Our Generation's Choice

Oxfam Briefing Paper
94
Our
Generations
Choice
'Overcoming poverty is not a gesture of charity. It is an act of justice.'
Nelson Mandela,Trafalgar Square, 3 February 2005
On the eve of the G-20 Meeting of Finance Ministers and Central

Bank Governors in Melbourne, the worldwide movement of men,
women and children committed to eradicating extreme poverty
continues to gain momentum. While their efforts in recent years
have secured unprecedented action from world leaders, progress
towards the achievement of the Millennium Development Goals
continues to lag. Urgent action is now required at the G-20
meeting to get progress back on track.
Summary
Our generation faces a challenge. It is a challenge that arises from the actions
of human beings and can be overcome by the actions of human beings. It is
the challenge of extreme poverty in a world of plenty the kind of poverty
which causes the unnecessary deaths of millions of women, men and children
every year. It keeps children out of school, entrenches gender inequality, and
harms our shared environment.
In the lead up to the G-20 Meeting of Finance Ministers and Central Bank
Governors in Melbourne, this paper examines recent efforts to combat global
poverty. It considers how effective these efforts have been and analyses
some of the criticisms that have been made about them. Crucially, it looks to
the future, identifying urgent action required at the G-20 meeting and beyond.
The paper has a particular focus on the Millennium Development Goals
(MDGs) the eight, time-bound goals agreed by the international community
in 2000. While the goals have received some criticism, the paper concludes
that even the most meritorious criticisms provide no reason to abandon them;
rather they provide compelling reasons to build on the goals and improve their
effectiveness. Acknowledging accountability challenges, the paper highlights
the crucial role which citizens must play in holding their governments to
account for the achievement of the goals. The paper also examines the cost
of achieving the MDGs and finds that it is eminently affordable. Indeed, the
cost of failure would be far-reaching and should not be contemplated.
In recent years, as the global community has become increasingly aware of
extreme poverty and its devastating effects, the political will to combat such
poverty has grown significantly. A number of international meetings have
provided a focus for unprecedented civil society campaigns to pressure world
leaders to eradicate poverty. In particular, the G8 Summit at Gleneagles, the
2005 World Summit in New York, and the World Trade Organization (WTO)
Conference in Hong Kong each provided a pivotal opportunity for action. The
Live8 concerts, the marches, and the now iconic white band worn by millions
around the world, symbolised the birth of this movement, rather than its
climax.
The worldwide movement of men, women and children committed to
eradicating extreme poverty continues to grow and gain momentum. This was
demonstrated clearly when, in October 2006, more than 23 million people
from all over the world stood in unity to demand further action from world
leaders.
These demonstrations of public will have contributed to some important gains
most notably the debt relief deal and aid increase announced at Gleneagles.
But ultimately the potential of these three key opportunities to combat poverty
in 2005 was only partially fulfilled and the promises that were made may now
be dishonoured by complacent leaders. Deeply entrenched structures of
power and the self-interest of rich countries have proven formidable obstacles,
as illustrated by the recent stalling of the Doha round of trade negotiations.
On the eve of the G-20 meeting in Melbourne, this paper argues that urgent
action must be taken by the group to ensure the Millennium Development
Goals are achieved. Specifically, the group should:
1 Our Generations Choice, Oxfam Briefing Paper, November 2006

extend debt cancellation to countries which require it to meet the
Millennium Development Goals and, as a first step, commit to debt
cancellation for all countries which are eligible only for concessional loans
from the International Development Association of the World Bank;
agree to abandon the harmful conditions which have applied to previous

debt relief initiatives;
commit to new funding for debt cancellation rather than including this in
aid budgets, as has been common practice in recent years;
commit to increase aid to 0.7 per cent of national income by 2015, at the
latest, and provide detailed timetables for achieving this increase;
support national development strategies designed to achieve the

Millennium Development Goals and ensure that long-term, predictable
and flexible aid is provided to implement these strategies;
use the meeting as an opportunity to pressure the United States of

America (USA) and European Union (EU) to cut their most harmful
agricultural subsidies and give poorer countries better access to their
markets as a crucial step to getting the Doha round of trade negotiations
back on track; and
press towards true democratic reform of the World Bank and International
Monetary Fund so that poor countries can actively participate in decisions
regarding their development.
The paper presents a choice for the G-20 Finance Ministers and a choice for
the entire international community. But, most importantly, it presents a choice
for each and every one of us as citizens about the kind of world we want to
bequeath to our children.
Our Generations Choice, Oxfam Briefing Paper, November 2006 2

1 The choice
We have the cash, we have the drugs, we have the science - but do we
have the will? Bono1
Our generation faces a challenge. It is an enormous and complex
challenge, but it is by no means insurmountable. It is a challenge which
cuts to the heart of our humanity and raises uncomfortable questions
about our values. It is a challenge which will not fade with the passage
of time, but will continue to grow in the face of inaction. It is a
challenge which discriminates on the basis of colour, race and gender,
affecting certain groups more acutely than others yet it will
ultimately affect us all as it resonates throughout humanity. Most
fundamentally, it is a challenge that arises from the actions of human
beings and can be overcome by the actions of human beings.
It is the challenge of extreme poverty in a world of plenty; the kind of
poverty which causes the unnecessary deaths of millions of women,
men and children every year. It keeps children out of school,
entrenches gender inequality, and harms our shared environment.
In the next 24 hours:
30,000 children will die as a result of poverty;
1,400 women will die needlessly in pregnancy or childbirth;
100 million children, most of them girls, will not go to school;
around one billion people will not have access to safe drinking
water; and
8,000 people will die of HIV/AIDS.
The statistics are compelling and frequently cited by those seeking to
mobilise support for combating poverty. But statistics can also be
alienating. Although they depict the scale of the problem, they fail to
convey human impact. Untold human stories remain hidden behind
the staggering numbers. These figures represent the loss of mothers,
fathers, brothers, sisters, sons, daughters, friends, and colleagues.
Yet, within a generation, for the first time in history, every child in the
world could be in school. Every woman could give birth with the best
possible chance that neither she nor her baby would die. Everyone
could drink water without risking their lives. Millions of new health
workers and teachers could be saving lives and shaping minds.
We know how to get there: political leadership, government action,
and public services, supported by long-term flexible aid from rich
countries, and the cancellation of debt. We know the market alone

cannot do this. Civil society can pick up the pieces, but governments
must act. There is no short cut, and no other way.
And the stakes are high. On the line are the lives of millions of women,
men and children each with their own loved ones; each with their
own aspirations; each with their own story.
The question is: will we seize the opportunities outlined in this paper?
Will we build on the momentum of recent years rather than grow tired
and give up? Will we maintain pressure on governments, forcing them
to take action and refusing to hear excuses? Will we be relentless in our
pursuit of a fairer, more just, and more compassionate world? Will we
make poverty history?
The choice is ours.
The Millennium Development Goals the eight internationally-agreed
goals which aim to halve global poverty by 2015 are eminently
affordable. On the other hand, failing to meet the goals will come at a
high price. Yet, progress towards the goals is seriously lagging. Our
governments are relinquishing their commitment to 'spare no effort'2 to
overcome the injustice of extreme poverty. Unless rapid action is taken
we will not achieve the goals.
Significant increases in aid are desperately needed. But, in the end,
what is missing from the equation is determination, not dollars. If we
can successfully harness the global determination to overcome poverty,
the dollars will follow.
Ultimately, it is up to us to hold our governments accountable and
those of us living in democracies have a particular responsibility to do
so. We must use all the democratic processes and opportunities
available to keep our governments on track. The G-20 meeting this
November presents such an opportunity.
Too often, we have allowed the size and the complexity of the
challenge to become an excuse for inaction. In reality, the biggest
obstacle has been a lack of will. So, while overcoming extreme poverty
may well be our generations challenge, it is more importantly our
generations choice.

2 The chance: a moment of opportunity
for the G-20
The growing profile of the G-20

The Group of Twenty Finance Ministers and Central Bank Governors
(the G-20) was established in 1999 in the wake of the Asian economic
crisis. It has a mandate to facilitate:
'dialogue on key economic and financial policy issues among

systemically significant economies and promote cooperation to achieve
stable and sustainable world economic growth that benefits all.'3
The G-20, representing around two-thirds of the worlds population
and 85 per cent of its gross domestic product, is more geographically
and economically diverse than the older and more prestigious Group
of Seven (G-7). Significantly, its membership includes a range of
emerging economies, such as China, India and Brazil,4 bringing the
worlds richest countries together with countries in which extreme
poverty persists.
The G-20 meets annually and its agenda is determined by a rotating
leadership troika comprising the past, immediate, and elect chairs of
the group. Statements and recommendations are determined by
consensus and there are no formal votes. The general practice has been
for the group to issue a communiqu following each meeting, outlining
what it has discussed. It is unusual for country representatives to
commit to formal agreements, nevertheless this is not unprecedented.
For example, the group agreed to an Action Plan on Terrorist
Financing in 2001, whereby all G-20 members committed to ratify and
implement international agreements, freeze the assets of terrorists
within their jurisdictions and make public the lists of terrorists whose
assets are subject to freezing.5
There are growing arguments in favour of boosting the profile and
status of the G-20 because of its broad and diverse membership, while
some have argued that the group is well-placed to eventually replace
the G-7.6 Not surprisingly, member countries which do not belong to
the G-7 are among the strong proponents of the G-20s superiority.7
To date, combating poverty has not been a focus for the G-20.
However, in recent years, the group has acknowledged its
responsibility to provide leadership on international development
issues. It has made a firm commitment to achieving the MDGs
through intensified cooperation aimed at overcoming severe

challenges and has expressed its determination to carry the
momentum forward.8
A timely opportunity
The G-20 will meet in Melbourne on 18 and 19 November 2006. The
work program for the meeting lists five key issues for discussion:
reform of the World Bank and International Monetary Fund; energy
and resource commodities; demographic change; domestic economic
policies and principles; and aid effectiveness.
Clearly, a number of these issues are directly relevant to combating
poverty particularly ensuring that aid is used effectively to improve
the lives and livelihoods of poor people. Yet, while discussion of these
issues is vital, civil society groups have argued that a range of issues
are missing from the G-20s agenda for example, the need to extend
debt cancellation to countries which require it to meet the Millennium
Development Goals.
Australia this years chair has given little indication that it intends
to make combating poverty a central focus despite its strong interest in
promoting the G-20 as the premiere forum for shaping global economic
policies. In fact, Australian Treasurer, Peter Costello, omitted any
reference to development in a recent statement of his priorities for the
meeting.9 This is surprising given the timing of the meeting and the
opportunity it presents for Australia to become more centrally
involved in international efforts to combat poverty.
Put simply, the Australian Government seems to have failed to grasp
the urgency of the moment. But it is not too late to act. The G-20 has
the potential to play a decisive role in ensuring the achievement of the
Millennium Development Goals but it must act now.

3 The cost
The Millennium Development Goals

In September 2000, at the United Nations Millennium Summit, the
largest gathering of world leaders in history committed to a set of eight
time-bound goals to combat global poverty. These goals known as
the Millennium Development Goals (MDGs) are 'the most broadly
supported, comprehensive, and specific poverty reduction targets the
world has ever established'.10 They have been characterised as:
'a blueprint agreed by all the worlds countries and all the worlds
leading development institutions a set of simple but powerful
objectives that every man and woman in the street, from New York to
Nairobi to New Delhi, can easily support and understand.'11
Box 1: the Millennium Development Goals
Goal 1: reduce extreme poverty and hunger by half
Goal 2: achieve universal primary education
Goal 3: promote gender equality and empower women
Goal 4: reduce child mortality by two-thirds for children under five
Goal 5: reduce maternal mortality by three-quarters
Goal 6: halt and reverse the spread of HIV and AIDS, malaria and other
major diseases
Goal 7: ensure environmental sustainability
Goal 8: develop a global partnership for development
Already, significant progress has been made towards the achievement

of the MDGs. If there is any cause for hope, it is the progress made in
the past 15 years in getting young children into school. Almost every

region has increased primary school enrolments, particularly Latin
America, the Caribbean, and North Africa.12 Enrolments in sub-
Saharan Africa have grown quickly too. Even some of Africas poorest
countries Eritrea, Guinea, Malawi and Chad have increased
primary enrolments by more than 50 per cent, albeit from a low base.13
In addition, the Millennium Project outlines that:
'Between 1990 and 2002, average overall incomes increased by
approximately 21 per cent. The number of people in extreme poverty
declined by an estimated 130 million. Child mortality rates fell from
103 deaths per 1,000 live births a year to 88. Life expectancy rose from
63 years to nearly 65 years. An additional 8 per cent of the developing
worlds people received access to water. And an additional 15 per cent
acquired access to improved sanitation services.'14
Addressing criticisms of the MDGs

Despite progress towards the MDGs, the goals have not been immune
to criticism.
Lack of accountability
One of the major criticisms has been that there is a lack of
accountability for the achievement of the goals or, more specifically,
that 'nobody is individually responsible for doing anything for any one
result'.15 Naturally, there will be accountability challenges associated
with any long-term, global plan. Heads of state will change during the
life of the MDGs; humanitarian emergencies will demand immediate
assistance; and creative strategies will be essential if communities are
to hold their governments accountable over an extended period of
time.
Yet, if we recognise that the accountability challenges associated with
the MDGs arise primarily because they represent a long-term, global
plan, we must ask ourselves what the alternative is. Not to have a plan
at all? Or to focus solely on local or short-term initiatives? This would
do little to change the unfair trade rules which help to entrench
poverty in many communities. Neither would it address the issue of
climate change and its disproportionate impact on the worlds poorest
communities.
Despite the many challenges associated with co-ordinating
international action, it is clear that extreme poverty can only be
eradicated through a sustained and concerted effort on the part of all
members of the international community. The MDGs are based on the
recognition that extreme poverty is a global issue with global causes
and global implications. It is precisely for this reason that combating

poverty requires a global strategy. This strategy must, of course, be
applied locally and long-term plans must be broken down into short-
term initiatives. This is already being done by many countries, as
outlined in their Poverty Reduction Strategy Papers. For example,
Bangladesh has embarked on a number of initiatives aimed at meeting
the MDGs, including a five-year school lunch program to encourage
school attendance, combat hunger and improve nutrition.16
Despite the criticisms, the MDGs have succeeded in eliciting a greater
level of accountability than previously existed. Some developed
countries have incorporated the MDGs into their aid programs,
reporting progress against them annually,17 while developing countries
are incorporating them into their poverty reduction strategies.18 In
addition, governments and other agencies are increasingly exploring
strategies to provide opportunities for people living in poverty to hold
donors and governments to account.19 Moreover, the process of
compiling the United Nations annual report on the MDGs has
highlighted the need for improved data collection and reporting
demonstrating the intractable link between accountability and accurate
monitoring processes.
While the goals may not expressly confer any responsibility for their
achievement, they were agreed to by world leaders, acting on behalf of
their nations. As such, it is national governments which have the
responsibility to ensure the goals are achieved. It is for this reason that
the goals have been interpreted as country goals indeed, 'this is the
spirit in which they are pursued the world over'.20
If national leaders are responsible for achieving the MDGs, citizens
need to hold them accountable. Of course, strong democratic processes
are essential to such accountability and, for this reason, countries
lacking such processes present a particular challenge. Yet, the millions
of citizens around the world who live in democracies have the power,
the opportunity and the responsibility to ensure their representatives
pursue the MDGs relentlessly. This is already occurring in some
countries. For example, Oxfam has successfully supported citizen
groups in Uganda to hold their governments accountable for the
appropriate expenditure of debt relief. Local citizens established
Poverty Monitoring Committees to help ensure debt relief was paid
into local schools and health clinics.
Recognising the vital role which civil society must play if the MDGs
are to be achieved, the United Nations has established and funded the
Millennium Campaign with the objective of informing, inspiring and
encouraging peoples involvement and action for the realisation of the
MDGs, and supporting citizens efforts to hold their government to
account.21

Limited scope of MDGs
Perhaps the most compelling criticism of the MDGs is that they do not
go far enough. The objective of goal one is not to make poverty
history but to halve the number of people living in extreme poverty
and suffering from hunger. In addition, many of the MDGs represent
setbacks on earlier international commitments for example, the
gender equality MDG is a setback on commitments made by
governments at the UN Conference on Women in Beijing.22 Perhaps
the limited scope of the MDGs reflects the manifest lack of consultation
with civil society during the development of the goals.23
Accepting that the MDGs do not go far enough provides a compelling
reason to ensure they are achieved on time, so that further work can
continue. Conversely, if we acknowledge they are simply the first step
towards eradicating extreme poverty, failing to achieve them will be
unforgivable.
It is therefore clear that the two most meritorious criticisms considered
here provide no reason to discard the MDGs rather they provide
grounds for building on and improving the effectiveness of the MDGs.
The cost of meeting the MDGs

Various estimates have been made regarding the cost of meeting
individual MDGs and their associated targets. For example, it is
estimated that halving the number of people without access to clean
water which is part of goal seven would cost $4 billion a year for
ten years, which is comparable to a months spending on bottled
mineral water in Europe and the USA.24 Oxfam has calculated that
meeting the targets on health, education, and water and sanitation
would require an extra $47 billion a year, which can be compared with
global military spending of $1 trillion a year, or the $40 billion spent on
pet food each year.25
The most comprehensive analysis of the likely cost of meeting the
MDGs was conducted by the Millennium Project and published last
year.26 Researchers found that the total cost of meeting the MDG
financing gap for every low-income country would be $73 billion this
year, rising to $135 billion in 2015.27 In addition, middle-income
countries will require around $10 billion to meet the MDGs.28
However, during this time, a number of countries will graduate from
the need for aid to achieve the MDGs. On top of direct investment in
the goals, there will be additional costs associated with 'capacity-
building expenditures of bilateral and multilateral agencies, outlays for
science and technology, enhanced debt relief, and other areas'.29

On this basis, it is estimated that the total cost of meeting the MDGs in
all countries will be around $121 billion in 2006, rising to $189 billion in
2015.30 This estimate assumes that the poorest countries will require
100 per cent cancellation of their debts to achieve the MDGs. It also
includes funding for regional co-operation and infrastructure, global
research, implementing international environmental agreements and
financing international organisations, such as the United Nations.
The Millennium Project estimates that the amount of official
development assistance required to meet the MDGs is around $135
billion this year, rising to $195 billion in 2015.31 This equates to 0.54 per
cent of donors GNI by 2015. However, these estimates exclude aid
which is not directly targeted at meeting the MDGs for example,
infrastructure and governance initiatives therefore donor countries
will need to commit to reaching 0.7 per cent of GNI by 2015 if the
MDGs are to be achieved.32
While this cost is 'utterly affordable',33 a number of rich countries are
seriously lagging on their aid commitments and have not provided
timetables to meet the 0.7 per cent target. Achieving the MDGs will
require donor countries to meet this target.
Making aid effective

Investing in essential services
All the money in the world will not be enough to achieve the MDGs if
it is not spent effectively aid must be properly targeted.
Oxfam has found through experience and research that developing
country governments must take responsibility for providing essential
services such as health care, education, water and sanitation in order to
achieve the MDGs. While civil society organisations and private
companies can make important contributions, they must be properly
regulated and incorporated into strong public systems, and not seen as
substitutes for them. Only governments can reach the scale necessary
to provide universal access to services that are free or heavily
subsidised for poor people and geared to the needs of all citizens.
When governments invest in essential services, progress is made
against the MDGs; when they fail to do so, progress lags and, in some
cases, can be undone. For example, in one district of Nigeria the
numbers of women dying in childbirth doubled after fees for maternal
health services were introduced.34
By contrast, in Sri Lanka where more than one-third of the population
lives below the poverty line, maternal mortality rates are among the
lowest in the world. When a Sri Lankan woman gives birth, there is a

96 per cent chance she will be attended by a qualified midwife. If she
or her family need medical treatment, it is available free of charge from
a public clinic within walking distance of her home, which is staffed by
a qualified nurse. Her children can go to primary school for free, and
education for girls is free up to university level. This has resulted in a
literacy rate of 88 per cent among adult women and an increase in the
average age of marriage.35 Other success stories include Uganda,
which has doubled the number of children in school, and Brazil, which
has halved AIDS deaths and decreased the hospitalisation rate by 75
per cent.
Sadly, there is still an enormous way to go if developing countries are
to ensure universal access to quality essential services. Children still
have to pay to go to school in 89 of the 103 developing countries,
meaning that many poor children are forced to drop out of education.
Most of them are girls. The public services that do exist are kept afloat
by a skeleton staff of poorly paid, overworked, and undervalued
teachers and health workers. Teachers salaries in the least developed
countries have halved since 1970. Oxfam estimates that to provide
basic health care and education for all, the world needs 4.25 million
more health workers and 1.9 million more trained teachers.
Faced with failing government services, many have looked to the
private sector for answers. Sometimes this has worked. Countries such
as South Korea and Chile have achieved impressive welfare gains with
high levels of private investment in service delivery. But often these
services are prone to high inequalities and high costs, frequently
excluding the poorest and most vulnerable communities. For example,
when China phased out free public health care in favour of profit-
making hospitals and health insurance, household health costs rose
forty-fold and progress on tackling infant mortality slowed. Services
that were once free are now paid for through health insurance, which
covers only one in five people in rural China.36
Rather than helping developing countries provide essential services to
their populations, rich countries and international institutions such as
the World Bank have often exacerbated the situation. Because donor
aid is the equivalent to half the national budget in some of the poorest
countries, donors can wield enormous influence over developing
country governments. Too often they have used this influence to push
private sector solutions to public service failures. A recent study of 20
countries receiving World Bank and IMF loans found that privatisation
was a condition of 18 of those loans.37
What poor country governments need is aid that is well co-ordinated,
predictable, and channelled through public systems and national
budgets. What poor countries typically get is insufficient, unpredictable

aid, disbursed through a jumble of different projects that directly
compete with public services for staff and scarce resources. As much as
70 per cent of aid for education globally is spent on technical
assistance, much of it to highly paid Western consultants. A study of
technical assistance in Mozambique found that rich countries were
spending $350 million per year on technical experts, while the entire
wage bill for the public sector was just $74 million.38
In addition, rich countries are aggravating skills shortages in
developing countries by recruiting thousands of their workers. For
example, of the 489 nursing students who graduated from the Ghana
Medical School between 1986 and 1995, 61 per cent have left the
country, with more than half going to the UK and one-third to the
USA.39
If developing countries are going to make significant progress in the
provision of essential services, they need to make sustained
investments in health care, education, water and sanitation. They must
particularly focus on preventative reproductive health policies and
actively combat the HIV and AIDS pandemic. Fees for basic education
and health care must be abolished. However, developing country
governments will only be able to do this if rich countries meet their
commitment to contribute 0.7 per cent of their income to aid. This aid
must be long-term and predictable, and supported by debt cancellation
for those countries that need it. Rich countries must also reduce their
active recruitment of professionals from poor countries.
Investing in women
Another priority is to ensure that aid is working effectively to meet the
needs of women and promote their wellbeing. Proven strategies
include working with womens movements, changing laws to combat
discrimination and protect womens rights and promoting women
leaders and workers.
In Brazil, for example, womens organisations working within and
outside government ensured that the 1988 Constitution reflected the
importance of womens reproductive health.40 In South Africa, where
the constitution was rewritten to promote womens rights, one in two
public servants is a woman and women account for one-third of the
National Assembly, up from three per cent during the apartheid era.41
Promoting women leaders can help to put womens concerns on the
political agenda. For example, in India, local councils which have a
majority of women tend to spend more on public water facilities and
latrines for low-caste groups.42 Promoting women as workers can
increase womens use of essential services. For example, in Botswana,
Mauritius, Sri Lanka, Costa Rica and Cuba, the high proportion of

female teachers and health workers has been instrumental in
encouraging women and girls to use the services.
Fighting corruption
Corruption has the biggest impact on the poorest people. For example,
in Romania the poorest third of families pay 11 per cent of their income
in bribes, while the richest third pay just two per cent.43
Corruption needs to be fought on a number of levels - firstly, at the
level of society as a whole. In countries where the rule of law exists and
there is an ethos of trust and strong accountability mechanisms, there
will be far less corruption. Public education can play an important role
in this respect. In Uganda, Oxfam has supported the anti-corruption
coalition which has sought to draw attention to the harmful effects of
corruption through public campaigning.
Corruption also needs to be tackled at the political level. If the problem
is to be successfully addressed, it has to become politically impossible
for leaders or elites to abuse public resources for their own private
gain. In many countries, multi-party democracy and the emergence of
civil society and a free press are proving to be instrumental in the fight
against corruption. Scandals uncovered recently by the press in Costa
Rica and Kenya, for example, have led to the prosecution of senior
officials.
Government and business leaders must signal their intolerance of
corruption and their commitment to accountability, and civil society
must hold these leaders to account. In Georgia, for example, Oxfam
supports the Georgian Young Economists organisation to analyse the
government budget and publish its findings. Donor governments are
also funding initiatives aimed at building demand-led governance.44
Trade justice
Rich countries need to make serious progress towards trade justice if
the MDGs are to be achieved. In particular, urgent action is required
from the EU and the USA. Irrespective of when Doha round talks
restart, these countries must end export subsidies and all trade-
distorting subsidies that lead to dumping, especially on cotton.
Moreover, they must not contest the development mandate of the
Doha negotiations.
Least-developed countries should be given 100 per cent duty-free,
quota-free access to rich country markets. This must also include
reforming the rules of origin and overly burdensome health and
safety requirements which allow rich countries to exclude poor
country exports. Rich countries must also agree to a meaningful aid-

for-trade package made up of new money and with no strings
attached.
Debt cancellation
Debt cancellation is urgently required for all countries which need it to
achieve the MDGs. This means widening the list of eligible countries
and abolishing the harmful conditions that eligible countries have to
comply with to benefit from debt cancellation (see box two). The deal
agreed to at the 2005 G8 Summit at Gleneagles signaled important
progress but was insufficient. Many poor countries with massive debts,
such as Sri Lanka, Kenya, and Viet Nam, were left out of the deal.
While there is a need for careful analysis of which countries require
debt relief to meet the MDGs, initial research by Oxfam and others
suggests that more than 60 countries will need 100 per cent of their
multilateral debts cancelled, at an annual cost of $10 billion.45
Box 2: the World Bank and IMF reneging on debt relief

The Multilateral Debt Relief Initiative (MDRI) a centrepiece of the G8 deal
which grants debt cancellation to the worlds poorest countries retains the
harmful conditions which have marred previous debt relief packages.
Although no new conditions were included in this initiative, qualifying
countries still have to complete the Highly Indebted Poor Countries (HIPC)
process, which involves complying with harmful World Bank and IMF policy
conditions and budget ceilings. Moreover, the finance for this debt
cancellation, although additional to the World Bank and IMF, will be taken
from rich countries aid budgets and spread among all the poorest countries.
Although it was announced as a $40 billion deal, the actual savings for Africa
will be around $1 billion a year, leaving it to carry the weight of more than
$200 billion in debt.46
Meeting the MDGs has been identified as a benchmark for immediate

debt relief because governments all over the world have agreed the
goals represent an achievable ambition. Ultimately, however, poor
countries debts need to be cancelled so that they can achieve their
human development goals, in the broadest sense, and protect the
rights of their citizens.
A recent study, which adopted a rights-based approach to debt
cancellation, identified a need for more extensive debt relief than that
required to meet the MDGs.47 The study argued that if a government
can only meet its debt service payments by taxing poorer citizens so
that they cannot pay for enough food or shelter and by failing to
provide basic health and education, this violates human rights.48

MDG-based debt relief therefore represents only a minimum standard
and an interim measure.
With this in mind, the World Bank and IMF need to immediately
conduct an MDG-based analysis of the debt sustainability of each poor
country, and recommend debt cancellation accordingly. Rich countries
and the international financial institutions must agree to provide
cancellation of all bilateral, multilateral and commercial debts owed by
the poorest countries where such cancellation is required to meet the
MDGs. This cancellation should not be financed out of existing aid
budgets but from new contributions.
There is also an immediate need to end harmful economic policy
conditionality associated with the HIPC initiative. The G8 declaration
that countries must be able to decide, plan and sequence their
economic policies to fit with their own development strategies must
become a reality.
The cost of failure
Let us be clear about the costs of missing this opportunity: millions of

lives that could have been saved will be lost; many freedoms that could
have been secured will be denied; and we shall inhabit a more
dangerous and unstable world.
United Nations Secretary-General Kofi Annan49
Having concluded that the world can afford to achieve the MDGs, the
pivotal question is: what will it cost not to achieve the goals?
Loss of lives and denial of rights

Failure will cost the lives, wellbeing, livelihoods and education of
millions of women, men and children.
The projections are staggering. For example, missing the MDG target
on sanitation will cost 10 million childrens lives.50 Yet, achieving this
goal will require the utmost determination, since one in three people in
the world has no access to a toilet or latrine. 51 Similarly, the
international target to halve the proportion of people who have no
clean drinking water is far off-track and, in total, will fail 210 million
people.52 On current progress, Africa will not meet the goal until the
year 2105. More than one billion people still live without clean water53
and water-related diseases cause three million deaths a year.54

Entrenched gender inequality
Much of the cost of missing the MDGs will be borne by women. More
women than men are likely to die from AIDS if goal six, which aims to
reverse the spread of HIV and AIDS, is not achieved. Similarly, more
girls than boys will not be in school if goal two, which aims to achieve
universal primary schooling, is missed. Tragically, this has already
been demonstrated by the failure to achieve the first MDG deadline
eliminating gender disparity in primary and secondary education by
2005, which is part of goal three.
Issues of gender inequality and poverty are mutually reinforcing not
only will women be disproportionately affected by a failure to achieve
the MDGs, but combating gender inequality will need to be a central
focus if the goals are to be achieved. Evidence shows that babies born
to mothers without formal education are at least twice as likely to
suffer from malnutrition, or die before the age of five, than those babies
born to mothers who completed primary school.55 Even one or two
years of schooling for mothers cuts child deaths by 15 per cent,56 and
womens education does more to reduce malnutrition than anything
else, including increased food availability.57 It is one of the most
effective ways to fight the spread of HIV.58
There is little doubt that failing to achieve the MDGs will further
entrench gender inequality and the cost will be a less equitable world.
Increased risk of conflict

Missing the MDGs will also come at the cost of a less secure world.
Extreme poverty can increase the risk of conflict in a range of ways.
The Millennium Project explains this well:
Poor countries are more likely to have weak governments, making it

easier for would-be rebels to grab land and vital resources. Resource
scarcity can provoke population migrations that result in conflicts
between social groups, as in Darfur, Sudan, in the wake of
diminishing rainfall. Without productive alternatives, young people
may turn to violence for material gain, or feel a sense of hopelessness,
despair, and rage. Poor farmers who lack basic infrastructure and
access to agricultural markets may turn in desperation to narcotics
production and trade, such as growing poppy in Afghanistan or coca
in the Andes. Many slums are controlled by gangs of drug traffickers
and traders, who create vicious circles of insecurity and poverty. The
lack of economically viable options other than criminal activity creates
the seedbed of instability and increases the potential for violence.59
The message is clear while there are multiple reasons for combating
poverty, including justice and humanitarian concerns, there is also a

compelling need to overcome poverty because this will help to
promote international peace and security.
Financial cost
Finally, failing to achieve the MDGs will come at a financial cost. This
is because well-targeted initiatives to combat poverty can ultimately
save money. For example, Brazil spends $395 million a year on a
program to provide drugs which improve the health and extend the
lives of those living with HIV and AIDS, but this has saved more than
$2 billion in public health costs since the epidemic started.60
Similarly, it has been argued that meeting the MDG targets on water
and sanitation could result in savings. For every $1 invested, another
$3$4 is saved on health spending or through increased productivity.61
Conversely, failing to provide water and sanitation will cost
developing countries $84 billion per year in lost lives, low worker
productivity, higher health-care costs, and lost education
opportunities.62
Ironically, while rich countries continue to languish in their self-
interest, giving the impression that the costs of eradicating poverty are
simply too high, the reality is that global wealth could actually be
increased through the achievement of the MDGs.
In summary, it is clear that the cost of not achieving the MDGs is far
greater than the eminently affordable cost of achieving them. In fact,
the cost of failure is so far-reaching that it is simply not an option.
Unless urgent action is taken to ensure the goals are achieved, millions
of women, men and children will pay with their lives. Moreover, we
will face a more insecure and inequitable world.

4 The context: 2005s broken promises
The G-20 meeting in Melbourne occurs at a significant time, following
on from some pivotal international meetings held during 2005 and
preceding the half-way mark for the achievement of the MDGs. There
is much unfinished business and many of the promises previously
made by world leaders have been broken. It is important to view the
G-20 meeting in this context. The group not only has the opportunity
to build on the gains achieved in 2005, but also to lead the way in
addressing vital areas of unfinished business.
The G8 Summit at Gleneagles

In 2005, 36 million people from more than 70 countries united together
under the Global Call to Action against Poverty, demanding action
from world leaders to combat poverty. A focal point for the campaign
was the G8 Summit held at Gleneagles in July of that year. A quarter of
a million people marched across Edinburgh demanding that the G8
take action, while across the world more than two billion people tuned
in to watch the Live8 concerts. They demanded that leaders deliver
debt cancellation, more and better aid, and trade justice. They set a
new goal for this generation to make poverty history.
The G8 made a number of commitments regarding aid, trade and debt
relief. Specifically, it agreed to: cancel debts owed by up to 40 of the
worlds poorest countries to the World Bank, IMF and African
Development Bank; increase aid to poor countries by $50 billion by
2010, with half of this going to Africa; increase humanitarian aid and
support for peacekeeping and arms control; and call for a world trade
deal which favours poor nations.
Ultimately, there are four points to make regarding The Gleneagles
deal. First, it included some significant advances which are already
having an impact. The debt cancellation deal surpassed all previous
efforts to provide debt relief to developing countries and the aid
increase was significant. Progress will be made on the MDGs because
of these commitments and evidence shows that the deal has already
impacted millions of lives.
For example, debt cancellation in Zambia will reduce the countrys
debt from $7 billion to $500 million, releasing vital resources for
reducing poverty. This was reflected in Zambias budget for 2006,
which included substantial increases in funding for health and
education. On 31 March 2006, President Levy Mwanawasa announced
that, from that day on, all Zambians would have access to free basic
health care. In addition, new funding is going towards HIV and AIDS
programs, the recruitment of doctors and nurses and the purchase of

medical equipment and medicines. Similarly, extra spending on
education will enable the recruitment of more than 4,500 teachers and
the construction and rehabilitation of schools.
This is just the beginning. The G8 and African Union claim that, if the
pledges made at Gleneagles were to be fully implemented, they could
double the size of Africas economy and trade by 2015; lift tens of
millions of people out of poverty every year; save millions of lives a
year; get all children into primary school; deliver free basic health care
and primary education for all; and provide as close as possible to
universal access to treatment for AIDS by 2010.63
The second point to make regarding the G8 deal is that, even so, it fell
well short of what is required globally, and even within Africa, to
successfully overcome poverty. In the light of undisputed need and
unprecedented expectation, neither the necessary sense of urgency nor
the historic potential of Gleneagles was fully grasped by leaders at the
summit.
The increase in aid will fail to bring the aid levels of some G8 countries
up to the international target of 0.7 per cent of GNI agreed to in the
1970s. More importantly, the increase will come too late and fall far
short of UN and World Bank estimates of what is needed to meet the
MDGs.
While the communiqu contained the strongest words to date on
education, health and HIV and AIDS, it was far weaker on making
specific financial commitments. The highlight was a commitment to
achieve near-universal HIV and AIDS treatment by 2010. On the other
hand, the discussions on trade were disappointing. The G8 failed to
substantially move forwards on creating a more just world trade
system, and in some cases moved backwards on existing
commitments.
Furthermore, the G8 failed to make significant progress towards an
international Arms Trade Treaty. While the majority of G8 members
were in favour of endorsing a treaty, the USA and Russia were
opposed. There was some progress made on small arms and light
weapons with G8 leaders recognising the importance of developing
common principles over export controls. Nevertheless, it was
disappointing that the G8 communiqu contained no substantial new
initiatives and did not commit governments to do anything to achieve
these laudable aims.64
The third point regarding the G8 deal is that, tragically, some
commitments made at Gleneagles have already been dishonoured.
Some rich countries as well as the World Bank and IMF have made a
number of attempts to water down the debt deal. For example, the
original agreement was to count all debts owed up to the end of 2004

to the IMF, World Bank, and African Development Fund. However, to
save money, the World Bank deal now only covers debts up to the end
of 2003 a stroke of the pen costing poor countries $5 billion in debts
that will now not be cancelled.
The fourth and final point to make about the G8 deal is that, despite
the enormous power the G8 yields, it was, at the time of the Gleneagles
summit, a small group of eight men.65 Indeed, the G8 has been
criticised on the basis of its concentrated geographical representation,
including its exclusion of developing countries, and there are
persuasive arguments in favour of replacing the G8 with a more
representative decision-making body. Similar arguments apply to the
G7 Finance Ministers summit, which has been described as Euro-
centric and criticised for significantly under-represent[ing] several
key players in the modern global economy, a potentially fatal handicap
when it comes to tackling some of the most pressing challenges now
facing policymakers.66 For this reason, a more representative group is
necessary, such as the G-20 which includes a number of emerging
economies such as India, Brazil and Indonesia although the lack of
women leaders remains stark.
In summary, the G8 deal was a positive and important step forward
but it did not go far enough. Moreover, aspects of the deal have
already been dishonoured. Perhaps it is now time to target larger and
more representative decision-making bodies as vigorously as the G8
has been targeted in the past. While this group of eight powerful
leaders has the opportunity and the responsibility to make
unprecedented inroads in the fight against global poverty, there are
hundreds of other countries which share that responsibility and should
be held equally accountable.
The World Summit 2005

The World Summit, held in September 2005, had originally been
intended to review progress towards the MDGs and commit
governments to further action. In this respect, it was a monumental
disappointment. World leaders appeared nonchalant about the lack of
significant progress on aid, trade and debt relief, and the summit was
described as bleak and depressing.67
Among the reasons for this lack of progress and even some setbacks
was the heated debate over Security Council reform, which provided a
significant distraction in the months leading up to the summit. The
overwhelming self-interest of rich countries was also a contributing
factor yet again.

Bizarrely, for a summit that was intended to review progress against
the MDGs, the USA attempted to remove any reference to the MDGs
from the summit outcome resolution and publicly complained that the
section on development was too long.68 Furthermore, there was a
refusal to commit to the international aid target of 0.7 per cent of GNI.
In the end, while leaders did recommit to the achievement of the
MDGs, the summit outcome document failed to make any real review
of progress. There was no sense of urgency and no acknowledgement
that progress towards the goals was seriously lagging.
The section on aid funding represented a step back from the Monterrey
Consensus of 2002. While the document commended those countries
which had pledged to increase aid to 0.7 per cent of GNI, it simply
urged others to increase aid in line with their commitments. This
particular wording enabled reluctant rich countries to avoid
committing to the 0.7 per cent target, putting the financing required to
meet the MDGs in jeopardy.
The outcome document was also disappointing on other fronts. The
section on trade, for example, was weaker than the Doha trade
agreement of 2001. It endorsed trade liberalisation and made no
mention of the elimination of subsidies, or the power of poor countries
to decide the pace and scale of opening their markets. Additionally, the
text included no new controls on small arms and light weapons or any
commitment to increasing resources for humanitarian crises.
Amidst the disappointments, there were some important gains. Most
notable among these was the endorsement of a collective
responsibility to protect civilians from genocide, crimes against
humanity and ethnic cleansing. This requires governments to take
timely and decisive action to protect civilians where the government
concerned fails to do so.
The outcome document also endorsed a number of the targets agreed
at Gleneagles, including universal HIV treatment by 2010. In
committing to universal HIV treatment and ending user fees in health,
the United Nations General Assembly not only signed up to these
targets set by the G8 but effectively gave them the same status as the
MDGs.
The document also endorsed the G8s Multilateral Debt Relief Initiative
the $40 billion debt cancellation deal for the worlds most heavily
indebted poor countries. In a positive reference to debt relief for
middle-income countries, the document acknowledged the need to
consider additional measures. It expressed support for the Education
for All Fast Track Initiative and recognised the need to end impunity
for violence against women and guarantee rights to labour protections,
property ownership and reproductive health services.

The Doha round of trade talks
If you receive subsidies, the price at which you sell your cotton does
not matter. Those of us who do not receive any kind of support cannot
sell our cotton, no matter what its quality.
Francois Traore, Burkino Faso, West Africa
The issues
Trade has the potential to significantly reduce poverty, particularly
among those who depend on agriculture for a living. Of the 1.2 billion
people who live on $1 or less a day, most are farm workers and rural
poor who are struggling to send their children to school, or to buy
medicines and enough food. But trades potential is not being realised
because rich countries are rigging international trade rules in their own
national interest.
If Africa, East Asia, South Asia, and Latin America each increased their
share of world exports by one per cent, the resulting gains in income
could lift 128 million people out of poverty. Yet, when developing
countries export to rich-country markets, they face tariff barriers that
are four times higher than those encountered by rich countries. Those
barriers cost them $100 billion a year twice as much as they receive in
aid.
Rich countries spend $1 billion every day on subsidies to benefit their
own farmers. The resulting surpluses are dumped on world markets,
undermining the livelihoods of millions of smallholder farmers in poor
countries. It is estimated that, as a result of dumping by rich countries,
cotton farmers in sub-Saharan Africa lost $305 million in 2001,69 while
in 2004, Mozambique alone lost $38 million in potential sugar sales to
the EU.70
In September 2001, in Doha, Qatar, the world embarked on a round of
negotiations to reform the WTOs global trade rules. Rich countries
declared it a 'development round' that would provide fairer rules to lift
millions of people out of poverty. Five years on, negotiations have
been suspended after the stubborn self-interest of rich countries
created a deadlock.
If trade is going to work for global development, rich countries such
as the USA and EU states will need to cut their most harmful
agricultural subsidies and give developing countries better access to
their markets. Instead, they have demanded that developing countries
open their markets in a way that could damage their development.
Poorer countries have been expected to cut farm tariffs too steeply,
despite the impact that this would have on millions of subsistence

farmers, food security and policies to fight rural poverty. In
negotiations to open up industrial markets, they were asked to slash
their tariffs by twice as much as rich countries.
Hong Kong 2005

The most recent WTO Ministerial Conference was held in Hong Kong
in December 2005. Like the World Summit a few months earlier, the
WTO Conference represented another opportunity squandered.
Oxfam analysis71 shows that, if the proposals on agriculture were to be
accepted, both the EU and the USA could actually increase their trade-
distorting spending, despite having announced cuts of 70 per cent and
54 per cent respectively. An offer to end export subsidies by 2013 was
welcome, but these only account for 3.6 per cent of EU spending on
agriculture.
The US proposal on agricultural market access has serious implications
for food security and livelihoods because it denies developing
countries the right to defend essential products on which poor farmers
depend. On the other hand, the EU offer would exempt many products
exported by developing countries from tariff cuts, thereby significantly
diluting market-access gains.
Although the Hong Kong meeting reaffirmed the right of poor
countries to protect certain products of vital importance to food
security or livelihoods, additional special measures will be needed to
prevent increases in rural poverty. This special treatment could be
extended with only minor reductions in other countries gains from the
Doha round.
Developing countries at the WTO are also being asked to sign up to a
deal on Non-Agricultural Market Access that defies the lessons of
history. In return for minimal progress on agriculture, they are under
pressure to dramatically and permanently open their industrial
markets to foreign competition. The vast weight of historical evidence
suggests that countries must be able to raise and lower tariffs
according to changing circumstances if they are to promote growth
and industrialisation successfully. Yet the current negotiations at the
WTO aim to eliminate this flexibility.
When negotiations on services were launched in 1994, it was with the
promise that developing countries would be allowed the flexibility to
take into account their levels of development and national policy
objectives. Negotiations were to be carried out on a request-offer basis,
and countries would only have to participate when they felt ready. Yet,
over the last year, increasing pressure has been placed on developing
countries to agree to open their markets. Before making offers,
countries need to assess the potential costs and benefits of

liberalisation, but so far the negotiations have not provided space for
this.
The WTO Services texts go some way to allaying concerns regarding
developing countries rights to regulate and provide universal service
in significant areas like telecommunications, sanitation, and education.
However, in practice the system can be inflexible.
A minimal development package was presented to developing
countries in Hong Kong. This included commitments on aid-for-trade,
DFQF (duty-free and quota-free) market access for the poorest
countries, and a permanent amendment to the TRIPS (trade-related
aspects of intellectual property rights) agreement. Efforts to provide
trade-related assistance to poor countries are welcome, but what has
been agreed so far does not constitute a sufficiently attractive package
to make up for the concessions and damage being done in other areas.
There is an urgent need for fairer trade rules that more evenly benefit
developing countries. However, what has been offered in the Doha
round to date looks very unlikely to deliver this, and could actually
make things worse. One study suggests that the poorest countries
would lose the most, with sub-Saharan Africa facing losses of more
than $300 million in all the most likely outcomes.72 This is in contrast to
the dramatic gains predicted by the World Bank,73and would be a
bitterly ironic end to the so-called development round.74
What needs to be done

A recent meeting of the Cairns Group75 failed to revive the Doha round
following the indefinite suspension of talks in June 2006. The group
urged WTO members to re-engage in negotiations no later than
November,76 making it clear that modest reforms in domestic support
and market access would be insufficient to conclude a deal on
agriculture.77
The Doha round is definitely worth saving. There is still a strong
development case for a multilateral system even one as flawed as
that of the WTO. Within such a system, developing countries can work
together and stand less chance of being bullied to agree to unfair trade
deals. For this reason, countries should resist the temptation to try to
get what they want via a series of bilateral trade agreements. Apart
from introducing more complication and incoherence into trade
relations, these deals usually involve developing countries losing more
than they gain because of their weak negotiating position.
If the multilateral talks are to be resurrected, trade negotiators need a
complete change of mindset. The USA and EU should only come back
to the table once they have done their homework and have a clear
commitment to end the dumping of their agricultural surpluses.

Meanwhile, they should at the very least respect current rules on
subsidies - or if they continue to break them, accept that they will face
litigation in the WTO court. However minor, such gains would at least
give the worlds poorest countries something to show for five grinding
years in the negotiating chamber.

5 The challenge: what the G-20 should
do
While there have been some important breakthroughs in recent years,
we have not yet succeeded in turning the tide against global poverty.
Deeply entrenched structures of power and the self-interest of rich
countries have proven formidable obstacles. The recent stalling of the
Doha round of trade negotiations illustrates just how formidable these
obstacles can be. Corruption in developed and developing countries
can also thwart efforts to combat poverty. Clearly, much work remains.
Although the task is large, it is eminently achievable. The
accomplishments of recent years have already improved the lives of
millions. Most importantly, it has become clear that the actions of
concerned individuals across the world can achieve unprecedented
results.
And now, concerned individuals are again joining together to elicit
action from their leaders. This time, their focus is on the G-20 meeting
of economic leaders in Melbourne. If we are to achieve the Millennium
Development Goals, it is imperative that every meeting of world
leaders from now until 2015 makes rapid and significant progress in
combating poverty. The G-20 meeting is no exception. It must act and
it must act now. Next year will be too late. Instead, next years meeting
in South Africa should be used to build on the substantial progress
made at this years meeting.
So, what should the G-20 do at its meeting in Melbourne?
First, it should commit to broader debt cancellation to build on the
Multilateral Debt Relief Initiative agreed at the 2005 G8 Summit.
Debt cancellation should be granted to all countries which require it to
meet the MDGs. As an initial step, the group should analyse debt
sustainability to identify which countries fit this description. The group
could commission researchers to report back prior to its 2007 meeting
in South Africa. In the meantime, G-20 members should immediately
commit to pay their share of debt relief for all countries which are
eligible only for concessional loans from the International
Development Association of the World Bank, as the United Kingdom
has done.
Second, in extending debt cancellation, the G-20 should put an end
to harmful economic conditions associated with the Heavily
Indebted Poor Countries initiative and the Multilateral Debt Relief
Initiative. Specifically, the group should agree to restrict conditions to
requirements for financial accountability and poverty-reduction goals,

agreed through open and transparent processes in which ordinary
individuals, community groups and parliaments have an active say.
Third, debt cancellation should not be financed from existing aid
budgets. Accordingly, G-20 members should commit to end double-
counting this money and instead make new contributions for extended
debt cancellation.
Fourth, members of the group should formally commit, or in many
cases recommit, to reach the international target of allocating 0.7 per
cent of their GNI to overseas development assistance by 2015 at the
latest. As part of this commitment, each member should provide and
adhere to a timetable for reaching 0.7 per cent GNI, in the same way
that EU members have done.78
Fifth, G-20 countries should commit to support national
development strategies designed to achieve the MDGs in line with
commitments made at the 2005 World Summit. Further, the G-20
should make every effort to ensure long-term, predictable and flexible
aid is provided to countries which need it to achieve the MDGs. This
will be crucial to ensure universally accessible, quality essential
services and the achievement of the MDGs
Sixth, given the unique membership of the G-20, it provides an
excellent forum for informal discussions aimed at getting the Doha
development round of trade negotiations back on track. Given the
presence of the USA and EU states at the G-20 meeting, emerging and
middle economies should seize the opportunity to push for an end to
the intransigence of pivotal rich countries.
Finally, the G-20 should use the meeting to address the fundamental
inequalities in the structure and operation of the World Bank and
IMF. Reform of these institutions is a key agenda item for the
Melbourne meeting and a central focus for G-20 generally. While
progress towards greater institutional democracy seems likely, there
are indications that the changes will not go far enough and will favour
more economically powerful developing countries. This means
emerging economies may need to put aside their own self-interest to
advocate for true democratic reform, so that poorer countries are also
given a voice.
The G-20 needs to act on each of these issues as a matter of priority. It
needs to act because of the urgency of the moment; because people are
dying every day as a consequence of inaction. It needs to act because
citizens are demanding such action. It needs to act because the world
simply cannot afford not to achieve the MDGs.

It is now up to the G-20 to seize this opportunity to do something
great. As more than 23 million people from all over the world said in
unity just last month:
What is needed is the political will to achieve and exceed these
goals
To the leaders of the wealthy countries: Be great. Fight to keep your
promises debt cancellation, more and better aid, and trade rules that
help fight poverty. You know what needs to be done. Do it.
We also stand before the leaders of poorer countries to say: Be great.
Make it your first responsibility to save the lives of your poorest
citizens. We ask you to achieve real transparency and accountability
in how money is spent, to tackle inequality, to root out corruption.
You know what needs to be done. Do it.
We want justice now. No more excuses. We will not stand for
them.79

Notes
1 Bono (2005) A Chance for Real Change in Africa, IAEA Bulletin Volume 47,
No. 1.
www.iaea.org/Publications/Magazines/Bulletin/Bull471/real_change_africa.ht
ml
2 Millennium Declaration, United Nations Millennium Summit, September
2000.
3 Statement of G-7 Finance Ministers and Central Bank Governors, 25
September 1999, Washington DC.
4 The G-20 comprises the finance ministers and central bank governors of
Argentina, Australia, Brazil, Canada, China, France, Germany, India,
Indonesia, Italy, Japan, Mexico, Russia, Saudi Arabia, South Africa, South
Korea, Turkey, the United Kingdom and the United States of America. The
European Union is represented by the rotating Council presidency and the
European Central Bank. In addition, the Managing Director of the IMF and the
President of the World Bank, together with the chairs of the International
Monetary and Financial Committee and Development Committee of the IMF
and World Bank, participate as ex-officio members.
www.g20.org/Public/AboutG20/index.jsp#membership (last accessed in
October 2006).
5 Communiqu, G-20 Meeting of Finance Ministers and Central Bank
Governors, 16-17 November 2001, Ottawa.
6 See Mark Thirwell and Malcolm Cook (2006) Geeing Up the G20, Policy
Brief, Lowy Institute of International Policy, Sydney.
www.lowyinstitute.org/Publication.asp?pid=377
7 See, for example, the Australian Governments view expressed at
www.g20.org/Public/FAQ/index.jsp
8 The G-20 Statement on Global Development Issues, 2005.
www.g20.org/Public/Publications/Pdf/2005_statement_on_global_developmen
t_issues.pdf (last accessed in October 2006).
9 Peter Costello (2006) Opportunity for world leaders to sample Melbourne,
The Age, 4 September 2006,
www.theage.com.au/articles/2006/09/03/1157222002199.html
10 United Nations Millennium Project (2005a) Investing in Development: A
practical plan to achieve the Millennium Development Goals, New York:
Millennium Project, 2005, pp.2.
11 United Nations (2005) The Millennium Development Goals Report 2005,
New York, 2005, pp.3.
12 Except for Eastern Asia and European countries of the CIS, which started
out with 90 per cent enrolment rates or higher. United Nations (2005)
Progress Towards the Millennium Development Goals, 1990-2005,

http://unstats.un.org/unsd/mi/goals_2005/goal_2.pdf (last accessed in October
2006).
13 UNESCO (2005) 'Global Monitoring Report: Addressing Progress towards
the EFA Goals', New York: UNESCO.
14 United Nations Millennium Project (2005b) 'Investing in Development: A
Practical Plan to Achieve the Millennium Development Goals, Overview', New
York: Millennium Project, pp.6.
15 Centre for Global Development (2006) Can the West Save the Rest?,
Event Transcript, 23 March 2006.
www.cgdev.org/doc/event%20docs/transcript_Easterly.pdf (last accessed in
October 2006).
16 Government of Peoples Republic of Bangladesh (2005) 'Bangladesh:
Unlocking the Potential, National Strategy for Accelerated Poverty Reduction',
16 October 2005, pp.197 www.imf.org/external/pubs/ft/scr/2005/cr05410.pdf
(last accessed in October 2006).
17 For example, the United Kingdom Government through the Department for
International Development.
18 For example, see Government of Bangladesh (2005), op cit.
19 See, for example, AusAID (2006) 'Australian Aid: Promoting Growth and
Stability, A White Paper on the Australian Governments Overseas Aid
Program', Canberra: AusAID.
20 UN Millennium Project (2005a) pp. 3.
21 See: www.millenniumcampaign.org/site/pp.asp?c=grKVL2NLE&b=138312
(last accessed in October 2006).
22 Development Gateway Civil Society: Helping to Shape Policy, An
Interview with with Kumi Naidoo, Secretary-General, CIVICUS: World Alliance
for Citizen Participation.
http://topics.developmentgateway.org/special/aidharmonization/template23.do
23 Ibid.
24 Kevin Watkins (2006), We cannot tolerate children dying for a glass of
water, The Guardian, 8 March 2006.
25 See Oxfam International (2006) In the Public Interest: Health, Education,
and Water and Sanitation for All, Oxford: Oxfam International, pp.18.
Calculated from various studies estimating global costs per sector. Education:
$10 billion in extra external
aid needed per year to achieve Universal Primary Education (e.g. see M.
Doney and M. Wroe (2006) Keeping our promises: delivering education for
all, London: HM Treasury and DFID). Basic health care: the Macroeconomics
and Health Commission estimated an extra $21 billion in external aid needed
per year (World Health Organization (2001) Macroeconomics and Health:
Investing in Health for Economic Development. Report of the Commission on
Macroeconomics and Health, Geneva: WHO). Water and Sanitation:
Toubkiss estimates from various studies that achieving the water and
sanitation MDGs needs $15-20 billion in extra investments per year (J.

Toubkiss (2006) Costing MDG Target 10 on Water Supply and Sanitation:
Comparative Analysis, Obstacles and Recommendations, Marseilles: World
Water Council, pp. 7).
26 UN Millennium Project (2005a) op cit.
27 Ibid, pp. 248.
28 Ibid, pp.250.
29 UN Millennium Project (2005b) pp.56.
30 UN Millennium Project (2005a) pp. 249.
31 Ibid, pp. 250.
32 Ibid. pp. 252.
33 UN Millennium Project (2005b) pp. 1.
34 Maternal deaths in the Zaria region of Nigeria rose by 56 per cent, while
there was a decline of 46 per cent in the number of deliveries in the main
hospital. See: P. Nanda (2002) Gender dimensions of user fees: implications
for womens utilisation of health care, Reproductive Health Matters 2002, Vol
10, No. 20, pp. 129.
35 S. Davey (2000) 'Health: A Key to Prosperity. Success Stories in
Developing Countries', Geneva: WHO, CDS.
36 Hao et al. (1997) cited in S. Mehtora and E. Delamonica (2005) The
private sector and privatization in social services: is the Washington
Consensus dead? Global Policy Vol.5, No. 2, pp. 105.
37 EURODAD (2006) World Bank and IMF conditionality: a development
injustice. www.eurodad.org/articles/default.aspx?id=711
38 See Oxfam International and Water Aid (2006) 'In the Public Interest:
Health, Education and Water and Sanitation for All', Oxford: Oxfam
International, pp. 73.
39 World Bank (2005) 'Global Monitoring Report 2005', Washington:
International Bank for Reconstruction/World Bank.
40 J. Pitanguy (1994) Feminist Politics and Reproductive Rights: The Case of
Brazil, in G. Sen and R.C. Snow (eds) Power and Decision: The Social
Control of Reproduction, Cambridge, MA: Harvard University Press, pp. 101-
122.
41 Assembly figures from UN statistics:
http://unstats.un.org/unsd/demographic/products/indwm/ww2005/tab6.htm
(last accessed October 2006).
42 D. Joshi and B. Fawcett (2005) The role of Water in an Unequal Social
Order in India in A. Cole and T. Wallace (eds) Gender, Water and
Development, Berg: Poole.
43 World Bank (2004) 'World Development Report 2004:Making Services
Work for Poor People', Washington DC: World Bank.
44 For example, see AusAID (2006) op cit, pp. 62.

45 See Oxfam International (2005) 'Beyond HIPC: Debt cancellation and the
Millennium Development Goals',
www.oxfam.org/en/files/bp78_beyond_HIPC_050921.pdf/download. Also:
Jubilee Debt Campaign, ActionAid UK and Christian Aid (2005) In the
Balance: Why Debts Must be Cancelled Now to Meet the Millennium
Development Goals, Joint NGO Briefing Paper.
46 Stephen Lewis (2005) 'Race Against Time: Searching for hope in AIDS-
ravaged Africa', Melbourne: Text Publishing, 2006, pp. 23.
47 New Economics Foundation (2006) 'Debt Relief As If People Mattered: A
rights-based approach to debt sustainability', London: nef.
48 Ibid, pp. 4.
49 United Nations General Assembly, Fifty-ninth session, Report of the
Secretary-General, In Larger Freedom: towards development, security and
human rights for all, A59/2005, 21 March 2005, pp. 23.
50 WaterAid (2005) Dying for the Toilet, www.un-ngls.org/un-summit-
wateraid.pdf
51 World Health Organization (2006) Health Through Safe Drinking Water
and Basic Sanitation,
www.who.int/water_sanitation_health/mdg1/en/index.html (last accessed in
October 2006).
52 United Nations Development Program (2005) Human Development Report
2005, 'International Cooperation at a Corssroads: Aid, trade and security in an
unequal world', pp.42.
http://hdr.undp.org/reports/global/2005/pdf/HDR05_complete.pdf
53 WHO (2006), op cit.
54 Elisabeth Malkin (2006) Big-time shift in facing water crisis, New York
Times, 21 March 2006, www.iht.com/articles/2006/03/20/news/water.php
55 G. Bicego and O. Ahmad (1996) 'Infant and Child Mortality, Demographic
and Health Surveys Comparative Studies No. 20', Calverton, Maryland: Macro
International Inc.
56 World Bank (2002) 'HIV-AIDS and Education: A window of hope,'
Washington, D.C.: World Bank.
57 L.C. Smith and L. Haddad (2000) 'Explaining Child Malnutrition in
Developing Countries: A Cross Country Analysis,' IFPRI Research Report.
No.111. Washington, D.C.: International Food Policy Research Institute.
58 World Bank (2002) op cit.
59 Millennium Project, 'Investing in Development', op cit, pp. 8.
60 P. Chequer (2005) Access to Treatment and Prevention; Brazil and
Beyond, presentation at International AIDS Society Third Conference on HIV
Pathogenesis and Treatment. www.ias-
2005.org/planner/Presentations/ppt/3333.
61 WHO (2006) op cit.

62 WaterAid (2005), Dying for the Toilet, op cit.
63 Chairs Summary, Gleneagles Summit, 8 July 2005.
www.g8.gov.uk/servlet/Front?pagename=OpenMarket/Xcelerate/ShowPage&
c=Page&cid=1119518698846 (last accessed October 2006).
64 Despite the G8s lack of progress in garnering support for an Arms Trade
Treaty, 139 states recently voted in favour of a proposal to develop such a
treaty at the meeting of the United Nations General Assemblys First
Committee on Thursday 26 October 2006. From now on, a UN process will
unfold that could result in the establishment of a global Arms Trade Treaty,
possibly by 2010.
65 Including the President of the European Commission. The subsequent
election of Angela Merkel as the Federal Chancellor of Germany means there
is now one woman leader within the G8.
66 Mark Thirwell and Malcolm Cook (2006) op cit.
67 Christian Aid (2006) 'Poor left behind as world leaders posture, says
Christian Aid', 15 September 2006,
www.christianaid.org.uk/news/media/pressrel/050915p.htm. See also Clare
Short (2005) Depression and Mistrust Prevail at the UN, The Independent,
15 September 2005. www.commondreams.org/views05/0915-25.htm
68 Colum Lynch (2005) 'US Wants Changes in UN Agreement', Washington
Post, 25 August 2005. www.washingtonpost.com/wp-
dyn/content/article/2005/08/24/AR2005082402321_pf.html
69 Oxfam calculations based on International Cotton Advisory Council (ICAC)
figures in 'Cotton: World Statistics', September 2003.
70 Oxfam calculations using data from Mozambiques National Institute of
Sugar, 'Balance for the Sugar Sector', 2003. The sugar regime has now been
reformed, but poor countries will still lose out because of a failure to
implement the reforms gradually or to provide adequate compensation. For
more detail see Oxfam and WWF (2005) 'Critique of the ECs Action Plan for
ACP countries affected by EU sugar reform'.
71 See Annexe 1 of Oxfam International (2006), 'A Recipe for Disaster: Will
the Doha Round fail to deliver for development?' April 2006,
www.oxfam.org/en/files/bp87_recipefordisaster_060427/download
72 Polaski, Sandra (2006) 'Winners and Losers: the Impact of the Doha
Round on Developing Countries,' table, p 34; Carnegie Endowment for
International Peace; www.carnegieendowment.org/trade.
73 In 2003 the World Bank predicted global gains of $832bn from trade
liberalisation, with the majority $532bn going to the developing world.
More recently, they have downgraded expectations, predicting global gains of
$287bn, with only $90bn going to developing countries. See Timothy Wise
and Kevin P Gallagher (2005) 'Doha Rounds Development Impacts: Shrinking
Gains and Real Costs', RIS Policy Brief No. 19.
74 The results of economic modelling can vary widely, depending on the
factors included and the assumptions made. All models make a number of

simplifying assumptions and tend to miss out dynamic effects. For this reason,
any figures generated by such models should be treated with caution. This is
recognised by almost all serious economists. However, at the very least, the
Carnegie study shows that the gains predicted by the World Bank, and often
cited by developed country negotiators, are far from guaranteed.
75 A coalition of 18 agricultural exporting countries accounting for over 25 per
cent of the worlds agricultural exports.
76 Cairns Group, Communique, 20th Anniversary Ministerial Meeting, Cairns,
Australia, 22 September 2006.
77 Ibid.
78 See
http://ec.europa.eu/comm/development/body/communications/docs/MDGs_de
pliant_002.pdf#zoom=125 (last accessed in October 2006).
79 Stand Up pledge, see www.standagainstpoverty.org/files/Pledge_Long.doc
(last accessed October 2006).
Oxfam International November 2006

This paper was written by Jo Pride. Oxfam acknowledges the assistance of James
Ensor, Marc Purcell, Max Lawson, Melanie Scaife and Kim Hayes in its production.
It is part of a series of papers written to inform public debate on development and
humanitarian policy issues.
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Published by Oxfam GB for Oxfam International under ISBN 978-1-84814-517-7

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Oxfam Briefing Paper

On the eve of the G-20 Meeting of Finance Ministers and Central

1 Our Generations Choice, Oxfam Briefing Paper, November 2006

agree to abandon the harmful conditions which have applied to previous

support national development strategies designed to achieve the

use the meeting as an opportunity to pressure the United States of

Our Generations Choice, Oxfam Briefing Paper, November 2006 2

3 Our Generations Choice, Oxfam Briefing Paper, November 2006

Our Generations Choice, Oxfam Briefing Paper, November 2006 4

The growing profile of the G-20

'dialogue on key economic and financial policy issues among

5 Our Generations Choice, Oxfam Briefing Paper, November 2006

Our Generations Choice, Oxfam Briefing Paper, November 2006 6

The Millennium Development Goals

Box 1: the Millennium Development Goals

Goal 1: reduce extreme poverty and hunger by half

Goal 2: achieve universal primary education

Goal 3: promote gender equality and empower women

Goal 4: reduce child mortality by two-thirds for children under five

Goal 5: reduce maternal mortality by three-quarters

Goal 7: ensure environmental sustainability

Goal 8: develop a global partnership for development

Already, significant progress has been made towards the achievement

7 Our Generations Choice, Oxfam Briefing Paper, November 2006

Addressing criticisms of the MDGs

Our Generations Choice, Oxfam Briefing Paper, November 2006 8

9 Our Generations Choice, Oxfam Briefing Paper, November 2006

The cost of meeting the MDGs

Our Generations Choice, Oxfam Briefing Paper, November 2006 10

Making aid effective

11 Our Generations Choice, Oxfam Briefing Paper, November 2006

Our Generations Choice, Oxfam Briefing Paper, November 2006 12

13 Our Generations Choice, Oxfam Briefing Paper, November 2006

Our Generations Choice, Oxfam Briefing Paper, November 2006 14

Box 2: the World Bank and IMF reneging on debt relief

Meeting the MDGs has been identified as a benchmark for immediate

15 Our Generations Choice, Oxfam Briefing Paper, November 2006

The cost of failure

Let us be clear about the costs of missing this opportunity: millions of

Loss of lives and denial of rights

Our Generations Choice, Oxfam Briefing Paper, November 2006 16

Increased risk of conflict

Poor countries are more likely to have weak governments, making it

17 Our Generations Choice, Oxfam Briefing Paper, November 2006

Our Generations Choice, Oxfam Briefing Paper, November 2006 18

The G8 Summit at Gleneagles

19 Our Generations Choice, Oxfam Briefing Paper, November 2006

Our Generations Choice, Oxfam Briefing Paper, November 2006 20

The World Summit 2005

21 Our Generations Choice, Oxfam Briefing Paper, November 2006

Our Generations Choice, Oxfam Briefing Paper, November 2006 22

23 Our Generations Choice, Oxfam Briefing Paper, November 2006

Hong Kong 2005

Our Generations Choice, Oxfam Briefing Paper, November 2006 24

What needs to be done

25 Our Generations Choice, Oxfam Briefing Paper, November 2006

Our Generations Choice, Oxfam Briefing Paper, November 2006 26

27 Our Generations Choice, Oxfam Briefing Paper, November 2006

Our Generations Choice, Oxfam Briefing Paper, November 2006 28