UNICEF pushes efforts to cut child deaths, hunger.

The United Nations Children's Fund (UNICEF) has made a "promise to children"--to try to end child deaths and child malnutrition on today's scale by the year 2000. The Fund estimates that a quarter of a million children die every week from common illnesses and one in three in the world are stunted by malnutrition.

That broad goal, declared on 30 September 1990 by 71 Presidents and Prime Ministers attending the first World Summit for Children, includes 20 specific targets detailed in the Plan of Action for implementing the World Declaration on the Survival, Protection and Development of Children in the 1990s, adopted at the Summit.

Among them are: one-third reduction in under-five death rates; halving maternal mortality rates; halving of severe and moderate malnutrition among the world's under-fives; safe water and sanitation for all families; and measures covering protection for women and girls, nutrition, child health and education.

Other goals include making family planning available to all couples and cutting deaths from diarrhoeal diseases--which kill approximately 4 million young children annually--by one half, and pneumonia--which kills another 4 million a year--by one third.

UNICEF Executive Director James P. Grant on 5 February told the Fund's Executive Board that 1990 had been "probably the most momentous year for children in history".

Ratification and promotion of the Convention on the Rights of the Child, unanimously adopted by the General Assembly on 20 November 1989, were urged by the world leaders at the Summit. As of 31 January 1991, 130 States had signed the Convention, which entered into force on 2 September 1990, and 71 countries had either ratified or acceded to it.

Ten members were elected to the Committee on the Rights of the Child. It is expected to hold its first session in mid-September to begin drawing up guidelines for use by States parties in the preparation of their reports on the condition of children.

Immunization saves

millions

The 128-page report--The State of the World's Children 1991--released on 19 December 1990, states that its 10-year effort to immunize 80 per cent of the developing world's children by the end of 1990--a rise from about 15 per cent in 1980--has added impetus to the idea of defining internationally-agreed targets.

Some 12 million young lives have been saved and 1.5 million children were prevented from being crippled by polio by the immunization campaign, the organization reports.

Richard Jolly, Deputy Executive Director for Programmers of UNICEF, on 5 February said that programme expenditure had increased by an estimated 8 per cent, with roughly half of the health expenditure devoted to immunization of children.

Of special importance are vaccines against measles--the biggest killer among the vaccine-preventable diseases--which kills some 1.5 million children per year, and neonatal tetanus, which kills some 800,000 infants each year and can be prevented by immunizing all women of child-bearing age.

Polio, UNICEF says, is likely to be the next major disease to be eliminated, following the eradication of smallpox in the 1970s.

The Consultative Group for the Children's Vaccine Initiative, established at the Summit, met from 3 to 5 February to discuss plans for developing improved vaccines to immunize the world's children. The Initiative is intended to improve existing vaccines and introduce essential new ones.

The Group consists of bilateral donors, scientific and medical experts, and representatives from the Rockefeller Foundation, the World Health Organization, the UN Development Programme, UNICEF and the World Bank.

'The largest generation'

UNICEF reports that, given present trends, the number of children born annually is predicted to peak around the year 2000 and then begin to fall. Therefore, children of the 1990s may be "the largest generation ever entrusted to mankind", with some 1.5 billion births expected during the decade.

If the "promise to children" is to be kept, the report states, then spending priorities in both industrialized and developing countries must be re-examined. Close to $20 billion a year--one eighth of 1 per cent of the world's annual income--would be needed to meet health, nutrition, education and water and sanitation goals for the next decade.

Developing countries, the Fund says, will probably have to find about two thirds of that amount, with the remainder expected to come in debt relief and aid increases from the industrialized world.

The Fund emphasizes that the means are available to save millions of children from ill-health, poor growth and early death. One way is to make vaccines, oral rehydration salts, antibiotics, growth charts, iron tablets, vitamin A supplements and family planning services--all relatively low-cost technologies--available to all.

In addition, a "communications revolution for the poor" is required to inform parents about such concepts as birth spacing, pregnancy and child birth, breast-feeding, safe weaning methods, growth promotion, preventing and coping with illnesses, and preventing the spread of AIDS.

UNICEF advocates training individual community health workers to relay information on techniques and methods, which it says could cost a little as $500, as opposed to more than $70,000 for a fully qualified doctor.

Addressing the problem of rapid population growth, UNICEF argues that reducing child deaths is essential to the process of reducing birth rates. If states that "when child deaths have fallen to the point of being very unlikely, then family size becomes more predictable and controllable, confidence begins to grow, and family planning becomes more attractive". Economic progress and improvement in the lives of women, including the education of girls and women, UNICEF says, would also reduce births.