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Introduction Children
embody our dreams and our hopes for the future. They also inherit our
legacies, Excessive and wasteful consumption, social inequities and inefficient resource use perpetuate a vicious cycle of pollution and resource degradation that contribute to poverty and the erosion of livelihoods. These conditions severely harm adults and children, particularly those living in ecologically vulnerable areas. Children are at greater risk from environmental hazards because of their physical size, immature organs, metabolic rate, behaviour, natural curiosity and lack of knowledge. With the current trend of environmental degradation, children have fewer and fewer places to hide. They can even be exposed to harmful environmental hazards before birth. On the other hand, children are also dynamic and powerful forces for environmental protection. They show a natural interest in nature and are often passionate about the preservation of their planet. With proper support, children can acquire useful knowledge from participating in environmental activities and can contribute in a unique manner, with energy and vision, to finding solutions. The link between children and the environment has been recognized in numerous international declarations and agreements over the past decade (see box 1). This booklet offers a succinct overview of environmental issues affecting the health, development and well-being of children and presents the state of knowledge in this field, conceding that significant gaps exist in the information and data available. For people working at the international, national, local and household levels with children, health and/or environmental issues, this document encourages inter-disciplinary thinking and suggests concrete recommendations for action. [ top ] Progress Made Since the World Summit for Children and the United Nations Conference on Environment and Development
It is useful to
provide an overview of where we stand a decade later with respect to
the commitments made at these two international conferences in terms
of protecting our children and safeguarding the environment.
Since the World Summit for Children A series of goals were adopted at the World Summit for Children, which, if achieved, would fulfil the rights enshrined in the Convention on the Rights of the Child. During the 1990s, progress was made towards fulfilling these goals. Millions of young lives have been saved as a result of increased immunization coverage and expanded basic social services, including primary health care, children’s and women’s nutrition programmes and clean water supply and adequate sanitation. At the global level, the international community has adopted numerous critically important treaties and policies to protect children from exploitation. Over 60 countries have achieved the Summit goal of a one third reduction in mortality among children under the age of five; in over 100 countries, under-five deaths were cut by one fifth during the decade [4] (see figure 1). Most notably, the deaths of young children from diarrhoeal diseases – one of the leading causes of the under-five mortality rate – were reduced by 50 per cent, saving more than a million lives every year [5]. Yet in spite of these advances, many of the promises for children made at the World Summit and subsequent international conferences of the past decade remain unfulfilled and the lives of countless children and their families continue to be blighted. In addition to the nearly 11 million children dying from readily preventable causes each year, an estimated 150 million children in the developing world are malnourished [6]. Over 120 million are still out of school, 53 per cent of them girls [7]. Unprecedented incidences of civil wars and ethnic conflicts marked
the last decade, with perhaps more children losing their lives than
ever before. HIV/AIDS is reaching catastrophic levels, particularly
in sub-Saharan Africa, robbing millions of children of their parents,
schoolteachers and village nurses. In addition, far too many children
continue to live without clean drinking water and adequate sanitation.
During the 1990s, the global community recognized children's right to a clean, healthy environment. At the 1992 United Nations Conference on Environment and Development, UNICEF proclaimed “we must preserve our planet in order to nurture our children; equally, we must nurture our children if we are to preserve our planet.” [8] At the 2000 United Nations Millennium Summit, the international community reinforced this commitment with its adoption of the Millennium Declaration. Among the resolutions was the goal to halve the proportion of people living in poverty and those suffering from hunger and lack of safe drinking water by 2015. The Millennium Declaration’s principle is also echoed in the Say Yes Campaign of the Global Movement for Children (see box 2), championed by Nelson Mandela and Graça Machel, which calls for people throughout the world to take action and protect the rights of children, including protecting the earth for children. The
Special Session on Children of the United Nations General Assembly
in May 2002 served to review the progress achieved in the last decade.
It also provided an opportunity for world leaders to reaffirm their
obligation to safeguard the rights of all children through enhanced
national action and international cooperation to make the world fit
for children.
Since UNCED Nonetheless, in the context of the gravity and urgency of the environmental challenges facing the international community, the relatively gradual improvements achieved since UNCED are widely regarded as insufficient to meet the commitments made at that time. Global environmental degradation continues at an alarming rate, fuelled by social and economic problems such as pervasive poverty, unsustainable production and consumption patterns, inequity in distribution of wealth, unequal access to resources, uneven impacts of globalization and the debt burden. Numerous studies offer compelling evidence of the immensity of the environmental challenges facing us. For example, it has become increasingly evident that:
Such environmental degradation continues to be a powerful contributor to many current pressing global health threats. Tragically, it is often children who succumb to environmental health threats. For example, acute respiratory infections (ARI), often caused by bacteria that thrive in unclean environments, are the biggest cause of childhood mortality. The highest incidence of ARI is in developing countries [12]. Furthermore, diarrhoeal diseases claim nearly two million children under five every year and malaria continues to debilitate and kill in many countries [13]. The linkages between
environmental degradation and health will be one of the issues discussed
at the World
Summit on Sustainable Development, to be held in Johannesburg, South
Africa in August 2002. The Summit will review how the commitments made
at UNCED have been implemented. It will also provide an important opportunity
for the international community to inject a new spirit of cooperation
and urgency based on agreed actions in the common quest for sustainable
development. Environmental Risks to
Children’s Health
Environmental conditions that are harmful to human health are termed
“environmental threats” or “environmental risks”
and include such factors as air quality, water quality and specific
pollutants. Health threats due to behavioural and lifestyle patterns,
such as smoking, unbalanced diets, lack of exercise and drug use could
also be considered as “environmentally” related, but fall
beyond the scope of this book.
Environmental threats to human health can broadly be divided into
“traditional” hazards, stemming largely from a lack of development,
and “modern” hazards, arising essentially from unsustainable
patterns of development.
Traditional environmental health hazards remain the primary source
of ill-health today for the majority of world population: biologically
contaminated water, poor sanitation, indoor smoke, rampant disease vectors
such as mosquitoes, deficient food hygiene and unsafe waste disposal
are usually associated with poverty and social exclusion.
Modern environmental health hazards are closely associated with unsustainable
patterns of production and consumption. Typical “modern” environmental
problems include, air, water and soil pollution, unsafe use of chemicals,
inadequate solid and hazardous waste management, climate change, ozone
layer depletion and acid rain due to the use of fossil fuels. In rapidly
industrializing countries, modern hazards often compound the traditional
health threats.
[ top ] Underlying Causes of Children’s Environmental Health Problems Poverty remains a primary root cause Poverty, widespread in the developing world, is an underlying cause of both the ill-health and under-nourishment of children. It also contributes to the deterioration of natural resources and the environment. In industrialized countries, poverty is found in pockets, typically in urban centres, with similar consequences as in developing countries. Today, with a $30 trillion global economy, 1.2 billion people still struggle to survive on less than $1 a day, at least half of them children [14]. Even in the world’s richest countries, one in every six children lives below the national poverty line [15]. In ecologically fragile areas, for instance in arid or near-desert areas, or in flood-prone places, low-lying regions, remote mountainous terrain, overcrowded urban slums, or refugee camps, natural resources are scarce and environmental conditions arduous. In these places – mostly inhabited by poor people – the toll of environment-related diseases is highest. Poverty robs children of the right to grow to their full potential. Childhood is a time of rapid growth and development, when great leaps are made physically, intellectually and emotionally. It is also a time of great vulnerability to environmental risks that can lead to illness, permanent physical and mental problems or death. Poverty exposes children to terrible risks to their health and development. The
gap between the richest and the poorest of the world has continued to
widen and inequality across nations has steadily increased since 1980
[16]. Serious
disparities also exist within countries. Both globally and within most
countries, a small proportion of the population consumes a much larger
share of natural resources than their poor counterparts. Over-consumption,
both in terms of the level and pattern, intensifies poverty and aggravates
environmental pollution. To reduce poverty requires not only economic
growth, according to research, but also disparity reduction measures,
such as explicit policy and strong leadership on children’s issues,
good governance, proper economic incentives, sufficient investment in
basic social services and sound environmental management. Developing
countries around the world face the challenge of speeding economic growth
while slowing environmental degradation. They, therefore, need help
in coordinating and integrating economic and environmental policies
to achieve sustainable development.
The influence of global trends Among the trends influencing the phenomenon of poverty in today’s world, globalization and urbanization are perhaps the most significant ones, with the latter having a particularly direct impact on children. In spite of the many new opportunities globalization brings, it has tended to deepen economic disparity within and between nations. As the Secretary-General of the United Nations Kofi Annan has pointed out, “Millions are experiencing globalization not as an opportunity, but as a force of disruption or destruction: as an assault on their material standards of living, or on their traditional way of life.” [17] The scale of the impact that globalization will create on the world’s environment and children’s well-being, and the exact forms such impact will take, are yet to be seen and further evaluated. In the course of the last century, urbanization has led to the concentration of half of humanity in cities around the world. In most developing countries, this means the populations of their main cities far outstrip the capacities of urban infrastructures and basic services (see box 3). One quarter to one third of all urban households in the world live in absolute poverty [18], according to estimates. In Africa, cities have the highest rate of poverty of all regions: 40 per cent and rising [19]. Degraded environmental
conditions and other physical hazards are common and inescapable for
the poor in densely populated cities, where infectious disease can spread
rapidly. It is estimated that at least 220 million people in the cities
of the developing world lack access to clean drinking water, 420 million
have no access to even simple latrines, and over a billion urban residents
are exposed to health-threatening levels of pollution [20].
Additionally, pollution from traffic and industries is prevalent to
urban settings. Large numbers of adolescents face particular threats
with little or no support (see figure 4).
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including
the consequences of how we treat the natural environment. At the dawn
of the 21st century, nearly 11 million children still die every year
of readily preventable causes [
Outcomes
from two global conferences have explicitly established the linkages
between children and the environment. At the 1990 World Summit for Children,
leaders adopted a World Declaration and Plan of Action, recognising
that “children have the greatest stake in the preservation of the
environment and its judicious management for sustainable development
as their survival and development depends on it.” [
The
concept of sustainable development adopted at UNCED provides an over-arching
policy framework within which the international community addresses
the environmental, social and economic dimensions of development. From
the environmental dimension, notable progress has been made on several
fronts since 1992, from the negotiation and implementation of a remarkable
number of multilateral environmental agreements, to the widespread efforts
on the local level to implement the recommendations of Agenda 21. Furthermore,
the realization that environmental challenges need to be addressed in
all their complexity is increasingly entering the mainstream. This is
reflected, for example, in the attention accorded environmental issues
in national and local political processes; in the vibrancy of the non-governmental
sector; in the unprecedented media coverage devoted to environmental
degradation and its impacts; and in the innovations and initiatives
being undertaken by the private sector in response to changing consumer
attitudes.
The
quality of the environment and the care a child receives from parents
and family members exerts a powerful influence on whether a child survives
his or her first years and subsequently influences his or her physical
and mental development processes. Figure 3 shows the top killers of
children, with acute respiratory infections, diarrhoeal diseases and
malaria accounting for approximately 40 per cent of under-five child
death. These three categories of disease are closely related to environmental
factors, as shown in the first data column in table 1. Overall, environmental
conditions are responsible for 33 per cent of the global burden of disease.
As illustrated in table 1, 15.4 per cent of the global burden of disease
associated with environmental factors is borne by children under the
age of 15. This child component of environmental global burden of disease,
measured by the loss of disability-adjusted life years (DALYs), represents
about two-thirds of the total environment-related DALYs. Taking action
to reduce environmental threats could make a major contribution to child
health. 
