Do United Nations conferences produce only fine words and forgotten promises? And are goals and targets only set and never met?

In 1990, the World Summit for Children brought world leaders to the United Nations in New York to discuss new possibilities for protecting the world's children against malnutrition, illiteracy, and disease.

A declaration was made, goals were set, a plan of action drawn up. What has happened since? The following is a summary of the 1995 targets, and a preliminary scoresheet of achievements (data for 1995 are not available for many nations).

1. Target: at least 80% immunization coverage in all countries
As of 1994, 108 countries have reached 80% immunization. Only 15 countries have fallen back in the 1990s. The year 2000 goal of 90% coverage has been achieved in 45 nations. All figures refer to DPT3 vaccine .

2. Target: elimination of neonatal tetanus
When the 1995 data are in, WHO expects that over 100 developing nations will have achieved the goal (defined as less than 1 case of neonatal tetanus per 1,000 live births).

3. Target: major reductions in measles deaths and cases
Impossible to quantify as no reliable baseline was established, but measles immunization has now reached 79% in the developing world as a whole, and a majority of countries have probably achieved a 90% reduction in cases and deaths compared with pre-immunization levels.

4. Target: elimination of polio
Eradication has been certified in 24 countries. Transmission has probably ceased in 57 more, and reduced to very low levels in another 28. Annual cases now approximately 100,000 as opposed to over 400,000 in 1980 and almost 200,000 in 1990.

5. Target: 80% ORT use
Data from 60 countries indicate that ORT use (to prevent or treat the dehydration caused by diarrhoeal disease) has reached approximately 60%.

6. Target: support for breastfeeding
Over 4,000 hospitals are following the WHO/UNICEF guidelines on successful breastfeeding and have been declared `baby-friendly'. Over 100 governments have taken action to prevent distribution of free or low-cost breastmilk substitutes.

7. Target: virtual elimination of vitamin A deficiency
As of 1995, 17 nations were moving rapidly towards the goal of adequate vitamin A for at least 80% of children under two. Large-scale programmes are under way in 24 more nations. In 35 affected countries, the problem is not being acted on.

8. Target: universal iodization of salt
An estimated 60% of the population in developing countries where iodine deficiency disorders were a problem are now consuming iodized salt. An estimated 1.5 billion more people were using iodized salt in 1995 than in 1990.

9. Target: elimination of guinea worm disease
This goal is thought to have been achieved in all affected countries save those disrupted by war or civil strife. As recently as the late 1980s, 3.5 million people were affected. By 1995, that figure had been reduced to approximately 110,000.

10. Target: universal ratification of the Convention on the Rights of the Child
As of the end of February 1996, the Convention had been ratified by 187 out of 193 governments.