Child Health and Human Rights (1994) / Chapter Skim
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As physicians and health professionals, our traditional role in addressing human rights has focused on the need to protect and support colleagues who experienced unfair political reprisals that violate international human rights standards. The Institute of Medicine (IOM)
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This lecture marked an important transition in the human rights activities of the Institute of Medicine Although casework on behalf of health professionals still lies at the heart of our human rights work, we realize that we must also address the special health needs of vulnerable populations who are victimized by war and civil disorder. When these victims of oppression are groups of women and children rather than individual well-known physicians, the nature of the human rights violations may be extremely difficult to document and assess, and our responses are often challenged by incomplete or contradictory information and the absence of reliable indicators or sources of expertise.
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In this new framework of humanitarian interventions, the role of private human rights organizations has become more complicated and uncertain. The emerging power of international human rights law has created a multitude of opportunities as well as challenges for organizations that have traditionally been concerned with a narrower scope of human rights activity.
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An earlier report anticipated the national health care reform debate and identified a number of specific health policy goals for pregnant women and children.
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Other reports, such as the 1993 World Development Report Investing in Health prepared by the World Bank, provide important indicators and statistics that measure the comparative burden of selected diseases on children and other age groups. In 1993, a UNICEF report observed that tremendous progress has been made in the last 50 years in addressing infant and child death rates, increasing life expectancy, and providing access to safe water for rural families.
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is devoted to basic social needs, amounting to $4 billion per year, about the same amount that our country alone pays for sports shoes each year. PREVENTION AND TREATMENT: NEXT STEPS As health professionals, we know that disease prevention efforts such as immunization, prenatal care, behavioral interventions, screening, and so forth, are preferable to waiting for disease and infection to start before offering treatment interventions.
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Lawrence, M.D. Chair, IOM Committee on Health and Human Rights
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But the fact is that, for all the setbacks, more progress has been made there in the last 50 years than in the previous 2,000. Since the end of the Second World War, average real incomes in the developing world have more than doubled; infant and child death rates have been more than halved; average life expectancy has increased by about a third; the proportion of the developing world's children starting school has risen from less than half to more than three quarters (despite a doubling of population)
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Seen from this longer perspective, the fact that two thirds of the world's people now have the right to vote, or that more than 80 percent of the world's infants are fully immunized, or that health care is now a right codified in international law, or that there is now such a thing as a worldwide Convention on the Rights of the Child—are all symptoms of a remarkable change and in the face of such progress, pessimism is a sign less of sagacity than of cynicism. In the decade ahead, a clear opportunity exists to make the breakthrough against what might be called the greatest obscenity of our time the needless malnutntion, disease, and illiteracy that still cast a shadow over the lives, and the futures, of the poorest quarter of the world's children.
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and many thousands of individuals and organizations (most notably Rotary International) have struggled towards the goal of 80 percent immunization coverage of infants in the developing world.
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Almost 60 percent of those deaths, and much of the world's illness and malnutrition, are caused by just three diseases- pneumonia, diarrhoea and measles all of which can now be prevented or treated by means which are tried and tested, available and affordable. Even those problems which have traditionally been considered the most expensive and the most logistically stubborn the lack of adequate nutrition, safe water supply, and basic education are also now becoming susceptible to a combination of new technologies, falling costs, and communitybased strategies.
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and other forces in Somalia, under U.N. auspices, is a right to food intervention and as such represents a major advance toward a new standard which says it is impermissible to massively and systematically interfere with a people's access to food; such interference invites military and other actions on the part of the international community to enforce the right to food.
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Amidst all these changes, there is a revolution underway in the developing world with respect to children, and I would argue that it could serve as the cutting edge of global and national efforts to address the major burning issues of our time. It can be leveraged into a global movement capable of dealing a death blow to many of poverty's worst manifestations during the 1 990s, it can help spur economic development and bolster democracy, dramatically slow population growth and ease the stress on the environment.
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Among other rights, the states that signed the Convention (States Parties) recognize the right of the child to the highest attainable standard of health, with emphasis on primary health care, and I would suggest that you make the Convention an important instrument in the advocacy toolkit of the Committee on Health and Human Rights.
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Even within present resources, much more could be achieved if more priority were given to meeting the needs of the poorest. Only about 10 percent of government spending in the developing world is allocated to basic nutrition, health care, water supply, sanitation, primary education, and family planning.
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Now think of what could be accomplished if both ends of Pennsylvania Avenue were to exercise, together, the kind of leadership that is needed. By increasing investment in American children and strengthening American families, and by reordering foreign assistance to reflect this new priority, the United States, the world's sole superpower, would once more set the global standard and give a major boost to human development and economic growth and to democracy and human rights at home and abroad.
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. Sixth, to the extent that oral rehydration therapy becomes the established priority for treating diarrhoea in the homes and hospitals of the United States, it will continue to catch on and save millions of lives in the countries where diarrhoea remains the number one or two killer of children.
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MAKING THE "IMPOSSIBLE" POSSIBLE 19 In closing, let me say that I hope my remarks tonight have infected you with a little of my "pathological belief in the occurrence of the impossible" and that you will join UNICEF and allow UNICEF to join you in making it happen .
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Appendixes
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Key Terms
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