In 2000, 189 U.N. member states, including the United States, adopted the U.N. Millennium Declaration. In the Declaration, countries made commitments to achieve a series of measurable development targets worldwide by 2015 known as the "Millennium Development Goals" (MDGs or Goals). In all, there are eight MDGs comprised of 21 quantifiable targets measured by 60 indicators. Table 1 lists the Goals, and Table A-1 in the Appendix provides the corresponding targets. From September 20 to 22, 2010, world leaders gathered at U.N. Headquarters for a High-level Plenary Meeting (the Meeting) to review progress toward achieving the MDGs over the past decade. During the Meeting, participants discussed best practices and challenges to implementing the Goals, and governments adopted a General Assembly resolution outlining a "global action plan" to achieve the MDGs in the next five years. The resolution did not include any financial commitments; rather, it called on governments to fulfill existing aid commitments made at other international meetings and conferences. A key area of discussion among Meeting participants was governments' lack of success in meeting the MDGs in the past 10 years. There is general consensus in the international community that while there has been some progress in achieving the MDGs, the majority of Goals will not be met by 2015. Many also acknowledge that MDG progress is unevenly distributed across countries and regions. Moreover, no progress at all has been made toward some of the Goals, and in a few cases the indicators show regression. The Barack Obama Administration has generally supported the MDGs. President Obama addressed meeting participants on September 22, emphasizing the need for greater sustainability, accountability, and focus on economic growth in development assistance programs. His speech was consistent with the U.S. Strategy for Meeting the MDGs , released by the Administration in July 2010, which highlights four imperatives for achieving the Goals: (1) leveraging innovation, (2) investing in sustainability, (3) tracking development outcomes (not just dollars), and (4) ensuring mutual accountability among aid donors and recipients. In general, the Obama Administration appears to invoke the MDGs as a construct for U.S. development policy more frequently than do members of Congress. Since the Millennium Declaration was adopted in 2000, little legislation has been introduced that, either in whole or in part, addresses the MDGs. Nevertheless, members of the 112 th Congress may be interested in the Goals and the September High-level Meeting from several perspectives: D evelopment assistance in a tight fiscal environment —Members of Congress authorize and appropriate U.S. official development assistance. In light of growing concerns over the federal budget deficit, members may wish to reassess foreign assistance priorities and strategies; New international commitments —Congress may consider commitments made on behalf of the United States in the Meeting's outcome document, Keeping the Promise: United to Achieve the Millennium Development Goals (General Assembly resolution 65/1); and O versight —Members may wish to conduct oversight on the overall effectiveness of the MDGs and the previous and future role of the United States in helping to fulfill the Goals. More broadly, Congress may consider how, if at all, the MDGs should shape existing and future U.S. and international development activities. Selected questions that policymakers may consider follow: In what areas , if any, have the MDGs been successful? Many agree that some MDGs have been met or are on track to be met by 2015. Some are hopeful that the "lessons learned" from these experiences could be transferred to other Goals. Are the MDGs practical? Some experts contend that the Goals provide unrealistic expectations for countries or regions, particularly those starting out at a lower economic threshold than others. Moreover, some argue that the scope and breadth of the MDGs, and a lack of prioritization among them, have affected their progress. What is the role of foreign aid in the MDGs? Some maintain that in order for the MDGs to be fulfilled by 2015, donor countries must fulfill existing aid commitments and make new ones. Others, however, argue that higher aid levels do not necessarily lead to greater development impacts. Who or what is held accountable for MDG progress? Governments are primarily responsible for fulfilling the MDGs. At the same time, it is unclear to whom, if anyone, governments are accountable if they fail to achieve the Goals. This report discusses overarching trends in MDG progress and lessons learned from previous and ongoing efforts to achieve them. It examines U.S. policy toward the MDGs and how, if at all, the Goals fit into U.S. development and foreign assistance policy. It also examines different schools of thought regarding the effectiveness of the Goals, their role in international development, and their long-term sustainability. This report addresses the MDGs as a whole; it does not assess or analyze issues pertaining to the individual Goals. On September 22, the High-level Meeting concluded with the adoption of General Assembly resolution 65/1, a "global action plan" to achieve the MDGs by 2015. In the resolution, entitled Keeping the Promise: United to Achieve the Millennium Development Goals , governments reaffirmed the MDGs and welcomed progress made toward their achievement—recognizing that they can be met with "renewed commitments, effective implementation and intensified collective action by all Member States." At the same time, governments recognized that progress toward the Goals is uneven among regions and between and within countries, and expressed "deep concern" that progress toward the Goals "falls short of what is needed." No new financial commitments were made by governments in the resolution. Instead, governments called for the "expeditious delivery of [aid] commitments already made by developed countries" in the context of the Monterrey Consensus and the Doha Declaration. In the resolution, governments also committed to specific measures related to each of the eight Goals in the next five years, and requested the General Assembly to review progress made toward the Goals, and the implementation of the resolution, on an annual basis. To follow up on these efforts, member states agreed to hold a General Assembly special event on the MDGs in 2013. Countries also requested that the Secretary-General continue to report annually to the General Assembly on progress toward the Goals, and to recommended steps for advancing the U.N. development agenda beyond 2015. During the Meeting, the United Nations, governments, non-governmental organizations (NGOs), and private sector entities also announced individual development commitments. Several organizations and governments, for example, pledged a combined $40 billion over the next five years to accelerate progress on women's and children's health through the Secretary-General's Global Strategy for Women's and Children's Health . Other examples of such commitments follow: South Korea pledged $100 million to support food security and agriculture in developing countries (MDG 1); Dell committed $10 million toward education technology initiatives in 2010 (MDG 2); the World Bank announced it would increase the scope of its results-based health programs by more than $600 million until 2015 (MDG 6); the United States committed $50.82 million for the Global Alliance for Clean Cookstoves, a public-private partnership led by the U.N. Foundation to install clean-burning stoves in kitchens around the world (MDG 7); and the European Union offered €1 billion to the most committed and needy countries to make progress on the Goals they are furthest from achieving (MDG 8). Some of these commitments seem to be specifically created to accelerate progress on the MDGs. Others, however, appear to be part of broader development efforts and initiatives already being undertaken by governments, international organizations, NGOs, and the private sector. In advance of the September 2010 High-level Meeting on the MDGs, governments, NGOs, and others scrutinized MDG indicators to determine progress made toward the Goals. Generally, experts monitoring the MDG indicators have identified two overarching trends. First, while some MDGs are on track to be achieved, others have made no progress at all or, in some cases, have deteriorated. Second, progress toward the Goals is unevenly distributed among regions and countries. The following sections discuss and provide examples of these trends in further detail. While significant progress has been made toward a few MDGs, there is general agreement in the international community that many of the Goals will likely be missed both on a global level and by most countries. No progress at all has been made toward some Goals, and indicators show regression on others. For example, many predict that MDG 1, target 3, halving the number of people who suffer from hunger, will not be achieved. Throughout the 1990s and early 2000s there was some progress in combating hunger worldwide, but any advancements have recently stalled due in part to global food crises and the global economic crisis. In the period from 2005 through 2007, for instance, 830 million people were undernourished, an increase of 13 million from the 1990 level of 817 million. In addition, many observers agree that MDG 2, which aims to ensure that all children complete a full course of primary schooling, will likely remain unfulfilled at the global level. The United Nations and other organizations maintain that there has been progress in this area—for example, enrollment in primary education recently reached 89% in the developing world—but that the pace of this progress is insufficient. For the Goal to be achieved, all children at the official age for primary school in their respective countries would have to have been attending classes by 2009. In over half of Sub-Saharan Africa, however, at least 25% of school-aged children were not enrolled in 2008. Moreover, MDG 4, which addresses child mortality, sets a target of reducing the under-five mortality rate by two-thirds by 2015 that will likely not be met.