Professional Documents
Culture Documents
UNICEF: The State of The World's Children 1993
UNICEF: The State of The World's Children 1993
OF THEWORLD'S
CHILDREN
1993
A9 ti1'l
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l'mo.Jic.W. J. UXIC!'J':
HQ lPl.1Sl) 8J-6oI155O J61.r IWI114
a.-: ~ , _ ~ ( :It.
T _ _ e-~r " ! r ........ u;:
_ _110_" L:.t.l:.c '
In !h" reJlOO, lho loW annutJ numlltr of child 11>0 <IVtfllIU'UId lfI lhr _ of undl'r 1lnI..... .f1,,,
dc>.ltu In Ihc dcvdoplna ,,<>rid i. Ii_ .. 12.9 milOOn. in lIIc <Io>'o!<lpina ..<><Id """" ~ "'" boo ....mm>""od ..
In ~ y..... "'" flJlll'l' or I ~ millio<l ba b<cft uK'd. r.........'"
"illio ""'" pvn ,lot ~ ' 0 WI .......
1960 1m! 1980 1990
TIlt WKla-fiv<: mo>r1alilr "' ~ (USMR ) .. lhc nun>-
LB.9 11.• 1&.1 12.1
boo" '" dIiIdnD whl <!it - . , lh< OF ol llft It. nay
l ,OOD .... blnloo.ll is otl"cacd1»"_ foaon,,~
- . ---. _ "*"', _ 0IlIll'lJ. mel ~ ~
". ..... ..... r...c- "
pooc:Ilal .... .. bJ L""lCEF
11. io _ " ' " an< III IN 'o" no. .ponciM •
-.. . . .......
......... 1nOd III _
-"'-"'"
T" oI• ....t ""'-"
eeee - :..,...¥.•_:::;l:l!;:l!:::=!:!: ;::;l 'l;;; . : 1
_ 1 .. "'...,.., .
_ .......ia" __
- . . due dw
_ "'.aac
. .,. J <Ifdlc 19801
...,.•
- 1_
.......... The: ~ b US-loU!. ill .. ? ''s _
~
e
-
1991l..... benl _ _ It><·. . . . ........ <Jf
"'*"'" t.:.
'not ~
THE &'1'ATE or
THE WORLD'S CHILDREN 191::6
I The age of D<:spiK: all1be problem. of \llc post oold lOW "vrld, it is d<ar thaI lho
m<ans .n> oow ., hand 10 enc! mass malnuuition, pm..",\lIbI< ~ ,
neglect and the
and wide>pr=i illilttK·y IIJOOl"J;i 1M .....nd'. chikl:m. FolJowulg the 1990
age of concern W<ltld Summit for OIiId....., many """"tries Nve now dr:awn up o,pcciflC
plans f.,,- ochi<vina !his pl. An accumulation ofreasons su"",' \lui, the
limo io now rWn to make this I ttomp L The additional C<>S1 wuuW l>c in
the rqion of S2S billi"n I l'cal'. At Iho moment, nnly abou t 1{1% of m.
""""""'" available for dc\"clopmcn, on: de\"l<:d ro sud> p"'Jl'O'CS.
II A common T <> gh'C this co"", priority•• wt>r!d\o,ido: IDD\-.;mcn, is ""fUi=l to brin& '"
cause b<ar 1l>c wnc I:ind of p<naW't- as is tDdal" bcins c.onr<! b)' tho
C1,ironmcntal and women'. mo'uncnl>. I'ro!<:<;ting lWlIy'. chilc.l=
r...om !he won, O"PC'C\S of ~ wwld , ~ elToN 10 """""'"
<:.wironmtlUlll prom:tion. iu.wnabk: economic ifU"-.h, "'lualily for
women, popu"";",, do,,~.... and politkal olllbilily. It is lh<td"<>rt< •
<:aU'" tha, m<:IilS "'" ' Upp<>n of all.
III A movement /o.bny hul>dmls of organi>.ali<-. cspccialI)' in "'" dc\"doJ>inll. ..1>rld. "'"
for basic aln:ady b<:ginning ' 0 ""l"",d to this ctIaIlcna<". In p;uticular, support ill
nmkd fTOltl the m<dia, rrum heal'" ond cdUClltion pro(<:>SiooaIJ, ond
needs from the non-a<n'c:mmcntal oop.<Watiom.
IV The wider Polit:icol and e<:<l<IDIl'li< ~ in lho wOOd fl latiC is creo1ing lho
context condilioos ,,'hlch, """"'"crdilT><:U!I. offo new hope for O'..""ming Iho
,,,"" Ill.pOCtS of "Ufid lIO''aty. flUI lh.,s. wlx> auppoo1 • ~ l<I
m<t1 basic: human "....Jo m.... :ilic b< ."'2n!- thaI oction ,m ddK. Jnde, aid
:u>d . _ ond on IJa<lini Id'l~ po, is • I>COC$SOI) ' pan ~f t lu" . lI\lj;llk.
-"
Statistical a.si<: indicomn, nutrition. h<al1h, cduc:olion. d<mugnophk indico'......
ceooomiI: i...we.t<>n."""""" 1«0 popuI<lus wuntr'.es, newly in<J<p<ndcn'
tables
00Wlt ria. ,IK: tllle <If ~
PANELS
1 PneumonIa:
3.5 rmon deaths
9 The earth Summit:
d'ti.. i and Agenda 21
t¥< ~:<i1
2 Mexico:
from words to deeds 10 ' ''M'
a SpOOsh I9sson
-' -~
3 Vitami n A:
51 ospicion coofmlad 11 a Emergencies:
newattoic
-" -~
4 Im munizati on:
~sucress 12 """, ad"id"i·s~t
- " 13 -~
5
--
DIarrhoeal diseases : Breaatfeedlng :
a strategy !<;o" the '9Os bab'/-/rier'dy ~
-~
14
-- 15 --
Polio:
6 the end n s>;t1I
Maternal death s:
9i 1181 get q care
Fig. .
~ S
l..kldeo'-tiYe deaIl1s b)' rI"lIWI e8ll9Il. CII'. POJ:li IliI1 COlX1tIIlIa, 1990
FQ. 7
1981-199'
--
lIS r....... 10 the . . . at el<tI..:tioa. and 10qdy fl'ftd
it5d! rn.n lbr iron pip cI fooci>l ond u:uIUrian
. . . . ,. f_
[n P"d~"ticc, Financial rcSOUI'C"" "'" a n~~C'S • In 1990,\.."NICl:f admot<d .. 110_ a fCU "" "'....
sar)" but not sufficient prerequisite for m""l_ _ m<><mX> .-cd w on«''''' hnIIl\. Iol:Ifi<ioD, ""'-
ing these basic needs. Sustair>ed political cation• ...w ~~ l<f .,..l """lOtiool """ .....,w " .... WorlJ
F.oriPlat<o (.. "" oddi<ionol ........"..
c ummitmcnt ~nd a great deal of managerial ~ '" _ lI>«I / ......,. pb/IAUIa pi> II,,,..>in«
~"(}mpcl~ncc ar~ even more imporUlm. Yel it is _ ...w_ anJ 1Iu. ha. ~ "'" "'""'" ........1<
eccessery (0 reduce this challenge 10 thc "" ~~' l l5 bilIioo a jUf.
THE STATE OF THE WORLD'S CHILDREN 1993
dlIdI .. ~ _
ewly .......
.......
gi\in& nations $prod <:adl )'ftl' on spon$
Perren/age 01 bilaleral ODII (OCeD lounlri<!s) The evidence for this new hope, amid all
allocaled {o m«/ing baSIC needI, 1990 the seismic shifts in the political Bnd economic
-, landscape of recent years , is a series of qutetcr
NttbUtor.. ....... ~
ollo<. 1r<I to
... ~fo<
t-ic~ ~
eh.anges which ha\'C nol made the nightly
news bu t Which ha\'Caffected the daily lives of
-. ..
OOJI(VSl -"", ~ Wll<.- 2O'Ilo-.d
miUiolUof people.
..'",
M S mill",,, ) (lJ:iS rniIionoI
miIiom}
~-
,~ 1', 1 ,~
..
'",
TItc lirsl o f these changes is the entirel)'
-......
~- '00 new p riori!)' that has been given 10 the las):; of
'" •
-
,~
'00 immunizing th" wo rld 's children . For a
...."
<- ,~ ,~
'00
,.
"'~
00.
'00'
'U
OJ ,. '00
decade, national healthservices, UNICEF, the
World Health Organization (WHO) and
many thousands o f individu als and organ-
""'>
. '"
'W
1 112
•m
' 00
sss ....
•• i14tions have struggled towards the goal of
._"
~,~
"~
.....-.. -
m
,~
'-'
~
00
, ,.
'"
00
80% immunization coverage in the d el'Cloping
world . In 1990, that goal waS reached. The
...,.WI is the SlIving of O\'Cr J million children's
..
U· ~
,~
.....'",
.... .'" ,
F,once ~ m ,~
tion , blind ness, deafness, and polio. Second,
",
,..
" '"esrs
"""TOIi>
,~
m
00'
~ 01 J9 ...
U
lSJO
•
THE STATE OF THE WORLD'S CHILDREN 1993
Pneumonia:
3.5 million deaths
Ae$pi'atery • .:ectiocos ao:::oo.nllor rT>::l<llltw'la «b:aled 10 ~ the frn daroger signs. and
qua,t9' 01 III illnesses lItlCllleaths among IhII chi· Q:lITfTUr\y hc9th~ can be trained to ciag .
dren DIme"", !:(.9W01"d.lheyMllllso~ oose~ pr<l!iCfb!oo-Ihe·spolanlbo6c:s.
--
still lor 3O'Ilo 10 EQ% 01 811 'oiMs 10 docIoo and and 19IXJOiOd thB stnaI mnoriIy 01 6 ' '' 0'''''''1
cirOcs Ind lor lIbouI a UWd ol .. 1lospiIaI...m.. eesee lhal need to be 1Xg&ll!'y ~ .. iSi'ttled to IhII
......., The ldI on bQm _1IfId _ "'"""""" ..
9I'lI:lrn1<lUS; ;nj a is IlMGd 00 IIImosl ~ ..,.,..
","",. In "'""I' o:>:JUI\tIe$. IhIIIt'Illl:lic.Il prOlessioro IS 5tiI
fllU:tNnto*JN ht!<iM....wa-slOprewib9chgs..
i'l C'Of!< 9O'Ili 01 cases, lhlI ptCItlIBm is Ihl com- !lui II recent $l\.ItII' by 'M-lO haS <XlJ'dudocI: • The
moneold. 101 wN::hlhereisroknowno.n. Bullhis _ to""ll QOOSlO>is dea': this stllltogy... ItBs
.x- roo! ~ '4! 10 one ltWdof the d9'ollopi 'll beetl lll'r8cti>u. I'lIfI tUduced m<>'UIJly tal speaII
"""":1'. budgels Ie< m.gs and " odt:io_ ~ b thet'iS<iWS. S1l.d9s of ARJ (acutlI a'U)'
swaJowad ~ ... ee P0660to"l1 01 ""eoessi'fY ..,Ioctioos,l irJIllfYenlion$ ;" &ng/Bdesh, India,
_ _ ~ PrImm, IhII ~ and
ambolics. Nor does ~ PI"""'" fanilios worttwIdIl
from spetI<'lo'lg M /IS_ad $3 DIior'l a '{fW on the T............ show ~ i1 pneur>onia m<lI'lail)<
rroe than 2.000 coogh lItlCl cold '80 Ii8Cies J>'JW on ~ tan 25~ to 67111 •
"'~.
av...60 de' ' . "'l/co..<lln8S """" hIMlroatioroll
-......." ~ ~ of resporatory;,lee- ,-0\11,"" '_ 10 1IY l<l put "'" ~ SIfa1e!1V roo
loon$, prcballIy orly ~ Of 3'IlJ. 8!rb allhII hSSOIl eI!ecI. The aimis to nn.ce d8alhs ~O'Tlll'lN'lO"ill
of the ctold'. U1g. The feSI.IIl is I"l'JIT'O'lI'l, and by allees1 one If'ird ill 1Ilis decade.
-...ttlOUI3'l3"llbDlic Ite'8 isa 1(1%1020% nsl< thai
IhII CIIiId ...... die _ days. 8IJI b8"a.... !he In aodition . abouI ~ 01 8CUIo ruspiraIory
rooI_
Yicums are ......,olly ehidroo from the p<>or<l81 lr1Ieclions coUd stil be Itt.errled by 0mu1i:al0l.
laniies, wiIhoul 9a$'/ acoass 10 00cI0ts pnd r.:. OM 8 ItYd 018 ......, d'>I<hIrl dill eoct1l"""" !rom
pitaI:s. 1II 1lbOA>1areollM aI ai, Of n<Jl 'M1oclprog c:<>Ugl, .....s ~ 0I1t>c:o!lands""".
IMIiIaIJkI WI 1mI,t. The r/l:'llJl is IhalllDP"OlCirnately3.5 eee e ee ~ tre1 IreQo8nlIy IoIIDws 8'1
miIon d*hn doe 00CIl~ . IIIlad< 01 ~ • Other known """ Iacl"'" ...
low biI1h waoghI and tmhmiIIon. Ras&W1 1n BraliI
h llll% 10 9O'Ili ofcases. IhIIprotllem isb8cterial .....s Pwu lias shown 1h8l Ihll ri&k j >:;Ia ! B! by
pnauT'o:JIia. u.tW:h can be C(III/l'cAl!d by a COlQ!I of r-. _ and !Iwl _ d1iId"en .... t>onle
~
onIbiolics. <JSlJIIfy <Xllrimo><azolo, II'Istf19 lor 1M! ted. ,600 tmm i1don8si8 lIaS Clln1II1h8 fi1di1g 1h8I
(lays lItlCl costilg 25 cerII5. l3ut • me IICiI!nlJIi<;
risks ... dOo.bIed by <Mln lI'iId "lIM1in A <lElIideo iCY
problerns all r ~ SII'Illle, IhII ~ protl- (pat'Iel31. <M!rctowding and 8 smoI\y ..... Ol... ~
lems _nQl. How- can IhII ri1'1 (;W8 and !he ri\to1
(i1c:k.oci1g wood S<roka and <:ig;wlt<lliIrd<8) also
cWgs bII maoa lMIiIabIe to the righIet1idmn !IIIl m , >:;I as !hIl ...... lOl<lIJoI'. . 8lOlylnlecWns .
"'" """
In """'"" ~. "clear _ 10 It>io q<IIIStion
h8e "-lt951edand Icu>d IOIMJrk. Parell$CllIIbe
• ~ _. _
_ _ _ OCQ,O"
is""""",,,
t>ebv "*ogo.
oI...... _ _ <:tUll,..._1NI~cl..............
_ aliI,,,,,,,,
•
ou rreach capacity now exists to p ut the mOSt
Fig. 3 Three million lives saved basic benefits of scie ntifie progress at the dis -
Immunizlllion C<Mf~ in Il~ deYtloplng world
.... been inuNscd le' ~PP'O<imIIltly SO'Ib In tM posal of the 11Ist ma jority of the wo rld 's poor.
Loll 10 ~"". As a n!SUll wee mllIiorI death, Secondly, it dem onstrates that, with sustained
'rom v.o<;<I"".preve<>tabll: d l ~ lIe< ..., now ~ng political commitment, prog=s can now be
~tO'd odl )'N'".
lTIlIde to wards bas ic social goals even by the
Dealhs prevenredand s/ill occurring, from poorest of developing countries; OV<:1" the last
vacdne-ptf!'llentobJe dlseosn, In miJIiOn~, nve ye ars, immunization coverage has been
all dewloplng COlJn/rie~, 1991 lifted dralTllltically in many nations with per
CIIpi\2 incomes ofless thlIn 5 500 a year, includ-
1.6m ing Bangladesh, the Central M rican Repub lic,
~ualorial Guinea, M yll.lUlla.r, N cpaI, th e
3 MILLI ON Sudan, Uganda, Viel Nam , and 21mbia."
DEATHS
PREVE NTED Other adl'anttS in knowledge and lech-
niqu e arc now lining up outsid e the d oo r mat
immunil,ation has unlocked . And th e poten-
tial remains enormous. Thin~'-fi," thousand
O.8m Cases. 01 childl'm under fi", die in th e d"."lo ping wo rld
~i tis every day. Almost 60% of those deaths, and
O.6m
I
OA m
mucb of the worl d 's illn..ss and mal nutrition,
an: C3U31:d by jusl three dise ases - pneumonia,
diarrhoea and measlcs • all af wbich can na W
be p revl:nled or treated hy means Which are
tried and tested, ava ilable and afford able (figs.
4 and 5 and panels 1 and 5). Similarly, th e
vitamin A deficiency which threatens up to 10
O.lm
m illion of the world '. children with death, seri-
OAm OAm ous illness, and loss o f eyesigh t, could n ow be
brough t unde r co ntrol at a COSt which is
1.7 MILLION a1mosl negligi ble in relalion 10 the benefits it
DEATHS STILL " "Quid bring (p.anel 3) ." O r 10 lake another
OCCURRING exam ple, the iodi ne d eficiencies that lower the
mental and p h)'sical ahi~ties of u p to a billion
O,9m people a nd are the WQrld 's sing le biggcst cause
of m ent al retardation could also nQW be d imi~
natcd at a tntal COSI of approximately 51 00
Th= million <!Nth, prev«lteclls less than the
figure reported in "' II yea(l Slore (l/ lilt W<lrl,:I'~ million - less th an the COSI of IWO modem
C/IiJdfflI{3 .2 million). This is as a ' twit of recent figh ter p lanes (panel I O) ."
changes in the method used by !hf, Worlcl
Heillth (Kga n~tioo for calculali"'l ttle num be>- Even those aspects of poverty w me h ha ,-e
d measles deilth, prew<ned by immunization. traditionally been considered th e m OSI ex pcn-
_ ""'" ""''--".II,..... ,.... s i\'I: and the most logistically srnbbam • the
s
THE STATE OF THE WORLD'S CHILDREN 1900
bdr; of adequate nuuition, SlIfe ",.10:< w pp/)., e<'U1t education can be pl'O"ided It • t'OSl of
and buic cduatiDn - an a1Jo now bec:omin& approximr.td). 520 per clIiId pn )Ul'."
suscqnibk 10 . rombination Qrnew leChnoIo- EquaD)' Wgc-saJc oiaIs in AiOO and in India
gic$, r.1linr: C'OIU, eed rommunit)'-basrn have $hoII.'tI thai !he incidc:oce of child maln u -
I lI'Itqies.. The OOSI of providina <:karl ....""Ifr in trition can also 110"' be halved II • COIl of kss
Africa, fo r example, has been hah-ro since the: than SI0 per child iX'r year." ~A Jir«l all<M:k
mid· I98 Os and naw stands al In average 1m mahm/fi/wlf j, 'IfflktJ..." SlIl'S I World Rank
figure of about 520 per person per ~"t:ar. " report, "Imd 1000cnJN/tIIlJ u'il/i'IK /0 make lho,
SintUarly, coumries such as &nglad tsh and t!fOrl now haw t1/«1iw. and afflYf'tklbk NltulUTU
Colombia l\A'" (kmonstI1l100 tha t. buic, rel- 10 ""'M il lwppm. ~
Nnr COals
Fig . 4 Child duthl Tbese ach'anCU in teehnoIogy and 5Ua-
~ 60'6 011M 12.9 child dNchI ln lq)', and the atraordinarypotmtial they lui'"
-.-..
... --'d - " )'UI' ~ ~ "" """""""'" =nIed, 'Il'a'e the: principal alIlttm of thc:
chNlel.. 01 by" -... C<IfTIlIiNlian 01... Ihrft. Ifi>rldS4..;zjDr CItiImm hOd IlIIhe UnilN
N ; f,y.-" in SCplanb.;:r 1<;;0 - i t ibool tb::
Undft"-f_ drafhs by mofn coust. same tinw as die irnmunWioOon p i .... bc:ina
dtoPmping cotJnlM. '990 iUdKd. TIlt 5""";/ "'25 Incnckd by
...
'"l . i _
p•• ,
-
(J-"'ol
1)lo;,1
,- ._
(1 -"10)
I pproxi INId}< 1Wf lhc: ..'I'lrid', Pn:sidroulnd
Prime Minlslen Ind ~tcd in I SI:l of spe-
ci6c t'OfTIIIliunrntll which. if impkmenlt'd,
would indeed mart tilt: t:qinning of I new Cnl
orccncern,
Those commilmenrs, designed 10 refltc'1
the pcxo:ntial of the new kncwledgc and lite
new leeh noloa irs now availab le. were
up~ as I series or 5J)tCuk gOllI, 10 be
achieved by the end of 1bc: present ~rury.
These ~ include: comrol of !hoe major
chiJdhood diKt~; I halving of child malnu-
trition; I onc-dUrd rtducIion in undcr-&.~
......... 11' - ck2lh I1Ill:S; I hlhinc 0/ matemlII morali1y
,,,,OJ
1.1 ......
----po..
rlI1e$; Slfo: 1I'ItCl' Ind ADitaOon roc-III C'OmmU '
nitic:5; unh~ a-.'ailabk fami!)' pbnninc
.......-.g--....-... senica; Ind t.sic' nil>Oricm for III chi1dtm
.,=.. (pare S9).
In P'Kb. d*ftn often .... Irom ....,q.Ie ~ lb gh~ tiKK aJmIJIilmmClI more pmna•
--_
.. """ 'd'It ~ '""ocu 01 Mqwnt ~
.-.d ~. for Ihl' ,..pooe oIlhil dwt,. NdI
<hlld dNI.h twos been ~ 10 only _ caM..
•
.......
ncnl PUJo:~ 00 polilical pta lly, III tIr
COWUriC:1 represc:nlc:d at the: Slim",;,. and
mans mort' who have subsequently ~ the
lkclaralum aml Plan ofA Clion, also agreed to primary eduClltiOn, basic Malth cale, nutri.
draw up detailed national programmes for tion, water, and sanitation."
reaching the ag=d goals. As of September
1992, such plans have bee n completed in ove r The drawing up and financing of such
50 cou ntries and ale nearing completion in plans is inc\~tab1y a ~BucratiC process, and
more than go others (see pages 60and 61). In tOO much should not be expected too soon.
June of 1992, the United Nations Secrwuy- But most nations ha\"<: made a start towards
k~pin8 th~ promises that have been made to
General repo rted 10 the Gencra.l Assembly
that 3 1 COUntries neve 110 far indicated they the ....,or\d·s children. Imrnuruzarien levels
will IeSlrIlctUN: bu~1S 10 increase the pro- hB'·~ been sustained (fli. 6 and pancl4) Bndin
po rtion of gO""<:ntment spending devoted to some cases, notably in China, lifted aho\-c the
ncv.. goal of 90% (al which point very signifi-
cant decreases in the incidence of disease can
Fig. S Preventable deat hs be expected). Polio has almost eenainly been
l ~ !able ~ the RUmbe< 01 eN id o:\e.Otlu e«h eradicated from Latin America and the
)ti< by INin ca<Q,. and the l"opOIIiDn(Ii tt...... deaths Caribbean (fig. 7 and panel 6), where a year
Ihat ( ould oowbe pnwnIftI by....liw+f WnpIe and has now passed since the last conflrmed case
~ _ wch a:I vacclnes, ontibiot;cs, Ofal
tmydr.Mion therapy, and the propor......-.qmtnl 01 of the virus. Reported cases of the main vac-
cIianhoe.oI dMale. cine-preventable diseases are declining (figs. 7
and 8) and WHO bclievcs there is a reason-
Pen:mlage of under·frve deathl prevmlolM by
--
able chance that the 1995 goal of eliminating
.-
Iow-<Oll me/hod" developing countfie" 19 90
neonata l tetanus will be met Countries such
........
..low,,,..
as Bangladesh, Bolivia, Ecuador, Malawi,
Namibia, Sri l...anb, Tamania, and possibly
_.
Rra7.~ have already begu n serious efforts to
"" ",,"
-
halve the rate of malnutrition. S irniIarly, several
~ cou ntries ale moving determ inedly tcwards
the goal of wat<:t" and sanitation for aU - includ-
-
ing Banglade!Jl, Burundi, China, Ghana ,
"' :::;Ii
ri
India, N igeria, Paraguay, the Sudan, '!bgo,
--....
Viet Nam, and virtually aU the countries of
.........
- ~
-...
'"
Centro! America. " And to acha.'\"C the Summ;/
goal of empoc..e ring all families with tod ay's
knowledge about the importance of breast-
feeding, hundreds of hospitals and malernity
units have begun to c~ institutional poli-
cies and to use their enormous influence 10
• Includel ~ with diMfIIoeal dIl6'" and re\"'rse the trend towards the boltle-feeding of
mu..... with pneumoni.l. infants (panel 13) .
In l"1ol~, (~ oil'!"" die from multiple " """
or if(Im 1M intetreto led e1fecll 01 frequenl ;lines,
N ot lCll'lt, !he promise of the S,,,,,,,ril is
-
ond malnutritlon . FDf the purJIIl'f oIthi. (hart. ~ach
child death hi. been a Uo<aled 10 ooIy on<: <aU"'. being kept by the rapid splead of accep tanee
-.,...., """'" for the l.otl'll<'micm em Ik Rights 0/ /he Child,
,
THE STATE OF THE WORLD'S CHILDREN 1993
Mexico:
from words to deeds
Some 50 I'llI!JOnS tI1Ml now '*""'" '"
na1IOfIIII o The baby.fnen<ty ~ hnaIiYe [pBr8 1:lj
progra , ''MS oIlI<:IlOn(NPA!Il_al'~ the has nllMld a'Ieod rapdy, end 30 malIImily<rita Of
targIIlS llg8Bd aJ 1IlIl WortS Sl.nml fa CIlIlcrwI, tcspitaIs hIM!!lO far bean ~ 1latl'I.fnllrdy'
Thos.e 1a'gIeI$, 10 be ,eacted by Iha 'f9JJI 200;1, -.s. The practioa cllreedslrbJtion 01 o:>I!WTW'
i"d.xta a ~ 01 c:hiId ""*>uInIion. <:onI/<Il of!!lll cial Want /c:lmUl$. oom, oon n many ooo.ntr\Bs of
"""" ctikt100d r _ a ooe-tlWd raWctico iI'l
. 1hIIdIr. B' );Ji 1Q world, has bem """IJ'l'ldIl. and a
.......1MI <leaIn rat .... a t8IorIg 01 mBt _ rru'I' Ir8Of'rIIl OfOgl<ll lO,", is undor WUif to ~ Iha
aIJfy, IheI7\lYlSion "'_Will,.
to.... ~
1"......- ... '. ,yollaml\tplamOlg~
n
~ (lfb'_ 'leediog Ia txlIh JUlIi1g s!llll
end lPWlIi pWi::: .
end "bs!ic od ....!lOr> for .. ~
o F~ IhaWlSmad& iI'llt18 198Os, !he llSSl
In Lam !lmIlrica. ahIosl .. cn.mries hoM! b.I years hiM!88llIl a 7Q9(, i lCl aa5 e'" the rescu•
..... ,Ue!ed NP..... Me«:o, '" particUar, haS rnede C8!I <l8II1llrted for ewealiOfl.As a I'(lSIA of ltl8 ' - '
a del:.arrrW>ed 81M; a 00Iaied t>PA Ms bem '*"""'<l NaliDo8IiIq-..enl 0Il1he ModBrnizati<:o"l 01 Baosic
,"", lind lIS prtlQflISlI is bIlI1g m;ntOfed ~ SIJ< a
EO .... tm, spec:laI el'klrl ls being neoe eccce
10
months un:lII' Ire ~ CII!\irJrI!rlsI 01 edoceli:;nll dspariOOs. In ltiII ca.ntI}I's 10 poortl5I
PmsodMl CalDs SrIIiNIs ee GMarI. The ...., stales, SUllpon has been lllCYlded 10 1.000
""".
o As ltIe llEtl\ crisis has eased end !he c<:U'it'Y
~. onci.Idir1g 2 70.000 frwlCiaI .9Ct
•
which seess to lay dow n mini mum stand ards mere e>U!itence gives cili:<eTlS, jOUmalislli, and
for thc survi,'3l, p rotecti on, and dcvcjopmem non-governmental organi~alions (NGOs) an
of aD children. The ('..."....m;,'" WllS adopted by agreed p illuorm fro m wlUeh to remind politi-
the General Assembly of the U nited Nalions callcaders of their pro mises and tc cam paign
rewards the end of 1989 and came into fo rce, against the n eglect and ahu"" of children in all
with the nCCC5Sar~' 20 ra tifications, on tile ere its forms (panel 12) .
of th e 1990 WOrld Sum",it fur Cltildrm.
Flnall)", it is dear that these promises m..de to
Usually, such corwen tions require many the "'w ld's children ha", now established them-
decades ro lIclU~", the stllge of wid,:sp= d
sexes on the fnrcrnarionsl po~ticaI agenda.
int ernational n:cognition; but in this C".IS<', the
Over the IaSI "'~, ~'I.'llTS \irtuaD)' every major
Sum",il W'ged aD narionalgO'o"Cmmems to rarify sununit meeting of the \I'Orld's leaden - till'
as quickly as possible and more than 120 hal'C Ih,'ro-Amcril;;l/\, the Islamic Stat<:s, the franco-
so far doncso (~ pagC$ 6Q and 61 ).
phone ccences, the non-aJigncd lt1OI"CnICm,
the Common\l'Calth, the Organi;o.ation of
In some narions. lhc p rocess of translating African Unity, rn., Sou th Asian Association for
the C<mwmion imo nationallaw has begun, In Regional Cooocrecon, the League of Arab
m any natio ns, it is beenming th e a~ptcd States, and fLna1ly the Unin:d Nations
sllrndanl for what is and is not acceptable in Conference on r:nvironmem and De\"dupmcm
the treatment of the young. In all nations, its (pancl9) - has formally oonfumcd the coeeen-
menr tn achieving the bnsic social gooIs that
\I'-'l'C agn:cd at Ihc: lrbr/dS"",,,,ilfOr ChiiJrm.
Rg. 6 Sust81nlng Immunizati on
The goal d JlO'H, Immoniution by 1990 tw been P ronU5tt Oil papu
Khleved after , determined W(lrI(M(Ie etlo<l. Now
the queotioo I> whe ther INI effort u n be ....uinod. T he imporumce of the Comxnt;,m , the
So f.". the l;>fl.off ",. been slight, lind many nMion'
h.1.... ~un the """'tow.",!:> 9<l'* <0YCI;tgC. Sm",rui goals, lind tlu: nanonal programmes
of action that hall: been drawn up should nei-
Immunizalion coverage, children underone th er be o,-c l'C'Stirnated nor undereslimate,,! ' Al
yeor, affdeveloping countries, '98' ·1991 the moment they rem ain , for the most pan,
,- BeG wn Pollo3 ..
,. Me.uies .. TTl"
promises o n pa per. But wh~n, in the mid-
1980s, 0\"er 100 of th e wo rld 's po~tica1 leaders
• ..
,~ ,
R
..
~ ~
•• •• • "
~ paper. Today. it is a realily in the liveso f tens or
....
millions offam ilic:s around the wo rld .
>OM
,-
,m B ~ ~
One lesson to be learned from that a<:hi"",e-
• "" ••
~ B
..
,ses n M ~
ment is that formal politiatl commitmenlS at
lhe highl'St k",'els arc necessary if availa ble
, ~,
" M "n ~
M
~ solutions arc 10 be PUI int o action "" (.l nm ionaJ
uak. Rut a second lesson is that such commit-
The yem 1981 to 1985 e>:d ude d.1~ for Chin;I
• For Jn9""nt ......,...." m ents will only be translated into action 1»' the
-""""_lNCU."" ,.... dedication or the professional servia:s; by th e
•
THE STATE OF THE WORLD'S CHILDREN 1993
'"
These: changes amount to one of the l1IO$t
Fig . 7 Progress on polio sudden and fundamemal transformations in
10 the 199O:i II i> noentiol lo moolto< nol j<J>I. the
1M 01 immunil.tiotI feKI>ed bulthe 1m,...:1 on the history. And for all the suffering that is surfac-
target dlll'ale. The World Summit lor Childrm ll'\ the ine:: in the turbulcm wake of these changes,
gcW oI ....odiuliog polio by tI>e 'fur 2000 . The ch¥1 from Somalia to the former Yugoslavia, it can
>how> lhot reported <lise ..., on the dKlinl! - w;th
Lotin ~ . nd the C.ribbeoon leoding the woy.
still be said that this is a transformation which
holds out ncw hope for world developrnern. If
Percentage fall in reponed cases at the various forms of free-marker economic
poliomyelitis, by region, between ' 98' po~cies now being adopted are not crushed
and 199 1 (1989 for sub-Saharan Africa) under the weight of miliUU'Y sp<:nding, debt
1981 1981 1981 198 1 1981 repayment, and trade protectionism, then
(1 ~ (:H 240) (3750) (7400) ( 810) there is cuI hope of achieving sustained eco-
...
(3670)
nomic growth. And if tit<: $tep$ now being
taken towards democracy do not falter under
the assault of continued poverty and social
u nrest, then there is also real hope thai the
poor will eveotualll" begin 10 .hare mOre equi-
tabll" in the benefitsof that growth.
These developments are changing the
ovenill environmem in which the de\"Cloping
world mUSI earn its living and within which its
g people mllst struggle 10 meet their own oeeds.
--
reponed ca.\f"S and actual cases depends on the worsl aspects of poverty has been reached
merits or the surveillance system. in the early years of the 1990s. Rroad-scale
political and economic clutnge i$ creating an
"
THE STATE OF THE WORLD'SCHILDREN 1993
Vitamin A:
suspicion confirmed
Tho 1006 Slate of the Wortrs CI*tr9n "'IXM1 ...-d ~ h was also C<> t1l ••i8d !hal 1hoo8
dr1IYt' llllentr.n to a sta"Ii-og new Ilf'OP06!IIIor pro- !VI(ingIs hok:I good lMlIl ...t9I1ha lack'" \<Ia'Tln A
1ecD'lg I!llIlYes ar<J IhDI - . '" mnny millions cI is so mkl !hal h ~ _ show up '" IhG fll"l'lIllhI
ctti..... /'bV, d oin • d>r had indcaIed problems.....rom ~ ro:;JW I>IMI been 1he8O)C(lJl!9d
lhm lhe_ '" " la'nin A moght be ~ for a i"dcatOf of vilanWl A <leIicieo <:f. 'T1>(nkn." says
WII" proporIIOn "' ......... an:l deal!lllllrJlllrlQ trot IhII 9""4" , mpoIt, "rhe daliilb> oI~,A d8-
l.f1d9<. fives. The r.d'lgs Of ltle study WlIffl s.mnea CIl!flCJ' b pJDIc /lIWl1lpUfJOSM mJSI be rrMsed
I4lI:¥ the ~ i'MlsIlgalQf, 01 Al'rOO Sorm1Er. and ~ men WlSilMI to mi:1Ir" de!;,J<ees of
<1IltDtwy."
' W8know lhath JO lllr1 m1OO~devel:lp
rri/d ~ h8nce w~ A dIllic;:iIlOlCy. TlITWlIl to Ihe Qll9S1icr1 of IM'ether ~ I'itamo'l
1N8f"/)'9II". GMJn J1l8S8~, BtId/he ; D a J A!I<4>PIeI''' 'lslOct*Nocan_lha nt.ks, th&
t1sk 01 deaIh I07la'19 ChkJ'on wiffJ ~ ard pro/>- BeIagIo gro..p <XlIosidtoed It"e _ at ... _ .
al:It evan tNiItlldJckiall vitlmil A dtilU!IlCy. ~ ale'""'estJgatioo os I1I!ll1 lest ll9COOe • two elICl in
m8Y a<::<:tU1t /0£ lIS much as 20-30 f)1J£ C$'1/ of 81 l"da. ' d>r ; : i. llI'ld NepeI. The SlUdiea, iMJM'lg
pm.~ 00II1hf ;, ~ a'cy»IgCOllllrie!J,' a 10181 '" ITIOnlllal l 00,OCC CIliIoi"a1. 00"Im11hat
llM"G ~ extra vtIlwrin A can redlo::8 cI'ild
~ tIild Olg boon k;noIof1 that a QUIW1\O' of a ~ deaths by abouI one !hOd n """'V ..._ '" me
<:Iti<ln _QOi"I!l blirdeolChyeerkcJrn lI'OEI_oI ~_ .
lNsP8f1iCU;arvi\llrlWl. BoI8'ncetne ~
01 the ~ IR,1i'Igs tmm ~ Q{ho< There,", It1re& main W<I\'$ ot laClcIOg !hII prot>-
invesligauore .. other IBlS 01 ltol ......:rl::l hoM !em Palenl. can be e<1JcaIed aboul 1hII ",""",,-
swjlllO ~!hII d9IIpar 'eliI oiI b8'-' lrlC<l 01 Yitarrin A In ll1eof ctti"eo'l del (plenty ol
vitamn A ar<l !he h8a/lh and 01 )'<lUng weeo teaI'I vegetabIeIs.j. 0' Iood!l t/'IaI ~
cttioo. '"thflliUngs/nco>6",«I,' said a 1990 OOlS - IiUCll as lilJgiar 01' s3I • can IlaYo wa-nin A
rtIPO'1 by me Co i " ! I!", on Hee/Ih ReseaId1. "r1lIJ eddedtOthemlll !hllpoiolol P'OCEEl og.O' '<itnmIn
S/lB1egic ~ _ bo 1JStOtIlOOg." A"",,",_ can be ~ every 8lx """""" \(l \'O'SIQ
~ el risII. III (J/ these stralllQies are I1eXpeIt-
Ea<1y in 1992, 30 exp8'tS snell 5: d. $ mel i'I sivlI. VltaminA~",,".lor ~.C05I/Ill illie
6elsglo, Il3Iv. to oonsidlIr al 1hest1JtIe:I t.I'dlirI8k8n lIS5 coots oodl. And 'MIt> II3:XtI9s roN ng:.IarIy
so IIw and 10 I).j lOgElIIw <XlII<2lllions. rea<:tW>g """ BlNb(J/1hII _ 'I illMl e. K!h<:Ud
be PO$IlJle !O aO<l \IltarrIn A \(l Onn'uimlion
<MnII. me ll'OOP c<:Jnli'med !hal eYG'I mild 1M•
........ A de6co!lo o:::y!llbs\lrlllllly 0 0 rt
..-
d\e d$IlIl1
raUl llI'l'O:'IQ o:I'Ib9'I ~ the age of $be rnonI!'<Il There ill no Ior1ger any"""'""" 10 ~ VrlaIrin A
an:l . . ~ In por1iCIJar, wam A de6cieo >cy ~ hIMl ~ ll1eof pIaoe ............ 1hII
~lly ' (:I_ the lItl'>'t'Jrit>' and risk .... the I'Illn</lU '" llIIw Iow'1XlIlI straIagieIlhat c:or.Ad roN
_ ""'" - . nY80CS faong chiI<i1lo1 .. 1IJe lOgi i tica"dy ~ . . . end daa\Il !lr'I'IOI'l\l !hII
oo.eloping wotld _ diarrhoeal 'isea_, measles. ctti"en '" 1ha de'> 3')J)Iog """"d.
n
environment more co nd ucive to a n::newal of
fig. 8 Progren on mealies p rog ress against pO\"!:rt)·; and advances in
The WMd Summillor Chlidr... oet the 9"'t d a 90'!11 technology, in strategy, and in political ce rn-
~ ""tion In ~ <u". (and • 9~~ ,educ...... tn
deaths) by the y ~ar 2000 - <ompaml ....th millT1cnt 10 m~ting basic social 8o.b have
~muni"'tion ~Is. The number 01 '~ porIed given that challenge both a specific focu s and a
measlts UI'!S i$ now dKlinfng in . u ~ wfIh new impetUs.
E,o,t A>ia ~ the n~tl"'.
--
sho<Jld be <OI'1sidered as only broadly indk.liYe. the symptoms of poverty and lC'Ow the cau ses
undisturbed.
u
THE STATE OF THEWORLD'S CffiLDREN 1993
Trus is an argument which is no longer lial of the poor, to reduce their control over
deserving of the politeneSS extended to it in cil'<:llmslancc, to narrow the choices available
d1epaSI. to them, and 10 undermine the long-term pro-
It is an \Inacceptable argument on rwu cess of develo pment.
cccno. First, it is an inhuman argument. Th e struggle for soo::ia1 justice and econ-
How much longer must the poorest families omic development. both within and between
wait before it is decided ihat the world has natiom;, musl continue - just as the poor them-
reached the rever of socio-economic develop, selves will continue 10 struggle, as they neve
ment at which a few dollars per capita can be always done , to meet most of their own needs
afforded 10 help them pre'",n! millions of bl' their own e fforts. But it is a n-agie mis1llJ<e
their c:hiJdrcn from becoming malnourished, net 10 recognize thaI those e fforts am be
blinded, crip pled, mentallyl'CIJlrded? enhanced by reductions in disease, disability,
m alnu trition, illiteracy, and drudgery, Today's
Second, it fails to l'KOgrili:e that frequent
advances in knowledge and teChnology could
illness, malnutrition , poor growth and ill-
therefore augment future prospects as sure ly
itmocy a n: some of w mosr fundamem.al
as they could diminish present suffering, And
OluStS as weuas rome afthe most"",..,,,, symp-
the argument that m~-"i'l!l !OO~y'~ adva nces
IOIl1!i of poverty. it fails 10 take into account
widely available is dealing only ,,~ th symp.-
that !he pulse of economic development is
roms is an argument as ckstruclive to the
",,,akened wrn,n millions of children suffer
future as it is in10Cnsitivt to the present.
from poor menial and physical growth; that
the march toward eqWl1ity of upponunlry is
slowed when the children of the vcry poor The vu.lnenble yc~
drop OUI of $Chool an d into 11 lifetim<: of illiter- -r1lt'st links between poveny's causeS and
acy; that the produetivit), of co mmunities is effects lend special wcightlO the case for doing
enervated by hours spent carrying water from what could now be done 10 protect I'oung cbil-
unsafe so urces and by the time , energy, and dr<:n from the "Ul'St aspcclS of poverty.
health that is lost to the disc<lSCl' it brings; that
There arc many ""ternal l'lIUSCS of that
the prospects of Hndinll a job and eaming an
poverty, And the pro<:es:i of d~...,lopmcnt
income ere crushed by preventable disabilities
must address all of those l'lIUStS, whether thl")'
such as polio o r nutritional blindness; that a
be rooted in accidental geographica.l cecum-
family's eapacit)' to sa"" and invest in the
stances or exploltath..., economic relation-
future is the less when a child is born menially
ships, But o ne of the most inn-aetable of th ose
reu.rded hy iodine deficiency; and thal the
caUSC$ is the fact that the children of the poo r
contribution of women 10 economic develop-
UQ 1101 usually receive th e kind of start in life
mem cannot be liberated if wo me n remain
which "ill enable them 10 1lIJ<e advantage of
chained 10 long years o f child·bunng, lung
the c p pcrtunkies that d o bc<.ume al'llilablc,
days of ancndance on illness, and long hours
And one of the main aim s of devetopmem
devoted to me fetching and carrying of Wolter
must be to break int U this insidious 'inner
and fuel.
cycle' of lfWnutrition and d isease leading to
In these and many other ways, the wo rst poor mental and physical growth; leading 10
sym ptoms of poverty help to crush the poren- poor performance al school and at work; lead-
"
ing to n:du <;<.-d adul t ca pacity for cami ng an slum or the most opulent mansio n. N ature,
income, initiating change, respo nding to new too, is here a!tempting to neutralize the for_
opportunities; leading to poor and often large tuneS ofbirth by providing a standard ofnutri -
families which an: vulnerab le 10 trn: malnutri- tion that don 001 reflect, and is not affected
tion an d disease that dose trn: cycle and allow by, the socio-econom ic le...el of the family into
the current of P"'"cr!Y 10flow from one gener- which that child i! bo rn.
ation to the next.
Thc pla~.., at which to makc that brt:ak is The rapacity for eXlending this special
befo re the child is born and during the early protection, and for protecti ng the period of
years of his or he r life. Ij the mcn tal and phys- mOSI rapid physi~'a1 and mental gt"O\\1h from
ical growth of the child can be afforded spe- the most da maging aspccl!l uf pm..,rty, has
cial protection at this time, if fam Well and now bee n ''lilitly increased by ad,'aIlccs in
com munities and governments can pre ven t koo,,·lcdgc and com munications capaci ty. By
the worst BSpI..-.::ts of PD,·ert}' from aJfccring suc h means as imntuni7.ation, growth moni -
the child's no rmal growth and develo pment, toring and promotion," the proper manage-
ifspcL'iaI measures can be taken to give those ment of diarrhoeal diseases and resp iratory
vul nerablc mo nths and years something of infections, supplementi ng ,~tamin A and
the protection which is gi~n to ch ildren for- iodine, targeted food subsidies, and kM'-COM
tunate enough to be born into a higher socio- water an d sarutancn services, it is now possi-
economic class, then a major cont ribution to ble to broaden and sll"Cngthcn this basic pro-
the breaking of the ~1'de will have been made. tection for the ~I ''u!nerablc years of iife.
With mday's knowledge and communications
This is thc kind of protection for the vul- power, families, governments, and the inter-
nerable yean which millions of pa n:nts the rnItional community could now build a shield
world over make sacrifices to prmide. From of basic protection aro und the early years for
the point of \i cl\" of thos e paren ts, it is special all chiMrrn. And in so doing, a major contribu-
protection given fnlm 1m", and common tion could be made not only to meeting imme-
sense. FlOm the point of view of the effects of diate hwnan need! but to breaking trn: 'inn er
pm..,rty on growth and development, it is spe- cycle' of JlO,..,rly and undetd""elopmcnl.
cial PIOtcction gi'·cn in o rder to artificially and
temporarily lift a child HI a ttiglter sooc-cco- Th e proem oppot1UJlity to mee t the most
nomic tcvd , for the \'UInerable carly years, SO basic nnd obvious needs of childre n in the
that the poverty into which that child is bo rn poorest quarter nf the world must therefo rc
wiUnot, as far as is possible, inflietlong term also hi: seen in the context of this profound
damage. relatio nship between tlte physical and men tal
To illustrate the thesis still fw!her, this is needs of children an d the social and economic
also the kind ofspecial protection that na turc d<:...elop mcn t of their societies. -t th ink it i.
itself tries to prtl\'me to those n dnerable years '''me,'' says Pro fessor M uhammad YUI'lUS,
in the form ofbreastrnilk. ln almost all circum- fou nder of Bangl.adesh's G rameen Rank
stances, brcastmiD: means thai during the first "" Iovement, "I" C01'~ (JIll boldly 111 i,lSis, tM,
six monlhs of life a child is well nourished childrm .Jwuld IJ<I plaud U.llbe anm.tage in all
whether he o r she is born into the mean est dffltlopm",llhinking."11
"
THE S'D\TE OF THEWORLD'SCHILDREN 1993
Immunization:
sustaining success
6Y 5epwnoer 1991. the WC<ld HealthO'gariz. "'tas l"l 1991 ltI/I'I ;' 1990. No< .. 11 : S ,thII polio
ation and UNICE.= """" llbI9 to repotllO the UN n
8i ld::atioo I c:ampaig> the regioro .. on the ""'lJ'I
Seao!a'y-Genooll tha11h1l gooI'" i'nrnur1IlI'lI ami. oIw::tory,..,;tt, Ml a slngIa case '" ~ polo
01 1tle """'''0:1' S e:tliIdrfn hid ~ aetliIMl(l. The being IiIIXIfded in Ite lIlsI 12 monlh5.
Il!Sl<'I 01 !t¥S ~ erra'l, 'ffldI.tlg ~
~ Is n ab-snnn Mica that !hi SI9lIp8Sl
lhousMcIs 01 ~ and "'~ wor'd- dechl has occurred. o.eraI. lhe ~
wIOO. io tMl """" 3 mIion <:hi:! ~ and """" _felb)'~letv 10'll.... 1991 ._<XMl<-
4OO.lXXl cases '" ~ pe60 are roN tieing age l8li>g below 50% lor paio, measles, tnd Cf'T.
PIW8IIIed eedl~_ _ 01 this ""'*'"
is ~:ed tor by !he 1991
1lla iot_ 0Ml1O .-:tlllle goal by the end 01 ioptos n:m Ca,eooi, 1t>Il CEn:raI Nrbn~ ,
eecce. ~ e-o Sffill
_...--....,_Ilef
19!'n!ed IT'=I 1:: ~ \','!1et.'1er ~ an ~
~ w<Ud dsIracI fran
E:!':!cp!a. G!=.e, Mm..
Leone. -.._5';SI........ ~~
lila taslc 01bI.ikfrlg fOOre ~ S\'Slern& '" have De8'l ~ bot scx::iaI ;nj pcJilCJ'....
'" pri'Tw)t _1;&'9.Two~s8lt... 1I>e8Cf'Oove. rest. Coi.>1ui9s "';!h SIftlnQ8I' _ systems suctl
mont oIlhe goa'. ~ '" possilIe 10 tJegin _ "". ig as Botswana. Sunrd. Cape ViIrdB. tI"oI Gantia,
-questions. Nan'tiI and Rwtrida hlMl f\"Ie01l<Wled l'iItt kMlIs
01 ~ and are";b : IQ d'lImatic dElcir'e6
Sann IaI-oIl Jrcm tte """,ecedorned loveia 01 ., ttol ,k:iieo 00001 disease.
~ ~ l7i1he la'g9t dille - 1hIl and
at 196(l · was 1<l be 8>'.pected 8ulll1e 1ig.ns for As ~ as h a::!llllYerOOl1l oflrle irrJTU1I-
1he00d of 1991 SIlOwlhallhe lal has ~ 1IighI. t8!Q'1 target it9aIl is \he set\J:'IQ-""
01M wtrellC!>
~tetv $ r. the 00. " 'iQ 'Mrl::l II!; 8 systEm capable of det.& .og
vao::crIll!llQ 0/f!I 100
.......... OnohtnIred and cno~co.rrtries ....... cNIcnn 00 1cIUI' 0' 1Mseparale ocxasioI OS in
malnlaired or Incr_ iTrr'lJrizatlon ...... ... I!lBir firsI ~ of We.... Jl'OSl co..ottrIes. Ihal S\'Slern
1991•end 26 COI.f1II\e5 ,"""'" <led a 1811 in «Ml'llgII. ~ n<:1N being lISed b' other ~ ~ ...
Asia.in~.Irle~_isb9ng
l'1 A8ia. ~ r.oo ~ IiItle or no '111-011.
used to COIT'bal Urhoe9I disoosas (piv>iIl5). acule
Ba ogIadesh I\aS 0'M'lr0CIITI9 enc;m"O,lII <Xlds i1 ,aos·
,espitll!tlr>' ~ (p!lnIIIl ~ end VItamin A d86-
i1g ii'mu'iMion ClM!nt\lf! lrom lImosl zero ...
CIllJlCY (peneI31. hie .. usinglIle system lor itasale
1980 IO~ '" 1990and haam:linlaonod <XMDgII ~ ~ (per'osI 14). Md Bengledest,
a1llO'll. ... 1991 despote<M!lf'1 ~ dil6c:u'tv.
EYen VIllI Nam, w+ictl t>aIll*' dirlic:IJties n o:lblaW>- has begL6l1l!lf1ll irrm..riuIlkln DIlIrIB1l """"""" 10
lng .........g,v0cdn8._ _ IOIll8iI1\a01~age. \.Il eo IQlheo ' lIrnt,r pIarY*Igsoervlc8s.
Relt« than WlWling betind dIl1ic doors1 0 _
... the IIM:kIe East and Nonh Africa, UrosI III
alTWUily, me<l\'toeeIth_have ~ ~
lXUl1Iles hlIY8 iltISlllO'led lI1eir iEMlls CiA. i'm'uila- DV!he idee0I1Af'll 3111'\laieb1e _ 10.-:I'l (lUI
liOIl o::MWaged8slllle!he ~ ClIlJSGdby Iho
Into !he comtlVlily 10 estlltlliloh reg.Jler, ordered
"''"'.
In Ih8 Am!If'caI5. ~ has J$1lllIIlfld stablll
lXlnlacl with M entinl p(lpIjelKn .... tl'ielorog M ,
lheI. rTlly prcMIl0 be the mosI f\.rldllml!nIII chi>'"IQll
w'm lhe Orportant exceplions of Boui and I:lrOI.9'I 800uI DV !he ~ ef!o1 01 It>e
v-zuela. whicrI reoorded lower imI.nzaIr:ln ,sees,
"
OalrUdl Q parily 1bcre ace man)' ptobko tll imU-S in the
depkJ)TnI:n[ of Jarae Dumbe:ra ofaxnmw1ity
'10 ~ arguments lJlUS( be Iddcd lWO beakh won:ers- in thdr~and men-
0lMr reasons ...-hich add "'l:iatn to !be . . Don, in their car=- wuctutt and 1DOCi\~
th:iIt tJ1c, I.imc is new right for a ~~ in their rqular mainirw and aupcoiaion, and
e-antt aaainH tJ1c, worst aspects of~. eapccialIy in the orpnizaDoxl of the _,tiaI
One of tJ1c, mosl irnpomtnl rommon fae:- refcn-al 1CT\;.u. Bul audt problcml can be
tors unitinc locby's means of prolcaina Ii\u and h:n" bttn O'InCO'k "tom !he potitial
and health and groo.<"tl:t is thai a!mosl all of commitmmt baa been 1IlSt:Uncd and "1lcn the
!hem ace able to be p UI . 1 !he: di·po!!Jl oHamj. IiJUnciall"l:SOUl'l:CS haI\~ been made a\ublc.»
lies by • o;(lmffiuMy health ,,~ with only a Abow all, it can no Ioneer he claimed th:iIt
few months of t11tining. A wdl-t11tincd, ",'CU- pulling a trained health care "''\llter wilhin
.u~, and "'~U-supportcd community reach of C\-ery fam~y is not a pra etkal and
hl:a1th worker can, for example, hdp 10 pro- affor dable proposition" Asswning a ratio of
vide: family planning infonn.ti<m and ilCr· one health ...Qnu,r for C'O"ery 200 fami~el, for
vices; advise on prenatal can: and safe birth example, il wo uld require app ruxlmately 2
prac tices; inform families of the adva nlages of million such health wo rke rs 10 SCT\'\: the
hn:wstfee<!ing; organi>:e immunization and world'$ poOresl 2 billion Jl'CQple (it it nOI possi.
~rd-kttpi!1& iiCl'\iccos; diagnOllC acute respl- ble, in practice , 10 reach only the poorest
rllOr)' Infections and pn:scrihc antibiotics; 20%) . At an average COSt of a pproximalely
teach oral reh>'dratio n lherapy and the: proper S I ,000 per year, to CO\"Cf aaIariea and regular
mmagcmcm of diarrhoeal diseases.: promote in'$C T\.;a, retraining, !he IlllIIlCOSt ..wld be in
home hygiene and diseose Pfe\= tion; 0fP- the region of 52 billion doIlar1 a }~. Such a
ni1.c grov.'th monitorin& sessions; promote IUm ~ nl$ approximalely 2% of the
tol1a)"1 kno\o"1cd&c about the special fcalina amount the dc\'clopm, "-orld now lpn>ds
nero, of the )'OWlC child; orpniu pnxection C\tt}' )uron Ih<: salaries of its 1Oldioera."
~ rnabria; disln"btnr the tnO$I cw:nlill Fora " idc:r ~ of acn-x:.e,.!he point ha$
dfu&s and mcdir.:inc:s; pmo.-idI: ,i l:l1Tlin A, been dabonted by t\marl}-a Sen, I..amom
iodirx, and iron supplements .. "~ neca- Uni"'~nil)' Profcsaor II Han"lll'd and formcT
sar)~ and refer ~d;fljOllt beahh p,obkons
Drwnmood ProfcssorofPolitical &:tH....l l)· 1I
to mc:n qualified health professionak. In dw: UnnwtyofOxfcxd:
short, 1he)' can dcm)~'IOda)"s """"'" beahh
Itnowicd&c and put it ill me disposal 01 com- .. T,W fWStUm _ """' lot rQimI ... QS II>
m....u1Jcs. And if UEy are supponed in lhII rdtnMr a poor ctIWllry Jhott/J . " II> -u
wi: by !he run range of lodar 's conununicI- ~derwk<1N/tmif Aw~ ~'"'~
tiona c:apacitics, Id100II and I~ rcJi. nuud '" _ i c 1"*,11 II> ,,1fdnUrM _1Ii-
giotn 1eaders and local gtI'''Cftlml:lll offidah, tlOou p.bIic JIfYIKm"'''''' 0/ 1waJdo aJ... ami
!he print and dcctronic media, mail oullcls eJMcwUm. 11 is II« ilkT.zi_ 1(> IlllPftdn
and profosional organizations, NGOs and aMIMr /l. PfK" ""''''ry rrm '~ ' I/> s~ II>
"'"OfTl<'n's 1lTOUps, Ibcn the mined heahh "'''''''' "" MahJI aNd ed1K4I;"".
..'Otker can be me central lpan of the brid&c " h, un.nnrrin,: dtis quatitm Ule "',," '"'" on{y
bet.....= p Te$CfIl lmOYoicdge and prntnt need, OOIl tJu tnlpiri4.aJ rtaDly rJrm ""'II)' poqr WllII -
"
THE STATE OF THE WORLD'S CHILDREN 1993
iAtIy,theJrml~~~
pIacc in our timesahoadds it wtiIhtro the i<b
thai. the ~ is 1'JlIW right fill" • dc:I=incd
~ tJetk..t>a and IJrU ....... tJtn. .udo
~;.,~_,.,ria ~tJ/IolwT=va.
dfon toO\'UWtII( the ~ aspoclSof JlO'uty.
nru.,ftIOlOI U-P"PMr<»wUryu~ r"fttility rl15 ha,,, falltn in a1moM cvnr
amJlrrliMd in crpmdilll "'Dn9 "" /ui;JhA and rqion of the Yiwkt In Latin AmericI. the
UuctJiioft !wmw cf ,mnW poutrt,); I~ -'y annucal number of binhs has now bl:tun to
"' _ 11.90
;~ I US
.E S 11.80
~ll l.1S
j'5 11,70
I~ I US
11.60 1988 91 . ,,,,,...
_ _ _ from
Interpol'led _ World
'm I'opuIotion
..... f'msp«tl daLl._
"
decline; in Asia, tnrth$ will reach a peak in the social services fOT poor families with the vote
mid _l 990s and begin to fall; even in South is, after all, good politics. At the $&Ine time,
Asja, a peak will be reached within a decade economic reforms may also create the kind of
(fig_9) . Only in Africa willthe annual number environmen t in which a new effort 10 meet
of births continuc 10 rise until well into the next basic human needs would ha\-ea much greater
<:cnNry." A lUJning-poinl in the modem fill chance of success. Mcanwh~e, thc p<m-erfU]
will therefore soon be reached. ror once the tide of demog raphic ch ange is also beginning
annual num ber of births is stable or declining , 10 tum.
any further investment in such services as rOT all of these reasons, a new potential
h.",]th an d educatinn can be used 10 imprm-e now exists for moving to..... ards a wo rld in
the quality of the services offered and to which the basic human need s of almOSt c\" cr~·
increase the proportion of people reached . In man, wo m an and child are met . BUI it is
other words, the tas k of providing such ser- equally clear that this attempt will not gather
vices " ill nO longer be a case of'running to the ncccssary momentum unless the political
stand still', and the goal of meeting basic commitmenl is sll$tamed and the extra
buman needs will no longer be a IIrget that is resources begin 10 he made available.
forever rnO\-IDgaway,
If ad':antage is to be taken of the political
commitmenl$ that have been made, an d of the
Twmfy per ceDI for basiC$ national programm"" of action that ha,-e been
As the en d ofthc 20th century approaches, d rawn up , then those extra resources must
there is therefore an accumulation of reaso ns begin to become available in the next 12
for believing that ending the ,,"'On t aspects of months to 1"'0 years.
poverty is an idea whose time may (mally tl a\~ Some nations ha\" alrea dy oc'gUll the pro.-
- ,. cess of finding the necessary funds from their
own rcslJurccs. In mest cases, this is almost
New strlllegil'$ and low..cost teChnologies
cerllinly going to mean an increase in the pro-
arc available. Specific goals which reflect this
portion of government expenditu= allocated
pote ntial haw been agreed upon. The com -
10 nutri tion , primary health care, clean " 'ater,
mirrneru to those goals bears the iignalUres of
safe sanitatio n, basic education, and fam~y
more Pres ideots and !'rime Minislers than
planni ng 5CT\~ca, UNICEf sU"Ongly su p-
any othe r docufTlCm in ruSlory. T he plans for
po rts the United N atio ns Development
achieving them have been or are bdng drawn
Programme's suggestion that at least 20% of
up in mOSI nations . And there is a growing
government spending should be allocated 10
acceptance of the idea tha t targeting some of
these direct methods of meeting priority
these worst effects of PO"crty, particularly as
human neecs.» If implemented , such a
they affect children, is an essenti al part of
TCStructuring of government budge ts wo ul d
long-Ierm developmem SU8teg)".
enable the devd oping nation s as a whole to
find se,-craJ times the 525 billion a year thaI is
In the wider world , the ground bein g
gained b)" democ ratic system s means thaI the needed 10 achieve the agreed goals.
long-starved concerns of the poor may begin In practice, suc h a shifl in present pattern s
to pUI o n political weight; providin g basic of ~urcc allocation will nOI be casy to bring
"
THE STATE OF THE WORLD'S CHILDREN 1993
about. AU governmen es, however well-inten- So far there i!; no i ign irtcam sign that the
tioned, have limited room for manoeuvre a.- indll$trialized "'Ili om will mak e additional
political pressures push them against the walb re sources avsilsblc o n th is scal e. Aid contin-
of economic constraint, Currently, the gov- ues to stagna te. And there have been few seri-
ernmen ts of the developing world a s 3 whol e OllS attempts to l'CSU1J Clu re exillting aid
an. s!",nding 0'''''' one third oftheir combined allocations. Go·..ernrnent-to-gm"CmITltllt assis-
budgets on the repayment of debt and On the tance cannot eas ill' shuffle o ff the coil of
financing of the mUitary.'" Such disTortions do fo re ign policy considerations, eco nom ic vest-
not hap pen b)' acciden t. And the internal and ed interests, and hist orical aSSOl:iatiom, which
external forees which have shape d such means that the richest 40% of the developing
spending patterns will not disappear over- world's population receives twice as much aid
night. Nor ,,;0 the pressure 10 devote disp ro- PI=!" head as the poorcst 40%,'" a nd that the
portiOll:IlC amounts of public resollru:s to nations which account for two thirds o f uie
more advanced and m ore expensive health world's child death.s =ive only one quarter
and education ser vices fo r the wealthier and o f the "o1lrld's aid. M ore positil'ely, it wou ld be
more influential sections of sndcty. a mistake to im ply that all th e aid net used. for
d i....et1y mee ting b-. sic h uman needs is irrelc_
Bur even iii the face ofsnsucn pressures, j,
va m 10 this ","usc. Roads "'''', help to meet
should be possible 10 allocate 20% o f govern-
basic needs. Jobs even more so.
ment spending 10 the task o f helping the poor
meet th eir needs for food, water, s.aniunion, But agai n, it is not too m uch to expect that
basic health CaN, fam ily planning , and the 20% 0fdevelopment aid should be allocated to
ed ucation of their child ",n. dirMy helping people to meet their m ost
basic oeeds for food, water, hea lm care, family
Retlnlclunng aid planning and primary education. Such a
restructu ring of aid expe nditures ....u uld, on its
' l'llere remains the qu estion of whether Ihe own, m ake available the extra S8 bil~on a year
industrialized nations are p rc:paml to assisl in required. It ,,"u uld be a n inCn:1ISC in the kind of
this effort. Following the com mitment made at aid that me majority of peo ple in the devel op-
the lf in-/d Summit for Child rm, every de\-elop- ing .....u rld "..a m to I"CCf.'jvc, and in thc kind of
ing cou mry wruch. dr.ws up a detailed pro- aid that the majority of ptQplc in the industri-
gramme o f al"lion for reach.ing \he agrecdgoals alized wo rld .....a m 10 give. And it is an in erease
- no maner wh.atlalx:l i~altachcd to the proct:Ss .....hieh should now be o ITered to any dC\1'lop-
- should 1lO\'o' be able 10 CXP<'C1 thai some p ro- ing cou ntry that commits irsclf to a pro-
portion of the COSt wlllbc met by increased Or gnlJTune of action to meet basil.' human needs.
reallocated aid. Thai p roportion will vary from
Icss than a quaner in East Asia and Latin °lne same co mmium:m must also be
Ame~ (0 between a quarter and a half in expected fro m the multilateral nrgani7.ations
South Asia, and u p to tWO thirds in the least .....hich currently disburse approximately $12
dt"\"ClolX.'d co un tries and sub- Saharan Africa. billio n a year. In particular, the United
Fnr !he devdnping wo rk! as a whole , the addi- Nations could play an increasingl y l"<.'rlrral role
tional external assistance required will be in tltt in in ternational effons to achi el'e agn-'Cd social
region o f an additional S8 bil~on a rea r. goals llOd to lay a nc..... fou ndation for human
develo p ment in the 2 h t century, And il is a all socie ties, til a " 'Qrld in which the need s and
role mal could abo provide a focus for the the righlS of aU people are increasingly recog-
impending refonn of me United Nations sys- nizcd . Only a fewdecades ago, it did nO! seem
tern and It'::ld to the kind of changes wh ich a martcrof great concern that the poor maicri-
wo uld make ""nSC 10, and meet with the ty had 00 nght tovore, no freedom o f expres-
approvat c t, a " 'Crldwide public. sion or religion, no righlto due proc<:ss uflaw,
Or that their children we re not educated or
immuoi7.ed and received urue or no benefit
The fading ueust
fro m ad"anees in bygiene and health care . In
Above an, this is an opportu nity that mUSI many nations, it eve n s«med natu ral tha I the
no! be allowed [0 t '-aporate into the perennial ehildren of the poor could be sold or bonded
atmosphere o f pessimism about the p rospe<;ts or madc 10 work 14 hours a day in field or
for wo rld d evelop me nt The neces sary task of mine Or faclOry. And almost elUtClly 50 yt'::lrs
drawing anendon to human needs has unfor- ago , wben more than a miUion people starv ed
tunately givCTl rise [0 me popular impression in the Bengal famine, they died in a world
tha I the develo piog wo rld is a stage upon which raised no mu rmur o f proteSt,"
which no light falls and only trag edy is enact- Seen from this long er peespecnve, the fact
ed. BUI the fact is that, for all the SCi-backs, that twu thirds of the world 's peo ple now ha,..,
mure progress Jus been made in thc last 50 UtC right to ''Ole, or that 80% of the world's
years than in the previous 2,000. Sin« the end infants arc immunized. Or that there is such a
of the Second \'O;'orid War, a,..,rage real thing asa wo rldwide Com~rion on In" RighlS of
incomes in the developing: wo rld have more Iht Child, is a s>mptom of a ""ma rbblc change:.
than douhled; infant and child death rates And in the race ofsuch progress, pessimism is a
have been more tha n halved; average life sign ICS!l of sagacity than of cynicism. In the
expectanc)' has increased by about a third; the de<.-ade ahead, a dear opponunity exists to
proportion o f the develop illll world's children make the breakthrough apinSt what might be
starting school has risen from less than half III called the last great Qbsce nity - the nccd1ess
more than th ree Quarters (desp ite a doubling: malnutritiCIn, disease, and illitel'llcy that still
of population); and the pc=ntage of rural casts uhadCM'lI\'C/" the Ih"CS, a nd the fulUTI.'S. o f
families with access to sa fe Water Jus risen the poorest quarter of the world 's child ren.
from less than 10% 10 almost 60%. Yel e\..,n
these c xtraordinar)' statistics cannot capture It is almost umhlnkeble thal the opportuni-
the true dimensions of the change tha t has I)'to reach these ba";c social goals should be
occum:d in onl~' a few decades. M u ch of the missed because the political commitment is
world has also f~d itself from colo nialism, lacking or beeau~ the dc'ocloping world and
brought apartheid in all its forms [0 the edge o f the d onor nations cannot. togc"!hcr, find an
extinction, and largcll' freed ilSClf from the e xtra 52 5 billion a year, The t~hnologics and
iron grip of fascist and totalitar ian regimes. strategies arc a'oailable and affordable, The
And underlying all o f these changes is the slow outreach and communications capacity are
and eve n more fundamental change from a there to be mobili<ed. The political commit-
" 'orId organ i7.ed almO'lt exclusivdy for the menu ha"c been ma de. An d the broader con-
benefit of a pri,'ileged 10% or 20%, in a1m0'l1 text of political, economic, a nd demogra phic
"
THE STATE OF THE WORLD'S CHILDREN 1993
Diarrhoeal diseases:
a strategy for the '90s
Ten ~ ogo. _ <i!lease ""'" 11>& 109- !he majcf C&l"'" - 01 mab.JtriIion lmOI"9 lhe deuo!k).
"""" I<iIIw ollhewortd'. ~ ~ '*"'>sI4 ping wortd's ct1Idr9n. SI\l<III_ study has shown
rr6:ln ~ l\.w eed1\W'. MosI 01 the victins !hat fr8(J.I8I'II derl'ro9aI oise8se 8IUlIa tho child'1
<IIld 01 deI1yltation. And IiItlDugh 8 d1eIIp ..-.l normal ~ by m<1lcrIg !he apJ;IIltQ, WII;lItng
~mIlltnld~ ...-dln'lalirQdo/1y<b. lheibiotplic> ,d1ood. bumi>g upcalorias In kMI .
IiarI tw:l beM lI'.ailllble lor /T'OlI'lY l"flil'S. ~ was and <h**lg ~ Mrients!rom the bcdy .
I<r>o\M1 10 few 0lllSi<lB lhe scienti/ic c:omrTU'Iity.
A_tlQ)' b'tho 1990S1T.us1 O......."gyelVN
TOCIajI, thIIrb to a dBcad& 01 poOO'OOIlCO" some priority 10 dean _ end sale sarl1IalIon l!fId 10
i:.Jnnolalll~ioo~(ORf)ilI kroQwn lA! 0KU:altG parents abooIl)"VJelllng _ (is.
used by llJlIlfOl'i"mlet}l one fanilv In ltnle .. l/le _ and II. '" oizio 'lithe "'"""'" on II>lW cI"OIdron '8
dllWiojJirIg WOOd. The result ~ 1110 saVrIg or hoaIth and ~ . TodIIy's ~ ........
appt:O»'"etel\' 1 nA;)n IIv$s each ~ ..-.l lhe pr8"o'lIl1tIon pa;si>I8 Otl a lerge scaIIl and BI a bw
domoIb, cI ~ d$&a!le 10 ~ plao(l oost The pmelpal ~ "'\1: l>/MStfoo<ing;
""""'9 the ~ 01 cI'Ilj dealII. iTr'r'I.r'mlg llgl:insI f'I1IlaSle!S; ~ a ilIIr'rI&; I<J:iep-
llis "'O"fl$" In the last <lacOOe has rnsI"oaped iog Iood and water ~; rod wasI'IiIlg I>li.-'ds
the c" , 'lI'l b' the ne><l. OHT s!il1l(lIlds 10 bB bebe to..o::tW>g toed.The""'"" ~ 01 Pf9"o 81 dii '9
prorroted; a ma,'orit)' 01 l!lIl d8l."lopiilY 'MlIId's tiatrIloelo !rom CliIAing rnaIo1..(ri\Ion are<XlI'Iti>ued
!lwnIlies stj OOrw:Jl usethet~ llI'ld~ feeding "'"~ ll'I8 l _... tlraaSI-
lion SIll CIIIJSIOI ...... 1.5 ""..., _ a '/f'J3t. 8ul 1eedngj..-.ll1W>ll the crid anexua moela day Itr
at leasl• week aIler tna ih!SI ill 001fII. In oddlioo
~ is boo::<' . '0 more and more cleer that tile am-
.......,.
paign tlI\l8inSI_ :fEE :... musl now be
PI'¥" 000' ollhe rtrnlIri"9 de!llhs ... ceeeoby ~ d*l d8aIhlI tJ)' one lhrd iIrld <1tl
dysente<y and ponislent diarrIIoea, which ro::>rmeII' mah.rlrition tJ)'h9Ilwe<etwo 01the mosI ~
~ 8ClPOI:<I!l:e 81'lbolic lrootmerll ;, ~ Ia-Qa\$ ageed on by the worId's leedon 81 !he
to ORT. r M YOWS "9". two Ihrds of" darrt1DeII.
reIIlled deaths ......... <:Illl98CI by ~ today
1900 Wat1 Sumtm lor CJlitnrl. Noittw \llrgIII1131
be _ IOiIt"o:lut a widiri'1g 01the bat!Ie againsI
that PI oportia, has !allerl1O lIls:s Ilul haIr. AI. ee d8IThoeIlI ct SId a radooIioo ;, the KJlI It8i
same ti'n& IhlnI is a~ ,.+ 81; OJ that (liar- UIke on bol:h the t..'IlS and the ~ ~ 01
.meeIo:be8se is8lsoemajor_· perhep$-' many rnIons of the world'. d'idmn.
change is probably as favuurableat this time as It is tim e that Ille challenge replaced
it is ....er likely to be. ·l bc diffi~"Ultiesa~ enor- excuse. If today's obvious and affordable Stl"pS
mous. But !hey shrink beside the difficu lties "'" not taken 10 pro !<:l.1 the lives and the health
that can be and have been overcome in the and the normal growth of many millions of
course of all the many great achieve ments of )"Cung cbildren, !hen !his ""ill ha\"l: less to do
our times. with Ille lack of economic capacity than \Villl
the fact that the chil dren concerned a re almost
In Ille Industrialized ....orld, neither reces-
CXdUlih'ely the sons and daughters of the poor
.ion nor competing claims on resources can _of these ",·he lack nOlonly purchasing j)O"'"Cr
justify the failure to find Ille extra SS billion a
but also political influence and media ancn-
year ....hich would be required to support the
tion. And if the re$Our<:es arc not to be made
developing nations tha t decide to ma ke meet-
available, if the ocerccmlng of ihc wors t
ing basic social gools imo a national priori[)'. aspects of poverty, malnutrition, illitel"llcy and
In the developing "'"Cnd, underdevelop- disease is nOl to be achiC"o·ed in the yean;
men! isa fast_fading cxcu>IC for fail~ to make ahead, then let it now be clear that !his is not
that commiunc m and to begin mobili7.ing the because it is not a possibility but because it is
necessary financialand human resourcu. no! a prioril)'.
THE STATE OF THE WORLD'S CHILDREN 1993
Polio:
the end in sight
On 1; SoVtw..... 1991. 1eI:x>'8l0lY lO'Wysis c0n- lhe r:baase. "" 0CU'IlrY can be hle. Ev9n ;, I'I8tict"e
firmed ll18llils TlI'lOrio Cort8z. e 1WO-)Olllr-<lid lX11 with -.; high Ie'JeIs of fOlfIt"e ~. !he
from the rruidPaity d F'Sdl8ioaqu'Ol!lOUll1 _ poIioWusClll'l bo ~OO and "..av ~1lIJli<II1-
PenJ. had ~ ~ by type 1 polo Wus.
sn:e then, no b1her cs- 01 polo hoM! been ltclusands ol peopIe ..-.::l ~ ... enow
,eoooded 8I'I)M'!'Iol<8 " 1tJe_em hlIt ,lispIee. lIMlMld in IheeIlat to IIrl'IdC:atIl polo Imm !he lBoe
01 the earIh by !he end oIlhe 2OIt> cenlcoy - the
Sew<aI """'" >-'" 01 vigikrIoe io aI1eIl<1 Bul Ia'Q!II"'" by the 1900 Wc:vld StnYnl fer e:t>iI:t&1.
;1cU;;";l;dio1otj:n~Io;:r';;; Pio1 Amat.:an .~, National ~'l""'11"~ n;Uli : c n pro!f,: :nmc:, wncse
~ (PAl-q, ....tich hal led lfl8 lilt" to l!d>'e.8i'.'ts ' - bee<1 one oIlhe ~ 8IJCCOSS
IlI1Idic:<Ite polo fmmlhB Arnerk:as. Sl<Jrioo oI ltvl last ~ lQ bung SlCll)Of1oo by
'M-tO and LNICEF as _ as by blatoollllid pro-
n ItI!I O!hlo' hall ol lhe globe, !he wus sUI per. 0'''''1IllS' end nstmAionI such as I!le floc::i<eIeIer
BIyseslhe _ 01"""" 100,000 ctWlmn """" __. Fa.indation IlIld A!IIInla'S us C8rll<:r.I ra DIsea:'le
Trngo:: ... 1l>i!I JigInt .... e slil r.... ItS ~
ptllQI'ass. A tIecilde llQO. 1he"""'s cl8fnedCMlftlllll
Contrd. Inan <ltItSUlr<fI'"q """"'*' 01 pcp..Gr Sl.P-
pat, Rotary InIernaliorI8I I'ia'l raisBd more I!larl
e rriIion ¥ictfns a _ . TodIly. polio YlICOnB has $:300 mlIon lor pc*> .. -..mit>, .........- In;!
,lIldOlld85% ol Q"ichln~ . \'l sorecce- pm.idodlhoosandoof~loll'l5ist
irrfnri
tries. IhlI d8CIirlo hBs bean rotting 'eSSlI'IBn .spec- zation:lEWvlces. In most ~ thetask of Jdor.
tllClJlr. reponed CBS9II <If palo In ttoe PI ....... IIIS. rrWlg ~ of mIont of parents llbOOl lhe
!Or ~ fellrom ',422 .. 1988 to jJSl 92 n wilen Bndthe '<Itoon lI'ld the Wfrj of imuizaIion
'''''.
Ttvee cp.81ers 01III new Cl'ISeS 01 polo '" 196Q
coo.id nol " - ~ ed'ieI'ed ~ IIle IIJPPOfl
of the mass meo:ia, the so::I'ioob. 1he religious
lO"ld 19!1O """'II repoft lld by e:troiIlnd Ria. But in lBIIde<s. end """"y " " " ~ ~
licl"$. TWQ 1tWd8 of .. ooots htrve ~ met by the
is.
bolt>. risR.l lrmvWzlltion ......... /d;l WI ~
hope of .. aclbI lii i(,l lhe <:f<'Oflo:&w by lfle _ 2000 de><*JI;i 'll Wl;>'Id iI5ef.
... _....
In Alrlca. - . . """~ h systems ..... g<o:WaIy Eradic:llt>1tl polio from the world will 0081
_ . 1ho posilIon ~ 14 Mican
~ $ 1.4 Dillion <:Mill the .-t 10 ~
COO1lrIes SlI llawl 'o'rm.rizatm «MIrageleYeIs d But orce ~ is ..... '!ilrred. pcio i"muliza.
lion will 1"10 longer be ''GCElEVy. The programme
()r,ce hq'l _ 01 rWli>e mn.rizaIior, have Wrl1henIIom PIlI' lor iISIII! ......,. limes ....... The
" - ' ...::tiewd, !he key 10 era<:ication is a ~ .'I/I'kg:o .. ~ In'l deMry costs. hi.Jcfng
S!Mng$ 10 the ~ Wl;>'Id. wi Ilr\'ICIU"I1 10
"""" system Iha1 can i l. ' tety cIeI8cl my new
C8!l8 cI l!ao:ill ... at ....,. ~aIOiy _ SSOO m5on , yea-by the ~ 2000In'l WrIrise 10
pected c:ase_
detarTT*"oB wh8IheI polo is I!lII eaee, thY SU\I'
be .~. byimulil:ing
.. <::hiIdtan n lhB....... Until .. 00lIllri0s ..... lruo01
lIIl8SlWna1ed $3 Dillion a ~ by 2015.
• l.ISADl8$~""""''''' $oI/I_ " tho U
"'yeotS 10 c:cvrtJol "'*' "1rIt_
•
Acommon cause
Part I of lhb report has ad\'&IlCCd the cue fonnalioo of public: halth throuch thc pro.....
tha an ~ gap has hem aIkM"ed Non of afr w:alrr and s:aniu.tion (plnd 1), thc
10 ~ up bol."n ...i w aJOJJ now be ckn: control of iodirx dd"Kimcy ditorda's in
and wtw is being do ne 10 II\Ci Wille the ,,'Onl Europrand thc Ullilal StUn (plnd 10), and
aspecm d pll"my. In particular, ad'.'1nC!:I in thc C<1"IcioIl brinJinI dlw.'D of infl.lll 11'10I"-
~ ..-hich aJuId bring better health, taUty rates in thc Unired Kill1dom and thc
nuuition.,and MJatioo 10 millions ol ramilie Unilrd Swes in thc rarl)' pan alibis cmlUr)'
an: beiDa dmicd to the JXlll=l: quana ollhe (panr18)•
..mtd's people. Tb e argument has also bem
~ lhat, "'~ this gap mnainI . -ide, the
Moll' ~tl)·, most counllies of the ..'Orid
OIl$O: is n<)( primarilya deficiency in fC5OU K'a
havt: v.itnesxd 190"0 outsW1ding c:umpla of
or in outrnch capacity but in commilmmt the power of poopk's m ll\~ mc:nlS 10 bring
and priority. The poor lack both purchasing eha ngr of I fundammlalltind Ind on I n ;nlrr_
power and proportionale political inflUCf'lCl:; nlooruJ leak: tmy I rt' thc m()\~mrnl for the
thtrrfort the gaps bcl'\~ knllllo'lw,c and protection of w environment and thr mere -
n«d will not easily be: closed either by the rnent for the adva ncement ofwomc:n. These
lnvistblc hand of martel forces or 1»' the visi- causes, too. lad«:d priority. "IlleS(: cau ~,
ble pl'OCC.'SSCS of con\~ntional poli tics, 100, were unlikeh' 10 be advanced, espcciall}'
in the vital early sllIgel, by either market
In l uch circumstances, gaps between forces or con''Cruional polilical procc:sses.
wh. t i. and what could be , berwee» 1m(lY,'I- And tl>C$I.' causes, 100. only brpn their long
edge and need, an nol hkely to be closed hy and un finished ..m-a.ncc whe n large: n um ba"s
any aUlOOlatic or iDe,'illlble PrllCI$I of sceo- of proplc bcg:an 10 kno\o' moll' and cart' man:
rcononUc <k\..,Iopmcnt; they an doled, and do llXlrl: about thc mistlltes thai " '-'1"1:
most often. by Iatgc and growina Dumben: of being milk Ind the inillSliers thai ...~ being
palplc ",'110 begin brirI&in& pll$$\I1t 10 beaT rommin<d
for dui~. Wbc:thu acting in dc:fme:.. of
lhcir <M'n inlnnQ; or in solidarity with the It is lhcrdOll' e-idcnl that the ItrIllIak 10
righu of others, it is SWPlt' . _ _...u of end pI"C\=tIbk malnutrition, rtisav, and
illiteracy, me, suucg:k to mm tile: tn05I basic:
IIllIny difJ"ermt tinds "..hich have in tIx' ptiI
IlKfXUl«I in Ji''iDa priority to the issues thai ofhwnan ~ and lO&!It:JooI' tile JlOOft$I quar"
"..,rt brin& ~ in aW:in& .....u.bk 10 terofhumanilY10Wrt in tilt moll bIsK ben-
dill of piDglU'" mint also lkpmc1, in WF
the mall)' the bc:ncf1tS of pr",ICSi WI ""rr
~,<:111 ..1Jel:hef 01" Il(M WF numberI of
«lnfincd to the: ("-, and in briD&ini about
chanaes tIw an: !CHby rec:oeniud as Jleps pMpko arep~ tomardl in tNsaUIC. To
(OI"'1Ird far civiliutirln iUd f. maintain the political ~wm tllII hal; 50
fa.r been ~ and to ,n'C the pls WI
&.-craI of tilt; panels in dIis report docu- 00'" been aarttd a new priority, nothina lea
menl the crlnuibution of peoplc'lll'lD'.'mlmrs is now =ruired than I worldwide Hl'CngUlm-
to mis pl"Ol'tSS of nWing the benefits of ina of thc basic ececs movemcnllO thc poinl
prtl@:1'n$ more wid d )' avaib.ble. 'They shaw """"-= ;1begin!1 10 exert the IIlTlC: kind of pres-
tha t " 'hal loda)' would be called NG o. have SUI't' as is today being brou&ht 10 beer for thc
been rncntial to such chanrn as, the U1In. - protection of the cnvironmem,
THE STATE OF THE WORLD'S CHILDREN 1993
"
Part Il of thi~ rep ort i~ therefore an appeal legislation and the ending of child labour. It
to individ ual~ and organization~ in aU ccu n- "':I~ s ueh a change thai, with a slow and tidal
tries to l",,:ome in\'l)lved in this ~truggle. stre ngth, gave milliorn; of working people the
right til VOle and 10 be educated . It ts such a
Redcfininl lbe acc:eplable c hange that is loday pushing back the fronti ers
o f racism and ap artheid, rendering unaccept-
'People's movements' is a blanket term that
able amrudes and actions which h3\"C e nd ured
mu st cover man)' strange bedfelloy..'S. Some
fo r unquestioned ccmurics. Jt is su eh a cha nge
an: movements of the less privileged who are that is beginning 10 slow the '':1St and eareless
aCling in defence of their o"..n in ten:sts; others
momentum of en,'i ronmenlal exp loitation
an: movements of the more p rivileged who are
whic h, unchcekl-<1, would crush the rrgcncra-
seeking to show solidari t)' with the disad \':In-
ti\"C L'ap ad lY of the eanh itself. Il is such a
lagI'd . So me O!l"rate in the broad dal'light o f
change thaI is at last beginning to baner al the
civilliberties and freedom of expression; oth-
high and ancie nt walls which still exclude most
ers operate in the dart; COM nt'S of eensorshi p
of the world's women from the citadels o f
and repression . Some wort; at great geographic
equalitY. And it i, just su eh a change that mu st
and econ omic distance from the causes the}'
now be sough! in the slrUggle 10 ov ercome the
sup port; o the rs have the din o f d aily involve -
wo rst aspects of " 'orld poverty.
ment under the fingemail ~ o f the ir concern .
So me advance their cause through the aL~'U 'lb sUL~.......d in that aim, a change will ha,'c
mula ted impact of thousands of small-scale to be wrought in the ethi cal clima te which
prolecrs. which demo nstrate what can be sha pes and cond itions ou r response 10 depn-
achieved at the same time as showing that ,."ti on On tod ay's scale. In the years im medi-
public su pport exists for achievement on a ateh' ahead, the unnecessary deaths of tern; of
larger scale; OtheN ehoose the route of acquir- thousands. of ch ild T<:n each day, an d the pre-
ing and puhliei7.ing the facIS, mobili7.ing pub- ve ntab le ill health and peratsrcnt malnutrition
lic support, carryi ng thei r case to thc mcdilt, ofsn many millions mo.... , muSt be made into
lobby ing businL"Ss k aders, and p,,:ssing for an evil as repugnant a nd unacceptable as siev-
speci fic changes in legislatlon LJr poliL'}'. cry or coIoni31ism \\':IS. rscsm is, an d sexism
R}' some combination of these methods, ....':ill become.
people's movements have not infl'«luentl}· r,,'er}' advance in capaciry makC$ a call on
succeeded in bringing about a change that is civilization to keep step. Th e nlrrtl\''ing of ttle
eVe n mOT<: profound and la~ting than the sum gaps between new kn owledge and need i.
toULI of the ir prnctica1 or politit;al achie ve- therefore a measure of the s UCCC$S of social
mentS. On occasion, the)' have succeeded, o rganization, a H:St of civilization in the con -
also, in changing the ethical climate of an age , ducr of national and international affairs. It
in n:defining pu hlic and political perception "f " "lIS not an u nacceptable disgraee to humanil)'
that Which is aL'Ct:p table and that which is not. for large numbers uf pcople to be d)~nll from
h \\':15 such a change in e thical climate Ihat plagu es and fe,"Crs when the cause was not
helped to undermine the edifices of sla,."r)· understood and the cure was not availab le. II ;1
and coloni31ism. It was sueh a ehange that , in an unacceptable disgrace to humani l)' for mil-
man)' nati ons of the world, brought faClor)' lions of ch ild ren 10 be dying every yca r from
THE STATE OF THE WORLD'S CHILDREN 1993
•
di!ICascs that can demonstrably be prevented ing powe r nor into purclulsing p<l'\'TI; and in
lind tn,:au:d lit almost negligibl~ COSt. most cases, pare nu in the poorest quarter of
the world do not ha,.., the adwotageS of edu-
The e,~ls of mass malnu trition, pre- cation, o r we alth, or political influence, or
ve ntable illness, and widespread illiterncy are
media access.
no longer inevitable. They too must therefore
be rendered un accepta ble. And they too must Such a movement merercre depends , in
now be made 10 retreat from me high ground signiflCltnt degree, upon all those people and
o f domination which they ha"e occupied for o ~ations _ inclu ding the wo men's mo,'C-
5\) long over the lives o f so man}'. menu an d the environmental movements -
that arc willing 10 act in solidarity with the
poorest 'luarler of the world's people.
Solidarity
The mo ral basis of thai solida rity is obvi-
Ma ny hundreds of o rgani7.atiOI1$, espec-
ous. BUI unfonu nately it is difflCUlt 10 l:ccp thl:
iany in th~ develop ing wurl d, are alre3dy
need for tha t solidarity on today's crowded
beginning to respond to thi, challenge. In
age nda . The problems of mass maln utri tion ,
par ticular, many have come forward in su p-
illile racy and disease arc 'old' pro blems, prob-
port o f the ~...,mm.inneO\ made by their politi-
lems thai have been with U5 for so many thou-
cal leaders to achi<....·e basic social goals by me
sands o f years that they have com e to be
end of this century, In some 70 countries,
regarded as pan of me fixed architecture o f
people's organizations of o ne kind or an other
elliSlen"". They thl:reforc cannot compete in
have worked with governments in d ra"ing up
media appeal with the appcamnce of gups in
national programmes o f action for achi eving
me ozone layer, or with explosions in ehl:mical
those goa ls. In many more, vo lu ntary organ- plants o r nuclear power stallo ns, or with thl:
izations have been holding their own national drnmatie possibilities o f global warming. 'llie
con.-ultations on how best to support a move-
news of the tethnol ogical or strategic
ment t""'Olrd s th~-se targelS in the 1990s.
am"llTlt:e$ which make: it possib le to O'o"CTCOme
These efforts arc iust a beginning; and some of these p roblems also creates \"er}' link
when mcasurcd againsl me demand s o f lite stir in lite media of either the ind ustrisllzcd or
task in ha rtd mey are still onl}' II very weak me de "eloping world. The dust therefore
beginning. NUl hundreds of organi7.ations but rcrrt:lins undisturbed on the comfortable
thousands, nor mousands of people but mil- be lief that only centuries of economic d~""el
lions, will need to gi,"C their.support to this op mc m can dcli\TIthe be nefiu of modem sci-
cause if it is 10 beco me a maner c r national and ence 10 me poorest qua rter of the world 's
international p riority_ population.
Unfortunately, a people's mov emen t to l.lul perha ps the mosl d ifficul t problem of
meet basic needs, an d to pro tect chi ldren fro m all is that mese wo rsl as ~ts of poverty arc 001
the sharpesl edges of PO'TIty, faces an e"en newsv."Gnhy by the prevai ling criteria of the
more dillkull tas k than other mavernents of media in almOSI all na tions. Unlike even the
similar ambition. The children o f the poorest s udde n disastcrs of drough t or famine o r
families are the most powerless gro up in any flood, the death of 35,000 children each day
society; their needs transl ate neither into VOl- from malnutr ition and disease is nOI an event
•
THE STATE OF THE WORLD'SCHILDREN 1993
lhat happe ns in one place alone time or from and 10 protCCl children from the worst aspctts
one tclevisualcause. It happens ",'Cry day, and ofa bsolute poverty,
it happens qui etly in poor comrmmhies
The cs usc of children and of the pocrcn
throughQut the de,'CIQping world. It is there-
fore not ' n" ,,"S',and so il slips from the public families, the cause of those least able 10
C)'C an d from the political agenda. demand priority for their O\\TI righlS and
ncws, there fore warra nts support on both
This docs nOT make lhe tnl gedy of those moral and p'-.lctical grounds. And it warrants
families any the less real. The impo rtance of rh<: suppl]rl of aU those individuals and organ-
lUI issue should nOt IJc, entirely decided by its izations, in all countries, that are involved in
novelty Or ilS photogeneil)'. There is some- any and every llSpc<:1 oft he struggle for a more
thing a miss when the world can react with hor- just and more suslainable world.
ror and compassion in the face of sudden
disasters, of famines aml floods, while remain- Populalion
ing una....-arc or wunoved by UK- 'lastly greater
loll of death and malnutrition taken by o rdi- To tak<: the issue of rapid populaLion
nary, preventable discll$CS lik", measles, diar- growth first, Maurice Strong, Secretary-
rhoca, and pneu..monia. Ami there is also General ortne 1992 U"iud N<Uwm Cm~""""a
something amiss when II passionate cry goes "" F."uirrmmwi mid Dt:t",lopmwr, pointed oUI
up ove r the loss of biodiversity while cold during the build-up 10 the Earth Summit !hal
n /he effor/ toredlla iUness and malm' lrilWIl, w id
silence greets the un necessa ry dealhs of so
many thou$lll1ds uf children 0;30;h day. It is 10 fWJl:}, Ill<! gc.uls of Ill<! Ifi>rld S"",mli fur
unac~..,plablc for the tmg edy of these chil_ C }'i!drt1l, is cr"cial nol onOo fur iu 0«''' sake "'.,
dren>s uves and deaths 10 continue whcnlhc also IlJ Q mtam of Mlping ra I/ooJ papIlla/ion
means exist to prevent it. And not to act in sol- xrowr}, a,'" maN pauibk nrfJirom""mally sus-
idarity with !heir n<:cds, al ihis time, is 10 tacit- laina ble dLntlopmnrl ill I},e ZIsI ctll /flry and
ly acquiesce in Ihe ,..,rdie( of a "'"Qrld ",·hich beyond." Backing this statement are me hun·
sars that these children do not matter b<:C'.lUSC drcds of demographic slUdit'S which show thar
!hey are the children oflhe poor.
the four principal factorsn in,-ol,,,d in lhe
slowing of populalion gro"'th are: the educa-
l n e praetiClil basis for solidarity is equaUy tion of girls and women; rh<: availability of
strong. If the basic social goals that ha'"e been health services and the lowering of cl!ild dc::tth
agreed can be reached, if children can be pro- rares; me a\·ailab~iIY of family planning !\Cr-
I"':ted from the worst aspects of pO\"ny, !hen vic<:s; and increaWtg incomes. B UI prob ably
a profound contribution can be made to !\C,·cr- the most J>O"''Crful Isctor ofall is the synergism
aI of the greal causes that arc now of prime betweentheseforccs; acting together, the)' can
concern 10 the world as a whole. Sustainable exert a far greater downward pressure on birth
et."Qnomic gfU"''th, pr<>gn:s>; 1()',>,'3 rds equaliry rates than the sum ofthcir individual effeus.
for women, the protection ofthc environment, And even in the absence of one of the factors -
the slowing of population growth, the achieve- significant improvements in incomes - ccun-
ment of greater equity and political stlh~iry tria such as China, Sri l..lInka, and lhe Indian
aU of these would be ad''lInccd by doing whal state of Kcrala have shown thaI the reduction
can now be done 10 meet basic human needs of child deaths, the education of girls, and the
availability of family planning service!l can mental concern is tM e'....r-prcsent threat of
logether bring birth rates dcwn almost 10 the disca"" in their immediate' llITOundings. The
levels of the induslrialized ...,orld. greatest 1hn:at to their lives and health is not
' [bese three social factors in the population pollution of wa ter by chemicals but pollution
equation arc among the mOSI prominent ofthe by foccal urganisms, not indostrial waste but
bask SU<.~a1 goals th:n hav~ been agreed. human waste, and the greatesl of their ~mi
T hose goals include a one-third mluction in rol\ffiCntal problems is the Lack nf the clean
childdeaths, fllITlily planning information and water and safe sanitation .....hkh alone can pro-
t.~ them ~I diarrhoealdisease, schistoso-
services for all, and a basic education for all
childrcn. A5 ach~~ng these goals would miasis, hook.....o rm, guinea weI11\, cholera, and
reduce child deaths, so il would give parents typhoid. 'lltis is the silent enl11'OT\mcntal crisis;
the confidetlct to have smaller families. As it and it \likes it$ daily 1011 on the ~fe and healthof
v."OIIld make family planning scn 'iees a\lli.il· millions of those ..... bose vclce deserves to be
able, so it would give parents the mea,U to have heard in the environmental debale.
smaller familil"ll_And as it would bring educa- s..',:ond , reaching the goal of a basic, rde _
tion to 100 million children who art 1JOW not vant education for all children also interlocks
in school - mosl of them girls - so it would with the movement for t nl'ironmcntal protec-
make the paren!l' of the fUlure more likely to tion. Education and re-education about envi-
clumt smaller fa milies. ronmental issues is the key to saving the
Ifever there was an obvious casc for priori- planet. Making p<:ople av.llre of the facts. of
ty action, it is therefore surely the achievement the fragility and unity of ecosystems, of the
of these particular goals. All of them are often hidden en\ironmental dang~rs to health.
important human adlllneCS ill Iheir OWll right. of the real impact of human activities, of the
All of them interact 10 impl'O'..... the lives and long_term consequences. of the choices and
the health of millions of women and children. altemali\.CS.isand ...-ncoeunuc to be the main
All of them can be auomplishcd 'II rclativcly hope of the environmental movcmern. Hut
low l'OSl. All of them gil'e people more choice without bask education and lit.-raey, millions
and more eonlJ'Ol over their oo'n lives. And aU of prop Ie ll'iU be denied such kno..... ledge and
of them make a strong and s)'nergistie conui - cncice, thty will be less at>1c to at>sorb nell'
burion to lowering the rate of population information, make infonn«l dC<.i sioflS, and
growth and can therefore reduce the gradient adapt to the man)'changes that the 21 st century
of the road 10 susUiillllblc de'-e jopmem , will surelybring.
Finally, the meeting of bask human needs
EnvirollJlleDI
also joins in common cause with environmen-
A movetTlent to mCCI the basic needs of all tal prolection becaose a large proportion of
children therefore tmtkcs common cause ,,'ith the world's people canont reasonably be asked
the need to reduce raIL'Sof population growth. to tum their attention and their effnrts 10 the
Rut it al.o joins hands ....i th the environmental question onong-tcrm sustamabilnywhilethl:)'
mOI'CfI\cnt on other jroms. are p=pied ",ith the desperate struggle
From the poinl of view of millions of the for short-term . urvival and the meeting of
poorest families on earth, a principal emiron- their minimum human needs.
"
THE STATE OF THE WORLD'S ClliLDREN 1993
onfliOo-.-.o. &a:zl 1992.. blll.Calml ..d:ti81Il7' ... Kbtt &mIIiI Tot 0lbIIrl:
..
01 hl Sl.om>l' _ . llIic:e ..,,;l.-.kfion,..., ~ ..... _ ... i.. dcttilln .......
• ro", bv \ 18 01 t.-""""" t...-aI SlIM rod uy _ _ i'l IN jM!qaM, ~ lot
GeNa ......
o.pIf_,h"'......,_
IwO'V ct.1Ir o:o.Id I'(ll bJ
_~
Ai> Ok-
.,..
SUSl'~
".., :
dfo'!eIlo 'IeI'! IIIld _000 0• •"
rd ~ loaiI~
=:.:=
o .... ,"*' pmwy _• t•hl.7t-i. .,tiIlgan_ _ iQMlJ8I
.....
prOIed tly the ¥oQrId loeOn. t-..««l from more
lIWllWO yel!n' ' 'IV ' ..," , l.7t lfltYlO1ltI QlMlIl'-
"","".-.:I ~ " ' _ ~ r d
"
co. n, . en IleeIIh.
"*"Tl, polO4I'ly, and ~-.:n
~gt>IIIt. . t¥"'Motrt1~t;rO'iU'ln.""
" .~ and doMII-
_
aro;l(>W
.
.... ,tiCO'•••.,.,.
_
* ' J I.'
"$>IOIIC ~ .b' rHt:J anfMIl,
_ p.-....' _ "-l.t»'I.,.-*t
~ 'W'on ~
• wcnw> be , d
"e;J ~ ,.. . . ao-
"_lifiOll
rf//d *' b'
bo 7 and _
' .. l'la 01
&.omlIl' b" C7II:twr _ ~ ..u:n; ,,_, 01-.:1 d'id " 0 _ nuL.CIIl'"
'-Ih.___
~ 2'. Sl4Uli", _ _
.....-.• ,.... _ ........m.
~il-"'cWtul_"' ,'
, _ "'_
"~CDoW
~
1«1
r:Nd
i .....-'•• 01..... c.e.
". _ " iIobo'Id $I,;mW b'a-.. "'1Dng
*'WlI """'" ~ t.grl m . . . . ~.~.~,;,;
_ I I I Flil-.:lm_hI l-.edtol ~
' /W /iDNI ~"'.'I,
pr;lldes. rIOid /aiI:8 - . . . D:
......."'" II> u.. ",..aw
_
.-...!"-G'.......h,·_.,oI.
illl .... liIi'..... }IIlI lrtO'r\
'Flu: U",·u:d Nalk",s Ctnifernlct! tn, services [0 enable people 10 plan me number,
H"l;irrm",e.u Ilnd Det..lapmem ....'ali the most timing, and spacing: of binhs.
signifinnt anempt yet made to Umte these
Control over Ihe timing: of birms is today
concerns of poverty and environmental almOSI taken for granted by most \lumCn in
degmdation (panel 9) . The agreements it
me industri:>liMd .....o rld. But it is a revolution
came to are rene<:tN in tWO ma jtlr documents
ret to ~vme [ 0 many miUions uf womcn for
- the Rio lJ«laro.rion 0" lim,i"",mml " "d ",-hom the bene fits \lu uld be even greater.
Devtlapmem and Acenda Z I. ·I'lle /'kdartllio"
stares thaI the eradication uf poveny is indis- family planning would S,WI: the rives of
pensable [0 susl.1inable development. And be"""cCn a third and a qUllrter of the 10.000
Agm du Z1 also na rcs, "Spai[u: major ~ for women who die t!!ery week from the eurnpliClt·
'/lild Sll roit'al, Ikvtfupmelll rmd pTl)/('Clitm t«rt tions of gi\ing birth . It could aOO prolCCl
axrud "Ixm <II IN lrllrld S r"nm il for Chi!drtll unknown millions of \\umen from permanent
u"d rmllli,. wlid tWofOr Agenda 11." and painful disabiliti.,. that can oc,:.. r in child-
birth and arc more common whcn pregnancy
The Wllmel1'. movement is unwanted. And it .....ould certa inly reduce
the toU of the iIleglll abortions, estimatcrl at
l\kcting basic needs - espc<:iaUy for pri-
approximmcly 50,000 Nl.'h day, mat result in
mar y health care, famil)" planning and basic
an estimated 150,000 you ng .....omen d)lng
eduntion - would also make a fundamental
caelt year.
contribution [0 the worldwide women's move-
mcm, A[ Slake hlTe is not only the quan ti!)' of
A central concern of hundreds of millions women's deams bUI the quality of ....'omen's
of women , women who are for the most part lives. Hy freeing .....omen from the constant
silcnt partners in that movcmcm , is me sur- hearing and caring for children, family plan-
vival, heallh. and normal physical and menll.1 ning can Increase the time, en.rgy, and
development of ihe'ir children. This m ncem resources available for education, fur learning:
abso rb'< the maioril)' of their time, ....u rr y, new skills, for income eaming, for partici pa-
c!TUrlS, and resources. And there euuld be few tion in a wider range of community activities,
g""ateT contributions 10 their li\'es than the and for the rCS[ and leisure almost totalJ)'
easing of that [aV.. lmmuniu tion, eomm l of denied 10 many millions of women in the
diarrhoeal disease and acute respira[on' infec- potlre:;t smlta of society,
tions, vitamin A and iodine sup plememati on, Pinally, achieving the goal of basic t:rlUClt-
safe ....'aIIT and sanitation - all of thC5C could tion and litemcy for all children would
prm~de practical support to millions of strengthen the roots uf thc worldwide mo......-
wo~ n who are at pre",m denied this assis- men! lowards equality for women. Gi rls are
tance because it is nut a sufficient priori!)'. almost universally discrimin ated againsl when
If there is a larger co ntribution that could il comes to edurntion. And evertfrom a purel)'
be made to the 1i1'CS of women in the "..o rid·s pracucet point of view, this is one of the mOSt
poorest communitics, then il is the achieve- costly mistakes that any society can make.
ment of another of the basic """ds goals - the Hundreds of studies in reccnt j'Can ha......
universal a,·ailability of thc information and shown that me education of girls is strongly
"
THE STATE OF THE WORLD'S CHILDREN 1993
Iodine:
a Spanish lesson
For CNer 70 j'OOIS iI Nos been known !hal ltl8 pa:>sod sirrila' lHi ' 'O t. "b:izlIdsaot /las, \'UI:W:IuI
l'tWioo ti minula QUlIlIlties cf iXi1e to Qtl can 8I'IY OOubl, beo'I'I the rmst 00Sf·1lIl'8clNe,<lflMlrlli\oll
O<M "'" IIBaIlh po obleo' IS Clll..-l by lack 01 o::xlri& hedIJ1 _ _ adopIed ,;, Swilzlrin:t', ....,..
in lhII! diet. less than a I ,<x:>nU 01 ioOne • 8 'ecenI study 01 the S¥t\sIl_.. iCe.
requi"'" lor 8 wI10Ia Iilelms; buI. ~ iI a .,..-,ge
at lodiro& defo::ietocy disordots (DOJ soon maka ~ il Spail. lhe ~ ~ ol tr>e!tmll
Ue,Wid\Itlli full. The mosI vlstillXll'l!lEll).le is
lhe~ ...... of goitres I>'<UId lhe ne<::I\. EIullhv
i'lYt!libIe resUlt lif8 more i1sdouI; I'u1dn:lds of
rnkins are today M-ig 0IJl tMilIives"""'" rlldJCed
_-- - "..
wa'l !alOng me I/I8W 1halt.e was ro"""" 10 lageI
,,-~-"'"
_~.~- ..
io<fne o:lefi<>eo 1(:1 SPeQlicat; aro:l.tholll>e"""""" to ..
........... , "".......... ,. . ......
a ,"""", IDO I'l!IYIIline<l 8 serUos llUI
"--'---
.....->IaI ....c ptyysiaIj capac:rty ClIUSad by 81'1 ~ ~ pmt:1Illm n wts ol "'lrIlij Ihe"""'19llOl.
~ t'*'. o::rly an ~ Jli'l"lI!& i'IIlalHe by
deIdency prob/Im II'at, lor Iho IrO,ISlPWI,Itley n
a SpenGh docIor. """'0 perwaded ,, ' 9' "'" 10
not """" .......... ti.
.spend theO vac8000II aoti::'1Q <:!ala on 00. !ineIy
Aboull lli11icn peopIo ..... B1 ri9It Mosl....-.- P'lt"SUIIded IflEI stilt" to open up lhII! I)IOblem Ie»"
_the 'o'Il'Y)'CUlg. Ioi:lt'oe is essenliBllO lIle tn· PI.ilIic debaI8 lnllO Mel a nationIII SIJWi.
mooe IhIIl '''Il'JIat''" ,..""..,.
lFO'Nlh 9I'ld deYeIop .
l'1 ltoa d8'w'aIopWlg world, ltoa nlIlin proIjam III
mont:r1d~ ~<:a"'lbe sI\.lrlled.
isdess, mernaIy flllardiKl, Dr Irv'apab!e ti rI(ll'II'llIl llaIe ho!i been !he lad< 01 PI.IJlic an:l pollICal
spooc;h. ~t Md~ _e119SS '" lha -tv '" !he problem n:l1ha
so'iPIdIY '" lIS solution. Ilul "*"""fng Iha 1990
The ~ is~8t"CI~ Becao .... Wott1 St.mI1>'t for ~ . ....... 8 !he Ia"get 01
.. tunans 9lIl sail• ....., ~ kXIne be can eli'l1inal»lg 00 In 1tI5 dacOOe was accepIe(l by
lIdOOd to sa/! witIlout aNectill\l its /lpplBllf1OO Of poliIQj lolaclln. 8 /'Ul1bar01 alUf\1IiBs have bog..n
tas\l:I. 100 can 00 eliTwlaled by ~ .. sail aI 10 Il1OV(l 1(lW;lr(ls lha iociMion d all sa'! sqlJlIiM.
lIle poo1l of PO" ' \l,I 0" pacl<agO'1g . The 00$l is Ecuador an:l TBfVa1IlI are bringng tha prOOIem
BO !IITIlIII • lIllllOO<;'oa!OIy 5 C$l1s . . peruoo po' underconl!1Jj. D.mg 199:l.I!hJlanMdBoiwl.....
~ - !Ilat iI can ""'-'Illy be _ '" lhB II\8II<el ac:tw.e It>e gQO;lI oIlU'OntJW t:iISGS. By 1995, both
COSl 01 tI>e SlIII. Giveo1I!le a>opeml"'" of ltoa sail O'roaaod l'1dooI COUdbeproducing~ iodled
nwsll)l. lilrge and rewnng IlUJliC e;xpeolllih,l'es SilII for the< enIWe ~
III'x:IUd nJl b e . - - y to """'" lhls prot>lam.
l'1 rt'Wly 00lJ:'lI1illa. il "'" laka Sf:M.'<aI more ye8'S
SwI\uI1lrId and thlt LntedSlaleS """" the In! to PUt .. place It>e le9slation. lhe lII<:tf\oiOgy. <WId
oountri9s to locize ccn",.. ciaI sa.1 ~. 111 It>e nee! ! I 'XY control procedures 10 iln!lure Ihat aI
1922. a &Mss dDclor. Hans Eggerblrger, organ-- SilII is ~ icxlized whI!n il rtlIld1es tha c:cn-
iled a petiIioI'l ;., lis hCmII CIInI<ln to ~ ltie .sun8'. But i1 tha ,,_nl''', ~ known to
lIilf\horlties to Iottze aI sa/I as iI came l/"r'Ilu<Ill!l<l oe 1Il risk can ee gMlIl iQdina by ~ or by
fliiNay 8Ia/IOn lrcm lfle S8Il•.....:wkS. Tho b<nIfits CBP'!'JIlIII 8 COS! oI lil1le _lhan 10 0IlIIIS PI"'
~ bGca'm e.«rt. <nl 0CQl rmaI Clf'IlO"lll t'IiId parsorI PI"'yM.
•
as$IXi;llCd ",ith thl: eonlidcna: to adopt new economic opponunity btromcs a rtalistic
....ays; tht "'iUingnns to demand and to usc pc&ibiliry,
health $CT\'iccs; thl: capacity 10 adapt 10 ",",' Action on mny k>~1$, and rtdrrss for
opportUnities and to ClI11I hiahcr UlCOilocs; the llWl)' wrollp, is needed to COl rtet thc unec-
pr!X<rion of ~ rmironrnents; tht IIIOl'e apl2bk degrees o f inequalil)' both ",i!hin and
dflCimlux offamily ~ thc kM~ betw«n nations. But direct action 10 protta
of child death rw:s; the improvancnlS offam· the po<m:$l, and C$pC<OiaDy children, is f'und3-
ilr bc::aIth and nutrition; the uscorfamil)' plan- mental 10 lilt process of nart'CMq IhoK JmII
nine ""'to ices; and thc mluaion of a ~ irJcqualitia of n:soum:s. capaciUcs and
f.m.ilyAu."
~
F.mpcMmna "''OmCll "'ith M Ic:uI basK:
and lil~ itlhl=fOtt oee of thc
""""""'"
Tbr ca".,." of iAClmnirlc tb::...-ont asp«1:1
of JlCI'"CrI)' :and radllng basic social pis
lII05I IilipOlWU sin&\e tkmeuu in the dro.'rI- tMrd'on ~ and is otn:ngthcned b)"
opmmI ploocst. BUill is abo IlOf: oftbe lII05I aU or thc ma.jor ClU5($ or 0Uf times.. And it is
important o:tcp$!Dlllvds _Ol'ICl, J:lIinini man: time that dlc:sc paoo>:Jful tinb found ~
control 0'0'U their O""'ll ti\u, mon: irdlumcc cq>i rioo. T boN: at thc sharpcsl: end of the
0'0'U the aJIlllIIunit)' and family dccisiom that rnoblem. nf ah$ohl~ pO'o'ertJ - the poorCSl:
Uf«t. IhoK lio-es, and mon: oppoc umily to Q\IlIfttI' of tht ~'5 pcopk - aR OCI;\lpied
dc\'dop their 1M'll potential almosI C'I'UY "'~ hour of C\'U)' ",'OI1cing
day in thc suua&Ie to meet the basK: nC'C<b of
PGlitical advuct theirflllllilies.. ~'are5ttU£ltlinl in a da)'-t o-
da~' practical sense; &Del, in many cues, they
F",.Oy,1hc: groooirc 1OO\"CmCIli for ckmoc-
are .mrgzling in an orpruzcd politic:aIsmK.
11lC)' and for &nal(l' rquity can al!o support,
And ",'hat thc). eeed is thc ~ and p0liti-
:and be aupponed by, thc ll1O""CmCIlt to 0'I"a'-
cal 5Upport of Ibomands or indi\iduab and
COlnl: 1M "''Ol'SI up«U orpO'o"Crl)' and In mccI
organizations, in all coururics. "'flo are pre-
thc basic social ao-Js that hl\-e been agrttd. partd IO mo..· sOOdarir)' "'itb that muggk:and
In particular, education and tilCTllCY arc
the $Oil in which dcmClCnq .nd p.rticipa-
oon Rourish and in which srcalcr cqualiry of
qurnca 10 n:wgnUc tht pCM'U of
=~
awr_
knov,' mough about it'S ca\lX$ and CI)I'tIIe-
..
THE STATE OF THE WORLD'S CHILDREN 1993
Emergencies:
a new ethic
Progr_ tCl'l'oa'ds !tollachie.,.''''1of!lPElOk: n- _ ,(lies shaH !hat lo:IoTnI jlflM,aioo,
Cle\ a'lIJO""oI {IOllIs. SUCIl asV098dsco a flCl ;, !tIS ItYQugIl ~ food ~ is C06I"'OIklcl...",
,1'Jl)OtI, is ~ disr\4lted by dsast$s end _ . t>oIpirog 10 awicl <isasun; aI !he ....... lime ""
gerrie;. am1Ild ronb and lIconcm c crises.
'*"""
VItile ~ cross· oo-der wars seo:rn 10 tle
wilIlme ll<'dngol\lleCllld _ ._ ~
""'"*'" cootributJro;110 Iong·term diMllo!lo'illI'L
The <MlllIdilg ~ 10 IJr(M:le IunlnI<oo
10 be a1 Dlm:>st 1M i espJO King
W!Ienoe and cMI fIIife.
'!O aSB in eIIric
ren reIieI """" In \he midsI 01_ ...-.J eM! strife is
an idea Ih9l halo gai"ed ~ "COlP'lIr1OIl in
""'"'" ~ The Jilt4Bnd lUy of Ihollrltema6cnal
Wilt> lodl.y'_ ~ cap!lCIIy. 5I.d1 CCl'mU"Iily ro ~ to proted .. ....... ~ oM-
dssstn 00 1otlgoBo' go lXW'IOliald by!hll i1lema1 . 6'"\3. ~ wUii'Jiil'j inI ~ .. """" i>eo<l
IoneI <::orm>.nty. PIb1Ic (Ipinoon dEmands tl>aI ..... ~ worktwlde. The C<::>mtw>!O'l on the
oo:;:IiQrIs De taken to oliGYIaIe runan sulIeMg. The RVn at J1Ie CtI/d and !hll Dedaath? 01 the \M:ri1
SuImlIor Cl'Iittlf'l _ ,.do e«! ltd new elt'ic
widespread crilocism or slo w or Oflildequate
response to ItllI etIges n SomaIiG and i'\ me Iormar WIth Ii'e tome <l ~ law end high l!Mll
y~ is an ivication oIlhs new global attic . poIitK:8'OO " ilitl'I8I" .
A ~ - . . . . dlMlIopmBr>l fl the posl-
8lJI C<IJlIng 'MIl1 disasl<r need not lWways be a COld _ era has beer1 1he .... 9 IIIS801 the 11ter-
~ komde.eIOP,oeo'I.1n someCQflS, _ .
na\IOnlII IXfl'mrity 10 WG'k lm:.q> ee Uroled
gency lICIions ClII"lhoM:! a Il')ISilMlIong'uw", fnpeo:t Naloons 10 ~ """" ... ,Iie ~ II(lIWlSI
1I'ofO<.9h inlIrO'/JJg organizDlJOrI;li CIiJlQCity rm g<MO ,., . . 'ISthai """,",,!he UN CMner. 8uI sane-
_.
_ e ~ It>irt. in ""l' pr~ ..."" WQ<,lo:;l .wi p.rioIl1lle"ipable IIfId p-olect 1he _able.
"""" ~ ..-. 1.......... to nW'lonsoipeople. So But ~ Is ~ 10 tt-n<1Ivl:JlJgh In lI/:t<llnCe 1ha
etIocM was me l"diwl Gc:Mo",.,rs <'IClioo ... pOSSil)Ia i'roIK:t on 1he lri1tMdad W;ftns, 8nd 10
IIlOYIfl9 IIid anc:Ill1Cl6lllng food·lor_!hal
ln food!M:lidad. pIaIl ~ _ to miligal& !hair
__
•
Amovement for basic needs
Mm10ments to meet basic needs alrea dy Some focus thei r efforts on the raising of
ClUat, in some form, in almost "'-er)' country. fund . for practical proiccts in me developin g
T hen: an: lhousands of orga nizations in both ,",'Crid. Some are =gaged in thc long-lenn
industrialized and developing wortds cam- processes of public education or in campaign -
paigning to promOlc ed ucation, or 10 protect ing fnr political and ce onomie eh:lngt:. Many
children against d~. or 10 end hunger in arc im"Ol\"ed in both of these activities.
me world, or 10 promote family pLlnning, or 10
encourage bre-~nfceding, or to combat specif- Today, N G Os in both industrialized and
ic problem s such as iodine deficiency or vita- de\-cloping: nation . are beginning to mobilize
min A disord en, or to sup por t immunu.ation in su pport of the s pedflC basic needs goals
and po~o eradication, or to promote today', agreed o n at the IlVrld S""'''';I/Qr Childrt>l."
health knowledge , o r (0 help stree t children, or
Such invoh·cmc m is spccifiCll1ly in,·ited in the
10 protect ch~dn::n who are abused at home, at Pk", of Acswn drawn up at thc S I"" "';/:
work, or in war. "Famih"u , CSJmm,m;tits, tocal ~IIHj cms,
NGOs, wriaJ, " tllUrrU, relig","s, busi"ess, and
The great ma;ority of such groups are now olJter im li/Urimu, ind" di"l the ", ..... ""dia, a rt
located in the dC\"I'loping world, and their m cotlruged 10 play an atliv< role in mppar, oj Ihe
growth has been one of !he most n:markablc toolsI'tIlIndtJled in Ihu PkJl/ ofACIUm. 77,capt-
fcatum o f recent yean. " From tM middkoflM rim« ofIll, 1980. .hof<!J Ihal it U <ml)' l" .cml"
19701,"saysa 1992n:portfrom the DECD, " Q Ill, nwbil~lUum of,,1/ $«Jors of JlXUI)', i",llIdi/lJf
Irtnd of J{TOfC lflg importall« has /w n the tIIler- IhuJ, 1110.1 Il'CJdilitmally dM ' 101connMrchi!dsur-
getl«' 11/ i"di#'unl$ 'wn-N'J'IXr""'t>lMI o't'l" - tWaI, prol,a lon " nd dtl.'llcpllltlll as their JII"jQr
iztJliotu in 1M Sowh as aclro. parlnM1 in ftx;w, 1110.1 Slini/iaJm prop-tSs ~n N <ldli eved ill
tkvt/opmcm rJfprts. I" w 1980J, CO"Urwlro. theu iJrt(JS," M
esti",altSpili tMir III/111M al 6,000 10 8,000.""
As a result, NGOs in aboul half of the
Othce sources pur the number of mdcpcn- de,oclo ping countries ha,·e participated in the
dent development organizations at 12,000 in
d rawing up of IUltional programmes of actio n
India alone, induding many, such as the for \"Caching the basic humanitarian goals
Pwplt'. SCU"'" ,\1""""""', that are ...."Orking ag reed at the ll"f,r!J Summi, /Qr C/rildrt" and
sped fiCll1ly to put tod ay's knowledge and tech- endorsed by the u; ,iud N ations CDlJjtm lC< Oil
nology at the disposal of the pooresll'CnUTIlllli- <ljrolllHem Imd Det'tlopmcm.ln so me coun-
tics. In Pakisllln, at ICllSt 3,000 N O Ds llI"C also tries - COSla Rk a, the Dominican RepUbliC,
....'Coong directly wi!h communities to meet
Ghal\ll, Jamaic-.., M alaysia, Niger, the
obvious human eeeds.sln Indonesia, there are Philippines, Zimbabwe - NGOs ha'~ been
at leaS! 600 independent o rganizations con- officially invited to join the government com -
cemed with dC'lelopmcm issues. In M exil'O, missions <;harged with drafting national p ro-
thcre are known 10 be more than 250. In the
grammes of action. In o thers - Argentil\ll,
Philipp ines, there are 200 organizations help- Bah rain, Benin, Bolivia, Botswana, India,
ing to meet the necls of S~I children. Kenya , Mauritius, Nepal, PaJ:iSUUl. the
In the Ind ustrial ized world, also, many Sudan, Tanzania, Thailand, Yemcn - NGOs
hundreds of orga nizations are involved in !his have participaled by holding their ov.-n nat_
struggle againsl the worst aspects of pG'ocrty. ional consulllltio llll.
"
THE STATE OF THE WORLD'S CIDLDREN 1993
Brazil:
a children's movement
The ~ ~ _ <:hidf9ro <l 9'aziI has rigI1Il)' Mev 1987. h PitlSid& a ol h~ AsoorTtlt,o
bfOlJQh1 WO<Idwi<le condowmalion. lass well ..... II8nded a peIlIlOn o9'e<! b)I 1.3 .......
-- olll>Ol..e.1r'lds of ~
.....,..., Ire 1tIIl elforts Elra2lIirroB suppoo ti'll lhe ic:ID& It\al etti1In".,g,ts
iWId crg;rtMions in E\lw:l1O build a ctC1ren's staJd be tUIl In 10 ee rei< GoretIIUIion. The
<:I"ildrm's r'QhIs n'I(MlITMlt'II . . . 1lfTived.
lJnder lWOdecad9soldda!ol'stop, lhelaw_ ConstIIuIiomI <:hi:rQe was ecIlIevad. BuI !:tis
had become an ~t lor Ihil 0I'lIl'llSSi0n til had to btl lIlb.m l7j dw lQBS in raw
a'Id POicY.
d1Id1ln in 8m>J. 1hc>.Jslrods smt 01110 M'st> ~Ild again bvlhe crut;:h, the mad&.eM I:Jy
Wlleel...... insuwDorls limply !tlIly IWnI mlomHnlndad)Jclgeo and g<:MlOn ... ~ otIicillls. •
pool' ~ eeeeec. SUC!1 ~ ~ no
leg(:' e::".,..:;;..
.t:eg::l:1 te r=~ .,=· ~'o~:' ..by
ri<Jtts, iWldllb..m by PI*'"' iWId 0Iher ~ a new Cttien', and AdoIssoen\s' Slat"'a. lklder
had become the R'J'm. !he po opoood law. 1Mpo,o.u or lhI'Iocuts 10<1IlprM'I
~ of fieedolll ....... 10 be li'rOted to cases in
'M1(vl 00' ...........")' flll\m9d n 1965. !he_ wtich 1tIIl1aw had tleen btokert " POSSitlIe. l'IbIwl.
l8ws and "'tiMions 181,.«1 n place, tnJ many _ diIdran _ 1 0 bo IOO.OnIld 10 lt1eit lllmIiEls.
_.
or the same altJludes and prllCbCesprevPed ~ the " oot, lhlin lI>ejI _ to bo put into Ite CW1I aI
)udic:iaoy. lhe PD'Oe..... n IhII lIItgB mel CNfY -
Inslitutions Ite1would bo as smsII and farrit;-il<e as
crowded ins titutions. Sur now ~ was at leasI po!I!lible. ~ ;, ."..., IIoOI.J'<l bo '*""":ld 10
possible to begrl ...... ' ....... ;,1W lor charlge. Nrd in alIend ~ ochooIs and ,.,.,.., 8 IW1 ollh8
Itie same __ tlW eIeclJons were _ , 200 oIlhe
r'()I'l~ org;rizAlons (l>K>Os) ~
on behall 01 Elra!iI's _ C!lblW1!<:Jrmecl1/'l(lm- Onceegai'1, It>ouoardsal~...-.:lorgon
_ 1110 8 _ <:!tim", I1llMmIlnl lz8Iioros mobilzecl il ~ of Iter-law, aod In
From ~9 expeoie of YI'O:\OrIg w:tn IIJCll ~ 1990. WllS IlPP'O"E'd by Co/9'8SS and 1'II1ltied,
UNICEF _ _ 10 helD tmg lnIeres\!1d perti!I$ 'M\InJl cIu1gas. by !tie P , _ ' l
Iogmhef iWId 10 prlMdaa WIClB nrgoof ~ The
new Goo<lo ".""1I. whic!I<JPedi~ !he ThG<e .. Sll alotlg _lOgo beba ............c.l
bo ronten! _ wha! hag boon dono 10 p-019C1
pmbIems. ... '" II. ~'. "O'l"CY tI\IIl ~ ctti",,'s!i<jlts in B<azi. Bul1haoons~uionaI...-.:l
etlCQUr8gIId NGO ~
IogaI <:toIiflIIas 1NIt ha\Ie been bfaqlI allClUI .... !tie
The mosl fUldal, ,,,,,tal 1.asI< of tho new 8SSE<'1Ii8l fouo datIOO .. lor PlO9' 8SS. losIiIutio:ls !of
""""""""" was 10 msItlIe lI>B.-y Idea ot<:hl<lren's d*lren ..... begjl. 1ii1Q 10 ",<:MOe rranno and to
~ 10 I!ralJiafl ~ ana it! ~ The Mlp wiltl ilco:T'oe-8MVIg opporttnlla$. Miwly
o:QfIrJg oIlhe <::<:U1trY'. new C/:InSlJIl..6:: oIlEred a stales ha\Ie set I.4l 50S leIepI it> .. ir'>IolI. ...-.:l NGOs
perlecl~. Willi theWP!X"1 oImart)' lnthe have eIso set up chid..,'s aod adolesceots'
C3thoIc CIuch. !he mad&. iWId the legal lnl d8Io8ncacont..... oIIet> . taIlIIdlJy~ _
f'I"llId'ic:sj P":lllS :..a.!he d"iI;)-...... ng,ts rtlCJIo08- - r Slal8 aod m.ri::ipaIly OON haS a C<lI.l'd Ie<
rntnl b\IQlVla J"I!IIioniII C\lIT"(llIigl wtC;t\. in hi las! Ite ~ 01 thacNk:l 00 wtid1 NGOs 8rId goyem-
... months 011986, saw al"!lo3t 3,(0) artk:l9s and "...,t ha\Ie """"~. TodsY. Ilb\Ige aI
72 t,*"oo . 00""'8''''«1 on cI*hln's fI\tII;s- ... cttien no Iong!o" goes ~
•
In Sl)mr coonl:ries, also, NGOs hal'e dec:i- remind 1hc:m of 11K' basic a<x:ialgoab "'hich
<kd 10 de\'OI:e their effora to ~ a<:hi<:\'elJ>Cnt agreed on al1hc:S"",,,,i,.
"'l:f'(
"
THE STATE OF THE WORLD'S CHILDREN 1993
help ....ith ,"acc;nation .,ffom and has dou bled lorsmp in recent years. It is communication
WI numbcT on national immunization days. thaI is nourishing democracy an d popular
And on WHO's recemly published list of par ticipation by creati ng new ic\..,ls of public
majordo nors to the Expanded Programme On awareness. It is communication thaI has built
Immunization, the sixth name waS 001 the the environmental and women's movements
government of an induslrillliud nation but Ol'er the laSI decad e. It is m mmunication that
Ror<J ry ImeTliaticnal - whose 5300 million has made possible the dramatic rise in immu-
contribution exceeds thai of the governments nization levels in the develop ing wo rld. And it
of Canada, Sweden , me United Kingd om , o r is communication that could now makea sim-
the United Stal~. " ilarly massi,'c contribution 10 the cause of
meeting basic needs .
In mherwords, then: arc already thousands
of ofl:anizations which arc worki ng in large In so far as it is possible 10 generalize al all,
ways and smaU, p<l liti Cll II ~' :and practically, me dia coverage of basic po verty issues tends
IIlltionall y and locally, towards th e achieve - 10 con&idcronly what is and not wha t could be,
III focu. only on the actions taken and not on
ment o f basic social goals.
the o ppormnitics missed or on the larger pic-
rure of need.....ind if thernedi e istn mese esen-
IIll'nt thai has sufficiem weight o f p uhlic and OtIS commiuncm 10 both stimulating and
media support, Or the sense of time-related ren eering growing public suppo rt for meeting
common aims , 10 begin bringing 10 bear the basic needs, then a new kind of journalism-
sust ained poli tical pressure which is nc<:ded . against-povcny "ill ha l'e 10 be pioneered .
O nly when !he climate of opinion Ixgins 10 Local priorities and local circumstances ....ill
lum, when mass malnutrition, disease, and dicta te the nature and content of that jnurnal-
illitcrac)"art widely perceived as unacceptable ism; hut its aim mUSI be to keep public and
and sha meful, ",ill today'! solutio ns bee put politic.al leaders Interested and informed of
into practice on the same scale as tod ay's the main factS and trends, the gains ma de and
problems. And to achieve that change , literally the ne«ls still unmet, the new lechnologies
millions of people and thousa nds of organ- and the ane mpts to app ly them on a suffic-
izations "ill hal"e 10 be prepared 10 stand up iently Large scale, the human oonsequen~
and be counted in sup port of this cause . and the economic implications .
Mcdi<t professionals them sek es are best
able to decide how this contri bution can be
Media IUpport mad e. !JUI in the gaps between roday's cap-
In both de l'e1oping and industrialized a~iry and today's rcaliT)', the re is 5CO~ for a
nations, there are particular <Xcupational dn;ade of repo rts and im"estigarions, analyses
gro ups whic h could make a polentially ded- an d edito rials. Subiects which the news media
sivc diffe rence . could legitimalely be expected 10 im'C'S!igale,
in those: countries which now cnjO}' press frre-
In particular, the media in most countries
doms, might, for exampl e, inelude :
is bceoming the chief mid wife of ~aeeful
change. It is communication, nOI violence, - What propo rtion of the nation's children
tha t has delivered so many natio ns from dicta- are growing normally in mind and body and
what proportion are being sfU nt ~"d by malnu-
Flg.l0 Progress against m;lllnutrttion trition? (f'8. 10) Is the nUlfitionai health of the
Tho WOrld ~ummil lot Childrm ~ the !/Oil01
h ~Mng me 1990 ' - I of child """ ~" trition by th~
eedon's dt~dn:n being regula,ly monilOred?
ytat 2000. Th.. {h.rt ~u 1M r.rst eltim. lts of Is it easier lU find UUl how many households
~ional Ifonds in nwlnu1rilion. Tho while IineI $how have television sets than il i. to fmd Out how
that a<hitYing lIN! ""gel w;~ ~ Ml iKC...... tion many children suffer from malnutrition?
01 ~_t PI'09_s, partic:ularl)o In South Asia and
",boS.N,,,,, Alric~ . - Hov.· many thousands of children ha,..,
died fmm measles Or tetanus in the last year
Halving child malnutrifion: paJt tfend~ and what propo rtion are immurazcd agairun
and future neroj, by region, 1975-1000 these diseases? (figs. 8 and 6, and pancl 4) Arc
80 there areas of the country, or classes in society,
that are bei ng bypasse d by imm unization
services?
- How many of a nation 's children have
been cripp led by polio in the last 12 months
and what progress is being made towards 'sur-
rounding' and eradicating the ,iNS? (fig. 7
and p;meI6)
- Is il known how many children are losing
their health andlor their eyesight each year
bc<:ausc of vitamin A deficienc y and what, if
anything, is being do ne about changi ng diets
or addin g vitamin A to ro oonal supplies of salt
orsug-~r? (panel 13)
"
THE STATE OF THE WORLD'S Cm LDREN 1993
- How many children are still dying from - Are there significant difIerences octwccn
diarrhoeal disease and how many parents ha,·c rates of illness and death, malnutrition and
been inform ed ahoullifc-saving orill'l:hydra- illiteracy, between girl and boy children, ur
ticn Iherapy? (panel S) between rural and urban areas, or between
different disoicu Orprovinces?
-1= acuterespiratory infections me biggest
killer ofm., nation's children, and what is being In both indusoializcd and de"eloping
done to makeantibiotics availablein time? countries, critical aneotion could also be paid
10 how foreign aid is being used; what propor-
- WNI is the counrry's under-Ii,." death tion finds its way to the poorest gro ups, to pri-
nile and is it signifit:antly higher or lowe r than mary health care , 10 basic education, 10
in ccu nrries at similar levels of economic tow-cost water and saniuuion programmes, 10
development> family planning?
- What proportion of children are born The questions and the style of the coverage
....'Cighing below 2,500 grams (low birth ",ill vaf)', bu t media propricIOrs, edilon, and
weigh!)? How does this compare with neigh - ioumalisl$ ",ill fllld no shortage of suhjccu
bouring countries? And what docs this say which, o n grounds of both national impor-
about uhe hc;J'.'i and ',;'CIJ-bdni of ,lit nation', tat,,;;: liiid human in(en.~t , could sustain a
women' dec ade of imeme media aneotion in support
of basic needs goals. Sporadic and casual
- What percentage of lhe runion's children
are anending primary school? (fig. 11) How reports ",11 not lift this cause; nothing less is
many drop OUt before becoming literate and required than a decade of tmense and sus-
tained media attention and scrutiny of the
why?Arc more boys enrolled than girls?What
progrcS$ being made towards meWng the
an: the reasons behind high droP-UU1 Tates?
basic needs of me poorest quarter of a oation's
• Wh"1 proportion ofhabics are exclusively peo ple. But if a sufficicntly large number of
breasrfed for the first six months orUfe? How respected medi a professionals were 10 take up
many infant dcalhs are estimated to be caused this ch allenge in the years ahead, lIten lite pub-
each year by the drift rewards bortle-feedlng? lic and political pressure to meet agreed basic
Has government banned the ad"ertising of needs goals would be: '''''ry sub.tantially
ccmrnerciat infant formulas? A~ free 5a/IIpies increased.
of infant formula still being gj.·en away in
maternity units' (pmcl 13) BCaltb professional s
- Has thc Coltnlllio" (Ill 1m RighlJ (111m Health pro fessionals in the devcleplng
Chlld been ratified? Arc its provisions ocing wo rld already make one of the most significant
violated? What changes in national law and of all contributions 10 the meeting of basic
policy ace tx.ing made to enforce it? needs. BUI il is a eonoibution that could he
_ Wha\ proportion of go\"emrnent expen- multiplied man)' times ever in the 1990s.
ditures are snocatcd 10 meeting the most obvi- The number uf health prokssionals has
ous and basic of human needs? Is priority morc thlln doubled in the past rn.'ClIde, and
gi\'t:n In h",..-cos \ so:r\"ices for the many Or there arc now well over 2 million doctors and
mo~ expensi"e so:nil'l:Sfor 1M few? ove r 6 million nurses, auxiliary nurses and
mid\l.i\'e in the ck\-dopinl_'OC\d.. Along ..~th
Fig, 11 Primary education
health adminisD-alOCS, heads of rM<licaI c:ol,-
(IN: allhf)'PM" 200ll ~ WI try Ihf - * I s..m.iI
... ChIIhrr _ thM.. <hiIdoon • bMlc Iqc:s, pao:cliatric:ia hospitJI admir\i$Inrcn.
oGJuIIun ...t .t 1Nll1lOIl1hol*l t<If'lIlIM pm...y and medial rocarchm, these profeWonids
I<hoot. The ct..t """"'" ....... ,........ li<lo, d ~ form a '-as! mny of poIential support rO!"
In - " ~ now.-h g<ade 4 of pnn.y I<hoot.
The while . . , _ Ole \he ~.- to bridging the gap bclVl'«n today i knowledge
iO(""",,, the 1M9"I. and tce:hnology and its widespread use.
~ ~::-~::"
60 "
. 1 bc)·1J't adI'OCItina SUltqjcsof primary
halth <:II'C and opposinc the a..... tioo of the
""'-
lfCIl majority of hcalttl n:sourccs 10 city
~l_ "" " ; d,_ • Tl1q arc o ploring WlII)"S to mate man:
efficimt uSC' or highly qualified medical IXT-
sonnel b)' dcployinlr; them in support or the:
tNininll, supervision, and referral bIlck-up 10
community health \lu rleen .
• '11Icy an: usinglhcir influence: to make the
~alth bcncfirso rramily plannin& more widely
_ 'n,
-_..._..__..
_ .. . - the offi<JIII _
and matcmiry ImiIS 'babr-frimdly' (pand
. ' Since .....,. ot theM . - _ _ .., okt<J, the 13) , and bclp ina to moNtor lhc: imcmationa l
d.uo In II'oe cNrt ~ • hi!lhef Itod 01
eodc on lhc: rnartcrinc of infan t formulas.
........,..lI.lMn lOCl\I&,
.......... •'They lU'C helping l<)moni!or mic:ronulricnt
.
_
~
THE STATE OF THE WORLD'S CHILDREN 1993
Breastfeeding:
baby-friendly hospitals
F1!Iy ·two~ " 12<:<llJ:1!fios...... decilIroo idea Is 10 P@r'SlIIlde llhosp/'.alstololowIte 7 ....
· ~ . frillnl~{ early i'I 1992. ' " ~ moro $lepl1O~~· -v.tich"'d.odes
are expected 10 I\llYIl earned eelIlle' tly lha...-.::l ol ' ob ,' io '\l III mothers oIlIIe a<Mnegea oIlJreaSl·
lila \Ieao'. The ... is to l:ri'1g IIbouI a 'lMJlIlion in mI<, I;ooping newborn baI:>iBs ;, the same room as
lhe WIly IlOSPt* trBal ..-.om babim and _
~.
"'* ....-s. rajecIng the use 01 iaEding bottIas.
IIfId heIlling mothers IOIIh llO\' I" 0bkI0 ' IS they "lIlY
' - in t>egi. ",'9 ~ Hoop4eIs wt'ictl
Fa "*'lI ~. II'lOSl ~ " - <:i9cou'.
aged ty' '1wdio9. Nnwbom _ _ """"'" loIow!he to Slaps arodeslgna:ed 'bab\'.f";end'I".
booln ;:",pl ..,.." from lhoir motIlers lind bo1tlI>- nitiaft. Ihe taI'lj)lIigi, lIi'ned 111 ' baby- ~:
Joodl,-oil resboo.nltoii'-ern, :,:;,-.ul.:;:;u·... vi ~-ili.-" staluSiof iOOaing t\OOpoL3lll i1 12 00ln\fl(IIl . SOMa.
kltrnoMs. fil1rti1g leo . . - ......... hIM! raM>IIIy
Pft"<'Ided I'osp'tals 'MIh fnllI or ~ mJo:.
E!nlzj, C600 ,1'_. Egypt. Gabon. Kenya,Me>do::l.
Ngem.1'lll<sIlln, ~ .......... n"""".:ll...:l TLIkay.
~. Millions 01 motl"Iers. !II'\ldQI.<s 10 do whaI is Oneyear on, !hal had been /lChi8Yed. ThenB><1
best b' !tllW d*m"\, hIM! been JlIlI'Sl,l9ded 1(> $lage is108J<ten::l1he8Wa'd 1081_ 100 hospitals
,-
bolIle-feed, The resUI nes a
been Sloopdacine in ineactl ol ¥ nlgioos -ilc::lJci"(lIhll~
~ -reJnIon:e(lby~ IrId by!tle world. By 1995. the hope IS ItI8I hospital ~aetioo
wcn:tMd9 riooi'lll1elUl'tHoI WOOUlwhogo OlA wi h8\Ie been ~aoosblloed ioail c:cu1Iries.
.
lkrJcimcics and raising a"'"'I1"C1'ICU of these r...,.. all the pl obklhS of unde:tfundina of
hidden probkms and their Iow-cou solutil)l15. schoob and inadequate: cquipmc:nt, ~ arc
srilI allc:asl: fivetimes :l$ many Ic:lIIchcn as Ib;:n:
- lllcyan: anemptint; m<km)'ltify medkaI In.' health ,,"OItC:n in the de-."dopina work1;
knoJy,~ and 10 put asmtial information II
and lhc formal C'ducation S)~ is by far !he:
tbc ~ of all familia. broadc::a channc:I for the: dissc:min:otion of the:
l luou&h their prof~ orpniutions, nc:w knoYo~ in which so much of !he pee-
hmth ...."Orkcn I I aD k>'ds 1m lIIso bqinning smt potc:ntW resides..
10 contribute tu bridain& loday's pp bmYccn !15 ..w the: mtdia and the beallh profo:s-
knoJy,~ and ~ The I - - * - , Cotuocil
sion, ~ is dangc:rous lICfOSI so
"NuTKS, rcprcscntinc I mil60n nurses in all many diffc:n:w plOOlc:UlS and priorities, COWl-
countrie:s, is Ilaininc its mcmbm to inform lric:sand cuItwc::s.. But. basic c:dualion, espt-
pw=IS of mday's Iow-cosl mWoolb of pro- ciaD)' if il is to ~ for only. f~' )Ul'S, IhoIdd
lcain& the vuInenbk )UJS of &fO"''Ih.. The: mc:mpl to bc:nc:r c:qWp chil<I=> for the: roIc:s
/~ I'rJitwic ~ has . ,
and =pcnsibiIitic:: tbc:y ....iD 1ISSl.UTK: in the:
alkd on iIlIlhrft Q1.IIrte:r1I ofl miDion man- fun=. And bo.-c2uK 1Oday'1 chiId:m an:
bc:n; 10 11K ~dw~"udut%o.--
_....,.n",., aIId _ _ ~ oMicII CI*IJ
mJw;, dw Id1f/ dilM'P S.-J dmlJI f/ dtiIdrM by
infonnation 10 their _'II
towue IOW'S pamns, and also the carricn of
pualts, no dIiJd
shoWd ],er,~ school ..itholrt loday's buic
ltdJI... The .r:aJJ>ati.M ~ pIw,.. krJoo;l,~ of bo9.' to protect the vuJnmbIc
uan.,w has ~ its 700,000 phu- )UI"I of dUldbaod in tbe mou dTcai\~ and
macisu in 6S coun1:l"Xs 10 pmmIXI: on! Ic:asI c:ltpoc:nsn~ "'lIy.
Idt)"dntion SIlt$ Biber than Iln~
dn.lp. Ttli' I,,~ ~ f/ ' Ibis, too, is I spc:ocirll' nr.thc:r than. acncraJ
M idfrion has eUd 80,000 llIOIIb e:" in 42 d ... lknge N o dWd should \al,~ school ..ith-
nations 10 bc:axne: aetiYc:1y im~ in rrduc. CUI toov.in&: about
ina matemll ~. I'IIQ and in purting • T he: basics of &ODd nutrition.
loda)"s dWd<an: ~1c:d&'c:II !he: dispoIaI of
- ' Ibe: im~ of brc:Wfl'c:dina, tbc
--~ dangtts ofbottk-f«din& (pand 13), and !he:
"Thc::tc: dToru, 100, an: only I small bqpn- spc:cial fc:cding nc:c:ds oflhc )UJng dWd.
nina. lJut the y . - e:nouaJt tu dlow thal if far _ Tbe: c:nonno<D bc:nd'JIlI ofthc: responsible:
Iarga" numbers ofbeallh professionab were 10
planning of famiJy ~c and the: ,,~D-informc:d
become: acm~ly imvh'ai in this cause, Ihc:n
timi ", and SPi cing of births.
some: of the: lllOSI bask of h~th &oa1s would
bc:drawn ..ithin r9Ch . • 1bc importance of clean wa ter and safc
sanilltion, home: hygiene and disease: pre-
vendon,
EdIlQIOn
• 1bc nc:ed fori mmutW.ation.
A third OCCIlJntionallroup which could , in
mosl countric:s, mUe I ~ii'lirlClm and spe- - What to do aboul !he most commo n ill-
d rLC comribution to this cause is the education nc:ssc::s _ espc:cialJy diarrhoeal di:;ease and
COUihs and colds ~ and when il IS esstntial 10
..
profession.
THE STATE OF THE WORLD'S CHILDREN 19ffi
...
Norway' Al the political level, a strengthening of the
Uniled States 10. 1
Germany NGO mov"ment could make an even more
Canada crucial contribution to the meeting of basic
needs. Only in=scd public pressure can
finland
Irmnd ," make tht: meeting of basic needs inlll a lasting
Belgium
.," lUloonal and inlernational priori1}~ Rut it is not
Uniled Kingdom
""'=- ,.,.
$.6 ..
, only pressure for more aid that is required.
Mon: and more YUlumary organiutions are
Auslria
New Zealand
AustraUa
Frall(e
.." 1
taking on the responsibilily of dnlwing pu blic
anennon to the deeply entrenched injustices in
economic relationship s belween developing
Jipan u
Italy'
o--""T-•
2
•6 ~,,,,;;-,,-,;;,,
8 10 12 16 18
f 1'1
and industrialiud nations. 1ms }'ear, for
example, 20 of the best-known voJunl>ll')'
agencies in 13 Europe-4I1 counmes have jointly
USS per capna lobbied forfurt:her action on the debt crisis thai
• Figures are 1<)< 1989. continues 10 have such a d~"'llslating effCCI on
_ <lI<D ... to _
lives and li,..,lihoodsin !he dc\'Cloping world."
"
THE STATE OF THE WORLD'S CHILDREN 1993
Maternal deaths:
emergency care
fwry ,., S1 eslinalfKl SOO.CXXl VI'l):'l1lln die efIed." 1hll LniIed KingOOm and thelJrWllld StaleS.
ffQm thlI ceo I ipIicalioo os 01 ~ 1"'i9Q< " ~ and gMo'lJ ""lWTlPIe. maternal mortaiIy ,," ,oaIi eJ 81 VfI'I
fa'
lWIh. ~ per C$"ll of ~ deaIhs J>appon tq, ....,.. !I'o'eI'\ Mill lTpoYEll'llOWllS in ruriliDn and
n lh8 00 ' , . Ig -.or'd. l'1 Alri::a, 8 ~·fi chnoes _1lad~'-WW'll mortai\ylO\l9rylow
of <Mng ;, Pteg"arc1 01' doillbo~, ..... appro><!- IeYels. cw,.nthe 19X1lo, _ f!lT"Ol<gIlnl:y_
lTlllell' 1 " 20: In AsllI the risk is 1 in 54. i'l lBlin iii(: C<Ifll b!Iciime ...cleIy avaiIllblB, did maternal
AlnericII 1 in 13. tI , iOI1IIein Wope , n 10,000. mofIlIIity begin M 51"", Jell. ~ tOOay. ""'"' Os a
The 1990 World&.mmilIarO'li<hln ~ lor 8 teIgious corrm.rily n the Uriled Stm"" whoose
_mortaiIyrale is...... lOthaIollrda -aod
fllducbon inmallln"lal d8Mhs of at IEesl 50% l7l'1he aboul 100 _ ~ than the US ave-aga •
~ 2lXXl. and ma<ry ~ IIf8 r>Wibegio • • ".10
look lor'<'4yS and ~ ol8dwvlng this large!.
desPte hi(1lleYels of i'amII. tdo:a~ ruriliDn
and I - . corn. The meson? Its "" 'iIleiS re!vse
There are Oll!y three optiOnS - pre..erlllng ITOXlem medical !lllIW:tl!;. _ in eo ,oao l)!li cies.
unwamlld~. ~ot>st 9\I!Ccom
f*;alioo .., lind pre'WlOting cl8a1hs _ conlpica· AI 01'18 lYre. ft was II'IOughIlhal 1M pmllII'lm
tlQl"l5 do ocwr. ccuid be mduc8d b)I early 100lIilicaIb, of l!'IOse
WOI'J>II<1li1<l11y 10 lIIJIlw co I~ "' chl<bnh 00
ThelirsloptiorJoIlEn\l8Sl scop8. ~tely lhal ItIey lX>.lId be rrIO\o9d to, or,--. a JJlCX!Ilm
one tnird of all pi eo • >ciee ,., \tot doMlIopi'>g wOO:! rmlllrl'rtY LriI. A1lftasllWO Ioisils to e _ ,*,lfe
are UI1WlIflISd. IVld es moil ~ed t*ths !al 111O ana irrmrizaoon~ t\lWllli aruessential6..f"-
!he t rigll rill< eategeo:y, famiIv plio lX>.lId lt1efe. fig pmgnaro::y. BuI ' - ' l l fr'Iclir9$ O1dic81a !hal in
Jorv ~ a ~ "" I"Il.<Tlbw of epprooim<ltely 50'!(, 01 obstetric eoTo8lg8t Cies ttoa<e
matemal daatns. ~ wcUd .:so redJce thlI 1011 of is no otMous .... facItlI' _ can be oOOeoved or
l00.000p..ng.....:men 1!8dl _ .
""*""
L.fISalu ab:lr!lon, I'\OhIcfl rrJH lhfllM)s cf 0Ier lICled on _ in tI"JIl P'''Il' """'V.
..
THE STATE OF THE WORLD'S CHILDREN 1993
Nonetheless, change is surely in the air for pled, in realterms, in only 3O)'C:at$." And ever
some of me poorest and most militarized much oflhat time, militarized clitcs run.., guv-
nationsof the world when: the cold Wll r has for erned for the benefit uf the few, used their
so long take II heavy roll. In Ethiopia, for weapons more often againSllheir own ~~ti1-cns
example, wh.re half II million soldiers ha,~ than against foreign aggressors, and succeed-
been dcmobifu:cd in me lasl year, the mili~ ed only in denying people their righlB- without
lary's share of total gOl'cmmcnt cxpendirnn: meeting their needs. In addition, the people of
has Calk" from almost 60% to jLJ~t Ol"er 30%, the developing wnrld ha\'C also had 10 pay the
and spending on health and education has cost of the military culture in the coinage of
risen from 12% in 1989/90 to almost 20% in war itself. And no one has paid a higher price
19'92/93. Meanwhile the first anniversary of than their children. In the las! decade alone,
the new government wa s celebrated with II mete than 1.5 million children have been
pa rad e not of U'OOps an d tra ditional military ldUed in wars, mOre than 4 minion have been
hardware but of p""plc bearing o)iv. branches ph~..ically disabled, more than S million ha,'C
and V,'lII'ing nags On which wen' emblazoned been fur<.--ed into refugeecampsand more than
me white don.'S of IX'IICC. 12 million havelost their homes,"
Ikmititarizat ion
':1"", enec of;ill it~ on progn.~ towards
meeting basic hwnan nce<h hal; been pre-
If !he: wI"ernian of funds from defel1<.'1: to dictably OO'llSlating.The famines and depril'll-
de...·dopment remains mainly II rnarter of lions end~ in recent years in sueh countries
potenti al, the cnding of the ~'QJd war has as Chad, Ethiopia, Liberia, Mozambique,
already begun 10 help me cause of the world's Somalia, the Sudan, and Uganda ha"e all been
poor in other ways. either caused or elCaeem'lled by militlllj' coo-
Chief among those ways is me substllnlial flict. Crops, roads,markets, schoolsand clinics
progress thai has already heeTI made, in many have been destro)l.'d; uade and commerce, and
nations, IOwards the dem~il:arization and the ' 'Cr)' means of carning II living, hav" been
democra.rization of society. For the days are disrupted; civil liberties Ita,,, been crushed
now gone when military dictatorships could along with the bopcs of milliOJlS of people for a
derive political legitimacy, miliury equip- minim.ally decent lif~.
ment, and economic aid, merely by saluting ·Ib some of the vi~tims ufthil; long-running
the ideological flag of one or other of the \"'0 lI'lIgedy, the ending of th~ cold war has
suPl''llO'''eI'S. brought new tunnoil and ncwde'lI~tlItion , To
In this sense, the significanceof m., ending others, it has brought new hope. In the last
of the cold war can hardly be exaggcr.ltcd. three years alone, over a third of the world's
Fcmyyears of coWwar rivalry bas contributed nations ha,..,ehanged the course of their polit-
to the miliw.rlzlltion of polifical cunures in ical oc..'Clopment in thcdireaion of deffiO<.TlIC)".
many developing nalions, helping 10 fertilize This is good news for a mo,'ement rc meet
the weeds nf dictatorship and 10 seed new basic human needs in the lears ahead. For the
tynmniCll. Thc result has been a waste of more progress Wt is made to"'lIrds democra-
resources on an exrraordinary scale. Military cy, thc more the POOl'C'St groups in society will
spending in the de\'eloping world has quintu- begin w cxcrci!le a degree ofpoliticalinfluence.
FmaIIy, IM ..... ~ of poIirial aod praI ~. bul abo "" dot ftwa /JIId .".,..". af
fn:cdoms an abo hdp 10 cmltC 1M kind of ~ p~.""
environrncnt in whid! prople and thcir orpn.
izatiom can 10'011: for the diangcs tha i will RtdilUliDl aid
enable: thI:m 10 meet dicit own ncc:ds. In llI1 1ne , nding of the cold war ml Yelse fur-
already quo ted lnalysl", Arnat~'a Sen hn ther thi5 cause by re~ll iid away Iecm
I rvued this <:lISC' thlt political and press free- !IOITICof thost: countries thl.. billa ntly l uach
doms arc centnl, not lnciderual, 10 the cause far llrate' priorily 10 military , pending than
of meeting human needs - in ..,!ation 10 the 10 meeting human needs,
~ specifIC question of cnding hunger Ind
malnutrition. It is I n Itgll~TU that applies Aid 10 O\'l:Tmilital'izcd cmnomies is t:1'ISing
just IS lO'clI to the stnJ&gk: for benc:r halth or to be pcrc:ci\-.:d 1$ essential 10 the foreign
edualioll: poIicics of donot nations. And IS theK is little
support amona 1M !.U'p8yua of !be iI\dumi.
M Dt.«mcy /JIIJ WI ~ PTa' """
wed world for hdpina 10 rltlll'a me, pur-
""Ilw pnuby ll{ja "efro- 1M <i':J,i_ '" m- of ...upons IDd ee ..'Iginc or ..-an in
~~~~u~w_~11/~ !be dc\-dopir.g WDrid. it is Iikc:b' that aid ..-ill
rAt lfJOt'" 'Il m~ '" Ilw JIIffnV« II{ inl:n:ISinItY begin III no.... _dine TO me,
.ft-Uw t'Iic:fi"u. new contours of the po$I-mId ...... pc:riod.
M~. rriIl# «-cruey is " tIWjDr Ju, ~ All mmin& of 18 donor natiom in Paris in
IN riP! di~ a dt>oo«o"Iic "'"" af~ l:>camber 199 1, it ..... -eJftd in principle
Iftml u ...";,, irMf" ~ ~f«for Olk IlIal reduced annli spcndilll and progres
qruue publK lX/iW", "t'Jim1 1u4~, Tw IO"'-ards dc:mocraq' ahouId b«omc important
exo",pk. ill India IN Wllit cf fam iMJ Iw btm oilcria for ihc aIlocBtion of aid in the 1990s.
11wJrr>uxh/y pohiiciuJ, NI"i"l ftJ ~Ii",inau IN Ge rmany has m ady announc,d a 25% em in
"haw""""". bill r.n. quil l (:O.lIimUlriDn of aid 10 India b<:I:ause: of "cxcessil": arma·
.rukn,~ umk rmm rishmt m alld lkpn'wIWn IwJ mcn lS" , J~pan hu informed the Democratic
""I ytl bta>>M rormptmd,'",/y promi"ml i" IN 1'«lpk's Republic of Korc:a thaI there "'ill he:
..nos mu/.... ",ld;" IMJfJetwriai poiiria. TN sa_ no consideration of eithcr aid or credilS until
tall Msaid <lbou11DJdn IMs tmd ,Itt pour I'tlu- aU nucleu facilities art' oproc:d for inlema-
Iit.~ lkprit>.uiort af...-... TIM po/iliaJI ~. tiona! inspKtion. And the Indl:pclldcn!
ric:a '" dNJ -'do ~ ~ jaiJum - U Group on Fmancial l"kJl\'S to 1k\~1oping
~ iIocrNK if rNs.t isswa fWf'I' '" be Countries OGfl"l)C) - dIain:d by fonncr
bn:1tIPl i1flopoIiliculfJlfdjoemtaIUIic/<laG. -.to- German a.aocdIor Hdmul SdImidt. and
ilftr-ueTusu fIlwJa ,wu.oIicjru mA. ind\Idinfl: the former ~ or Prime
M pW& lIQiIw Iw '" ... ..,. /1$ ..m....r I1y
...
MinistCB of un-dl, Ni&tri&. Pnu IDd the
....public_ -itul /1$ _..m....rp ....,.... Rc:pubDc of Kon:>I . has ~ thaI
Ik. To ~ Ilw"obhI rJ/...... Iloe pttIiIi. the: future aIIocarion of aid and !oms sbooId
allJ r-lt ll/lkJ 'id"oIicastd u~ PJTU fl\'tlW' tho5c countries lO'hich spend iess IIwi
",,, _ _ a subsuPttia/ _riba<n-, bott il abo 2% of G OP on mili~ capacity. The main
caIh for aaitJU'" cf Ilw ",,/>lie. Ubimauly. rJv aid-cnina CQWIIries an: also, of <.VUnl: ,
(/f«INmesS",,,,,/Nil...:riorl tkt>mdJ ..." only an arnot1& the main If'TlIf-scllina countries, and it
"
THE S'D\TE OF THE WORLD'S CHILDREN 1993
"""
when
. . other
~
~ rn:::« poopIe h;Ive altematiYes
comes \(I ~ care. And ... many C<U>-
prmtely. The I'lMll'l.I8S genora:w lXlITlIIlJr1dI:o" lhe
«ntroI oIlhe oamv'ily ltrougI1alocal ~
menl co<m>IlI.....
lnll$, ~ Ilw/lh S9'V09S are bew "ilill
IJesprte III dotbIs thai -..::n
a scr>eme <XlI.Ad
i '" . o,h~. Sperdrlg wtlI -...wood I7,r
debt. laIng 8>CPOI1 Prices BOd rrl1Iary S\>llioJio'll
~ n "Iii ecs
ul A.'toCii·~ " 'f.u,.,i ii;s, u;:;
I\aY8 ~ "'PBid _ _ dIlm<>'aIllIId _ I3m"I8l<o rItia\Ml is ~ So far ,-.,. 2.000
I)(MlIMIIlf1t _ C&"treII • ~ ~ 20
""'l!I<MIMelbare~ There is8loo w>JespooJ _ peopIe- hlwe t>een ~ by 5lOIflg O'W
~ at lhe rvdolnesiI anti poor lI8"'lC8 crI
"",",i'I_,,,.. 1I '*-:s, to 1tIo MW S'l'$lOO1. In 1002. ., 6Yl'JUation tly It>e
Looclon S<:flocJ of Hygiene lnl TrwiclII Mo:Kicroe
h< 8 _ . private ptu:madsts an:! ~ C>:IIlClOOed 1h9t. a't!lou\1t tt>n ere rrwJYprollIIms,
dtI.VijsIs h;Ive I3i<m IMr me rOO 01 ~ pm.. local 0Df'I'ITUlIi0lG am J')rlM'lu to be IxllI1 o:>I11l9"
- . . 01 _ ewe ... many regions. OfI6<1 lhS lenl ln 1tIo 1oc:eI 1'r\8l1ag!lI ' '' '! of hIIIrith care Ju:1<lII
rreans ll>«lrbiDo-lI prices "" UOOlmenlS and m.gs lnl ln troeio <istr'bJtiotI of !l S otIa D"u\lB. About
!hal iIII'& hCfJll'>\Iy lA' «; I ;ary M<l scrroII!...-..s I\lIII of _ revenue 00 fer has beM spent 00 ,epIen-
""""'. isIliog <\"ug !IIJIlPIIes. AAoIhIw qua1'" has been
~ to 1I.fl 1tlo hootth COOlra& and IYlM<lIl rum-
In Sep!srOer H187.!tIe MInis1""" 01 Heath 01
mo6l Alriarl gcMlrIYTlIlntS di$'> "ll"d "";1Il WH:)
1Mls let _ worl<ers. Thol ,.. ,. >det has bgeo
and U'«:::EF..., IIIlli'eIy ....... llpPItIIldl to lI"Os pr0b- !<epIlIS5iMngs.
lem. The r8Slil Wll!llhe lIU1l:tOng oIlhe Elm'Ia<o no _ O'O"'<IT'•• ~ty volced t!o<.()l hosbeenll'W
1nIlIa1tYe. lis am _ to lranstorm !he 40.())) OC"- cha<yrog Ieoi migllt e:>:.<:t..Oe It>e ;norest. But all...
.. " , ell _ laci\Jf.lS In liUb-StI\llra'l Africa i'Jto e.><l)lomg eet ~ e<n:em n Carmroon, D
8 ""'" ki1d 01 _ serW::e wlich .....cud in I8rglt $<IpIntaSlo.d'/ has ~ ItIllt 1tIoMW system
pan be alI1IftlIBd by, and ' ......... lStia 10. 1!vIQ(lIlr is bmgOlg aigo .lbo nllotlefts to 1hI! poon:ISt 2O'Ilo
rTUlkias b \II3S irJl9'ld9cl1O 00Ml. who cotJd f'CI 8lford lIle jlIIC8S e!'agtld by prMIte
t:ntggists b<Jl ..ro cotJd alIord lhll rro.d1 cMDpeo-
WilIl Illle orno 8ddtioniII rTll'lneY lIVlIit:tJle from
prices of 1hI! n(MI-Sl\'IOl_ 0IlJI1r8S .
9O""'rmeo u, lW' ~ SOlf\oic:e c:o.*j """" be
!i1a'I<;ed by ~ onpeople's pIOV(II' ~ 'TfMl ownI ~ ." aays the Loodoo
l<I pay lOr _ com. tv. lhe SMl(I tfne. It was SChool 8II8IualIon. "is l1Jal much _ ~
IhIIm wha! !hey wa'll - D ~1'oeIic and ~ ritiIlINelJIld!tl8nood lor Slb>lMIiBl _ _,.. 4 ...
lMll'loolth wor\<EI" end a reial:W Sl.Wi 01 the most mit(JIOC(J$$ shotid M tfK»g1 rized.·
rernaim: 10 be XCfl ...iW:tlJr% ,. WniIar stand 00 JO"nlI1flCfUS to spend mor'l' of their aa"JI
principk ..in bo: Wen in rdation to ...apons reoura::s on prftli&e pn ljectl or on !he mili-
AIcs to 1M ck\'dopLna ...'Odd. tary ). Onr ""'3Y of "s:a'inc dw tikdihood is
In ,. ~ propoA1, tanner U'orid Bulk by rqU]arly monilllrinc pl CCi .... 1O'Io"ll"lb the
~ Rolxn McNamua hils supporttd
qrud basic DCrds ph.
tht: IGI'FDC ~tion lllI part 01. FaT from bcinf: too idc:a1isue • notioo, the
pll.n 10 m1o.w;>: pmssp<nling in bod! ind=i- idea thai !he flow of aid and kIans should ee
'lliud and ck\clopina .. w\ds. 1k plan emis- hcr.-ily influenced by lIw: IiUIihood or thdr
qa Xcurity Council guarall1CCS of lmitorial bc:ina usN 10 meet basK needs is an KIn cur-
inlqri1)" continuN ~uction$ in com en· rently being considcmI by the institution that
tional snd nudcaT ""CapOllS in ind usuiaJized is me ....o rld's ~ source of dc\'doprnml
oountrics (indudina a SO% CUI in Unilc<! finance.In October 1991, the Ptuident oI thc
States' arms spending O\"CT the next six to World Bank lold !he annual mcclin& or the
eigln yean) , tighter controls on thI: prolifera- International Monerary FundlWorld Bank
tion of nuclear wcapons, IICW limitatiolls 0 11 thalpm"rl)' cn.dication should be rhc: !hnl<',
arms cxpo ea, and the Wing of international " 11t'f:7Drrhi"K oI¥tfivt" and rhal lhe volume of
aid to progres s towa rds a SO% CUI ill military Uank k nding .. ,hm,ld ~ (iMod 10 ./10", 10
cxpt:ndirures (as. percentage of G N?) by the ...duff /lOWTljI.....
elld of mis ""nlUry." T he evolution or suc h IlCW crite ria for aid
NecdJeu fO sal', any such ~uctioll!l and loans could both I$$isf, and be llSSiJl~
..'OUId, if implemented, be capable of JlIyilt8 b)', I lI:reatcr public concern fer l id in the
flalI)' times <M:J" for tht: cffon \0 m«t basic industrialUed world . Pu blic su pporl for aid iJ
huma n needs. I\OIl dead. BUI il has been Jeriously ..'OUnded
by tht: wid:sprud and largely justified per-
Aid lo, buic lieNs ception IhaI aid is 1lOI primarily bcin&: used W
mce1 the needs or ~ the capacities or
10 tht: indlWrialiud ...'Odd , rhosc ....ho ....p. !he poorest, or 10 diKcIly atllCk the " 'Om.
pan progrtS$ to\lo'afds mming basic human aspects cl poo.'l:rt)~ Mobilizinc public support
needs d>ould abo be IIInf'e thai ir-e> :a in for irxn2scs in aid rhcrdon:: depends, in tarJc
aid ~ noc moup.. Two othn" cttanaes ~ part, ... rnaIcina: aid programrro:s !heIllKh'eS
nc:cdcd. I1lln .."OIth)" of thaI .suppon. And thai
F"U'Sl, as has Ueady bcm discussed in Pan leponsibilil)' is one ..1tictt sits on bod! 'donor'
I, \hi: ptopot Uoo 01aid gl\'m for Ihc pl.Ifp(l5Q industriali=I rwions and " IXip;o ll' dn'riDp--
of dim:d)' meenn, rbc basic ~ oIrbc poor ing nations with equal weicht.
should be inanscd to at lcasl 20%-
S«ond, the now and dirc<;OOn or aid IolmLItioll.ll1 trade
should also be inllUCDttd by whcthtt or noc In ad dition 10 the potential reductioN in
tid is liUly to be used to brin& I dditional ben- milillJ'}' spending and the acnw alh..ncn
dig 10 the poornt quarteT of me recip;em made by democracy, the ccnacee of the
countries· populations (as opposed fll pKl'l'id- Soo.·icl Union and the end of the cold.... .r ha,,,
Ina "'rvices fllr rm, net-so-peer or allowing also led 10 economic rd"onn and to the adop-
"
THE STATE OF THE WORLD'S CHILDREN 1993
"
THE STATE OF THE WORLD'S CHILDREN 1993
CIS:
a stitch in time
... 1992.UNICEF I!II"Id WHOled . ~ Nations wilt> I)r ~ '" most 01 the ~ health
lacI ·~ missb'1 to 14 nsIions of ~ lormlIr butIgoet$ '"' now urA'>g ~ one ItWd 01 estrnal9d
Sovillt Unioo. The _ Is B repotl abcut a runan requirements. VllCdne production lias aI bul
crISis., 1he ~ and. I...... ' . i . 0000tion ltIaI.:l ceased. and dsr\lplions to trade and payment sys-
10 heIp...-, essen!laI SMoices nowcooJdavoid _ "..., lI\alallMlislties o! HealthllrtI ,ep::>r;i 'Il
lho neod for nu:I'I greater ~ I'lIIlp ii tho fuIuoe,
In '9$flOiIM, ti>e UNICEF ExeoJlroe Boerd has
_ shClrtage8"'........
~ bxI costs 8<'Id
leek01
ctur./I>andeq<Jpmenl:,
~ ttreateo pre-
~ lhBl pIatls be d'8Wn up IoII1'e opening sdlooI Jnj ~ sd"ooI ~ I)'\lgI'llITfTUl
of """'" UNICEF oI'km .., ............. Amo l ; , and ~ lhIlllll!WOl1< of !mit mI< kildwlo
~. K~. T~T~ ...tw:rl_ ~ Nil of... etIiIdren lJ'ldet!he age
'""U"""""' "
Th'oIJrTcuIIIle 1geOs,.i..I'IlCEF has ...."..,.ltIaI
01_. In !ldlj(jon. 0 "'l_rnonp<tlk: fnlncIl ls
~ IIftldi>g """'*<Ii """"'" """""" lisms
pel I8ioo IS8Ild CIlIId bet'oefJts.
""'*'""
~..- both ecoooo,oc _ and runan_
10 prOIeCt \'C"¥III <;hbtn from !he ~ Ill'Iectli of The poosped oll'w..o'\l8f 8IllIO ll>feateos rnat'Iy 01
Ih9 <risTakBs and~of the acUI WC<ld. 1he200 rriIion i'tIatliIanlll oI 1he CIS. Pnce liberal·
Th!I ~ I'I'i"od$ and bodies d IhB )Q.ng ca" iZ8OOI1 nltrllda ~ ew.teup\ood poir;es tly
81 IrOId'I es _ li-res irl 1he Iirsl rronth 01 1992
suI!9r ""' '' .. .. d ~ from IMIO tum-
pomry <lepriIiawn, So ro mall... ""'" ~ the alc:Irie. Wages hiMl n::>t !<ePI pece . In tile ~
circ:umstanc:es ~ Is : S! : Iiico'lO proIecIlt'Ml tIeeIth. ~.tnJset>okl1JlCClll8& '''' JU. ee!uU
nutrit>on and 00 o;ation ofthe \'CU'9 ~ Ihe po ctAoo 'os n 11191 """'" ItoI prlceof....al and'"'ll"' .... roee
....... nollO be perpet<>ated InIotho OOXI generation. '*>elokl. M<ny lai'T'685 roped b',' u:W1l ~
food. but """' ........ are rrissing"'"""' and IlIllY1\I
In the new nauons ee of fctmer &Mel Unioo. tInMr!l tlI bread lind potalOea.
thII baso; inffasIn.octull slll Il>OStS to -.n ltIaI
those minirTun ~ are ll'JIIi8llI8 to tI'OI!I 25 /II ol ll1(l9flI'IttlIo, II all c:orp::u"dOO b','9'M'l:n-
....., choIdrfItll.l"lda< the age 01five wIIO I'IlJlf'eI'Il" Il'lIlIll!I trllIgedy. Au$Nn ~ ""Il'IIts ""Y
ltII!Ir naticnI' Mura lI\BI 11% of me ~ S<:MeI Union • homI!lO a
~ 01 M ~ - ""'" ~ aa lit1 eco-
-
lkH<e mMy ~ courlries . 1he . . - IogiclII criBis area. .Airro::>s1 • QIJ8Il$' 018Il cI'iIc:Wtrl
oatbns of the ~h of ~ born n Sld1 l1'8aS 3'e rOlPO'\lJd to have geoelic
Stales (ClSl begBn lf8 WIth.--~ ileracy
and D . . - networI< cI sc:hools and r.oaI!h poals.
~"'""""9" prnbabIv _~ i1
Powrly'" tne ~ S<:MeI repubIcs is I"<ltY"I
!he 18sll"""'S of 1he USSA, and IhII flIlio of ~ CtI lhe same scale (It of 1he SM1(I ~ a!I ir; to
b8 _ n tne de'> ' .;, III world,8ul the aitualIon
IIdties 10 IlQflO,IlIlOl 'MtIln!ollhe ~ "' the
waId. ~18t1. lor e>;llil1lIe. 11M 7.640 heoIlt!
centres and 278 ~ lor 16.5 ",.;on people. ,I"
iIlrapd)o~ . l'l l989,oI'lIcleI(qres~
oIla'n'1eoi1 eeees the $ovIeI 1,kion M1g beIDw
me po...arty Ine: in "'""Y regions 1Oday. OYW ltvee
!lui b)' 1992lha1 'tIImslrucllK6 was !h'eatMed QUBrters oI lhe popo.Jallln has taIlM into p<MI'ty,
•
promote the righl kind of growth but also ro more of the political influellCC which, in most
mlnslale tha l gmwth lnro improvemenT s in me cases, is the missing link between what could
lives of the disad,'amagcd. M arket economics be done and what is being donc to eradicate
is '101 a panacea for social p rogress. And if me wo rst o f poverty, and bycconornlc reform,
gO'o·emmems abandon meir l'I'spons ib ilities , increas ing num bcl"S of the poor should be able
then the result will be societies in wh ich to meet their own nceds by me ans of their o"m
inequalities continue 10 increase and in which efTorts and theirown incoffiC$.
economic demand !XlU'll' for aU and hu man
needcounts for nothing. It is me raponslbility ConellllioB
of government to support pare nts by investing In 1992, many specific tragedies have
in health and educati<)JI fo r all childrt:n ; to again assaul ted the vcry idea of childhood in
construct tht safety nets which will mean thai such places as So malia and the former
the minimum needs of the '....lncrable an: met; Yugoslavia, T h e response to these tntg cdies,
to make aeailablc to aU me basic benefits o f wherever they occur, is a major part of the
advances in hum an knowledge that arc oflittle work of UNICEP and is addrcs.sed in many
rommercial imCT'CSt; and to offsct the inbuilt other UNIC~ pub lications and statements
tendency o f mm et forces ro fa\UUT the d uring the course o f the year.
already advantaged. Basic needs will not be
met, an d basic investments will not be: mad e, Rut for mo re than 10 years, thc SUlIl ojthe
by any invisible hand. lrt>rld 's Children report has conCCTltralOO 00
those issues which profoundly affect far larger
The end of the cold war, the collapse of numbers of children but which are so constant
Soviet communism, the widespread move- in time an d SO diffuse in place that they d o nol
men! towards political democracy and ec0- at any one time constitutc the kind of news
nomic reform, have raised a ""()rldwidc hope eve nt wh ich qualifies for the world's ancntion.
tha t this century could end as optimistically as That traged y, howeve r invisible and un-
it began disastrOus ly. It is an unprecedented noti ced , is far greater in SClIk: than even thc
opponunity which has SO su ddenly been pre- grea test of the e mcrgcndes which so oft en
sented. Ru t it is no more than that - an cppo r- command the world's, and UNICEf's, coo -
tW1ity - and it wiD not remain open forever. cern. No famine, no nood, no earthquake, no
And it is now csscnual that the industri3liw:! " 'lIr, has ever claimed the hes of2 50,OOO chil-
nations tha t ha,·e urged democratic politics dren in a single week. Yet malnutrition ao d
and free-marker e<:onomicson the develo ping disease claim that number of chUd ,·ictlms
" w id should now do e'"er)'lhing in their every fJlUk. And for every oneofthose children
power 10 create the inte rnational environm ent who dies , many more uve on with s uch ill
in which such polie~ can PlU\-e themselves. health and poor growth that they wiD neve r
lf mis can be done, then the eco no mic a nd gl"(lW to the p hysical and mental potential with
political reforms now being so widely im ple- wh ich they "..e re born.
mented rould e ngender the kind of progress Wh en little o r nothing could be done about
from which thc poor might also deri ve some this large r_scale trlIgcdy, then neglect was per-
benefit. By the a<h·anee of democracy, the haps understandable . Aut slowly, quicl.l)', and
poorest classes could begin to acquin: a lirl1c withou t the world taking very mu ch notice, "'"c
"
TIlE STATE OF TIlE WORLD'S Cm LDREN 1993
br.<e arri\'l:d allhc point ,,"heft Ihis n....d}· is IOmlllTOW'I W'llrkl ~ W ..'Odd will
no Jonctr necessa.,.. II is thcn:foo: no longer <:nU:r<kali.:dy iruo IhaI DeW • depo:nds on
acaptabk in a <mdd .. -idl any daim on ci\';" W ~ WI is brought 10 bear by PQliti-
1iza00n. Tbe tim" bas ~(ore ~ for I cians, press, publit, and proCessional scrvm
ne'o" age of CQncern. in 111 tlltions.
Politieal.nd ewnomic change in the world Such pressure will 001be eas)" ti thc:r 10 ere-
is begin ning to <;mile Ow cc nditions wh ich, att or 10 I USlS;n. A m Ol"l'mcnt 10O\" rwme th~
hoo.." ..,r dimcult, offer new h ClpC for Over- WUI'$I aspecu o f pol'en)', and panieul~rly 10
coming the wors t aspects of \\'arid pove rty, prOlcu r htldren, bas no ob\iously pOl\" rful
~rti<;ularly as thc). affec! me ,",,'Urid's children. tQfI$tirucncy IIld no immediate vested mlCrest
T be cost of PfO\';ding health and education 10 appeal to. 1lle c:m'iron mmtal and "'O!nCn'.
~ in ~ de>-elopina ..wld remains rd . - mOl'mICnlS arc, in '"Vlins ~ becomina
u.-ely low, and lhl: gradU31 labilizalion in w C\~'I eonctm, for ee otJvious n:uon
numbcn: ofinfarm bciIIJ born mans that fur- Iha1I1moII C\crjiJlIC isdirectly ll)U<:hftl in one
ther im.'OUntNlI in baic In\ia:s can 00\10' "';I)"or another by bodI of lbno: ~ In
brcin 10 inacax-Ihc piopoi lion of lhc popu- SQk IIl:IId in tc"'erity, !ht' trqe4y of maIn\Ifri.-
~ scrsed, ]:,~-;;t.ik . u'll re....~ lion, disease. aDli iiiiu:rxy sbouid lOUdl
and suslecics for comrollinc malnulriDDn, beara and minds IS poyo-afuBy IS \hosI::
disaK llnd iDi1cDCY ha;\-e been trXd and leSt- uagedks ..1lKb, ~. ,irnJc, of bc:ina 'e>" ms',
cd and rlOOl' stand 9o'lliting 10 10 into action on Ml: !he poyo'tt10 shod< the .."Ilrid and ro cliciI
the $aJIX leak as lhc probkms !hey can so the rtdinp of bwnan sdidarily on ..1Iidl1ll
1aJIdy 110I,..,. ci>ilizI.tion depmds. Bu t in addition 10 that
instincti~ 1'l:IpO~, the more comple:x reali-
The convergence of .n of lhcsc different
ties or ccmmon ca use: mUSI also become more
forces m CIII$it is nov.- possihlc 10 achieve om
" idely known and understood. A moveme nt
of !he grealest goals thai h umanity could ever
to ml:<'t boosic needs will not succeed unlcn ;1,
5<'1 for [(!jClf -me goal of adequate food, clean too, becomes ~wryonc' concern.
"''lIICr, tafe sanitation, priTNlry heal th care,
family plallllini, and ba sil:education, for vir- Maltina ccmmon cause is not. qucstion o f
tuaUy ~..,ry man, ,",'Oman and child o n earth. marginal mutual support. None: or the great
issues thai an: assuming priorily today - W
In \990, !his Dew pootenrial for SpccifK
ceuse of sIowin& population growth, the: cause
K'Iioo against lbcst " 'Om asptCU of pl!'\'crt)'
of achie>~ equalitY for " 'Omm, W causr of
"'as fonnublcd Wo. Kt ofbasic: social pis
mviron:mI:nully I\lSllinabie de...c lopmcnl, the
which attUnld). rdlC'ct that ~tilol and
ClUK cl pit", " demoxrKy _ wiD or an be
..-hkh ha\'l: been form.1J)· KCqltC'd by lhc
uat majority 0( lhc -.'Orid) paliticaI k:adas.
ralized nnIas Ibr lIKl5I basic hunwl.-ds or
Ibr rOiglXtJel 1 quancr of the earth's people an:
A stan bas brtn 1Il3dt', in matlJ' nations,
met. 1lUs c::autl:, 100, IIIUIl. dlerdore bc:co.nc
tOVlwds k«pina; !he prorniK oflbl..: pis..
thc COi"'O " orlll And IIl'lOlli ~ ofthc
w., lherd"oo: SWId on W ~ of. ~ er.r. p reso:n1 repon , then: is bardly any indi\iduaI
or oona:m ror the sikrll and imisible tngedy or orpniution W t could no! now b«ome
tha t poverty innictson 1001)"'1 c:hildren IIld on invoh'td. c
•
The year 2000: what can be ach ieved?
o Basic 00Jcaticn lor all ~ 30d 000',_,,,·.", o D's5 1. 1lIIion 0I101O>l 3:l(je10 ..-.aI:lIe all """kIs Ie
pMlaoy Ed 'ClItioo'1 by 8I 1eas1 00'M0. ...... ~ bxj sec:ui!II.
o A I'laWog 01 1M lrllI i1it<li'OCy r.lI(l ..-d 1M Child hHlth
,.,-
ad>ie . ems ~ ollQ.llll eo:U:::8tioniIi ~ lor males
......
fn il'r e ClI WIlI'. llI"O>-)<lW-otI chlctm and
............... toon:s imrnrizaIion b women ;, tho c/jd•
ProtectIon lor lIlf1s WId women ,...
o_ F*"""topb'ri'Ig .... """00 a-d sevces to ee eeoe o A I'lEMlg ot chld dealre O!II.OOO by cia II IOflfI In:! 1I
25% rfd.cticI1 "'Ire;
o:idao lC8 <:J . . i I....,.,. , [
all ~ 10 thotn 10
~ ~
"
A progress report
"'*""'"" the 1990 Wcrti Surmt b 0Itm<l, rmsI <XlU"IIries I900d to chw "l> na.Ili;nII pOQIal"lIlS oIlilClUJ
WAs! b llCI'ioMlg taic lIOCillI g::Bs. 1hDsII go:.Iilb i'U.de ctII1WI 01 hi ....,., d lb......:l d a IlM1Il 01
"*'
01 _ _
maIr'\.Giliorl, a ."...,.fli'tl mc1.<:tic:n ." .....-/MJ (lelIlh 'IlleS. a I'\lM"J;j d ~ rrorlIIiIy 1810&, 11>11 prtMoli<ln
10 " c:cnm.riIies, ee ~ .. M, of tmlv planning i ob" OllI), and - . a n d 8 besc
!
.... '"""'n lor .. cl:1Ik;hn The I<tJle bE*:>w1il'lOm h SI8IuS (J tI"es8 ""As. n aad1 a:tnI)'. '" rJ S<V& .W 1992.
The &nmt aI90 <Illl':lll ccutres to IlllilV !h'I ~ ()II 11>11 /lj;'llS 01 hi 0'lI1 \fItich Eel<s 10 Iav dcMn
............" $I8I"CIS lor tI'ie ~ p..-.tU .. ...-.d ""' " " 8 K 01 .. <>'tim. ........... ,...rett 120 nationI hMI
0:0. doneso. n - _ pri-M:j are n"'*""" n
!he 1rtIIe belcrw,
,_ --r
.........-
, T---,
--
0 0
"-
, ,
0
0
~
~-
0 0
0
....
0 0 0
0 0 0
",- 0 0
-
0 0
0 0 "'"" 0 0
~
0
----
0
0 0
0 0 0
0 0 0
0
0
0
0
0
0
0
0
,-
-,~
, -
0
0
0
0
0
0
0
0
0 0 e •
••
0 0 0
0 0 0
• 0 0
"-
'"""""'
0 0 0 0
0 0 ..", 0
---
0 0
0 ~- 0 0
, 0 0 0 0
0 0 0
~-
0
0
. -
0
0 ~
. -
0
0
0
---
0
•
--~
0
0 0
"- 0
0
0
0
""' 0
0
0
0
0
0 or;;"- L9
0 0
OJ
•
- 0
0
0
0
0
~ ••
• ---
-
0
0
0
0
0
0
••
•
- .-
~ 0 0 0
~ 0
0 0
-
0 0
-_. •
0 0 ~ 0
0 r-o-1 0
• •
0 0 0
0 ~~ 0 0
-
, ,
0 ._f,Qoi. . . 0 0
0
0
• ~
~ 0 •
.4 ..
0
0
• • ~- 0
0
•
0
• 0
••
-....
~._ .
0
0
0
0
0
0
•
--
---
So """".
0
0
0
0
• •
•
,' 0 •
-
0 ,~ 0 0
---
'CICUg
• •
...,-
0 0 -" 0
0
0 • • ~ .01
0
0
0
0 • • •
0 ••
• •
,-
0
0 0 0
0
• 0 0
-- • ••
0 0
'*'0_
, 0 • T",.,,,._.
,.-
0
0 0
• •
-
0
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0 , Ui _ ~ _
0
0 0
• 0
0
•• ,"'- 0
0 ••
-- -- ti
"SA
0 0 0
, . • • 01 0
0
• • !I " · ts..
0
0
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••
I"'" •
j~j ••
0
•0 - 0
,,-
0 0 I • •
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0 • I::. 0
o ~ •
"
References
~ __ O*;nn'. F..n:l. a- _ llu _ .. I..I:l)<l A., ' _ow- hi _ ll-.
DI>. ' . .... . .. U>o 19$100: • lJNJCEF
1..NICa'. _ 'YCIII< l lX10
~.
14
~ IOW_ hi Sntotloo Soctor
WAJ'9IItonI. No. I. ~ , 3. FfItnery 15l92.
Pt..-......
l.NC€l'. _
2 _ Bail. Woil' ~~'.~,,~
... /CO'! 1m, ~! 26.
,~
,~ ~ tIP. 011.
fI'QCI'l 01 "'" ~ l(I " " lor1Y-_
- . CII 1tIi! Golr9;l1 i\ssiImtIly, 11 JonI 1992, 20 Md\ae. NoI, 'Soc:soI _ _ t...... tom
"'47126A, 1.hIKI _ _ Y....
Bto9*""" , '"' 0lIl,... C/lbwI, No. 2, ~ (l.lI. ...,...
..... \992,UNIC8', Now YorI<
9 Dol' • <OIl centro lOr !rIO OI\101 , lot Ec<:n:mo::
Co-opo;nIi:In :nl 1"'"ce ' 0.. ' i f• • Cf>. 21 Fo" I til '""" ""'"' aI ~ """"",,,",,"" ~
.....ro, 1991, _ '4,0EC0. Palo, \lKI l _ 'G<w'cl tot GIow!n'. n. Sl""> of lIV - .
~ 19197. llC. &l.al. l.Nl:Ef, N8w Y<Jri<, 1Qll1l
'0 "Tho '" . ... TOU<1l', p , 9 01 'A &""'lI CII II-. Sparta
Bleo'ICISS', 1llIf<x>O 'iSi, 25.i.iy 19\12 22 I'onoMIro 10 >J lUI, IIqb:.j IlIdJ, _ "*"'* WI
It Mom:tra. SlIr1Il;m. '~ ~ II .,
e..r~' .~_Ucl .. ~1991
[roo,,.. ~ EM. .. . ,•••• \HCEF 23 ~ WoIt, ~ MJ Nat>lnoI PI"". ",. " 0<0007',
Flar<rigCWla.lNCEF. _ Vorl<,1m _ ~ tndl'lrfw1g, 1kI.. 3. No, I , llI). 1·21,
Ol<bd ~ Pn!s>. 19lIlI
12 'Er"IdoV tb;len Horvor'. I paley ".,..,......, on
~ ............", Mo:>-nol, c.-.
'1).12 24 '\AI TI'ooTl EIIl G<m', ",. ELoo'liol. ~ , 99, 2 _
ClcloI::>w HIll. SpOn.ood by u. ~ ~ fIIr
• "," , oOlb .. 0.. ' . '.. tl. IN Food _ 1yi<:lJt""
'W'
2':1 Son ~"F\.dc.<.::llonto ~ 1UJp'. F<>.<lh
~ '" "" ll"il«l - . l!'O lI"oted _ _......., T...." MomoriIIl.oc:lue, ~ D<ab<W>
(Ncren'. hnd, 1l"e Lnt«l _ ce ~ ., • •
c..""'....
--
I ~ I.<n:tOn, 2 ~ IW:)
P,CO""''''' .... 1.hIood $Ialeo "rP'ct b' ..,.•• _001
0.. , " ,. " It-. _ _ ..., trill _ _ 26 l.iiI.o _ _ I'opoM!a> I)i<f.:soon, _ ~
.:I LNJP."""~'.4Rww>c>11992
. p.85
31 Fa a """......., II! 1t.e W l8CIO'S. . . 'lI'e
~ CLooIion', Il>o SllWe d I1lI v.t>ifs ~ .u so.wo. OIl. tlI.
f991, lll>. 31-.17. LNCEl', t>ew Yori< 1990 ~5 BIocIs d _ ClnIcr "" _ . . , 0>It:tw<I.' _
32 ~ _ . 'T"", fIIlwwlj Foaill Itt Cl:*I 11M _ .. W3'~. VQl 10. . . 24-
~, Aq>Il. VQl 15, No. T, PI» 3-6, ' 1iI88, 11191 , Ail/'oIlilIt01 • • ,. ,_ _ &I"<IUNICEF. T...-...::>oI
......-- "'"'"" PIi•• IOJd "-....". l.<>"O:n ~ PI"V."'. Itt ..... LnuIcl _ _ ee.-(JI
'M ~ ~ 11\l9:l-IIl!l:Il
33 De . • " • • 0ilJ0r0 Itt ..... ClrginoaIion Itt &:0 ... ,..... 46 Son OIl, at.
Co-oporabon .-.l De. " ,. , ~ (JI ~
G<J<v",.....
0.. ' " .... ~ 0 . . ' - . . .. os::o " MI;/'IWfIIo-a, OIl, Cll.
~Cl::ulI1los, ~ . 2~ , OECO, Poril. lQ(lll 46 _ 6Iri-, Ao5iOIa'l<>I ~ to -..:. Pb<e'ly,
301 l.tlDP,"""'" Do> " . - Rww>c>1 f992, ~. 78 Wl:rtl-. Wd"'I/!<:t\ nc.. 1991
OIl _ BIn<, _e- r_
3.'j S<!II ' Pal ~ ....., ,, ~' , ur«::eF, Ni;MI Y(l<1<. 199:1
,-
Do< I, '"!II 0:ulrri0cI, _
/lw:lOI1lm.I>.511
~
Borl<,
lind ....
w..... VO', D.C .
--
~~111\11
sn.rr.on. " ..., - . J ,D, 0'lt1 PrMiny ., ~ .
:Ill C£CO, Drocl<:w)I d ~ Do< tj la , ~'I Clo!IAlI Ftr<l, T22 C SlrOOl, NoW.•
~D .C .. 20001
-40 'OoU &1"<1 De:. I •• '... . '. aA:)STV' /Jo•• rrb=• ..u..- 55 ........ ..........,. o-s UI>'. Il>o _ , OIl 12·13-
~1992,_ 1 8 ~1 992
- - -I I - - -
STATISTICS
Econ omic and soci al statistics on the
n ations of the world , with particular
refere nce to children 's well-being.
C"_ '""" on Ibr <1m ~ ..r•. -
I:-iDEX TO COI.' l"llU!'S
T AlIlJ CS
1: Blli~ lndio:atol'$
U5MR 0 IMR LJ population U binhund uoo<:r_fj,".
death. 0 GNP per capita 0 life expemnC)" U adulllil<=<:Y
o IIChoo! enrolment 0 inoomc disuibutiun
2: Notri lioa
Low binh weighl 0 hmmfeeding 0 mWuu100n
fJ (<)0(\ production fl caloric intake 11 food sp<'1lding
3: Health
Ace... 10wat.... 0 ""'CeSS 10sanitation U sceess 10 It.allh "",",'icc:s
n im munization of children and pn1l nanl "'nmetl 0 O RT vse
4: Edllcation
Male and remale lilC'ne)' U "'dio and 'el"visiun "'..
o prinwy $dlool entol",..." an d com pletion 0 """""dory schoal enrolmenl
5: Demographicindicators
Child 1"'I'0laoon U population growth "''l: 0 milk deal!> ralc
n crude hinh ral. n life ""JlI.'Ctaocy 0 fortility",\e 0 urbanintion
6: E<ollolllic indicators
G:-l!' per capita and annual growth r11l0$ 0 inflation 0 "","eny
U gonmmc:nt cxpen<!ilUt<: 0 aid 0 deb!: """j""
7: WomeD
Life expectancy 0 ~lI.ncl' 0 mmlmcnl in school n
controlCcpli.'c usc
o tetanlls im munizatio n n
lnlincd au rndancc at binhs
U mal. m al mumd ily
8: Bnic iDdic. IOrJon ' n' poplllOlll coUDlrin
,. Newly ind~odenl .ollolriu
10: The nle of Pr<>&.. ..
USM R ....'liuetion ratn 0 G NP p<T <1lpiUl gro,,"lh raIn
o fon.ility reductiun rales
General note on the data
n.. dig PItMtlIll n r-1iIttI5 IN aQ)''* «I ~ &nmt .b' 0lI:*a0I lPIk ' - _ rd.dId on
. . . . . _ _.......... d'l"O*- T_ to • • .., . . 21_ . ....' . . :-. ......
. - - ~ IO..-v IlUC8I - 12 .. ..'Cl\IO......., ...
...m Dr' . . u-.l
iii*! II . . ~..-... ........, <Doe" NIlo-.~~.,.\.ti1992.'-_~
..... '8"08 d ffIiIIdily. CllIoiIl ~ dIO 100.... .-0 ...... - . Fnillt. .. b.r lIiMFl ~
__
~ ~ ,.. '
~~ ......
lIIl::ie 1..hllId NIlo-.IliJIll'CY ' -
.....,.~ wIIn
!iU • i U . ' - e-'\ d U IQllCl fmm mlICIilr-. III
.....v- ~ ..,~ .. iii.iIo _ t-l
lIwe IN .... nMiabioI oIriciol ~ 8IlI. "*"l'l' _ lO h _ cll ..,a,aI_ ' 1ll 7" 10.
hi pfIIPOt OIllIe lriiled N$tiQr18ll'}Olfle'f r...
boer! U$Ild.
....,.. a.ct1 • • 'OIto l'ltjl _ . ._ . . . . . do Th!I ......... d TO.- t.'lI clooI:ht per 1CD) M titrlI
rd ..... hi ~ ~ (n 0Ihir II:lI.«a, ~ _ 10 deIi'V-iIh h two tVw IJ9A'I P.IIlI cI
. . . . - . . Iro'n Itoe UNCEF ..., clIoe. ~ km Ire two ~ ~ ., lItllII 1 III 7
Wln .,....... orlr cu,"' 0' ... _ _ • rei 10. NIIllIaI ... VbtI &mom b' ~ ~
IlllicnIIllIlU r-~.-:l. gr;,lllI taoglt n.. U5tMl p ...... ;II a l'lIll.aO'I d hi
...m....
NiIlIcn ~
~
~
.. ., of-.
_...-:l
fllU:6..... IOt"dl ...... 'fht . . . . aI h ......
roJd lllIb'4llll h _
a-
.... lion ll'WI b..n:l n _ t.J«:EF p l . . .. t-. ild III ... 0'IIICn d • rvre. cI ........
. .... _ . ~ lluI CXlOfty~"
~ klm • I'IllW rd lXJ'aU'g ~ ~ I1ll'CMl ~ 10 10" t:r. ua<l __ tr<I ' " ~
IN " . . . . _ rnDrIlIiIy . . ~ _ . ~ • 7 en_IIN!I'I -.-
dMote ..... S • wltItIllr tIoo'lI co.... 1IIIil4 . . ~ Alwgilia'lill>:a'l b _ _ 9 en
' - _ . . . , .. ~hlll1i11n_ tl-. -....m or ~ ret ~ .. __ - .
\ll1iI, at ~. 'Mll as _ , '" """".... • ,.. ....., COIo9'I(II or It'e ,...,.. •
...... 11 \Wl . NENI , obm'.. ...niljl ~ lhtWortl 9(ijlII (tatIlI1II NIl 0IlM adl:IlocI.
Explanation 01 symbols
E81lr IellQrt5 19lCl med81 '8.es III pordI ..... ll\IiIlol td.dId. Si'a IhIl ... III ... "PtWI • 10 j)'Oo\da •
_b~~n- _ _ ........., lli'l*I IlICll.n III . . -.-:n d chlOYo _ lOO'nen
"" -11_ .......... DIU....., uoing ........ ~ IUCIl 0IlIIlId dID W"'iMIOO . . . - .
. . . . . km ,.. IladIFd . . 0 " 11"'. ~. • "'0'1 C:V""~b 0CMrIIiJIl-,,1...
1of'8oe~~ro_bA _
J; I" dIQ , . .... 10 \18ft (It ~ 0IliI' ,., ~ . . ..., ltl . . gA,rrn -v. .... llQtl'I....
_ c»d dill. ... (It '*100t'ilI ~ 1lI.~.
~ .. ~ _ ~gu..lXreI NgIO"IIII . . I" . .... . _ (It oIglOlOid _ages.
l.SllR elIll-. lor ~ ocI\1 ' 101 - . - . . ... ~ I_., _ _ ""'" _ . r i&cI by 1M UnIIiId HIIIloN
~ DMIIDn. In _ - . IllIoM eIlirMIM II'08J' diflIr ""'" h INsl .......... 1\gUreI.
Index to countries
"* -..oLUo::al
l"lltle ~ t<des, CClI..O"ll'8s .n rarl<ed " ....... \I onler 01 !hIi' eslinaIed 1991 uncIa'.1Iw rTlCI'IaIly rate.
1M iOO €l CEll'I.I'T'ilEI'3l"1Ct:a!i'li1lhe1!1rt ee IJW'1 i1 1te isl r:J co.rtres below.
MJ.. Ii,;ia, a s ss
GJlea B'
""'"'
.....
""'"
......
.....
Nqie
"", """""
00
ua
""
-""'.
......,
y
ea
'""" """ --
"""'"
~ NewCli1ea
.""
eo
'""""eo
P1ilj;Volll$
.-. """ .,"" "'"'
-...."""" ...
klCb
'"eo ..... lsb"T*: Rep. r:J
....., """"
BaglirjeSl
.....
Korea, Rep. fA " """""'"""""
"
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Measuring human development
An introduction to _ 10
I dcYel;)pi'lei. ;" 1M 1990'1 is to .......-.e » ........ 1u1Wl .......'a cJW;nn. ThaI ill -..t>r Ih!l staIJ!IIIC!II ..-.- lois
face, tt.> tI'u8 ...... » CCliespondi 'll '--' Ic:r a Ihu ("(l\lOr'lS oIlI'e II.(lr1d nor n a9ClllO"9 0<<:* '" ttler
~ <:II rt-.nv I'o.ml;v1 (1$ wei as eootiOrii:: per CIpiIlI GNP t:>A fl dt«>eo do 'II on:b' rJ !tleI" <nter
~ . FIt:m ur-acEF"a pont <:J _ . fl pMio.,U, M rmrIalty >aleS.
1Iw8 .. a . - l b 1111 lVIllId ffiIltl'Oj <:II ~ !tIC
_ 01ctiId ~ .....,- its ral8 01 dw1ge.
The SflOOd '" "' ''''_ .. '1dci1g tho I..l5o\oFI Cl¥1 be
~ by ~ iIs IMlrnll" IrfUlI reWc:ticn
Tm .....·M rmrIalty mlfll'J5M\l is U!IlId in lallIe 10 ,"'" (IlAAAl, U1ika Ite lXI'.... isa ' 01 absri""
r-ll&QlllllS the. PfI"ICiI::t8 0'di::3l0" ct Ild> po O\li - ' CIW\';laS. IIl!I AAJ=IR ~ ll'e fact hiI the mrs 10
U5MR iII1l ' " " <»::hBd ort,o WI1h 'ltl - ... ~. As.
U'MR re...........a~ . F.,;t, _ _ ""...., _ ........ cJ. <nter."" ~ n nlIld'Ied . lor
-.II 01 !hlI de. • """ ~ prrnr;s'- Ihm on 'ir"pJ!' ~ 1M ......, _ I>lO.lc\lon <llMc>J9y
llUO'l ll!l scnc:d .. ...... ,... ie'<lIl. PE'" CIlP\il caI<Jrie h,P""'" b a gwwr ..........1Ilq:l '" ~ Tho: AAJ=IR
III 7ilily. c. tt'8 ......,.,.. '" doc\ors ~ ~ theoelooa shooos a l"lt* I1llll d ~ for, lilly. a 10
pof:UIIlIoo -III oI....nictl all meanlllO 1111 enll. pont rec1.Icticr1 ~ Ih8I rec1.cbl1 """" IS at a _ ...
oI <nter·t.e m::rta6ly \A IaI fl U5MR 01 10 ~ Irl;m
Secord. II'1II U5MR III kn!l'lwIlC be Ihu ..... 01 a IWla 100 10 90 ,,,,_ ,IS a...:l.alorl d IO'Ib. _ ! h l l
'IfJiely 01 i'wIs; ee ~ tWilMh .....,- !hIl I13EM $ITlI'I l().,poinl llll from 20 10 10 IlflOe9!lI l\! a nldJc:lo'J
~ 01 moIhon: ttIII _ '" 1mm..r<zlIllon .....,- . " " ,.
OAT UI8; !he .. ' Oily 01 " _ rei ...., ctiId heel!h
...-vices ~ P'en8IllI carel: Iro:;:omoI ..-.oj food 'Mu> used ;, ~ wnh Gf' \1O'MIl _ thlI
awilabiiilyn ""'!llo:ntf, It>lI .. t ' olily '" ~ _ ......
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",., Slf1taOOn; .....,- the <MIf1lII sa!ef\I 01 1hll dlld's eI thlI ~ berg mQ t1j rnj 0»IlIY <7 regoo.
llf>:I 'Ner rnj penxl el li'ne. towa'd:'l thlI SIlbSfB<:;.... , ol
!IOT8 elite rrosl - - . . . ol t>.mJ1 .--II.
n ird. LeMR is iIlss ~ lhln, tIBf. pili' caprIa
GNP 10 h laIacy 01 IN -aoe. TNs is beocIuse 1he "'" IlIbIe 10 .mws. live ill ro 1b<ell ~
~ !ll8!I o;bJs I1.ll rJ/oN 1!lD dti1ln III the lien to be ~ thlIlnUll 'lldJt:IIon rae el1h8 U5MFl lr'(j tho
CIl!I1I'Iol41r<l trnos BS Iko'i 10 ............. - . ~ lte rron- InlAI ,ate 0::( gowt!I n per cep;ra G/'P. Such
made acelIl d::l8s 1»""'1 !hfm II) _ ..... IIIi:ltJB'Id <X> ' ........... help 10 throW 1h8 eo'illl'asis on 10 me
II'ral as nu:h nxrre, n 0Irt0I' V<tfds, • is nu;!l mcnI P<*;>es. pricnIIes, lIld Oltler f8ctC<'S WI1CtI ~ 1he
dl'roJI tr a ~ rnronty to 8!I8c:I a retO'>'s ll5MR, moo ~ .........'... onlllOClal .. 09'8S$.
a"Id . Ihcoefo:o& pteS6'IlS a m::tO aconle. , l8t trcrn
por1oct, pocIIn 01 It>e I>lIeiIh -..s 01 'Ihe rrqorily 01 Fnlti. lho tabla ~ Ite 1Ol8I J8r1ilv rate b' aech
ci*i"en lond cl ~ lIS a v.OOiIlI. oo.IllIY onl its """""9' arnJal rate ol I1lW::to:'I. " wII
be llfD' It"el J1U'I'I oIhl reoor-. ..ndl flaw llCh!Mld
I1:r those ~ 1ho U'iMR ill d..-. l7i I..NCS' aI!l '"" ...4 <8Wctb'"e .. U5MFl have llI!Io a:;t"OIMoj
iIs -ve rnosl ~ "i'dc:alo '" It'wl sial. 01 a .... ...... 4 ~ ''101ity,
'll\BLE 10: THERATE OF PROGRESS
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•
THE STATE OFTHE WORLD'S CHILDREN 1993
Despitf W problems of !he post cold war neglect may be giving WlIy to llI> llgt' of
world, !his ytar's Stau ofrltt World'. Childtm ~~ .
rq>ort argues thai it is possible - within a
de<:llde - 10 bring to an end the age-old rnJs !be most dramatic indiarotion is the
of child malnutrition, p~tabk dixaK, achievemem of the 80% immuniu.tion targ<:I.
l lUh videsplUd illi~. in !he dt"Vdoping world - savini! 3 million
children's lives cadl ycac.
As an indication of how close dUll gOIIl migIu:
be, UNICEF puts the fllWlcial ro:u It alnn OTt..... <'qllaUy flOW"I1ill . lnIt.-giel U( oow
S2.'i billion a With today'slow<OSl
)'l'at. lricd and tested, availablo: and affordable.
mtq:ies, says !he report, II>Cb a sum coukI SP«iflC goals which refkcr. this new potcntW
bring unckr Q)lIlrol !he ~ childhood were agrttd 011 II !he 1990 Wurl</ Summil
dileases, halve !he rate of child malnutrition, for ~ and the commitment ro
proville dean water and safe sanitation 10 oIl achicvins these goals by t/w: end of the
communitits, maU family planning services decade now bears the signalUl'tS of ~
univCJ$lllly awilable, and provide almost ~1I IIlld !"rime Minislen than any
evet)' child willl at leaM I basic education. other document in history. DeWlod plans
~ve a1mIdy bml drawn up in Over 50
If so much could be done for 10 many and natimul and an: in prqlllflItion in 80~.
for 10 ~tde, then why is it not done? Meanwtule !he broader <:tmwn of political,
economic, and okmogn.phic changt: is
11K extent of smsmt ncgIea, uys UNICEF, probably as favounbk at this tirM as it is
is • KalIdaI of which the public is largdy ever likdy 10 be,
un&WlU'l: . On a~, tlM: govmuncms of the
devdoping world aK devotina: urue more What is rcquirul DOW, saY' UNICEF, is a
than 10% of !heir ~ to helping the worldwide mobilizlltion of public and
poor meet !he;,. needs for nutrition and politic:al support for the cau... of meeting
heallh care, w:au:r and sanitation, education basic human ~. Only Ihtough massive
and family pl.anning. Similarly, leas than 10% popular concern, and Waugh !he pracOcal
of aD international aid for development is and politic:al energies of literally rnilIionll of
devoted to dirtetly meeting lhese most people and tbousands of DfiIJili.ationl, will
obvious of human needs. tI>e ro ounitmems t1ull have bml made be:
given a priority in national life. And only
But there is now an accumulation of I'U$Ot\S, by such means will • Dew age of eooean
lillY' UNICEf, for bdieving tha t the "ie of be born.