The Millennium Development Goals (MDGs), agreed to in 2000 by the global community represent the most significant global development initiative of the past decade. We conducted a survey of Australian medical students to explore their knowledge of the Goals and Australia's international aid program. The results indicated that while students are passionate about eradicating extreme poverty, knowledge of global initiatives such as the MDGs is severely lacking. We call on faculties of medicine to teach students about the MDGs and the role they can play in creating a world without poverty.
When asked why they chose to study medicine, medical students are more likely to say “to make a difference” than to “make a fortune”. Such sentiment is further demonstrated by the thousands of medical students who participate in global health activities throughout Australia and the world. Whether by joining a local group, fund-raising for a humanitarian cause or congregating in the hundreds every year at the Australian Medical Students Association (AMSA) Global Health Conference, most medical students are committed to alleviating poverty and improving health around the world.
In espousing the role of doctors as natural advocates for the poor,1 Rudolf Virchow, one of the founding fathers of social medicine said, “[Medicine] has the obligation to point out problems and to attempt their solution”.2 Such passion for the marginalised and impoverished of the world would surely stir Virchow's heart. However, our recent survey of Australian medical students showed that the passion is not always matched by knowledge of the world of global health and development. We asked medical students what they know about the the Millennium Declaration, which 190 nations – including Australia – agreed to in September 2000. The declaration lays out eight Millennium Development Goals (MDGs) that the global community vowed to meet by 2015 in an effort to eradicate – or at least alleviate – extreme poverty. The MDGs include specific goals on child health, maternal health and infectious disease and commit the countries of the world to working together to improve the lives of the extreme poor.
The goals provide a road map for global poverty alleviation efforts and represent a compact between nations, rich and poor. While poor countries use them to frame a development strategy and evaluate the progress of several key indicators, developed countries, NGOs, and multilaterals all use the Goals, and the specific targets attached, to guide and coordinate their initiatives. In recognising the increased need for aid to achieve the Goals, subsequent meetings of world leaders laid out commitments for developed countries to increase Overseas Development Assistance (ODA) to 0.7% Gross National Income (GNI) by 2015. The Rudd Government has put the MDGs at the centre of Australia's overseas development program and pledged to raise ODA from the current level of 0.32% to 0.5% by 2015/16.
In 2008, at the mid-way point to the MDG target date of 2015 we conducted an online survey of Australian medical students to explore their knowledge of the MDGs and more broadly about Australia's international aid program. We developed a 15 question online survey that was sent via email through the Australian Medical Students Association's Global Health Network to students at all medical schools in Australia. Participation in the survey was voluntary and it took less than five minutes to complete. A small incentive of two movie tickets was offered to motivate students to participate and to encourage responses from a wide sample of the student population. At the completion of the survey, students were directed to resources with more information about the Millennium Development Goals.
With more than 2,000 responses, representing students from every medical school in Australia, this is one of the largest medical student surveys conducted regarding international development. Australian medical students overwhelmingly believe (96%) that supporting the development of poorer countries is important.
Despite these generally positive attitudes to development, the most notable statistic that emerged from the survey was the students' lack of knowledge of the MDGs. Only 32% of respondents said they had not only heard of the MDGs, but knew at least something about them; this result highlights the students' low awareness of the world's most important development objectives (Figure 1).
We also assessed students' understanding of Australia's aid commitment, asking whether they thought it was too big or too little, as well as asking for estimates of Australia's current contribution to ODA. Estimates of Australia's aid program (as a % of GNI) varied widely from the miniscule (<0.05%) to very generous (>10%). An average of the results yielded a figure of approximately 1.7%— a figure more than five times the current Australian contribution of 0.32%.
We then went on to explain Australia's current contribution and the pledge made by the Rudd government to increase aid from 0.32 to 0.5% by 2015/16. Participants were informed of the pledges that Australia has made along with the international community and asked whether it was important for Australia to set a plan to reaching the 0.7% target. An overwhelming majority (85%) felt that meeting the 0.7% target was important.
The results of the survey indicate that while Australian medical students are very interested in global development and care deeply about it, knowledge of the MDGs and Australia's international aid program is very low. The lack of knowledge of the MDGs is not surprising given the Howard government's lack of high-level political support for the Goals, but now, with the Rudd government's renewed emphasis on MDG-focused development, this is the time for a deeper engagement by the medical community.
Australian medical students have an important voice. Our generation has the opportunity to contribute to the eradication of extreme poverty in this region and throughout the world. For medicine to fulfil its social role, future health professionals – now and into the future – must be empowered to understand the challenges of global health and be equipped to contribute to the global response to these challenges. Medical curricula must include information on development, global health and initiatives such as the MDGs. We call on faculties of medicine to provide opportunities for students to learn about international development, the MDGs, and the unique role they can play in creating a world without extreme poverty.