the outcome documents of their review conferences, poor nutrition and heavy workloads for pregnant women. health and gender equality and empowerment of women, significant progress has been made in reducing child mortality globally, including through the efforts to eliminate new HIV infections and vertical transmissions in children, to combat malnutrition, malaria, diarrhoea, hunger and anaemia and by addressing other factors including the lack of access to vaccines, but the targets are likely to be missed. The Commission notes with deep concern that child deaths are increasingly concentrated in the poorest regions and in the first month of life, and expresses concern that children are at greater risk of dying before the age of 5 if they are born in rural and remote areas or to poor households. The Commission also notes with deep concern that some regions have higher female under-five mortality rates owing to discriminatory practices. The Commission recognizes that progress on reducing child mortality is linked with women’s access to health-care services, safe drinking water, sanitation and housing, as well as mothers’ basic education and nutrition. 24. The Commission notes that with regard to Millennium Development Goal 6 (combating HIV/ AIDS, malaria and other diseases), progress has been limited, with the number of women living with HIV increasing globally since 2001. It also notes the particular vulnerability to HIV infection of adolescent girls and young women, as well as other women and girls who are at a higher risk. It stresses that structural gender inequalities and violence against women and girls undermine effective HIV responses and the need to give full attention to increasing the capacity of women and adolescent girls to protect themselves from the risk of HIV infection, including through the provision of healthcare services, inter alia, sexual and reproductive health-care services. It further notes the challenges faced by women and girls living with HIV and AIDS, including stigma, discrimination and violence. The Commission further notes that, despite increased global and national investments in malaria control, which have resulted in decreasing the burden of malaria in many countries and the elimination of malaria in some countries, malaria prevention and control efforts, particularly for pregnant women, must rapidly increase in order to achieve the Millennium Development Goals. 23. The Commission notes that with regard to Millennium Development Goal 5 (improving maternal health), progress towards its two targets, to reduce maternal mortality and to achieve universal access to reproductive health, has been particularly slow and uneven, especially for the poorest and rural sectors of the population, within and across countries. It notes that the number of preventable maternal deaths continues to be unacceptably high and that adolescent girls face higher risks. It further expresses concern about the significant gaps in funding that remain and the magnitude of the unmet need for all sexual and reproductive health-care services, including emergency obstetric services and skilled attendance at delivery; safe and effective contraception, services for the complications of unsafe abortion and safe abortion where such services are permitted by national law; and prevention and treatment of sexually transmitted infections and HIV/AIDS, among others, through the primary health-care system with effective referral to higher levels of care. The Commission further notes continuing challenges to progress, including failure to protect and fulfil reproductive rights in accordance with the Programme of Action of the International Conference on Population and Development, the Beijing Platform for Action and 25. The Commission notes that with regard to Millennium Development Goal 7 (environmental sustainability), while progress has been made globally in access to safe drinking water, progress on access to basic sanitation has been particularly slow, and the target is likely to be missed, with serious implications for women and girls, especially those living in vulnerable conditions. The Commission expresses concern that the lack of access to safe drinking water particularly affects women and girls and that they frequently bear the burden for its collection in rural and urban areas, and further recognizes the need for further improvement in this regard. The Commission further notes that the lack of adequate sanitation facilities disproportionately affects women and girls, including their labour force and school participation rates, and increases their vulnerability to violence. The Commission further notes that women and girls are often disproportionally affected by 6