Overview
Children’s survival, nutrition and education have improved dramatically over recent decades. But progress on indicators of child health and well-being is currently stalled across the Sustainable Development Goal (SDGs). No country is currently providing the conditions needed to support every child to grow up and have a healthy future.
Children (aged 0 to 18 years) today face a host of new threats linked to climate change, pollution, harmful commercial marketing, unhealthy lifestyles and diets, injury and violence, conflict, migration and inequality. Their very future is uncertain, and urgent action is needed to address these threats.
Some of the most important actions needed to protect children and ensure their future are: centering the child in every policy linked to the Sustainable Development Goal agenda;
- urgently reducing greenhouse gas emissions to fight the climate crisis;
- taking multisectoral action, coordinated at the highest levels of government;
- increasing funding and political prioritization of children; involving children and youth in the design of their future;
- enacting new national and international regulations to curb harmful commercial marketing, including an Optional Protocol to the UN Convention on the Rights of the Child; and
- improving reporting of data on children’s health and well-being.
Investing in children’s health, education and well-being brings substantial returns for societies. For every dollar invested in children, there is a benefit of around US$ 10 for many interventions and up to US$ 20 for some. Each dollar invested
in health brings 20 times that in benefit in lower-middle income countries and nine times the benefit in low-income countries. Improving health and well-being in childhood benefits the individual throughout the life course and for generations to come.
Main health risks
Environmental threats
The lives of all children are existentially threatened by greenhouse gas emissions leading to climate change. Children’s lives today, and future existence, are at risk from rising sea levels, extreme weather events, water and food insecurity, heat
stress, emerging infectious diseases and large-scale population migration. These issues are already affecting hundreds of millions of children today.
Urgent action is needed to reduce carbon emissions in order to keep warming below 1.5 °C and implement the provisions of the 2015 Paris Agreement on climate change.
Indoor and ambient (outdoor) air pollution are both responsible for an estimated 7 million deaths (2016). Air pollution is associated with poor childhood respiratory health; it impairs the lungs and the brain and increases the risk of cardiovascular disease,
obesity, type 2 diabetes and metabolic syndrome across the child’s lifespan.
Climate-related health risks are compounded amongst the 40% of the world’s children who live in informal settlements where substandard housing, overcrowding, hazardous locations, unhealthy living conditions, poverty and poor access to basic services
can harm their health and well-being.
Obesity and non-communicable diseases
The rapid rise in childhood obesity is one of the most serious public health challenges of the 21st century, with the number of children and adolescents affected by obesity increasing more than ten times from 11 million in 1975 to 124 million in
2016.
Children are frequently exposed to harmful commercial marketing, typically seeing tens of thousands of advertisements a year for addictive substances and unhealthy commodities including fast food and sugar-sweetened beverages which contribute to obesity
and chronic diseases, as well as online gambling services, which can harm their relationships, school achievement, and mental health.
The marketing and inappropriate use of breastmilk substitutes (formula milk)— a US$ 70 billion industry — is associated with lowered intelligence, obesity, increased risk of diabetes and other non-communicable diseases, accounting for an estimated
loss to society of US$ 302 billion.
- Evidence suggests that children in some countries see as many as 30 000 advertisements on television alone in a single year, many for harmful products.
- A review of 23 studies in Latin America reported that advertising exposure was associated with a preference for and purchase of unhealthy foods by families and children who are overweight and obese.
- In a sample of five- and six-year-olds in Brazil, China, India, Nigeria and Pakistan, 68% could identify at least one cigarette brand logo; 50% could do so in Russia and 86% in China.
- In a study of 11- to 14-year-olds from Los Angeles, United States, African-American youth were exposed to an average of four to one alcohol advertisements per day.
- In Iran, food advertising during children’s programs is dominated by food items that are potentially harmful to oral health, as are almost two thirds of food adverts during children’s television in the United Kingdom.
The commercial threats to children’s health are dangerously underappreciated. Children’s high online exposure can also harm them when companies buy and sell their profiles for the purposes of commercial targeting. Children are also exposed
to via bullying, exploitation, and contact with criminals and sexual predators.
Injuries, violence and conflict
Road injury is the leading cause of death for children and young people aged five to 29 years. And more than 1 billion children — half of all children —are exposed to violence every year.
In 2018, 1 billion people had moved or were on the move either as internally displaced persons, international migrants or refugees, including many children, as a result of conflict, violence or inequity and lack of opportunities.
WHO response
In 2010, the World Health Assembly, passed Resolution WHA63.14 Marketing of food and non-alcoholic beverages to children. In so doing, the Assembly endorsed a set of 12 recommendations which call for global action on marketing to children
of food and drinks high in saturated fats, trans fatty acids, free sugars or salt.
In 2017, the WHO Western Pacific Region passed Resolution WPR/RC68.R3 Protecting children from the harmful
impact of food marketing. It calls for accelerated, multisectoral and multi-stakeholder action; sharing of best practices; provision of technical support and advocacy; and more collaboration among countries on measuring and mitigating harmful impacts
of food marketing.
In 2020, a WHO-UNICEF-Lancet Commission published the report A future for the world’s children?, which is based on the expertise of
more than 40 child health specialists from around the world. The report sets out new threats to child health and well-being and provides recommendations to ensure children’s health today and in the future.
WHO and UNICEF are providing technical support to countries as well as communication and advocacy on the report’s findings and messages globally. WHO will, inter alia:
- Work with Member States to foster a new legally binding and regularly monitored Optional Protocol to the Convention on the Rights of the Child to curb harmful commercial marketing of fast foods, sugar-sweetened beverages, inappropriate use of breastmilk substitutes, alcohol and tobacco, and collate best practices;
- Develop a package of child health interventions involving other sectors as needed;
- Adopt a systematic process to generate and capture evidence for policy and programming;
- Provide integrated technical support to country child health programmes; and
- Develop a scorecard with partners for monitoring the implementation of the recommendations of the report.