Government of Mongolia


2007 Mongolia Needs Assessment

Table of Contents
Abbreviations.................................................................................................................................. 3 Glossary of Terms........................................................................................................................... 3 Cover photo: “Camel driver, Bayan Gobi, Mongolia” Michelle Genther, 2004. ........................... 3 INTRODUCTION .......................................................................................................................... 4 ECONOMICS AND POVERTY.................................................................................................... 7 Privatization in Mongolia ........................................................................................................... 7 Consequences of Privatization.................................................................................................... 8 External Factors ........................................................................................................................ 10 Poverty: Urban versus Rural ..................................................................................................... 10 Gender Equality ........................................................................................................................ 13 MDG 1: Reduce Poverty and Hunger by One Half .................................................................. 14 Graphs and Tables: Economics and Poverty (A).................................................................. 15 HEALTH....................................................................................................................................... 17 Mongolia’s Healthcare System ................................................................................................. 17 Overall Health of Mongolians................................................................................................... 19 MDGs........................................................................................................................................ 20 Diseases and Illnesses ............................................................................................................... 21 Factors contributing to spread of disease.................................................................................. 23 Urban and Rural........................................................................................................................ 23 Summary of Issues.................................................................................................................... 24 Graphs and Tables: Health (B).............................................................................................. 25 ENVIRONMENT AND AGRICULTURE .................................................................................. 27 Mongolia’s Environment .......................................................................................................... 27 Animal Husbandry .................................................................................................................... 27 Help from the Bilateral and Multilateral Community............................................................... 28 MDG 7: Ensure Environmental Sustainability ......................................................................... 29 The Role of NGOs Regarding MDG 7 ..................................................................................... 32 Graphs and Tables: Environment and Agriculture (C) ......................................................... 33 CONCLUSION............................................................................................................................. 39 WORKS CITED ........................................................................................................................... 41

Government of Mongolia | 2

2007 Mongolia Needs Assessment

ADB EPAP EU FAO GDP HDI HIV/AIDS IFAD JICA MDG MOH MOSTEC NGO SFP STD/STI TB UNESCO UNICEF UNDP USAID VTS WHO Asian Development Bank Environmental Awareness Project European Union Food and Agricultural Organization Gross Domestic Product Human Development Index Human Immunodeficiency Virus / Acquired Immunodeficiency Syndrome International Fund for Agricultural Development Japan International Cooperation Agency Millennium Development Goals Ministry of Health Ministry of Science, Technology, Education, and Culture Nongovernmental organization Sustainable Livelihoods Project Sexually Transmitted Disease/Sexually Transmitted Infection Tuberculosis United Nations Science and Cultural Organization United Nations Children’s fund United Nations Development Program United States Agency for International Development Vocational Training School World health Organization

Glossary of Terms
aimag bag dzud gher negdel soum province sub-district a severe winter episode with a lot of snow posing a risk to livestock traditional Mongolian tent dwelling former collective farm district

Cover photo: “Camel driver, Bayan Gobi, Mongolia” Michelle Genther, 2004.

Government of Mongolia | Abbreviations 3

2007 Mongolia Needs Assessment

Bordered by Russia to the North and China to the South, Mongolia is seated in an area of Asia that has historically been dominated by socialist ideology. Mongolia followed a socialist, centrally-planned economy and single party government until the fall of the Soviet Union. In 1990-1991, Mongolia began a radical transition to democracy and market economics that is still continuing today. With only 2.5 million inhabitants, Mongolia's sparsely populated territory lends itself to agriculture and mining. Our most valuable assets include gold, copper, and coal deposits and livestock used for raw materials for cashmere, wool, meat, and leather products (World Bank, CAS, Attachment 4). Despite achieving a high degree of market liberalization and the privatization of public goods, property and institutions, Mongolia's limited growth and multiple structural impediments have resulted in limited human development. One third of Mongolia's population is now living below the poverty line and inequality of income and the quality of life exists both between urban and rural populations and within the urban population of the capital, Ulaanbaatar.

Historical Overview
Ten years after declaring independence from China with the support of Russia in 1911, a communist regime was established in Mongolia in 1921. Beginning in the 1940s, Mongolia pursued a centralized, planned economy that fixed prices and tariffs (Nyamsuren, 224-25). By the 1960s, all property was owned by the state or cooperatives (EGSPRS, 2). Under this communist system, Mongolia enjoyed relatively high standards of living (compared to other Soviet bloc countries) thanks to highly subsidized basic necessities, broad social services coverage, and high, stable employment levels. These measures allowed citizens to live well and enjoy a largely egalitarian and poverty- free society despite the fact that Gross Domestic Product (GDP) per capita levels only reached $471 in 1989 (Nixson and Walters). All of this was possible given that our economy was to an immense degree dependent upon financial support and trade with Soviet Union. Imports from the USSR were at 58 percent of the GDP and external financing 30 percent before the 1990s (Nyamsuren, 226).

Government of Mongolia | INTRODUCTION 4

2007 Mongolia Needs Assessment This high level of dependency on the USSR proved to be a devastating factor in the dramatic changes that occurred in 1990-1992. The fall of the Soviet Union in 1991 and the withdrawal of financial support and a stable market resulted in dramatic declines in GDP (20 percent from 1990 to 1992). Savings also dropped from 35 percent of GDP to 26 percent, imports dropped by over half, and inflation reached its highest point in 1992 at 325.5 percent. Large loans from the Soviet Union suddenly ended and unemployment soared (EGSPRS, 1). The Soviet Union had also been a major customer and in 1990, exports fell by 40 percent and did not cease to decline until 1993 (Nyamsuren, 226-227).

In order to deal with these severe losses and momentous circumstances, Mongolia began a series of reforms aimed at transitioning to a democratic society with free, multiparty elections, a new constitution, and the initiation of a market economy (Nyamsuren, 225). Of greatest importance were the liberalization of state-controlled prices and tariffs, the privatization of public enterprises, the liberalization of trade on the international market, a new, floated exchange rate system, and the adoption of conservative monetary and fiscal policies designed to halt our rapid rate of inflation and reduce the government deficit (EGSPRS, 1). These reforms fundamentally altered the structure of society and the changes affected all areas of life for Mongolians.

After implementing rapid economic reforms--also known as "shock therapy"--during the first ten years of transition, Mongolia is now pursuing development strategies that are more supportive of the poor and focused on eliminating poverty. Since our economy before 1990 had been maintained primarily by the support and partnership of the Soviet Union, it would clearly be neither self-sufficient nor competitive in the global market. However, the effects of massive privatization of businesses, housing, pasture land, and livestock previously owned by the government for public use have caused a dramatic increase in inequality within Mongolian society. The loss of the system subsidizing basic necessities, which had provided fairly equal access during the central planning period, also contributed to the social inequality witnessed in the decade following the implementation of these policies (Nixson and Walters).

External factors have also made our launch towards a new economic system start off on shaky footing. The collapse of CMEA (the economic cooperation and trade organization of the eastGovernment of Mongolia | INTRODUCTION 5

2007 Mongolia Needs Assessment bloc countries), harsh winters and droughts in 2000 and 2001, and the end of the system of textile quotas for importing countries like the US in 2005 all presented challenges to our new, evolving economy.

Poverty is currently the most pressing issue Mongolia faces as we continue along a path of economic liberalization and increased participation in the global market. While income figures are important, Mongolia recognizes that a more accurate assessment of our population's needs takes into account issues of environmental factors, health, and education. approach to development is therefore both logical and absolutely crucial. A multi-directional

At the core of our development plan is a human resources approach. We strongly believe that in order to achieve the goals we have set we must focus on building capacity at the community level and improving access to basic social services in addition to macroeconomic restructuring. We hope this report will prove useful for donor organizations to gauge Mongolia’s historical progress and current development needs as we strive to improve the quality of life experienced by every Mongolian citizen and strengthen our ties with other nations and members of the international community.

Government of Mongolia | INTRODUCTION 6

2007 Mongolia Needs Assessment

Privatization in Mongolia
For the 70 years prior to Mongolia’s economic and political reform, its adherence to a socialist structure proved successful in the achievement of high levels of human development. Over this period, the people of Mongolia enjoyed improvements in gender equality, education, access to health care, and social security. From 1960 to 1990, life expectancy in Mongolia jumped from 46.7 years to 63.7 years, and adult literacy had risen to 97.8 percent. 98 percent of pregnant women received prenatal care, malnutrition was rare, and nearly all citizens had access to healthcare (6, HDR).

Mongolia was able to achieve such impressive standards of human development as a consequence of our close ties to the Soviet Union and the subsidized imports the USSR provided. Naturally, when the Soviet Union collapsed in 1991, all aid, subsidies, and support immediately ended, and Mongolia’s leaders found themselves required to decide on a new plan for the future of our citizens.

Since the beginning of Mongolia's transition, the principal aim of reforms has been privatization. Mongolia began this process by adopting a voucher system, in which citizens were granted vouchers that could be used to buy shares in government and cooperative businesses. The system began in October of 1991, when three red vouchers of 1000 tugriks were awarded to citizens born before May 31st of that year (Nixson and Walters). These vouchers could be used to buy shares or could be traded on the secondary markets. A second series of blue vouchers worth 7,000 tugriks was awarded, one per citizen, from October of 1991 to July of 1992. These were intended for bidding for shares in joint stock enterprises that were created from formerly stateowned enterprises. This system of vouchers led to the privatization of an estimated 4500 entities between 1991 and 1994, and 942 from 1996 to 2000 (Nixson and Walters).

In the agricultural sector, collective farms, called negdels, were also privatized using this system of vouchers. Although in the 1980s Mongolia had introduced a system of limited private ownership of livestock, the majority of herds were run by state cooperatives in which there was a Government of Mongolia | ECONOMICS AND POVERTY 7

2007 Mongolia Needs Assessment low degree of economic inequality between members. The voucher system was applied first to herds and herd-related assets like wells and shelters, and later to larger assets and the cooperatives themselves (Nixson and Walters).

A third important area in which privatization occurred was Mongolia’s housing sector. All residential apartments and buildings were owned by the state prior to 1991. Citizens would apply to the Housing Commission and would be put on a waiting list until a vacancy appeared. In 1996 it was decided that when these apartments and buildings were privatized, it was decided that the tenants living in them at the time would become owners without any charge. The change in the governing party in 1996 resulted in an expedited and more transparent privatization process, deregulation of the Mongolian economy and the objective of attracting more foreign investment (Nixson and Walters).

By 2003, over seventy- five percent of Mongolia's economy had been transferred to private ownership, compared the 1990 starting-point of 4 percent (USAID/Mongolia, 23). Some of the largest privatization moves in Mongolia occurred in 2003 when, with assistance from USAID, the Trade and Development Bank and Agricultural Bank were sold. USAID estimates that the combined result of these transactions provided 20 billion USD to the Mongolian treasury (USAID/Mongolia, 4).

Consequences of Privatization
Given the abruptness of the fall of our largest benefactor and the accelerated pace of the privatization in Mongolia, it may come as little surprise that the transition has been turbulent and the outcomes of this new path have not been exclusively positive. One of the consequences of the privatization of businesses and government entities is restructuring and budget tightening. In order to become competitive in the global market, businesses must reduce their employee headcount. Frequently, reducing the size and scope of the government is considered absolutely necessary, and these two policies were pursued in earnest in the first decade of transition in Mongolia. The resulting unemployment was and is a crucial element in the fate of the population. Of the entire population of working age in Mongolia in urban areas 27.3-38.8 percent is unemployed (Government of Mongolia, 12). Government of Mongolia | ECONOMICS AND POVERTY 8

2007 Mongolia Needs Assessment

Those who kept their jobs also felt the effects of new, profit-oriented objectives; many businesses reduced or did away with services to employees such as child care, educational provisions, health care, and occasionally even housing. These services represented “non-market elements of a social wage” that the new, reduced state did not provide and which reduced workers’ standard of living and plunged some into the new category of “poor” (Nixson and Walters).

The level of unemployment is, in addition to household income sources, the most important factor for determining poverty and unemployment (Dore and Nagpal). Those most likely to be poor in Mongolia are single parent households with many children, households with less than 100 heads of livestock (dependent on household structure and size), the unemployed, those lacking basic education, and specific vulnerable groups such as the elderly, disabled, street children and orphan children (EGSPRS, 11).

Livestock privatization had varied results and was not extensively documented by the members of each cooperative. However, data from 1992 indicates that “5 percent of households had herds with more than 200 animals, whereas at the bottom end of the distribution, 42 percent of households had herds containing less than 31 animals.” (Nixson and Walters). This distribution has changed, but large disparities remain; estimates from 2000 indicates that “63 percent of households had less than 100 animals, 22 percent had herds of 100-200 animals and 12 percent had herds between 200 and 500 animals. These families with fewer than 100 animals were at greater disadvantage when, in the winters of 2000 and 2001, Mongolia experienced dzuds, or extremely harsh winter storms. These years and others have meant that many of these small herders lost their only source of livelihood (Nixson and Walters).

Not all Mongolians benefited from the privatization of apartments and among those who did, disparities exist regarding the extent of gains. Those living in the gher district at the time of privatization did not gain anything as they did not reside in apartment buildings. And amongst those who did become owners of the apartments they inhabited appeared an imbalance in the value of property gained. Apartments located in the central district of Ulaanbaatar became more Government of Mongolia | ECONOMICS AND POVERTY 9

2007 Mongolia Needs Assessment desirable and expensive, and were largely obtained by wealthy Mongolians and foreigners. Occasionally, situations arose in which only one of two families living in the same apartment was granted ownership. Due to the increase in the cost of basic service charges such as gas, electricity, water, and heating, the fact that apartment-dwelling families no longer paid rent mattered little. Table (Monthly expenditure on household services, Nixson and Walters).

External Factors
Despite our progress towards democracy and a market economy, several external factors over the past 17 years have made the goal of reducing Mongolia's high poverty rate much more difficult. Growth has been unsteady (see graph A1).

The East Asian financial crisis of 1997-1998, fluctuations of market prices, and the end of international agreements favoring Mongolia within the global market (World Bank, CAS, 3). Because 90 percent of Mongolia’s exports consist of a few raw materials (minerals like gold and copper, animal skins and wool, and knitted items), the economy is highly vulnerable to market price fluctuations (HDR, 12).

January 1, 2005 marked the end of the decades-long WTO Agreement on Textiles and Clothing, which established quotas on the quantity of textiles that could be purchased from a particular country. This meant that the US and other large consumers could purchase all textiles from countries that pay workers less and produce goods more cheaply like China. Mongolia’s textile companies are in critical need of modernization, and the industry suffers from electricity rates three times higher than those of the residential sector and these issues prevent it from becoming competitive in the world market (Brooks, 2004).

Poverty: Urban versus Rural
Between 1995 and 2000, the percentage of those living in poverty did not increase significantly but the “depth of poverty” increased as did inequality (Government of Mongolia, 12). Despite the promise of employment and the proximity to social services that living near urban centers suggests, “a substantial proportion of urban population lies within the extremely poor category” according to a World Bank Participatory Living Standards Assessment from 2000 (Government Government of Mongolia | ECONOMICS AND POVERTY 10

2007 Mongolia Needs Assessment of Mongolia, 12).

During Mongolia’s socialist period, citizens’ ability to migrate within the country was limited. This was changed in Mongolia’s new constitution, which permitted free movement. Coupled with this legal change was a loss of government investment in agriculture and an overall decline in social services, and from this new set of social conditions an enormous shift in population distribution developed (HDR, 42). Two opposing trends are distinguishable over the first ten years after Mongolia’s reform.

The first trend was a wave of migration from urban centers to the countryside, as thousands of workers employed in large state industries, construction, and public administration lost their jobs and left the cities to work in agriculture. The period of underdevelopment that resulted from Mongolia’s structural changes increased temporarily the importance of the agricultural sector (HDR, 42). The number of herders increased by 136 percent from 1990 to 1993, but the total output of the agricultural sector dropped to subsistence level (HDR, 43).

However, the opportunity that herding represented for many small herders rapidly evaporated after the winters of 1999-2000 and 2000-2001, when Mongolia experienced dzuds—severe winter storm conditions—and herders lost 7 million animals, equivalent to around 22 percent of the country’s total livestock (Dore and Nagpal). This sparked a reversal of migration patterns, as families who had lost their livelihoods turned (or returned) to the city to search for employment. Ulaanbaatar saw a 5 percent increase in population in 1999 (HDR, 43).

Despite the differing trends, Ulaanbaatar is still the destination of the majority of Mongolians. Between 1990 and 2000 the population of Ulaanbaatar increased by over 27 percent (HDR, 43). While moving to the capital will not guarantee a better standard of living than staying in the countryside, there is a significant difference in access to basic services and employment opportunities (see graph A2). As of 2006, 43 percent of Mongolia’s rural population lived below the official poverty line, compared to 30 percent of the urban population (Dore and Nagpal).

The Rural Population
Government of Mongolia | ECONOMICS AND POVERTY 11

2007 Mongolia Needs Assessment Of immense import to explaining the pronounced difference between poverty levels of these two populations are the ecological and geological realities Mongolia faces. The vastness of our country and harsh weather conditions matters much more to those living off of agriculture and away from electricity grids or sanitation services. It is difficult and expensive to deliver social services to remote provinces, called aimags, located in Mongolia’s six geographical regions: "high mountains, taiga forest, forest steppe (grasslands), desert steppe, and desert regions" (HDR, 20). The majority of these are not linked to the capital by paved roads or the existing roads are in need of maintenance. Fuel prices in rural areas are currently 10-20 percent higher than urban centers, further limiting the rural population's access to education, health care, employment, information and safe drinking water (HDR, 21). Rural herders are often isolated and unaware of market terms of trade for exports like cashmere and wool (HDR, Box 3.1, p 39).

In addition to the isolation of the rural population, Mongolia experiences harsh weather conditions that damage property, hinder food production, and damage people's eyesight. 20-30 hazardous climatic phenomena occur every year, one third of which can be classified as natural disasters, including heavy snowstorms, drought, heavy rain, strong winds, floods, and dust storms. Snowstorms may last weeks and droughts may last for several years, greatly interfering with food production cycles and imperiling livestock herds (HDR, 20).

The Urban Population
Urban populations are much more likely to have access to central heating, sanitation services, and clean drinking water, but not all of the urban population actually enjoys these benefits. Within the category of urban residents two sub-categories exist: those living in apartment buildings in the city, and those living in the semi-permanent gher district at the outskirts of the city. One quarter of urban gher dwellers do not have waste disposal facilities. In addition Mongolians living in urban gher districts frequently experience water shortages and are forced to drink from unsafe water sources that may be polluted. Water consumption between apartment and gher dwellers differs substantially; the former consumes 240- 450 liters per day, the latter, 8 to 10 liters per day. In 2003, the majority of urban poor lacked central heating. (HDR, 31). Roads in gher districts are generally left unpaved and become soft and muddy once the ground thaws (HDR, 32). Government of Mongolia | ECONOMICS AND POVERTY 12

2007 Mongolia Needs Assessment

Gender Equality
Mongolia's Constitution provides equal rights to men and women, and we, the Government of Mongolia, have signed several international conventions on gender equality and rights. In addition, in 2001, the National Council for Gender Equality was created “to monitor and support the implementation of policy and to promote women and gender equality” (15, Government of Mongolia). In 1996, the National Program for the Advancement of Women (NPAW) was established to address Mongolia’s needs in gender equality. However, gender disparities still remain “in all dimensions of poverty, and specifically; access to economic opportunity, capacity to access public services, vulnerability to economic and domestic violence, and political empowerment” (15, Government of Mongolia). Currently, while 50.5 percent of the population is female, women represent only 11.8 percent of Mongolian parliament members and 16.9 percent of heads of agencies and organizations (Embassy). In addition, 54.3 percent of Mongolia’s unemployed are women.

The roots of some of these issues can be directly traced to policies Mongolia adopted in order to transition to a market economy. The Pension law of 1991 provided women with four or more children the option of receiving state pensions early, providing a financial incentive to them to stop working sooner than men. Because privatized assets are registered as belonging to the head of household (frequently male), women are not able to control these assets or use them for their own business endeavors (16, Government of Mongolia).

Programs and Support
In order to address Mongolia’s high rates of poverty, the Mongolian Government, with donor countries, UN affiliated agencies, and other international organizations, authorized the National Poverty Alleviation Program (NPAP), in 1994, implemented in 2000. Over 13,000 small- scale programs have been implemented as a cooperative effort to improve living standards in remote aimags. Many of these deal with providing education or training for disabled children and adults, creating employment in rural communities, improving basic medical and educational services, and generally addressing the needs of vulnerable groups. These projects are to a large degree initiated by local communities and thus are representative of their true needs (EGSPRS, 21-22).

Government of Mongolia | ECONOMICS AND POVERTY 13

2007 Mongolia Needs Assessment The Law on the Facilitation of Employment takes up Mongolia’s high unemployment rates. This law allocates a minimum amount (no less than 0.3 percent) of funds from the annual budget to the Employment Support Fund. The Fund then transfers this money to employment offices in Ulaanbaatar and the aimags, for vocational training programs and employer support (EGSPRS, 22).

The Mongolian government adopted a new goal of supporting regional development in order to reduce the high concentration of population in Ulaanbaatar, ensure a greater degree of economic sustainability in other urban centers, and reduce the development disparities between cities and rural areas. It is hoped that economic development based on the natural assets of different regions, such as mineral deposits, will help improve the quality of life by allowing populations to enjoy health, cultural, and social services and employment opportunities in remote regions of the country (HDR, 45). The Millennium Road project addresses similar needs. This project, adopted in 2001, is to build a road running East-West, as well as five North-South roads, with the goal of expanding both domestic and international trade (HDR, 46).

MDG 1: Reduce Poverty and Hunger by One Half
The UNDP’s first Millennium Development Goal is to halve, between 1990 and 2015, the proportion of people whose income is below the national poverty line. Given the economy’s moderate growth and the numerous structural impediments Mongolia faces, achievement of this goal is unlikely (see table A3). Harsh weather conditions, volatile market prices and an undiversified export sector, h i g h unemployment, and difficulty providing social services to populations in remote regions of the country have all made it particularly difficult to reduce Mongolia’s high poverty rate (MDG Report, 3). In order to mitigate these problems, Mongolia must focus on improving growth rates, diversifying the economy and encouraging diversification among small herders, improving regional development as a part of a strategy to reduce the urbanrural gap and improving the poor’s access to food (MDG Report, 4).

Government of Mongolia | ECONOMICS AND POVERTY 14

2007 Mongolia Needs Assessment

Graphs and Tables: Economics and Poverty (A)
A1. Mongolia’s rocky transition: GDP growth rates: 1989-2002

Source: HDR, p. 11. A2. Mongolia: Urban-Rural Differences, 2002

Source: World Bank CAS, 6, 2004 Government of Mongolia | ECONOMICS AND POVERTY 15

2007 Mongolia Needs Assessment

Mongolia’s Progress: Reducing Poverty by 2015
40 36



Poverty Headcount



20 18 15



Actual MDG Target

0 1990 2000 2015

Source: MDG Report, 2003, 3.

Government of Mongolia | ECONOMICS AND POVERTY 16

2007 Mongolia Needs Assessment

Mongolia’s sparse population settlements, immense land size and population concentration in a few large cities place it in a unique situation. The impacts of these factors are perhaps most clearly seen in the health sector. At present, the health sector is made of up approximately “17 specialized hospitals and centers, 4 regional diagnostic and treatment centers, 12 districts and 21 aimag general hospitals, 323 soum hospitals, 18 veterinary posts, 233 family group practices, and 536 private hospitals and 57 drug supply companies and pharmacies” (Embassy). The majority of health services are situated in the areas with most of Mongolia’s population, which include the capital city Ulaanbaatar, leaving rural inhabitants with limited access to the country’s health care system. In 1997, Mongolia had one of the highest ratios in Asia of physicians and hospital beds to population, 25 physicians and 78 hospital beds per 10,000 people (Ebright, 1509). At last count this number was at 27.7 physicians and 75.7 hospital beds per 10,000 people (Embassy). Approximately 57 percent of Mongolians live in Ulaanbaatar and 43 percent reside in rural areas (Embassy). Making Mongolia’s healthcare system more accessible to rural dwellers is one of the biggest concerns in the health sector today. In addition, Mongolia is on the brink of an HIV epidemic (UNICEF) and is continuing to battle the spread of four major chronic infections: hepatitis B and C, brucellosis, tuberculosis, and sexually transmitted diseases (Ebright, 1509). Steps to reverse Mongolia’s high maternal mortality rate must also be taken.

Mongolia’s Healthcare System
The transition that Mongolia underwent in 1990 also had a drastic effect on its healthcare system. Before the transition, Mongolia followed the Soviet model of economic development, in which healthcare services were entirely financed and provided by the government (Bayarsaikhan, 28). Under this system, all Mongolians had free access to healthcare. The financing was a

combination of local and central government funds, as well as aid from the Soviet Union. This aid accounted for 30 percent of the country’s GDP (Bayarsaikhan, 28), until the Union’s collapse ended this source of funding. As a result, the overall government budget was reduced and the healthcare allocation drastically decreased.

Mongolia’s healthcare system has undergone many changes since 1990. The universal free healthcare coverage of the decades prior to the 1990s had to be disintegrated due to the suddenly limited funds. The government could no longer fund quality, accessible, and full- ranging health Government of Mongolia | ECONOMICS AND POVERTY 17

2007 Mongolia Needs Assessment services, which was made difficult by high inflation and depreciation of the national currency (Bayarsaikhan, 30). Policy began to focus on how to generate funds to the health sector without making individuals pay excessively and also how to aid the most vulnerable of Mongolians, the low- income and the poor.

The solution was social health care. In 1993, the Mongolian Parliament enacted the Mongolian Citizen’s Law on Health Insurance, which provided compulsorily insurance to all “public and private sector employees and low- income and vulnerable population groups” (Bayarsaikhan, 31). Under the low- income and vulnerable population heading were children under 16, students, pensioners, mothers with infants, military service individuals, herders and individuals provided with social assistance, accounting for almost 70 percent of the total population (Bayarsaikhan, 32). The Law also made voluntary insurance available to unemployed individuals of working age with the ability to work. The Law was implemented on January 1, 1994 and covered nearly 95 percent of the population within the first two years (Bayarsaikhan, 31). Funding for the health insurance came from a variety of sources: government, private and individual user fees and copayments. As of data available at the most recent date, approximately 14,000 employers and 545,000 individuals pay insurance fees (Embassy).

Over the next few years, however, problems with maintaining the universality of the system emerged. First of all, because health insurance was a new concept for Mongolia, there were challenges with registering and collecting premiums from self-employed nomads (Bayarsaikhan, 32). Then, due to the low population density and “high dependency on imported pharmaceutical, medical equipment and supplies,” the healthcare costs increased (Bayarsaikhan, 34). A large portion of the total national health budget is taken up by non-service-related costs, which include heating, electricity and building maintenance (Bayarsaikhan, 34). These services are even more important in Mongolia because of its extremely cold winter months.

Another issue developed along with private sector growth in the country. The number of private practices and institutions has been rapidly rising in Mongolia since the introduction of social health care. Although there is now more variety of health care open to Mongolians, the number of them has contributed to the overall health expenditure increase (Bayarsaikhan, 36). This is an Government of Mongolia | ECONOMICS AND POVERTY 18

2007 Mongolia Needs Assessment issue because all of these private practices and institutions count on the national health insurance fund for their operating costs. Dividing up the fund among all of the institutions makes less funding available to individual facilities.

The next challenge facing the health care system was its ability to provide quality and diversity of services to the insured. The system largely worked for those who were hospitalized. Therefore, unless insured members were hospitalized, they did not see many benefits (Bayarsaikhan, 38). A report showed that in 2001 approximately 62 percent of the contributing members did not receive any benefits (Bayarsaikhan, 39). Students and nomads have been gradually excluded from government subsidies and a large number of them dropped out entirely from the insurance system, causing the health insurance coverage rate to decline from nearly 96 percent in 1996 to 78 percent in 2003 (Bayarsaikhan, 39). In addition, limited funding has blocked the expansion of benefit packages and consistent training programs for health insurance workers (Bayarsaikhan, 40).

Adding to the aforementioned concerns with the health care system are those related to poverty. There has been increased marginalization of certain groups of the population, increased internal migration and number of homeless, as well as poor living conditions (Embassy). In the discussion of differences between urban and rural populations, it is essential to look at the unequal health status and access to services that has emerged in the last decade and a half (Embassy). There is routinely better healthcare access in urban areas than in rural.

Overall Health of Mongolians
Mongolians are relatively healthier than their counterparts in other low-income countries (Embassy). Throughout the last decade, there have been many improvements in infant mortality, average life expectancy, and death rates. Since the transition and until 1992, average life expectancy fell from 63.7 to 62.8 years, and then increased again to 63.5 years by 2002 (HDR, 8). Between 1992 and 2002, infant mortality rates decreased from 63.5 to 30.4 per thousand live births (Embassy). According to the Human Development Report for Mongolia, the decline in infant mortality was from 64.4 deaths per thousand live births in 1990, to 48.0 in 1994 and 29.6 in 2002 (8). The maternal mortality rate reached its lowest amount in 2004 at 98 deaths per 100,000 live births (MOH, 12) (See graph, B1). The availability of physicians and healthcare Government of Mongolia | ECONOMICS AND POVERTY 19

2007 Mongolia Needs Assessment facilities to administer healthy deliveries is high; with 98 percent of deliveries in urban areas and 92 percent in rural areas taking place in healthcare facilities and 98 percent of deliveries were conducted by a gynecologist, a physician, or a professional midwife (HDR, 8).

Despite these improvements, maternal and child mortality rates are still relatively high. The Human Development Report stated that the maternal mortality rate in Mongolia has been fluctuating, with numbers decreasing from 1.5 to 1.2 per 1,000 live births between 1985 and 1990, and then increasing to 2.4 during the first few years of the transition, and finally falling to 1.4 in 1997 and to 1.2 by 2002 (8). WHO has identified several causes of the high maternal mortality rates. The biggest cause of maternal mortality, with 68 percent, is due to difficulties encountered during puerperium, which is the six week period immediately following giving birth. The next cause of death, accounting for 45.5 percent, is extragenital disease.

Complications encountered during delivery claim the next largest figure of lives with 25 percent. The cause of death with the lowest percentage, 22.7 percent, is due to complications during pregnancy. Better access in all of Mongolia to prenatal care is required to decrease the prevalence of vulnerability during pregnancy.

The Mongolian government is committed to attaining the Millennium Development Goals. Of the eight goals, the ones that most pertain to the health sector are: “Goal 4: Reduce under- five mortality by two/thirds between 1990 and 2015, Goal 5: Reduce by three-quarters, between 1990 and 2015, the maternal mortality ratio, and Goal 6: Halt and reverse spread of HIV/AIDS and tuberculosis” (World Bank, 5). According to evaluations by the World Bank in 2004, Mongolia was well on track and is likely to attain Goal 4, with under- five mortality rates being 87.5 in 1995 and 42.4 in 1998. As stated above, the maternal mortality rate is not decreasing by as much as needed and the decline from 200 in 1992 to 109 in 2003 is not sufficient to fully meet the required three-quarter decline in rate by 2015. Due to Mongolia’s unique status regarding the low prevalence of HIV/AIDS, achieving Goal 6 will depend on initiating policies and programs to prevent the rate of infection from increasing. According to World Bank data, TB rates increased from 70 to 100 per 100,000 people in the last decade. More attention needs to be brought to battling TB. Government of Mongolia | ECONOMICS AND POVERTY 20

2007 Mongolia Needs Assessment

Diseases and Illnesses
(See table, B2) Mongolia is currently experiencing an “epidemiological transition,” which is identified by a reduction in communicable diseases and a rise in non-communicable diseases as the main causes of death (Embassy). WHO identified these as cancer, cardiovascular diseases, injuries and “mental health problems.” However, several kinds of sexually transmitted diseases are still a factor throughout Mongolia. Syphilis has increased from 3.7 to 6.7 per 10,000 people from 1991 and 2002, while gonorrhea made an even greater jump from 9.3 to 19.6 during the same time period (HDR, 9).

Of perhaps greater concern is the possible epidemic of HIV/AIDS. By 2002, there were only two detected cases of HIV infection (Ebright, 1509). Between 2005 and 2006, twenty people were diagnosed with HIV, indicating a high-risk environment for an HIV epidemic (UNICEF). The spread of HIV to the general population will most likely occur through sexual transmission, with the main indicators of vulnerability being increasing sexually transmitted infection rates, which now account for 47.3 percent of all communicable diseases, low knowledge among Mongolians of misconceptions and preventions of HIV/AIDS, increasing high risk behavior, and low condom use among the general population and the vulnerable groups (UNICEF). The Human Development Report also added over 50 percent of the population being under 23 years of age, increased number of sex workers and decreasing age of sex workers, rise in migration and population movements between countries, a rise in drug use, as well as the rapid increase of HIV infection in neighboring Russia and China, to the list of risk factors (9).

Recent developments have been made in the fight against HIV/AIDS in Mongolia. Mongolia’s Ministry of Health proposed a budget in 2005 to the GFTAM (Global Fund to fight HIV/AIDS, Tuberculosis and Malaria) to help enact programs specifically for HIV/AIDS (WHO). The budget was approved for US $4.2 million and will run from 2006 to 2011. The goals of the programs are “(1) to reduce HIV transmission among vulnerable populations through reduction of high-risk behaviors by scaling up existing targeted prevention interventions; (2) to establish and scale up prevention [programs] at workplaces vulnerable to HIV/AIDS/STI (mining, construction, transportation, trade, entertainment companies and uniformed services); (3) to Government of Mongolia | ECONOMICS AND POVERTY 21

2007 Mongolia Needs Assessment strengthen the health system for improved prevention, care and support [programs] regarding HIV/ AIDS/ STI, including the link between HIV and TB; and (4) to scale up HIV/ AIDS advocacy, human rights protection and de-stigmatization” (WHO).

Another communicable disease of concern is tuberculosis, TB. Between 1991 and 2002, the rate of TB occurrence doubled, from 7.4 per 10,000 population to 14.9 (HDR, 9). Mongolia is on the World Health Organization’s list of seven Asia-Pacific countries with high numbers of TB (HDR, 9). An entire building of Mongolia’s major university hospital, the National Research Center for Infectious Diseases, is reserved specifically for the treatment of patients with TB (Ebright, 1509-1510).

The prevalence of viral hepatitis has also seen an increase. It is the most commonly reported infection in Mongolia, even though incidence has decreased from 14,278 cases in 1990 to 5,249 cases in 1999 (Ebright, 1510). The majority of hepatitis cases, 80 percent, are those of hepatitis A, and hepatitis B has been falling due to a national immunization program begun in 1991 and a program to eliminate the reuse of phlebotomy and injection needles (Ebright, 1510-1511). Despite the reduction in rates, chronic frequency of hepatitis is still one of the main health obstacles for Mongolia. This is due in part to the lack of funding that would make available better treatment (Ebright, 1511).

Mongolia’s immunization program introduced in 1991, has been quite successful in some areas, but lacking in others. The program provides vaccinations against TB, polio, hepatitis B, diphtheria, pertussis, tetanus, and measles (Ebright, 1513). In 2002, WHO declared Mongolia free of polio (Ebright 1513). Despite the universality of the immunization program, vaccination against influenza is not as common and depends largely on outside funding (Ebright 1513). This is especially worrisome in the winter months, when influenza rates are greatest (HDR, 10).

Immunization programs would not work against Mongolia’s leading causes of death. Cardiovascular diseases and cancers were responsible for over 58 percent of all deaths in 2002, while acute respiratory infections and diarrhea were the leading killers among infants (HDR, 8). Among the general population, respiratory illnesses such as pneumonia are most common during Government of Mongolia | ECONOMICS AND POVERTY 22

2007 Mongolia Needs Assessment the winter, while infectious diarrhea occurs mostly in the summer seasons and is a major health problem in Ulaanbaatar (Ebright, 1512).

Factors contributing to spread of disease
Some of the same factors that contribute to the spread of disease in other low- income countries are also present in Mongolia. Most diseases are spread in areas of close-contact, such as urban centers. The poorest areas with the least access to available health facilities are also most vulnerable.

Perhaps the most influential factor in the spread of disease is access to safe drinking water. According to a Living Standards Measurement Survey, LSMS, indicated in the HDR, nearly half of all Mongolians were using water from unsafe sources. These sources included unprotected wells, rivers, run-off and snow (HDR, 9). Access to sanitized water is as much a problem in urban areas as it is in the rural. Approximately a quarter of the urban poor receive their water from piped sources, compared to half of the more affluent (HDR, 9). Programs specifically addressing water treatment are needed.

Urban and Rural
There are obvious disparities between urban and rural areas. In regards to the availability of physicians, the ratio of physicians to population was one physician per 209 people and in Orkhon it was one to 314, while in the rural aimags, Arkhangai, Bayankhongor, Zavkhan, Khovsgoi, Uvs and Tov, the numbers ranged to over 700 (HDR, 2003). A 1998 Reproductive Health Survey found that aimag and soum hospitals do not have sufficient laboratory facilities to make diagnoses, have a low drug supply, and do not have iron and folic acid tablets to distribute to pregnant women (HDR, 9), which is essential to the overall health of both the mother and the baby.

In addition, safe drinking water is much less attainable in rural areas as a whole as it is in urban centers. Despite international aid given to water sanitation projects in the last few years, rural areas are still not given the same priority as urban for funds (WHO). More attention must be given to the introduction of better access to water in rural Mongolia in order for all Mongolians to have the same rights. Government of Mongolia | ECONOMICS AND POVERTY 23

2007 Mongolia Needs Assessment

Summary of Issues
Much progress has been made in the last decade and a half in many areas of the health sector in Mongolia. The new healthcare system provides services to all interested Mongolians. There has been reduction in under-five mortality rates, as well as maternal mortality rates. Communicable diseases have been greatly decreasing in the country thanks to an efficient immunization program. There has been a lot of focus on preventing HIV rates from reaching epidemic numbers.

A significant amount must still be done to ensure the further improved health of Mongolians. Although, HIV/AIDS prevalence has been low, it has also been increasing every year since the turn of the century. The rates of TB, viral hepatitis and STD infections have been fluctuating, with the rate of STDs currently increasing. More priority must also be placed on ensuring that expectant mothers receive the necessary care required for a health pregnancy. Most importantly, there must be an equal level of access to quality healthcare services and clean, drinkable water throughout all of Mongolia to help alleviate all health concerns.

Government of Mongolia | ECONOMICS AND POVERTY 24

2007 Mongolia Needs Assessment

Graphs and Tables: Health (B)
B1. Maternal Mortality per 100,000 population

Source: Ministry of Health, 2004, 12

Government of Mongolia | ECONOMICS AND POVERTY 25

2007 Mongolia Needs Assessment B2. Major infectious diseases by year, Mongolia Disease Year 1990 1995 Tuberculosis V. hepatitis Brucellosis Syphilis Gonorrhea Salmonellosis Shigellosis Measles Mumps 1,664 14,278 ------705 2,234 866 1,930 296 240 2,543 7,877 850 718 3,308 360 1,589 558 255 2,781 1996 3,104 8,198 1,158 810 3,274 323 2,294 123 436 881 1997 2,723 9,394 1,122 1,291 2,934 256 2,146 4 736 533 1998 2,806 8,042 1,308 1,329 3,486 239 1,261 8 1,287 303 1999 3,221 5,249 1,482 1,093 2,207 243 1,383 10 426 242

Meningococcal 776 meningitis Chickenpox 810






Source: Ebright, 2003, 1510

Government of Mongolia | ECONOMICS AND POVERTY 26

2007 Mongolia Needs Assessment

Mongolia’s Environment
Since Mongolia’s transition in 1990, the country’s environmental and agricultural sectors have seen dramatic changes. Mongolia is a large country roughly one half the size of India and is one the least populated areas in the world with 1.7 persons per square mile. Mongolia is also a landlocked country, popular for its pristine environment, extremely temperate climates, and immaculate grasslands for arid grazing which make up approximately 80 percent of the land (Dore & Nagpal).

Animal Husbandry
Historically, Mongolia has been a country populated by nomadic herders and with an economy that thrived on agriculture and animal husbandry. Since the transition in 1990 there has been a large growth in the number of herding families. In 1990 there was an estimated 148,000 herders, and by 1999 there was nearly a threefold increase in that number, with an estimated 418.000 Mongolian herders (“Implications,” 8).

Starting in the early 1990s, a shift was being made from nomadic herding to stationary herding in and around the urban areas of Ulaanbaatar, Erdenet, Darkhan, and Choibalsan. Reduced livestock mobility created by privatization of the land has made it difficult for the remaining nomadic herders to navigate between public and private land. This has encouraged many herders to herd on the land near cities where there is better access to veterinary services for the animals and allows them to stay put and use the winter pastures from the former negdels, but has also had major effects on land degradation and potential desertification (“Implications,” 9). The increase in the number of privatized herd owners, who own large quantities of the countries livestock, is also making it harder for the smaller, nomadic herders to earn a profit off their herds. As well, the introduction of taxes upon the herders has created additional distress upon herder incomes.

Even with the large migration of Mongolians to the urban centers, livestock husbandry still plays an important role in the economy, employment and export revenues of Mongolia. In 2000, agriculture accounted for almost one third of the total GDP; however, over the last seven years there has been a steady decrease in revenue from agriculture. The figures in reference to table C1 Government of Mongolia | ENVIRONMENT AND AGRICULTURE 27

2007 Mongolia Needs Assessment show that the agricultural industry supported a consistent 31 to 38 percent of total GDP from 1992-2000, but in 2004 the GDP provided by agriculture has shrunk down to just 25 percent of the total. This is mainly caused by a large influx of workers into the industrial and service industries (EGSPRS, 116).

In 1990, in the initial phase of the transition, livestock was transferred from state and cooperative ownership directly to private owners. With the change of livestock ownership the state policy had to be changed as well. In 1990, 68.2 percent of total livestock was in state and cooperative ownership; and in 2003 97.2 percent of it was in private ownership. Although the state policy regarding livestock husbandry has changed since then, livestock husbandry still remains a key mean of the country’s economy and form of revenue for many Mongolians (“Macroeconomic”).

Help from the Bilateral and Multilateral Community
Several donors such as the ADB, IFAD, World Bank, USAID, the EU, FAO, and IDRC have prepared many new and or follow up projects in the extensive livestock sector. Many of the cases are second generation projects, and reflect the accumulated experience of the agency concerned about extensive livestock development. The focus of most of these projects is on building local community-based institutions for natural resource management (“Sustainable”). We view these project initiatives as an essential first step.

Organizations like the ADB have created technical assistance packages that will provide training for co-operatives and facilitate more sustainable pasture management. The World Banks Sustainable Livelihoods Project (SFP) is broken up into three components, pastoral risk management, microfinance outreach, and a community investment fund. A project like the SFP will prove especially beneficial, because the money will be distributed widely into different needed sectors. The project includes elements such as micro-finance for herders, including development of specially designed micro-financing products for herders, and testing new approaches to pastoral insurance; setting up herder organizations, with revolving herder community risk funds; hay and fodder development and management; and capacity building for project implementation (“Sustainable”).

Government of Mongolia | ENVIRONMENT AND AGRICULTURE 28

2007 Mongolia Needs Assessment Valuable projects like the USAID funded Gobi Regional Economic Growth Initiative, which is managed by Mercy Corps, has created a four year project that hopes to increase productivity by orienting herders towards market production (through genetic improvement of cashmere goats and use of supplementary feed); improving veterinary services; and establishing revolving fodder funds; improving management of water sources and pasture through reducing herd numbers and reducing pressure on degraded pastures; improving water supply; increasing productivity and profitability of enterprises through an increase in credit to herders, co-operatives and businesses; position herding enterprises to maximize profitability by management training; and stimulating the creation of new businesses (“Sustainable”).

MDG 7: Ensure Environmental Sustainability
Target 9: Integrate the principles of sustainable development into country policies and programs and reverse the loss of environmental resources. Land Degradation A very serious threat to the livelihood of Mongolia’s agricultural sector and ecological integrity is the fact that the pastureland is rapidly undergoing degradation, though the extent to which this is occurring is debated. Table C2 shows that in the late 1990’s that 122.2 million hectare acres (ha) of land had been degraded in some way, and that 24 percent of that land has been moderately or severely damaged (“Implications,” 8). “There are a range of causes: overgrazing in areas close to markets and water points due to the failure to manage and maintain deep-water wells constructed in the socialist era; mining operations, especially for gold, coupled with the lack of land rehabilitation and infestations of grasshoppers and Brandt's Voles. There is a risk that degraded pasturelands leads to desertification (MDG Report, 24).”

The effects of natural disasters, droughts, dzud, forest fires and parasitic infestations have also been made worse by a growing over-concentration on grazing pastures, especially since the numbers of herders and livestock have been increasing and migrating ability for the herders has decreased since 1990. (EGSPRS, 19). Table C3 is a reference to the types and population of livestock in Mongolia in 1990 and 2000.

Government of Mongolia | ENVIRONMENT AND AGRICULTURE 29

2007 Mongolia Needs Assessment In many rapidly growing cities green and open spaces are becoming a rarity. In Ulaanbaatar, construction on previously forested land or on green areas in the center of the city is leading to a loss of valuable open spaces. Officials and citizens claim that more overgrazing by animals owned by herders who have moved to urban areas to be closer to markets has caused severe degradation around cities. In addition, solid waste dumping is also degrading land within town limits (Dore & Nagpal). Air Pollution The increasing number of people moving form the countryside to the cities has created a population explosion in and around Ulaanbaatar. With the area around the capital now

containing more than 60 percent of the population, there have been increasing effects on both the environment and to the agricultural sector. Air pollution has been a serious problem in Ulaanbaatar for many years and is now becoming a major health concern in provincial centers as well. Emissions from combined heat and power plants, heat-only boilers, industry and mines, and area sources such as household stoves, refuse burning, road dust and ash, and sandstorms present major health risks. Automobile emissions are also becoming major contributors as the numbers of personal vehicles in the capital grows. Perhaps the single largest pollutant of concern is particulate matter (Dore & Nagpal). Graphs C4-C7 help to show how Ulaanbaatar has experienced major increases in pollutants such as sulfur dioxide (SO2 ) and nitrogen oxide (NO2 ), during the winter season when the air is harsh and becomes difficult to breathe. Ulaanbaatar also suffers from a high exposure to particular matter, e.g. dust, during the winter. The graphs clearly show that pollutants in Ulaanbaatar exceed WHOs recommended maximum levels for pollution within a city during certain periods (“Country,” 8-9).

Another issue dealing with air pollution is the acceptable concentrations of SO2 , dust, and carbon monoxide as a result of incomplete combustion in household stoves and poor ventilation in traditional dwellings. In Ulaanbaatar, 75 thousand households living in gher areas, use an estimated 200 thousand tons of coal and 160 thousand cubic meters of wood for fire per year. Household stoves release ash and waste into the atmosphere which pollutes the air and potentially adds to unsafe air levels for the rest of the population (EGSPRS, 124). The ADB has implemented projects to improve household stoves, to help reverse this issue. The project has

Government of Mongolia | ENVIRONMENT AND AGRICULTURE 30

2007 Mongolia Needs Assessment been successful in Ulaanbaatar, but the government could use greater support, to start similar projects in secondary cities.

Commercial enterprises, including small meat and animal hide processing units, placer mines, and wood and construction factories, also release wastes without much treatment or oversight. Small town environmental authorities have limited financial or technical capacity and often lack the necessary manpower to assess environmental indicators and changes (Dore & Nagpal). Energy Efficiency Tied in with air pollution is the problem of inefficient energy. A combination of inefficient energy production using low-grade coal, inefficient heating systems, lack of insulation, and lack of incentives to conserve energy use, are the main reasons for poor energy efficiency (MDG Report, 24). This creates greater costs for both households and businesses. Another issue is that the cost of environmental compliance has not become a major concern by the management of state owned power corporations. Deforestation Mongolia has also been facing a downward trend in the percentages of forested areas that are currently remaining. The 2000 United Nations MDG report recorded Mongolia as having 15 percent of forested land during the Soviet era, and only eight percent of forested land in 2000. Graphs C8 and C9 show the percentages of forested land as of 2000 and the targeted goal by 2015 (Goldammer).

One reason that Mongolia’s forested areas have been shrinking is due to destruction caused by forest fires. The most common reason for the starting of forest fires is human carelessness. Since 1990 forest fires have been much larger than in the previous decade (reference to graphs C10 and C11). From 1980-1989 there were on average 1,096,022 hectare acres (ha) of burned forest/land per year, compared to 4,771,297 ha of burned forest/land per year from 1990-1999. (Goldammer)

There has also been a rapid increase in illegal harvesting of wood, with an estimated consumption of 2.5 million ha of wood annually consumed as firewood or other household-use Government of Mongolia | ENVIRONMENT AND AGRICULTURE 31

2007 Mongolia Needs Assessment wood. This is an area that has not been given much recognition by NGOs, but is a place where we feel that their methods and resources could be used to re-educate local populations on the importance of respecting and taking care of the forest.

The Role of NGOs Regarding MDG 7
The role of NGOs has had a wide impact on limiting many environmental problems. Successful projects such as the Dutch/UNDP funded Environmental Awareness Project (EPAP), which was actually a multitude of small pilot projects (most costing less than $5,000 each) which taught local populations easily and efficiently different ways of living and working that are low- impact on the environment. As of 2000, there were approximately 1000 NGOs operating in Mongolia, 100 of which were connected to environmental issues (“Implications,” 35). Because Mongolia is such a vast and sparsely populated country, NGOs can be effective in focusing on the MDGs, by being able to participate in smaller and more diverse projects and programs.

Government of Mongolia | ENVIRONMENT AND AGRICULTURE 32

2007 Mongolia Needs Assessment

Graphs and Tables: Environment and Agriculture (C)

Source: EGSPRS, 116 C2.

Source: “Implications,” 8

C3. Livestock in Mongolia 1990-2000 ('000s) 1990 2000 Livestock 1. Camel 537 323 2. Horse 2,262 2,661 3. Cattle 2,849 3,028 4. Sheep 15,083 13,206 5. Goats 5,126 10,077 Total Livestock 25,587 29,295 Source: “Implications,” 9

Government of Mongolia | ENVIRONMENT AND AGRICULTURE 33

2007 Mongolia Needs Assessment

C4. City

Population/ million

Suspended Particles levels/ mg m3 90

World Health Organization Recommended Max. Levels Source: “Country,” 8-9 C5.

Sulfur Dioxide levels/ mg m3 50

Nitrogen Dioxide levels/ mg m3 50

C6. “Country,” 8-9

Government of Mongolia | ENVIRONMENT AND AGRICULTURE 34

2007 Mongolia Needs Assessment

Source: “Country,” 8-9 C7.

Source: “Country,” 8-9 Government of Mongolia | ENVIRONMENT AND AGRICULTURE 35

2007 Mongolia Needs Assessment C8. 1990 Percentage of land area covered by forest Land area protected to maintain biological diversity (%) Carbon dioxide emissions (ton/person) a Ministry of Nature and the Environment. 2002. b Protected Areas of Mongolia. 2000. cSustainable Development Programme 21, 1999. dMDG Target Source: MDG Report, 24 9a 7b 200 0 8b 13 b 2015 9d 30d

4.08 c

4.19 c


C9. Government of Mongolia | ENVIRONMENT AND AGRICULTURE 36

2007 Mongolia Needs Assessment






15 13 10 9 7 4,08

8 4,19


0 1990 2000 2015

Percentage of land area covered by forest Land area protected to maintain biological diversity Carbon dioxide emissions (ton/person)

Source: MDG Report, 24 C10. Table 3-27 Wildfire statistics of Mongolia, 1981-1989 Year Total No. of Total Area Fires on Forest Burned on Forest, Other Wooded Other Wooded Land & Other Land, & Other Land Land No. ha 1982 109 1 100 000 1983 95 245 400 1984 116 513 900 1985 99 1 896 700 1986 204 3 187 000 1987 233 1 228 000 1988 142 243 000 1989 192 1 281 000 Average 160 1 096 022 Source: Goldammer

Area of Forest Burned

Area of Other Wooded Land & Other Land Burned ha 943 700 158 000 357 700 1 893 300 3 156 400 1 084 700 240 700 1 230 000 1 060 000

ha 156 300 87 400 156 200 3 400 30 600 143 300 2 300 51 000 82 400

C11. Government of Mongolia | ENVIRONMENT AND AGRICULTURE 37

2007 Mongolia Needs Assessment Table 3-28 Wildfire statistics of Mongolia, 1990-1999. Year Total No. of Total Area Burned Fires on Forest, on Forest, Other Other Wooded Wooded Land, & Land, & Other Other Land Land No. ha 1990 129 2 577 000 1991 101 6 099 000 1992 171 1 541 000 1993 63 2 763 000 1994 126 3 600 000 1995 120 168 570 1996 417 10 194 400 1997 239 12 440 000 1998 132 5 200 000 1999 76 3 130 000 Average 157 4 771 297 Source: Goldammer

Area of Forest Burned

Area of Other Wooded Land and Other Land Burned

ha 55 000 639 000 390 700 202 000 165 000 34 200 2 363 600 2 710 000 700 000 30 000 731 950

ha 2 522 000 6 035 100 1 123 300 2 561 000 3 435 000 134 370 7 830 800 9 730 000 4 500 000 3 100 000 4 0971 570

Government of Mongolia | ENVIRONMENT AND AGRICULTURE 38

2007 Mongolia Needs Assessment

Mongolia recognizes and emphasizes to our partners in development that the transition to capitalism is a lengthy process and will require patience and struggle through difficult periods. We do not expect instantaneous changes and concede that there are many obstacles that need to be dealt with along the way, as seen in the preceding assessment of needs.

However, we are optimistic about our current progress and the prospects of a future in which those currently living below the poverty line are supported through multiple channels, enabling them to increase their income and quality of life. We are fully committed to joining hands with donor nations and organizations from around the world to improve standards of living, engage in new trade partnerships, create new educational and career opportunities for our citizens, and ensure a strong, steady, and sustainable development plan.

We have seen that the health sector has already met many challenges, such as providing Mongolians with a health insurance system, reducing child mortality rates, and greatly reducing many communicable diseases. We also recognize that much still needs to be done to ensure a healthy and happy population. However, we hope that with the help of our donor partners we will be able to satisfy some of the other needs of the health sector, including, stabilizing and further reducing maternal mortality rates to meet Millennium Development Goal standards, providing more quality healthcare, as well as ensuring that all Mongolian residents, both urban and rural, have equal access to health services and clean, drinkable water.

Maintaining Mongolia’s pristine environment is desirable for cultural and ecological reasons, as well as necessary in order to ensure the economic sustainability of our agricultural production and public health. T he problems we face of land degradation, energy deficiency, air pollution and deforestation must be dealt simultaneously as we pursue greater economic growth. We appreciate all that has been done to set Mongolia on its way to attaining a healthy environment and viable agriculture and hope that we can continue to rely on donor agencies for guidance and support.

Government of Mongolia | CONCLUSION 39

2007 Mongolia Needs Assessment We feel that, although much remains of our journey, we provide a positive example of stability during transition for North Korea and Central Asia. In addition, Mongolia can be counted on to increase our influence in demonstrating our commitment to nuclear non-proliferation and maintaining regional security. We express our most sincere gratitude and appreciation of the continuing support of the donor organizations involved with Mongolia's transition to a stable democracy and a market economy.

Government of Mongolia | CONCLUSION 40

2007 Mongolia Needs Assessment

Asian Development Bank. Country Synthesis Report on Urban Air Quality Management: Mongolia. Philippines. December 2006. http://www.adb.org/Documents/Reports/UrbanAir-Quality-Management/mongolia.pdf Asian Development Bank. Mongolia’s Environment: Implications for ADB’s Operations. Manila: Asian Development Bank, October 2002. Bayarsaikhan, Dorjusuren, Soonman Kwon and Aviva Ron. “Development of health Insurance in Mongolia: Successes, challenges and lessons.” International Social Security Review. 58. 4 (2005): 27-44. Brooke, James. “Down and Almost Out in Mongolia; End of Garment Quota System Signals Tough Times Ahead.” New York Times. December 29, 2004. Academic Search Premier. Accessed 05/03/2007. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=15493381&loginpage =login.asp&site=ehost- live Dore, Giovanna and Nagpal, Tanvi. “Urban Transition in Mongolia.” Environment; Jul/Aug 2006, Vol. 48 Issue 6, p. 10-24. http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=21431312&loginpage =login.asp&site=ehost- live Ebright, John R., Togo Altantsetseg, and Ravdan Oyungerel. “Emerging Infectious Diseases in Mongolia.” Emerging Infectious Diseases. 9.12 (2003): 1509-1515. Embassy of Mongolia, Washington DC. “Health and Social Welfare.” Accessed 05/14/2007. http://www.mongolianembassy.us/eng_about_mongolia/social.php Goldammer, J.G. “Fire Situation in Mongolia.” Global Forest Fire Assessment 19902000 3.4.6 Fire Situation in Mongolia. Rome, 2001. Book on FAO Corporate Document Repository <http://www.fao.org/DOCREP/006/AD653E/ad653e59.htm> Government of Mongolia (EGSPRS). "Economic Growth Support and Poverty Reduction Strategy." 03/07/2003. http://povlibrary.worldbank.org/files/Mongolia_PRSP.pdf Government of Mongolia and UNDP Mongolia. “Human Development Report Mongolia.” Mongolia. 2003. http://hdr.undp.org/docs/reports/national/MON_Mongolia/Mongolia_2003_en.pdf Macroeconomic Assessment 2004. 2007. Asian Development Bank. 17 May 2007 http://www.adb.org/Documents/Books/ADO/2005/mon.asp.

Government of Mongolia | WORKS CITED 41

2007 Mongolia Needs Assessment Millennium Development Goals Report. 2003 Report. Official Website of the Government Organizations of Mongolia. 18 May 2007 < http://www.opengovernment.mn/english/phpgov/index.php?vlink=indexhome.php&vmenunum=100&vurl =/phpgov/index.php&vlang=1>. Click on Information, then Reports and then Millennium Development Goals Report. Ministry of Health. Health Indicators. (2004) p. 12 <http://www.moh.mn/.../d627c7ad4dcc3de9c8257027002bf09e/$FILE/Health_Indicator_ 2004_eng.pdf ->. National Statistical Office. “Statistical Yearbook 2003.” Mongolian National Statistical Office. http://www.nso.mn/eng/emxtgel.php Nixson, Frederick and Walters, Bernard. “Privatization, Income Distribution, and Poverty: The Mongolian Experience” University of Manchester, UK World Development. 2007, Elsevier Ltd. Science Direct. Accessed 05/09/2007. http://www.sciencedirect.com/science/article/B6VC6-4KGG1YH2/2/cfdd7abc123532e5f8c6d7a64a14b493 Nyamsuren, Tsogt. “Mongolia: In the Grip of Poverty,” in Poverty in Transition and Transition in Poverty. Ed. Yogesh Atal. Paris: UNESCO and Berghahn Books, 1999. Rossabi, Morris. Modern Mongolia: from khans to commissars to capitalists. Berkeley and Los Angeles, University of California Press. 2005. UNICEF. “HIV and AIDS situation in Mongolia.” 10 May 2007 http://www.unicef.org/mongolia/activities_2589.html . United Nations Development Program / Project of the Government of Mongolia. “Sustainable “Grassland Management Project Document.” http://www.undp.mn/ProDoc.Grassland.pdf 13 Dec. 2002. USAID/Mongolia. “USAID/Mongolia Strategic Plan 2004-2008.” Ulaanbaatar. 10/09/2003. http://pdf.usaid.gov/pdf_docs/PDABY661.pdf World Bank, Government of Mongolia. Economic Growth Support and Poverty Reduction Strategy. 07/03/2003. http://povlibrary.worldbank.org/files/Mongolia_PRSP.pdf. World Bank Group. “Mongolia Country Assistance Strategy of the World Bank Group for Mongolia” 05/05/2004. http://www.wds.worldbank.org/external/default/WDSContentServer/WDSP/IB/2004/04/ 09/000012009_20040409140521/Rendered/PDF/28419.pdf

Government of Mongolia | WORKS CITED 42

2007 Mongolia Needs Assessment World Health Organization. “Mongolia: Health situation.” World Health Organization Regional Office for the Western Pacific. 2005. 05/20/2007 http://www.wpro.who.int/ countries/mog/health_situation.htm.

Government of Mongolia | WORKS CITED 43