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Countries have improved on a number of Millennium Development Goals since the 1990s. For instance, 13 out of 15 countries in the region have increased the proportion of children enrolling in primary school; the likelihood of a child dying before his or her fifth birthday has reduced in many countries as has the chance of a mother dying while giving birth. More households now have access to a clean and safe water supply and sanitation facilities. Despite this progress, meeting the MDGs by 2015 will be a challenging task for many Pacific island countries and Timor-Leste. Many are unlikely to meet the targets of halving poverty, achieving universal primary education, reducing child and maternal mortality by two-thirds, and improving access to safe water supply and sanitation. Particularly in the poorest countries, infectious diseases such as malaria, HIV and tuberculosis continue to spread at alarming rates and rising incidence of lifestyle diseases is placing additional burden on fragile public health systems.

At one end of the spectrum, Polynesian countries— particularly Samoa and Tonga— have made the most progress and are on track to achieve a number of Millennium Development Goals. At the other end of the spectrum, PNG and Timor-Leste, the two most populous countries, face a number of different development challenges and both are unlikely to meet any Millennium Development Goal by 2015.

Of all MDGs, progress towards MDG 1—reducing poverty and hunger—has been the slowest and is of most concern in the region. While monitoring and understanding poverty in the Pacific is hampered by poor quality and out-of-date data, indications are that the number of people living in poverty continues to rise and was doing so even before the food and fuel crisis and the onset of the global recession.

High population growth on the one hand and low levels of investment and job creation on the other hand, has resulted in large-scale unemployment and under-employment across the region, which have contributed to the rising incidence of poverty. In most Pacific island countries and Timor-Leste, the growing young population finds it difficult to access quality education and training and even more difficult to find paid employment—the number of new entrants into the labour market each year far outweighs the number of job openings. Chapter 4 examines ways that countries can create more jobs through expanding and diversifying their trading base. Chapter 5 examines how labour migration offers opportunities for a more prosperous region.