Child health worsens even as polio cases ebb
NEW YORK, Thursday 22 July 1999: Even as the global assault against polio, one of the most feared childhood diseases, enters its final phase, the health of children across the planet is more precarious today than a decade ago, when ambitious goals were set for the defeat of many childhood illnesses, the United Nations Children's Fund (UNICEF) reported today.
An analysis of the tangled picture is one of the highlights of The Progress of Nations 1999, UNICEF's annual country-by-country report on the status of world's most vulnerable children and women.
UNICEF's Executive Director, Carol Bellamy, noting that the world's population will hit the six billion mark later this year, said that a massive international push was needed to ensure that the six billionth baby, wherever he or she is born, will grow up in a world free of polio, which at one time killed or crippled 500,000 people a year, most of them children.
Audio clips: UNICEF Executive Director Carol Bellamy (RealAudio format)
The six billionth baby (33 KB)
Impact of the debt crisis (47 KB)
The focus on polio (43 KB)
HIV/AIDS and the young (63KB)
Last year, the number of confirmed polio cases worldwide was roughly 6,000 compared to 35,000 a decade earlier.
But Bellamy warned that the full eradication of polio faces a mosaic of threats.
"We are on the verge of consigning to history a disease that has terrified communities and devastated countless lives," the UNICEF chief said in a statement marking today's international launch of The Progress of Nations 1999. "But ongoing civil conflicts in places like Angola and the Democratic Republic of Congo are threatening the campaign against polio just as we approach the finish line, and persistent poverty is draining public health resources in polio-affected countries. We cannot waver in these final, critical stages."
Bellamy said the polio eradication effort, which is being carried out in collaboration with WHO, Rotary International, the U.S. Centers for Disease Control and Prevention (CDC) and other partners, still needs approximately $500 million to achieve its goals.
Despite these impediments, since 1988 the number of polio cases globally has decreased by 86 per cent. This achievement is the result of the use of the oral polio vaccine (OPV) and a combination of routine immunization and national immunization days (NIDs), in which thousands of health volunteers fan out across regions or entire countries to deliver OPV to all children under five years of age, regardless of how remote or isolated their villages may be.
Such logistically complex operations are necessary because blanket immunization of an entire age cohort of children is essential to the eradication of polio.
Last year, 450 million children were vaccinated against polio. In India alone, 134 million children were vaccinated on a single day.
"Health workers have trekked through deserts and waded waist-high through water to deliver oral polio vaccines," Bellamy said. "Others have delivered the heat-sensitive vaccine by camel in southern Sudan, by bicycle and motorbike in India and by boat in Cambodia and Viet Nam. And in countries like Sri Lanka, El Salvador and Somalia, warring factions have put down their weapons during a 'cease-fire for children' to allow children to be vaccinated."
The NIDs have reinforced poor health systems and created structures where none existed to deliver other life-saving services such as Vitamin A capsules, which can substantially reduce mortality in Vitamin A-deficient children. The supplement - which can save children from dying of common ailments such as measles and diarrhoea - is now being distributed to tens of millions of children each year.
"The success of the global polio eradication stragegy has given us hope that we can mount a similar campaign to defeat HIV/AIDS," Bellamy said.
The eradication of polio will be complete three years after the last case of the disease is reported, and will result in annual savings of some $1.5 billion, the amount now spent each year for protection against polio.
In addition to its focus on polio, The Progress of Nations 1999 offers a devastating picture of the destructiveness and loss of life caused throughout the developing world by the current HIV/AIDS pandemic. Some 16,000 people are infected by HIV every day, and there are 8.2 million AIDS orphans in developing countries.
In Uganda, for example, there are currently 1.1 million children under the age of 15 who have been orphaned through AIDS, a stunning 11 percent of Uganda's total child population. By contrast, the orphan rate from all causes is around 1 per cent of children in the industrialized world.
This kind of disparity, the UNICEF report says, is one of the many that will face the world's six billionth baby, depending on where on the planet that child is born. "Statistically, the six billionth child has less than one chance in ten of being born into prosperity and a three-in-ten chance of being born into extreme poverty," Bellamy said. "If the baby is born in Africa, the odds are that life will bring malnutrition, inadequate schooling, poor sanitation, unsafe drinking water and a span of years shortened by the cumulative effects of grinding poverty and debilitating disease."
The child's prospects will also be deeply limited by the burden of debt, whose heavy social cost for hundreds of millions of the world's poorest children and women is also described in the UNICEF report. A child in the developing world is born bearing an average debt obligation of $417. Sub-Saharan Africa spends more on servicing its over $200 billion debt than on the health and education of its 306 million children.
The report calls for outright debt cancellation for some or all of the world's poorest countries. "The global economy is now worth nearly $30 trillion, but 650 million children - more than twice the U.S. population - still live in the grip of absolute poverty," the UNICEF Executive Director said. "Debt relief and debt cancellation are a first step to ensuring hundreds of millions of children and women in developing countries their right to health and education."
The authors of the topical essays in the UNICEF report include the Prime Minister of Bangladesh, H.E. Sheikh Hasina, and the development theorist Sir Shridath Ramphal.
In addition to its main articles, The Progress of Nations 1999 includes supplementary analysis, statistical information and league tables that provide a comparative assessment of the situation of children from country to country and region to region.
The UNICEF report also highlights a new statistical yardstick, the Child Risk Measure (CRM), which is based on such factors as armed conflict, prevalence of HIV/AIDS, incidence of under-weight children, under-five mortality and primary school attendance.
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