UNICEF looks to the future; African children a major priority.

Deep concern over the deteriorating situation of children in Africa and focus on other major concerns-debt relief for child survival and the needs of street children and abandoned children-marked the 1988 session of the Executive Board of UNICEF (New York, 18-29 April). The Fund will invest $2 million within the next two years in a programme to provide essential drugs to African countries, and try to raise $30 million more for that purpose.

Originally proposed in 1987 by African health ministers who met in the capital of Mali, the "Bamako Initiative" seeks grass-roots participation and a steady supply of inexpensive but good-quality drugs to make primary health care universally accessible to children and women in sub-Saharan Africa.

The Fund will continue assisting countries interested i"debt relief for child survival". According to UNICEF Executive Director James P.Grant, the concept involves reinvestment of debt payments made by developing countries in programmes to aid children and mothers,

'With a human face'

Although most countries participating in the debate supported the notion of "adjustment with a human face", some had reservations about translating the concept into a specific debt reinvestment scheme. The United Kingdom, for example, pointed out that debt problems are normally handled through rescheduling. Debtor Governments must decide how best to use resources thus liberated, it felt. Nevertheless, the recommendation on the subject was approved without a vote,

Street children and abandoned children are to receive more UNICEF help in the future, particularly in Latin America and the Caribbean.

The plight of those and other "children in especially difficult circumstances" all ovcr the world was stressed by many delegations and by the NGO Committee on UNICEF, a coalition of 162 organizations, which has been a strong advocate of that cause. Child victims of armed conflict, including army recruits, those with AIDS and girls submitted to circumcision in Africa were specifically mentioned.

An intense AIDS prevention and education campaign to benefit women and children will be launched by UNICEF in countries which do not yet recognize an AIDS problem, as well as in those with significant numbers of reported cases.

Another health-related goal is the prevention of diarrhoeal discases which kill millions of children in the developing world by stressing sanitation, hygiene and health education in water projects.

The reduction of infant and child mortality, particularly in Africa, will continue to be a top UNICEF priority through 1991. The particular needs of the female child will be emphasized in all child development programmes. Two other major programmes involve reducing maternal mortality and promoting appropriate child spacing.

Breast feeding, growthmonitoring, malaria control, prevention of acute respiratory infections and development of basic health services will help reduce infant and child deaths, according to UNICEF.

Africa will remain the priority region for UNICER New initiatives will be taken in Latin America and the Caribbean, hard hit by a devastating economic crisis. There UNICEF is proposing the establishment of a special adjustment facility to help countries deal with those aspects of the crisis which most affect low-income families.

An increasing priority in Asia will be the improvement of the health and nutrition of women and girls. The urban poor in that region will increasingly become the target of child survival and development efforts. Programmes for women will be given higher priority in the Middle East and North Africa.

The Fund plans to spend $684.7 million through 1991. The highly successful UNICEF greeting card operation will continue to be an important self-funding source. Net profits in 1987 surpassed the $32 million mark.

In an opening statement, UNICEF Executive Director James Grant referred to th "Grand Alliance for Children" a network of "allies" assembled through the National Committees for UNICEF.

"Children in a global context"

From a report of the UNICEF Executive Director outlining major themes and progress of UNICEF activities:

In the turbulent 1980s, the economic crisis has reversed hard-wo gains in social progress achieved in most developing countries since independence, with vulnerable children and mothers suffering the greatest adverse impact. The gap between the 40 least developed countries, most of which are in subSaharan Africa, and the other countries has been widening steadily for the last three decades, but most rapidly since 1980. Medium-term prospects for growth and development are grim, with the outlook for much of Africa and Latin America particularly precarious. If present trends continue, per capita income levels in the least developed countries in the year 2000 will fall well below those of 1980 and, in many African countries, below 1970 levels. Lack of resources to sustain health, education and other basic services will render many in the population unable to participate in their country's development.

If targets for reducing infant and child mortality can be achieved, the number of children dying each year could be reduced to about 7 million-a decline of 11 million from the 18 million children under the age of 5 years who would die in the year 2000 if the 1980 mortality rates remain constant. Three major lines of action emerge: continued mobilization and consolidation of a "Grand Alliance for Children"; definition of relevant goals for the Fourth Development Decade and an accompanying strategy of action; and a special initiative for Africa and the least developed countries.