Conference of the Global Health Council

Speech delivered by
Dr. Kul Gautam
Deputy Executive Director of UNICEF
Arlington, Virginia  – 15 June 2000
15 June 2000

It is a great pleasure to be in the company not only of so many good friends of the United Nations Children’s Fund, but of so many close working partners as well – partners dedicated to ensuring the health and survival of the world’s children. And it is especially gratifying that this Organization’s 27th Annual Conference should be focused on so central a theme: the remarkable progress we have seen in the decade since the World Summit for Children – and how we can best carry that progress forward to meet the challenges of the 21st Century. Needless to say, this is a meeting that Carol Bellamy badly wanted to attend. But as we speak, she is en route to the Horn of Africa to assess UNICEF’s response to the twin emergencies of drought and war that have descended on that long-suffering region.

So history repeats itself. Some of us at UNICEF remember that her predecessor, James P. Grant, was unable to participate in an NCIH conference in the mid-1980s because he had to make an emergency visit to Ethiopia, which was being ravaged by an earlier famine. It was just one of the countless threats to child well-being that occurred during Jim Grant’s watch – and which were much on his mind in 1989 when he first began toying with the idea of a World Summit for Children. Before this audience, there is little need for me to offer a detailed account of the genesis and outcome of the Summit. Many of you here are not only well versed in the history, but were actively involved, as participants and as contributors. Indeed, it was the success of your work in promoting child survival in the 1980s – and the enhanced prospects of even greater gains in the 1990s – that encouraged UNICEF to float the idea of a World Summit for Children almost as a trial balloon in our 1989 annual report on The State of the World’s Children.

In fact, in a political environment in which the term “Summit” had long denoted an august superpower gathering, a “World Summit for Children” sounded like an outlandish proposition. But of course, by September 30, 1990, the largest group of world leaders ever sat down at an immense circular table at the UN and pledged to achieve specific, time-bound goals to promote and protect the basic rights of every child on Earth.

Dear friends, from that day to this, the Declaration and Plan of Action that emerged from the World Summit for Children has represented the clearest and most practical expression of what the Convention on the Rights of the Child is all about. There was skepticism, of course – including characterisations of the Summit as little more than a good photo-op, at which a group of world-class politicians postured and made promises they would never keep. But that is not what happened. Out of all the UN development conferences of the last decade, none have been more systematically followed up and vigorously monitored than the goals of the World Summit for Children. And as a result, we have a very clear picture of what has been achieved over the last 10 years.

For one thing, the 1990s saw significant progress toward the Summit goals in a variety of areas – including gains in immunisation that have brought polio to the brink of eradication; the widespread prevention of iodine deficiency disorders through salt iodisation; access to primary education; provision of Vitamin A supplements, and the promotion of breastfeeding standards. Second, the Summit helped accelerate the movement toward universal ratification of the Convention on the Rights of the Child, which came into force just weeks before the Summit was convened – and has now inspired 191 countries to affirm that every child, regardless of who they are or where they live, has a whole galaxy of fundamental rights – to health and nutrition, to quality basic education, to clean water and adequate sanitation, to gender equality, to freedom from violence and abuse and exploitation – and the right to participate in the process of realising those rights.

The result is that much of the world has moved from an abstract “concept” of child rights to actual implementation at national level of those rights – and UNICEF itself is approaching its programming from a child rights perspective. All of which leads to the third notable achievement of the Summit, which is that it helped put children on global and national political agendas as never before – a process that has continued apace in recent years, and was dramatized not long ago by the UN Security Council’s decision to address the plight – and long-term security implications – of children in armed conflict. Yet for all the millions of young lives that have been saved, and for all the futures that have been enhanced, these triumphs do not compensate for the fact that far too many of the promises that governments made to children 10 years ago remain unfulfilled.

For example, although the annual toll of children under 5 who die of preventable causes dropped to 11 million in 1998 from 14 million in 1990, we are still far from achieving the reduction of one-third that was promised. Part of the reason is that 2.5 billion people still lack adequate sanitation. Because we have failed to fulfill the commitment to provide a quality basic education for all, more than 110 million children are not in school – and most of them are girls. And because we have failed to ensure universal access to maternal health care, as promised, nearly 600,000 women still die each year of complications in pregnancy and childbirth. Moreover, the obstacles to fulfilling these and other promises have become even more daunting over the years, presenting us with an increasing number of new challenges.

As all of us are only too well aware, the explosive spread of HIV/AIDS is decimating the developing world, especially sub-Saharan Africa, and has already wiped out numerous gains that had been achieved in combating child mortality and morbidity. Indeed, the current HIV infection rate among children and young people portends a catastrophe of almost unimaginable proportions. AIDS is rooted in deepening poverty and inequity, which themselves remain immense obstacles to human development – along with the burden of external debt; gender discrimination and violence, environmental degradation, terrorism, and natural disasters. Moreover, the rapid proliferation of armed conflict – along with attendant problems like anti-personnel land mines, the spread of small arms, and the recruitment of child soldiers – has placed an enormous strain on UNICEF’s mission to advocate for the protection of children’s rights, to help meet their basic needs, and to expand their opportunities to reach their full potential.

Yet, we now stand at the most opportune moment imaginable for reaching the remaining Summit goals – and for mobilising a global alliance dedicated to achieving a breakthrough in human development based on specific actions for children. The moment is especially opportune for a variety of reasons. We now know so much more about what we must do to guarantee the rights and well-being of children. We know that a significant leap in human development is possible within one generation if we can do three things: ensure that children get the best possible start in their early years; give every child a quality basic education; and make sure that adolescents are given every opportunity to develop their capacities and participate meaningfully in society.

As Carol Bellamy frequently reminds us, in a $30 trillion global economy, the knowledge, the resources and the strategies already exist to achieve these three outcomes for children – outcomes that are crucial first steps if we are to break the endless cycle of global poverty, much of it occasioned by poor health and poor nutrition – poverty that has not only compromised the lives of countless numbers of children, but jeopardised the future of the very societies in which they live. We have the tools, in new health technologies; in new health promotion possibilities; in new information and communications capacity that will allow us to truly reach every village and hamlet. And we have the tools in new modalities, especially the rights-based approach to child well-being.

In the last 10 years, we have seen remarkable progress for children – but not nearly enough. What we need now is action – action to achieve not only the commitments that were made a decade ago, but to launch nothing less than a second revolution in child survival – a revolution aimed not only at saving lives, but at imbuing those lives with dignity and worth, in a world based on equity, as Jim Grant would have hoped.

Just two weeks ago, we concluded the first preparatory meeting at the UN of donor and developing country governments, NGOs and representatives of the UN community in advance of the 21st Century version of the World Summit for Children – the UN General Assembly’s Special Session on follow-up to the Summit, to be held in the fall of 2001. The preparatory meeting was an auspicious start, in the sense that every journey of a thousand miles must begin with a single step. And many steps will be needed before governments, NGOs and numerous other partners in civil society finish mapping out and approving a plan of action for the world’s children for the first part of the 21st Century.

However, the excitement is already building – and we believe that the Special Session for Children has the potential to match, if not surpass, the success of the original Children’s Summit in terms of global attention and specific results. That is because the Special Session offers an unparalleled opportunity not only to assess the Summit goals through an end-decade review of progress from a global, regional and national perspective – but also to re-energise the international commitment to realising a global vision for children now and in the years to come. Among the materials provided to the Special Session will be a new Agenda for Children in the 21st Century, which draws on lessons learned in the past decade as it assesses new challenges. And it will set forth ideas for future actions, including an elaboration on the three outcomes for children I mentioned -early childhood development, a quality basic education for every child, and expanded opportunities for adolescents to take their place in society.

The international commitment to building a better future for every child is strong and it is clear. The challenge now is to bring it to critical mass – to engage millions of additional people who can lead the fight for child rights at every level. The galvanising power of the partnerships we are building came to the fore last month in Johannesburg, where Nelson Mandela and Graca Machel, joined by Carol Bellamy, announced that they would assume a direct and personal role in mobilising leaders from every sphere to act on a basic recognition: that if we want a more just, equitable and thriving world, we must invest in children now, acting always in their best interest.

We are already witnessing what real leadership for children can accomplish. We have seen it in the global campaign that has all but eradicated polio, a drive spearheaded by governments, international organisations, visionary scientists and other citizens – and groups like Rotary International, which has spent more than $340 million on worldwide polio eradication efforts since 1985. We have seen it in the creation of the Global Alliance for Vaccines and Immunizations (GAVI), a coalition of business leaders, philanthropic foundations, development banks, UN agencies and national governments – all dedicated to ensuring that the world’s children are immunized using every effective vaccine available.

We have seen it at the recent World Health Assembly, where WHO’s Director-General hailed the growing embrace by the large pharmaceutical companies of the idea that life-saving and life-enhancing pharmaceuticals, including those for treating HIV/AIDS, must be made available to all who need them, and not just the few who are fortunate enough to be living in industrialised countries.

And we have seen it at the recent World Salt Symposium in the Hague, where UNICEF, governments, the salt mining and processing industry, health, and international organisations celebrated the remarkable progress that our partnership has achieved in the drive to eliminate iodine deficiency disorders – and heard UNICEF challenge them to use the lessons of the salt iodisation campaign as stepping stones for the development of other nutritional interventions for children Dear friends, the world we live in is a very different place than it was 10 years ago. Driven by dazzling rapid advances in information technology, globalisation is transforming the planet’s economic and political landscape more profoundly than anything since the Industrial Revolution.

Next year’s Special Session for Children will be a historic opportunity to mobilise universal support for a new global vision for children – one that makes the benefits of globalisation accessible to every child. It is an undertaking in which we look to your ideas, and your recommendations for the goals and strategies that will best ensure child survival and development during the first 10 to 15 years of this new century. We very much depended on the contributions of this community some ten-eleven years ago to help us identify the goals to which we should commit ourselves on behalf of the world’s children. And we will come to you again this time around as we take stock of how far we have come and consider our next steps.

Members and friends of the Global Health Council, the future belongs to those bold enough to act on their dreams – and UNICEF, which has never been bashful in pursuing its mandate, has a 21st Century dream for children. It is a world where children survive to experience childhood as a joyous experience – a world of play, of learning and of growth, where they are loved and cherished, where their health and safety is paramount, where their gender is not a liability, where they can indulge their natural curiosity and expend their boundless energy in a just and peaceful environment – and where they have every opportunity to grow and develop into caring and responsible citizens. That world has remained a dream for more years than anyone can count. But UNICEF is convinced that together, we can make it come true – for each and every child on this planet.

Thank you.