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Tuvalu, which consists of nine coral atoll islands, is widely dispersed over 1.2 million square kilometers of the Pacific Ocean stretching in a north-south direction over some 560 kilometres between latitudes 5 and 11 degrees south and over longitudes 176 and 180 degrees east. The total land area of the country is approximately 25.6 square kilometres, which is relatively evenly distributed across the nine atolls. The land is low lying with no point higher than four metres above sea level. Coastal erosion is a major problem for most islands of the group and, without proper control measures; the total land area of the country will be detrimentally affected.

This Millennium Development Goals Report (MDGR) is designed to be a tool for awareness raising, advocacy, alliance building, and renewal of political commitments at the national level, as well as building capacity for monitoring and reporting on goals and targets. This MDGR is, therefore, primarily a public affairs document, especially since during its preparation there was limited consultation with the non state actors and the private sector as key partners in achieving the MDGs. As a living document, the MDGR will be revised periodically, based on consultation with development partners.

Asia-Pacific is a region of contrasts. It has some of the fastest-growing economies of the world while, at the same time, the Least Developed Countries (LDCs) continue to face persistent challenges. As a whole,the region has made significant inroads into poverty reduction with progress toward the internationally agreed Millennium Development Goals (MDGs). China and India, together accounting for nearly 40 percent of the world's population and ranking among the fastest-growing countries, account for most of this progress, along with the "tiger" economies of East and South-East Asia. Due to the tyranny of averages, the relatively poor performance of the Asia-Pacific LDCs gets overshadowed. Only a more disaggregated appraisal reveals the far more limited gains in the LDCs1. Thus, the dynamism of Asia represents both a challenge and an opportunity. It could increase inequalities that contribute to growing tensions. It also could generate resources and opportunities. Attainment of the MDGs in Asia and the Pacific as a whole will be marked by the far more limited progress made by the 14 LDCs of the region.

In 2003, the ADB conducted a summary review of the MDGs in the RMI. The ADB described the progress of the RMI in meeting the specific targets of the MDGs as “slow” (ADB, 2003:13). In some areas, particularly in reducing infant and maternal mortality and increasing gender equality in education, the RMI was praised for making marked improvements. However, in other areas, the RMI was seen as making little or only moderate progress, particularly in terms of access to clean water and sanitation, combating communicable diseases such as HIV/AIDS, TB, other sexually transmitted diseases, diabetes, influenza, etc., and addressing specific poverty reduction strategies such as access to employment opportunities and reducing development gaps between the urban centers and rural outer-islands.