2011 Pacific Regional MDGs Tracking Report

2011 PACIFIC REGIONAL MDGS TRACKING REPORT
2011 Pacific Regional MDGs Tracking Report
Table of Contents
Acronyms and Abbreviations Executive Summary Part 1 Purpose of the Report Background and Objectives Part 2 Guidelines and Overview Assessment and Data Guidelines A Brief Summary of Progress Part 3 Performance on the Eight Goals Goal 1 Eradicate Extreme Poverty and Hunger Goal 2 Achieve Universal Primary Education Goal 3 Promote Gender Equality and Empower Women Goal 4 Reduce Child Mortality Goal 5 Improve Maternal Health Goal 6 Combat HIV/AIDS and Other Diseases HIV/AIDS Malaria TB Goal 7 Ensure Environmental Sustainability Goal 8 Develop a Global Partnership for Development Part 4 A Closer Look at the Health-Related MDGs Child and Maternal Health HIV/AIDS, Malaria and Tuberculosis Non-communicable Diseases Health Financing Key Challenges Annex 1 Statistical Notes Country Tables References ii iv 1 1 4 4 7 12 12 16 18 21 24 27 28 31 33 34 38 45 45 48 50 54 56 58 58 59 73
Acronyms and Abbreviations

ADB AIDS CKI CMI COFA DAC DFAT DHSA DOE EPPSO EU FIC FPI FSM FY GAO HIES HIV HPV ICT ILO IMF ITA ITU JEMCO LDC MDG MECC MESC MEWAC MFEM MHMS MICS MISGLB MOE MOFNP MOH NHIS Asian Development Bank Acquired Immune Deficiency Syndrome Cook Islands College of the Marshall Islands Compact of Free Association Development Assistance Committee Department of Foreign Affairs and Trade Department of Health and Social Affairs Department of Education Economic Policy, Planning and Statistics Office European Union Forum Island Country Family Planning International Federated States of Micronesia Financial Year Government Accountability Office Household Income and Expenditure Survey Human Immunodeficiency Virus Human Papillomavirus Information and Communication Technologies International Labour Organisation International Monetary Fund International Trade Administration International Telecommunication Union Joint Economic and Management Committee Least Developed Country Millennium Development Goal Ministry of Environment and Climate Change Ministry of Education, Sports and Culture Ministry of Education, Women Affairs and Culture Ministry of Finance and Economic Management Ministry of Health and Medical Services Multiple Indicator Cluster Survey Marshall Islands Scholarship, Grant and Loan Board Ministry of Education Ministry of Finance and National Planning Ministry of Health National Health Information System
Acronyms and Abbreviations Cont

NSO NTA NZ NZAID OECD PALARIS PIFS PIRMCCM PNCC PNG RMI SBOC SGS SIS SOPAC SPC SPREP TNPF UNAIDS UNDP UNFPA UNGASS UNICEF UNSD US USP WHO WIBDI WPP WTO National Statistics Office National Telecommunications Authority New Zealand New Zealand Agency for International Development Organisation for Economic Co-operation and Development Palau Automated Land and Resources Information System Pacific Islands Forum Secretariat Pacific Islands Regional Multi-Country Coordinating Mechanism Palau National Communication Corporation Papua New Guinea Republic of the Marshall Islands Statistics, Budget and Economic Management, Overseas Development Assistance, and Compact Management Second Generation Surveillance Smaller Island States Pacific Islands Applied Geoscience Commission Secretariat of the Pacific Community Secretariat of the Pacific Regional Environment Programme Tuvalu National Provident Fund Joint United Nations Program on HIV/AIDS United Nations Development Program United Nations Population Fund United Nations General Assembly Special Session United Nations Childrens Fund United Nations Statistics Division United States University of the South Pacific World Health Organisation Women in Business Development Incorporated World Population Prospects World Trade Organisation
Executive Summary
The Pacific Plan guides the regions efforts towards achieving the MDGs, while the Compact on Strengthening Development Coordination is a tool for implementing the priorities of the Pacific Plan. One of the key deliverables of the Compact is to track the progress of FICs towards achieving the MDGs, which is the main purpose of this Report. The MDGs assessment in this Report is not strictly made against the global targets, as the assessments are supplemented by proxy data and qualitative information. Recent national MDG Reports formed the main source of the dataset used to assess progress. However, there were many difficulties in compiling comprehensive, quality and up-to-date MDGs data, indicating the weaknesses of statistical capacities in the region, which requires attention. While the MDGs assessments contained herein are debatable, what is unambiguous is that more concerted effort is needed in the region to accelerate and sustain progress towards achieving the MDGs by 2015. PNGs population of around 6.7 million people means that overall progress for the region is inextricably tied to PNGs progress. Consequently, as PNG is off track on all the MDGs, the region is also off track on all the goals. However, excluding PNG, the region is on track towards reducing child mortality, with mixed progress on all the other goals. Polynesias progress is comparatively better than any other sub-region, with Micronesia not on track for any goal. With the exception of Cook Islands, Niue, Samoa and Palau, all countries are off track on at least one goal. PNG, Kiribati, Solomon Islands and Nauru are not on track for any of the goals, while Cook Islands, Niue and Palau are on track for six of the goals. Majority of countries are off track on poverty, followed by environmental sustainability, then gender. On the other hand, most countries were on track to reduce child mortality, followed by achieving universal education and improving maternal health. The regions progress on reducing poverty is constrained by generally low economic growth, lack of job opportunities and rising prices. Even though good progress is made towards achieving universal primary education, the quality of education remains a concern. Similarly, while there is very low gender disparity in education, progress on empowering women is much slower. On the health-related goals, the relatively low measles immunisation coverage needs to be addressed to sustain progress on reducing child mortality, while more concerted effort is needed in ensuring universal access to reproductive health to improve maternal health. Interventions for maternal and child health are well known in the region and needs to be scaled up. The Global Fund to Fight AIDS, Tuberculosis and Malaria is instrumental in assisting countries combat the major diseases. Continued support from the Global Fund is needed to sustain and accelerate progress towards combating HIV/ AIDS, malaria and tuberculosis. Although non-communicable diseases (NCDs) are not included under MDG 6, majority of countries, in recognition of its importance, have included combating NCDs as an additional target. Of the ten countries that included NCDs, FSM, Samoa, Tonga and Vanuatu are off track on combating NCDs. On environmental sustainability, achieving energy security remains a key priority in the region, as most countries are highly dependent on imported fossil fuels. In other areas, access to safe drinking water and basic sanitation is a major concern in Micronesia. The successful achievement of the first seven goals is critical on the support of development partners. To this end, overseas development assistance (ODA) has doubled, with two-thirds of ODA directed to the social infrastructure and services sector, which includes education, health and water supply and sanitation. However, there is room for improvement for major developed trading partners to provide better access to their markets for countries in the region. Climate change is a critical emerging issue, with the potential to derail progress on all the goals. The adverse impact of climate change is already being felt by some countries, such as FSM, Kiribati and Tuvalu. Key approaches to addressing climate change include mainstreaming climate change measures into national plans, improving access to climate change funds and strengthening development coordination. This Report makes five broad conclusions, which serves to reinforce the undertakings made in the Port Vila Declaration. Firstly, there is a general lack of comprehensive quality data to accurately assess MDGs progress, so more effort is needed to strengthen statistical capacities. Secondly, as intervention strategies are generally well known in the respective sectors, these need to be built upon, sustained or scaled up. Thirdly, development partner support through funding, technical assistance and capacity building is critical, hence, requiring better development coordination and harmonisation. Fourthly, governments, development partners, civil society organisations and the private sector need to work together. Finally, strong political leadership and resolve towards achieving the MDGs is the catalyst towards progress.
PART 1 Purpose of the Report
BACKGROUND AND OBJECTIVES

Forum Leaders affirmed their support for the Millennium Declaration in September 2000 and later set out their Vision for the Pacific in the Auckland Declaration of April 2004, which laid the foundation for the Pacific Plan. Endorsed in October 2005, the Pacific Plan is designed to strengthen Pacific regional integration and cooperation based on four pillars economic growth, sustainable development, good governance and security. The Pacific Plan is the foundation for the regions efforts towards the achievement of the MDGs. In 2009, in response to concerns that the region was off-track to achieve the MDGs despite high levels of development assistance, Forum Leaders agreed to the Cairns Compact on Strengthening Development Coordination in the Pacific. The key objective of the Compact will be to improve the coordination and use of available development resources with the aim of achieving real progress against the MDGs. The Compact is a tool for implementing the priorities of the Pacific Plan. Forum Leaders commitment to the achievement of the MDGs was further strengthened in 2010 in the Port Vila Declaration on Accelerating Progress on the Achievement of the MDGs (see Box 1). One of the main deliverables under the Compact on Strengthening Development Coordination is to provide an annual Pacific Regional MDGs Tracking Report. This Report is the second Pacific Regional MDGs Tracking Report. The principal purpose of the Report is to assess the progress made by FICs towards achieving the MDGs by 2015. As latest data are not available on a timely basis and considering that policy interventions take time to be reflected in the data, the MDGs assessment is unlikely to change markedly on an annual basis. For this reason, thematic focus areas are chosen to elaborate on pertinent issues. At the February 2011 Forum Compact on Strengthening Development Coordination in the Pacific Regional Workshop, Health was chosen as the main thematic focus for this years Report. The emphasis on Health was chosen due to its centrality in the achievement of all the MDGs and because the 2010 Pacific Regional MDGs Tracking Report indicated that a cluster of countries were off track on the health-related MDGs. A wealth of information is contained in the 2010 Regional MDGs Report and much of it remains valid, particularly with regards to the challenges, emerging issues and measures needed to accelerate progress. Consequently, only a few key areas in this regard are briefly highlighted in this Report. A major component in the preparation of this Report was to validate and update the MDGs dataset. This proved to be a tremendous exercise, given that data for the MDG indicators were not easily accessible and there were quality concerns with available data. For some indicators, data was not available at all. Therefore, as was the case for this Report, a key objective for subsequent Reports will be to improve on the dataset from which assessments are made.
The Pacific Plan is the foundation for the regions efforts towards achieving the MDGs.
The Compact on Strengthening Development Coordination is a tool for implementing the priorities of the Pacific Plan.
One of the key deliverables of the Compact is to track the progress of FICs towards achieving the MDGs.
Continuous improvement of the MDGs dataset is a major objective.
Box 1. Port Vila Declaration on Accelerating Progress on the Achievement of the MDGs (Extract) Hereby reaffirm our intention to achieve improved standards of living and human wellbeing as measured by the Millennium Development Goals and commit to: Continue to localise the Millennium Development Goals into national and regional plans, programs and prioritise budgets with particular focus on those that have the greatest consequences for Pacific Island Peoples; Advocate for the special needs of Small Island Developing States to ensure the development and pursuit of appropriate and sustainable policies and program responses, including through the use of international platforms such as the BPoA and MSI that articulate an agreed special case for SIDS; Coordinate efforts to support the achievement of the Millennium Development Goals, drawing on the principles of the Paris Declaration on Aid Effectiveness, the Accra Agenda for Action and the Pacific Principles on Aid Effectiveness, as actioned through the Cairns Compact on Strengthening Development Coordination in the Pacific, itself endorsed by Forum Leaders at their annual meeting in 2009;
Consistent with these commitments we call on our Development Partners to: Work with us to immediately identify and develop major new activities and programs to expedite the achievement of the Millennium Development Goals; Deliver on pledges to scale up aid and to channel a share of these increased resources to Pacific Island Countries towards accelerated Millennium Development Goal efforts; Honour commitments under various and relevant international and regional arrangements, such as Paris Declaration on Aid Effectiveness and Accra Agenda for Action, and Pacific Principles on Aid Effectiveness, and actively engage with regional efforts such as the Cairns Compact on Strengthening Development Coordination in the Pacific, which aim to improve the effectiveness of development efforts through greater transparency and better governance of national and development partner resources; Strengthen their support to Pacific Island Countries towards achieving sustainable development by mainstreaming the MSI and BPoA into programmatic work plans of development partners, including the regional banks, Bretton Woods Institutions and the UN system, including through development of vulnerability and resilience indices; and Support the strengthening of national systems in data collection including disaggregated data, analysis and dissemination. We strongly urge non-governmental organisations, civil society, the private sector and other stakeholders at the local, national, regional and international levels to join us in redoubling efforts towards achieving this objective. We, the Leaders of the Pacific Islands Forum, commit ourselves and our governments to implementing this Declaration with the intention of accelerating progress to achieving the Millennium Development Goals in the interest of all Pacific Peoples allowing them to enjoy peaceful, prosperous, secure and fulfilling lives.
Source: PIFS (2010)
Furthermore, as the MDGs span a wide range of areas, it is out of the scope of this Report and technical capacity of PIFS to provide very detailed in-depth analysis and policy recommendations on each of the issues for each of the goals. However, such analysis are undertaken and reported by respective technical agencies, such as the UN agencies, SPC (including SOPAC), SPREP, WHO, ADB, World Bank, IMF and other independent research bodies. Therefore, to this end, the purpose of the Report is to highlight the key developments undertaken under each Goal at the regional and national level and, where applicable, report the major findings of recent research. Finally, one of the other major purposes of the Regional MDGs Report is for raising public awareness and social mobilisation. With the 2015 deadline drawing closer, the annual Report serves as a tool for renewed regional and national political commitment, as well as advocating for wider participation by all stakeholders towards accelerating progress towards achieving the MDGs. The Report is outlined as follows: Part 2 discusses the assessment guidelines and MDGs data construction; Part 3 provides the MDGs assessment on each of the goals based on the latter guidelines and Part 4 elaborates further on the major issues related to the health-related MDGs, including NCDs. Detailed country data are provided in Annex 1.
It is out of the scope of this Report to provide detailed in-depth analysis and policy recommendations on each goal; Instead, key developments are highlighted.
The Report is important for raising public awareness and social mobilisation.
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PART 2 Guidelines and Overview
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ASSESSMENT AND DATA GUIDELINES

The MDGs are intended as global targets and not every country is expected to achieve the specific Targets. It is in this overall context that the MDGs assessment is made for each of the countries. For some FICs, given their baselines, it would be unrealistic to expect the achievement of the Targets. In addition, for all countries, there is a lack of comprehensive data on all the MDG indicators, and where data is available, there are concerns about the quality of the data. Given these shortcomings, proxy data, as well as qualitative information, supplement the MDGs assessment. Qualitative information includes level of government commitment, donor support, as well as good initiatives in place towards achieving the MDGs. In the preparation of this Report, the dataset for the 2010 Pacific Regional MDGs Tracking Report was reviewed, refined and updated. Since the release of the 2010 Regional MDGs Report, several countries finalised their second national MDG Report (PNG, Fiji, Samoa, Tonga, Vanuatu, Solomon Islands), while FSM completed their first national MDG Report. These Reports formed the main source of the MDGs dataset used to assess progress (see Appendix 1). For countries that had not released a recent national MDG Report, updates were sourced primarily from national sources. Global sources for MDGs data, particularly the UN Statistics Divisions MDGs Indicators Database, was used when national data was not available. The MDGs dataset was cross-checked and verified against the metadata for the MDG indicators to ensure consistency and comparability across time for each country. Given that global data sources usually transformed national data to ensure comparability across countries, it would not be comparable against nationally-sourced data. To this end, as much as possible, the same source (either national or global) for which the most up-to-date data was available was used to update the indicator for each country. For cases where national and global sources both reported data for the latest year, national sources were preferred. However, in doing so, the data presented in this Report is not strictly comparable across countries. Significant corrections and updates were made to the dataset used in the 2010 Regional MDGs Report. However, there is likely to be remaining quality issues in the current dataset, which will be continuously improved upon in subsequent Reports. The difficulties in compiling up-to-date quality MDGs data for the FICs highlight the weaknesses of statistical capacities in the region. For the purposes of accurately tracking countries MDGs progress, but more importantly, for the formulation of appropriate development policies, it is imperative that more concerted regional and national effort is made to strengthen the collection, reporting and maintenance of statistics. The MDGs assessments also account for countries own appraisals, particularly for those that have recently completed their national MDG reports. In most cases, countries use proxy data and qualitative information to assess their progress against the MDGs. These factors are accounted for in the overall assessment. However, there are occasions when the recent
The MDGs assessment in this Report is not strictly made against the global targets; Proxy data and qualitative information supplement the assessments.
Recent national MDG Reports formed the main source of the dataset used to assess progress.
Although comparable across time for each country, data presented in this Report is not strictly comparable across countries.
Difficulties in compiling MDGs data indicate the weaknesses of statistical capacities in the region; More effort needed to strengthen statistical systems.
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national assessment is different from that contained in this Report. This could be because of differences in data and/or accounting for recent incountry information from relevant technical agencies. Therefore, as the MDGs assessments are not solely based on quantitative indicators, it is open to interpretation. Although a balanced approach was taken to make the final assessment, there may be cases where the assessment is considered to be either too optimistic or too pessimistic. Regardless, it is clear that across all countries, efforts to accelerate progress towards achieving the MDGs need to be scaled up. For FICs that have made good progress, sustaining these outcomes is a challenge in itself. Support from development partners is crucial in this regard. Based on the Assessment Guidelines (See Box 2), the following MDGs progress classification is used:
The MDGs assessment is not based solely on quantitative indicators; countries own appraisals, proxy data and qualitative information also used.
On track (good progress) Off track (insufficient progress) Mixed (uneven and/or inconsistent progress) Insufficient information
While the assessments are debatable, what it is clear is that concerted effort is needed to accelerate and sustain progress.
Box 2. MDGs Assessment Guidelines In forming the final MDGs assessment for each country the following are taken into account: 1. How does the baseline and latest data compare with the MDG Target, developing country averages and the global target for developing countries? 2. Is it realistic to expect that the country will achieve the quantitative target? 3. Is the data trending in the right direction? 4. Are there any issues with the quality of the data? 5. What are the trends in proxy data or qualitative information from national and technical sources indicating? 6. What are the countries own assessment on this target? Does the basis for the countries own assessment still hold? An on track assessment does not necessarily indicate that the country will achieve the quantitative target by 2015. Instead, it means that good progress was made towards achieving the MDGs: (i) (ii) Latest data is either below the global target or recording modest to significant increments in the right direction. Proxy data and qualitative information (strong government commitment and/or development partner support, good initiatives in place) indicate good progress.
On track indicates good progress towards achieving the MDGs, not necessarily the quantitative targets.
An off track assessment indicates insufficient progress towards achieving the MDGs. In other words: (i) Data is trending in the wrong direction or recording marginal increments in the right direction.
For cases where recent data has regressed, comparisons are made to the baseline data, as well as considering the Assessment Guidelines, before finalising a countrys assessment.
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(ii)
Proxy data and qualitative information (weak government commitment and/or development partner support, lack of initiatives in place) indicate insufficient progress.
In the 2010 Regional MDGs Report, yellow signified slightly off-track. The change in this Report to use mixed progress was to adequately capture a countrys progress, where there are different Targets under each goal. The overall assessment of each Goal is based on the performance of each of the Targets. If a countrys progress on one of the Targets was on track but was off track on the other, the overall assessment would be mixed. For instance, a countrys progress on MDG 3 (promote gender equality and empower women) would be assessed as mixed if the country was on track with the gender parity target but off track with the empowerment indicators. Similarly, the assessment on each Target would be based on the performance of each of the quantitative indicators, as well as other information, in line with the Assessment Guidelines. A mixed assessment indicates: (i) (ii) Uneven progress: good progress on some indicators but insufficient progress in others. Inconsistent progress: initially, insufficient/slow progress but good progress more recently; initially, good progress but insufficient/ slow progress more recently .
Off track may indicate weak government commitment and lack of initiatives in place.
Therefore, equal attention for accelerating progress towards the MDGs should be placed on areas with mixed progress, as well as those registering off track. MDGs assessments are also made by sub-region (Polynesia, Micronesia, Melanesia), as well as for the entire region. Given the population size of PNG, an assessment for Melanesia and the entire region is provided with and without the inclusion of PNG. These assessments are qualitative and are based on the progress of each of the countries, weighted by the population size (as most of the MDG indicators are based on population). Therefore, as PNG is by far the most populous country in the region, the regions, as well as Melanesias progress, is inevitably tied to that of PNGs. For the Polynesian sub-grouping, as Samoa and Tonga have the largest populations, their assessments influence the overall assessment for Polynesia. Therefore, if the two countries are both on track on a particular goal, Polynesia will also be assessed as on track, irrespective of the performance of the assessments in Cook Islands, Niue and Tuvalu. Similarly, for Micronesia, FSM and Kiribatis assessment strongly influences the overall assessment of the sub-region. For Melanesia (excluding PNG), Fijis assessment has a strong influence on the results. On MDG 8 (global partnership for development), this Report recognises that the premise of goal 8 was that developing countries would focus on achieving the first seven goals, while the developed countries would support these efforts through increased aid flows, fairer market access, debt relief, as well as ensuring access to affordable essential drugs and ICT. Therefore, countries are not assessed on progress towards the overall goal, but assessments are made for ensuring debt sustainability and access to affordable essential drugs and ICT. However, trends in aid flows and market access are discussed.
Mixed progress indicates uneven and/or inconsistent progress; Equal attention needed for mixed and off track progress.
Regional and sub-regional assessments are qualitative, based on each countrys progress and weighted by population.
Samoa and Tongas results influence Polynesias assessment; FSM and Kiribati for Micronesia and Fiji for Melanesia (excluding PNG).
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A BRIEF SUMMARY OF PROGRESS

PNGs population of around 6.7 million people means that overall progress for the region towards the MDGs is determined by the progress in PNG (Table 2). Consequently, as PNG is off track on all the goals, as a whole, the region is also off track on all the MDGs. By the same extension, Melanesia is also off track on all the goals. However, excluding PNG, the region is on track towards reducing child mortality, with mixed progress recorded for all the other goals. The encouraging result on MDG 4 is led by the low levels of child and infant mortality in Fiji, the second most populous country, as well as in Vanuatu, the fourth most populous FIC. Polynesias progress is comparatively better than the other sub-regions, as it is on track to achieve four of the goals achieving universal primary education, reducing child mortality, improving maternal health and ensuring environmental sustainability. In contrast, Micronesia is not on track for any goal, off track on the poverty goal, with mixed progress noted on the other MDGs. At the country level, with the exception of Cook Islands, Niue, Samoa and Palau, all FICs are off track on at least one goal. PNG, Kiribati, Solomon Islands and Nauru are not on track for any of the goals, while Cook Islands, Niue and Palau are on track for six of the goals. Majority of countries are off track on poverty, followed by environmental sustainability, then gender. On the other hand, most FICs recorded on track for reducing child mortality, followed by achieving universal education and improving maternal health.
As a result of PNGs progress, the region is off track on all the goals. Excluding PNG, the region is on track towards reducing child mortality, with mixed progress on all the other goals.
Polynesias progress is comparatively better than any other sub-region, with Micronesia not on track for any goal.
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Table 2 Progress Towards the MDGs

MDG 3 Promote Gender Equality and Empower Women
MDG 1 Eliminate Extreme Poverty and Hunger
MDG 2 Achieve Universal Primary Education
MDG 4 Reduce Child Mortality
MDG 5 Improve Maternal Health
MDG 6 Combat HIV/ AIDS and Other Diseases
MDG 7 Ensure Environmental Sustainability
Melanesia Melanesia (excl PNG) Fiji PNG Solomon Is Vanuatu Micronesia FSM Kiribati Marshall Is Nauru Palau Polynesia Cook Is Niue Samoa Tonga Tuvalu FICs FICs (excl PNG)
Off track Mixed Off track Off track Mixed Mixed Off track Off track Off track Off track Insufficient info Mixed Mixed On track On track Mixed Mixed Off track Off track Mixed
Off track Mixed On track Off track Mixed Mixed Mixed Mixed Mixed Mixed Off track On track On track On track On track On track On track On track Off track Mixed
Off track Off track Mixed Off track Off track Off track Mixed Mixed Mixed Mixed Mixed On track Mixed On track On track Mixed Off track Mixed Off track Mixed
Off track On track On track Off track Off track On track Mixed Mixed Mixed On track Off track On track On track On track On track On track On track On track Off track On track
Off track Mixed On track Off track Off track Mixed Mixed Off track Mixed On track Mixed On track On track On track On track Mixed On track On track Off track Mixed
Off track Mixed Mixed Off track Mixed On track Mixed Mixed Mixed Off track Mixed On track Mixed On track On track Mixed On track Mixed Off track Mixed
Off track Mixed On track Off track Off track Off track Mixed On track Off track Mixed Off track On track On track Mixed Mixed On track On track Mixed Off track Mixed
Note: The arrows denote improvement () or regression () from the assessment in the 2010 Pacific Regional MDGs Tracking Report. Given the differences in the dataset and assessment guidelines used in the two Reports, this is provided for indicative purposes only as the assessments are not strictly comparable.
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The regions progress on MDG1 is constrained by generally low economic growth, lack of job opportunities and rising prices. Even though good progress is made in majority of FICs towards MDG 2, the quality of education remains a concern. In addition, although gains were made towards gender parity in education, progress on empowering women is much slower. On the health-related goals, the relatively low measles immunisation coverage needs to be addressed to sustain progress on reducing child mortality, while more concerted effort is needed in ensuring universal access to reproductive health to improve maternal health. Interventions for maternal and child health are well known in the region and needs to be scaled up. For MDG 6, regional and national intervention strategies are in place to combat HIV/AIDS, malaria and TB but are highly dependent on the support and funding from donors. Although NCDs is not included under MDG 6, majority of FICs, in recognition of its importance, have included combating NCDs as an additional target. Of the ten countries that included NCDs, four countries are off track on combating NCDs. With regards to environmental sustainability, achieving energy security remains a key priority in the region, as most FICs are highly dependent on imported fossil fuels. In other areas, access to safe drinking water and basic sanitation is a major concern in Micronesia. On goal 8, while aid flows have increased to the region, better access to developed country markets are needed to bolster FIC exports. Overall, the region is not facing any major debt problems. In assessing the regional progress towards the MDGs, five main conclusions can be drawn: (i) (ii) (iii) There is a general lack of comprehensive quality data to assess progress, so more effort is needed to strengthen statistical capacities. As intervention strategies are generally well known in the respective sectors, these need to be built upon, sustained or scaled up. Development partner support through funding, technical assistance and capacity building is critical, hence, requiring better development coordination and harmonisation. Governments, development partners, CSOs and the private sector need to work together. Strong political leadership and resolve towards achieving the MDGs is the catalyst towards progress.
Five Conclusions Improve statistics. Build, sustain and scale up activities. Strengthen development coordination. Stakeholders to work together. Political leadership and resolve.
Climate change a critical emerging issue; potential to derail MDGs progress.
(iv) (v)
Countries that are making good progress towards the MDGs either have most of these elements in place or are working towards achieving them. These conclusions are not new but serve to reinforce the findings of the 2010 Regional MDGs Report, as well as the undertakings made in the Port Vila Declaration. Finally, a critical emerging issue that has implications on the achievement of all the MDGs is climate change (see Box 3). ADB (2010) noted that climate change has the potential to prevent Pacific countries from attaining the MDGs, as well as posing threats to peace, prosperity and security. The adverse impact of climate change is already being felt in some countries.
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Box 3. The Impact of Climate Change on the MDGs Agricultural production and food security, access to clean and abundant water resources and gainful employment that underpin the solution to extreme poverty and hunger are vulnerable to climate change. Climate change stresses pose additional burdens on agricultural production and other subsistence activities like water collection, which may burden families enough to remove children from school. Livelihood activities must become more resilient to future climate for education goals to be met. Climate change also threatens to destroy infrastructure (e.g. schools) and increase the displacement and migration of families thus disrupting and limiting education opportunities.
MDG 1
Eradicate Extreme Poverty and Hunger
MDG 2 Achieve Universal Primary Education
MDG 3
Promote Gender Equality and Empower Women
Women, the majority of the worlds poor, are the most vulnerable to climate change. Their traditional roles as the primary users and managers of natural resources, primary caregivers, and unpaid labourers mean they are involved in and dependant on resources that are put most at risk by climate change. Further, women lack rights and access to resources and information vital to overcoming the challenges posed by climate change.
MDG 4 MDG 5 MDG 6
Reduce Child Mortality Improve Maternal Health Combat HIV/AIDS and Other Diseases
Climate change will worsen health primarily through: increased vulnerability to poor health due to reduced food security and water security; water-borne diseases associated with reduced water quality due to floods and drought; more favourable conditions for the spread of vector-borne and air-borne diseases; and the direct link between temperatures and heat stress. Climate change threatens environmental sustainability because it will cause fundamental alterations in ecosystem relationships, change the quality and quantity of available natural resources, & reduce ecosystem productivity. The poor depend on these resources for their day-to-day survival and livelihoods in many parts of the developing world.
MDG 7
Ensure Environmental Sustainability
MDG 8
Global Partnerships for Development
Climate change threatens to exacerbate current challenges to the achievement of the MDGs. Funding for development and adaptation must be greatly increased to meet the needs of the poor.
Source: UNDP (2011)
Adaptation measures aim to reduce the consequences of climate change, while mitigation measures aims to reduce the rate at which climate occurs (ADB, 2010).
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With the highest point at about 4.5m, Tuvalu is considered to be one of the most vulnerable countries in the world to climate change and is reportedly experiencing flooding from high tides more frequently each year (Bateman, 2011). Consequently, many Tuvaluans are migrating from the island. For Tuvalu, climate change has emerged as a major fiscal, social, and existential challenge (IMF, 2011c). In Kiribati, as a result of climate change, coastline erosion recurrently disrupts transportation lifelines. According to the IMF (2011a), as a result of the vulnerabilities to climate change, coupled with other challenges Kiribati is facing, the full achievement of the MDGs is likely out of reach. FSM declared a nationwide state of emergency in 2008, as flooding related to high tides disrupted crops and groundwater sources, resulting in a shortage of food and water supplies (Fletcher & Richmond, 2010). In 2010, in an international landmark case, FSM challenged the Czech Republics plans to expand a coal fired power station (Oatman, 2011). Although the Czech Government eventually endorsed its plan, it recognised FSM as an affected state, and the case could pave the way for other countries to contest the effects of potential energy projects around the world. At their meeting in August 2010, Forum Leaders re-emphasised the importance of climate change as it remained the greatest threat to the livelihoods, security and well-being of the peoples of the Pacific (PIFS, 2010). Addressing climate change requires a multi-level collaborative approach. If not addressed urgently, the impact of climate change has the potential to significantly derail progress towards the MDGs. The Pacific Islands Framework for Action on Climate Change (PIFACC) was endorsed in 2005 and set the platform for addressing the impact of climate change. Following a comprehensive mid-term review, a revised Framework is expected to be presented to the 22nd SPREP Meeting of Officials scheduled for September 2011. Addressing the limited national capacities to address the impact of climate change, mainstreaming climate change into national development plans, improving access to climate change funds and strengthening coordination on climate change response activities are key focus areas (CROP, 2011). Climate change financing is critical for designing and implementing adaptation and mitigation coping measures. The UN Framework Convention on Climate Change (UNFCCC) provides a range of financial mechanisms, including the Global Environment Fund (GEF), Kyoto Protocol Adaptation Fund, the LDC Fund and the Special Climate Change Fund . However, countries still find it difficult to access and manage funds. Options for accessing and using climate change financing are currently being examined, and it is widely recognised that effective development coordination and harmonisation is crucial in this area.
Adverse impact of climate change already being felt by some countries.
Mainstreaming climate change measures into national plans, better access to climate change funds and improved coordination are some key issues.
More recently, in December 2010, the UN Climate Talks concluded with a set of decisions known as the Cancun Agreements, which included the establishment of a Green Climate Fund (WRI, 2011)
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PART 3 Performance on the Eight Goals
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GOAL 1 Eradicate Extreme Poverty and Hunger

As noted in the 2010 Report, extreme poverty, defined as the proportion of the population living below US$1.25 a day, is largely considered irrelevant in the Pacific context due to the generally high dependence on subsistence living and entrenched traditional social safety nets (subsistence affluence). Instead, poverty is viewed from the perspective of hardship and lack of opportunity, in other words, poverty of opportunity. This is measured by the percentage of people living below the basic needs poverty line (BNPL). The vast majority of the regions poor, around 2 million people, live in PNG, the most populous FIC. The remaining FICs account for roughly 0.6 million of the poor. Inevitably, FICs progress on MDG1 is thus influenced by PNGs progress. Consequently, as PNG is off track to meet MDG1, FICs are also considered off track (Table 2). Nevertheless, PNG reported a slight reduction in the proportion of people living below the BNPL, from 30 percent in 1996 to an estimated 28 percent in 2009 (Table 3), making PNG on track to achieve its national target of 27 percent by 2015. Excluding PNG, the results for FICs progress on MDG1 is mixed, with most countries off track on halving the number of people living below the BNPL and achieving full employment (Table 4). On a positive note, the region (excluding PNG) is on track to halve the proportion of people suffering from hunger, with a generally low level of food poverty in most countries (Table 5). The incidence of basic needs poverty, excluding PNG, is still the highest in Melanesia, given the population sizes and poverty rates in Fiji, Solomon Islands and Vanuatu. Fiji is off track to meet MDG 1, while Solomon Islands and Vanuatu have reported mixed results. However, Vanuatu is on track to meet Target 1.a., with a relatively low level (15.9%) of the population living below the BNPL.
Poverty of opportunity rather than extreme poverty is relevant in the Pacific context.
Approximately 2 million people are living in poverty in PNG, about three-quarters of the poor in the region.
Most countries off track on halving the number of people living below the BNPL and achieving full employment; however, low level of food poverty in the region (excluding PNG).
In recognition that it could not achieve the MDG target of halving the proportion of people living below the BNPL by 2015, PNG set a more realistic national target in 2003-04.
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Table 2 Progress towards MDG 1

MDG 1 ELIMINATE EXTREME POVERTY & HUNGER TARGET 1.A. Halve, between 1990 and 2015, the proportion of the population living below the basic needs poverty line Off track Mixed Off track Off track Mixed On track TARGET 1.B. Achieve full and productive employment and decent work for all, including women and young people Off track Off track Off track Off track Off track Off track TARGET 1.C. Halve, between 1990 and 2015, the proportion of people who suffer from hunger
Melanesia Melanesia (excl PNG) Fiji PNG Solomon Is Vanuatu
Off track Mixed Off track Off track Mixed Mixed
Off track On track On track Off track On track Off track
Micronesia FSM Kiribati Marshall Is Nauru Palau
Off track Off track Off track Off track Insufficient info Mixed
Insufficient info Insufficient info Insufficient info Off track Insufficient info On track
Polynesia Cook Is Niue Samoa Tonga Tuvalu
Mixed On track On track Mixed Mixed Off track
Off track On track On track Off track Off track Off track
Mixed On track Insufficient info Mixed Mixed Off track
On track On track On track On track On track On track
FICs FICs (excl PNG)
Off track Mixed
Off track Off track
Off track Off track
Off track On track
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Micronesian countries are off track to achieve MDG 1, particularly on targets on poverty and employment levels. There is insufficient information for most Micronesian countries to make an assessment on hunger. Although there is hardly any data available for Nauru on the MDG 1 indicators, it is likely that Nauru is off track given the economic hardships the country is facing. The results for Polynesian countries are mixed but more favourable than the other sub-regions. The lowest incidence of poverty (approximately 190 people) is in Niue, the least populous country. Niue and the Cook Islands are the only FICs on track to achieve MDG 1. The regions progress on MDG1 is constrained by generally low economic growth, lack of job opportunities and rising prices. In the last five years, FICs (excluding PNG) experienced either declining or marginal to negative growth rates, recording an average growth of 0.8 percent (Figure 1). In addition, the growth rate of per capita GDP was negative for the same period, indicating a decline in household incomes. A contributing factor to the adverse economic growth outcomes was the negative impact of the global financial crisis and the preceding international food and fuel crises. Various natural disasters also curbed growth for affected countries, particularly Samoa (tsunami) and Fiji (cyclones).
Niue and the Cook Islands are the only countries on track to achieve MDG 1.
Figure 1 FICs - Real GDP Growth Rate1 % 12.0 10.0 8.0 6.0 4.0 2.0 0.0 -2.0 2006 2007 2008 2009 2010 2011 2012
MDG 1 ELIMINATE EXTREME POVERTY & HUNGER

Table 3 TARGET 1.A. Halve, between 1990 and 2015, the proportion of the population living below the basic needs poverty line Basic needs poverty (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 13 23 16 23 (2002) (2002) (2001) (1994) 28 27 23 20 (2008) (2009) (2010) (2006) 0 7 8 8 (2002) (2002) (2001) (1994) 8 8 6 (2008) (2004) (2010) 7 5 9 7 (2002) (2002) (2001) (1994) 4 10 8 (2008) (2009) (2010) 28 (1998) 31 22 25 (2006) (2005) (2006) 10 (1998) 9 7 7 (2006) (2005) (2006) 6 2 (1996) (1999) 9 8 3 12 10 (2005) (2006) (2002e) (2006) (2006) 35 30 (2002) (1990e) 31 28 23 16 (2008) (2009e) (2006) (2006) 9 ... (1990e) 9 8 6 (2009e) (2006) (2006) 8 5 (2002) (1990e) 9 5 7 7 (2008) (2009e) (2006) (2006) Latest Poverty gap ratio (%) Earliest Latest Poorest quintile in national consumption (%) Earliest Latest
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TARGET 1.B. Achieve full and productive employment and decent work for all, including women and young people Employed living below $1 (PPP) per day (%) Earliest Latest Own-account and unpaid family workers (%) Earliest Latest
Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 3 6 3 (1999) (2004) (1998) -1 5 5 0 (2009) (2008) (2007) (2008) 25 53 27 (2001) (1990) (1991) 63 86 30 56 34 (2008) (2006) (2009) (2006) (2004) 0 (2009) 44 29 84 (1997) (2002) (1994) 59 35 (2008) (2000) 1 (1995-99) 3 (2005-08) 56 23 77 (1999) (1999) (1996) 50 71 (2006) (2007) Latest Earliest Latest
4 (2006)
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(2005)
27 (1999)
57 8 (1996) (1991)
13 19 (2004) (2006)
TARGET 1.C. Halve, between 1990 and 2015, the proportion of people who suffer from hunger Underweight children under age 5 (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 0 7 2 (2002) (1990) (1986) 2 2 2 (1999) (1999) (2007) 0 11 2 6 (2002) (2002) (2001) (1994) 2 5 2 4 (2008) (2009) (2004) (2006) 13 19 (1991) (1989) 15 13 5 (2007) (2007) (2005) 11 (1998) 13 5 0 (2006) (2005) (2006) 7 11 (1996) (1993) 7 23 12 12 (2008) (2009e) (2007) (2007) 7 10 (1990-92) (2002) 8 9 7 (2006) (2004-06) (2008) Latest Food poverty (%) Earliest Latest
Note: See detailed country tables in Annex 1 for sources. Data not available.
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Although there is sparse data on employment for FICs, it is likely that with subdued economic growth performances, employment generation is increasingly difficult. Data available for Fiji, FSM and RMI indicate that unemployment rates have increased. The unemployment rate in the RMI is currently estimated at 30.9 percent . However, the seasonal worker programs provided by Australia and NZ, and more recently, the US , are providing crucial avenues for employment and income, as well as remittance transfers. At the same time, countries across the region are experiencing rising inflation, following high global food and fuel prices (Figure 2). Several FICs posted double digit inflation at the peak of the crises in 2008, with Solomon Islands inflation soaring to 17.3 percent during that year. Although most FIC economies are expected to recover in the years ahead, employment conditions are unlikely to improve markedly to narrow the gap in demand for jobs. Furthermore, the risk of high inflation is anticipated to persist given the projected increase in global food and fuel prices. As a result, the poverty situation is unlikely to improve significantly. Pacific island countries recognise the importance of raising economic growth to improve living standards. At the macroeconomic level, generally, governments are focused on public financial reforms, structural reforms and promoting private sector led growth. Most countries also have varying social protection initiatives to address poverty. Samoa, with the assistance of development partners, is currently conducting studies to formulate specific pro-poor policies. In addition, regional initiatives have been developed to combat rising food and fuel prices. A Framework for Food Security in the Pacific 20112015 was developed in the 2010 Pacific Food Summit with the aim that the region be self-sufficient in food supply. Similarly, Pacific Energy Ministers endorsed the Framework for Action on Energy Security in the Pacific in April 2011. Across the Pacific, civil society organisations, particularly NGOs (see Box 4) and religious groups, play an important role in the fight against poverty. Given the limited resources of governments, these organisations fill an important gap in reaching poor, vulnerable and marginalised communities, often working with women to alleviate poverty.
Tackling poverty made hard by low economic growth, lack of job opportunities and rising prices.
Given stretched government resources, CSOs play a vital role in filling the gap in the fight against poverty.
Source: ADB. The Australian Pacific Seasonal Worker Pilot Scheme is limited to Kiribati, Tonga, Vanuatu, and PNG. The NZ Recognised Seasonal Employment program is open to FSM, Kiribati, Nauru, Tuvalu, Palau, PNG, RMI, Solomon Islands and Vanuatu. The US added Fiji, Kiribati, Nauru, PNG, Samoa, Solomon Islands, Tonga, Tuvalu and Vanuatu to designated countries eligible for non-immigrant visa programs.
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Box 4. NGOs Focused on Community-led Approach to Poverty Alleviation Examples from Fiji and Samoa FIJI The Foundation for Rural and Integrated Enterprises & Development or FRIEND, a non-government organisation, was set up in 2001 with the main objective of working with the rural and marginalised communities to alleviate poverty through social and economic empowerment. FRIENDs programs are based on a participatory process, encouraging communities to take ownership of their own development to escape from the poverty cycle and improve their living standards. One of their well known programs, Developing Enterprises for Sustainable Income (DESI), focuses on providing individuals and communities with the opportunity to earn income using available resources and their existing skills to beat poverty. Through DESI, FRIEND provides assistance with the production, packaging, sales and marketing of the products under their Friends Fiji Style brand. FRIENDs other three programs target the youth, health and governance at a community-level. In 2007, UN Habitat recognised FRIENDs work by listing it as a Good Practice in its Best Practices Database in Improving the Living Environment in the area of poverty reduction, social services and urban governance. SAMOA One of the first non-government organisations of its kind, Women in Business Development Incorporated (WIBDI) was set up in 1991 to initially promote and advance the economic and business status of urban women. WIBDI has since evolved to uncovering income-generating opportunities for rural families. Given the strong family culture in Samoa, WIBDI focuses its programs on individual families instead of whole village communities or individuals alone. Committed to poverty alleviation and sustainable development, WIBDI assists individual families use local products, traditional knowledge, technology and trade to generate income. WIBDI provides skills training (handicraft, printing etc), fine mat weaving programs, as well as assistance with organic certification of farms, fair trade labelling and establishing niche export markets for products. For example, WIBDI assisted rural Samoan coffee growers to successfully sell and package their organic product to a coffee house in NZ. Sources: FRIEND (2011), WIBDI (2011)
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GOAL 2 Achieve Universal Primary Education

The progress of FICs (excluding PNG) towards achieving universal primary education is mixed (Table 6). Although the net primary school enrolment is high, averaging around 94 percent, the proportion of pupils that start grade 1 who reach the last grade, averaging around 79 percent (Table 7), is still low to ensure that children will be able to complete a full course of primary school by 2015 . On a positive note, youth literacy rates, except for PNG, are quite high at an average of 94 percent. All Polynesian countries are on track to achieve MDG 2, recording relatively high primary enrolment (97%) and retention rates (86%), as well as high youth literacy levels (99%). Progress for the other two sub-regions (excluding PNG) is mixed, with only Fiji and Palau on track to achieve universal primary education. Of particular mention, in the post-crisis years, the net enrolment rate in Solomon Islands increased significantly to 97 percent in 2010 (see Box 5). PNG is off track to achieve the global education target, as a result of slow progress in its educational reforms. Progress is hampered by in-school factors (lack of educational infrastructure, absenteeism, inability to meet school fees), out-of-school factors (lack of parental and community support, high unemployment, institutional constraints), as well as geographic issues and the adverse impact of the HIV/AIDS epidemic (PNG, 2010). Even though the region is making good progress towards MDG 2, the quality of education remains a concern. In March 2009, Pacific Forum Education Ministers endorsed the Pacific Education Development Framework (PEDF), which is expected to address the key challenges in the education sector. The PEDF encompasses the education-related MDGs, as well as the Education For All (EFA) targets and includes all sectors of education with the exception of higher education. The Framework includes technical and vocational education and training. According to the PEDF, teacher quality is a critical concern for most countries, with high levels of teacher absenteeism in some countries. In addition, many students finish school with inadequate basic literacy, numeracy and life skills based on tests administered in a number of countries in primary schools. These tests also indicate the under-performance of boys, which is another challenge in most countries. In addition, most countries are finding it difficult to address the poor state of the physical learning environment of schools including inadequate learning materials, libraries, ICT tools and the lack of maintenance of school infrastructure. This challenge is linked to the issue of sustainable financing of education systems and the structure of public expenditure on education, given that in most countries, salaries represent over 90 percent of recurrent government budgets.
Although the region (excluding PNG) is on track to achieve universal primary education, the quality of education remains a concern.
TARGET 2.A. Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling Melanesia Melanesia (excl PNG) Fiji PNG Solomon Is Vanuatu Micronesia FSM Kiribati Marshall Is Nauru Palau Polynesia Cook Is Niue Samoa Tonga Tuvalu FICs FICs (excl PNG) Off track Mixed On track Off track Mixed Mixed Mixed Mixed Mixed Mixed Off track On track On track On track On track On track On track On track Off track Mixed
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Table 7 TARGET 2.A. Ensure that, by 2015, children everywhere, boys and girls alike, will be able to complete a full course of primary schooling Net enrolment ratio in primary education (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 92 100 93 92 100 (2001) (1991) (1991) (1990) (1991) 98 99 100 96 93 (2007) (2009) (2006) (2009) (2008) 81 100 100 83 84 (1986) (1991) (2004) (1996) (1991) 91 83 100 83 90 (2009) (2006) (2010) (2007) (2007) 99 99 95 99 99 (2001) (1992) (1991) (1990) (1991) 99 99 100 100 99 (2009e) (2006) (2009) (2006) (2007) 99 87 75 82 (1999) (1988) (1992) (1990) 96 100 83 88 85 (2009) (2002) (2007) (2007) (2005) 98 42 25 (1990) (2002) (2001) 79 84 93 (2005) (2004) (2008) 96 92 99 99 (2002) (2000) (1994) (2000) 95 96 95 96 100 (2000) (2005) (2007) (2007) (2005) 92 39 88 (1986) (1989) (1990) 96 53 97 86 (2008) (2007) (2010) (2008) 91 62 69 (1999) (1995) (1990e) 97 59 67 72 (2008) (2009e) (2004) (2008) 98 61 62 32 (1986) (1990e) (1991) (1990) 100 63 83 92 (2008) (2009e) (2007) (2009) Latest Proportion of pupils starting grade 1 who reach last grade of primary (%) Earliest Latest Literacy rate of 15-24 year-olds (%) Earliest Latest
Note: See detailed country tables in Annex 1 for sources.

Solomon Islands: NER in Primary Education % 110 100 90 80 70 60 50 40 30
1999 2010 56 97
Data not available.
Box 5. Solomon Islands PostCrisis Progress in Education Solomon Islands made remarkable progress in recuperating lost ground in education following civil unrest that spanned between 1998 and 2003. The net primary enrolment rate rose from 56 percent in 1999 to 97 percent in 2010.
tor. The RAMSI intervention had three important effects on education: (i) Restoration of security allowed schools to reopen; (ii) Injection of SI$118m in RAMSI budget support stabilised government finances, providing vital funds for education, including payment of overdue teacher salaries; (iii) Security and economic stabilisation led to donor re-engagement, which saw the influx of large aid inflows, largely directed to health and education. NZAID and the EU are key donors towards primary and secondary education, respectively. In addition, the Solomon Islands government has consistently prioritised education during the post-conflict period. In 2009, the Solomon Islands government fulfilled its promise to deliver feefree education up to form three. Under the program, over 600 primary schools and 200 secondary schools receive grants in lieu of fees. The scheme is funded primarily by NZAID, with additional contributions from Taiwan/Republic of China and the Solomon Islands government. The importance of peace and stability, strong government commitment and coordinated donor support are key components in advancing primary education in the Solomon Islands. Source: Whalan (2010)
During the crisis years, most schools on Guadalcanal were seriously disrupted; some were burnt down or vandalised, others closed as teachers and students fled violence and those that remained open, struggled to accommodate the large displaced student population. The 2003 Regional Assistance Mission to the Solomon Islands (RAMSI), which restored law and order and stabilised government finances to resume basic public service delivery, was the catalyst in rebuilding the education sec-
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GOAL 3 Promote Gender Equality and Empower Women

Excluding PNG, FICs progress towards promoting gender equality and empowering women is mixed (Table 8). All Melanesian countries, except Fiji, are off track to achieve MDG 3, while mixed progress was noted for the Micronesian and Polynesian countries. Gains are being made on achieving gender parity in education while progress on empowering women, as measured by the share of women in the non-agricultural sector and seats held by women in national parliament, is much slower. Progress in Melanesian countries is comparatively slower than that observed in the Micronesian and Polynesian countries. A likely reason is the strong patriarchal cultures inherent in Melanesian countries, which discriminate against women, compared with the other sub-regions. Collectively, with the exclusion of PNG, the region has achieved gender parity in education, with an average gender parity index of 98 for primary and tertiary education, and 101 for secondary education (Table 9). PNG is unlikely to achieve gender parity in education. In addition, there are a few countries that are below the developing country average of 96 for gender parity in primary (Tonga, Nauru and Vanuatu) and secondary (Niue, Solomon Islands) education. Solomon Islands and Vanuatu are also below the developing country average of 97 for gender parity in tertiary education. Most education ministries have implemented gender equality measures, with gender offices now included in the curriculum writing teams of Solomon Islands and Samoa (SPC, 2010d). The PEDF, discussed earlier, is also focused on addressing gender disparities in primary and secondary education, particularly for Melanesian countries. On womens empowerment, generally, in FICs, men outnumber women in paid employment outside the agricultural sector, approximately twice as more men than women. The public sector is usually the largest employer, with most women occupying lower level positions although there are a growing number of women in some countries holding midto senior-level public service positions (SPC, 2010d). Cook Islands and Niue are the only countries where women account for more than 50 percent of employment in the non-agricultural sector. With generally subdued economic growth performances, overall lack of job opportunities in most FICs hinder womens participation in paid employment. Although economies in the region are recovering from the global financial crisis, a general shortage of jobs is expected to persist. This situation is likely to continue to constrain womens share of employment in the non-agricultural sector. Across majority of countries, governments have done little to raise the economic participation of women, with CSOs and the private sector leading most of the work (SPC, 2010d). At the regional level, there has been little analysis on gender and the economy or support for womens economic rights through the Forum Economic Ministers Meetings (SPC, 2010d). Table 8 Progress towards MDG 3
MDG 3 PROMOTE GENDER EQUALITY AND EMPOWER WOMEN TARGET 3.A. Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015 Off track Off track Mixed Off track Off track Off track
FICs (excluding PNG) have achieved gender parity in education, while progress on empowering women is much slower.
Melanesia Melanesia (excl PNG) Fiji PNG Solomon Is Vanuatu
Micronesia FSM Kiribati Marshall Is Nauru Palau
Mixed Mixed Mixed Mixed Mixed On track
Polynesia Cook Is Niue Samoa Tonga Tuvalu
Mixed On track On track Mixed Off track Mixed
FICs FICs (excl PNG)
Off track Mixed
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Representation of women in parliament is well below the developing country average of 18 percent. Collectively, women in FICs occupy only 7 of 141, or 5 percent, seats in parliament. Solomon Islands, FSM, Nauru and Tuvalu have no women in parliament. According to SPC (2010c), although there are no legal restrictions preventing women from contesting elections, there are significant customary barriers and entrenched discrimination. The majority vote system common to the region also has an adverse impact on womens success, with women faring better in proportional representation systems. Lack of financial support was also reported as a major challenge. Globally, quotas and political party measures are key interventions in raising womens participation in parliament. For instance, the 2000 French Parity Law was applied to the French territories, effectively raising the share of women in parliament to 53 and 43 percent in French Polynesia and New Caledonia, respectively (see Box 6). These outcomes are much higher than the 23 percent average of developed regions . At the regional level, to address low levels of women in decision making in Smaller Island States (SIS), PIFS, with donor support, is convening mock parliaments for women in Kiribati and RMI in 2011. These sessions provide a practical forum to expose participants to the realities of policy-making and parliamentary engagement. At the national level, governments are examining temporary special measures to raise womens participation in parliament.
Only 5 percent of seats are held by women in parliament in the region.
Table 9
MDG 3 PROMOTE GENDER EQUALITY AND EMPOWER WOMEN
TARGET 3.A. Eliminate gender disparity in primary and secondary education, preferably by 2005, and in all levels of education no later than 2015
Gender parity index in primary education Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 98 270 98 87 105 (1991) 96 (2009) 112 (2006) 90 (1990) 102 (1991) 80 (2009) 86 (1990) 100 (1995) 200 (1990) 156 (1995) 99 (2001) (2002) (2009) (2005) (2009) 46 43 31 34 36 (2001) (1991) (1990) (1986) (1991) 55 76 40 39 36 (2006) (2006) (2009) (2006) (2007) 6 10 4 3 6 (1991) (1990) (1990) (2005) (1990) 4 15 4 3 0 (2011) (2011) (2011) (2009) (2011) 92 101 98 103 93 (1994) 96 (2009) 98 (1994) 102 (1999) 111 (1999) 105 (1992) 110 (1999) 98 (2009) 70 (1994) 107 (1995) 100 (1996) 103 (1995) 250 (2000) 204 (2000) (2000) (2008) (2000) (2002) 15 37 33 42 40 (1994) (2000) (1988) (2002) (1990) 14 39 36 40 (2000) (2000) (2005) (1999) 0 0 3 6 0 (1997) (1990) (1990) (1990) (1990) 0 7 3 0 7 (2010) (2010) (2011) (2011) (2011) 94 85 80 93 (1990) (1991) 99 84 (2008) 105 (2006) (2010) (2009) 62 57 95 (1990) 107 (1991) (1986) 84 (2010) (2009) (2008) 72 55 30 40 (1990) 120 (1999) (1995) (1995) 30 85 (2000) (2008) (2005) 30 20 31 38 (1990) (1990) (1999) (2004) 30 32 39 (2008) (2005) (2000) 0 0 0 4 (1990) n/a (1990) (1990) (1990) 1 0 4 (2011) (2011) (2011) Latest Gender parity index in secondary education Earliest Latest Gender parity index in tertiary education Earliest Latest Women in the nonagricultural sector (%) Earliest Latest Seats held by women in parliament (%) Earliest Latest
(1986) 100 (2000) 91
(2000) 102
(1999) 104 (1999) (1992) 99 90
(2008) 119 (2009) 107 (2008) 75
(2008) 120 (2009) (2008) 90 60
(1999) 103
(2007) 107
(2007) 235
(1991) 110 (1990) (1997) (1991) 97 88 96
(2006) 190 (2009) 166 (2009) (2009) 67 42
(2009) 106 (2008) 97
(1990) 113 (1995) 97
(2009) 105
(1991) 112
(1991) 172
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Box 6. Application of the French Parity Law in French Polynesia, New Caledonia and Wallis & Futuna The Parity Law was passed in France in 2000 and extended to all French overseas departments, territories and countries. This law required all political parties to maintain gender equality on their lists of electoral candidates. In other words, all parties had to have 50 percent of each sex on their lists, alternating the names of male and female candidates. The Parity Law was applied to French Polynesia in 2001, Wallis and Futuna in 2002, and New Caledonia in 2004. In French Polynesia, although the adoption of the parity law was not supported by political groups, it was immediately promulgated and applied from 2001. As a result, womens representation in the Assembly rose from 12 in the 2001 elections, to 48 percent in the 2004 elections. Currently, womens share in the French Polynesian parliament is 53 percent. In New Caledonia, some indigenous Kanak men opposed the application of parity, insisting that there were only a few qualified women candidates, and that the law undermined Kanak custom. The opposition to the application of the Parity Law mobilised women from various backgrounds in support of the law, resulting in the rejection of an amendment to postpone the application of parity. Consequently, womens representation in Congress rose from 17 to 46 percent in the 2004 elections. Currently, womens share in the New Caledonian parliament is 43 percent. In Wallis and Futuna, twenty representatives are elected by universal suffrage using a list-based system of proportional representation. In 2002, although parity was observed in drawing up the lists, none of the women were elected. The high number of lists, the low number of lists led by women, as well as the cost and travel inherent in an election campaign hindered the effective application of the law. Currently, womens share in the Wallis and Futuna parliament is 20 percent. The application of the Parity Law to the Pacific French territories is a good example of legislated measures to raise the participation of women in parliament. However, as the experience of Wallis and Futuna demonstrates, it does not guarantee the election of women into parliament. Sources: Bargel et al (2010), SPC (2010c)
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GOAL 4 Reduce Child Mortality

FICs (excluding PNG) are on track to reduce child mortality (Table 10), with the average under-five mortality (U5M) rate at 28 (Table 11), which is below the global developing region target of 33 . The average infant mortality (IM) rate is also low at 20. However, the average measles immunisation coverage is only 71 percent, which is an area of concern. Melanesia (excluding PNG) and Polynesia are on track to reduce child mortality, reporting average U5M rates of 26 and 19, respectively, with average IM rates of 20 and 11, respectively. Mixed progress is noted for the countries of Micronesia, with a comparatively higher average U5M and IM rates of 51 and 30, respectively. According to the UN (2011b), countries with high U5M are those with 40 or more deaths per 1,000 live births. In the region, Kiribati (72), PNG (70), RMI (46) and Nauru (44) have high U5M. Even so, only PNG and Nauru are off track to achieve MDG 4. PNG has a relatively high rate of U5M and IM (53) and low measles immunisation coverage (62) in the region. Although Naurus measles immunisation coverage is quite high at 99 percent, the U5M and IM rates have increased from the early 1990s to 2009. RMI is on track to achieve MDG 4 as the U5M rate fell by 51 percent from 1988 to 46 in 2009. For Kiribati, although the U5M rate rose slightly from 69 to 72, the IM rate fell to 46, while the measles immunisation rate increased to 82. In addition, Kiribati is undertaking several child survival strategies, such as the Integrated Management of Childhood Illness (see Box 7), and coupled with improved staff capacity, as well as the roll-out of water and sanitation projects, there is cautious optimism that Kiribati will achieve MDG 4 with continued donor support (WHO, 2010b). Consequently, overall, Kiribatis progress is mixed. Compared to the 80 percent developing region average for measles immunisation coverage, collectively, only Micronesia is above with 85 percent. Both Melanesia (excluding PNG) and Polynesia have comparatively lower average measles immunisation coverage of 69. Samoa, Palau, Fiji, Solomon Islands and Tuvalu recorded a decline in coverage. Samoas measles immunisation coverage plummeted to 52 percent in 2009, with coverage in urban areas much lower than that in rural areas. According to Samoa (2010), public delivery of immunisation services are concentrated in the rural areas, and while the same services are available through the private sector, uptake in urban areas is low. Samoa has introduced incentivised performance, offering incentives to community health workers and advocates to encourage and support families to have their children fully immunised (WHO & SPC, 2011). The failure to achieve and/or sustain high measles immunisation coverage may lead to measles outbreaks and increased susceptibility to pneumonia and diarrhoea, all of which are leading causes of child morbidity and mortality (WHO, 2010a). Therefore, to sustain the gains made in reducing child mortality across the region, it is important to raise the immunisation coverage to at least 90 percent. WHOs Expanded Programme on Immunisation (EPI) is targeting district-specific planning in Pacific island countries, using the Reaching Every District strategy aimed at improving routine immunisation.
The region (excluding PNG) is on track to reduce child mortality, with average U5M rates below the developing region target.

MDG 4 REDUCE CHILD MORTALITY TARGET 4.A. Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate Off track On track On track Off track Off track On track Mixed Mixed Mixed On track Off track On track On track On track On track On track On track On track Off track On track
Comparatively lower measles immunisation coverage for most FICs is an area of concern, particularly in Melanesia and Polynesia.
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Table 11
MDG 4 REDUCE CHILD MORTALITY
TARGET 4.A. Reduce by two-thirds, between 1990 and 2015, the under-five mortality rate
Under 5 mortality (per 1,000 live births) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 26 0 42 27 69 (1996-2002) (1991) (1991) (1990) (1991) 18 0 15 26 25 (2006) (2006) (2009) (2008) (2009) 16 29 33 12 57 (1991-97) (1997-2001) (1991) (1991) (1992) 14 8 9 16 15 (2006) (2001-06) (2009) (2008) (2009) 83 99 89 94 94 (2001) (1990) (1991) (1994) (1995) 97 99 52 (2008) (2009) (2009) 58 69 93 10 37 (1990) (2005) (1988) (1991) (1990) 39 72 46 44 26 (2009) (2009) (2009) (2009) (2009) 20 65 63 19 25 (1999) (1990) (1988) (1995) (1990) 13 46 34 36 22 (2009) (2009) (2009) (2009) (2009) 79 75 70 99 98 (1999) (1990) (1998) (1997) (1990) 91 82 78 99 75 (2009) (2009) (2009) (2009) (2009) 28 (1990) 23 (2009) 17 (1990) (1986-1996) (1990) (1990) 15 53 30 14 (2009) (2009e) (2009) (2009) 86 45 70 66 (1991) 72 (2009) (2009e) (2009) (2009) Latest Infant mortality (per 1,000 live births) Earliest Latest Measles immunisation of 1 year old (%) Earliest Latest
100 ( 1986-1996) 70 38 40 (1990) (1990) 36 16
(2009e) 77 (2009) (2009) 31 33
(1990e) 62 (1990) (1990) 60 80
100 (2007) 90 (2008)
Note: See detailed country tables in Annex 1 for sources.
Box 7. Integrated Management of Childhood Illness (IMCI) in the Pacific WHO and UNICEF jointly formulated the IMCI strategy in the mid-1990s to provide a more integrated approach for addressing the main causes of childhood morbidity and mortality, and for improving child welfare. It includes elements of prevention, as well as curative care, combining the management of childhood illness with aspects of nutrition, immunisation, disease prevention and health promotion. The IMCI strategy consists of three components: 1. 2. 3. Upgrading the case management and counseling skills of health care providers. Strengthening the health system for effective management of childhood illness; and Improving family and community practices related to child health and nutrition.
With the support of WHO/UNICEF, Fiji, FSM, PNG, Solomon Islands and Vanuatu have adopted the IMCI strategy. Amongst other factors, the IMCI has proven to be an important strategy in reducing child mortality. In the Solomon islands, a reduction in child mortality due to neonatal causes is attributed to the improved status of maternal/ safe motherhood programs and services, supported by much improved paediatric care and the focus on the IMCI approach. In Vanuatu, where acute respiratory infections (ARI) and diarrhoeal diseases contribute significantly to the child morbidity burden, the introduction of the IMCI strategy and the support for integrated health services is expected to reduce the burden on the health system caused by advanced cases of ARI and diarrhoeal disease. Sources: WHO (2003, 2010a)
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GOAL 5 Improve Maternal Health

The region (excluding PNG) recorded mixed progress towards reducing the maternal mortality ratio (MMR) and achieving universal access to reproductive health (Table 12). Overall, Polynesian countries are on track to achieve MDG 5, with mixed progress recorded for Melanesia (excluding PNG) and Micronesia. The assessment on Target 5.A. is complicated by the measurement of maternal mortality due to the lack of a standardised definition for maternal death across the FICs. In addition, MMR per 100,000 live births can be misleading for countries with populations less than 250,000, as the statistical impact of an individual event has a magnified effect (WHO, 2010a). Only PNG, Fiji and the Solomon Islands have populations greater than 250,000. Consequently, there is a wide range of reported MMR, from zero (FSM, Cook Islands, Niue & Tuvalu) to 711 in PNG (Table 13). The developing region average for MMR is 290 PNG, Palau and RMI recorded MMRs above this average. However, Palau reported only 1 maternal death, while it is estimated that RMI reported only 5 maternal deaths in 2009 .
Polynesian countries on track to improve maternal health, while Melanesia (excluding PNG) and Micronesias progress is mixed.
Maternal mortality rates per 100,000 live births are misleading for countries with populations less than 250,000, which apply to majority of FICs.
Progress towards MDG 5

Table 12 MDG 5 IMPROVE MATERNAL HEALTH Melanesia Melanesia (excl PNG) Fiji PNG Solomon Is Vanuatu Micronesia FSM Kiribati Marshall Is Nauru Palau Polynesia Cook Is Niue Samoa Tonga Tuvalu FICs FICs (excl PNG) Off track Mixed On track Off track Off track Mixed Mixed Off track Mixed On track Mixed On track On track On track On track Mixed On track On track Off track Mixed TARGET 5.A. Reduce, by three-quarters, between 1990 and 2015, the maternal mortality ratio Off track Mixed On track Off track Off track Mixed Mixed Off track Mixed On track Mixed On track On track On track On track On track On track On track Off track Mixed TARGET 5.B. Achieve by 2015, universal access to reproductive health Off track Mixed On track Off track Off track Off track On track On track Mixed On track Mixed On track Mixed On track On track Off track Mixed On track Off track Mixed
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MDG 5 IMPROVE MATERNAL HEALTH

Table 13
TARGET5.A. Reduce, by three-quarters, between 1990 and 2015, the maternal mortality ratio
Maternal mortality (per 100,000 live births) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 485 (1991-2001) 0 74 205 413 (1991) (1990-94) (1995) (1990) 0 0 76 0 (2008) (2006) (2008) (2009) 98 99 76 96 95 (2001) (1990) (1991) (1999) (1990) 100 99 81 98 98 (2008) (2009) (2009) (2007) (2007) 224 110 0 0 (1990) (1994) (1991) (1991) 0 215 324 366 (2009) (2009) (2004) (2009) 93 60 100 (1990) (1998) (1988) 90 80 94 97 100 (2008) (2009) (2007) (2007) (2009) 60 739 130 96 (1995) (1990e) (1990) (1998) 28 711 100 86 (2009) (2009e) (2008) (2007) 98 50 85 79 (1990) (1990e) (1999) (1990-95) 100 52 70 74 (2009) (2009e) (2007) (2007) Latest Skilled birth attendance (%) Earliest Latest
46 (2002-06)
TARGET 5.B. Achieve by 2015, universal access to reproductive health

Contraceptive prevalence rate (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga 47 36 18 33 (2001) (1991) (1991) (1990) 23 29 27 (2001) (2009) (2008) 33 35 26 23 (2001) (1994) (1992) (1995) (1991) 24 53 44 20 42 (2009) (2004) (2009) (2008) (2007) 100 55 99 (1991) (2002) (2001) 100 100 58 98 97 (2008) (2008) (2009) (2008) (2007) 46 24 (2007) (2009) 45 31 (1995) (1990) 40 22 45 36 21 (2009) (2009) (2007) (2007) (2007) 90 39 162 93 25 (1990) (200405) (1988) (199702) (2000) 42 51 138 69 18 (2008) (2009) (2007) (2007) (2007) 10 (1999) 35 71 81 95 100 (2009) (2009) (2007) (2007) (2007) 28 8 24 (2009) (2007) (2007) 31 20 7 15 (1990) (1996) (2001) (1991) 29 24 35 38 (2009) (2006) (2007) (2007) 59 77 92 (1999) (1990) (1996) 30 65 67 64 (2004) (2006) (2007) (2009) 78 (1996) 100 78 74 84 (2008) (2006) (2007) (2007) 46 24 (1996) (1996) 30 11 (2006) (2007) Latest Adolescent birth rate (per 1,000 females) Antenatal care coverage, 1 visit (%) Unmet need for family planning (%) Earliest Latest Earliest Latest Earliest Latest
Tuvalu 39 (1990) 31 (2007) 39 Note: See detailed country tables in Annex 1 for sources. Data not available.
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Given the problems associated with MMR data, the UN (2003) recommends using attendance by skilled health personnel at delivery to assess progress towards reducing maternal mortality (UN, 2003). On average , skilled birth attendance in FICs (excluding PNG) is 87 percent, which is well above the developing region average of 65 percent . Majority of countries that are on track to achieve Target 5.A. registered over 90 percent skilled birth attendance. FICs progress towards achieving universal access to reproductive health (Target 5.B.) is also mixed but with more countries off track on this Target. Contraceptive use is very low across all countries, averaging around 26 percent (Table 14), compared to the developing region average of 61 percent. Use of contraceptives is important for maternal and infant health, as it prevents unintended or closely spaced pregnancies, and pregnancy in very young women, which can be risky (UN, 2011b). Teenage pregnancies also increase the risks of complications or even death. To this end, it is cause for concern that the average adolescent birth rate is relatively high in Micronesia (excluding Palau) and Melanesia (excluding Fiji). RMI still has the highest adolescent birth rate among FICs, although the rate is trending downward. Antenatal visits allow for appropriate interventions vital to ensure maternal health and that of their infants. In this regard, the region has a high rate of antenatal coverage (at least one visit), averaging around 79 percent . However, WHO recommends a minimum of four antenatal visits and for countries where data is available, antenatal coverage for at least four visits is much lower. For instance, according to the 2006 DHS, PNGs antenatal coverage for at least one visit was 78 percent. However, the same survey reported that the antenatal coverage for at least four visits was 55 percent. Similarly, in Tuvalu, the 2007 DHS reported antenatal coverage (at least one visit) of 97 percent, compared to a much lower antenatal coverage (at least four visits) of 67 percent. Unmet need for family planning describes women (married or in a consensual union) who are fecund and sexually active that do not use any method of contraception but want to avoid or delay pregnancy (UN, 2011b). There is sparse data available for FICs for this indicator. However, five of the seven countries where latest data is available, report a much higher percentage of unmet need for family planning than the developing country average of 11. The 2009 Madang Commitment by Ministers of Health for the Pacific island countries laid out nine recommendations to improve maternal and child health (see Box 8) with good progress reported in implementing the recommendations (WHO & SPC, 2011b). As the interventions for maternal and child health are well known in the region, countries need to build on existing policies and strategies, as well as follow the Continuum of Care model (WHO & SPC, 2011a).
Most FICs on track for reducing maternal mortality record over 90 percent skilled health personnel at delivery.
Contraceptive use is low across the FICs, while teenage pregnancies are relatively high in Micronesia (excluding Palau) and Melanesia (excluding Fiji).
Although antenatal coverage of at least one visit is high, there is less coverage of the WHOrecommended four antenatal visits.
Interventions for maternal and child health well known; need to build on existing policies and strategies and follow Continuum of Care model.
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Box 8. Th 2009 Madang Commitment Recommendations to Improve Maternal, Child and Adolescent Health 1. 2. 3. 4. 5. Where MDG 4 and MDG 5 are at risk of not being achieved, strengthen the current efforts to reduce under-5 and maternal mortality rates (most urgently needed in PNG). Where populations and number of births are small, complement monitoring rates and ratios with absolute numbers and improve the quality and reliability of data, especially maternal deaths. Strengthen ongoing services that contribute to good maternal, child and adolescent health with particular attention to family planning to prevent unintended pregnancies, including among adolescents and teenagers. Encourage optimal use of the Pacific Policy Framework for Universal Access to Reproductive Health Services and Commodities. Encourage the implementation of broader strategies to improve maternal, child and adolescent health, and include these in improving policy formulation and national programming, strengthening health systems, and improving monitoring and evaluation to track progress. Tackle challenges in the broader areas of human development poverty, food insecurity, status of women and transport with inter-sectoral actions. Enhance partnerships among countries as well as between countries and international and regional organisations such as WHO, SPC, UNICEF and UNFPA. Sustain, scale up and emulate best practices reported by some countries. Carry out cervical cancer prevention and control activities using a comprehensive approach, especially in the context of plans to introduce the HPV vaccine, so that primary prevention does not replace secondary prevention, which needs to be introduced or strengthened in all countries.
6. 7. 8. 9.
Source: WHO & SPC (2009a)
GOAL 6 Combat HIV/AIDS and Other Diseases

The region (excluding PNG) is on track to combat malaria and TB, with mixed progress noted for HIV/AIDS (Table 15). Malaria is only endemic in PNG, Solomon Islands and Vanuatu. Collectively, Melanesia (excluding PNG) is on track to combat malaria and TB, with mixed progress on HIV/ AIDS. Micronesia also recorded mixed progress towards combating HIV/ AIDS, while it is off track to combat TB. Polynesia is the only sub-region on track to halt and reverse the spread of all the diseases. At the country level, PNG and RMI are the only FICs off track to achieve MDG 6. Regional and national intervention strategies are in place to combat HIV/ AIDS, malaria and TB but are highly dependent on the support and funding from donors, particularly the Global Fund to Fight AIDS, Tuberculosis and Malaria (GFATM). Strong and concerted government commitment, as well as CSO engagement, is also vital to the successful fight against the diseases.
Polynesia is the only sub-region on track to combat all the diseases.
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Table 15. Progress towards MDG 6

MDG 6 COMBAT HIV/ AIDS AND OTHER DISEASES TARGET 6.A. Have halted by 2015 and begun to reverse the spread of HIV/AIDS TARGET 6.B. Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it Off track Achieved Achieved Off track Achieved Achieved Achieved Achieved Achieved Achieved Not applicable Achieved Achieved Not applicable Not applicable Achieved Not applicable Achieved Off track Achieved TARGET 6.C. Have halted by 2015 and begun to reverse the incidence of Malaria Tuberculosis
Off track Mixed Mixed Off track Mixed On track Mixed Mixed Mixed Off track Mixed On track On track On track On track Mixed On track Mixed Off track Mixed
Off track Mixed Off track Off track Mixed On track Mixed On track Off track Off track Mixed On track On track On track On track Mixed On track Mixed Off track Mixed
Off track On track Not applicable Off track On track On track Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Not applicable Off track On track
Off track On track On track Off track Mixed On track Off track Off track Mixed Off track On track On track On track On track On track On track On track On track Off track On track
HIV/AIDS
Tracking FICs progress towards combating HIV/AIDS based on the official MDG indicators is difficult given the limited data available for each country (Tables 16 & 17). Therefore, proxy data is used to supplement the assessment. In the region, the HIV/AIDS epidemic in PNG is the largest and the only generalised one. Of the 28,882 reported cases in FICs, PNG accounted for 98 percent. Fiji recorded the second highest, with 333 cases, followed by Kiribati (52) and FSM (37). RMI and Samoa both recorded 22 cases, with the remaining FICs recording less than 20 cases, with no cases reported for Niue. However, there is a high probability of under-reported cases. For illustration, PNGs cumulative HIV/AIDS reported cases is 28,294 but UNAIDS (2010) estimates that 34,000 people are living with HIV in PNG, while the estimate for Fiji is less than 1,000 people. PNG and Fiji are off track to halt and reverse the spread of HIV/AIDS, with newly reported cases increasing each year. Countries with higher reported cases are also those that have widespread counseling and testing facilities. The Commission on AIDS in the Pacific (2009) notes that it is unclear whether low HIV prevalence in some island countries are a result of low levels of testing, relative isolation and late introduction of HIV, prevalence of protective factors or the absence of vulnerability/risk factors.
It is estimated that 34,000 people are living with HIV in PNG, where the HIV/AIDS epidemic is concentrated.
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Notwithstanding the low HIV prevalence in most FICs, sexually transmitted infections (STIs) are endemic and it is a growing concern, as the main source of HIV transmission in the region is unprotected sex (Commission on AIDS in the Pacific, 2009). The high prevalence of STIs in Kiribati and RMI significantly raises the risk of further HIV infection, and coupled with already reported cases, indicates that these countries are also off track to combat HIV/AIDS. Major risks and vulnerabilities highlighted by the Commission on AIDS in the Pacific (2009) include gender inequality and gender-based violence, commercial and transactional sex, male-to-male sex, as well as mobility and migration. The Commission also reports that connections between alcohol, drugs, unsafe sex and HIV transmission are also evident across all countries. Stigma and discrimination (see Box 9), which is relatively high in the region, hampers efforts to combat HIV/AIDS. With regards to treatment for HIV/AIDS, except for PNG, all other countries achieved universal access to antiretroviral therapy (ART) for all those who needed it. ART coverage for those with advanced HIV infection is less than 100 percent in Fiji and Samoa as persons refused treatment based on personal beliefs and/or denial. There are no advanced HIV cases in Cook Islands, Nauru, Niue and Tonga. With regards to the regions response, a Pacific Regional Strategy on HIV and other STIs (2009-2013) is in place, building on lessons learnt from the implementation of the Pacific Regional Strategy on HIV and AIDS (2004-2008). According to the Commission on AIDS in the Pacific (2009), the engagement of traditional, church and community leaders in the response to HIV, national ownership and implementation, as well as empowering partnerships (government, CSOs, development partners) are some key factors in combating HIV/AIDS in the region. The Commission also highlights that the cost of implementing HIV programs is costly and requires the support of development partners, as well as the need to strengthen aid coordination and harmonisation. The GFATM is a vital source for funding programs in the region.
The STIs epidemic in the region is a major concern, since the main mode of HIV transmission is unprotected sex.
Except for PNG, all FICs have achieved the target of universal access to antiretroviral therapy.
MDG 6 COMBAT HIV/AIDS AND OTHER DISEASES

Table 16
TARGET 6.A. Have halted by 2015 and begun to reverse the spread of HIV/AIDS
HIV prevalence of 15-24 years old (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 0.0 0.0 (2001) (1991) 0.0 0.0 (2008) (2006) 44 (2001) 15 21 24 (2009) (2008) (2007) 60 (1991) 70 9 36 50 (2006) (2009) (2008) (2007) n/a n/a n/a n/a n/a n/a n/a n/a 0.0 0.0 (2009) (2009) 15 8 2 (2007) (2007) (2003) 33 12 (2007) (2007) n/a n/a n/a n/a <0.01 <0.01 (1990) (1990) 0.1 0.9 0.0 (2009) (2009) (2008) 42 21 (2006) (2007) 22 32 (2008) (2007) n/a n/a n/a n/a Latest Condom use at last high-risk sex (%) Earliest Latest Orphans to 15-24 years old awareness of HIV/ non-orphans AIDS (%) attending school Earliest Latest Earliest Latest
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Table 17 TARGET 6.B. Achieve, by 2010, universal access to treatment for HIV/AIDS for all those who need it
Access to antiretroviral drugs (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga n/a n/a n/a n/a n/a 89 n/a (2010) 0 n/a 100 (1995) (1989) 100 100 n/a 100 (2007) (2008) (2009) 3 (2004) 96 52 100 (2010) (2009) (2009) Latest
Box 9. Discrimination Faced by Women Living with HIV in PNG They are scared of going close to me. They say, You have sickness. Yeah, (my) family, mother, cousins, and sisters, niece. They dont accept me in the family because I got this type of sick. They used to give me good clothes, (and) good money. All my family looked after me well, (especially) my parents. I was a very smart girl everybody likes me, giving me good food, clothes, money and everything. But after getting this sick, nobody likes me. I go around house to house, (and) wait for people to give me money and feed me. Now I am selling chicken (at the market). But at home, they reject me. (25-year-old PNG woman) In my community, yes, from all my neighbours, because they dont want me to stay with them or tell stories with them They are scared of me, I might give them HIV. So they dont want to story (socialise) with me or hold my hands or shake hands with me. They dont want to get my half-food. Because theyre scared the HIV might be in there and I might pass it to them. They are thinking of that so that makes me just want to stay by myself in the house. Im not free in that community. (25-year-old PNG woman) Source: Pacific Islands AIDS Foundation (2011, pp.24-25)
100 (2009) Tuvalu Note: See detailed country tables in Annex 1 for sources. Data not available. n/a Indicator not applicable to country context.
Malaria
Malaria is endemic to only PNG, Solomon Islands and Vanuatu (Table 18). While Solomon Islands and Vanuatu are on track to halt and reverse the incidence of malaria, PNG is off track to achieve the target. Malaria is endemic in all coastal provinces of PNG and it is one of the leading causes of morbidity and mortality, making malaria the highest disease burden in PNG (PNG, 2010). The HIV/AIDS epidemic in PNG exacerbates the incidence of malaria, as those infected with HIV are vulnerable to malaria. Children under 5 years and pregnant women are also vulnerable to malaria. Funds from the GFATM have been instrumental in the fight against malaria, particularly in the free distribution of insecticide-treated nets (ITN). However, overall, progress is slow and insufficient to ensure that PNG will halt and reverse the spread of malaria by 2015. In contrast, Solomon Islands and Vanuatu made sizeable gains in the fight against malaria. Almost the entire population of the Solomon Islands is at high risk to malaria, with only 1 percent of the population living in areas free of malaria (WHO, 2010c). The burden of malaria was significantly reduced in the 1990s through the implementation of targeted and effective control measures but this trend was reversed in 2000 due to the ethnic conflict that disrupted health services and led to a decline in government finances (WHO, n.d.). Following the end of ethnic conflict in 2003 and with support in 2004 from the GFATM, AusAID and other partners (see Box 10), as well as strong government commitment, significant progress was made in malaria control (WHO, 2010b).
Malaria is the highest disease burden in PNG but progress is slow and insufficient, with PNG off track to combat malaria.
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Box 10. Collaborative Effort in the Fight Against Malaria in the Solomon Islands and Vanuatu Funds from the GFATM, which is coordinated by SPC, was and continues to be instrumental in financing the fight against malaria in the Solomon Islands and Vanuatu. In addition, the strong commitment by both governments towards reducing the burden of malaria ensured that malaria control programs were prioritised. The national malaria control programs, both in the Solomon Islands and Vanuatu, are supported by numerous partners including WHO, World Bank, AusAID and Rotarians Against Malaria (RAM). WHO provides mainly technical support through experienced malaria staff stationed in Honiara and Port Vila. AusAID provides considerable financial assistance towards both governments malaria control programs. RAM has been active in both countries, primarily through the provision and distribution of bednets, working in partnership with local NGOs including church groups and womens organisations. The World Bank provided support to the malaria control program targeting three Solomon Islands provinces as part of a loan disbursed between 2003 and 2006. Led by strong government commitment, and crucial financial and technical support by development partners, Solomon Islands and Vanuatu are on track to combat malaria. Sources: PIRMCCM (2005), WHO (2010c), RAM (2011)
Malaria was for many years a major health problem in Vanuatu but through the concerted efforts by the Government, supported by WHO, GFATM and AusAID (see Box 6.b.), the burden of malaria was reduced significantly (Vanuatu, 2010). The malaria incidence (per 100,000) rate fell from 19,800 in 1990 to 1,600 in 2009, consistent with the increase in the percentage of under 5 children sleeping under insecticide-treated bed nets, which rose from 13 percent in 2002 to 81 percent in 2009 (Table 15). The Ministry of Health is targeting the elimination of malaria from target areas by 2015 (Vanuatu, 2010).
Solomon Islands and Vanuatu are on track to combat malaria.
MDG 6 COMBAT HIV/AIDS AND OTHER DISEASES

Table 18
TARGET 6.C. Have halted by 2015 and begun to reverse the incidence of Malaria
Malaria incidence rate (per 100,000) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a n/a 19,800 (1990) n/a 18,012 13,718 1,600 (2008) (2008) (2009) n/a 22 (1990) n/a 36 19 1 (2008) (2008) (2009) n/a 13 (2002) n/a 40 81 (2007) (2009) n/a n/a n/a 19 n/a (2007) Latest Malaria death rate (per 100,000) Earliest Latest Under 5 sleeping under bed-nets (%) Earliest Latest Under 5 treated with anti-malarial drugs (%) Earliest Latest
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Table 19
TARGET 6.C. Have halted by 2015 and begun to reverse the incidence of TB
TB prevalence rates (per 100,000) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 6 (1991) 147 (1990) 42 (1990) 54 (1990) 0 (2008) 0 (2009) 33 (2009) 34 (2009) 5 (1991) 22 (1990) 3 (1990) 6 (1990) 12 (1990) 0 (2008) 0 (2009) 4 (2009) 3 (2009) 59 (1990) 32 (1990) 34 (1990) 0 (2008) 0 (2008) 18 (2009) 23 (2009) 32 (1998) 0 (1990) 86 (1990) 72 (1990) 0 (2008) 51 (2009) 33 (2009) 50 (1994) n/a 71 (2008) 78 (2008) 88 (2002) 100 (1999) 100 (2002) 89 (1994) 100 (2008) 168 (2008) 13 (2000) 15 (2008) 105 (1992) 146 (2008) 100 (2000) 100 (2008) 12 (2009) 513 (1990) 351 (2009) 8 (2009) 302 (1990) 207 (2009) 2 (2009) 3 (2009) 85 (1990) 64 (1990) 2 (2009) 65 (2009) 18 (1990) 81 (2009) 18 (1991) 110 (2009) 90 (1990) 420 (2008) 90 (1991) 140 (2009) 87 (1995) 25 (1995) 64 (1994) 20 (2008) 96 (2008) 97 (2008) 60 (2006) 1129 (1990) 288 (2009) 154 (1990) 753 (1990) 231 (2009) 112 (1990) 105 (1990) 224 (1990) 54 (2009) 83 (2009) 6 (1990) 8 (1990) 80 (1990) 26 (2009) 8 (1990) 69 (1990) 80 (1990) 11 (1990) 2 (2009) 51 (1990) 19 (2009) 62 (1990) 24 (1990) 39 (1990) 67 (1990) 91 (2009) 73 (2009) 61 (2009) 90 (1994) 60 (1994) 90 (1994) 90 (2008) 64 (2008) 94 (2008) 93 (2007) 523 (1990) 337 (2009) 630 (1990) 185 (2009) 176 (1990) 110 (2009) 26 (2009) 250 (1990) 250 (2009) 18 (2009) 312 (1990) 115 (2009) 10 (2009) 139 (1990) 72 (2009) Latest TB death rates (per 100,000) Earliest Latest TB incidence rates (per 100,000) Earliest Latest TB detection rate under DOTS (%) Earliest Latest TB cure rate under DOTS (%) Earliest Latest
78 (2009) 100 (1994)
83 (1998) 100 (2008)
327 (1990) 194 (2009)
7 (2009) 296 (1990) 155 (2009)
87 (1990) 120 (2009) 100 (1994)
Note: See detailed country tables in Annex 1 for sources. Data not available. n/a Indicator not applicable to country context.
Tuberculosis
FICs (excluding PNG) are on track to combat TB, with low prevalence and incidence rates of TB in Melanesia (excluding PNG) and Polynesia (Tables 19). Although the prevalence, incidence and death rates in Micronesia has fallen, through the implementation of DOTS , the sub-region still records relatively high prevalence and incidence rates, particularly in Kiribati, FSM and RMI. Collectively, Micronesia is off track to halt and reverse the spread of TB. PNG has the highest prevalence and death rates of TB, and is second to Kiribati for the highest incidence of TB. Given the HIV/AIDS epidemic in PNG, and its close association with TB, death rates from TB are expected to increase (PNG, 2010). Outbreaks of multi-drug resistant TB (MDR-TB) in the Chuuk State of FSM, as well as MDR-TB cases detected in RMI (SPC, 2010f ), are making it difficult for these countries to contain TB. PNG, FSM and RMI are off track to combat TB. A Drug Resistance Survey conducted between 2008 and 2009 confirmed that the TB strains in Kiribati were sensitive to first line anti-TB drugs, and that strict adherence to the DOTS strategy in Kiribati (see Box 11) has made it possible to avoid the emergence of TB drug resistance (SPC, 2010f ). In addition, with the injection of funds by AusAID to SPC in 2010 for the TB Epidemic Control Project
Micronesia is off track to combat TB, given the high prevalence and incidence rates of TB in Kiribati, FSM and RMI.
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in Kiribati, the project is expected to have a big impact in containing TB (SPC, 2010c). The Regional Strategy to Stop TB in the Western Pacific (2011-2015), successor to the Strategic Plan to Stop TB in the Western Pacific (2006-2010), focuses on promoting universal access to TB diagnosis and treatment, strengthening TB laboratory capacity, scaling up the programmatic management of drug-resistant TB, expanding TB/HIV collaborative activities and strengthening TB program management capacity (WHO, 2011c). The GFATM, administered by SPC, is an important source of funding for TB control programs in the region.
Multi-drug resistant TB in FSM and RMI are proving difficult to control TB; cautious optimism for Kiribati given strict adherence to DOTS and AusAID support.
Box 11. TB Epidemic Control Project in Kiribati The AusAID-funded TB Epidemic Control Project in Kiribati is implemented by SPC, with the DOTS strategy a key part of the Project. In South Tarawa, specialist nurses survey households to identify TB sufferers, while community DOTS workers manage post-hospital home treatments by delivering and ensuring TB patients take their medicine correctly. These workers also assist in identifying TB sufferers. Also part of the DOTS strategy, TB patients are removed from overcrowded households and treated in isolation in hospital for up to two months until the majority (95%) is no longer infectious. Patients are then transferred to a Maneaba for further recovery. The Maneaba, a spacious traditional building, allows air to flow through, which is ideal for patients recovery and also limits the spread of TB. In addition, through the Project, Kiribatis first TB laboratory was built and opened in 2010. Source: AusAID (2010)
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GOAL 7 Ensure Environmental Sustainability

FICs (excluding PNG) recorded mixed progress towards ensuring environmental sustainability (Table 20). Collectively, Polynesia is on track to achieve MDG 7, with insufficient information available to make an assessment on Target 7.d. Melanesia (excluding Fiji) is off track on Targets 7.a. and 7.b., with all Melanesian countries off track on Target 7.d. However, Melanesia (excluding PNG) is on track with Target 7.c. Micronesia recorded mixed progress on all the targets, with concerns on the proportion of people without sustainable access to safe drinking water and basic sanitation. Progress towards MDG 7
Table 20. MDG 7 ENSURE ENVIRONMENTAL SUSTAINABILITY TARGET 7.A. Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources Off track Mixed On track Off track Off track Off track Mixed On track Off track Mixed Off track On track On track Mixed Mixed On track On track On track Off track Mixed TARGET 7.B. Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss TARGET 7.C. Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation TARGET 7.D. By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers
Access to safe drinking water and basic sanitation is major concern for Micronesia
Off track Mixed On track Off track Off track Off track Mixed On track Off track Mixed Off track On track On track Mixed Mixed On track On track Mixed Off track Mixed
Off track On track On track Off track Off track On track Mixed Mixed Off track Off track Mixed On track On track On track On track Mixed On track Mixed Off track On track
Off track Off track Off track Off track Off track Off track Mixed Insufficient info Off track Off track Insufficient info On track Insufficient info Not applicable Not applicable Insufficient info Insufficient info Mixed Off track Off track
A considerable amount of work has been done in the region towards sustainable development through the implementation of the Pacific Plan and in line with the objectives of the MSI. In the 2010 Port Vila Outcome Statement, it was noted that more than 30 regional initiatives were implemented since 2005, with successes in conservation (Micronesia Challenge), energy and fisheries (regional solidarity to reduce overfishing) . The Statement also reported that despite efforts towards the development of national sustainable development strategies, significant challenges remain in linking strategies to adequate budgets for effective implementation.
Cook Islands targeting 50 percent power generation from renewable energy by 2015.
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Achieving energy security remains a key priority in the region, as most FICs are highly dependent on imported fossil fuels. To this end, in 2010, Forum Leaders endorsed a Framework for Action on Energy Security in the Pacific. At the same time, RMI, FSM and Palau launched the Green Energy Micronesia initiative, targeting 20 percent power generation from renewable energy by 2020. The EU is funding the Northern Pacific Renewable Energy and Energy Efficiency Project. In addition, similar to the Tonga Energy Road Map (see Box 12), Cook Islands also adopted a Renewable Energy Chart, targeting 50 percent power generation from renewable energy by 2015, and 100 percent by 2020. There is limited data available on the official MDG indicators to track biodiversity loss (Table 21). However, according to SPREP (2011), native species are in decline, while human activity is driving unsustainable resource use and extraction. This has led to over-harvesting of fisheries, declining animal populations, and species loss. In addition, increased transport and trade has introduced invasive species. Moreover, unsustainable logging and forest conversion for agriculture has often resulted in severe localised impact on fresh water and soil loss. For instance, in the Solomon Islands, large scale commercial logging and shifting cultivation has led to significant deforestation. Logging activities in the Solomon Islands are also causing problems to freshwater resources and reefs in the coastal areas downstream from them (Roughan & Wara, 2010).
Human activity driving unsustainable resource use and extraction in the region.
Box 12. Tonga Energy Road Map 2010-2020 In 2009, the Tongan Government responded to the twin challenges of reducing the Tongan contribution to global green house gas emissions and improving energy security by approving a policy to supply 50 percent of electricity generation through renewable resources by 2012. A joint effort by the Government, Tonga Power Limited (TPL) and several development partners led to the development of the Tonga Energy Road Map 2010-2020: Ten Year Road Map to Reduce Tongas Vulnerability to Oil Price Shocks and Achieve an Increase in Quality Access to Modern Energy Services in an Environmentally Sustainable Manner. The Road Map identifies a least-cost program to achieve the energy objectives, including detailed actions with indicative funding sources and costs for each element. It also clearly defines the roles for Government, TPL actions and development partner support. Furthermore, in recognition that technologies, costs, demand for electricity and sources of financing change over time, the Road Map is expected to be updated accordingly. Since the release of the Tonga Energy Road Map, Government launched an Energy Efficiency Public Awareness Campaign in February 2011, a first of its kind in Tonga. The Campaign is expected to help people cut down on wastage practices to control their spending on electricity. In other developments, NZ is supporting the Tonga Village Network Upgrade Project with a grant of NZ$5.8 million. Source: Tonga (2010b)
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MDG 7 ENSURE ENVIRONMENTAL SUSTAINABILITY

Table 21
TARGET 7.A. Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources TARGET 7.B. Reduce biodiversity loss, achieving, by 2010, a significant reduction in the rate of loss
Proportion of land area covered by forest (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 64 58 46 6 33 (1990) (2001) (1990) (1990) (1990) 67 54 60 5 33 (2005) (2006) (2005) (2008) (2005) 22 (1990) 4 (1990) 125 (1990) 77 (1990) 70 4 161 176 (2008) (2008) (2008) (2008) 1.2 (1990) 1.7 (1990) 0.8 (1990) 0.8 (1990) 3.6 (2008) 2.6 (2008) 0.9 (2008) 1.7 (2008) 0.3 (1990) 0.3 (1990) 0.2 (2008) 0.4 (2008) 0.1 (1991) 0.0 (1991) 4.0 (1991) 0.4 (1991) 0.0 (1991) 0.0 (2009) 0.0 (2009) 0.2 (2009) 0.0 (2009) 0.1 (2009) 83 (1986-87) 3 76 (1990) (1990) 89 (2006-07) 3 81 (2005) (2005) 55 (1999) 22 (1990) 48 (1990) 132 (1990) 235 (1990) 62 29 99 143 213 (2008) (2008) (2008) 0.5 (1999) 0.3 (1990) 1.0 (1990) 0.6 (2008) 0.3 (2008) 1.6 (2008) 0.2 (1999) 0.2 (1990) 0.2 (2008) 0.1 (2008) 0.0 (1991) 0.0 (1991) 1.2 (1990) 0.6 (1995) 0.0 (1991) 0.1 (2009) 0.0 (2009) 0.2 (2009) 0.0 (2009) 0.1 (2009) 54 70 99 36 (1990) (1990) (1990) (1990) 55 65 78 36 (2005) (2005) (2005) (2005) 818 (1990) 1254 2142 (1990) 2109 161 (1990) 70 (1990) 198 92 (2008) (2008) (2008) (2008) 1.1 (1990) 0.5 (1990) 0.5 (1990) 0.5 (1990) 1.5 (2008) 0.3 (2008) 0.4 (2008) 0.4 (2008) 0.3 (1990) 0.3 (1990) 0.2 (1990) 0.1 (1990) 0.3 (2008) 41.8 (1990) 0.2 (2008) 28.5 (1990) 0.2 (2008) 0.1 (2008) 2.1 (1990) 0.0 (1991) 7.6 (2009) 3.2 (2009) 1.6 (2009) 0.1 (2009) Latest CO2 emissions, total (000 metric tons) Earliest Latest CO2 emissions, per capita (metric tons) Earliest Latest CO2 emissions, per $1 GDP (PPP) (kg) Earliest Latest Use of ODS (ODP metric tons) Earliest Latest
(2008) 14.4 (1990) 14.1 (2008) (2008) 15.7 (1990) 10.4 (2008)
Fish stocks within safe biological Total water resources used (%) limits (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 2 (1995) 2 (2005) 0 (2000) Latest Earliest Latest
Protected terrestrial and marine areas (%) Earliest 0.2 0.9 0.0 0.4 0.3 0.0 0.0 0.5 0.0 0.0 0.9 0.1 0.0 Latest
Species threatened with extinction (%) Earliest Latest
(1990) 0.2 (1990) 1.4 (1990) 0.1 (1990) 0.5 (1990) 0.6 (1990) 0.0 (1990) 4.8 (1990) 0.1 (1990) 1.9 (1990) 1.2 (1990) 9.4 (1990) 0.2
(2010) (2010) (2010) (2010) (2010) (2010) (2010) (2010) (2010) (2010) (2010) (2009)
(1990) 22.6 (2010)
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Table 22
TARGET 7.C. Halve, by 2015, the proportion of people without sustainable access to safe drinking water and basic sanitation
Using an improved drinking water Using an improved sanitation source (%) facility (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 94 (1990) 100 (1990) 89 (2001) 92 (1990) 91 (1991) 98 (2008) 100 (2008) 97 (2006) 98 (2006) 98 (2007) 96 (1990) 100 (1990) 98 (1990) 55 (1986) 77 (1991) 100 (2008) 100 (2008) 100 (2008) 82 (2006) 81 (2007) 29 (1994) 35 (1990) 92 (1988) 72 (1992) 87 (1990) 57 (2005) 90 (2009) 98 (2007) 90 (2007) 96 (2005) 29 (1990) 24 (1990) 61 (1988) 65 (1990) 46 (1990) 25 (2005) 35 (2009) 71 (2007) 72 (2007) 100 (2005) 92 (1990) 41 (1990) 30 (1999) 68 (1989) 93 (2000) 40 (2008) 84 (2007) 81 (2009) 92 (1990) 47 (1990) 22 (1999) 28 (1989) 96 (2000) 45 (2008) 18 (2007) 64 (2009) Latest Earliest Latest
TARGET 7.D. By 2020, to have achieved a significant improvement in the lives of at least 100 million slum dwellers
Urban population living in slums (%) Earliest 0 n/a 24 (1991) (2001) Latest 30 (2006) 0 (2008) n/a 7 (2007)
Note: See detailed country tables in Annex 1 for sources. Data not available. n/a Indicator not applicable to country context.
Access to safe drinking water and basic sanitation is a major concern in Micronesia, with Kiribati and RMI off track on Target 7.c. Although some gains were made in improving conditions in FSM and Nauru, concerns remain (Table 22). In mid-April 2011, some Micronesian countries met for the first time in Majuro (RMI) to look at ways to improve water and sanitation throughout the region (SOPAC, 2011). Delegates from Palau, Guam, FSM and RMI gathered to establish a Micronesian Water Committee and also noted that strong political will was critical to address the water and sanitation challenges. A Pacific Environment Programme Strategic Plan (2011-2015) was developed in 2010, with four strategic priorities climate change, biodiversity and ecosystem management, waste management and pollution control, and environmental monitoring and governance. Support from development partners, as well as financing from the GEF continues to be crucial for addressing environmental sustainability issues. The GEF has financed many projects related to biodiversity conservation, renewal energy, fisheries management, climate change adaptation, water resources and wastewater management, as well as coastal and marine resource management . More recently, Japan provided US$66 million for the Pacific Environment Community (PEC) Fund, which is used to support projects with a focus on the provision of solar power generation systems and sea water desali-
The Global Environment Fund provides crucial funding for environmental sustainability projects.
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nation plants. Samoa was the first country to access US$4 million under the PEC Fund in June 2011. Although data on the urban population living in slums is generally not available (Table 22) to assess progress on Target 7.d., countries in Melanesia are considered to be off track on this Target. According to SPC (2010c), an increase in the number of very poor squatters in Suva (Fiji), Honiara (Solomon Islands) and Port Moresby (PNG) is resulting in more incidences of begging and homelessness. In Vanuatu, according to the 2006 HIES, 30 percent of the population in Port Vila and Luganville were living in slum conditions.
An increase in squatter settlements in urban centres in Melanesia is a cause for concern.
GOAL 8 Develop a Global Partnership for Development

The successful achievement of the first seven goals is critically dependent on the support of development partners through more effective official development assistance (ODA), provision of better market access and debt relief. ODA to Oceania has doubled since 2002 to US$1.6 billion in 2009, with donor countries accounting for 82 percent of the ODA (Figure 3) . The largest donor country to the region is Australia, with net ODA disbursements of US$704 million in 2009. Other major donor countries are the US, EU, NZ and Japan, which together account for 98 percent of ODA by donor countries to Oceania (Figure 4). Total multilateral aid to the region was US$295 million in 2009, of which ODA from UN agencies was 36 percent. The European Development Fund, GFATM and GEF also made up the major multilateral aid to the region (Figure 5).
Aid to the region has doubled to US$1.6 billion; Australia is the largest donor.
US$M 1,800 1,600 1,400 1,200 1,000 800 600 400 200 0 2002 2003 2004 2005 2006 2007 2008 2009 Source: OECD (2011) Multilateral Donor Countries Figure 3. ODA to Oceania
Table 23
ODA Received from Donor Countries (US$M)

2003 MELANESIA Melanesia (excluding PNG) Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 346 128 43 219 56 28 218 112 13 51 16 25 63 5 9 27 17 6 2004 438 188 37 249 117 35 178 85 10 49 14 19 65 6 14 25 15 5 2005 490 245 39 245 172 33 214 104 21 56 9 23 88 7 20 30 25 6 2006 508 261 40 248 179 41 235 106 20 55 17 37 109 31 9 38 19 13 2007 610 322 33 288 237 52 232 111 23 51 25 22 88 9 14 29 27 9 2008 606 343 34 263 219 89 227 87 20 51 29 41 85 4 16 26 23 15 2009 672 350 50 322 202 98 258 119 22 59 23 34 109 6 7 47 35 15
UN US $105m
US US $216m
Figure 4. Donor Countries ODA to Oceania (2009) EU US $157m Other US$27m
AU US $704m
Japan US $112m NZ US $136m Source: OECD (2011)
Figure 5. Total Multilateral ODA to Oceania (2009) Other US$24m GFATM US$52m
GEF US$32m
Oceania, regional* 61 75 95 108 117 244 186 * Refers to ODA that benefits more than one country in Oceania, which includes French Polynesia, New Caledonia, Northern Marianas, Tokelau and Wallis & Futuna
Source: OECD (2011)
EU Institutions US$82m
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Melanesia receives the bulk of ODA, led by PNG and Solomon Islands, which together accounted for around 82 percent of the ODA to the subregion (Table 23). In Micronesia, almost half the aid flows are to FSM, with ODA to Polynesia comparatively lower than the other two sub-regions. Aid flows to Melanesia and Polynesia almost doubled from 2002 to 2009, while a modest increase was recorded for Micronesia. Approximately two-thirds of ODA to FICs is towards the social infrastructure and services sector, which includes education, health and water supply and sanitation (Table 24).
Two-thirds of ODA goes toward the social infrastructure and services sector.
Table 24
ODA from Donor Countries to FICs by Sector (US$M)

2005 SOCIAL INFRASTRUCTURE & SERVICES Education Water supply and sanitation ECONOMIC INFRASTRUCTURE AND SERVICES Energy Transport and Communications PRODUCTION SECTORS Agriculture, forestry and fishing Industry, mining and construction Trade and tourism MULTISECTOR PROGRAMME ASSISTANCE Food Aid ACTION RELATING TO DEBT HUMANITARIAN AID UNALLOCATED/UNSPECIFIED Source: OECD (2011) 445 127 5 65 21 31 74 71 2 2 136 28 0 3 5 14 2006 648 132 5 192 18 167 53 49 3 1 145 11 1 24 14 12 2007 566 147 5 145 61 63 40 36 2 2 150 19 0 0 5 15 2008 652 196 3 162 8 148 45 36 8 2 266 19 0 5 8 18 2009 782 163 27 29 22 1 46 37 5 4 233 34 0 0 31 26
Dependence on ODA, measured by ODA as a percentage of GNI, is much higher in Micronesia, compared to the other sub-regions (Table 25). FSM, RMI and Palau are heavily dependent on the Compact of Free Association (COFA) grants from the US. In 2003, the Compact grants for FSM and RMI were renewed but are set to expire in 2024. As part of the renewed agreements, grants to the countries are steadily lowered but annual contributions by the US are made to their respective Compact Trust Funds. It is envisioned that the FSM and RMI will utilise the Trust Funds when their agreements end in 2024. However, FSM and RMI are facing difficult challenges to ensure fiscal sustainability (IMF, 2010a & IMF, 2010c). The amended Compact has also tightened rules on reporting, auditing, and the use of grants, which proved difficult for FSM to meet (IMF, 2010a). As a result, FSM has not used US$150 million in grants, contributing to weak economic performance in recent years. Palaus Compact agreement ended in 2009 and a new 15-year grant agreement was agreed but is currently awaiting approval by US Congress. Fiscal sustainability remains a key challenge for Palau (IMF, 2010b).
Compact of Free Association grants to FSM and RMI set to expire in 2024; difficult challenges ahead. Palau awaiting approval on new 15-year grant assistance agreement.
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MDG 8 DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT

Table 25
TARGET 8.A. Develop further an open, rule-based, predictable, non-discriminatory trading and financial system; TARGET 8.C. Address the special needs of SIDS (through BPOA)
TARGET 8.D. Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term
Debt Sustainability
Official Development Assistance
Market Access
ODA to basic social services (%)
ODA that is untied (%)
Net ODA (% of GNI)
Duty free exports to ODA to build trade capacity Debt (% of exports of goods developed (%) & services) countries (%) Earliest Earliest Earliest Latest Latest Latest 2 2 3 10 (2009) (2009) (2009) (2009) 7 (2010e) 8 18 5 15 39 (2009) (2009) (2010) (2007) (2009) 59 (2009e)
Earliest
Earliest
Earliest
Latest
Latest
MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 19 (2001) 27 7 (200108) (2008) 68 (1991) 85 (2001) 21 7 29 26 5 (2001) (1990) 9 (2008) 9 (2009) 3 (1999) 10 (2008) 14 (2005) 11 (1990) 4 (1990) 14 (2006) 9 (1995) 0 58 0 (2004 -08) 65 (1995) 100 (2009) 29 35 (2007) 42 46 0 0 (1993) 45 (2009) (1990) 15 (2009) (1998) 32 (2009) (1990) 24 (2009) (1992) 18 (2009) 6 (2006) 16 (2004) 4 (2000) 4 13 22 30 (1990) (1990) 2 (2009) 5 (2009) 1 (2010) 9 (1990) 18 (1990) 11 (1990) 7 (2000)
(1990) 43 (2009) (1990) 16 (2009)
(1990) 16 (2009) (1990) 12 (2009) (1990) 18 (2009)
Latest
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Table 26
TARGET 8.E. In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries
Population with access to essential drugs (%) Earliest MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 100 100 (1991) 100 (1991) 100 95 (2002) (2008) (2006) Latest
TARGET 8.F. In cooperation with the private sector, make available the benefits of new technologies, especially information and communication
Telephone lines per 100 population Earliest 6 1 1 2 3 2 1 13 35 17 18 3 5 1 (1990) (1990) (1990) (1990) (1990) (1990) (1990) (1990) (2002) (1990) (1992) (1990) (1990) (1990) Latest 15 1 2 4 8 4 7 18 36 34 66 16 25 15 (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2008)
Cellular subscribers per 100 population Earliest 0 0 0 0 0 0 0 0 12 0 0 0 0 0 (1990) (1990) (1990) (1990) (1990) (1990) (1990) (1990) (2002) (1990) (1990) (1990) (1990) (1990) Latest 71 9 6 15 31 1 2 15 60 34 38 69 49 20 (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2001) (2008) (2008) (2004) (2008) (2008) (2008)
Internet users per 100 population Earliest 0 0 0 0 0 0 0 0 6 0 0 0 0 0 (1990) (1990) (1990) (1990) (1990) (1990) (1990) (1990) (2000) (1990) (1990) (1990) (1990) (1990) Latest 12 2 2 7 14 2 4 3 6 25 66 5 8 43 (2008) (2008) (2008) (2008) (2008) (2008) (2008) (2001) (2007) (2008) (2008) (2008) (2008) (2008)
Note: See detailed country tables in Annex 1 for sources. Data not available.
Overall, the significant increase in ODA to the region was instrumental in the progress that FICs made against the MDGs. In particular, the increase in aid to Solomon Islands following the end of ethnic tensions is clearly assisting the country make progress towards achieving the MDGs. However, much more work is needed in the Solomon Islands, as well as in other FICs, to accelerate MDGs progress. Therefore, it is paramount that ODA flows to the region are sustained. Work under the Forum Compact on Strengthening Development Coordination in the Pacific is important to ensure aid and development effectiveness (see Box 13). In terms of market access, there is limited data to assess the current level of duty free exports from the region to developed countries. However, there are agreements in place that provide duty free access to developed markets. Since 1981, SPARTECA, a non-reciprocal trade agreement, provides FICs duty and quota-free access to Australia and NZ, subject to rules of origin (RoO) requirements. However, various studies and reviews of SPARTECA criticised the stringent RoO, as they generally restrict the scope of exports and value addition (Oxfam, 2009). SPARTECA is also criticised for failing to address the more restrictive non-tariff and technical barriers to trade, such as quarantine, sanitary and phytosanitary measures and standards.
Sustaining ODA to the region is critical to accelerating progress towards the MDGs.
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Box 13. Two Years On: Key Messages from the Implementation of the Forum Compact on Strengthening Development Coordination 1. The Pacific is making good progress in improving development coordination. The attention to public financial management and the increasing incidence of more flexible forms of aid represent major gains in the last two years. However, many countries still struggle to turn resources into development results, and some are considerably behind the best practice in the region. The crucial factor in alignment and harmonisation is strong political leadership and aid management capacity in FICs. Development partners may have a strong contribution to make to harmonisation and alignment, but it will only go so far unless there is strong strategic direction from FICs, which among other factors requires strong institutional and human resource capacity at the country level. Having a national or strategic plan does not always lead to clear direction or determine resource allocation. While nearly all FICs have a national development strategy, only those with relatively good capacity, and with many years of experience with various forms of national planning, are able to use it to shape sector activity and budgets. Generally, development partners are finding it easy to align to national plans and budgets which are pitched at a high level of generality, but they need, and will generally respond to, tighter direction. The Pacific needs simpler and less fragmented aid delivery modalities, i.e. fewer projects, more program support and a reduced mission burden. Progress is noted for some countries, but in others, there is still no clear road map based on mutual understanding of how new modalities, such as program-based approaches, will be phased in. There is insufficient appreciation of how much time and effort is needed to create successful program approaches. Notwithstanding the importance of country leadership, the pace of harmonisation and alignment is still driven by the internal regulations and preferences of some development partners rather than country needs. Managing for development results is still an area of weakness throughout the Pacific shared by FICs and development partners. Some countries such as Vanuatu and Samoa have already, or are beginning to, give it the resources it needs, and to work out how to generate useful information that suits their capacity to collect and report it. Others are still challenged by the complex reporting requirements of national plans which they have never had the capacity to meet.
2.
3.
4.
5. 6.
Source: PIFS (2011)
Major exports to Australia and NZ are also confined to a few FICs. In 2010, FIC exports to Australia amounted to A$3.3 billion, of which PNG accounted for 92 percent . PNG also has a bilateral trade agreement with Australia (PATCRA II ) that provides duty free access to Australia. The second largest FIC exporter to Australia was Fiji, which exported A$190 million, followed by Samoa at A$44 million exports. FIC exports to NZ totaled NZ$103 million in 2010, of which Fiji accounted for 66 percent, followed by Nauru (NZ$12m) and PNG (NZ$11m) . Similarly, under COFA, FSM, Palau and RMI have duty free access to the US market for goods that meet 35 percent local content (FSM, 2011). However, quarantine requirements are a major barrier to fully utilising this facility. In 2010, RMIs exports to the US was US$12 million, while FSM exported US$4 million, with fisheries products the major commodities exported from both countries . As Palaus economy is largely based on tourism, only a few commodities are exported to the US, with a value of US$148,035 in 2010. The EU also historically provided non-reciprocal duty free access for ACP countries (includes the FICs) under the 1975 Lom Convention and its
SPARTECA provides FICs duty free access to Australia and NZ but is criticised for stringent rules of origin requirements and non-tariff/ technical barriers.
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successor the 2000 Cotonou Agreement, which largely benefited PNG and Fiji. However, the EU-ACP preferential trade arrangement was incompatible with WTO rules so negotiations on a WTO-compatible Economic Partnership Agreement (EPA) began in 2004, with a view for completion by end 2007, when the Cotonou Agreement ended. Negotiations were not completed on time, so PNG and Fiji signed an interim EPA to protect preferences for their fisheries and sugar sectors. PNG is now implementing the EPA. Nevertheless, FICs are committed to pursue negotiations for a comprehensive EPA as a single region, which is likely to conclude by 2012. In addition, there is a free trade agreement among FICs, the Pacific Island Countries Trade Agreement (PICTA), which entered into force in 2003. To date, seven FICs (Cook Islands, Fiji, Niue, Samoa, Solomon Islands, Tuvalu and Vanuatu) have indicated readiness to trade under PICTA, while 6 countries (Kiribati, Nauru, PNG and Tonga) are in the process of completing necessary domestic arrangements before announcing their readiness. FSM signed PICTA but are yet to ratify, while Palau and RMI are yet to accede to the Agreement. Although PICTA currently covers trade in goods, negotiations on trade in services is expected to be concluded by end 2011. The ultimate aim of PICTA was to set the platform to establish a free trade agreement between Australia and NZ, and the FICs (now known as PACER Plus). In 2009, Forum Leaders initiated negotiations on PACER Plus, which are still at the preliminary stage. One of the key concerns for FIC governments is the loss of government revenue, which has implications on service delivery and ultimately, on poverty (Oxfam, 2009). However, an important potential for FICs under PACER Plus is the potential for labour mobility. FICs are currently consolidating the Office of the Chief Trade Adviser on PACER Plus and intensifying national consultations. On debt sustainability, collectively, the region does not have significant debt problems, with debt sustainability issues currently affecting countries in Micronesia, as well as Tonga. Marshall Islands recorded the largest debt service ratio among FICs (Table 25), which is compounded by the decrement of COFA grants . FSM and Palau also face similar issues . Recent debt sustainability analysis by the IMF (2011a, 2011b) for Tonga and Kiribati indicate that both countries are at high risk of debt distress. However, in both cases, the debt situation is manageable but requires close scrutiny and prudent management.
Negotiations towards a comprehensive Economic Partnership Agreement between FICs and the EU are ongoing.
PACER Plus presents opportunities as well as risks for FICs.
Overall, the region is not facing major debt problems.
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Table 17.
Progress towards Selected MDG 8 Targets

TARGET 8.D. Deal comprehensively with the debt problems of developing countries through national and international measures in order to make debt sustainable in the long term Debt Sustainability Melanesia Melanesia (excl PNG) Fiji PNG Solomon Is Vanuatu Micronesia FSM Kiribati Marshall Is Nauru Palau Polynesia Cook Is Niue Samoa Tonga Tuvalu FICs FICs (excl PNG) On track On track On track On track On track On track Off track Off track Mixed Off track Insufficient info Off track Mixed On track Insufficient info On track Mixed On track On track On track Insufficient info Insufficient info Insufficient info Insufficient info Insufficient info On track Mixed Off track On track On track Insufficient info Insufficient info On track On track On track Insufficient info On track On track Insufficient info Mixed Off track Mixed On track Off track Mixed On track On track On track Mixed Mixed On track On track On track On track On track On track On track On track Off track Mixed TARGET 8.E. In cooperation with pharmaceutical companies, provide access to affordable essential drugs in developing countries TARGET 8.F. In cooperation with the private sector, make available the benefits of new technologies, especially information and communication
MDG 8 GLOBAL PARTNERSHIPS FOR DEVELOPMENT
In terms of access to essential drugs, as data for majority of FICs is not available (Table 26), assessments are made based on anecdotal evidence. For instance, Kiribati, Tonga and Tuvalu provide free health services to its people . Similarly, Vanuatu (2010) and RMI (2009) reported that, generally, essential drugs are accessible to the majority of its populations. For FSM, while the Government is committed to provide health services on a subsidised basis, shortage of drugs, particularly in Chuuk, is a major concern (FSM, 2011). As a result, FSM is off track on this Target.
4 in 10 people in the region (excluding PNG) use a mobile phone.
Effective use of ICT is an important tool for achieving the MDGs. In the region (excluding PNG), on average , 4 in 10 people use a mobile phone, compared to only 1 in 10 people that use a landline telephone (Table 26).
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Although internet use is much lower, averaging around 9 in 100 (excluding PNG), usage is on the rise. Internet use is much higher in Polynesia, averaging around 19 in 100 people. The successful SPC-supported Pacific Rural Internet Connectivity System (PacRICS) continues to be an important tool in increasing internet access across the region. According to SPC (2011a), to date, about 100 systems are in place in 16 countries in the Pacific. In January 2011, with the support of several development partners, a project was launched in the Solomon Islands to provide satellite broadband internet access using PacRICS to improve the delivery of government services (health and other sectors) in rural areas, which would also save money for the Government (SPC, 2011a). In addition, more laptops were distributed under the One Laptop Per Child (OLPC) program, with the latest in Kosrae in FSM (SPC, 2011b). Majority of FICs have introduced the OLPC program in their schools. In other areas, the Pacific Financial Inclusion Programs (PFIP) Branchless Banking Project, with the support of the private and public sector, aims to use mobile phones and other technologies to deliver financial services more cost-effectively, with the aim of reaching the under-served and unbanked populations in the Pacific (PFIP, 2011). PFIP and other donors are currently funding Digicel to introduce a low cost mobile-phone-based mobile wallet (m-wallet) in Fiji, Samoa, Tonga and Vanuatu. It is expected that by the end of 2011, the service will benefit up to 500,000 people of which 40 percent will be women and 30 percent living in rural villages.
PacRICS continues to increase the internet access coverage in the region.
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PART 4 A Closer Look at the Health-Related MDGs
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CHILD AND MATERNAL HEALTH

Although most FICs recorded a decline in child mortality, it is variable and uneven across the FICs (Figure 6). However, most FICs are below the global developing country target. The recent DHSs conducted in PNG, RMI, Solomon Islands, Nauru, Tuvalu, Kiribati and Samoa noted that neonatal deaths accounted for close to 40 percent of U5M and over 50 percent of IM . In the 2010 DHS for FSM, neonatal deaths accounted for 72 percent of IM (FSM, 2011), while neonatal deaths in Tonga accounted for 45 percent of U5M (Tonga, 2010). Fiji (2010) also noted that perinatal deaths underpinned the death rate of under-five children. While accurate statistics are not available for Vanuatu, perinatal and neonatal deaths are thought to be under-reported due to the relatively high rate (20%) of home-deliveries (Vanuatu, 2010). Consequently, improved service delivery should be targeted for maternity, perinatal and neonatal care (WHO & SPC, 2011a). Overall, the improvement in child health across FICs is due to higher immunisation coverage, exclusive breastfeeding, child nutrition, IMCI and clean water and sanitation. Clean water and sanitation is important for the prevention of diarrhoeal diseases in children, which is a major cause of morbidity and mortality of children. FICs that recorded lower U5M rates also recorded higher access to safe drinking water and basic sanitation (Figures 7 & 8). WHO & SPC (2009b) noted that MMR (Figure 9) was not an appropriate measure for monitoring maternal health for FICs, with small populations and few maternal deaths. Nevertheless, FICs that recorded higher skilled birth attendance also reported lower MMR (Figure 10), while countries that recorded higher adolescent birth rates also generally recorded higher MMR (Figure 11). Maternal mortality in adolescent girls are likely to be higher, with studies conducted in Fiji and Tonga showed that maternal and newborn outcomes were poorer among young mothers under 19 years of age (WHO & SPC, 2009b). In addition, prevailing low contraceptive use is an area of concern as many pregnancies are unintended, which is a contributing factor in maternal and perinatal morbidity and mortality (WHO & SPC, 2011a). Furthermore, the poor access to emergency obstetric care (below 40%) also contributes to higher maternal deaths. FICs with good coverage of emergency obstetric care and effective referral systems reported zero deaths per year or fewer than five deaths in a three- to five-year period over the last decade (WHO & SPC, 2011). Maternal deaths are becoming rare in SIS, where only one event may be reported over a span of years, such as in Cook Islands, Niue, Palau and Tuvalu (WHO & SPC, 2011a). An increase in the number of midwives, skilled birth attendance and antenatal coverage, as well as better access to emergency obstetric care are underlying reasons that maternal deaths are rare in smaller countries. However, it was also noted that a report of zero maternal deaths could be misleading as death measured the worst outcome of pregnancy and many non-fatal, near-miss maternal complications occur, which seriously impact the lives of women.
Figure 6. Under 5 Mortality Fiji PNG Solomon Is Vanuatu FSM Kiribati Marshall Is Nauru Palau Cook Is Niue Samoa Tonga Tuvalu 0 20
Earliest Latest 40 60 80 100 per 1,000 live births 120
U5M 80 70 60 50 40 30 20 10 0 0
Figure 7. U5M to Access to Safe Drinking Water PNG Kiribati
Nauru FSM Solomon Is
RMI
PalauTonga Tuvalu Fiji Cook Is Vanuatu Samoa Niue 20 40 60 80 100 Access to Safe Drinking Water (%) 120
U5M 80 70 60 50 40 30 20 10 0 0
Figure 8. U5M to Access to Basic Sanitation PNG Kiribati
FSM Solomon Is
RMI Nauru Tonga Fiji Tuvalu Palau Cook Is Samoa
Vanuatu
Niue 20 40 60 80 100 Access to Basic Sanitation (%) 120
Figure 9. Maternal Mortality Ratio Fiji PNG Solomon Is Vanuatu FSM Kiribati Marshall Is Palau Cook Is Niue Samoa Tonga Tuvalu 0
Earliest Latest
200 400 600 per 1,000 live births
800
57
For countries with larger and dispersed populations, living in remote outer islands and rural communities where transport is limited (e.g. FSM, Kiribati, PNG and Solomon Islands); access to reproductive health services is much more difficult. In these cases, WHO & SPC (2011a) reported that most maternal deaths are related to limited access to emergency obstetric care, as this care is usually only available in the main urban centres or larger provincial hospitals. FICs have implemented maternal, newborn and child health programs for decades. According to WHO & SPC (2009b), countries have included child survival strategies as part of their national health initiatives, including IMCI, while all national reproductive health programs have the key elements of the Safe Motherhood Initiative, including antenatal, intrapartum, neonatal and postnatal care; family planning; and prevention and control of STI including HIV. In some countries, programs also focus on adolescent reproductive health, cervical cancer prevention, mens involvement in reproductive health, infertility services and post-abortion services. However, several common factors hinder access and limit coverage of essential maternal and child health services (WHO & SPC, 2011a): (i) Lack of strategic direction to translate national policies to sub-national levels, which have implications on resourcing, implementation and monitoring at the provincial, divisional and district levels. Weak health systems, underpinned by inadequate human resources, under-equipped health facilities, inadequate monitoring and sub-optimal health information systems, which hinder effective service delivery. Inadequate management and poor coordination of health service delivery results in wastage of limited resources and unnecessary costs. Insufficient investment in maternal and child health programs, with majority of programs funded externally and targeted at national levels, which limits scaling up and expansion of services at the sub-national level. Limited use of scientific information and data gaps in maternal and child health hinder effective policy and planning. Inadequate attention given to addressing the social determinants of health, including issues of gender, human rights, economic, cultural, political, legal and environmental factors.
MMR 800 700 600 500 400 300 200 100 0 0
Figure 10. MMR to Skilled Birth Attendance PNG
Palau RMI Kiribati Vanuatu Tonga Fiji Tuvalu Cook Is Niue 20 40 60 80 100 120 Skilled Birth Attendance (%) Samoa FSM Solomo nIs
MMR 800 700 600 500 400 300 200 100 0
Figure 11. MMR to Adolescent Birth Rate PNG
Palau RMI Kiribati Solomon Is
(ii)
(iii)
Samoa Vanuatu Fiji Niue Cook IsFSM Tuvalu 0 50 100 Adolescent Birth Rate (%)
Tonga
150
(iv)
(v) (vi)
Maternal, newborn and child health programs in place for decades but access and coverage of maternal and child health services still lacking.
In the 2011 Pacific Health Ministers Meeting, WHO & SPC (2011a) recommended two main actions to improve maternal and child health: (i) Build on existing policies and strategies to redefine national plans (financing, human resources, and monitoring and implementation at national and sub-national levels), as well as incorporating effective leadership and management for results at all levels. Build on existing services to repackage a comprehensive and integrated set of interventions delivered through the Continuum of Care model (see Box 14), with specific plans to improve access for particular geographical areas and populations.
(ii)
Need to upscale existing maternal and child health policies and strategies.
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N ew Bor n and C hi l d H eal th ( M N C H ) C onti nuum of C ar e M odel for
Box 14. Maternal, New Born and Child Health (MNCH) Continuum of Care Model for Universal Access
HEALTH SYSTEM STRENGTHENING
CHILDBIRTH & DELIVERY; MATERNAL & NEONATAL CARE
HEALTH SYSTEM STRENGTHENING
1. 2. 3. 4.
Leadership & management Financing and insurance Human resources for health Medicines and technologies
CHILD SURVIVAL - IMCI - EPI - Nutrition PREGNANCY CARE & NUTRITION
5.
Commodities & supply chains Service delivery and quality of care sectoral linkages Inter Social determinants of health and human rights
MNCH CONTINUUM OF CARE
POST-PARTUM CARE - Nutrition - Family Planning
6. 7. 8.
Source: WHO & SPC (2011a)
HIV/AIDS, MALARIA & TUBERCULOSIS

Across the FICs, financing from the GFATM is a common key factor behind progress made towards MDG 6. To date, a total of US$129 million was disbursed from the GFATM to FICs since outlays began in 2003 (Figure 12). Slightly over half of the disbursements were towards combating malaria (Figure 13), with US$46 million directed to PNG, while US$23 million was provided through SPC for malaria programs in the Solomon Islands and Vanuatu. Coupled with support from other major development partners and strong government commitment, Solomon Islands and Vanuatu are on track to combat malaria. PNGs malaria program was scaled up in 2009 and a collaborative approach, similar to that in the Solomon Islands and Vanuatu, between the DOH, Population Services International (PSI) and RAM, is now in place to tackle malaria (GFATM, 2011e). PNGs DOH works toward the procurement and distribution of anti-malarial drugs, as well as improving malaria diagnosis and management at health facilities. On the other hand, RAMs main focus is in the distribution of ITN, while PSI is responsible for public awareness and advocacy campaigns. On HIV/AIDS, of the US$34 million disbursed by the GFATM, US$14 million was directed to PNG, while US$20 million was channeled through SPC for HIV/AIDS programs in the rest of the FICs. The Round 4 GFATM grant to PNG focused on community education and behavior change; management of STIs; reduction of discrimination and violence against people living with HIV; mobilisation and education of youth; scale-up of voluntary counseling and testing, treatment and care for people living with HIV; and prevention of mother-to-child transmission of HIV (GFATM, 2011c). However, the grant performance was generally inadequate, as the DOH had significant constraints to implement the project, including human resource issues, together with limited capacities in general program management, financial management, and monitoring and evaluation.
GFATM instrumental to countries progress against MDG 6.

60 50 40 US$M 30 20 10 0 TB Malaria 200 200 200 200 200 200 200 201 201 3 4 5 6 7 8 9 0 1 0.7 0.5 0.7 0.4 1.8 3.3 4.3 11.0 3.2 0.9 3.5 4.2 3.0 4.7 7.1 36.4 7.5 2.0 Figure 12. GFATM Disbursements to FICs, 2003-June 2011
HIV/AIDS 0.7 1.2 3.6 1.5 4.3 5.5 11.0 4.5 1.4
Source: GFATM (2011b)
Figure 13. Total GFATM Disbursements to FICs, 2003-June 2011
TB US$26m HIV/ AIDS US$34m Malaria US$69m
Source: GFATM (2011b)
Gender based violence major obstacle in combating HIV/AIDS in PNG.
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Gender inequality, particularly gender based violence (GBV) is one of the key factors driving the HIV/AIDS epidemic. Consequently, PNG (2010) reports that reversing the course of the epidemic will depend, to a significant degree, on the empowerment of women. GBV and related factors are also major contributors to the high level of maternal mortality and a major deterrent to the achievement of all MDGs in PNG. However, very little progress has been made to address GBV in the country. The Round 7 GFATM grant directed through SPC funded activities that strengthened human resources dedicated to HIV and other STIs; advocacy for legal reforms and the provision of legal advice to decision-makers; provision of test kits and drugs for STIs, including ARVs; campaigns aimed at increasing the availability of free condoms to key populations in all participating countries, as well as condom social marketing initiatives; and counselor training at the national level (GFATM, 2011d). Countries supported by this grant included Cook Islands, RMI, FSM, Kiribati, Nauru, Niue, Palau, Samoa, Tonga, Tuvalu and Vanuatu. Solomon Islands only received ARV treatment under this program. Total outlays so far to regional TB activities was US$26 million, of which US$11 million was granted to PNG and close to US$10 million was directed through SPC to the rest of the FICs . The Round 6 GFATM grant to expand and implement the Stop TB Program in PNG has generally performed adequately. However, the HIV/AIDS epidemic continues to be a major barrier. Built on the experiences and successes of the Round 2 GFATM grant, the main purpose for the Round 7 grant through SPC was to reach the goal of the Strategic Plan to Stop TB in the Western Pacific, which was to halve the prevalence and mortality from all forms of TB by 2010 relative to 2000, thereby contributing to the achievement of MDG 6 (GFATM, 2011a). The Round 7 Program focused efforts on sustaining and optimising quality DOTS and exceeding the Stop TB Partnership targets for case detection and treatment; ensuring equitable access to high-quality TB care for all people with TB; and adapting DOTS to respond to MDR-TB and TB/ HIV co-infection . Despite these efforts, SPC (2010f ) reported that the regional (excluding PNG) TB control targets were narrowly missed. Similarly, the target for the TB case detection rate, a measure of the effectiveness of TB programs, was also narrowly missed. However, SPC noted that the incidence of TB was trending downward and an acceleration of TB control programs was required across the region. Although much more work is needed to accelerate progress towards achieving MDG 6 by 2015, majority of the grants are in its final stages, particularly the multi-country funding (Figure 14). In addition, there are currently no GFATM grants in progress to combat HIV/AIDS in PNG, which is an area of concern given the epidemic there. Moreover, concerns over the $8.3 billion shortfall in pledges received in the 2010 Global Fund Replenishment (for 2011-2013) Meeting , as well as the freezing of funding by major donors following corruption allegations in early 2011 , could possibly have an impact on the regions Round 11 proposals. Given the costly nature of the programs needed to combat these diseases, FICs progress towards achieving MDG 6 will be critically dependent on the funding levels received in the years prior to 2015.
GFATM funds a range of HIV/AIDS activities in many island countries.
GFATM-funded TB regional project narrowly misses target on halving TB prevalence and mortality.
Continued support from GFATM is needed to accelerate progress towards MDG 6.
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NON-COMMUNICABLE DISEASES
In June 2011, through the Honiara Communiqu, Pacific Health Ministers declared that the region is facing a NCD crisis due to the rapid increase in the incidence and prevalence of NCDs. WHO & SPC (2011c) reported that of the estimated 63,900 adult deaths (from natural causes) that occurred in all PICTs in 2010, approximately 75 percent were attributable to NCDs. The Pacific also has the highest prevalence of obesity and diabetes in the world (Puloka, 2011). Most NCD-related deaths in the region are due to cardiovascular disease, followed by cancer (Puloka, 2011). Moreover, most island countries exhibit relatively high levels of tobacco use and alcohol consumption, poor diet practices and low levels of physical activity, the main factors that contribute to NCDs (Tables 18 & 19).
NCD crisis 3 in 4 deaths in the region attributable to NCDs. High risk factors observed.
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Table 18
Prevalence of Behavioural Risk Factors for NCDs

Daily Tobacco Use (%) Current Alcohol Use (%) Low Fruit & Vegetables (%) Low Physical Activity (%) Obesity (%)
Year Male Female Total Male Female Total Male Female MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 2003 2002 2004 2008 38 49 42 29 18 13 33 35 27 74 80 51 48 63 75 86 44 71 83 42 68 2002 2006 2002 2004 35 74 35 45 16 45 5 53 26 59 21 50 48 47 10 6 29 26 81 99 92 98 82 99 91 96 2002 2007 2006 28 60 44 6 27 17 16 44 31 13 52 2 15 7 34 99 93 99 94
Total Male Female Total Male Female Total 99 94 82 99 91 97 85 43 69 9 37 56 42 45 47 72 38 35 11 47 74 57 55 57 76 64 50 10 42 64 50 50 52 74 50 42 21 5 26 30 42 38 72 57 45 61 37 9 40 56 59 52 77 66 66 77 30 7 33 43 51 61 55 69
Crude Point Estimates for Population Aged 25-64
Table 19
Prevalence of Biochemical Risk Factors for NCDs

Year MELANESIA Fiji PNG Solomon Is Vanuatu MICRONESIA FSM Kiribati Marshall Is Nauru Palau POLYNESIA Cook Is Niue Samoa Tonga Tuvalu 2002 2004 27 20 23 21 17 22 19 22 18 36 32 34 2004 28 21 25 38 21 30 26 21 24 77 67 72 2002 2006 2002 2004 48 24 45 31 47 28 29 18 27 21 17 33 16 14 14 20 21 17 16 24 26 30 37 27 32 28 41 23 53 78 62 79 61 72 58 80 57 75 79 2002 2007 2006 20 29 47 25 21 10 11 22 7 11 22 9 11 15 15 14 12 23 14 14 28 48 15 44 22 46 High Cholesterol (%) Male Female Total Hypertension (%) Male Female Total Diabetes (%) Male Female Total High Risk of NCDs (%) Male Female Total
Crude Point Estimates for Population Aged 25-64 Source: PICT NCD Risk Factor STEPS Reports cited in SPC (2011c) Data not available.
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There is growing recognition and evidence that the socioeconomic impact of NCDs is a key barrier to the achievement of the MDGs (WHO, 2011b). Preventing NCDs is important for reducing poverty because it has an adverse impact on productivity, which could lead to lost employment. In addition, the high cost of treatment can also lower household incomes, as well as divert expenditure away from education, impacting the achievement of MDG 2. NCDs also have strong links with maternal and child health (WHO, 2011a). High blood pressure and diabetes increase the risk of complications in pregnancy, affecting maternal health. Smoking also has the potential to affect infant health mothers who smoke are likely to breastfeed for a shorter time and have less nutritious and lower quantities of milk. The growing burden of NCDs could also derail the fight against TB, as diabetes, smoking and harmful alcohol use has been associated with adult TB cases. The association between diabetes mellitus and TB is well documented in the Pacific, where it is now accepted that it is a significant risk factor for TB (SPC, 2010b). Although NCDs is not included under MDG 6, majority of FICs, in recognition of its importance, have included combating NCDs as an additional target. All countries in Micronesia and Polynesia, as well as Vanuatu, have localised MDG 6 to include NCDs. Except for Kiribati, Marshall Islands and Tuvalu, where NCDs are discussed generally in their national MDG Reports, Vanuatu, FSM, Palau, Cook Islands, Niue, Samoa and Tonga have indentified particular NCDs and risk factors to monitor progress on combating NCDs. Diabetes is targeted in all of these countries, with some countries including hypertension and/or cardiovascular disease. Niue also identified asthma and gout as one of its NCD indicators. Obesity is the common behavioural risk factor included for all the countries. In addition, Vanuatu developed specific targets against each of its indicators, while Tonga has a general target of reducing NCDs by 2 percent per year by 2015. Of the countries that included specific indicators, Niue reported that there was potential likelihood it would successfully combat NCDs; FSM, Samoa and Tonga reported being off-track; while Cook Islands and Palau were not sure. Although it is not clear from Vanuatus national MDG Report as to its progress towards combating NCDs, the reported figures for the stated targets have increased from 1998 to 2007. Consequently, Vanuatu could be considered off track to achieving its MDG targets on NCDs (see Box 14).
NCDs is a key barrier to achieving the MDGs
All FICs, except Fiji, PNG and Solomon Islands included NCDs as part of MDG 6.
Table 10
Combating NCDs
Melanesia Fiji PNG Solomon Is Vanuatu Micronesia FSM Kiribati Marshall Is Nauru Palau Polynesia Cook Is Niue Samoa Tonga Tuvalu Unsure* Potentially* Off track* Off track* Discussed; Not Assessed Off track* Discussed; Not Assessed Discussed; Not Assessed No MDG Report Uncertain* Target not included Target not included Target not included Off track
Note: *Assessment as reported by the country.
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Box 14.
Vanuatu: MDG Targets on NCDs

1998 Prevalence rate of diabetes, per 1,000 adult population Prevalence rate of high blood pressure Proportion of adult populations with NCD risk factors, smoking, males Proportion of adult populations with NCD risk factors, smoking, females Proportion of adult populations with NCD risk factors, alcohol use, males Proportion of adult populations with NCD risk factors, alcohol use, females Proportion of adult populations with NCD risk factors, obesity, males Proportion of adult populations with NCD risk factors, obesity, females Proportion of adult populations with NCD risk factors, physical inactivity, total Source: Vanuatu (2010) 3% 13% 49% 5% 50% 12% 19% 22% 2007 12% 15% 62% 6% 60% 11% 22% 29% 45% 2015 Target 10% 13% 30% 3% 25% 8% 20% 25% 25%
Even though Fiji did not localise NCDs into the achievement of MDG 6 in its latest national MDG Report, its government does recognise that addressing NCDs is important for Fiji to achieve the MDGs (Vuibau, 2011). For PNG and Solomon Islands, while there is evidence that NCDs are increasing, communicable diseases are the major health concerns. In 2007, a Pacific Framework for the Prevention and Control of NCDs was developed with a four-year comprehensive program of support, established in partnership with SPC, WHO and the 22 PICs, which was funded by Australia and New Zealand (WHO & SPC, 2011d). This collaborative effort, the 2-1-22 Pacific NCD Program (see Box 14) aims to reduce morbidity, disability and mortality due to NCDs and their risk factors, thus contributing to WHOs global goal of reducing death rates from chronic diseases by 2 percent a year until 2015 . The Program includes the preparation of national NCD plans and strategies and the integration of NCD policies on tobacco, nutrition, physical activity, alcohol, diabetes and cancer into national programmes. The Framework supports multi-sectoral approaches to addressing NCDs, given that contributing factors to the NCD problem fall outside the health sector and equally impact on the fight against NCDs. Since the program was established, some key highlights include (WHO & SPC, 2011d and SPC, 2010e): Annual Pacific NCDs Forum. 12 new national NCD plans developed. 15 national NCD coordinators appointed. 78 small grants for community projects to address key NCD risk factors. For example, Tobacco Control Summit (FSM), walking and fitness trails (Samoa), Go Local food security project (FSM), community gardening (Solomon Islands, Fiji, FSM), physical activity interventions (Niue, Nauru), tobacco legislation implementation (Cook Islands, Tuvalu).
NCDs affect PNG and Solomon Islands to a lesser extent, compared to other FICs.
2-1-22 Pacific NCD Framework aims to reduce the burden of NCDs.
Some progress but overall response to NCDs inadequate; calls for more concerted government leadership.
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Despite progress in the implementation of the 2-1-22 Framework, WHO & SPC (2011d) reported that the overall response was inadequate given the prevailing NCD burden, underpinned by the lack of bold, evidencebased multi-sectoral policies. This was a result of the absence of sustained and committed government leadership, as well as insufficient allocation of resources for NCD prevention by governments, coupled with weak health infrastructure systems. In addition, there was weak engagement from the communities in NCD programs. The 2-1-22 Framework is currently being reviewed and key lessons from the review will guide the next phase of support for NCD prevention and control. With the upcoming 2011 UN High Level Meeting on NCDs, Pacific Health Ministers through the Honiara Communiqu echoed other international calls to adopt a small number of global and publicly reported targets for NCDs that can be adapted to national context. In July 2011, the WHO Technical Working Group on NCDs Targets (WHO, 2011d) proposed several NCD targets and indicators, including a 25 percent reduction in premature mortality from NCDs and a 10 percent reduction in the prevalence of diabetes by 2025, with 2010 as a baseline. Interim targets are expected to be set for 2015 and 2020. This is an important development, especially if these targets are also included as part of the MDGs.
HEALTH FINANCING
WHO (2010) outlined three fundamental, interrelated problems that restrict countries from moving toward universal health coverage: availability of resources, inefficient and inequitable use of resources, as well as over-reliance on direct payments at the time people need health care. To this end, a few indicators are examined to assess the state of health financing in the region. However, more detailed research is needed in this area to make substantial conclusions. Government commitment to health can be gleaned from public outlays on health as a percentage of total government expenditure. Collectively, in 2010, 15 percent of government spending was towards the health sector . FSM recorded the highest spending on health, with 21 percent, almost double from 10 years ago (Figure 15). Public spending on health has increased steadily over the years, which is consistent with the high cost of health service delivery in FSM due to its dispersed population. Other notable increases in public health expenditure were recorded in Tuvalu, Kiribati, Vanuatu, Palau and Samoa. Incidentally, these countries are generally making good progress towards the health-related MDGs. Despite a slight reduction, public health expenditure in RMI and Solomon Islands is still comparatively high at 20 and 17 percent, respectively. Majority of FICs allocated more than 10 percent towards health except for PNG and Fiji, at 8 and 9 percent, respectively. Given PNGs poor performance on all the health-related MDGs, the low level of commitment and reduction of public health expenditure is an area of concern. Support from development partners to improve the health sectors in FICs is indicated by the external resources for health as a percentage of total health outlays (Figure 16). Generally, countries in Micronesia are heavily dependent on external resources for health expenditure, with external resources accounting for an average of 50 percent of total health
Three barriers to universal health coverage: Availability of resources; Inefficient use of resources; Reliance on direct payments.
Figure 15. Public Health Expenditure (% of Total Government Expenditure) Fiji PNG Solomon Islands Vanuatu FSM Kiribati Marshall Is Palau Samoa Tonga Tuvalu 0 5 10 15 20 2000 2010
25
Source: World Bank (2011)
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spending. COFA support to FSM, RMI and Palau, as well as Australias aid assistance to Kiribati is the major likely sources for health expenditure in these countries. Despite the high levels of public and external resources to health in FSM and RMI, they are each off track on one of the health-related MDGs . Therefore, in addition to geographical barriers, there could be areas of inefficiency and inequitable use of health resources. A significant increase in the external resources provided to the health sectors in the Solomon Islands and Vanuatu was also noted, which is a contributing factor to their progress on the MDGs. For PNG, around 20 percent of health spending in 2010 was from external resources, a decline from 24 percent recorded in 2000. Coupled with the reduction in public expenditure on health, as well as lack of new funds from the GFATM towards HIV/AIDS to address the epidemic, this is a major area of concern. Fiji has the lowest external resources for health, at 3 percent of total health expenditure in 2010, which declined from 7 percent in 2000. A likely reason could be the adverse impact of the ongoing political instability during this period. Universal health coverage is difficult to achieve if public financing is less than 5 percent of GDP (WHO, 2009). Higher government spending generally provides adequate public infrastructure and health service delivery at subsidised cost, which reduces the need to access private health services, where out-of-pocket (OOP) payments are usually required at the point of service delivery. Fiji, Vanuatu and PNG are the only countries where public health expenditure is less than 5 percent of GDP (Figure 17). These countries also have relatively high OOP payments (Figure 18). In Fiji, OOP payments have increased to 16 percent of total health expenditure, one of the highest in the region. OOP payments in Vanuatu and PNG are also relatively high at 12 and 9 percent, respectively. With the increase in public health expenditure (as a percentage of GDP) in Samoa and Tonga, a corresponding fall in OOP payments was recorded during the same time period. However, OOP payments as a percentage of total health spending in Tonga remain the highest in the region, at 18 percent. Generally, OOP payments in the region is relatively low by international standards, with global experience indicating that OOP higher than 30 percent of total health expenditure is a major obstacle to universal coverage (WHO, 2009). However, the current NCD crisis in the region, if not addressed urgently, could lead to more OOP payments on health care. Treatment for cardiovascular diseases and cancer, the major NCDs in the region, can be protracted and therefore extremely expensive. A likely reason for the relatively higher OOP payments in Tonga could be a result of the high burden of NCDs there. However, this observation needs to be substantiated by a more detailed study.
Figure 16. External Resources for Health (% of Total Expenditure on Health) Fiji PNG Solomon Islands Vanuatu FSM Kiribati Marshall Islands Palau Samoa Tonga Tuvalu 0 20 40 60 2000 2010
80
Figure 17. Public Health Expenditure (% of GDP) Fiji PNG Solomon Islands Vanuatu FSM Kiribati Marshall Islands Palau Samoa Tonga Tuvalu 0 5 10 15 20 25 2000 2010
NCD crisis could result in higher out-of-pocket spending by households for expensive treatment.
66
KEY CHALLENGES
In 1995, Ministers of Health for the Pacific island countries envisioned Healthy Islands, a unifying theme for health protection and health promotion in the Pacific, with three central themes: (i) (ii) (iii) The predominant and growing burden of NCDs. The lingering burden of infectious diseases and the dangers of their re-emergence. The need to support health systems to cope with the double burden of communicable and non-communicable diseases.
Healthy Islands vision to be revitalised.
Consistent with the overarching theme of Healthy Islands, the 2009 Madang Commitment addresses a broad spectrum of health issues from NCDs and communicable diseases to the need to strengthen health systems. However, there was also a call for the revitalisation of the Healthy Islands vision, with a focus on strengthening primary health care. WHO & SPC (2011b) reported that while there was significant progress in implementing the recommendations of the Madang Commitment, progress was not uniform across all countries, and highlighted several key challenges. Firstly, most countries faced the double burden of communicable and non-communicable disease. NCDs are the leading cause of death and morbidity, while HIV/AIDS, malaria and dengue continue to pose significant challenges to health. In addition, there is the ever-present threat of emerging infections, such as avian flu and pandemic influenza A (H1N1). Consequently, it was important to sustain policies and programmes to control and prevent communicable diseases, while efforts to address NCDs need to be scaled up. As most provincial and district health services still have a communicable-disease orientation, primary health care services desperately need to also focus on addressing NCDs. Secondly, health systems need to be strengthened. To this end, WHO proposed a framework of six building blocks to analyse health systems: service delivery; information; medical products and technology; human resources; health financing; and leadership. For effective results, these interactive building blocks must be considered in a holistic fashion. In addition, shortage of health workers is a chronic problem due to migration and fewer trained health workers. Strong leadership and political commitment, with the support of development partners was needed to overcome the health workforce challenges. Thirdly, as many of the underlying causes of disease are outside the control of health ministries, effective multi-sectoral partnerships are needed to address the relevant issues. This approach is particularly important given resource constraints (human, financial and infrastructural), and the weakness of the regulatory environment, especially of the private sector, which is needed to promote inter-sectoral engagement.
Address the double burden of disease; Scale up efforts to address the NCD crisis.
Strengthen health systems and improve health human resources.
Multi-sectoral approach needed.
Adverse impact of climate change on Pacific lives and health systems calls for better disaster risk management.
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Fourthly, the impact of climate change through adverse weather conditions, pose clear and imminent risks to the health of Pacific peoples, and in some cases, threaten the survival of entire island populations. The impact of climate change has the potential to overwhelm already frail health systems, highlighting the critical importance of disaster risk reduction and emergency preparedness and response systems. Finally, there is a need to strengthen development coordination. This is because there is a high degree of reliance on project-based health financing, which lacks long-term predictability and flexibility. Moreover, the number of agencies involved in public health has increased and so too the potential for duplication of effort. Mechanisms for aid effectiveness and sector coordination mechanism are in early stages of development.
Need to strengthen development coordination in the health sector.
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ANNEX 1 Statistical Notes
69
For data sourced from the United Nations Statistics Divisions MDGs Indicators Database (see UN, 2011), the nature of the data is as follows: Country Data: The figure is the one produced and disseminated by the country (including data adjusted by the country to meet international standards). Country Adjusted Data: The figure is the one produced and provided by the country, but adjusted by the international agency for international comparability to comply with internationally agreed standards, definitions and classifications. Estimated Data: The figure is estimated by the international agency, when corresponding country data on a specific year or set of years are not available, or when multiple sources exist, or there are issues of data quality. Estimates are based on national data, such as surveys or administrative records, or other sources but on the same variable being estimated. Modeled Data: The figure is by the agency when there is a complete lack of data on the variable being estimated. The model is based on a set of covariates other variables for which data are available and that can explain the phenomenon. The international agencies responsible for the particular MDG indicator are listed in Table A1.
MDG INDICATORS MDG 1 Indicators 1.1, 1.2, 1.3 1.4, 1.5, 1.6, 1.7 1.8, 1.9 MDG 2 Indicators 2.1, 2.2, 2.3 MDG 3 Indicators 3.1a, 3.1b, 3.1c 3.2 3.3 MDG 4 Indicators 4.1, 4.2, 4.3 MDG 5 Indicators 5.1, 5.2 5.3, 5.4 5.5 5.6 MDG 6 Indicators 6.1 6.2, 6.3, 6.4 6.5 6.6a, 6.6b, 6.7, 6.8 6.9a, 6.9b, 6.9c, 6.10a, 6.10b
RESPONSIBLE AGENCY World Bank ILO UNICEF UIS UIS ILO Inter-Parliamentary Union UNICEF UNICEF UN DESA WHO/UNICEF UNFPA/UN DESA UNAIDS UNICEF WHO WHO UNICEF WHO
MDG INDICATORS MDG 7 Indicators 7.1 7.2a, 7.2b, 7.3c 7.3 7.4 7.5 7.6 7.7 7.8 7.9 7.10 MDG 8 Indicators 8.5 8.12 8.14, 8.15, 8.16
RESPONSIBLE AGENCY FAO UNFCC UNEP FAO FAO/UN-Water UNEP-WCMC UNEP-WCMC UNICEF WHO UN-HABITAT OECD World Bank ITU
70
Cook Islands
7.1 7.2a 7.2b 7.2c 7.3 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%)
Earliest
Latest
Source
63.9 22.0 1.2 0.1 0.0 94.0 96.0 0.0
(1990) (1990) (1990)
66.5 70.0 3.6
(2005) (2008) (2008)
Estimated data cited in [7] Global monitoring data cited in [7] Global monitoring data cited in [7]
(1991)
0.0
(2009)
Country data cited in [7]
MDG 7
7.4 7.5 7.6 7.7 7.8 7.9 7.10
(1990)
0.1
(2010)
Estimated data cited in [7]
(1990) (1990) (2001)
98.0 100.0 0.0
(2008) (2008) (2008)
Estimated data cited in [7] Estimated data cited in [7] Office of the Prime Minister cited in [1]
8.1 8.2 8.3 8.4 8.5 8.6 8.7
OECD net ODA (% GNI) ODA to basic social services (%) ODA that is untied (%) ODA to landlocked developing countries Net ODA (% of GNI) Duty free exports to developed countries (%) Average tariffs by developed countries OECD agricultural support (% of GDP) ODA to build trade capacity (%) Countries reached HIPC points (no.)
n/a 19.0 67.6 n/a 21.0 n/a n/a 2.6 n/a (1999) * (2001) (2001) (1991) *
n/a 26.9 84.8 n/a 8.9 n/a n/a 10.0 n/a n/a (1991) (1990) (1990) (1990) * 100.0 34.3 33.9 25.4 (2008) (2008) (2008) (2008) ** MOH cited in *[2] & **[1] Telecom Cook Islands Limited cited in [7] Telecom Cook Islands Limited cited in [7] ITU estimate cited in [7] (2008) ** MFEM cited in *[2] & **[1] (2008) MFEM cited in [1] (2008) (2001) ** MFEM cited in [1] MFEM cited in *[2] & **[1]
MDG 8
8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16
Debt relief committed under HIPC and MDRI Initiatives n/a Debt service (% of exports) Population with access to essential drugs (%) Telephone lines per 100 population Cellular subscribers per 100 population Internet users per 100 population 100.0 16.8 0.0 0.0
On track Off track Mixed n/a [1] [2] [3] [4] [5] [6] [7] Data not available Indicator not applicable to country context Cook Islands, Office of the Prime Minister, National Millennium Development Goals Report, Cook Islands 2009. Available from http://www.stats.gov.ck. Cook Islands, Office of the Prime Minister, Millennium Development Goals National Report 2005. Available from http://www.stats.gov.ck. Lesley Clark and Charmaine Rodrigues, Utilising Temporary Special Measures to Promote Gender Balance in Pacific Legislatures: A Guide to Options. (Suva, Fiji: UNDP & PIFS, 2008). SPC, Demographic Profile of Cook Islands, 19962002. Available from http://www.stats.gov.ck. Cook Islands, Statistics Office, Cook Islands 2006 Census of Population and Housing: Analytical Report. Available from http://www.stats.gov.ck Secretariat of the Pacific, Cook Islands Population Profile Based on 1996 Census: A Guide for Planners and Policy-Makers. Available from http://www.stats.gov.ck. United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011).
71
Cook Islands
1.1 1.2 1.3 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%)
Earliest
Latest
Source
28.4 -1.3 62.9 2.0
(2006)
SPC from 2005-06 HIES
MDG 1
1.4 1.5 1.6 1.7 1.8 1.9
(2008) (2008)
[2] NSO cited in [1]
(2006)
2005-06 HIES cited in [1]
MDG 2
2.1 2.2 2.3
Net enrolment ratio in primary education (%) Reaches last grade in primary education (%) Literacy rates of 15-24 years old (%)
92.0 99.9 99.0
(2001) (1986) (2001) *
99.0 83.0 99.0
(2009) (2009) (2009e) **
MOE cited in [1] *NSO cited in [2], **MOE cited in [1] NSO cited in [1]
3.1a
Gender parity index in primary education Gender parity index in secondary education Gender parity index in tertiary education Women in the non-agricultural sector (%) Seats held by women in parliament (%)
98.0 112.0 86.0 46.0 6.0
(1991) (1990) (1990) (2001) (1991)
* *
96.0 102.0 100.0 55.0
(2009) (2009) (2001) (2006) (2011)
** **
MOE cited in *[2],**[1] MOE cited in *[2],**[1] MOE cited in [2] NSO cited in [1]
MDG 3
3.1b 3.1c 3.2 3.3
4.2
**
*[2], **PIFS extrapolated from [3]
MDG 4
4.1 4.2 4.3
Under 5 mortality (per 1,000 live births) Infant mortality (per 1,000 live births) Measles immunisation of 1 year old (%)
26.1 16.0 83.0
(1996-2002) * (1991-97) (2001) *
18.4 13.9 97.0
(2006) (2006) (2008)
** **
*[4], **[5] *[6], **[5] MOH cited in [1]
5.1 5.2
Maternal mortality (per 100,000 live births) Skilled birth attendance (%) Contraceptive prevalence rate (%) Adolescent birth rate (per 1,000 females) Antenatal care coverage, 1 visit (%) Unmet need for family planning (%)
485.4 98.0 47.2 33.0 100.0
(1991-2001) * (2001) (2001) (2001) (2001)
0.0 100.0 24.0 100.0
(2008) (2008)
**
MOH cited in *[2],**[1] MOH cited in [1] MOH cited in[1]
MDG 5
5.3 5.4 5.5 5.6
(2009) (2008)
MOH cited in [1] MOH cited in [1]
6.1 6.2 6.3 6.4 6.5 6.6a
HIV prevalence of 15-24 years old (%) Condom use at last high-risk sex (%) 15-24 years old awareness of HIV/AIDS (%) Orphans to non-orphans attending school Access to antiretroviral drugs (%) Malaria incidence rate (per 100,000) Malaria death rate (per 100,000) Under 5 sleeping under bed-nets (%) Under 5 treated with anti-malarial drugs (%) TB prevalence rates (per 100,000) TB death rates (per 100,000) TB incidence rates (per 100,000) TB detection rate under DOTS (%) TB cure rate under DOTS (%)
0.0 43.8 n/a n/a n/a n/a n/a n/a 5.9 5.3 32.0
(2001) (2001)
0.0 n/a n/a n/a n/a n/a n/a
(2008)
MOH cited in [1] MOH cited in [1]
MDG 6
6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a 6.10b
(1991) (1991)
* *
0.0 0.0 0.0
(2008) (2008) (2008) (2008)
** **
*WHO cited in [2], **MOH cited in [1] *WHO cited in [2], **MOH cited in [1] MOH cited in [1]
(1998)
0.0 n/a
**
*WHO cited in [2], **MOH cited in [1] MOH cited in [1]
72
Federated States of Micronesia

1.1 1.2 1.3 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%)
Earliest 27.9 9.8 43.6 13.3 11.2 (1989) (1998) * (1994) (1998) (1998)
Latest 31.4 9.3 8.5 0.4 58.6 15.0 13.1 (2005) (2005) ** (2005) (2005) (2005) (2009) (2000)
Source [1] [1] [1] [2] Census data cited in [2]
MDG 1
1.4 1.5 1.6 1.7 1.8 1.9
*National Nutrition Survey & **DHSA cited in [2] [1]
MDG 2
2.1 2.2 2.3
96.4 (1994)
96.0 95.1
(2009)
DOE cited in [2]
(2000)
Census data cited in [2]
3.1a
92.0 98.0 70.0 14.8 0.0
(1994) (1994) (1994) (1994) (1997)
* *
96.0 102 107.0 14.4 0.0
(2009) (2009) (2000) (2000) (2010)
** **
*Census data & **DOE cited in [2] *Census data & **DOE cited in [2] Census data cited in [2] Census data cited in [2] Country data cited in [3]
MDG 3
3.1b 3.1c 3.2 3.3
MDG 4
4.1 4.2 4.3
57.7 19.5 79.0
(1990) (1999) (1999)
38.5 13.0 91.0
(2009) (2009) (2009)
Estimated data cited in [3] DHSA cited in [2] DHSA (Family Health Unit) cited in [2]
5.1 5.2
224.0 93.0 45.0 90.0 9.7
(1994) (1998) (1990) (1990) (1999) *
0.0 90.0 40.0 41.5 34.7
(2009) (2008) (2009) (2008) (2009) **
DHSA cited in [2] FSM Statistical Yearbook 2008 cited in [2] DHSA cited in [2] *Census data & **DHSA cited in [2] DHSA (Family Health Unit) cited in [2]
MDG 5
5.3 5.4 5.5 5.6
6.1 6.2 6.3 6.4 6.5 6.6a
n/a 0.0 n/a n/a n/a n/a 13.0 105.0 100.0 (2000) (1992) (2000) * * * (1989)
0.0 n/a 100.0 n/a n/a n/a n/a 168.0 14.8 146.0 100.0 20.0
(2009)
[4]
(2009)
DHSA cited in [2]
MDG 6
6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a 6.10b
(2008) (2008) (2008) (2008) (2008) ** ** **
DHSA cited in [2] *WHO & **DHSA cited in [2] *WHO & **DHSA cited in [2] *WHO & **DHSA cited in [2] DHSA cited in [2]
73
Federated States of Micronesia

7.1 7.2a 7.2b 7.2c 7.3 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%)
Earliest 83.0 55.0 0.5 0.2 0.0 29.0 29.0 (1994) (1990) * (1986-87) (1999) (1999) (1999) (1991)
Latest 89.0 62.0 0.6 0.2 0.1 57.0 25.0 (2005) (2005) ** (2006-07) (2008) (2008) (2008) (2009)
Source US Department of Agriculture Forestry Service cited in [2] Global monitoring data cited in [3] Global monitoring data cited in [3] Global monitoring data cited in [3] Country data cited in [3]
MDG 7
7.4 7.5 7.6 7.7 7.8 7.9 7.10
*Census data & **2005 HIES cited in [2] Estimated data cited in [3]
8.1 8.2 8.3 8.4 8.5 8.6 8.7
OECD net ODA (% GNI) ODA to basic social services (%) ODA that is untied (%) ODA to landlocked developing countries Net ODA (% of GNI) Duty free exports to developed countries (%) Average tariffs by developed countries OECD agricultural support (% of GDP) ODA to build trade capacity (%) Countries reached HIPC points (no.) Debt relief committed under HIPC and MDRI Initiatives Debt service (% of exports) Population with access to essential drugs (%) Telephone lines per 100 population Cellular subscribers per 100 population Internet users per 100 population
n/a n/a 29.3 n/a n/a n/a n/a 5.8 2.5 0.0 0.0 (1990) (1990) (1990) (2006) (1993)
n/a 58.0 100.0 n/a 44.7 n/a n/a n/a n/a 7.2 7.9 30.8 14.5 (2008) (2008) (2008) FSM Telecommunication Corporation cited in [3] FSM Telecommunication Corporation cited in [3] ITU estimate cited in [3] (2010e) [5] (2009) Disbursement basis, OECD DAC country data cited in [3] (2004-08) (2009) FSM Statistical Yearbook 2008 cited in [2] US GAO for COFA funds cited in [2]
MDG 8
n/a [1] [2] [3] [4] [5]
8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16
On track Off track Mixed Data not available Indicator not applicable to country context FSM, Office of SBOC and UNDP Pacific Centre, Federated States of Micronesia: Analysis of the 2005 HIES. Available from http://www.undppc.org.fj. FSM, Office of SBOC, Millennium Development Goals and the Federated States of Micronesia, Status Report 2010 (forthcoming). United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). FSM, Department of Health & Social Affairs, UNGASS 2010 Country Progress Report: Federated States of Micronesia. Available from http://www.unaids.org. International Monetary Fund, "FSM: 2010 Article IV Consultation Staff Report", IMF Country Report No. 11/43. (Washington D.C.: IMF, 2011). Available from http://www.imf.org.
74
Fiji
1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 MDG 1 1.9 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%)
Earliest 35.0 8.2 56.0 6.9 6.8 (1993) (2002) * (1996) (2002) (2002)
Latest 31.0 9.3 50.3 39.0 7.0 7.5 (2005) (2008) (2008) ** (2007) (2008) (2008)
Source [1]
[1] [2] Country census data cited in [2]
Country household/labour force survey data cited in [2] *National Nutrition Survey cited in [2], **[3] [1]
2.1 2.2 MDG 2 2.3
92.0 91.4 97.5
(1990) (1995) (1986) * *
95.8 96.7 99.5
(2008) (2008) (2008) ** **
MOE cited in Fiji [4] MOE cited in *[5] & **[4] *NSO cited in [5], **MOE cited in [4]
3.1a 3.1b 3.1c 3.2 MDG 3 3.3
94.0 105.0 72.0 29.9 0.0
(1990) (1990) (1990) (1990) (1990)
* * * * *
99.0 107.0 120.0 29.6 n/a
(2008) (2008) (2005) (2005)
** ** ** ** **
*MOE cited in [5], **Country data cited in [2] *MOE cited in [5], **Country data cited in [2] *USP cited in [5], **Estimated data cited in [2] *Country & **estimated data cited in [2] *[5], **Parliament dissolved/suspended since 2007
4.1 4.2 MDG 4 4.3
27.8 16.8 86.0
(1990) (1990) (1991)
* * *
23.2 15.2 71.7
(2009) (2009) (2009)
** ** **
*MOH cited in [5], **[3] *MOH cited in [5], **[3] *MOH cited in [5], **[3]
5.1 5.2 5.3 5.4 5.5 MDG 5 5.6
60.4 98.0 31.0 58.6
(1995) (1990) (1990) (1990)
* * * *
27.5 99.8 28.9 29.9 100.0
(2009) (2009) (2009) (2004) (2008)
** ** ** **
*MOH cited in [5], **[3] *MOH cited in [5], **[3] *MOH cited in [5], **[3] *Country NSO data & **UNSD & WPP cited in [2] Country adjusted data, FPI+ cited in [2]
6.1 6.2 6.3 6.4 6.5 6.6a 6.6b 6.7 6.8 6.9a 6.9b 6.9c MDG 6
HIV prevalence of 15-24 years old (%) Condom use at last high-risk sex (%) 15-24 years old awareness of HIV/AIDS (%) Orphans to non-orphans attending school Access to antiretroviral drugs (%) Malaria incidence rate (per 100,000) Malaria death rate (per 100,000) Under 5 sleeping under bed-nets (%) Under 5 treated with anti-malarial drugs (%) TB prevalence rates (per 100,000) TB death rates (per 100,000) TB incidence rates (per 100,000)
0.0 n/a n/a n/a n/a 80.0 8.0 51.0 62.0 90.0
(1990)
0.1 96.3 n/a n/a n/a n/a
(2009)
(2009)
[6]
(1990) (1990) (1990) (1990) (1994)
26.0 2.0 19.0 91.0 90.0
(2009) (2009) (2009) (2009) (2008)
Estimated data cited in [2] Estimated data cited in [2] Estimated data cited in [2] Estimated data cited in [2] Country data cited in [2]
6.10a TB detection rate under DOTS (%) 6.10b TB cure rate under DOTS (%)
75
Fiji
7.1 7.2a 7.2b 7.2c 7.3 7.4 7.5 7.6 7.7 7.8 7.9 MDG 7 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%)
Earliest 53.6 818.0 1.1 0.3 41.8 0.3 0.2 92.0 92.0 (1990) (1990) (2000) (1990) (1990) (1990) (1990) (1990) (1990)
Latest 54.7 1254.0 1.5 0.3 7.6 0.2 93.0 96.0 (2000) (2000) (2010) (2005) (2008) (2008) (2008) (2009)
Source Country data cited in [2] Global monitoring data cited in [2] Global monitoring data cited in [2] Global monitoring data cited in [2] Country data cited in [2]
Estimated data cited in [2] Estimated data cited in [2]
8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 MDG 8 8.16
n/a n/a 3.8 n/a n/a n/a (1990)
n/a n/a 2.3 n/a n/a n/a n/a (1990) 1.7 (1990) (1990) (1990) * * * 15.3 71.1 12.2 (2008) (2008) (2008) ** ** ** *Telecom Fiji & **ITU estimate cited in [2] *Telecom Fiji & **Ministry of Information cited in [2] *Telecom Fiji & **ITU estimate cited in [2] (2009) Country adjusted data cited in [2] (2009) Disbursement basis, OECD DAC country data cited in [2]
On track Off track Mixed n/a [1] [2] [3] [4] [5] [6] + Data not available Indicator not applicable to country context Wadan Narsey, Toga Raikoti and Epeli Waqavonovono, Preliminary Report: Poverty and Household Incomes in Fiji in 2008-09 (based on the 2008-09 HIES). Available from http://www.statsfiji.gov.fj. United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). Fiji, Ministry of Health, Ministry of Health Annual Report 2009. Available from http://www.health.gov.fj. Fiji, Ministry of National Planning, Millennium Development Goals: 2nd Report, 1990-2009 Report for the Fiji Islands. Available from http://www.undp.org.fj. Fiji, National Planning Office, Ministry of Finance & National Planning, Millennium Development Goals Fiji National Report November 2004. Available from http://www.statsfiji.gov.fj. Fiji, UNGASS Country Progress Report 2010. Available from http://www.unaids.org. Family Planning International, A Measure of the Future: Womens Sexual and Reproductive Risk Index for the Pacific 2009. Available from http://www.fpi.org.nz.
76
Kiribati
1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 MDG 1 1.9 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%) 6.0
Earliest
Latest
Source
21.8 7.2 (1996) * 7.8 5.3
(2006) (2006) (2006) **
[1] [1] *SPC, **[1] [2]
(2006)
[1]
2.1 2.2 MDG 2 2.3
98.8 98.0 92.0
(1999) (1990) (2000) * *
99.5 79.1 96.0
(2002) (2004) (2005) ** **
Estimated data cited in [2] *NSO cited in [3], **SPC from NSO *SPC from NSO, **Census data cited in [4]
3.1a 3.1b 3.1c 3.2 MDG 3 3.3
101.0 119.0 120.0 36.8 0.0
(1999) (1999) (1995) (2000) (1990) *
104.0 111.0 100.0 38.5 6.5
(2008) (2008) (2000) (2005) (2010) **
Country data cited in [2] Country data cited in [2] USP data+ cited in [3] Country census data cited in [2] *Kiribati (2007), **PIFS extrapolated from [5]
4.1 4.2 MDG 4 4.3
69.0 65.0 75.0
(2005) (1990) (1990)
* *
72.0 46.0 82.0
(2009) (2009) (2009)
** **
*Census data cited in [4], **SPC from Draft 2009 DHS *Census data cited in [4], **SPC from Draft 2009 DHS Estimated data cited in [2]
5.1 5.2 5.3 5.4 5.5 MDG 5 5.6
110.0 60.0 39.0
(1991) (1988) *
215.0 79.8 22.3
(2004) (2009) (2009) (2009) (2009) (2009) ** **
MHMS cited in [4] *MHMS cited in [3], **SPC from Draft 2009 DHS SPC from Draft 2009 DHS *SPC, **SPC from Draft 2009 DHS SPC from Draft 2009 DHS SPC from Draft 2009 DHS
(2004-05)
51.0 71.0 28.0
6.1 6.2 6.3 6.4 6.5 6.6a 6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a MDG 6 6.10b
n/a n/a n/a n/a 1129.0 154.0 513.0 18.0 87.0 (1990) (1990) (1990) (1990) (1995)
n/a n/a n/a n/a 288.0 12.0 351.0 81.0 96.0 (2009) (2009) (2009) (2009) (2008) Estimated data cited in [2] Estimated data cited in [2] Estimated data cited in [2] Estimated data cited in [2] Country data cited in [2]
77
Kiribati
7.1 7.2a 7.2b 7.2c 7.3 7.4 7.5 7.6 7.7 7.8 7.9 MDG 7 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%) 3.0 22.0 0.3 0.2 0.0 0.3 35.1 24.4
Earliest
Latest
Source
(1990) (1990) (1990) (1990) (1991)
3.0 29.0 0.3 0.1 0.0
(2005) (2008) (2008) (2008) (2009)
Estimated data cited in [2] Global monitoring data cited in [2] Global monitoring data cited in [2] Global monitoring data cited in [2] Country data cited in [2]
(1990)
22.6
(2010)
(1990) (1990)
* *
90.0 35.1
(2009) (2009)
** **
*Census data cited in [3], **SPC from Draft 2009 DHS *Census data cited in [3], **SPC from Draft 2009 DHS
8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 MDG 8 8.16
n/a n/a 41.9 n/a n/a n/a n/a 1.7 0.0 0.0 (1990) (1990) (1990) (1990)
n/a n/a 15.5 n/a n/a n/a n/a 7.9 4.1 1.0 2.1 (2008) (2008) (2008) Telecom Services Kiribati Limited cited in [2] Telecom Services Kiribati Limited cited in [2] ITU estimate cited in [2] (2009) [6] (2009) Disbursement basis, OECD DAC country data cited in [2]
On track Off track Mixed n/a [1] [2] [3] [4] [5] [6] + Data not available Indicator not applicable to country context Kiribati, NSO and UNDP Pacific Centre, Kiribati Analysis of the 2006 HIES: A Report on the Estimation of Basic Needs Poverty Lines and the Incidence and Characteristics of Poverty in Kiribati. Available from http:// www.undppc.org.fj. United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). SPC, Pacific Islands Regional Millennium Development Goals Report 2004. Available from http://wwwx.spc.int/mdgs. Kiribati, Ministry of Finance & Economic Planning, Republic of Kiribati Millennium Development Goals Report 2007. Available from http://www.undp.org.fj. Lesley Clark and Charmaine Rodrigues, Utilising Temporary Special Measures to Promote Gender Balance in Pacific Legislatures: A Guide to Options. (Suva, Fiji: UNDP & PIFS, 2008). International Monetary Fund, "Kiribati: 2011 Article IV Consultation Staff Report", IMF Country Report No. 11/113. (Washington D.C.: IMF, 2011). Available from http://www.imf.org. In-country, for USP centres and satellite training.
78
Marshall Islands
Earliest 1.6 (1999)
Latest 3.3 (2002e)
Source
EPPSO cited in [1] [2]
29.0 26.7 19.0
(1997)
35.0
(2008)
EPPSO cited in [2]
(1999) (1991) *
13.0 (2007) **
Country census data cited in [3] *SPC & **2007 DHS cited in RMI [2]
2.1 2.2 MDG 2 2.3
86.5 42.4
(1988) (2002)
83.2 83.5 94.9
(2007) (2008) (2007)
**
*Census data & **2007 DHS cited in [2] Country data cited in [3] SPC from 2007 DHS
3.1a 3.1b 3.1c 3.2 MDG 3 3.3
98.0 107.0 90.0 33.2 3.0
(1999) (1999) (1996) (1988) (1990) *
99.0 105.0 103.0 35.9 3.0
(2009) (2009) (2008) (1999) (2011) **
Country data cited in [3] Country data cited in [3] CMI, MISGLB & USP data cited in [2] Census data cited in [2] *[2], **Country data cited in [3]
4.1 4.2 MDG 4 4.3
93.0 63.0 70.0
(1988) (1988) (1998)
* * *
46.0 34.0 78.1
(2009) (2009) (2009)
** ** **
*Census data cited in [2], **MOH cited in [4] *Census data cited in [2], **MOH cited in [4] *SPC cited in [2], **MOH cited in [4]
5.1 5.2 5.3 5.4 5.5 MDG 5 5.6
0.0 30.6 162.0
(1991)
324.2 94.1
(2009) (2007) (2007) (2007) (2007) (2007)
**
MOH cited in *[1] & **[4] 2007 DHS cited in [2]
(1995) (1988)
* *
44.6 138.0 81.2 8.1
** **
*SPC & **2007 DHS cited in [2] *Census data & **2007 DHS cited in [2] 2007 DHS cited in [3] 2007 DHS cited in [2]
6.1 6.2 6.3 6.4 6.5 6.6a 6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a MDG 6 6.10b
n/a n/a n/a n/a 753.0 112.0 302.0 18.0 25.0 (1990) (1990) (1990) (1991) (1995)
15.3 33.0 100.0 n/a n/a n/a n/a 231.0 8.3 207.0 110.0 97.0 (2009) (2009) (2009) (2009) (2008) Estimated data cited in [3] Estimated data cited in [3] Estimated data cited in [3] Estimated data cited in [3] Country data cited in [3] (2008) MOH cited in [2] (2007) (2007) 2007 DHS (average of men & women) cited in [3] 2007 DHS (average of men & women) cited in [3]
79
Marshall Islands
7.1 7.2a 7.2b 7.2c 7.3 7.4 7.5 7.6 7.7 7.8 7.9 MDG 7 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%)
Earliest 48.0 1.0 1.2 0.0 91.5 60.8 (1988) (1988) * * (1990) (1990) (1990) (1990)
Latest 99.0 1.6 0.2 0.6 97.9 70.8 (2007) (2007) ** ** (2010) (2009) (2008) (2008)
Source
Global monitoring data cited in [3] Global monitoring data cited in [3]
*Census data & **2007 DHS cited in [2] *Census data & **2007 DHS cited in [2]
8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 MDG 8 8.16
n/a n/a 45.8 n/a n/a n/a n/a 15.5 1.1 0.0 0.0 (1990) (1990) (1990) * (2004) (1998)
n/a n/a 32.1 n/a n/a n/a n/a 59.3 7.3 1.7 3.6 (2008) (2008) (2008) ** NTA cited in [3] NTA cited in [3] *NTA & **ITU estimate cited in [3] (2009e) [5] (2009) Disbursement basis, OECD DAC country data cited in [3]
On track Off track Mixed n/a [1] [2] [3] [4] [5] Data not available Indicator not applicable to country context SPC, Pacific Islands Regional Millennium Development Goals Report 2004. Available from http://wwwx.spc.int/mdgs. Republic of the Marshall Islands, Economic Policy, Planning & Statistics Office, Republic of the Marshall Islands Millennium Development Goals Progress Report 2009. Available from http://www.undp.org. fj. United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). World Health Organisation, Western Pacific Country Health Information Profiles: 2010 Revision. Available from http://www.wpro.who.int. International Monetary Fund, Republic of the Marshall Islands: 2009 Article IV ConsultationStaff Report, IMF Country Report No. 10/51. Available from http://www.imf.org.
80
Nauru
1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 MDG 1 1.9 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%) 83.9
Earliest 12.4 (2002) 4.8
Latest
Source
(2006)
SPC from 2006 HIES [2] SPC from census data
(2007)
SPC from 2007 DHS
2.1 2.2 MDG 2 2.3
75.1 25.4 99.0
(1992) (2001) (2002) *
88.1 96.0
(2007)
*Census data cited in [1], **SPC from 2007 DHS Country data cited in [2]
(2007)
**
SPC from *NSO & **2007 DHS
3.1a 3.1b 3.1c 3.2 MDG 3 3.3
103.0 75.0 60.0 42.0 5.6
(1992) (1992) (1995) (2002) (1990)
90.0 110.0 250.0 0.0
(2008) (2008) (2000)
** **
*Census data cited in [1], **SPC from NSO *Census data cited in [1], **SPC from NSO USP data+ cited in [1] SPC from census data
(2011)
4.1 4.2 MDG 4 4.3
10.4 19.0 99.0
(1991) (1995) (1997)
44.2 36.0 99.0
(2009) (2009) (2009)
Estimated data cited in [2] Estimated data cited in [2] Estimated data cited in [2]
5.1 5.2 5.3 5.4 MDG 5 5.5 5.6
93.0 (1997-02) *
97.4 35.6 69.0 94.6 23.5 (2007) (2007) (2007) (2007) (2007) ** 2007 DHS cited in [2] 2007 DHS cited in [2] *SPC, **SPC from 2007 DHS 2007 DHS cited in [2] SPC from 2007 DHS
6.1 6.2 6.3 6.4 6.5 6.6a 6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a MDG 6 6.10b
n/a n/a n/a n/a n/a n/a 105.0 6.2 85.0 90.0 83.0 (1990) (1990) (1990) (1990) (1998)
0.0 7.9 11.5 n/a n/a n/a n/a n/a n/a 54.0 2.0 1.8 420.0 100.0
(2009) (2007) (2007)
[3] 2007 DHS cited in [2] 2007 DHS (average of men & women) cited in [2]
(2009) (2009) (2009) (2008) (2008)
81
Nauru
7.1 7.2a 7.2b 7.2c 7.3 7.4 7.5 7.6 7.7 7.8 7.9 MDG 7 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%) 132.0 14.4 0.6 0.0 71.7 65.3
Earliest (1990) (1990) 143.0 14.1 (1995) 0.0 (1990) 0.0 (1992) (1990) 90.1 72.2
Latest
Source
(2008) (2008)
(2009)
(2010)
(2007) (2007)
*Census data cited in [1], **SPC from 2007 DHS *Census data cited in [1], **SPC from 2007 DHS
8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 MDG 8 8.16
n/a n/a 0.2 n/a n/a n/a n/a 13.1 0.0 0.0 (1990) (1990) (1990) (1990)
n/a n/a 24.1 n/a n/a n/a n/a 17.7 14.9 3.0 (2008) (2001) (2001) ITU estimate cited in [2] ITU estimate cited in [2] ITU estimate cited in [2] (2009) Disbursement basis, OECD DAC country data cited in [2]
On track Off track Mixed n/a [1] [2] [3] + Data not available Indicator not applicable to country context SPC, Pacific Islands Regional Millennium Development Goals Report 2004. Available from http://wwwx.spc.int/mdgs. United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). Nauru, UNGASS Taskforce, UNGASS Country Progress Report 2010: Nauru. Available from http://www.unaids.org. In-country, for USP centres and satellite training.
82
Niue
Basic needs poverty (%) 1.1 1.2 1.3 1.4 1.5 1.6 1.7 MDG 1 1.8 1.9 Net enrolment ratio in primary education (%) 2.1 MDG 2 2.2 2.3 Gender parity index in primary education 3.1a 3.1b 3.1c MDG 3 3.2 3.3 Under 5 mortality (per 1,000 live births) 4.1 MDG 4 4.2 4.3 Maternal mortality (per 100,000 live births) 5.1 5.2 5.3 5.4 MDG 5 5.5 5.6 HIV prevalence of 15-24 years old (%) 6.1 6.2 6.3 6.4 6.5 6.6a 6.6b 6.7 6.8 6.9a 6.9b 6.9c MDG 6 6.10a 6.10b Condom use at last high-risk sex (%) 15-24 years old awareness of HIV/AIDS (%) Orphans to non-orphans attending school Access to antiretroviral drugs (%) Malaria incidence rate (per 100,000) Malaria death rate (per 100,000) Under 5 sleeping under bed-nets (%) Under 5 treated with anti-malarial drugs (%) TB prevalence rates (per 100,000) TB death rates (per 100,000) TB incidence rates (per 100,000) TB detection rate under DOTS (%) TB cure rate under DOTS (%) 0.0 60.0 n/a n/a n/a n/a n/a n/a 147.0 22.0 59.0 0.0 100.0 Skilled birth attendance (%) Contraceptive prevalence rate (%) Adolescent birth rate (per 1,000 females) Antenatal care coverage, 1 visit (%) Unmet need for family planning (%) 0.0 99.0 35.9 35.0 Infant mortality (per 1,000 live births) Measles immunisation of 1 year old (%) 0.0 29.4 99.0 Gender parity index in secondary education Gender parity index in tertiary education Women in the non-agricultural sector (%) Seats held by women in parliament (%) 270.0 90.0 190.0 43.0 10.0 Reaches last grade in primary education (%) Literacy rates of 15-24 years old (%) 100.0 100.0 95.0 Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%) 13.0 0.0 6.6 0.0 0.0
Earliest (2002) (2002) (2002) 85.9 13.2 (2002) (2002)
Latest SPC from 2002 HIES NSO cited in [1] NSO cited in [1] [2] (2006) SPC from census data
Source
(2006)
SPC from census data NSO from MOH cited in [1] NSO cited in [1]
(1991) (1991) (1992)
100.0 100.0 100.0
(2006) (2006) (2006)
NSO from MOE cited in [1] NSO from MOE cited in [1] NSO from MOE cited in [1]
(1991) (1991) (1995) (1991) (1990) * *
110.0 80.0 200.0 76.0 15.0
(2006) (2006) (2002) (2006) (2011) ** **
NSO cited in [1] NSO cited in [1] *USP data+ cited in [2], **NSO cited in [1] Census data cited in [1] *Justice cited in [1], **PIFS extrapolated from [3]
(1991) (1997-2001) (1990)
0.0 7.8 99.0
(2006) (2001-06) (2009)
NSO cited in [1] [4] Estimated data cited in [5]
(1991) (1990) (1991) (1994)
0.0 99.0 22.6 52.6 100.0
(2006) (2009) (2001) (2004) (2008)
MOH cited in [1] Country adjusted data, Booth^ & FPI# cited in [5] MOH cited in [1] *Country data & **country adjusted data cited in [5] Country adjusted data, FPI# cited in [5]
(1991)
0.0
(2006)
MOH cited in [1]
(1991)
70.0 n/a n/a n/a n/a n/a n/a
(2006)
MOH cited in [1]
(1990) (1990) (1990) (1990) (1999)
0.0 0.0 0.0 88.0 100.0
(2009) (2009) (2008) (2002) (2002)
83
Niue
Proportion of land area covered by forest (%) 7.1 7.2a 7.2b 7.2c 7.3 7.4 7.5 7.6 7.7 7.8 MDG 7 7.9 7.10 OECD net ODA (% GNI) 8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 MDG 8 8.15 8.16 On track Off track Mixed n/a [1] [2] [3] [4] [5] + ^ # Data not available Indicator not applicable to country context ODA to basic social services (%) ODA that is untied (%) ODA to landlocked developing countries Net ODA (% of GNI) Duty free exports to developed countries (%) Average tariffs by developed countries OECD agricultural support (% of GDP) ODA to build trade capacity (%) Countries reached HIPC points (no.) Debt relief committed under HIPC and MDRI Initiatives Debt service (% of exports) Population with access to essential drugs (%) Telephone lines per 100 population Cellular subscribers per 100 population Internet users per 100 population n/a n/a 7.2 n/a n/a n/a n/a 100.0 18.1 0.0 0.0 CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%) 58.1 4.0 1.7 0.0 0.0 100.0 100.0 n/a
Earliest (2001) (1990) (1990) 54.2 4.0 2.6 (1991) 0.0 (1990) 1.9 (1990) (1990) 100.0 100.0 n/a
Latest (2006) (2008) (2008)
Source Environment Department cited in [1] Global monitoring data cited in [5] Global monitoring data cited in [5]
(2009)
(2010)
(2008) (2008)
n/a n/a (1990) 9.0 n/a n/a n/a n/a (1991) (1992) (1990) (1990) * 100.0 65.9 38.5 65.9 (2006) (2008) (2004) (2008) ** MOH cited in [1] *Posts and Telecom & **ITU estimate cited in [5] ITU estimate cited in [5] ITU estimate cited in [5] (2009) Disbursement basis, OECD DAC country data cited in [5]
Niue, Economics, Planning Development & Statistics Unit, Premiers Department, Niue Millennium Development Goals 2006 Report. Available from www.spc.int/prism/country/nu/stats. Lesley Clark and Charmaine Rodrigues, Utilising Temporary Special Measures to Promote Gender Balance in Pacific Legislatures: A Guide to Options. (Suva, Fiji: UNDP & PIFS, 2008). SPC, Pacific Islands Regional Millennium Development Goals Report 2004. Available from http://wwwx.spc.int/mdgs. Niue, National Planning & Development Office and SPC, Niue Population Profile based on 2006 Census of Population and Housing: a Guide for Planners and Policy-Makers. Available from www.spc.int/prism/ country/nu/stats. United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). In-country, for USP centres and satellite training. Family Planning International, A Measure of the Future: Womens Sexual and Reproductive Risk Index for the Pacific 2009. Available from http://www.fpi.org.nz. Booth, H., A Compilation of Data Relating to the Welfare of Children in the South Pacific and an Assessment of the Availability and Quality of Such Data. (n.p., 1983).
84
Palau
Earliest 24.9 6.6 10.2 0.0
Latest (2006) (2006) (2006) [1] [1] [1] [2]
Source
(2006)
[1]
2.1 2.2 MDG 2 2.3
81.8 99.0
(1990)
85.0 93.0
(2005) (2005) (2005)
**
*Census data cited in [2], **MOE cited in [3] MOE cited in [3] Office of Planning and Statistics cited in [3]
(2000)
99.7
3.1a 3.1b 3.1c 3.2 MDG 3 3.3
93.0 107.0 235.0 39.6 0.0
(1999) (1999) (2000) (1990) (1990)
103.0 98.0 204.0
(2007) (2007) (2002) (2000) (2011)
**
*Country & **estimated data cited in [4] *Country & **estimated data cited in [4] Estimated data cited in [4]
* *
39.6 6.9
** **
*Estimated data & **country census data cited in [4] *[3], **PIFS extrapolated from [5]
4.1 4.2 MDG 4 4.3
36.8 24.5 98.0
(1990) (1990) (1990)
25.6 22.0 75.0
(2009) (2009) (2009)
**
*MOH cited in [3], **MOH cited in [6] *MOH cited in [3], **MOH cited in [6] Estimated data cited in [4]
5.1 5.2 5.3 5.4 5.5 MDG 5 5.6
0.0 100.0 24.8
(1990) (1990) *
366.3 100.0 21.0
(2009) (2009) (2007) (2007) (2007) **
MOH cited in [6] MOH cited in *[3] and **[6] MOH cited in [3] MOH cited in [3] MOH cited in [3]
(2000)
17.7 100.0
6.1 6.2 6.3 6.4 6.5 6.6a 6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a MDG 6 6.10b
100.0 n/a n/a n/a n/a 224.0 8.2 64.0 90.0 64.0 (1990) (1990) (1990) (1991) (1994) (1995)
1.8 100.0 n/a n/a n/a n/a 83.0 3.0 65.0 140.0 60.0 (2009) (2009) (2009) (2009) (2006) Estimated data cited in [4] Estimated data cited in [4] Estimated data cited in [4] Estimated data cited in [4] Country data cited in [4] (2007) MOH cited in [3] (2003) Country survey+ data cited in [4]
85
Palau
7.1 7.2a 7.2b 7.2c 7.3 7.4 7.5 7.6 7.7 7.8 7.9 MDG 7 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%) 76.3 235.0 15.7 0.0 0.5 86.8 46.3
Earliest (1990) (1990) (1990) 80.5 213.0 10.4 (1991) 0.1 (1990) 4.8 (1990) (1990) 95.7 99.9
Latest (2005) (2008) (2008) PALARIS cited in [3]
Source
(2009)
(2010)
(2005) (2005)
Census data cited in [3] Census data cited in [3]
8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 MDG 8 8.16
n/a
n/a
65.0 n/a 0.0 0.0 n/a n/a n/a 4.2 35.1 12.4 6.1
(1995)
35.0 n/a
(2007)
US GAO & MOF cited in [3]
(1992)
18.3
(2009)
Disbursement basis, OECD DAC country data cited in [4]
(1995)
0.0 n/a n/a n/a
(2007)
COFA cited in [3]
(2000)
17.5
(2007)
Derived from IMF data cited in [3]
(2002) (2002) (2000)
36.1 59.9 5.7
(2008) (2008) (2007)
ITU estimate cited in [4] ITU estimate cited in [4] Office of Planning and Statistics/PNCC cited in [3]
On track Off track Mixed n/a [1] [2] [3] [4] [5] [6] + Data not available Indicator not applicable to country context Palau, Office of Planning & Statistics and UNDP Pacific Centre, Palau Analysis of the 2006 HIES. Available from http://www.undppc.org.fj. SPC, Pacific Islands Regional Millennium Development Goals Report 2004. Available from http://wwwx.spc.int/mdgs. Palau, MDG Task Force, Ministry of Finance, The Millennium Development Goals: Initial Status Report Republic of Palau, 2008. Available from http://planipolis.iiep.unesco.org. United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). Lesley Clark and Charmaine Rodrigues, Utilising Temporary Special Measures to Promote Gender Balance in Pacific Legislatures: A Guide to Options. (Suva, Fiji: UNDP & PIFS, 2008). World Health Organisation, Western Pacific Country Health Information Profiles: 2010 Revision. Available from http://www.wpro.who.int. 2003 Palau Population, Environment and Labor Force Survey
86
Papua New Guinea

1.1 1.2 1.3 1.4 MDG 1 1.5 1.6 1.7 1.8 1.9 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%)
Earliest 30.0 9.0 4.5 (1990e) (1990e) (1990e)
Latest 28.0 9.0 4.5 23.0 (2009e) (2009e) (2009e) (2009e)
Source Derived from survey+ & census^ data cited in [1] Derived from survey+ & census^ data cited in [1] Derived from survey+ & census^ data cited in [1] [2]
Derived from NHIS & survey data# cited in [1]
2.1 MDG 2 2.2 2.3
62.0 61.0 (1990e) (1990e)
53.0 59.0 63.0
(2007) (2009e) (2009e)
SPC from DOE Cohort retention rate derived from DOE data cited in [1] Derived from census^ data cited in [1]
3.1a 3.1b MDG 3 3.1c 3.2 3.3
85.0 62.0 55.0 20.3 0.0
(1991) (1991) (1999) (1990) (1990)
84.0 32.1 0.9
(2006)
Country data cited in [2] Country data cited in [2] Estimated data cited in [2]
(2000) (2011)
Country census data cited in [2] Country data cited in [2]
4.1 MDG 4 4.2 4.3
100.0 77.3 45.0
(1986-1996) (1986-1996) (1990e)
* *
70.0 53.0 62.0
(2009e) (2009e) (2009e)
** **
*SPC from 1996 DHS, **Derived from 2006 DHS cited in [1] *SPC from 1996 DHS, **Derived from 2006 DHS cited in [1] Derived from NHIS data cited in [1]
5.1 5.2 MDG 5 5.3 5.4 5.5 5.6
739.0 50.0 19.8 77.0 77.5 45.9
(1990e) (1990e) (1996) (1996) (1996) (1996)
711.0 52.0 24.1 65.0 78.0 29.8
(2009e) (2009e) (2006) (2006) (2006) (2006)
Derived from 2006 DHS cited in [1] Derived from 2006 DHS cited in [1] SPC from 1996 & 2006 DHS SPC from 1996 & 2006 DHS SPC from 1996 & 2006 DHS SPC from 1996 & 2006 DHS
6.1 6.2 6.3 6.4 6.5 6.6a MDG 6 6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a 6.10b
0.0 3.0 523.0 69.0 250.0 24.0 60.0
(1990)
0.9 42.3 21.9
(2009) (2006) (2008)
Estimated data cited in [2] 2006 DHS (average of men & women) cited in [2] [3]
(2004)
52.0 18012.0 36.0
(2009) (2008) (2008)
(1990) (1990) (1990) (1990) (1994)
337.0 26.0 250.0 73.0 64.0
(2009) (2009) (2009) (2009) (2008)
87
Papua New Guinea

7.1 7.2a 7.2b 7.2c 7.3 MDG 7 7.4 7.5 7.6 7.7 7.8 7.9 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%)
Earliest 69.6 2142.0 0.5 0.3 28.5 0.9 41.0 47.0 (1990) (1990) (1990) (1990) (1990) (1990) (1990) (1990)
Latest 65.0 2109.0 0.3 0.2 3.2 1.4 40.0 45.0 (2008) (2008) (2010) (2005) (2008) (2008) (2008) (2009)
Source Country data cited in [2] Global monitoring data cited in [2] Global monitoring data cited in [2] Global monitoring data cited in [2] Country data cited in [2]
8.1 8.2 8.3 8.4 8.5 8.6 8.7 MDG 8 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16
n/a n/a 13.3 n/a n/a n/a (1990)
n/a n/a 5.3 n/a n/a n/a n/a (1990) 1.8 (1990) (1990) (1990) 0.9 9.1 1.8 (2008) (2008) (2008) *Telikom PNG & **ITU estimate cited in [2] *Telikom PNG & **ITU estimate cited in [2] *Telikom PNG & **ITU estimate cited in [2] (2009) Country adjusted data cited in [2] (2009) Disbursement basis, OECD DAC country data cited in [2]
On track Off track Mixed n/a [1] [2] [3] + ^ # Data not available Indicator not applicable to country context Papua New Guinea, Ministry of National Planning and District Development, Millennium Development Goals National Progress Summary Report for Papua New Guinea 2009 (forthcoming). United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). Papua New Guinea, National AIDS Council Secretariat, UNGASS 2010 Country Progress Report Papua New Guinea. Available from http://www. unaids.org. 1996 HIES and 1996 & 2006 DHS. 2000 census. 2005 Micro Nutrients Survey.
88
Samoa
1.1 1.2 1.3 1.4 MDG 1 1.5 1.6 1.7 1.8 1.9 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%) 22.9 6.6 5.2 3.2 25.3 6.6 10.6
Earliest (2002) (2002) (2002) (1999) (2001) 26.9 8.2 4.3 4.7 30.0 (1990) (2002) 1.9 4.9
Latest (2008) (2008) (2008) (2009) (2009)
Source SPC from 2002 & 2008 HIES 2002 & 2008 HIES cited in [1] 2002 & 2008 HIES cited in [1] [2] [1]
(1999) (2008)
[1] 2002 & 2008 HIES cited in [1]
2.1 MDG 2 2.2 2.3
93.0 82.9 99.0
(1991) (2004) (1991)
96.0 83.3 99.5
(2009) (2010) (2009)
MESC cited in [1] MESC cited in [1] Country data cited in [2]
3.1a 3.1b MDG 3 3.1c 3.2 3.3
98.0 106.0 166.0 31.0 4.0
(1990) (1990) (1990) (1990) (1990) *
97.0 113.0 156.0 40.1 4.1
(2009) (2009) (2009) (2009) (2011) **
[1] [1] [1] [1] *[1], **PIFS extrapolated from [3]
4.1 MDG 4 4.2 4.3
42.0 33.0 89.0
(1991) (1991) (1991)
* * *
15.0 9.0 52.0
(2009) (2009) (2009)
** ** **
*Census data & **2009 DHS cited in [1] *Census data & **2009 DHS cited in [1] *Samoa (2004), **2009 DHS cited in [1]
5.1 5.2 MDG 5 5.3 5.4 5.5 5.6
74.0 76.0 18.0 26.0 55.0
(1990-94) (1991) (1991) (1992) (1991) * * * *
46.0 80.8 28.7 44.0 58.4 45.6
(2002-06) (2009) (2009) (2009) (2009) (2009) ** ** ** **
[1] *[1], **SPC from 2009 DHS *[1], **SPC from 2009 DHS *[1], **SPC from 2009 DHS *[1], **SPC from 2009 DHS SPC from 2009 DHS
6.1 6.2 6.3 6.4 6.5 6.6a MDG 6 6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a 6.10b
n/a n/a n/a n/a n/a 42.0 2.8 32.0 86.0 50.0 (1990) (1990) (1990) (1990) (1994)
14.7 8.9 n/a 88.9 n/a n/a n/a n/a 33.0 4.0 18.0 51.0 71.0 (2009) (2009) (2009) (2009) (2008) Estimated data cited in [2] Estimated data cited in [2] Estimated data cited in [2] Estimated data cited in [2] Country data cited in [2] (2010) [1] (2009) (2009) [1] 2009 DHS (average of men & women) cited in [2]
89
Samoa
7.1 7.2a 7.2b 7.2c 7.3 MDG 7 7.4 7.5 7.6 7.7 7.8 7.9 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%) 45.9 125.0 0.8 0.3 4.0 0.9 88.6 98.0
Earliest (1990) (1990) (1990) (1990) (1991) 60.4 161.0 0.9 0.2 0.2 (1990) 1.2 (2001) (1990) 97.3 100.0
Latest (2005) (2008) (2008) (2008) (2009) Country data cited in [2]
Source
Global monitoring data cited in [2] Global monitoring data cited in [2] Global monitoring data cited in [2] Country data cited in [2]
(2010)
(2006) (2008)
Census data cited in [1] Estimated data cited in [2]
8.1 8.2 8.3 8.4 8.5 8.6 8.7 MDG 8 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16
n/a n/a 28.9 n/a n/a n/a n/a 10.6 2.5 0.0 0.0 (1990) (1990) (1990) (1990) (1990)
n/a n/a 16.1 n/a n/a n/a n/a 4.6 16.1 69.3 5.0 (2008) (2008) (2008) *Country data+ & **ITU estimate cited in [2] *Country data+ & **ITU estimate cited in [2] *Country data+ & **ITU estimate cited in [2] (2009) Country adjusted data cited in [2] (2009) Disbursement basis, OECD DAC country data cited in [2]
On track Off track Mixed n/a [1] [2] [3] + Data not available Indicator not applicable to country context Samoa, National MDG Taskforce, Ministry of Finance, Millennium Development Goals: Second Progress Report 2010 (Samoa, 2010) United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). Lesley Clark and Charmaine Rodrigues, Utilising Temporary Special Measures to Promote Gender Balance in Pacific Legislatures: A Guide to Options. (Suva, Fiji: UNDP & PIFS, 2008). Samoa Communications Limited.
90
Solomon Islands
1.1 1.2 1.3 1.4 MDG 1 1.5 1.6 1.7 1.8 1.9 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%) ... 23.1
Earliest 22.7 7.5 6.7 (1999) 11.5 8.6
Latest (2006) (2006) (2006) SPC from 2006 HIES SPC from 2006 HIES SPC from 2006 HIES [2]
Source
Country census data cited in [1]
(2007) (2006)
SPC from 2007 DHS SPC from 2006 HIES
2.1 MDG 2 2.2 2.3
39.0 62.0
(1986)
97.2 67.1
(2010) (2004) (2007)
**
*NSO from census cited in [2], **SPC from DOE SPC from NSO
(1991)
83.4
**
*NSO cited in [2], **SPC from 2007 DHS
3.1a 3.1b MDG 3 3.1c 3.2 3.3
80.0 57.0 30.0 30.8 0.0
(1986) (1986) (1995) (1999) (1990)
* *
100.0 84.0 30.0 0.0
(2010) (2010) (2000)
** **
*NSO from census cited in [2], **SPC from DOE *NSO from census cited in [2], **SPC from DOE USP data+ cited in [2] Country census data cited in [1]
(2011)
4.1 MDG 4 4.2 4.3
38.2 31.0 70.0
(1990) (1990) (1990)
35.8 30.0 60.0
(2009) (2009) (2009)
5.1 5.2 MDG 5 5.3 5.4 5.5 5.6
130.0 85.0 6.8
(1990) (1999) (2001) * *
100.0 70.1 34.6 67.0 73.9 11.1
(2008) (2007) (2007) (2007) (2007) (2007) ** **
Modeled data cited in [1] Country adjusted data, *WHO & **2007 DHS cited in [1] *MOH cited in [2], **SPC from 2007 DHS SPC from 2007 DHS 2007 DHS cited in [1] 2007 DHS cited in [1]
6.1 6.2 6.3 6.4 6.5 6.6a MDG 6 6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a 6.10b
n/a 630.0 80.0 312.0 39.0 90.0 (1990) (1990) (1990) (1990) (1994)
0.0 21.1 32.2 n/a
(2008) (2007) (2007)
SGS cited in [3] 2007 DHS (average of men & women) cited in [1] 2007 DHS cited in [1]
(2008) 19.0 40.5 19.1 185.0 18.0 115.0 61.0 94.0 (2008) (2007) (2007) (2009) (2009) (2009) (2009) (2008)
Estimated data cited in [1] Estimated data cited in [1] 2007 DHS cited in [1] 2007 DHS cited in [1] Estimated data cited in [1] Estimated data cited in [1] Estimated data cited in [1] Estimated data cited in [1] Country data cited in [1]
91
Solomon Islands
7.1 7.2a 7.2b 7.2c 7.3 MDG 7 7.4 7.5 7.6 7.7 7.8 7.9 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%) 98.9 161.0 0.5 0.2 2.1 0.0 29.8 22.4
Earliest (1990) (1990) (1990) (1990) (1990) 77.6 198.0 0.4 0.2 1.6 (1990) 0.1 (1999) (1999) * * 84.2 17.6
Source
(2010)
(2007) (2007)
** **
*Census data cited in [2], **SPC from 2007 DHS *Census data cited in [2], **SPC from 2007 DHS
8.1 8.2 8.3 8.4 8.5 8.6 8.7 MDG 8 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16
n/a n/a 22.0 n/a n/a n/a n/a 11.3 1.5 0.0 0.0 (1990) (1990) (1990) * * (1990) (1990)
n/a n/a 42.8 n/a n/a n/a n/a 3.3 1.6 5.9 2.0 (2008) (2008) (2008) ** ** *Country data^ & **ITU estimate cited in [1] *Country data^ & **ITU estimate cited in [1] ITU estimate cited in [1] (2009) Country adjusted data cited in [1] (2009) Disbursement basis, OECD DAC country data cited in [1]
On track Off track Mixed n/a [1] [2] [3] + ^ Data not available Indicator not applicable to country context United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). SPC, Pacific Islands Regional Millennium Development Goals Report 2004. Available from http://wwwx.spc.int/mdgs. Solomon Islands, National AIDS Committee, UNGASS Country Progress Report 2010 Solomon Islands. Available from http://www.unaids.org. In-country, for USP centres and satellite training. Solomon Telekom Company Limited.
92
Tonga
1.1 1.2 1.3 1.4 MDG 1 1.5 1.6 1.7 1.8 1.9 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%) 16.2 7.7 9.4 6.0 53.1 57.0 1.6 1.7
Earliest (2001) (2001) (2001) (2004) (1990) 22.5 7.7 10.0 5.2 55.9 (1996) (1986) (2001) 2.0 2.0
Latest (2009) (2004) (2009) (2008) (2006)
Source NSO from 2009 HIES cited in [1] NSO from 2009 HIES cited in [1] NSO from 2009 HIES cited in [1] [2] NSO cited in [1]
Census data cited in [2] (1999) (2009) NSO from 2009 HIES cited in [1] NSO from 2009 HIES cited in [1]
2.1 MDG 2 2.2 2.3
91.6 84.0 98.8
(1990) (1996) (1990)
93.0 90.0 99.4
(2008) (2007) (2006)
MEWAC cited in [1] MEWAC cited in [1] MEWAC cited in [1]
3.1a 3.1b MDG 3 3.1c 3.2 3.3
87.0 97.0 67.0 33.7 3.0
(1997) (1995) (1995) (1986) (2005)
88.0 97.0 99.0 39.2 3.3
(2008) (2009) (2005) (2006) (2009)
MEWAC cited in [1] MEWAC cited in [1] MEWAC cited in [1] Census data cited in [1] Parliament Office cited in [1]
4.1 MDG 4 4.2 4.3
27.0 12.2 94.0
(1990) (1991) (1994)
26.0 16.4 99.6
(2008) (2008) (2007)
MOH cited in [1] MOH cited in [1] MOH cited in [1]
5.1 5.2 MDG 5 5.3 5.4 5.5 5.6
204.7 96.0 33.0 23.0 98.5
(1995) (1999) (1990) (1995) (2002)
76.1 98.0 27.0 19.6 98.0
(2008) (2007) (2008) (2008) (2008)
MOH cited in [1] MOH cited in [1] MOH, Reproductive Health Unit cited in [1] MOH, Reproductive Health Unit cited in [1] MOH, Reproductive Health Unit cited in [1]
6.1 6.2 6.3 6.4 6.5 6.6a MDG 6 6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a 6.10b
n/a n/a n/a n/a n/a 53.7 5.9 34.0 72.0 89.0 (1990) (1990) (1990) (1990) (1994)
21.1 36.4 n/a n/a n/a n/a n/a 34.0 2.7 23.0 33.0 100.0 (2009) (2009) (2009) (2009) (2008) MOH cited in [1] MOH cited in [1] Estimated data cited in [2] Estimated data cited in [2] Country data cited in [2] (2008) (2008) Youth SGS Survey & MOH cited in [1] Youth SGS Survey & MOH cited in [1]
93
Tonga
7.1 7.2a 7.2b 7.2c 7.3 MDG 7 7.4 7.5 7.6 7.7 7.8 7.9 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%) 5.5 77.0 0.8 0.3 0.4 2.2 0.1 91.5 55.0
Earliest (1990) (1990) (1990) (1990) (1991) 5.3 176.0 1.7 0.4 0.0 (1995) (1990) 2.2 9.4 (1990) (1986) 98.0 82.0
Latest (2008) (2008) (2008) (2008) (2009) MECC cited in [1]
Source
(2005) (2010)
MECC cited in [1] Estimated data cited in [1]
(2006) (2006)
Census data cited in [1] Census data cited in [1]
8.1 8.2 8.3 8.4 8.5 8.6 8.7 MDG 8 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 8.16
n/a n/a 25.5 n/a n/a 9.0 n/a n/a 3.5 4.6 0.0 0.0 (1990) (1990) (1990) * (1990) * (1995) (1990)
n/a n/a 12.4 n/a n/a 14.3 n/a n/a 15.0 95.0 24.7 48.7 8.1 (2009) (2002) (2008) (2008) (2008) ** ** *Country adjusted data cited in [2], **[3] MOH cited in [1] Country data+ cited in [2] ITU estimate cited in [2] ITU estimate cited in [2] (2005) MOFNP cited in [1] (2009) Disbursement basis, OECD DAC country data cited in [2]
On track Off track Mixed n/a [1] [2] [3] + Data not available Indicator not applicable to country context Tonga, Ministry of Finance and National Planning, 2nd National Millennium Development Goals Report Tonga: Status and Progress between 1990-2010. Available from http://www.undp.org.fj. United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). International Monetary Fund, "Tonga: 2011 Article IV Consultation Staff Report", IMF Country Report No. 11/110. (Washington D.C.: IMF, 2011). Available from http://www.imf.org. *Tonga Telecommunications Commission, **Tonga Communications Corporation Limited.
94
Tuvalu
1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 MDG 1 1.9 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%) 23.2 7.6 7.0 2.7 26.8 8.4 6.0
Earliest (1994) (1994) (1994) (1998) (1991) 19.7 6.2 8.1 -0.2 33.5 (1991) 19.2 1.6 (1994) 3.5
Latest (2010) (2010) (2010) (2007) (2004)
Source 1994 & 2010 HIES cited in [1] 1995 & 2010 HIES cited in [1] 1996 & 2010 HIES cited in [1] [2] 1991 census & 2004 HIES data cited in [1]
(2004) (2007) (2004)
1991 census & 2004 HIES data cited in [1] 2007 DHS cited in [1] 1994 & 2004 HIES cited in [1]
2.1 2.2 MDG 2 2.3
99.5 81.3 98.7
(1991) (1991) (1991)
98.1 91.2 98.6
(2007) (2007) (2007)
1991 census & 2007 DHS cited in [1] 1991 census & 2007 DHS cited in [1] 1991 census & 2007 DHS cited in [1]
3.1a 3.1b 3.1c 3.2 MDG 3 3.3
105.0 105.0 42.0 36.4 6.0
(1991) (1991) (1991) (1991) (1990)
* * *
96.0 112.0 172.0 36.0 0.0
(2009) (2009) (2009) (2007) (2011)
** ** **
*Census & **DOE cited in [1] *Census & **DOE cited in [1] *Census & **DOE cited in [1] 1991 census & 2007 DHS cited in [1] Parliament records cited in [1]
4.1 4.2 MDG 4 4.3
68.7 57.3 94.0
(1991) (1992) (1995)
24.6 14.8 90.0
(2009) (2009) (2008)
MOH cited in [1] MOH cited in [1] MOH cited in [1]
5.1 5.2 5.3 5.4 5.5 MDG 5 5.6
413.2 95.0 39.0 38.6
(1990) (1990) (1990) (1991) * * *
0.0 98.0 31.0 42.0 97.0 24.2
(2009) (2007) (2007) (2007) (2007) (2007) ** ** **
MOH cited in [1] *MOH cited in [2], **2007 DHS cited in [1] *MOH cited in [2], **2007 DHS cited in [1] *Census data cited in [1], **SPC from 2007 DHS 2007 DHS cited in [1] 2007 DHS cited in [1]
6.1 6.2 6.3 6.4 6.5 6.6a 6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a MDG 6 6.10b
n/a n/a n/a n/a n/a 327.0 12.0 296.0 87.0 100.0 (1990) (1990) (1990) (1990) (1994)
24.5 50.1 n/a 100.0 n/a n/a n/a n/a 194.0 7.1 155.0 120.0 78.0 (2009) (2009) (2009) (2009) (2008) Estimated data cited in [3] Estimated data cited in [3] Estimated data cited in [3] Estimated data cited in [3] Country data cited in [3] (2009) MOH cited in [1] (2007) (2007) 2007 DHS (average of men & women) cited in [1] 2007 DHS (average of men & women) cited in [1]
95
Tuvalu
7.1 7.2a 7.2b 7.2c 7.3 7.4 7.5 7.6 7.7 7.8 7.9 MDG 7 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%) 33.3 0.0 0.0 90.5 77.1 23.6
Earliest (1990) 33.3 (1991) 0.1 (1990) 0.2 (1991) (1991) (1991) 97.6 80.7 6.5
Latest (2005)
Source Estimated data cited in [3]
(2009)
(2009)
(2007) (2007) (2007)
1991 census & 2007 DHS cited in [1] 1991 census & 2007 DHS cited in [1] 1991 census & 2007 DHS cited in [1]
8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 MDG 8 8.16
n/a n/a 5.1 n/a n/a n/a n/a 14.1 1.4 0.0 0.0 (1990) (1990) (1990) (2006) (1990)
n/a 6.9 n/a 17.5 n/a n/a n/a n/a 39.4 15.2 20.2 43.0 (2008) (2008) (2008) *Country data+ & **ITU estimate cited in [3] ITU estimate cited in [3] ITU estimate cited in [3] (2010) Tuvalu (2011b) (2009) Disbursement basis, OECD DAC country data cited in [3] (2001-08) Aid Unit, Department of Planning & Budget cited in [1]
On track Off track Mixed n/a [1] [2] [3] + Data not available Indicator not applicable to country context Tuvalu, Department of Planning and Budget, Ministry of Finance and Economic Development, Tuvalu Millennium Development Goals Progress Report 2010/2011 (forthcoming). Tuvalu, Millennium Development Goals Report 2006. Available from http://planipolis.iiep. unesco.org. United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011). Tuvalu Telecommunications Corporation.
96
Vanuatu
1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 MDG 1 1.9 Basic needs poverty (%) Poverty gap ratio (%) Poorest quintile in national consumption (%) Growth rate of GDP per person employed (%) Employment-to-population ratio (%) Employed living below $1 (PPP) per day (%) Own-account and unpaid family workers (%) Underweight children under age 5 (%) Food poverty (%) 0.8 76.8 10.6 10.0
Earliest 15.9 5.6 7.4 (1995-99) (1999) 2.7 71.1 4.0 (1996) (1990-92) 11.7 7.0
Latest (2006) (2006) (2006) (2005-08) (2006) (2006)
Source NSO from 2006 HIES cited in [1] NSO from 2006 HIES cited in [1] NSO from 2006 HIES cited in [1] [2] NSO derived from 1999 Census & 2006 HIES cited in [1] NSO cited in [1]
(2007) (2004-06)
*National Nutrition Survey & **2007 MICS cited in [2] Estimated data cited in [2]
2.1 2.2 MDG 2 2.3
88.0 68.9 32.0
(1989) (1999) (1990)
86.0 71.5 92.0
(2008) (2008) (2009)
**
*NSO from census data & **MOE cited in [1] Country data cited in [2] NSO from MOE cited in [1]
3.1a 3.1b 3.1c 3.2 MDG 3 3.3
93.0 95.0 40.0 37.5 4.3
(2000) (2000) (1995) (2004) (1990)
91.0 102.0 85.0 38.9 3.8
(2009) (2009) (2008) (2008) (2011)
MOE cited in [1] MOE cited in [1] USP data cited in [1] Country administrative data cited in [2] Country data cited in [2]
4.1 4.2 MDG 4 4.3
40.1 33.0 66.0
(1990) (1990) (1990)
16.3 14.0 80.0
(2009) (2009) (2009)
Estimated data cited in [2] Estimated data cited in [2] WHO/UNICEF Joint Reporting Forms cited in [1]
5.1 5.2 5.3 5.4 5.5 MDG 5 5.6
96.0 79.0 15.0 92.0 24.0
(1998) (1990-95) * (1991) (1999) * *
86.0 74.0 38.0 64.0 84.0
(2007) (2007) (2007) (2009) (2007) ** ** **
MOH cited in [1] *MOH & **2007 MICS cited in [1] *MOH & **2007 MICS cited in [1] *NSO & **preliminary census data cited in [1] 2007 MICS cited in [1] MOH from National Family Planning Study cited in [1]
(1996)
6.1 6.2 6.3 6.4 6.5 6.6a 6.6b 6.7 6.8 6.9a 6.9b 6.9c 6.10a MDG 6 6.10b
n/a 19800.0 (1990) 22.0 13.0 n/a 176.0 11.0 139.0 67.0 100.0 (1990) (1990) (1990) (1990) (1994) (1990) (2002)
n/a 100.0 1600.0 0.9 81.0 n/a 110.0 10.0 72.0 78.0 93.0 (2009) (2009) (2009) (2009) (2007) Estimated data cited in [2] Estimated data cited in [2] Estimated data cited in [2] Estimated data cited in [2] Country data cited in [2] (2010) (2009) (2009) (2009) MOH cited in [1] MOH from Malaria Information System cited in [1] MOH from Malaria Information System cited in [1] MOH cited in [1]
97
Vanuatu
7.1 7.2a 7.2b 7.2c 7.3 7.4 7.5 7.6 7.7 7.8 7.9 MDG 7 7.10 Proportion of land area covered by forest (%) CO2 emissions, total (000 metric tons) CO2 emissions, per capita (metric tons) CO2 emissions, per $1 GDP (PPP) (kg) Use of ODS (ODP metric tons) Fish stocks within safe biological limits (%) Total water resources used (%) Protected terrestrial and marine areas (%) Species threatened with extinction (%) Using an improved drinking water source (%) Using an improved sanitation facility (%) Urban population living in slums (%) 36.1 70.0 0.5 0.1 0.0 0.4 68.0 28.0
Earliest (1990) (1990) (1990) (1990) (1991) 36.1 92.0 0.4 0.1 0.1 (1990) 0.5 (1989) (1989) 81.0 64.0 30.0
Source
(2010)
(2009) (2009) (2006)
NSO from census data cited in [1] NSO from census data cited in [1] NSO from 2006 HIES cited in [1]
8.1 8.2 8.3 8.4 8.5 8.6 8.7 8.8 8.9 8.10 8.11 8.12 8.13 8.14 8.15 MDG 8 8.16
n/a n/a 30.5 n/a n/a n/a n/a 7.3 1.7 0.0 0.0 (1990) (1990) (1990) * * (2000) (1990)
n/a n/a 16.5 n/a n/a 1.0 n/a n/a 9.8 4.5 15.4 7.3 (2008) (2008) (2008) ** ** *Telecom Vanuatu Limited & **ITU estimate cited in [2] *Telecom Vanuatu Limited & **ITU estimate cited in [2] ITU estimate cited in [2] (2009) Reserve Bank of Vanuatu cited in [1] (2010) Parliamentary Appropriations cited in [1] (2009) Disbursement basis, OECD DAC country data cited in [2]
On track Off track Mixed n/a [1] [2] Data not available Indicator not applicable to country context Vanuatu, Prime Ministers Office, Millennium Development Goals 2010 Report for Vanuatu. Available from http://www.undp.org.fj. United Nations Statistics Division, Millennium Development Goals Indicators Database. Available from http://mdgs.un.org/unsd/mdg (accessed 15 July 2011).

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