horton
http://dx.doi.org/10.1016/S0140-6736(02)11117-2
http://www.thelancet.com/journals/lancet/article/PIIS 0140-6736(02)11117-2/fulltext

MB: Given that there was significant progress in 1990-2000, these two articles are inconsistent:

"The fourth Millennium Development goal (MDG) documents the world's commitment to reducing by two-thirds the 10•8 million deaths of children younger than 5 years by 2015"

Volume 366, No. 9502, p1984, 10 December 2005
Editorial
An open gate to newborn and child survival
The Lancet
http://dx.doi.org/10.1016/S0140-6736(05)67794-X
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(05)67794-X/fulltext

"the 11 million deaths which occur now."

Volume 356, No. 9229, p577–582
12 August 2000
Global health status: two steps forward, one step back
Kasturi Sen, Ruth Bonita , PhD
DOI: http://dx.doi.org/10.1016/S0140-6736(00)02590-
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(00)02590-3/fulltext

MB note:

The editorial of 2005 above gives a 2000 baseline for MDG4. This error is different from the standard error of saying or implying that the MDG target, which many readers would already know has a baseline of 1990, was agreed by the Millennium Summit.

"The estimate for global child deaths in 2000 is 10·8 million"

Robert E Black, Saul S Morris, Jennifer Bryce

http://www.who.int/maternal_child_adolescent/documents/pdfs/lancet_child_survival_10mill_dying.pdf.

"Although the MDGs have been a successful means to achieve health advancements since 2000, many countries have been excluded from those successes. Take mortality in children younger than 5 years. Spectacular improvements in child survival have taken place since 1990: under-5 deaths have fallen from 12·6 million in 1990 to 6·6 million in 2012."

Investing in health: why, what, and three reflections
Richard Horton, Selina Lo
The Lancet
Volume 382, No. 9908, p1859–1861,
7 December 2013
Published online: 03 December 2013
http://www.thelancet.com/journals/lancet/article/PIIS0140-6736%2813%2962330-2/fulltext
http://dx.doi.org/10.1016/S0140-6736(13)62330-2

“Consider four drowning children. (This thought experiment was first devised by Peter Singer in 1972.) …
...the essential truth: we can’t avoid our responsibility to one another simply because someone else decides to avoid their responsibility. This conclusion, if correct, has profound implications for the way each of us should act in our day-to-day lives. It does seem correct.”

Richard Horton
The Lancet 386, 230
July 18, 2015
http://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736%2815%2961254-5.pdf

"When the millennium declaration was rewritten as a set of specific goals, the baseline for calculating the proportion to be halved was set not at 2000, but at 1990. That meant that progress already made could contribute to the achievement of the goal... it looks very much as if, come 2015, the world's leaders will have failed to keep their (watered down) promises."

Peter Singer, 2010
http://www.theguardian.com/commentisfree/2010/oct/07/millennium-development-goals-un-poverty

……………..…..…..………………………..……

Material on Thomas Pogge's observations that the baselines differ and the UN now report on "developing countries" rather than the harder global trends in the pledges:

Thomas Pogge's writings, for example:

Millions Killed by Clever Dilution of Our Promise
2010
http://www.crop.org/viewfile.aspx

"Pogge points out that while the Millennium Declaration adopted by the UN in 2000 makes that year its baseline, the eight specific Millennial Development Goals are measured against 1990."

Frances Moore Lappe, 2012
http://www.huffingtonpost.com/frances-moore-lappe/poverty-down-inequality-u=p_b_1878850.html

http://www.aljazeera.com/indepth/opinion/2014/08/exposing-great-poverty-red=uctio-201481211590729809.html

Commitments are in the Declaration, which leaders reaffirmed in 2005 and 2013.

Further information on the Declaration is at

millenniumdeclaration.org or
ungoals.org .