By Stephanie Holmes
BBC News
The Millennium Development Goals were hailed as a new framework for development - tangible targets that would propel and direct change in the spheres of hunger, health and human rights, equality and education.
But, as politicians, advocates and experts gather in New York, the economic storm clouds of soaring commodity prices and a global slowdown threaten to overshadow the future.
"We are very worried about the financial crisis," says Thoraya Obaid, the head of the United Nations Population Fund, whose agency focuses on maternal and reproductive health.
She admits that there is a risk that international aid priorities - and funding - will slip off the political agenda as governments and individuals grapple with their own domestic crises.
"Next year is supposed to be the year of reconciliation - of solidarity among nations - but the global crisis will affect everyone, not only at the national or government level, but also at the individual level."
The UN concedes that eight years on from member states pledging to halve the proportion of people who live on $1 (0.68 euros; £0.53) a day and reducing by 50% the hundreds of millions who go hungry each night, the results are mixed.
Towards the targets
The overarching goal of reducing absolute poverty by half is within reach for the world as whole, the UN says, but not in sub-Saharan Africa.
Some 80% of children in developing countries are now vaccinated against measles, yet one in four is still undernourished and underweight.
Though the goals risk painting even progress as failure, Ms Obaid defends them as a tool.
"Without goals… we cannot monitor what we are doing and demonstrate results. It is a way for governments, international organisations and non-governmental organisations to hold each other accountable and people to hold their governments accountable."
Yet the targets have not been unquestioningly welcomed by campaigners who warn that some fundamental issues have not been directly addressed.
"Many women's groups in India feel that the Millennium Development Goals (MDGs) do not speak of social exclusion. They look at the sum of all things but not at socially excluded groups - like women, minorities, children or young people," explains Lysa John, of Keep the Promise, an Indian NGO which campaigns to ensure the government meets its MDG pledges.
MILLENIUM DEVELOPMENT GOALS
Perhaps as a result, though India's economic success has fuelled progress on many goals - in particular access to education - the targets around maternal health are far from being met.
"The health indicators are where India has fallen off track," Ms John says. "We have the highest number of maternal deaths in the world."
The UN estimates that India has the highest number of women dying during childbirth anywhere in the world - one woman dying every three to six minutes from preventable causes, according to campaigners - yet the country spends less than 0.9% of its Gross Domestic Product on public healthcare.
"Women and children don't have a strong political voice," Ms John says. "Even beyond marginalised communities, the issue of maternal death is completely invisible - it is seen as God's hand, as your fate."
In reverse
Ms Obaid agrees: "It would cost the world $6bn (4bn euros; £3.24bn) to stop women dying during childbirth, less than the amount spent in a day and a half on the military, so you can see how a little investment could help to transform women's lives".
Economic success in countries across Asia is pushing down overall poverty levels but many of the poorest families within countries have been the hardest hit by the rise in staple foods like rice, wheat, corn and oil.
"It is the poorest of the poor - those who spend a large proportion of their income on food - who have been most affected by the increasing prices," explains Kostas Stamoulis, of the UN Food and Agriculture Organisation's Agricultural and Economics Development division. "It's the female-headed household, the landless people, the urban poor."
Until prices spiked, he explains, many countries were roughly on track to meet the first MDG - that of halving hunger.
"But if this trend does not get reversed then it will be very difficult to do it," he adds.
The FAO says an additional 75 million people joined the ranks of the hungry last year, pushed over the edge by increasing food costs.
"We believe we can still achieve it. But if food prices fall - even substantially - it will not necessarily cancel out these effects. Many households in distress have already sold assets that are difficult to build up, leaving them more vulnerable."
Political priorities
Long-term under-investment in the agricultural sector, Mr Stamoulis says, is only part of the reason why this particular MDG is proving so difficult to address, particularly in sub-Saharan Africa, where conflict combines with poor infrastructure.
"We also have to look at the political process in developing countries. We have to be even-handed, it's not just about the donors but also the recipients. Looking at the facts, agriculture was never a sexy sector to develop. It's about having the political will to focus on it."
India, Ms John points out, should channel a greater proportion of the growing funds available into meeting the health-related MDGs.
"The government talks about doubling and trebling expenditure, but they aren't increasing spending on a par with economic growth, the economy is growing far faster," she says.
There is also some anger, within the UN building, that the US government is considering a massive financial rescue package to bail out Wall Street, not so many blocks away across town.
"Why is it possible to find $700bn (477bn euros; £378bn) to help save the private sector on Wall Street and not find the money that is needed - in this case $6bn - to save women from dying?" asks Ms Obaid. "The issue becomes about where the priorities are."
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