17/05/2013 09:24 BST | Updated 16/07/2013 06:12 BST

Did We Get the Millennium Development Goals Wrong?

Along the mighty Indus river in Pakistan's most sourthern province, Sindh, I met one-year-old Daim at a mobile health post. He was possibly the most malnourished child I've ever seen in the 20 plus years I have spent working with World Vision. He was weak, distressed, crying without ceasing. As one of six children, his family were landless and amongst some of the most destitute and marginalised in the world. There are no schools, no health centres and no basic services. At only one-year-old, Daim's future already looked bleak.

Inequality is fast becoming the biggest social, economic and political challenge of our time. It threatens to steal the hopes of not only Daim, but that of a generation of forgotten children around the world.

The UN Millennium Development Goals, which will come to an end in 2015, have certainly given us a lot to celebrate. For the first time in history the proportion of people living on less than $1.25 per day has halved since 1990. More than two billion people gained access to improved drinking water. We've made many crucial gains in primary education, child survival, reductions in tuberculosis, malaria and HIV and AIDS.

Yet extreme poverty is as much a threat to children today as before. We need to ask ourselves some hard questions as to why this is.

I've seen it first-hand in recent visits to some of the world's most fragile and forgotten places - DR Congo, Afghanistan, Somalia, Niger and Pakistan - but I've seen it too in the some of the world's fastest growing economies. Despite India's incredible gains in recent years, the nation's shame is that 1.8 million children die every single year before their 5th birthday.

The facts speak for themselves.

As the international development community develop a new set of post-Millennium Development Goals, we must ask why the poorest of the poor have been left behind. One of the reasons, it seems, is that the goals focused on one clear problem: reducing poverty. This unintentionally encouraged governments to reach out to those closest to passing a certain threshold, rather than pulling up those living truly at the bottom. For example, it's easier to increase the income of someone living on 90 cents a day to $1 than someone who is living on 50 cents a day. This condemns families like Daim's to the global scrapheap. In 2013 this is morally unacceptable.

When the bottom 20% of the global population earn less than 2% of the world's income it's time we bravely face these issues head on. We must refuse to accept the argument that rising inequality is an unfortunate but necessary side-effect of economic growth, and that we can idly stand by and wait for the day when rights trickle down to the poor.

If we dare to dream a better world for our children, we must have the courage to address the inequalities faced by children whose lives are condemned before they've even been born. Those at the bottom of the heap deserve every chance to rise.