UNICEF: The State of the World's Children 1992

THE STATEOF THEWORLD'S

CHILDREN1992

United Nations Children'sFund(UN ICEF)

THESTATEOFTHEWORLD~CHUDREN

1992

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THE STATEOF THEWORLD'S

CHILDREN1992

oJames P. Grant

Executive Director of theUnited Nations Children's Fund

(UNICEF)

'lm..lSll~1I 1'01l UNICEf

Oxford University Press

CONTENTS

THESTATEOFTHE WORLD'S CHILDREN 1992

Introduction:Agenda for anew order

I . Keeping thepromise

2. First callfor children

3. Fewer deaths,fewer births

4. Investingin people

5. Aid and need

n., p<>Iitical on<! =>nomk chan&<:s of rttCtIl~ ha"" made itdear that .. J><W "vrld order II evolving. UNICEF "'bmil:$ tenpropositions for the qt'I>da Qf lila! ~ ordtt - from the point ofview of .. world wide 0fll0JIizati<m wlUch comes in'o <biIj' <:<>Dl.lI

dnWcaIJy n>d~ clIild deatho ""d ch~d malnutrition, and to cmuretha t ..u children have at I....' .. b3o.k oduntion, by <he end of W"""tory. ThaI prom;'" ",,,,n now be ktp<..

Prof. l:tiO" fo< the growing minds and bc>di<'< of childrcn ohouId h" .... firs' call on the raoun:a of th< adult W<>tld _ and childrrn Ilhould

be . ble ro count on that commilm<11t in good limeo ....d in bad .

- "Th. ril"ort l<> prot.... the ti_ an<! the t.akh m millions of !heworld', childrtn io in .ynngy with, n<>I oppositi<>n It>, 1be off""" tooIow population 1lfOWlh.

T<J<by'. <""'$en"" on .. '1tI3fkrl (ri"'ldly' "llPl'OKh to d"",lopmen,dItluld be """"",panied by .. <'tlff'OSp<lBding COI1$M$UJ on the -.lto guo.nm'" bIl' i< ,," -ntmenU in poop," and paItkularty in theIIea1Ih and educatio n of child=>.

Irn......... in irnematiorud aid shoold he: based "" I .",..ined andIIIClISWlIble cornmiunem to mectiJl& minimlll1l human needs.

- - - - - - - - - - - - - ---"

6. The economicenvironment

7. Disarmament

8. SettingAfrica free

9. The apartheidof gender

10. Planningbirths

Statisticaltables

M1ion by th< ind~ nali""" 10 Iig:h= 'he hurd... of deb<ond 10 <>pm ~ io ....ntill if «onomic ...fontl in <he:lkvdol>in& world u lO ....cceed in allowing in P<OPk w tun adocen' ~ving.

Dmtiliurizltion in the developing wo,ld. .lltd ~u«d miliwy' p<ndins in <he:ind~ world , ohOll!d be linlo:d '" incn:ues inlh< I'<OOW'C<::S ..'lIiIobl< fOl" dcvclopmm, ond 1M =oIution of""""""" global probl......

Mos' of Africa", deb'" ohould be fOl"gh-m and int<mal «<>nomicn:fonn should be gi>-cn • <:han"" to .ucceed by inc:n:ucd e><lemalIUppon.

A ocw world <:>nI<r ohouJd op""",, lh<: opo rth<id of ~nd.. . ,vigorously .. the apmheid of nee.

The wcll informed plannioa of b irth< ........ of th< mOlt rifocti>"I:. nd leos' e:<pcn.ivl:~ of imp roving tho quality of life on oorth.

-~

Fluio indi...ton, nutrition, t-lth, roOClllWn, d<mognphio

iIld;""",... economic indica''''", W<lmm, le$o populoutwun\tkt;, "'"

"'~ of progrnI.

PANELS

The year 2000 goals : 1 Reducing povltl'ty: 9one lorai, allor one WOtld~l Repor1

Mexleo: 2 Educ811on: 10kaepi'og the prWioo llChooI Sla;.*lg powur

Imrnunlzllltl on: 3 South Korea: 11stJ a bErg8io rTIOl'lI ed.Jca1ion per doIar

-Eastern Europe: 4 Baby-friendly hospi tals : 12ba oslIiol ,with a tunan lace a rriIIion &vas to seve

The United Slales: 5 Clllna : 13!he rise Mel riseofdild pQYBrty -...."",Wer on children: 6 Super-shots: 14Ihe 2OIt1 CEIllu'y's shame ctilcieo rs vaccne i1iliatM!

Ce8re: 7 HepllUtls B: 15shoIWlg ~ (3l be dor'e the SEMlldh vacc::ilo

ReshUffling the pack : 8 Facts for life: 16Ht.manne.lllop '160 ,t RaporI " ::: ;00 lor rriIons

TEXT FIGURES

Fg. 1 r_;, ......""'fI"O"laity.byregict>, 11l6O- 1990

Fg. 2 ~ d*:I "..nNilicn: PBSl t....,. on:l U>.nI~~ <:nrJlrie&. _lnl tr\f M'oIlricas.' 975·2O(X)

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F ~ DeaIhJ~"""SIi~.Irom""","",,__di ', , ' ...<>:U1II1M, 1991

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ChM>r}es n~ mal__ ond <:t*l heollIh ~ (i(:m(Jo .. e-... 19t& 11l9Sl

~ _ n pm-.y oct>ooI, by "'Il""', 1996-1_

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SUMMARY OFISSUES

The IX*t>caI a"ld ecoo 100 ,.:; ....... iQ8S Q! th!t las1 l/Yee~ t>aw IT*M il .-. IhaI .. rew WQI1d erda' ..emergO>g. 1'Ns~·s SWte 01 the Wa"<r a Chilhit1 raport....n ICI a.>ntrb.tt~ to!he;lQ9i'lda dIM! reworderflQm 1he pe<specI'...e oIa~ O'gIf'OZldion IOhk;h <XmllII i'll<l <;laily~ 'N!th some of the ll'eatoot!airQs 01 n Old.

1Th9IIt1o prQrnisu oI1he WOI'o:J s..rm. let Cttillr1 sI'IcUd be~ Ilnd 1M! II new world Of'do!t st>ouIdDring "" Bnd to 1TDnutnti<Jn,~ disease, Bnd _ eracy a'l'OIlI so mBrl\I "*"'" oIlhe """""'$.....

FIICI. A 'lLfWl\II' at..".", jOlP,J~ <Ii>-r~ mont .... "" "'"'~ w>a _ p«mI>t)IIfIt6 -.~ t.I d fII cases 01~ _ -¥ dB8th NIl ctJuMd by h a""'liplIdSc:.......... wflICtI<m ""'" be~orlIWIedIII "lOY /owc:osl.

2- 1h:l! !!1e .... ....:,..!e c! '!lrst ell!V~· -=,*" ~~ p:.:t:;:etlc::1 *~;ro-"'n.i~;;1d:1"oros

oIll'01l )'OISlIl 01..91110 have II i\rsl C8III CO lOcieties' _ • _ bo,looma on ""'""'P'1IC1 aItIc 01 anew world order.

FOCI:~"""'1"""""" of lho~ lOOtt, II>e '"'* 011M~".,.,.." _ l/le <*:f aioiI aN Il/6ll1 /laSll60Wl~ i'l/O nsi'lIl_ Of r:Nd~ llfId aoIIi'Ig _ of _ ......,.... I'l trIIWI)' ~lIO'lS rlihen<1l$l , r , _. the bel< af rtG ....... ~"...- JfIBI file riJ,ng!llJlMlal dIM 19l1Os /ISS IlIWI~by II S/IarJl~1'l1J>iJp'cp::Irli:)ol 01 CIlitnrl M'lg II fJIA'fJfIY.

3 ThaI ~ the issues Ii rnaIrlItriIlcln~ Osoaase. lind wid8spreed ilile<ac:y ..... notca-oImmed ""(I rewWCf1d otdIlf' fMlIve9. Ihen il wiI be Io9Y IYliJCI' rroe diIIicUl to rlld""" the lllI8 01 pop<Jation(1tIWlIl ard make ltollnVl!lili<lr1 to~~ ""","","Ie ~.

Fact~ cH<J _ gi>oe$~ mont CO'4Iw"",;,~~. M:>sf oIlh11~ Ila/IO'>S ""'/lOWl>"Ilri>sI fJf~ h SllI9O«""'" _ </!Iot>a.. child _ .... _lOiln mt.Cl'I3teIJptfr__i1 bi'lPJ.-. £:IoJov _ ",""I'><NI be _ W~1he-._-. ale"""01_ of oIIIdArl wiI !ll&obll...... !>Of_, oo'.trtfslO_poo:Ua_ll"""l/l.

4lhal me growing cu_osus arOUl'ld ltoI 0TipclrIar'ce 01 f1WI<tI!~ pcIiciIls _ be00'lC0 i iflllIli9d bv II~ oon&IlI'ISU!l on lNl~ 0/ QtM'!rl'Vl\ef'110 go.a'lI<lleEI b8sic;""6SlI1" ~1I '" peoplo.

Fact ll'l--. ~1IbaA laaf~~il th!t ..... ,_11/_" rJtto'<X.fJti '" OB9C"","",'&ltSWd> aspTTIIlfy-....... _ ~~o;Zl~ t>' IhIIP<'O' rrwP*r.

5 lhal increases In 1n18r'l\alional l'id - be basedon 1\ aJSl8i'llldend..-..ablll tXli"'''''OlI~10~ mininulll'un&r1 _ 80d lor~. In liIIIClAIl.,... Ihe prh:;pIo oI a lWst CIlII 10I

"""".Faol: t_!tMn ltl" d IJ# lIid is JJb:;aJoo 10"""""'" !I'll Dai:.- d I1IIJ poor br-.. JriMrl' M.--.n. "*....rw~. _ Wr#f p/IrrirIg.

6 Thal intOOllllkloal aetJon 00 delli, aid. and trado~ atlII\Il ~ etMr/lfVT'lIlI' In wt'Iid'IllCOnOn'ieI'fIb-rn .. 1ho ll8' !'~ ill 'Ml'Id cor> S<.a:OOd .. allOwing ils peopl&10""" a decOOllMrg.

FIlCl' TIM~ (Je/)/ CtI$i$ "-'S rtI8t !Ill f)OOt WCtICl IS ""'" ttJ;ISb•• og sse 0lkvI , .r- ro me rJCfI ""Iicr>s.PrcldGlb lilm tI !Ill~ _ a:>sn /1lIIpoot _1I1i.<ltlw$5D Il6>rr II~ r> bol~

7 TlIalIl proosss of~ !ItIDIAd bego in the OOoalopi"ll world and th!ll. ... SI8P with Itralprocess, la11n9 day expencit.... ... die FdJslriIlized nations SI'"<>.Ad bII linI<8d to "II' aca ~

i .... rl l'll8maWnalllld lor de\ I ';:.o'''~ ..-.d lor the"*"ubon 01 common gIobaI ..cUto, ...

Fact: 1!>II ....,...,,!lOW sptIfl/. M !IlI WCtICl'. motrl>')' _ !M CQ ' ll>o led ..... ..."..,.... at me """"'" flBIt of/>m¥Ity, The pools 0I!hf 'NM:! Slnml IrJr~ _~ <bs/J(; ""*"::1IOnS i1~ Ind~ find8_ """- Icr'" <>'tim - <:cUd D8 /I1IlI 1>y~ Itl" at~__.. me '*" "•';'11 wrxk11!1f>(1

1" "' /t>fI~~- - - - - - - - - - - - -

8Tl\IIl the "'-'" 01 A!rica's debt 00 """"* on and that the <X>"ltinenl be !r'"'IO oulI\cief1l _lll.lJPOIllO'*"" .,_ ,elam to .. .-.--l in 'egeneraq !he """""""'" of <l!o. ' , WI_.

FOd: _ l<Xl9y " crV)i~ '" fJ6Y IItXL'I tnt t!>rd of !Ill _ at il:r delJI:t. bm _ 8 808OItli", II

~ at", iii eow-t ..,qprd COSIi1g rho co. ..'" """"..-.' '""'" rn.. it$ 1ot8I...,.idi'O M thItt".Jth_"'" ........ of ftS petpI1.

9FllCI: I.Icre~ a mI;::rI 0i1s .- fl/ldl)'OW~ b«:aJw lhIJy ..... 1xm BmIo; me C3lJS8 at_ iS lfJe_ ct

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10 Thellhe responsille piar'o'WIg 01 bitre is OM 01 the mD6I 6IlocIMl and - __ ways at~ the~ 01 ~ 00 """" • both row end in Ih8 Mt.re • and Il\IIl OM of lh& grmtaslI,listal<ai 0/0l.I' tims is the lBik.nIlO rBllige!hal potootiaI.

F8cl: 0.... ~()OO a,gsI ........... _1JOft>"lO/1 00(11 day.~"..", CIIbm do """"" ,- bI!caI.<w lhIJy__bQ7l too Ill:lCr' ..,. II~ Ili'lI'I or oecause lhIJy wn Ixm ro mt1tt&'s """ ...... roo~ to !ii'u Iltlh SiW','.0.... .00.000 IaIll:I WO'1J!O'l cit.....-y _ /loICaL<'lo> If>8li <A:> '"" """" !Ill~ or ftIIIl7*WlI or !lll ,;glll to..JI'Ie"'- 1¥>d~ of lrlei"PlY"""'"'" ~ '" _ CQid """"""" hi rif,l. Ihtt tlllfI at__ /,IfOI'I1Il_1aII1>y~~

-~

---1- - THE STATE

OF THEWORLD'SCHILDREN

1992James P. Grant

Agenda for a new order

Keeping the promise

First call for children

Fewer deaths, fewer births

Investing in people

Aid and need

The economic environment

Disarmament

Setting Africa free

The apartheid of gender

Planning births

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Agenda for a new order

This report is issued a l a time when theworld order which has dominated the PQlitical and economic life of the 20th century isvisibly dying. It is offered, from me parucular perspective of UNICEFs experience inworking with some of humanity'. mostacute problems, as 11 contribution 10 thedebate on the ot:'W world order which illstruggling to be born.

In the blink of an historical C)"C, theworld has witnessnl the beginning of theend for apartheid, the liberation of Centraland Eauem Europe, the Cl'lding of the 40year cold war, lhe beginning of significamreductions in arms expenditures, the virtualabandonment of the idea of state econo micmonopoly , the narrowing of ideologicaldivid"", th" . rn:ngthcning of the economicheartbeat of Asia, the tum away from dina.tonhip in vinualll' every republic of J.arinAmerica, and a new impuJ5<' toward.democracy, pluralism, and eccncmtc reform in Africa.

n" period of history mal is most diffi.cult 10 understand is always one's own, butthe suddenness and SC1IIc of~ changes,in a landscape previously considered glacialin its rate of progress, suggests that we are

living through a revoludon. If so, it is arevolution significantly differenl from 1'1:\'0

lutions past. It is different, first of aU, inthat irs principal agcm is not violence hUIcommunication. And as ends arc ofteninherent in means, it is also diffel'l:J\l in thatit ill a revolution which appears to be transferring power nOI 10 the few but 10 themany.

These arc profound differences In theprocess of historical change, differenceswhich gi\'e a new meaning 10 the idea ofthe oomrnunieations revolution. For in themany coumne!< "'heR' poli tical and ec0

nomic change is now unfolding, it is thepower of communication that is allowingthe judgements , pro\'olting the comparisons,heighlening the frustrations and posing thealterTUltivn. Mtv- y",,~ of somewhal ~pty

talk abou t the global villagc, it is as if thefirst \il1age rnttting Wef'C being held andpeople were voting almost unanimously toreject the political and economic aUl<x raeicswhich have deprived them of choice withOUI meeting their needs.

Then: have been unpleaslll11 rnnindcn ofthe \'Ulnerabilily of this precess of change,bUI recent e\'enlll in the Suviel Union, and

THE STATE OFTHE WORLD'S CHILDREN 1992

particularly on the strn'tS of M OSI.'Q\\' and51. Pctcrsburg in August of 1991, ha,.., senta message of courage to people< aU over theworld. in many capital cities today, meee isan almost umgiblc sen$(; that some vital balencc mlill' 1:><: shifti ng, tha t the contour! ofIile possible mal' be: changing, that peoplelll'l." finding a new confidence in their ownrights and abilities to participa te in the management of their own alTairs. And h maya1ro be, although it shoul d be said only len_tatively, that thCTC is a new ncrvOUSJlC$l, anev.' he<;itam:y, amo ng those who might betempted to suppress those rights.

This advance for democracy is not excju-si':dy led by, or ccnrsec to, xeecm endCentral Europe. Ten yean ago, mOSt of thc22 republics of Central and South Americawere gripped by dietll.torsrups; today, all butone ha\'!: an elected govcmmcm, 1\ alsoappear> that Afric:iI may no\\' be embarkedon a gradual political trlInsformation. 'Theshock W3\'<:S from Eastern Europe and theSoviet Union afl' rc\'crlxniting through tha tcontincm " i!h a parti~..nar resonance becausetocy are coincidin8 "ilh the sudd en llJ1dpainful Ializaoon of the moral and fmancialInadequacies of many of its elcisting emnomic and political systems. Simulumeousl)',the ending of the roId w"r is raising newhopes that the destinies of many nations inAfrica, omd in other pam of the dc'doping..-orId, may """,' be: detached from the superpower rivalries which have so distortedinternational relationships in the POSI-"'l!1'era. Those ri'"lIl1ies have had mueh to do",ith !he llVt:I'-miliwi7.a.oon of the developingworld and "'i th the perpetuation of the kindof regimes which, in so many counnics andfOT so many decades, have denied humanrights and crushed human hopes.

,

Despile an imcmational agenda that iscrowded with pressing political, economic,and environmental problems, there is therefore mere cause for hope on the humanhorizon than perhaps at any other time inthis ~n!UI)'. It may be that the } 'eal'll aheadwill sho"" such optimism not to have beenjustified; hut wh at is not in doubt is that anew order is emerging in our times.

A new order for children

This repo rt s('Cks 10 conlribute III theagenda of thai new order from the pen;pccrive of a worldwide o'llani~alion whichcomes ;mo daily contact with some of thegreatest fll.iling$ of the old_

Those failings were the cemral issue ofme WorM SummJi fur Children held in lateScpu:mbc:r of 1990 al the United Nationsheadquancrs in New York.. 11>c timing of!he S"",,,,il, which brought lDgt:ther IS9nations, more than 70 of them represemedb)' their Presidents or Prime Ministers, couldnot haye bttn more propitious. The ou!come - an~ programme for, amongoiher things, ending mass malIIUuitiOIl, pre' 'CI1lable disease, and widespread illileraeybc:fore the end of the d=.Ide - amoumcd 10 adclailed description of a IIl'W enter for theworld's children (panel I ). 1bc e~nteof this agreement, at a time when the exist_ing ",-orId order is rapidly changing, meansthat then: is today a bcucr chance than everbc:fore offmding a place 0 11 the world's polilical agenda for the right.s of duldrcn and formttting the minimum needs of all families.

It is therefore obligatory, al this tim~, forall individuals and org:ani7.ations charged

...im rqpoo$I1JiIi{}' {Of lucb issua 10 emerlIS CuDy lIS pos!ibk inlO tho: dcbal<:! WI lieahead. For • new pace in work! hUtory isbeing turned, and if the needs or the poorCSI quartcr O{ mankind, and o{ Iho: childrm....lto an: the JIl()$1 ,'IIlnerable or all, llrl:

again rd~atcd to ihe (ootnotC'l of thaIpage, then the new world order which iswritte n there will be: neither " 'orth)' of illltimn ncr capabk: o{ mcctilli me ehal1cllicsof the future,

Amid the many voices and Iho: manydanlorous issues thai wiD compete {or priority in Iho: debatcs 10 eeese, !his year'sS_ '" W WlIrld', CAildmo rcpol'I isIhrrdon: • pka for Iho: ino;:hWon of themucs wtlidI lend to be ipoml and Wvoices wbic:h a~ normally silenL II is aPlc:a> particularly, {or me inclusion of ml*,"Oiccs silenced by pon n y and ilfucncy,for ecse woo arc silmecl by the effeeu ofmalnu uitiOll and pKVenllbk disease:, forthose who are silenced by being bornfema le, and for those many millions whoan: silenced hy death a1mosl bcfon: thcirlives have begun,

Specifically, !he rqxlI'IsubmilS 10 propoIoitions {or lbc conaidcn.1ion of aU lbosc + be:they hca:hof Slale 01' mcmbm of tho: public:- who arc concerned to bcoomc invm"Oll intho: d;"'nrim of the new world order ...1lidl...ilI ",'(I/,,, O\'ft d'E Do:Xt lew )ftrS. TakenWp:Ihcr, theyadd up 10 a popos:allhar. endina ee abIolIlle po'I'Uty of QDC quanc:r 0{

mankiDd - tho: ITlOfC than orlC' bi1Iion pcopkwho 5IilI Ij"" m>d die 'Aim prc;.'alIJ.bkhunga', divav, and illil:eracy • $houId rankIIongsidc tbc issues of prcson-inr; the pc.ccand prolCCIing the environment lIS priorityitcmll "'" the agenda of IIw. new werid order.

Coouvy to widely held opinion, thisIJ'l:IlI cause is far from bcing hopcksa, Welui,.., a1rcad)' In''''~ thn:c quan~ of lhc" 1Iy tQY.wds a world in which C"o'CI')' man ,WIlman, and child lin adcqua te food, deanwater, basic health cere, and al least aprimary educa tion. And then: is 00 technological or financial N rner to preven t thecompletion of thaI jnumcy in our times,

Reaching these qt:-o/d goal, is not a diseeee cause and don not stand as adislrKtion. from tho: eew challenFs of ourtimes. CRating the conditions in " irichpeople can lIIC'Ct tbcir own and thriJ {:mtilies needs for adequate nutrition, beahb~ and education is lID e:uc:ntial underpinning of cfforu to meet those ~dWJc:nFs. As that mvcstmCl1t liber.les peeple's productiYity, 10 it hdps ID 5IimulateKOllOl"ic gro....th ; aa it includes rather thanexcludes people from political Ind ecunomic life, 10 it helps 10 ounure tho: democl1l1lcplQUSl.; .s it gi"cs peuple tho: confidenceand the means to reduce family size, 10 ithe lps to 510w population growth; and as itJi ves the poor a stake in the future, 10 itIlelps to safeguard the en\'iro nme nL

For almost half a ccntwy, the w<lrld hasbeen distracIed from these J1ClII\asb by mili-

- - "" - - - ~ . ~ "" • I "'-"-,- Wl2tY UJr1WU ;onu ..... pi ....~DIUO .. ar,and the~ or war, Ita,,, divattd our ph)..ica1 and 6nanc::ial raoura:a. our Kicla and~, OW' inFnuitY and irro3Cinalion,and our human UlplCi:y and UiiKGIL 1'11.

1hreaI: S ,tm.iiI.. n.: time hal tb:n:flftQOOI'IC fclr 1be lIutd 10 U.....'dl .. ird' ID 1be

task ~ cnting the ...,ki C\" ~ absoItnepll\'CIty, IrllIInutriOOn, iIiIaacy, and 1ft' 'mIallIc disease and to build ... 1tM'Z'ds anew "uk! order ....hicb wil rdkcI manI::ind'.brighteslllOpQ r.othcr than ita darkest fan.

•

THE STATE OF THE WORLD'S CHILDREN1992

Thf IfII propo.itillns:

1 Thai 1M. pl'Omm 0/ W World Su",mi,ji)r Clrildrm .Mufd lie ltepl (I"d Uwl II ntWwurld ardn . hould bring '''' md 10 ",ulmlln"·liIm, pl"tUmahk diuau, ,,,,<1 illilnYUy amonKSiJ many millions of the world'. child"".

2 Thai the pn'ncipk of 'jim call JOT childn:,,' - meaniug Uw./ proI«lion for Iht growingbodie. and mind. of 1M. ymmg OI<;:/n '0 haw II

Jim caU on S~I~J' r"'C'l' rus _ should bao_llIl a.:«pIM cth~ of" nftll rrorld order.

3 1NJI if IN iJ",a 0/ "'a/"mn/ion, pnolIOl/abk diJw.Jt, and rriJespread ilJilnaCY, a""not "'''fronted as a ....... wurld order ftJO/ws,Ihm it will 1M wry ",,,,It ""'''' difficult 10",dllU lilt. I'IlU ojfNlfm/allrm Kf'l/fcrh a'u/~IJIl INnn"rion 111 tm,iromnmcally smrainabkrkwlopnumt.

4 111m rhe It"JU'irrg ro"SmSl<S around Ikimporlona of marlul teO""",it; polioo shouldlie UUOt" panied by " =fKmding conse",,,.On tlw. responsiMily 0/ govm nnenu w gUOl'll1ll<'<' basic irn!tSl "~"1S in f>Ulpk.

5 Tlral in<:TellUS in imemooon,,1 uid should1M bawl. on II Jusu.i"td and mtasurabk Wm",i,m,m 10 " l«li"lI ",i"im''''' humull "ads/llId for maimai"" ll, ill dijJiolll ri"'n, wpriMipk 0/a jim ca/l/or child"",.

•

6 ThaI imematio,lIlI QClWn em ddJl, aid,,,00 rmdt 11w"ld creole an em;iro",nnl1 in.chich «DI1O",it; refimn i" UuJ dtwl<lping world.",n $1tceffli in tJlI()f~ing iu PMPk If} tarn ad«e>l1living.

7 Thor tJ proaSJ 0/ dm,iJiUln'ztJ,ion llumldbtgin in rhe ckwfopi"l: world and 1M', in lItPwilh Ilw/ PrfJl't!SS./aJiing mi/iw.ry a".,ldiulUJin I~ i"d"mializtd ""Iiom should ~ fi"Ud10 slrnijiaJ.m i~leJ in im~"'Q/ionaJ aid /ordewlopmem amIfor lhe ftSofulum oj ",,,,,mollglobal problems.

8 ThaI uJe <haim oj AfrW 's deb, ~ $InuitoJ! ""d lhal lhe amli,rem bt. K'Wtl suJficimIaum...l ,';;;;;,);7. to iUlirw i;;4"oiil ;~f;;;iii tosue:eud in regenerating rM momem"m "jdaotl<lp",em.

9 ThaI a nno llIOrid <min sholiid oppose ,he"purlJreid ".f gtnder as rig<>TOUSfy us 1M"punheid "/ rIlCl!.

10 Thai W ruptmsible p/(l,,,,i'lg oj births i.<Me o/IM "'''11 e!J«~ mid /ea.1I e"f'tn.iwlC<Iys ".f i",prur;ing the qllalily 01 life Oil ta,,},

- btJl1, ,,,,.. and i" l~ fulure - mid /halO'''' <>fW grtaleSl ...iJwk4 1)/ "'" lima iJ 1M I"il"re10 rtaUu lhal pounlial.

Keeping the promiseProposition: Th<J1 W promise pj 1M WorldSu",,,.,;for Children shoulJ /Je kepi ami thas a"<'Ill UJI)1'/J orrkr should tm"n8 an nul ILl malnu_Iritiim, prevml<Ibk diua.st, tlJId illiu=yamong SO many ",illimu of IN; wur/d's dt.iJdrm

A quarter of a million of the ...'Odd'syoung children ~ dying every Wttk,' andmillions moee Ill"e surviving in the hal f-life ofmalnunition and almost permanent ill hc:aIlh.

This is not a Ulrealencd lnIgedy or animpending crisis. II happened today _ It wiUhappen again tomorrow. And by any objective SlaIIda rd of scale or severity, this issuewould rank in importance wi th any on thehuman agenda. But in practice, such probterm have had utue purchase on" prioritybecause they llJl' primarily the problems ofthe poo r and the powerless.

The childKn who an: the virtims of pre,'entablc malnutrition, disease, and iUitcnlC)'arc being moot shamefully failed by the prescm wurld order. BUI in the last two yeln,thai failun: has begun [0 feature on thepolitical agenda in a way that is unprecedented in UNICEF's 4Q-year history.

The most irnponam signal of IDaI new priori!)' was UK: convening of !he WCWU Summilfor ChiJdrm on 29 and 30 Septanbcr, \990.Over those two days, thc laJ&cst CVCT 1PIthet"ing of healh of stale met to consider !hepossibility of bri~ to an =1, in our times,me long-running tTagedy docnbed in theopening paragraphs of!his chap'''''.

C10ling fbi gap

The Sum mit me t at a point when it W:RSbecoming clear that one of the grea test

humanitarian gOllls of this century - immuni7.ing 80% of the wo rld 's children againslsix major d iseases by the cnd of 1990 _ wasgoing to be met (pllncl 3), That achievement i, now saving the lives of eve r Jmillion children each year .' II has alsodemonnraied, ailer a deca de-long effort,mal the world now has the outreach capacity 10 bridge the gap between mass-scaleproblem s and inexpensive solutions.

ln tluenced by that cxample, the Sun,m;1concluded with a commioncnt,' now signedby more than onc hundred and twentyheads of state, to begin ap plying today',=u1aled knowledge and inexpensivetechniques 10 a range of basic problems facing thc world's children (pa nel I).

Thc immunization achievement had alsoshown the usefulness of having a quantifieble target as B focus for national clfOlU andinl~tiOnal support. The Su mm,i thereforeformulated its conuniunenls lIS a range ofspecific goals which all nations would striveto achieve by the end of mis century. 1llo)sc,

basic goals, s.et OUI in fun 011 page 61 ,

include: a rt:duetion of cluld death rates byatleast one thint (lig. I); a halving of maternaI mortality rates; a halving of severe andmooetlltc malnutrition among the underlives (fig . 2); 90% immunization CO\'=l&C(panel 13); a 95% fan in deaths frommeas1ea; an end 10 polio and IC!llllus.; d~v..aler and safc sanitation fOT an families; abal;ic education for an children and completion of primary school for at lcasl 80"A.; thcavailabmty, 10 all couples, of family planningservices; an d ohser.1OIl<:C hy all nations of theCom.<mlion .... 1m Riglusoft1u OHM.

These goals were arrived al by a proc essof COIlsullation betw<:cn KQvemments and

,

THE STATE OFTHE WORLD'SCHILDREN 1992

The year 2000 goals:one for all and all for one

•

FOl'the lWOs. !heIe Is a broadagreEmIIl rt that~ess os beslllClilMld ~ IY\iII'1<et Jctoes dowhalmorI<oIlorc8s <10 beSI and go.ten'O'I1llOI 00 wh8I~dobesl. .... pa<ticUar.~ISIJCN1l'I"IllO'tthat m,IS1 guornnt.. !hII 1oog-tem1 ffleslrnefit ...pe(lpI8, 11 IIlei" haaIth. nulI1tion and eau::ation.wlltocuI IOI1ich 1ltO ... ,1iC progess will be bothK>wfld i\ pece MIl lleprMlll oi PlIJ)OOO.

10 Seplember 1900 II'e W<;:r1d Smmt IofCIlben,~ lOgelhe< lIlIIdB's !rom """" , 50naliooll Includiog 71 PrllSidellts and PrimeMi'llsl"". translated the id9a 01 ~ing illpeopIe' lntoaset rJ speclIic goalskr theyeIlr:zon1hII s.......m 0edamIi0n IIIsO pooo,ised a rewIX'6C8lCOI'IYIi\menI.Ioog ""'~Ii'1k-'wtllIt car> be 0\lI'le and _ ...... be d<:tle. ProQi 8l' .,,,"01aetion torr-**'Q Il18jUr2000goalswi be drawn up by mos1 naIicns OOfonllhll.ro 011991 (peneI2).

The gotlIS. lwerJlV·_ iI'l ... ' nduo:la " on&It*d rea.octl::#l n d*.l deaths. II~ 01 CllIclmanutriIioII. a hlIMnll 01 <ieaIt'III ,...,.".". womendrng~ and~. ........,.saty avaiabI8~~ ""'" watll" and SIrilatieJrl letIll, WId baIlic «lJCatIon b' aI dtien. Momspeollic ChJd haaIth goeIs~ Ql:m iItm..nza.liM. po(o 9ildcali<W t, !he /lWrinaIiOtl 01 reonataItetanus. • 95% raductioo " mo'laSIes deBtheiaJmlrJI/)' abDuIll4O.lXXl '**' yeIlI) , a hllMng ofctikl dealtlsCWl"d by~(4 ITilklna yeor),and a OI'"e-ltWd nDJctIon n ctiId lIeolltos from~(3""" a.,-\.

AI. 1Y$1 !Iighl.~ 01' SO MIlI'IY WgaIS seams(Hf!r ambilIous. I3vt the 'OflIl fI;r aI . III "" one"relationship betwelltl lIlem mak8S ~ leasible.~ d*:I rn>IruUiIion,!or~~r«\oces cNd o:leaIhs. Ra<1JcedClllcldoalhs-..

thal mc:nI flIInlIlls bea:rne irIIerlls'.ll(l In!amlypm.~. Mom arty pi<ning~ rnaKlmIIIlWldctit:I haolIIh. leId->:I ln nm to berl... 1"lJlIi!ion andIew9rdealhs. The mot<! that .. """""'" abDuI "'-'Chsynergisms. thestJoo 091 !hIIcaseb'~ alId11>3 yeIlr 2000 g<;o.IIs llithIlr \QgIllhIlf 01 il r;tlSII.......

1nseni1g lhe new~ 1hoSummirA::rC'tiwJwas er'lCI:UIIglId by II ......... i'I rllBdling 811 00I1iBrgIOOaI tatgeI- fIO'Ilo CllIcl~ •~ hade-,Bel i1thel8!a1970sat atWre 1'ltoIo'lll<Od lilt ... ,lXMlflIQ8"""" ....-.log at ittIe rrae It'oao110'll0. ~ ..a~ _ oilers rno:m1hon moraIllI'I<X>I..<lIg

ment.ln'rrulzing BO'Ib has ITl!Ia'ItD<.tdingasystem1halCI>"l deiMlr...wms to l 00 million W""ts Ic:u<:II Mt Ii"ne5 a \"<Y. 1hB orgarizatilnal legacy 01 IIIlIis. ~ !IUSIahld rod lJIi eo oglIe led i\ Ihe 1990s.(:OJd h8t> ac:tIo:Ml rTWlY 01 hl new~ Am ""YoMlrmu"izaIion. a~oI lCm-<:osl~

lira rt:1H avaIabIo lor~ a t1ealing 1h8pl<ble<'''1h8l ClI<I5CI iI1lNi1l ttTtlll quBJI\lflI 01 illIlOday', <:tikio:IaaltIs.m <:tiloj rMrolIri!ion.

AI !hII St.monIfor~ , 1h8 world', -..lII:!Io !9"d '10'" III 1 ' .. lhil _ 10meeI_'XJmmillT_ts". The1Ol3lCOSlhEIS~aetimled at $20 biIion a ;wv 1tnloJgto.JI 1h8199O!lone! III _ """ lhi1:l 01 !NlI~ r.oo 10come tom i u tn, 01' a ,_ . a" OJ01, !nI8'.~ao:l.

TlisIlXlnl aidreq..-ed llITlOI.f'IlS 10less 1h8I11%0I !h11~ worId',CU'n!<'il rniIaIy expen.~. so,noymltooNgh a price, in!hllposIcdj_ ...", 10 _ Ire !MIS at II1!lI>j rrilIiors 01eNdAl'1.~tha~d.many """"'Il"O'e,lIbw 1h8 world's 'lila 01 populaIia1 growth. andmel<e thegeE'll$Sl 01all~''' I$in the future.

Fig. 1 Child deaths~ l'fbrld Summit forChiId~ ha'I \et the target 0/~ one lhlrd O'ftItxtion In UnMf·""" d9th. by Wyear 2000 (Of ~ reduction to 70 I"" 1000 birth< _whk~ illowt<).

The chon <how1 the~.. in ff'dudng childdNth. from \%0 to 1990. The whl!l! UIll"I indiat ~the progreso N<:h region will~ 10 ad>_ l the)ONr 2000 LI~ ,,10 be m<"l .

the sP«iaJized agencies of the UnitedNatiuns. ThC)' are based on a review of thespecific, IOW<051 opportUnities now available. They therefore represent a comprehensive programme for narrowing the p pthat has bc:cn allowed 10 open ~twecn theavailability of low-cost lechnologies andtheir application to those in need.

Trends in tJndef-five mortalify, by region,1960·1990

The ch.1n doe< no! Kwr~t~ relIect ch¥Ige< inunde!.fwe~lh r~ "' the <KOfld~ of~ 1960<a<~t Ilgure.ve noI avaiIlIbIe lor JT\iII1yCCiOJlltrie<, 10p.1IticuI,I<. the~ of~(<Mf~ <in(e1985 ....~ftdu(eddMm.But in_((IU1lrie<, the dednt N>~~ by the _ (mi<

;nl~tto~dumglhi<_period._ lH:U _ _------ _-_.-

Thc agreemera to that programme, byvirtually every nation, marks the rejection ofthe long-held notion that the problem ofmalnutrition and disease is so vast andineviUb\c that nothing significant can bedone. In its place has come the recognitionthat the great majority of child deaths, andof the vast weight of iUnC$ and malnutrition which lie ~hind them, can nO'" beprc\'emed rclath·ely cheaply and easily.

One of the first consequences of theSum",i, has been 10 accelerllle the progressof the Comoenlio" m, ,I.. Riglr/./ oj 11..Child.' The Clmwmio" seeks 10 establishminimum standards for children's ~Urvlval,

health and nutrition and minimum standards of protection against aU forms ofexploitation and abuse. In the twO yeansince the text was adopted by the GeneralAssembly of the United Nations, it hasbeen ratified by ever 100 nations - a proccss which commonly rcquiTC5 a decade urmore. The C.",vcmio" therefore takcs ilSplace alongside the commitments made atthe Wur/d Sum",i, J07 Childrc" as a sign ofa new p<;Ilitical priority for children and ofa new promise of protection in the decadeahead.

From promise to practice

,

200080 85 9070

300

i~ 200

8


It is too early to tdl 10 ..'hat enax dxdcdaralionI of the 5_ .., and the si&ninaof tbc ecmw.u,;", rep resent rhetoric: whidI111;0 cdlo o:\'er mere WIlily down !he }'Un

ahead. m $C)mC nations, it is &1rcady b«om-ina clea r that !hey rqln:$enl • IOIid in tentwhich i, already being trsnslatcd in tO practical action (panel 2).

One of the firsl tests will be the drawingup of the dctailc<l NJfit;maJ procrammcs ofaction for achieving W S um"';l pis. AU<;Ol,Irltric.~cd at the Su",...u I&J'CCd.10 formulate such p rogrammell by the endof 199 1. By Oaobcr 1991, 60 counlric:shad rc:adl£d this first saco: and tNt number is ItltpCCtUI to surpas$ 100 early irli 792. Sc:JrM llJiddie.iDoome dc-\'dopincQ;IIlnU'irs web as Pml and MGieo hal'''begun impIcmcnting thcil' procn.mrllQ

knowin& lhat mosl of lhc funds "ill ha'"l: torome tIU'ou&h Ibc difficuJl PfOCe'" at reaUoa.tins inR:maI~. 0\heT prograJllJIXS, espccially those being m-wn upby the countries of $ul>-Sahatln Africa,will have little chance of bcinl put intopractice unless at lcall SO% of the cost ismel by inCT<'a!led aid . In lotal, it is estimated lbal the fmandal n lOultt$required to reach all of the year 2000 gooham Ount 10 an additional 520 billion • yaT. '

O f that sum, twO dIirdI might be found b)'the deYdopina councries themsdws andone thin! micfu be maoX .vU1Ibk in addiliorW aid (Ihouch dx ",,,poilion. will \wy

from "'cion 10 rqioo) . The 520 billionwtaI is about Ibc same as the worid ntNI

~ on tbf: miliwy eRr» ......

As Igrecd at tbc S-u, many indusai·~ nations ha'"l: beea reviewin& Ib:situation of dtildren in thc:iT own counuiesand examining their aid progn;mmes lO tee

•

how thty micht~ sen"l: the S_Miipis. The ~ okci:sion by eeNetbmands 10 panl 57.5 million for debtrdid for chiJdrm's progmnmes inEcuador, Honduras, and Jamaica (whidlwill buy b.ek dd>t of II leaSI twice thaiam ount in local cum:ncies) is one of thefirst tangible l'e$Ulu. To monitor tbe process,the I.)(,velopmem Assislltl1ce Comrrane e ofthe Oriani :Q\tion fo r Economic: Coopenltionand Deve lopmenl (OECD), which looselyooordinata the aid policies of the indusai·atiud natioN, is eonsidcrina Ktting up themo:d>&nisInI 10 analyse aid aIIoalions inrdation to tht~ goals .

In ee Iut 12 months, most "-k ofSI:ID: ita\ 'e m:onftnned 1beir commitmenrsII rqiomI poIiticII ga1hc:riop, induc1in&\hi: 1990 rroenina of lhc: South Asian Ass0ciation for~ Coopc::nIinn, Ihc: jIInc1991 SIllJUllit of the ()rganilatiIllI ofAfrie&n Unity, the Jwy 1991 IbaoAmeric::an SI1ll'tmiI in Gtiao:\aIaPn., !heOctober 1991 Commonwealtb Co nfercna:in Zimbabwe, and the December 1991Summit of Cenlrlll American leadet'1.

Children • an d an end to the wontupem of . bsolule poverty - .rl: th~fo",

on the politi<;aI agenda as no:va" eercre.And if mectinp, d«bratioN and resolutions could impnm: nuaition. heIhIt, andtd\Ic:ation, thm Ihc: priority of dUIdren in •Dew world ordc.'r wtJuld be assured.

n- unprccedc:nttd politic:al eornmitIDCllU l'CplQC'Ol ID oppoI'tllllity not to bemisxd. It has b!& bf:.", bmm.trd that whal..... I:adtina ...... not lbc InI:lIN or C'\'aI the~ but the political vrilI 10 ticklethese areal problems. TIle: C'\=tI of thc "Itwo >-eIn represenl the: gratest promise

80

70

60

Rg. 2 Progress~~"rt rn~lnutrftkm

The 1990 World s"mmir lot ClUJdrm~ tile goa l athaMng child ....Inurritioo by rhe yeo, 2000. As rhechart W>ws, this wm 'KIUi~ 1'1\Kcl!l",ation at pastpt<>greol. Almo>! no compotativeda~ em! fOf Africa.

Halving child malnutril ion: post trend5andfulUrerequiremenls, 5tlf'(ted coonlrie5,M ia and the An1<;>rica5, /915·1000

ANtIUAl.~...n~~ ".',lf"","

~Oll tronIl(l t1~lm)

5%-----...7%90 95 2000

The IeYtI at malnutrition fOf l!19O i. ~ by tile monrecenl ",Umate availa~e IOf each coon II)'.Malnutrition b defined al rTIOfl! Uwl two nandarddeYiation~ bdow tile de$ita ble we;ght lot age, andcil ikl ....fnW ilion rdl!fS 10 tile child poputatioounde< tile 19" at 1M.

- '-»- ''''

that has ever been made to the world 's children, and the gTCatCSI opponunil)' forbuilding sus tained politiaJ suppon for theircause. It is now time for all concerned individuals and organiutions in all countries tomobilize behind that co mmitmen t.

Participation

lbe World S ummit few Childrm and theCo.rwmie" on IIu Rights of IN Child arcpan of a process thai has alrea dy yieldedextraordinary p",ctical results in the lastrew year.<. The key to that process has beenpolitical commi tment rrcm national leaderships roU"''''ed by the mobilization of a widerange of n:s<>W"C(S to see tha t commitmentth rough . 'fbe immunizatinn achievement,for e=pk, began in the 19805 with declerations and publie commitments by politicallead ers; n has since bee n mmslated imoactio n with the support of many hundredsor thous:mds or people in both develop ingand indus trialized worlds.

By the mid-1 9805, most heads of stale inthe developing world had made and signedpolitil;al oommitments 10 the 80% immunization goal (lig . 3). The sheer scale o f theprofessional and public mobilization thatfoUowed is sometimes difficul l 10 graspfrom the pcnpccti\'e of the ind ustrializedworld. From lowly beginnings in the late19705 and early 19805, a system has bee nbuilt which now rc-..ches OVer 100 millioninfants - and their parents - on live separateoccasions each yea r. Againsl aU logistiOlldifficulties, this means that O\'CT 500 millionseparate contacts are now being made eac hyear between modem health services andchildren.' The n:sull o f this elfon - the

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-

Mexico:keeping the promise

rc

Most00U'IIt'iaare00'i preperr,g Nal:icw'>aI Pfo.lI"" . '''''' 01 Acllcn (NPAa) b ,ee::hillll lhe gem8QIged III trl!I 1990 Wcn1&nmt b 0'\iIcnItl. Byceeee 1991,60 00JI1ItIElS had IiM2ed1hei' planstnd 1hal rurber Is~ to Iaachaim:lst 100by the tnd oI ltle _ . The targel!5 Ir>ct.dIl B ore1hi'd .9dlt::loon In d"il<l dMths. a I'dW>g 01 eNd~, <Ind~ schooIlI<l.ocation lor at1eas1l3O'Jli (page 61),

MooJ,"_"~~!!ffl~t'!!'~o!!, !! '~lot~e

thotp-co'rise moprac'lil:e. o-.e ........... is Mo>:i<x>.wto/:lII Pt&lk1t:o II. CIlrlos S<lhts oe GorwI. we.,or.e oI 1hol iii>< 1ritia.l00l at the Swml

TO'WlOlIs II'ie tnd of 1990. Ptfl$<llll'l 5ahlscaIed a mae\i'lg 01serb mnislers todllClda rowMe>ck:o 'o'«I'..tl \10 about lldleYfJg lIl8 SamiIllOi*.~ was 10be Ihe lirsl lnaseries or silc~

C8bioel reWows - CIlElinId by ltle Pt"'"""'~ - tomonitor ",ogress for Ihe MI""'·. dlIid'...., Toooordi1a1a pilJrlI'ln;j, thot Mf1is1er1I 01 Health iIJId!'do "'8""" ;nj 0Iher -*" goverrmBIll ol'k:ialswere appoXlIed to a NaIionaI Coo ," '! S':lO I tor theAd.",,, ,, oIlheSUrront Goals .

By Novermer 1991, M""",o's own NPA.~e wilh b<IseIinII data b 1990.~Me:><lcarl twge19 lor 1994..-.l 2000. one! """""",' ... ll<llo1$forasysltm10Il'lOI'Ill;o- prog<6SS - _"IlJIf(Mld by !till g<MII l ' tOO II.

t.m .wI'lileJ.UNICEFwas alSObei'IQ """ca::l18dby !he Mayor of Mal:ico~~ 18"*"'l.pUs <>!t'e' rnayors<lndSl3le~ Ie< assisl ·llIICe In a renewed na1ianaI el!OIIloI'~

In all (XJJlIria:l , ..-00 restrl.CllJ:ing of govemmen! bu<lgel' WllI be recessary• l!le _ 2000goaIa _10be~. One ol IN firstprooIicalllC\r.lNl n Mw<io:> has boIIrla40% ; ... = In thobudget of PRONASOI... ,.... """""'mefll pre>g,mwhichaims1<> pr<l'I'idebasic_toIhePOOtest ftlItl or Meo<lco'sl)(lq)lB and wtich 1010 be

a mainvW1ida for IIlCJVJlg !ho COU"llry towa'ds Ihej'6Ilr 2OOOgoals.F'FlONASO.- WllI OOW~$1 .7

b5cn in 1991 -~ 8% of !he QOI'& i " .d'S lOl8I-_.Other Il(:bom lor<;IiIdrqn n t9911"d.lde:

o~ IWlh 5\lo'\Ooo$ ~~PflONASOLhoMIbeeo1"'-lI' " ... to 15 _~ n Ihe IXXlr8Sl viIages tnd city~· a25"' i .. 0YIl'1 9'ilO.

o Se.m 0Ul 0131 _ .... plIs Melcioc 0It)', _IU'hed imllrilat (>;N(lr3glI tQ 90% of ......Iiws. MmOro's t'f"A al oIrrIi::>&l lOO%~

byOclOb.... l002.

o DIstrbJdon otORS - 10~ ctb9n iIg<WlsI~ ca.osed by m il...... -has ,......, to 20rnfioo pa;:keIspar 'fOOl.

o A Moxica"t >«'SIioo of Facts /0( IJfe has 0000produced (pInIl16) Wdh390,00:) wpies po..dshadl o;> dat a End 1",.., pl!n'>ad bV end 01 ' 004.o The \YHClo'l..N1C£F code - r.,~ Jl;ISl'C'C"JS'"'U'1:veas1Hldng -l!l beirog rmde!lWl<D'dproctiQa In ..... hc>&pital ln ...m SlalII and """'In~ Cty lJuB '21. n- 36~ ''bab'i'-!ri<n1'y tIc>spoIaf SIalIlS End .... acl B5

Il'l(l(laIIJ lorIIImatIlrJ'ltV urrIS Intrle <XlU:ltry.

o T!nle mi5cn rn::>m paope WIli'9 pr<Md8d withctW<Ing _ t...., 1991, Dmging tha tolIlI_ to7lJll, of Me>ooo's JXlIl'.*ItOt n., am III 84% by1004 End 100'10 by 2QX),

n In III 0Iher C(UIlileJs. ~ retrI8IOJs to be soonwhelhef Mexico's COill ;bl.d to /lCtIieWlg Ihe&m-nlgoalscal be lIUSIaInad In tile Iai::$ 01 al1Ile~ \OotOch Il& 8Ilead In the 1990s. Bul in 1118fnI 'fOOl alter ItJ8 WOItI&mnIl /0( Cttilln. " l!ldear It>al~ tha ives End tha IlOI'l\"I8Ioe.. :'», "lI'lI 01 tha r.aticJn's cI'tien hils lISSI.l'll(Id

8 Il8W p<lliti::al prior1ty.

Rg, J The Immunizat ion achievementIn~ 1.Iu. 1970:1, ""' ... immuMtion reachedodtob<>ut IO~tol ~~WOII<f . dlildren,

till: inlema~1 (ommurnty~ !he ambitiou. target01 80 po;r<:...t Immunll.llion by 11M! ....t of 1990. Thedurt sI\oWl. till: resulu of till: t....~.r elfDtt.

Increase in immunization(Overage,childrtn underone year, all developingCWnlries, 198 1-1990

'0'

~ ~"~'~"C~"'=''";<::J8~S:J86,,=~8~'~88~8~''JJ' "'~:The)'eM' 1981 to 1985 a, duderogures for China• for pregnant ,.,..,.".."_ ""'" _.-:t<, _ ",..

largest international operation ever mountedin peacetime - is that tk liva of a/moJl9.000 chi!dmo a lll «ing sawd It!try day(fig, 4) , Another result is that there aretoday almost 2 million children who arewalking, ronning and playing normally inthe developing world who would ha\-e beencrippled by polio wen: it not for the intmu.nil<ation effoRs of the last ten Y"an. And aschild malnutrition is caused mon: by thefrequency of infection than by the lack offood,' the prevention of disease on r.hisseale has also helped [0 protect the normalgrowth of c"cn larger numbers of theworld's children. For the furnre, the Immunization CffOR has laid the foundations ofan outreach system which can now begin tomake a"ailable other key elements of primal)' hCll!th care as well as delivering newvaccines "" and when they become a,'ailablc(panels 14 and IS).

Also in the early and mid- I980s. mon:than SO of the devc!oping world's heads ofstale made a commitment to making widelyavailable a method of preventing dehydra tion known "" oral rehydratio n thmpy(ORT). This simple and almost cosueestechnique can enable pate nts themselves toprevent or treat the dehydration induced bydiarrhoeal disease. At the time, ORT waSlime knov.n outside scientific circles.T oday, the participation of millions of peeple has carried this life-saving knowledge toat least one third of aU the families in thedeveloping world (fig. 5) . The result is theSlI\ing of over I million children's liv~

eaeh year.'

The practical importance of this achievemen!, too, can easily be overlooked fromthe balconies of affluence: . Dehydrationinduced by diarrhoeal disease has killed an

"

THE STATEOF THE WORLD'SCHILDREN 1992

c:mmated I so million }'UUD& dIildrm in dlcfony yean of UNICEF's uiR~ .~!han !he combined ch'ilUin and militarydcWts of both 'oI'Orld wan. II rmWm oneof dlc bigesl killen of childTen in !he modem world. A simple and inexpenli,..,melhod (If ueating or prevcn linll thai dchy.dtDtion hll1 been available for 20 yean. Insak, II is I I if a cun:: for cancer had beendiscovered and then TIOI used . But today.the lona-<lVerdue move to put the knowIedic and lhc: llU,:lln$ of pm'cnnne thedeaths and tho: malnutrition !;auKd by diarrhoeal dix:asc: has now bqun in amcst.

Such achievnnmts demonsnte: thepocmtitl of poIiriaol commiDnm~ combiixd ....i !h the dcrliarioo of tnt peofessional KfVica and tho: participation r:LIaqc nwnben of peopk. 11M: expense andthe '-knhip of tho: health llenices hasobviously been indispcmbk, bu t the halthsc:rvica alone could no! M~ brou&ht abo.n~u on this scale. R.cadUng 0\1\ tolTWly hundreds of millions of ram~in withinfonnltion about QRT, or informationabout tho;: when and the when,: and me whyof immu nization. has been achieved wimthe participatio n of the IChools and theman mcdiI., !he: chutcha., mosquea andtanpln, the poliDcal. pa~ and profe:uional bodies, lhc business OCImmuni[)"

and the n des unions, the IIOn-lO\'mlmmta! and vOOmm)' otpnim:ionI. Wwomc:n'l If'lllIP' llIld 1ht JlC'OPc:'. l'Il(M:D'Jl:Dl1

Many~ in dlc industria/iz.edon;rid ha\"e cn-en financial and u:ehniadsuppon ( n<ll Ieut Ihrougb UNICliF whichis lhl: la rgest mterlUllional 5IIpp!icr of Ihcvaccines used in roching the immuni7.ationsoaJ) and many noo-smOCl'TllnalIai 011:anizations in both industriali1.td and

"

Ag." Three million savedThe ld1Oe,o'", . <If lhP: 110~ irnrnlriLItIontar!Jd ...!he dl:' 5 , • '9......te1 i.._ proaolil'9CMt ttne million d'OlcI clNW NIdI 'fNII.

DtooIhJ~rtd and Jl iH occurring, fromI'OCcine prevrnrabk distastJ, in milliom,all dewloping coonloo, 199/

....

....'1.7 MILUON DEATHSrnu OCCURRl Nc;

'--_ ...._-,..,.

(ko,'eIoping natiom NYc mobili=! ,"wortfrom ...ilk "",bliI;. To cite the moN 'protKIl1ar example, ROW')' lnremaliorW hasmobilized htuKltt<ll of IbouutKk or itsmembers in a1rnoM .n counlric:s, indudincilJ; dupt/:Q in Africa, Asia, and LltiDA:neria, to provide vahllnee:r1 and raise..d O\'a S200 miIIiorI in IUppol"l of "*CCinatilxl Ipimt polio lbe ~fund-raisina dfon evel" undaukm by •voI\Intuy KI'Vice orpniution in IUpporl of• specifIC Cl.ux..·

Mobilizaticn on • IimiIar $CI.II: ...-ill ben ......, in all oountriet., if !he C'OmllliIr1lmtSmalk by die: WlIrld s-.ir /tw Orildmt areabo 10 be convmed into acme,mu,

"The ptllCXA of wt\idl !he S-.it ifI*t. and !he MKW dwl&a it bas IIreadybroogIu Iboul, iI 1hem0ft &nOlher dirrlmlion of !he commllllia.liom revolution andthe tncreuina: pvtic:ipIitilxl of people: ..'hichis . , the eenrre of alntmlponr)' politialand economic ctwJce.

Ptople', promise

The incrasc in both political commiI·man and IOC:W mobiliu.tion for chiJdrm in= 1 )-ean offen ru$On&bIe I.;)pe that theneeds.oo the richu of the ..'Ol'id', dUIdTen.and particularly of tbosc bwJdreds of milIioos who 1Kk e\'m lbe bti>a of bWth,t1utririon, and education, w:ilI fir>d • pbceon the qaxb of the new worid orde:r that• lIlI'II' anaginc.

On bdWf of peopIa as wdl as of p"emment5, !he w....u S-u p CU:fJiA

InS • promise to the dliIdre:D of the 1991lLIt ...... pto:aniK to use uxby" knc:nv\alae.tec:!lnoKlCY, lUOUl"CC:$, and c:ommunic::atiom~ I tl poOl£et their IiveI, their pooo"tb,thcir hc:alth, and thcir ri&hts. It "'U •

ptQIni$e to end the quirt CI.laItIOPbe ofmamutritiol:l and ':1" Ie and iDiterIcJ. Andit "'U • promise to I:ttp thei:r IIC"C"lb andthe rigttts on the in[C'fNItitlnal qencb u •_ work!. lll'de!' C'\"OI\-es itt ee lkClIde

"""'.1lw promise m ust tlllW be kept.

"

THE STATE OF THE WORLD'S CHILDREN 1992

Immunization:still a bargain

The i.9s of 3.2~ chilii'en8 ';fiJIII!' llnl f\OINbeing S8'>'8d by \he i'mu'lizalIor1 9IlortlI of Ihe1980s.31nadcIti::ln, lha<e..... IIhlO!Il 2 ...... d\id.

"'" who "'. ".".. waI<rIg, ",.....;ng 80d pIayhgn:::tmlItt ...!hi OIl'> ' . _1\1 waId who would hlMloo.J~ by IX*' ware ~ Il(Il t:< Ihe lIdlieY&mon1 oflheOO%~goS.

Bol • irInI..ftz8tion W8$ the groolest p.Jtkhe3/lh SlJlXlI!I'SS S10IY of \he 19!IJs. ~ raTlllins lh9g&.tlest~ I>eaIth c"r' e og&oIlhe 1990s. BytUdi'>g onv.haI has t-1 """""""I, ~ is possible10p«MlI'II 8 fuoIhor 2 miImc/"joj deBths9Ildl~.BIId 10~the~ of~

ceeeee on o;ttI mahIIriIion BIId 0salliIIy.

No! only the d9YeIoping ""-""d SllrIdo to ganPdio ..adicalb .. tor exan IPl&. would save IhelJrj[OO Stales CMIl"$11 4 Il"iIlcn a l'38f ...~llIctla.' The C051 01 8f'3I:icaIion?~$100 rr6Jo aI'esrtor 1O)Wl'S.'

ThlIlirslct ' ogeis to rllIS8 nmnzatlon IBveIswhenl CIMlfagI!I stl lags. l'l easImI mel !lOUIhlmAIri::a. i'\"mrizabon reach&8 0I'l0\I 00ll.."1hlIllim intho 1990s n'UII be to~.. 1tI8~ ""Iha1IheY-200llatgel.Jl Ihe<:l8::kVt 01 <lisease.ThegeMset by the IVI:I«ISLmn/! lorCIliI::h-l"""......naticn '" IlIIOOalaI lal!n;S l536.lXXI _8.~. eradicatlQIO (J/ pOljo 1116,0):) cases ayew), and 8 015% redl.dic:n in rr--.. _(84O.0c0 a yoor).

TlTll. lhOOi ill lheer r "'" of~ vooci1esIl.dJ as hepallt\I B (panel 15) to Ihe 1r'rIrAlrizmiorsysIem nn::l Sl"llJlir9 .... """"""" on!he d*lren'sVllCCir<I ntiaIMIIp<nlI1 4).

8ul by tar me~~ oIlhe decade,.. be to bIlgIn l:1uid'1g on the orgonizational

~ 01 00'iIL O'rm.nizalion in ordll< toPfC"'iOa m:;lIlI ..... i ipI"oS J6 pIkroery-.an.

The~ Iegoacy of~_ ill 8!1)'S'tern!hal00'i makes rl'<)/flliloln 500 rriIIion oopera18COt1tocts bel-. h8allll lIOlr\o'ic8s lrld diIdmnfMJf\j yeer.' Thal system .. ""'" bego ' .(l to beused to09iver 0llW llital* ...""01prirmfy_are suchas ¥ilM1io A ond iodne .......... ,.. ,1>1••Mucnmen remsins to tl8 tlaOfI. Andthe mortI1hesystem is used, !he _ II1lI ...-.II CQGI 01 eachservao ~ oeivers and tll9 mom SUS\<iI'IllllIe ~

!l«:ol'l(ll.

EYen rT'I(Y9 f\IIdlwneol~. lhe lrnn'ulizatIon9lIM has m;ld;I 8~ towards prrl'i!lOVh8aIItl an> by "_og "OCiaI~ 80d~ cherooIs bd'nl • mejor heolIth~ It has d... lIb. hoIpad """'" heo/lhi1Io8 so::iIlIon<! not jus! 8 rTI(I<iQII raspoo iSItikIy.

Formany cI thet-Ilh """"""'" irwoIYed. <eachilg for~ iYtn..rlIzoti;)n goeIlIes "-'I'~.'I/

alSO 10< " newIdes cI wt1Q Ihe .... <;USl<lITl!n In nD1 lhIl pIlQpio \\too WIll< It'roI..91 c:hc doooi bill~...,lire poplJalloncl" QMlI\MlB. Goi'lgOOJI 011olh8~ lUreccu I!NI¥YItVa i1inl Wl need01 .......... ldlio:> , has bl9-fl lh8 IlI"')CeSS ol <::tdMldMIl rtq.bt oontact~ hea'th sevcee a'IdwerytmfoJ.

'The 6Ibt II8S not GW( s~ao ¢leollMJ ti'lgptrnlItyhedlt>CMIS)'S1&m'. saysalJNlCEF....__on lh8 irm.ni>alion lllIort n IIIe 1geOs, '~

has IIJSIJ~ • tar ........ llElCIicrl of sociIlly/awards " 100000WJ sodBI goal. A new l!Mde>S!:,led_'-h

stn't:es I¥ld!he ctm'IU>'ly I!Ji!IN/!D ... a tel' kMII'"""poc!8lion _ COf1mtm8m 10_. TI>/IIsa, r.lhe/ongIt'!, lO'lI /1'18~ba'III/iIsoI lhei'rVrJtri.zati;)n II/IIcrI, _ lhe /at:.1cfs mostIhIy 10acetlU'lllot~~ _ 9>'9I'll<a'~ lU"

tnij urNrn;JiP "9' ",,"''''~ fa' il'IO<'lt I1IIIIl~ti;)n seM;es 10lIaO'lllftdlMll'YdiId."

First call for childrenProposition: Thai 1M pri,lCipk 0/ 'fiTS! t;a/lfor chiJdrttl ' - mttlning Ural prol«/wn fin 1mgrowing IJodia and ",ina. of 1M young ought10 haw a fin! f a ll 011 $lXitrUJ' rl.!()un:t.l

Jlwuld b«.ome 'Ill uue(llcd emU; tJ/ " newn..md order.

The World Summit for Clri/drm calledupon all runions 10 be guided by the principle of a 'fIrs t caU for childttn' _ "" principlethaI 1M. wmriol 'Iuds of all children shouldbe giwH high prioniy in lht. allm;IlW" of~,>US, in IHui '1'- as wtU as in goodtim. s, at national and i" umalimuJ kwh asfL~1J as a/ family kwh. " lI

Til" principle of fIrSt call for children isfounded not only on the sands of sentiment. M 05[ of the mental and phpicalde'~lopmcnl of the human being occurs inthe lirs! (1:';\' years of life. Those yean areme child's one and only chance 10 developnormall y in brain and body and 10 grow 10his or her &\'oetic potential. If the ,'llliousStages of !hal de...dopmcm arc not complctcd at !he appropriate time, then lastingWunagc may be done \0 the complex processes of growth . There is no Sl'condchance. It is on the bedrock of this physiological fact that the principII: of flf'St call isbu~t. And it is lherefore a principle whiehdemands that, even in the wcrst of rimes,the protection afforded to children shouldbe the la st clement of social prolection 10be relinquished fIIther than the first to be:sacrificed.

·111e principle of first call is pflletiscd bymany parents in all countries. But the process of advancing civili7.ation is C'Sso:n liallya process of instirutionalising th""" [merfeelings and Jtighet principia which humanbeings int ermittently show themselves

capable of. And it is in institulionalising theethic of fint can, in automatically embodying that principle in the conduct of itsaffairs, that mankind has SO far failed totllItc the step folWllt"d for civilization whichsueh B change wo uld represent.

~allse the child has only onc opportunity for growth , and because the proces s ofthat growth is so subtle and susceptible, theessence of the principle of fll'St ClIU is thatprotcctioo should be not juSt B priority butan absolute. 1n other "'-ortis, the ehildshould be: able to depe nd on that commitment at all timet and through all difficultiet,rather than being at the mcn.J' of shiftingcircumstance and competing priorities.

In particular, the very essentials of eh~d

development + love and caring attention,normal physical growth, immunv.ationagainst disease, basic health care, and theopponunity 10 go 10 school - sho uld be awmmitrncnt which all societies make andmaintain in good times and in bad . Thatcommitment should not waver in times ofeconomic recession; it should not give " 'ayto the short_lenn demands of structuraladjustment programmes; il should not bowto the pressures of panlculu interestgroups; it should not fluctuate with the for_runes of particular political parti es; it shouldnot be shaken in times of turbulence orIrBnsition; it should not be: subordinalCd to

any ideology; il should not even be suspended in times of "''aT or civil . trife. It isin such times of stress that the principle offint call should be most tenaciouslyadhered 10 bUI is in practice most frequentlyrelinquished.

From UN1C Ii.F's perspecevc, il is theevents of the last decade which demand

"


that this principle of fin ! call be vigorouslyadvanced as a new world ord er begins totake shape. In crisis afte r crisi$, and incountry after country, Utis organiz:ltion haswitncs~ the consequCIu;n of that principle not being in place. Whether the causebe the debt crisis and structUral adjuslmemin Africa and Latin America, or me turbuknee of political and economic transition inCentral and Eastern Euro pe, or the shifl inthe political ph~osophie$ of many industrialized countries (panel 5), or the outbreakof War! in Africa" or in the Gulf, it is chil dren whose lives arc the most devastated,children who will bear the scats fOT longest,and chiJdrm who ate paying the ultimateprice with the loss of their one opportunityto grow normaUy, (0 be educated, and 10acquire the skills necessary to earn a livingfor themselves and their families in the 2 1stcentury.

So little heM is paid 10 the consequencefor children of the mistakes and excesses ofthe adult world that there are virtually noffie.:halilims for smsitively monitoring theirnutritional Status, their patterns of diKa5e,or their IC'o'C'ls of enrol ment in school. Evenin times of turbulence and transition, whenaU experience sa~ thai ehildl'tJl will bemost at risk, it is still easier 10 asccrtllinhow many video recorders have beenimported Or sold in any given month than itis 10 find OUt what has happened (0 thehealth and nullition of a nation's child ren.

Wc do m ow that it is children who havepaid the heaviest price for the developingworld's debts. FragmenlJlrY evidence,pic<:cd together by UNICEF over the lastdecade, " has shown a picture of risingmalnutrition, and in some cases rising ch~d

deaths, in some of the most heavily indebted

"

countries of Africa and La tin America."SlII've)'$ b}' UNESCO" have al.w shownthat the attempt 10 adjus t economics lO thedebt crisis has caused school enrol mentratios among 6 tc 11 year-olds to fall in atleast 50 of the most debt-ridden naOOM ofthe dC'o'doping world.

We also m ow, !O mke another example,that it is young children who an: at thismoment paying the heaviest price for theGulf war, In the first study of il:$ kind C'o'U

undertaken, it has been found that childmortality rates have increased steeply inIraq 01'eT the last year." Without widespread acceptance of the principle of firstcall, modern warfare will continue to be I

war againsl children (pand 6),

Simi1arly, it is children who an: bearingthe brunt of the hardships being enduredby Central and Eastern Europe as old economic SystClm finally collapse under theweighl of their own inadequacies andnation after nation make' its brave transition (panel 4). A special study byUNICEF's International Child Development cenee in Aorcnce," published earlierthis year, has sho wn that hc:lIth and eduearion services have been subject to some ofthe deepest spe nding CUI:$ and that thenullitional staNs of many childrl:I\ mayalread y be threatened. In Albania _ thewon t case • approximately 20% of aU children an: now malnourished and infammon ality has doubled from its 1989 Ie>·d."

AI described in panel 5, chiIdrm havealso suffered most in the less dramatic transitions in political and economic philosophywhich have 0CCUlT'Cd in many of the: industria1Ued nations over the last dcaKlc." In theUnited States, for example, the proportion of

, Exduding China

ORT~ specilIy lorolI.Uled 0J3j rehydrollion Sollls.sugar.I"~ <oIutionl. ood rewmmt'Oded~ IUd$.

-.,,- - ---.:-.,,-

In the past, il !MY have been in somedegree inevitable that the weU-being of ehiloren should be subject 10 the vicissitudes ofthe adul l world. But lodlI.y the very ba~;cs

of ehild protection, which Ire AI the sametime the very basics of protection for society' s futu~, need not be so ~y

relinquished. With toda y's new Cltpacities,low-cost protection for the health, nutrition,and educatinn of almost all children is possible in almost aU circumstances. Bynational action where possible, and withinternational support where nOI, consciousand specific policies can be pu t in place toprotect the basic needs and rights of children even in the worst of times .

A new "..orld order, if it is 10 representprogress for civilization, must thereforeabsorb into itself the principle that theshocks and the set-backs, the mistakes andthe mismanagements which will always playSOme part in human affain, mUSI neveragain be tra nslated into ri~ing malnutrition,disease, dnth, and illiteracy among themost vulnerable mcmbcn of society.

childmlliving in poverty has risen from 14%in me, 1960s to approximatdy 22% today."

Some nations have shown , in recentyears, that it is pos~ ible to begin puttingthis principle into practice. The Republic of!(on,a has ensured, in each of the temporary economic revcrsa1s of the 19701 and19805, that specifIC policies were in place toprevent rising 0;1 prices or falling agricultural output from being traI1slalcd intOworsening levels of health , ouuition , oreducation among ;ts children. Th" govero _ment of Indonesia, under economicpressure from the slwnp in oil prices io the:

1988198719861985

Fig . 5 One third use ORTORT Isao ioe' pt'JIloM: mf!1hod by which f.mil~

lIw:m~ ClIn~I itOd Ir eal ~ratian _"*' k:h ki~ more IN n two m~lion yotJr.g dlildl'MNCh yelr. The le<;hnique hil'~ t.1ughl to onethird oi l,," devoelopir.g worl<h families 10 \he1980. 00<1 b now~oting .,....,. one milliond>ikl dn ths each yelr .

Elfimated USf> of ORT 10 treot diorrtlMoepi~ in children oged0-4 yeotJ,1984-1988, by WHO region and910

01984

"as

I<30

.$",,,~ ..~(";..-,('. /#•a• 25,, .'• l /o~•E zo

~.•e• $ J• is of : ,<7z

"•. ,•to

"


Eastern Europe:transition with a human face

..

'Frs! cllIlo"~' is _ ~'~i'I

tirrwI o! crioos. 'M>olher .. IlCOtlOII'Iic ,ec . •..POlitical upheaval. 01 l'i"Il"Ifld conl1ic:1 . "l"'C'f1CpoIoC:ies 10:& needed tG prolecl h ctikj's a..opport\Iity to flOW norrnaIy ... rrind lI"Id body.

UNICEF hils a<Mx:aIed ItOs 1> ' w;:ipIe lor th8dMlIopi"g CO<.fIlt\e$ ... they ad<JIlC "'*""""'"policies lQ IOQP'.II'<iIh \lebIlW'Id '.... if;. ~ Bull~UNICEF stu::!)'...PUbIst'Jed i'1 1991. !lhows !hat thoPl; qie IS also reIevan1 lO ew...,"~ IICenlnllWldfastem Wope.

The two pt. . '-1t1ICh in COO II'lOO', i'1bolh. .~. has irl\IoMld 8P9"dogaJt8 51d!hit~ d Sl'bSidies (rI Ioo:l and 0IhIWps

• otOlls. Arld in bolh . lh8 capad\'y 01 fanikls tomae! lhlir .--:Is by lhlir OW" etbU 119$~"''''''' '' 'Oldby~. fllling i":'o"_and .-..g prices. N. the same lime.CUIS .., llOCial_1llMl-.d1ho "seJetynetS' JUSt \OA'1enth& SII'airl on een W!lS ircroosi1g._ •....., ~i ...~~'!~_be\w8erllate 1989 and May 1991. n Poland. lhelnloll991 ~ligI.nIilI~tobe2 miIIorI - aim::lst IS'll> d lh& latlout fotce.~e:.peC\S r81a n-.oo~by 1ha erd o! 1992 For those i'I v.QII<. ina:lm9shaw faliotl Sleaply.~ real lOCO,.In Poiandlei by 25% ., lh8 Ii'!! nine months 011990 . .,8<Ag;lria. !he • has ~ _ 50%. n~ ltie rurblr <:A oIl::i9IIy pool isll>lPeCteod to~ in 1991. IrI PoIMcIlI"Id !heUSSR.4O'llo nowlve belowlheo/fd<llpoYllItv line.

Q.Itlng~ has cr.>giId rlIlaliW prices_ rra1V "....... '"' now!iP8 do 'Ii 5O'Ilo to 6O'llI01 Tno;me on food lIIOno:I. The~ 01bt8i I!'AI. lI"Id _ ba'licfoods is """""" 10hawde<:W0l0' in B<Jg;ria.. 1-k.flgIwy. Poland. !hit USSRa'Ill Yug<lIlIa\oIL In AI'laniIl • ltlIl WllfSl caN ~1eIV 2O'lb of III ct1Jclren ..-0 nowmaIn::uished. lI"Id i1lllnt m:;:t1lIity is more th8fIdoI.tllo its 1989 lM!I 01 15 pet 1.QXJ 1liI'tt'I5."

"S<xSlIl n::<>m&' hits also de<:il >ad.Mroirrun~~l beneIiIs.dliId~. oId·aoalIB' '""" ... onddislllllltl' Pi')'.__ lhooreIJcaJ)'

mantained. to..l: ... po8ClJCe they haYlI '-' pored~ byWtalJoo.Canpar;es1\s'.1l8lso~~~ IorrT'e1y providad to~'!lmiIies. czec:tIosbJakiaCUl sperdngoo l"eallh by20% n 199:) lI"Id 00 e<:lUCalIOrl by 10'l6 In e!lCIl 01ee last two .-s.

... paol. !he 1'lEld<q"")f 01 sctiIlIsafe!l' nets IS arE&lIl 01 fJ'liscslc!o'aliorls abOVl the we9't theywouldhaw to bew. PcIard. for~.~!or~ risng 10 400.000 and i";:o",,,,,tali-og by 5~ 10 10'J1,: irlltoa8'o'EIf'lI.~roseto 1.4 mIi::l1by Dec8 ,blo 1990und_agai .::o",es IeII by 27%.

lhe""l<Slto.man~IlI... Iti!ICOIAd<*mstl,B'.any IlaY8 beenlMlicl8d.l.WorMa1eIy,there ..... !ligIs !hal It"e balJjI III ..........., ...........mooso.res ;ll bang It\l'own ou1wilt! !he bathWIll...01state CXlnlllll.

floosonabIo indemg III benifu. SEII'llOtNemorj.torir.g III cha"lgosilctlIkl ......bEIOlg, aweIU targeI.r.;; III iMlIIabIIl,~ fnllI schooIl"I"l!lEa. foodS\llI11lS 10 ........... m1nirrun roJIIitloMI S1anderdS,and1hemai1~'" baSic lloHIhand.........ooSIWVIoes · ... oIl!leseCOlAd NMlprtl!tlCIed 1hemostVIklerabiol. and eo;peo ie' f !he chidren, 8!1 EaslemEuope _ its bfave lrin8it>on to d!Io'QOaticl)OIIicIland _ma1<oI....."",-.

P-s il the oa..: ' '-i{I world. It"e nc:n nationsCOIAd !MY 0~ 101& by~ 10 mai1Ill/n..........., !lIa'IdO'dslll-.andf"lllfiDDn lit 0 tmllwher1l1'J'1'8'"'''1IS lQ '-'0 lICU1e dtficljly ildOi"Ig ISO. In (I\IlO' woros. i"JIemali<rIllI ..:l ocUd"-' 10~ It"e~oI'fir$( Gi6 by makngS<Q It"et lNdren do r(l\ """"'" mosI In on- III1lrt>uIi!!tlC8and lnJ'lSiIioo. Andil o:lOnG so. ~ ""'OlAdaI:oo help 10-..e that loro;:I·term progress is <'iOIl.ndeI., io IlId by short·term e.igoao 60s.

early 19805, took a conscious decision toCUt back spending on industrial projecuand on hospital buildin g in orde r to maintain expenditures on rural health clinics,immun ization programmes, and primaryschools ," In thc 19805, Chile" and CostaRica n succeeded in maintaining the downward trend in infant mortality byestahliming specific nutrition and healthprogrammes to protect the poorest childrenfrom thc h~rsh <:conomic ride of thatdecade . Also in the 1980s, Botswana hasmanaged to shield its child ren from thcWOf'St effect s of severe drought by . ettingup semitive moni toring s}'!Ilcms in order totarget government support, including foodsubsidies. Zimbabwe, also, managed to prevent any increase in cluld malnutritionduring the droughts and recessions of the1980s and it has do ne so by mean s of spe cific low-cost policies which have includedprimary health care programmes, immunization services, diarrhoeal disease comm1measures, supplementary feeding programmes, and NTal water supplies.

There is also some evidcnce to suggcstthat the principle of Ilrst call may be beginning to cstablish itself even in times of warand civil strife. EI Salvador has not aUowedits long and bitter civil war to waive therights of its children to the bencfits ofimmuniu.tion; on three separate 'da ys oftranquility' each year for the last 5CVenrears that war has been suspended so thatalmOSI all the nation 's children could bevaccinated. More recendy , the ide;, of 'corride rs of tranquility ', through whichessential supplies can reach civilian familiesand their children, has been accepted inSudan (the Nile is also now open as a routefor relief supplies), In Ethiop ia, two similar

corridor.! of peace were kept open un til theend of the Wlf earlier this rear. (n Angola,six such COrridOMl " 'eTC opened in 199 1. InIraq, UNICEF and WHO were able toopen a channel for ship ping the meetessential health supplies even at thc heightof the Gulf conmct,

Such C>lamples strike the sparks of hopefor a principle which must become a steadyflame in the )'CITS ahead . In every set-backand crisis, in every period of tr:ansition orturbulence, whether caused by natural disaster, civ~ war, mU:l1Ia!ional conflict,cccncrnic mismanagement, or politicalchange, ;t should be axiomatic, nationallyand mterrul!ionaUy, to asi::: wha t the effecton children is likely to be and what specificpolicies arc needed 10 shield their growingminds and bodies from the sharpest edgesof change,

In the atte mpt to i:::indle that flame, thew(lrld now has the advantage of a virtuallyuniversar agreement on the minimum pr<>teelion which mould be guaranteed 10

children, In the goals of the World S Ji",m;1for CJti/drrn and the provisions (If theConwnlion on w Righu of w Child, are setout the agreed minimum standards for theprotection of children's survival, health , andeducatio n and thc agreed minimum pro tcction required by all children, in all nation s,against exploitation and abuse whether inwar, at work, or in w horne,

The world therclore now has a set ofagreed criteria against which any and aUnations can meaSure practical progresstowwds a lICW order for children.

"


400Under·five mortality rate (US MR) andI~al fertility rore (UR), 1960,1980and 1989.

,so

'00

100

'0

""\

I"""- I1989

,","'....,...,-,"-lU "'""

12a, 4

Total ferti lity rate6,•0" -----.--,----""T--C--.------,------,-----,,----

'-<.. """""--- - .. ......._--

•

Fewer deaths, fewer birthsProposition: Thai if /he wues of mI,l/nulrirUm, (1f'efJmlabk di..."" and wilWpruuJiUiUYrJ0'. <:ITt tiel r;o"jro"ud as a new worldtmkr ewJws, thm Ii 'IOiU be WI)' mud. moredifficuh 10 mUla 1M rllU oj /JI)/JuWIWn J:ro1Clhand Iff<Jlu 1M Irwuilioll u> tmlironmmUllly,w/airulbk dewlopmml.

Public support for the csuse of protecting children agains t malnutrition anddis<:,.,., has sometimes been inhibited by theqwnCIll thaI, inlllimuch lIS IUch effortswen: IUc«ssful, they would ultimately beself-defeating bccaUSl: me)' would $CI'VC

only to cx.acerbatc the problem of rapidpopulation growth.

This argument is mora1ly and demognIphically unsound. As last years Swu ojthe World 's Childmo showed in lome dcmil,reducing child deatlu is one of the mostpmo.'el'fuI of the forces which make up therein. of population growth.

Four factors are mOl! strongly associated with falling birth l"lItcs . Thole [ourh=men of the non-3pocalypse arc: risingincomcs, female education, reduced ch~d

deaths, and the availablHty of family planning. When pulling together, they exertmany times more control on birth raresthan any one of them acting alone. Thereis therefore no conflict between meetingthe need, of pe<>pk and con troUing thcgrowth of population; indeed all of thcpropositions ad~=ccd in thi' report wouldcontribute in some way toward. a moterapid ~winll-down in thc rate of populationgl'O",'lh .

The particular link beN,ccn reduccdchild dea ths amt reduced births is one ofthe lu.t unden tood and most vital of

contem porary issues. In general, loweringthe ratt of child deaths helps also to lowerthe rate of births because it increase.parental confiden"" in the pn::dietability offamily building and reduces the need formany binhs as a means of insuringagainst, or comp ensating for, uie possibility of child death." "11 mighr ~ tJumghl, nsal'l the 199 1 Hllm{Jn D~ll]pmffll RtfXll1from the Uni ted Nati ons DevelopmentProgram me, Klh<>I, if morw childrm Surfliwd, f>OPulalwn probkms fC l]uld gtl fOOn e.Quilt (he r<lJtl"St. Ferlilil)' Itn<u 1<1 dropttilun fHl'"''fIls 'In' m,.,.. ctmfidtnt that <hel'rchildrm ttiill su rvivt. n

But the strength of this n::lationsbipbetwec:n faUing deaths and falling birthsdepends on the particula r stage which acount!)· has reached (ftg. 6). In the earlierstages, when under-five mortality rates flntbegin to faU from a vcry high level, parentalconfidence remains low and birth ratcs tendto change little. Most countries in thedeveloping world have now completed thisphast. In the nc.>:t stage, when unde r-fivemorta lity rates begin to fall below 200 per1,000 live births , the correlation betweenfalling deaths and falling binhs is still weak.But il is when countries begin to bringchild mortality rates down below 150, as ishappening now in countries such as India,and to mo,'c toward s and through the 100ban'ieT, that strong and consisrem panernsof fertility change begin to emerge. At thisstage, most countries begin to see a muchmore rapid fall in the number of births forevery furthtr advance thaI is made inreducing child dea ths.

Th is is good news which has so far goneunheard. For the great majority of coun-

"


The United States:the rise and rise of child poverty

'FiliI calb~' llllDI*l roIbe a probiemlornch~ 8ul .. !he mosI P'0!lP'l'0UlI1l8l1onolal,ctilddeprivaliontoas i 0 11Sed--.as~

hlos lisen lnl~ lmOIIgoctusge~'-

"'"1n1h8196Os, ltIep'4X> lU ,ol USchb""liW"ogIn IXMl'tv was haMld Iran 27% 10 14'lI.. In !he19700 . ~ aepllB:I< 10 17%. Then.:n !he , !leOs, ~rose lIlll"" kI 22'll>" .~ In a deeade 01 '*"':IIllurint_ed IlCOrJOmic lJtlWIIllnl a .- Z5'llii (> elS " .., America's GNP.

0vIr lh& sarre :xlyearperiod, 0'0'Ilt8I 1lO'IIl'IY ;,ltJ8Uri1e<l Stales.and~lWTlOI'IQ lheelda'ti.has dedioOld. [)MIn I1'IIintt by \)C1'eI"' ''' ~ llCti<::<l,lhe po oporIioo ,or older<;:lIimm (fl5<.)M-og InI"""'"'YIII by IOOnl then l"'O 1ti'd:I.

So WfroJ has a fl81ion with lhe demonslraledcapedIy to 'e<:U::e PO"'l'IY !lliIed to do 110 b' Its<hIdf8rl7 aIIrJ~ .. Amori::lr. " a report /rtw'nlhe~ ChIdmn's DefooI!Ie FI6Id(COF), deers the- way for lts __ by e><;:>Iodi>g--ThIt i\QI;I< i'ro1ge QltheblIId< (;fjd born 10 an" ",," Iied,~ rnottIt:o" Wilg on__ ina big dl\I s a~..tCh filsfawIlf Ihiln croein W'I 01 America's~ cI"ildrfn 1nnBr.,;ry_and Hspaoics8r8certl1irlya.er·~l8d. bul a~ of America's 12~ pool~ ...'Mile. Most 1M!' out3d9 bog dIiee. Mosl ~ i'lhlfTiIies _ <:rif 0I'lII Of lv.o c!lben. And mostbelong 10 I'>OuSehold8 \flOI1ln aI Ieasl one PE"'WlI_.

Tho.t """"~ lor rfsO"lg chid pa.8Ity In.lim, lNI lnllIioI'I or benefits l)t'O\oided by goo.oern.menttopooIlzIrrj\es withctti'enafId. sec:ord, lheS!IlIIdy fill Inreal WOQIOS lWTlOI'IQ America'8....sl<i1ed.

ThlI lI'YlItll9"~ ""'9" 01 ncn-superviooI'yWCIlkln lei by~t8y 20%~ 1973and 1990. AI the _ line. Ihl g'7>\"w..u's

eoo,., ;h,.. ~ 10 a ............... 'famIy WlIgIl' "IlJI'lfnto he>ttladed: even llft(I' reoanI i IQ : l US. the real..........., ...... .. 1990 Is 2O'll. _ then ~ _ ..196:1. for a ~trne. \'8BI',ra.nd WO'kef. ltilI rrh.......W8Q8 st1__a latnlywith one ~'*"'>ol$2lXXJ below tN poyerIy Ina.

As IaIro i ICOITOEl& haw • 10eased the rDXlOOri'r" 08Id~ faClibenhasbeengra<lld\lwilIOawn. The real ....... '" AId b FzmolieII with~~ \o'FDCl h!!o!o (IIQ!.'!-"!I:l !l')'~4O'll. """,,20__. TDdBy, loss then10'll0 0111I casIl benelits go 10poor llmI8s withchiIdrer\. ClII'w grOUpS havefaradrru::l1b9tter: <:NfJ(

hall ol " peoplil n IlOO' lfI'l'iias wilI1ol.t Cl'Iilt8n~~ helpto P<A tt8Tlabc:J,tethe~iroI - as C>XlO98d to rrl'f 14'll. ol people n IlOO'........".•,"'

AlIIrnpIing to """91Ilhe!le lac1<n. !he reponanrbJlas t-JS! _ 4O'll. 01 !he rise...cf"id~to lhItdedioe 01gc>YIltI'YJMlrl support.)usI-3O'lllto la&-1g realWlI98S """"'6I1he poor. lWl l;l!llL.W1dBr3O'lI> to1heriseoIl1lClltlef-«tt~

CaIhg onItJollk'ilecl SIaIes touselts~to ....., ctjd~ by thoI year 2000. h co=~ 1lIet .... (III HfIl iXN"rtY _Ill.lo'$'~ li'9

wIrh IfI9 -.y~ lWl flGt.C9t01 of~ of flU dli'im md lImatM!l the l'l8lb<l'se<>:n:mic anrJ9OtS8! ruruv."

"Silietilg cUd fK/IIfI'fY". on !he 0Ihet r.an:l,"would !i-'e the tIIIllot> a I>Jg& Itft'>i'>g s!a"1 (:1'1

/.aI::Idn91he~.~ suI>s/!n:;lea'luse.cri'ne, md<XherpOO/Ems l/Igl.seem socilwti'lg,"

Nod1MC08l'?~ " Ill' 1'10 /IIOOt'I61M oroII'_ . b.Jl1he COF puIS !he bII 8I $28~ a_ (lor .-.,g IM!IfY poor !lmIy with cf'ikten up10lhapc:wertyi>a\. Ths" less then19l1 ol AmioIca'sG/IP: ~ is alSO less Ihsr> 1heam:A.t'1l~ each.,.. tr; lila rid1Ilst 1'lIlol A/'r'IlIiCa1S as amsUI 01_ ta:< bmaksllJlllltl'l'lld ... the1asl15~

f lgY.... refIea only ...pend'lU.... by «Otral<)CI"Mlment and may therefore un<len tate... pmditu.... in countrlf:> with feder.1 S)':Iterm........"""'\,..,

~1M elf,," 10 miua dlild illness and maJ~

nutri tion and 10 mWr. the goals of 1M WorldSummit far Chi/drm", says Mauria: Strong,Secretary-General of the first WorldEnvirrmmmi C<"'fnmu in Stockholm 20years ago and of the World Corifnmu OnEnvirrmmenl and lNw/opmml to be held inRio de Janeiro in 1992, "is crucial .ICI ~Iy

for in own .ake bul abo w a means of hdping10 JIow f>01'Ulal ion gmwlil and maRe pouihkmvirrmmmlO1Jy rrmoilflJbk tkvelopmml inIN. 2hl cmtury and beyond.. "

A renewed commitment to protectingthe health and the lives of the world's childn:n is therefore in syn<Jgy with, notopposition to, the effort 10 cope withthose other great issues on the hu managenda for the 1990. - the slowing ofpopulation growth and the protection ofthe environment .

tries in Asia and Latin America have nowpassed through the earlier . rages of this1JlIn,ition, when birth ""tes mayor may notbe affected, and are approaching or entering the Slage during which furth er falls inchild deaths could be expected to be associated with much steeper falls in births. Inother word" reductions in ehild death.have now reached the point wherc significant di,~dend. in falling binh ""tes arc]jltely to be paid out for any further reductions in child d<:lths that can be achieved.In Africa, where under-five mortalilY ratcsin mOSI countries n::main in the 150 to 250band, it is essential 10 hasten this U'ansitionin order 10 quickly bring to a close theperiod during which population growth i,at its moot rapid.

1087

221111

"" "15121288

Fig, 7 SpendIng on basin~maryhNlth CM1' and primary<.'<location art' two01 tho m<»t important wayo 01 'inwning in people'.!Iut 0/ 21~cQtln~ for which rom""rat*figuf'fS "'" ,,"illblo, only tIIrft gowmm<1lts alloclt<:"""" thon Ml' fifth 01~,~~itu.... to~!»sic ~rvice).

Expenditure on primary health careand primary ond 5ec:onOOry education,cs a percentage of totolcentrolgovemmem expenditure5, 5electeddeveloping coomfies, / 988

0%ZIMIlA 8WEBOTSWANA

SIERRA LEONE

MAURmusTANZAN 1.0\

NIGERIA

SlJb-Saharan AfricaMOROCCO

JORDAN

KUWAIT

MiddleEast & Nonh AfricaBANGlADESH

SRtLANItA

INDIA

South Asia __==

n


Investing in people~ ncu w fJfIU'iIrt ___artJfUNi 1M Uol/'O"fO'lU of~ -*:poIM;ia Ihottld 6e~ by " _fPOItdi'V llINUtOUlIS /IlII IN mpomibilily 0/~u '" plrnUtl« lNuic irrvulmmu in"",.

Whether for idra1i5tic or sc:lf-inlcrulcdreasons, monopoly state control of economic life is an ide<! which has been giveno:tm!li~ field nials in the 20th century.BU I U that I;C'fltury end$, it is an ideawhole time has gone. In panKular, ifstands d.iscredircd amana die minions ofpc:opIc whose~ it ~ bul '111Joscn«ds it failed 10 meet.

11'£ ~~ ul ttiit f~liR is iCiui'lOOllII;III (lI'IIy O\'tt F.&Stml Europ: and !heSoviet Ullion bur 1M:!" cvm Iargcr UQS ofeM de\"tloping "''Oriel. Free nwkd:ewnomics, thaugb f~ many .mousproblem. of their ewn, havc~shown lb:nuclv,," ID be: lIlOft' successful inMini the living standanls of the majority.It .. therefore a truth now almost univenally Icknowledgo:d that the energy andenterprise of peoples an: Iibented onlywhen people an: free to rmk c their owndecisions and miswkes and 10 reap~ds

in rell.lion 10 lhcir 1aboofS.

The: idf:oloP-al cbums inlO which somuch alCf'IY and commi~ has disappeared ill the po5l-war paiod aR' 1Mref~

TWTOWina to aIJow moA COWIlries to sandon !he: oommon pound of. mvUt-£rin>dIyapproKto 1<1 ~dapiilc"L 1lIis )ur'1Woria'~ Rq#n from dle WorldBank, for cnmilG manhab fow dcodcsof UI\'IIStmft'l1 L1pCiicilce in support of timl."OI1dusion (pand 9). Similarly, dle oold oping world"s own l'C\iew of progrns, the

KCClltIy P'lblishcd n::pon of !be ~~ chaimt by fenner Pn:$idcrnN)~ of T anzania, has condudc'l1, "7M

fWClU/IJ~ of~I i" w.so..u. <karl>' .1touJ !hal~ K"I"Wu. QtJi,roroIIJ~ in Q cJima~ in ",hid! 1M bwi....ss J«UII'"", rJrriw. ....

lb~ I'GI~ of COVtnUll.tIll

The /"Ok of~I in dcvclopmml

is therdore brin& ~'$lw.tr:d. in manynationlI " ~ presenl time..

Certain Qp«U oi mal roie :Itt obviousbur. oucm IXJI 10 be forgotten. M.~foroes QlIIII(l( acnaa~ economic JfO"'Ih ina poIitialI VlC'UltIII. I>umbk peace, .-IbIc l iability, gu&I1Ulltt:S of Iepl andpropcrt)' n,:h1S, a reISOOIbly com~eru

ci>oil~, !he: cko.'dopmau of infraltrucrare, sound policie§ on money supply,taxation, inlcrnl and ~ch.ange rilles - aIrthell~ are the 1'Oponlibilil)l of governmentand aU I re pan of the framcwor!c with OUIwhich Ihe polenti al oonmo ubon of marketroren is di.sip l tcd.

BU! il is I1so important W ROle lNl thekssons of m:enl experience - and psnicll·Iatly the IUccnso of HOD« Kong, Japan,M.aIa)'sia, Sinppon:, South Korea,Taiwan, and Thailand>" - SUliQI IXJI thai~enl IboWd recre from ~ ceononUc fJdd in order 10 allow the free pia)'of market forcc:s nor ~= thai tome: linck'riplt NJancc' sbou1d be Khicved bctvo-eengo·..emmau and numts (" 'h.id! impljc,sthaI 1M IWtl muM a1wa)'S be in opposition).'The chief lesson il rather !hal progrtll is

Fig. 8 Arms, debt and peopleAbout ~o Jltf(e<l1 0/ ')OV'tmmtnl 'Pffiding in tho~opi"9 WOIId .. _ 0<1 10 the milila!)' and theOl'rYi<ing 01 dKIt. In IOmII! ~ion" lIli' i' lWIce a,mud' ..~u JPf"d on M alth andfduc:alion combinfd.

Percentage of centrol governmente}(pendi ture~ (CGE) allocated to themilitary, debt urvicing, heallhandeducation, and aid received a~

percentage of CGE, by region. 1988---,;;;;:r

OTH(R-

OU T

,MILITARY

AI D REC£IVED

• loo\ld<$ I"",__----,-,...""--_ '..,......:..-__._,,,..__ '. ' " .., 0lW,

:.....;....~,.i.;::,.-....r_ ~_"

m01t rapid when governments .nd markclSwoO: in intclligcnt partnermip with eachoth er."

In the rethinking provoked by events inEastern Europe and the Soviet Union, anequally dear if Its' widely proclaimed ccesensus is also emerging aboul what marketforces cannot do, and therefore about whatgovernments must do.

It is the responsibility of the State to:

o ConstrUct social safety nets to protectthe most vulnerable members of society andset a minimu m level of well-being whichwill be maintained even during economicdownturns.

o Ensure basic investments in people andespecially in bask education and healthcare.

o Prcmcre fuU emplo}mem so that thegreat ma;or;ty of citizens are able to meet.their own and their families neros by theirown drom and thcir own earnings.

o Counterbalance the long-teno tcndencyof market forces to confer marc opportunityon the already advantaged, thereby settingup a momentum rewards increasinginequality.

o Intervene in those instances where theIeee play of market forces is dcmonmablyCOun lCT 10 the public imerest. FromUNICEF's particular perspective, for example, it is 110\ in the public interest 10 allowmillions of ehildren to become malnour_ished because the free play of market forceshas persuaded millions of mothers to abandon breastfceding in favour of commercialinfant formulas (panel 12) , Nor is it in thepublic interesl for peer families the world

THE STATE OFTHE WORLD'S CHILDREN1992

War on children:the 20th century's shame

"

PooIec\IrlIl the~ IlWds IWld bodios of\'<UI9 ctill;tlwl 8hoUd havernt cal CI'1 eoc:ielIes'""'"","0' in good Iine9 a"ld In bed. in boom 0<rlKi Sl "JO " in peece 0( wer, Erl\renct;ng thai pm..~d '&$I cal' is lh&c:haIenge ci1ll8 199011. And~O~~ rroa OOsparBl&)r.-:led ltWlln eeWOI!d's war~

... the Iasl dec:ade. more !harl ooa llr<l • NollrriIb"lcttilln hawboonkiIod InW3fS. .. Mete tn(lrl4 miIIon have boon~ ""'Hod . li"rtls~tad. brains <DrorJed,Il\'llIIV11 rd tumg10'11 - lMJugh borrtliIg. Iarld·.nr-. !rearms.tort m ".,."., cI*ho "'" in I'IIIug8e~beca of WlIr; a !l.nIlo< 12 rr6:ln I1lMIbillhl!llr~

In 1991, lIlis lIIIa#lI8' 01.,.. io iOCllt olS <XlI'>In- in the more !han 40 wars SIiIllIWlg bJghl.

ThIs 'waI on d*lr",,' illa 20Ih """""y lrMImion.Oriy 5 % 01 the <::as<8\I9s in the FI"SI WQI\d WetW(!«I d\oiIilns. By the S8con;l Wor1d War, the prQp:>"Iion had rigetl to 5O'lIo. Md. lISlhe centu'y~the cMiIn lIl'o!n is IIOtITIEIIy about00'll0 • IT(lSI 01Ihem.....:wnen III1d~

Thu Indirect etrects In aIfoostas CliMISIali'>lI.Schools at>d cirics are dD!;ed or 00slr0yed. FoodIIUP$llY "- are brol<en. Walll< lind sanrtalion$)'.18= bn.lal< dawn. MAon$ fl8e' to r~CWfl.'II. Nwj 1WilIy$. hi r-.w~ is !)l)ToIby <:M::tren • d*:hn .-.ho miss lhI!IIr onlI d>lnoe 10grow normiII\I n mnct 80Id boct)', to be educatedlnd to a<:QlOre!he _ to hi a pIooB In !lOCI6ly.

The PSYd >c:logic8I WOI.o'lds _less Vi:Iille. 10 COles!lKti 0150 di' ... e1 ctti'en n M:lm'Ttique, 42hadlosl a fathero< rrott>a< b')I\OioIeno!I. 11 had seen01heard a paretlI beO'lg l<iIBd. 29 had I<iftr lised.rruoer, 16 had boon kidlllIIlPEId, III hall boontmlalened Of be9t"" or staN8d.The~_SlIid tQ be .reprooenl8\Ml.... In \OIaI, on estmated10 fl'Ii6Ion d1IldOWl In \Ile world r- sutrered

~ lraIn18incMI ondimemarJonol wn.Thesemany miIions ofchidren, physicalyana

mentatv scarred by lIloI oonflIcts of !tBr _5,ere part 01 the generation on ....nk:h the fuwr"rrusI be bul'1.

Themr. ,.... row"""", fa IIWCl11dw1<le~to cry OO! llQlW\sIlN. war CI'1 ctIIdren • aogalnstlho!le who """ the W<>apOM and those who""PPIt tlMlm. H_. must be fooqtt , tIIIwl, IIllhe·"i'j eest, ;;'h.::.:ro,_,;;.~.wkJ to; j)iViOC'.wnom".otiiIOOtSt .fleets.

1her& n """'" sil1IS 01hope. Armed oorActseems to be 'm io og with lh!IlIfl(i-,g rJ ItlIl ooklWfJI. ThIl W<rt1 S<.mml: for O!tim opec;ticaIyr.3lled fa ltla ~o!B$SlI1liaIMIldil'_;., am. r:JWfJI end;" _ ~•. kidlt1e .- Cot»mriot> 0tI J1>IJ Rights of rhe ctrId,WhoCfl~ dao:rerds 081/ 1'IlasibIII_to ......... pra/IlC:tiJtl end ewe atc'lottm wile In!

fI!/oc:ted by I'mIt:ld <n'Ilfct', Ili'IlIV'I beI:r1l'l1lift8dby~ 100 r'Iations.

Sc:ml na':icns~ beg<I1~ lh!I .....\Oi(;leInto p:actk:e. In B Sdwdor, eM WfJI has tleen!UIIPE" ided 0lI ltne sapeo ale days 8'o'EII'Y~ b'InIIBs1 seven~ so tha1 cI'ilchn can be i'nmtrized. "l.ebarIc::o'l,'days rJ~ ""-dchldrQr11C be wccio "led 8'«1 81ttle~ cl1tl8_In Sudan, bcIhsides~ tq-' to'culkh. rJ .-co', Itrn.!;JI'l WhoCfl-.ilaI "'-P"pliloa o;:cUd mach rriIons cf cMiaroa.1'I'IOStIy wcrroen;oj c!*lftln, IRlpped In lI18 WfJI zilIl&. SimiBrlIgi OOIlllii ilS ha.e ance blllIn IlllQCIi3Ied InAngcIa..00 ElhIcpla. .. hoQ. _ tiel rnedcaI II.q:lieB_~__lIIt!"01 hoiV>lol!heGUlcor6cl.

~ ad>~ _to oee::mu !he I\lIliI ralIwu.. lt1e~ WOIldwdI,! P'i*: ilIlinKln willneed lO haoden llQlli'\SIlt1e _ en d*hn';oj

imisllhat lhiI ......... IQ Olllin on J1>IJ 20lh CIInll.o:ys/"IctJd roJl be aIcwed lOseep <Mill Wo the 21.1-

over 10 be persuaded to spcnd 5500 milliona year on useless anti-diarrhocal drugs",tK:n oral rehydration therapy, the medicallyOOlTCet treatment, is so low in cost that it isof little commercial interest.

o Defend those elements of a humaneand sustainable society to which the Is"" ofthe market place attach little or no value.This responsibility includes the protectionof the environment, the protection of thefuture, and the defence of mose who do norhave sufficient influence or purchasingpower to translate human need into economic or political demand.

Invalio!: in people

The other hll1f of the development consensus which has grown more solid asideological divisions have narrowed is that itis a responsib~ity of governments to ensurethat vinually aU members of SOl:iety haveadequate nutrition, primary health can,clean water, safe sanitation, family planningservices, and at least a primary education.These basic investtnentS in people arcessential not only for humanitarian reasornand for the creation of civilized societiesbut also as the foundations for sustainedeconomic growth. A!< the outgoingPresident of the World Bank has said, in aICIICT 10 the Secretary-General of the:United Nations following the: World Summiffi1r ChiMrm, "/mJeSlmenr i" hu"..." Cllpila/,iM/udi", importamly baJir: IwJIth Clln andprimary ~du<alw" for (hildren, is o"e of lhemoIl tfft<:Jiu means of slimulming Iong-IeTmwmomic growth and imp_;"1 ,eneroJ wtlfa" ." The same conclusion was reached bythe Sol/Ih Commirri<m', review of recent

development experience which concluded :"salirfyitlfJ bark needs .""uM /raw priorityholh 011 grounds of C'1Uily and 10 =rai" ta>o

IIO>IIic grMJIth III <l rapid fXJCt. "'"

In recent years, research has demonstratedthe power of that investment in many differem ways. World Bartl< studies baveshown thai raising the average educationallevel of the labour force by one year canraise GDP by lI5 much as 9%." Other studies have demonstrated thai four year! ofeducation, as opposed to none, can increaseagriculrur:al productivity by 10%.'" ResearchOVer the year! in Australia, Bra;r,il,

Colombia, F.thiopia, Guatemala, India,Indonesia, Kenya, and SielTll Leone haveshown that improved nutrition can increasework productivity by IIp to 20%. Betteradult and child health has been shown 10save millions of lost workdays. COlTCCtingchild malnutri tion and iron deficiencyana~a have been shown to reduct: absenteeism, increase anention spans, andimprove school results) '

But for the present purpose, such stud~

ies are like striking matches in daylight. Theevidence that investing in people lays thefoundations for e.:onomie growth loomslarge before us in the shape of mose countries which have succeeded in achievingrapid and sustained progress in the post....·ar world. Liberating people's potential vialand reforms and univcn;al health and education services has been fundamental tothat success in countries and regions sucblIS Japan, South Korea, and Taiwan(panel I I) . All of these have shown thatbasic education and health for all are notjusl socia1 expenditures but e.:onomicinvestments, nOI just indulgences which canonly be afforded after countries have

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become prcepercue but the foundationswithout ,,'hich widcspre~d prosperity willnot be achieved.

In other "vrd~, the I~ns of the lasl 40years suggest that development proceedsmO$t steadily when it walks on the IWO legsof a m.an:.:t~friendly eeonomie policy and agovernment commitment to ensuringinvestment in people. And as the eensensuson market-friendly economic policies villiblygathcn momentum, it is even more essential thal the other leg of the developmemconsensus is also exercised.

Unfortunotcly, ' investing in people ' hasbeen the battle hymn of the internationaldevelopment efron for futeen years withoutbattle ever really being /Oined.

All for lo me

The governments of the developingcoumnes spend, On average, abou t onequan er of their budgeu on directly im'estingin people via health and cducation services(but no! including government expcndi=on agriculture and emplo~"I1lent creation) ,HcaJlil and education together daim 17% ofgo\'ernment expenditures in Latin America ,21% in the Middle East and NOIth Africa,23% in South Asia, and 25% in East andSouth East Asia (figs. 7 and 8).

In ccuneics where high employment andreasonable wages mean Wt the majority arcable to meet their own needs from their ownearnings, such It:\'cb of sociaI expenditu re bygovcrnrnerua might be adequate if allocatedaccording to need. But of the sums which areallocated directly to health and education,more than half ;s allocated to relative!}' high

COSt services for the few, and IC$S than half islI1Iocalcd to low-cost services for the rrumy(fig. 7). In other ,,'OIds, only about 12% ofall government spending in the del'elopingworld is devoted to imocsting in the: healthand education of the 000'1" majoritv.

Fig. 9 It can be done~World Summl! for Childrm loti. ~mbiliow

goal ' for Ihe l'H' 2000. But Ihe Br.lilO.on . tote ofCea,. {popu l.ltlon ~x miUion) h. l achiPled IOIlll! ofIhe mon bam 9011. In onlythree l'H" (ift panel 7).

Ch<Jnge~ in rekcled motemal and childhealth indicotOfS, Ceara, 1986-1989

Indiutor Od/"" lun/Aug~ cha roge,... ""

InfantfTlQItaIity 57 39 -' 2%"""',,,"'''''' 28 B -S<""""" '"""""""""""'"- 23 32 .,,.,

""-SaI:ts il the last_."""""""0Mk:lre112·23 se 81 .-rnonthl; rt«'MngBCG vaa:ne (%)

Children 12-23 SO 63 +26%Il'IQrltho; IKeiving3dolesdDPTvacrne(%)

Mahubitioll - 2nd e.o SA -33,*,

"'" """"""'Gomo.<dasslication (%)

Unln. othctwi>e . \.Jted.1lgute< .ppIy tochild,,," "9fd 0.36 month.-~,-----_ ....._....._..-.,- ..... ".,


Reshuffling the pack:Human Development Report

•

ThI l Qll' I-UrWl De>1'¥"n.~ J'IIJ:01 lmmUOOP ill..........,.; up by Jts0W!'l Pflied'ol'Si iQ Ii.AbrIhwn I..h::c*l • 'oe.l' P'''' ''' of /111I Pf/OPI8. byIN ptItJfie. lot /111I J'fIfJf*'. 1'he b lItb, <J JlIIO".. lX)IIrlIllIl a"IdII'e WlCIlri"II {)lit-. 1*ll4ArIian_ ~""""" til h .... 01010 _ilTI'i& ... WI lI'II lIllrTU:a aD 01.. growIh. EU_u,iclJOMlliinol ....,ilblll·I.I_b,.who;rl UN g,*>s............ ' . ,••"-1.-_ . a GrooooIll .. l'IIlicnIIn.::ore .'... ,tIUI .... ..-.._ -.... kI'Id of 9'O""Ih . _ • co I ot. I'lC7W rilaJ" c."""'..... lrun ..

To _ Pi"""_~ ... loi"cl of.. 5. '... l,N;lPpo • , . ,..,.,.,~

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Hul.'" C the Cr'IltIria 01~ il ,. '-ttWurI8I .. d8' ' v ,. « pIIdI.~ b'_ '1llIe. iI *ed 661!1 n n World Bonk lIIblBo~ ...... a;unrIes by pel' CIIlO11 GNP) bul sliPs10 102r1d Inthe lNJP tebIN, whIi::1l ...... Q:lUlII'ieoby~!'O.~. Srlla'lka it llWlked 1201hby por tlIllOl.a Gt.P to l'ltOfl1llIed to 15th on eei'O .... - aI its ad...."eilll .. h!IelIh..-.d1dlC8licn

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~ _ 111<1 10 IOCilII MlMc:a lie I'I8II/lhand~ \olO'll .W*""O

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It ill estimated, for example, that 80% ofthe 812 billion allocatc<! each year to watersup ply system s is spent on putting privatetap. in the homes of the relatively well-off,at a cost of approximately 5600 per personserved, and tnat only 20% goes to the public ",cU. and s\lInd-pipes which can bringclean ",ater to the poe r majority at a COSI

of 530 to 550 per person served. '"Reallocating even a proportion of totalcxpendi1\ll'CS in favour of the poo r couldtherefore liberate enough resources toachievc thc goal of safe water suppl\' foralmOSt every community in almost everycountry by the year 2000.

A similar argument, with similar statistics, could be built around the themc ofhealth caJ'C'. For many times m<)rC money 10be Spc1lt on curati"" than On preventivchealth is the norm; for 75% of publicspending on health to serve only the richest25% of the population is 001 unl)'Pical;Jl formOn.' to be spent on sophisticated operations than on the 10w-cDSt control of mas.disease is nOt uncommon;" for J()'% ofhealth budgets 10 be spent 00 sending aprivileged few for eeaeneru abroa d is notunknown....

The necessary rcstru<;turing of . uehexpenditures may be difficult but it is n01impossiblc. On becomi ng independent, forexample, Bangladesh found itself with ahealth system which devoled only 10% ofits expenditure to rural health clinics servlog the great majority of its popul ation.Today, that figure has been raised to 60%."

Ednation

Such distortions of public spending infavour of the better-off lll'C; aI!Io evident innational education systems.

Depite decades of research findings"'hich regularly dcmonsUlIte that investment in priIMry education yieldssignifiClllltly higher rerurns in both socialprogress end economic growth," government . pending in almOSt all de.-c:lopingcounuies is heavily biased towards highereducation for the few rather than basic cducation for the many.

lltis i. not the path that has been followed by those countries " 'hich haveachieved the mutually reinforcing goals ofuniversal education and sustained economicgrowth. In both Japan and South Korea, forexampic, universal primary edUl"lltion preceded economic takc-off. And in both, thisbasic invcsnncnt in people was made at astage when their per capila incomes, in realtenos, wen: lower than in most developingcountries today . Japan moved rapidlytoward. universal prim ary education at theend of the last century. South Koreaensured that almost all its children were inprimaty school at a sta~ when its per capitaGNP was little more than SlOOper yClU"(panel II ) . Emphasis on serondar}' andhigher educ ation came later and was notmade at the expense of primary educationfor the great majority. Nor did it run ''CrYfar ahead of the cwnomy'. capaeity toabsorb inelnsing numbers of more highlyeducated people.

Many othe r counuics have taken theopposite course, fuumcing higher educationdisproportionately with the result that up tohalf of all children fail to complete four


rcan in primary school while secondaryand tertiary education absorbli an exaggerated shan: of me budget in order to

produce many more graduates than theeconomy can u""fuUy absorb. In India,where bctw~n 60 and 70 children could begiven primary education for the 0011 oftraining one unh"eniry student.'. approxi .mately half of the nation's children fail tofmish primary school while the country as awhole produces more graduates than it canproductively employ. Inevitably, one of the,(fem is a brain drain of uncmplo}'Cd buthighly qualified peopk to the industrializednations. In this way, a significant~ ofgovernment spending on education is used10 subsid.i2c the rich nations rather man to

achieve basic edacerion for all which , as aUexperience suggests , is one of the cornerstones of development.

For reasons of both justice and efficiency,Ute overall effeel of educational expendirurc should be: (0 ",distribute incomes andequalize opportUnities. In most developingCOUntries tOOllY, its effect is a1m0!11 meopposite. Most government s~nding nnhigher education is s~nding on thealready advantaged; in Chile, theDominican Republic, and Uruguay, forexample, mOre than 50% of all government spending on higher education isdevoted to the children of families whobelong 10 the richcsi 20% of the popula tion. tn India, 50% of all governmentspending on education is used 10 subsidizethe best-educated 10%."

Within these inequities lies the potentialfor a degree of R$tl'UCTIlring of educationalexpenditures which could help 10 financeprogress tow2t"d5 the goal of access 10 basiceducation for all children (and the comple-

"

lion of primary school by at lcast 80%)before the year 2000 ,

(f that goal is to be mel, then an extraor_dinary effon is called for in the early 1990&.In particular, 10""-COSI waY' and means willhave 10 be found of retaining or muntingerose who now drop OUI of school in ther,"t year or two of fonnal education.Considerable PT'0KTC5S has been made inenrolling cllildren in school; the more diffi cult problem i. that up to half of those whodo enrol leave before be<:oming litel'llte (fig.10 and panel 10). Those children arc CSScntiaUy being locked 0Il1 of the 21st century.

Pioneering efforts in Bangladesh,"Colombia, Z~mba!n':e, am! in many ethercountries in recent years, have shown lhataccess 10 a basic education for all children,and com pletion of primary scnoot for theg=lt majority , can be achieved at anaffordable COSt. Using such new methods,the extra financial cos t of reaching thesegoals can be estimated at approximatelyS5 billion a year throughOUt the 1990s. Thecosts of not achieving that goal "in be farhigher. World Bani: research over the Last10 )'ears has demonstrated many times thaI"/Ill produaifniy of an uJuwud wor* f= isIhl moll rtlioble. mgine of IrWno",ic grotJ!/h.""But the investment in education yields itsdividends in many othcr fonns. It confersthe ability 10 continue learning, from a widefaIlge of SOUTCn, throughout adult life. Itmodernizes attitudCS'" and builds confidence in change. II stimulate. broaderpanieipation in political life. It assists theprocess of allowing what is good in the I\C\\'

to replace what is bad in the old. It bringsan al'.'3TCness of new ideas and new choices.It raises the average age of marriage, makesfamily planning more likely, and reduces

•

Lower eo"

birth Tates. As Japan's Prime Minister,Toshiki Kaifu, told me aS$emblffi heads ofSlate at me World Summil to!" Childrm : "IIis "" aagpratimr To lily IMT TM policy 0/prc"'()IUrg ~.dUl;lJ/W" ro'urilllled lhe vtry foun<lalion ofJapan's rkwlopmmL 1" devtlopingcountries rM Jim priorliy should be ro inj/ilultand i",prow btuk tdual /ion and raiu rJu liTno<:y mit am""g d1ildrm .10 m To maNe IMmTo liw wilh dignily. Norio",,'~m """10k. p/aa only whtn all pecpk hav< rkQ/'POl'IU"i/y To rtaiw tducallon."

In addition to c<.:onomic growth in thede':eloping world or increased aid from theindus~cd nations, both of which are tobe hoped for in !he IWOs, the "'sourccs forinvesting in people might come from threeother sources. Thc first is IIOme dcgrco: ofrestructuring of government spending inthc developing world 10 shift rerourttS infavour of !OW--<:t)ST services for the manyrather than high--<:t)St services for the Iew.In many countries, for example, even a relatively modest shift in this direction wouldIx: enough to invest in a basic education foraU. The second possible lIOurCC is 3 similarrestructuring of existing aid programmes inorder to devote 3 larger proportion to theIJISk of investing in people's health and education. ThaT notion is the subject of thenext chapter of this report The third possibility would be to tal<c full advanTage of thefact that the greater knowledge, technology,and communications capacity now availableholds Out the elcar possibility or investing inthe health, nutrition, and education of therising generation at a much lower cost than

SlIrvivcll rates in primary school, by region,1986· 1989

AAAB STATURea<:hing gr_' 2 .. 99'lII l .. 95'111 4 .93'111

Percentage of those starting primary schoolwho ruch grades 2 , 3 . and 4 1!J

SOtlTliU N ASIAllo!aching graoe. 2 .. 69'l11 3 .. 65'10 4 .. 59"l6

EA5TERN ASIAllo!oching g''<lt> 2 .. B7"III l .. 83'111 4 .. 78'l!>

Fig. 10 Disappearing pupilsOver 90 Pft'(ftIt '" child..." now uart IC~ in \heo.. .I~.pi"g ""'IIid. BlItm~lionl do 001even ruch lhefourth gr_. """'t ~'" 10<1 in \he f"'lt ~' Of two.


Reducing poverty:World Development Report

"

Tho 19l'lO~~rR!ll?orl~~1eI<t"..'.. .., its pag9S. !he Watd Bar>k damon·Sll<IIild that 1I1tI wortlI~ rJ1X7u'llrtY. mass......-..nribon.lIIera:;y.• hMth -c:o.Jdbe 0Y\lfC0ITIIlIby<tiredllO""" ". g odlon and IM1lhe <::cUl1:I'ieswtic:I1~ Ihio were IIIso~ to 8d'49Y8t"iCt* rates d ecoooo,oic grOWl!>.

It! IhII decade 9iloa l/'e'I. ee emuaI WorldDev8l:lpml'rI!~ has dweIed n'Oe 011 IhIlP'Sat1 ...... Q 1L poIiaos Yotic!> 1hIl BonklXIfl5lllooo8~ Of 8 hi< d .. iOe to gowth.

h its 1991 f9IlClII. lhe Benk relums to lhe!hemlld <:lied JXl"fl'1Y~ argui'Ig fQr 00 """Ionand _ """""'" and~ amtion pmg:;nvnes. "1tMIsIi'lg ;, peotJIe' , says !tI& repM,"rtW<EtS _ r(JI;.JIll i1~ tmns tJut i'l1J8n1_&<1 economic r"""s· . Tho wo l·knownQ:<amplllol ol..laP;wl and IhIl~ ofKt:woo"8died. And as i'I 1980._It>e Benksho:1lMld I!"Ollfmners with -. ku~ 01 pMwy ooOl!lo:wl....... sY......1lly ""'"' prodlx:tlve. Ihe 1991 report(J>OIes SIIdas /rom h:Ia end lhe Plilllpp nes 10show !hal bet teN 1OI..rished c:ttilIn I1l7'"UP10benot jo.ISI hea'tt"ieI bvI tigtw..mg iIl1ils.

The 1991 _0.. ' , ........, Rt!po#lllwetoreCI'lI'llIbJles 10the<XlIlftuIlnl:e rJQPi"io:l !haIllC(Jlomic growth and tu:natl -b<iIl9 lII'lol.ld belU$UIId~ and !hal lhe two 10'(1rnrtuaIV ,.. ,lucir 'll. But~ sticks cIoseIy tolt"otviewthai gowo"j"~'s pIooo is in the-.a d oociBl...._'. '1 ra!l>e" lhIln eoolla,,1ic "'."""Q811elll•Ma><lrOOm lrMJstmert ., poopIe and lT1<lirTun,>1$ .eo otio<, i'I rna:rI<6ts' is lhe rob of lhe ElarV<',~....

To diiiiOOO.,bate!he S"""gi$ii~ IIw!s<I!WO dicta, !he f9IlClII~ \he growth reo::tdot inci>icblI O&.al:\liog o:JulIries VIilIl lhBifcooIo'mily 10 this EIIM:e CMIf !hi Iasl 20 yen.T--.g price listortioos as .~ of 'mar\<8l

i'1wrlerenoe' and ooo:;aOOn as a Il"IElllSUfe 0('ifMlstmenl i1 1l"CJllle'. the B<ri:~ lhaICOI.llII'es 1hiIl dd bid,' on bolh criI9:ia lJaI', on"""ll'ag!l. boI :11% 8 i9<Jr. The co..o:1lries ...ti::Ilddwei OIlortt one CIlteoonorly (regIrdess or vohichonaj er-by 3.8%Itl"*_80.( lho8e CO\.I'lIIies .....'""-'l1l 10 anticipate Ihe Benk's 8lMce andperform _1lQIlfYlI bolhoriIIri:t. hade m.dl mor<I1",1l'96$Va growth rate of 5.5% 8 i9l<. .., otherwiKiii, i/o; w10< iiOO;; up iU ca.......w;.,. moot1IW1lhe IUn d irspert, .

Yellhs aar.. ill r'lOI 8'V<In-11llnjod Inlis !ICIUli1)oe eese two 83Pf!Cl' 01 de\ ' • • , IIlO ~ fll)icy. Its~ (;(l<"(i'ues10Dethai m2fflIIsC8IldOiI1Je'M'CIIl\IlI'ld thai alllCQlOI l lc: growthill M ; liIOttoegood~ ltoa!<rod oIlJowth votlic::fl!heWorld Bori. has assisted In the A-nemn feQiorl andIOHch has beneIiIad rlililhetlhs poor~Of ltie........0lWl'lent) . Govemmao1 1n1...-.,11oo In lhuIlCOIlOITlf, on100othllrhero, is 8lw<r)<ll 1"fl\lll"ded asgUtty \.ltd pro.eo i'nlcenl.

lNs ill arodds ..;m lhs~ which lhs6aIiI row a::NocBIes. lI'ld Ihe0Cf"IlIIldic1b1 eccesionett:!Ufacas. As. rtfffl SIUdy" pcinlsOUl, IO'd8lllha Barl< iIWl acIo 'OdE "'ges, l!le state has hada tI8El'uy hand in the rn:>sI ,. o::>:llmfU 1lCOl1Ol 11ies 01thelast 40~.InHor'og"~,Japen , lhaRilpublicoIKoma.~lI'ld Ta!wmgoyerrtnrllllSh!t'<9hllo , ::: : I prtvale enterprlsetoen<MtaI diMiiOPrnt>"11 SIffiIeQf, They hlwe. !of e><arrPe. enacledf\lndamenld lindI'llIOtrns.protecllld doo ,IIlOSlic pIl)l1aIrs. PfOO"(lIed E: 'Ecled iro:UI;';nes.. andascrmnat<Kl agejns! IIfOIl8flY and IirIInciaI hoIdngi'I Inlavout <:J fldustnalllSllEts. Bo.1 as ee B¥Jk righIty",*,15 DUl. lI'IBir gtMlil". '1S~ ., goeneraI,lM:lidod iha two crucliII~ the'( hawI no!aIQwed~~orticns >J pricvs lI'ld 6lCCl"IIlO gorates; lIld the'( hawI rOCIl aIowed~poIIcias 10 De captUred lI'ld arrSt·jacketed tr,o_......

hu previously been thought possible (sec ,for example panels 5 lUld 16). Put inanother way, the gap between the experience and technology now available and itslarge-scaie application is an opportunity towring considerable social and economicrctum$ from relatively small investme nts.

The year 2000 goals ado pted at theWorld Summit f(11" Children reflect these

Aid and needProposition: 11Ial iro:rt= i" in/.tmQ.IioMiaid .1wu1d be bauJ (»l <I nm ailltd <1M mM

I Utabk cammitmlnl to mUlillJ: ",i" imumlu<man IIUIh and fDr maimaining, in dijfirollrim,s, 1M pniwipl4 of <I fin! «JiIfor dlildmr,

The public in the industrialized world haslong believed that the great majority of theaid it gives to the developing world isspent On directly meeting the basic n~sof the poor. In fact, the proportion of theindu strialized world 's aid that is used forsuch purposes is only 10% to 15% (figs. IIand 12) .

If aid 10 secondary education , liS

opposed to primary, is excluded, then thatproportion drops 10 below 5%. Only aboutI'll, of international aid goes to the prim&ryhealth care syslems which could pn:venl or

10W<o$1 opponunities and represera apractical programme, ,,~th a significantpol itical ccmmienern behind it. for 'invcating in peo ple' over the neX! decade. Tholtprogramme, adapled to rultiOnai needs llI1dsupponed by the inlem.atiOn.al CQmmunlty,should become the essential complement tothe economic refurms that an: now beginning in many countries of the de"e1opingworld.

treat 80% of the disease, mlllnu lJition, andearly deaths in the developing world. Onlyabout 1% goes to the family planning ser_\~ces \\'hieh could do so mueb 10 improvethe lives of millions of wome n and children(sec pages 58 to 60), And considerably lessthan 1% goes 10 primary education" which ,liS ,,' ..e have SCCII, is both a b3sic humanneed and one of the best possible investments that any country can make in its Ownfuture.

If a renewed elTort to end absolutepoverty is 10 be a pan of a new world order,then the proportion of international aidwhich is devoted diTcctly to this task mUSIrise significantly over the next few ycars.

l"e final declaration ado pte:d at theW<>r/d SWlm;l for Child.", called on the

"


industrialized nations to review present aidbudgets in the light of the goals adopted.Na tional programm es of action, which meetindus trialized countries are preparing as afollow-up to the Summir, will not be avail.able until after this report is pu blished, bu t""vera! donor countries are known to beseeking to increase their ll1Iocations to pro.grammes which will help to achieve me:year 2000 goal.. In the United States,Congm,;s has made funding appropriationsin fillCal 1992 totalling some S500 millionfor international follow-up on the commit ments made II the World Summit forChildrm and much largn- appropriationsfor domestic programmes. In AusOlllia, aidallocations are being examined with a 'iewto shifting the balance in favour of programmes which support the Summit goals.In Norway, a white pape r will be: submittedIn parliamau On this subiea blc ;n \991.In Germany, an a11-pany agreement in theBrmdl!Slng has commined the DevelopmentMinistry to the policy that povcny aUC\ia.lion, with the participation of the poorwm..,h~, will be: the central purpose ofthe aid programme. Switzerland, Canada,and the Netherlands ha"e all mken initiali,'est""=tIs debt_n,:licf for the speci fic purposeof programmes to bcnefit children andaccelerate progress towards the S ummitgoals.

Pwpole or aid

Aid which is allocated to meeting thebasic needs of the poo r, and particularly tothe nutritioo, health, and education of thechildren, would receive growing supportfrom th e public in the industrialized

•

nations. All the evidence, most rttentlyfrom a major survey of public op inion inAu. tralia," suggests that many "'ouIdl1'\lIreh in the cause of abolishing mass malnutrition, preventable ill-health, andwidespread illiteracy among the world'schildml.

It is especially important, at this time,that this concern is expressed and thaI thenon-governmental organizatiotu and theconcerned public in the indu.miafu:ednations should also mobilin behind thecommitments made and the goals ag.=d atthe Summit for Chi/drm, And one of themost important wa\"s in which that publiccan contribute towards the achievement ofthose goeis is through inL",asing the pressure for aid to be used for invC'Sting inch~drcn.

'ille particular importance: of this poten tial contribution from the industrializedworld lies in the fact that man\" of the proposals diSC11Med in this report, and many ofthe goals adop ted at the W",./d Summi' fqrChildrrn, have a fundamental politicalweakness. In many cases, they are askinggovernments to give priority to 10ng-I~'T111

needs or 10 the poorest and mt influential""" tors of society . It i. Oftl'11 difficult forgovernments, confronted by short-termpressures and po"'erful vested interests, toadopt changes whose political Or eeonomicbenefits are often nOt visible above the declora! horizon. Making international aidavailable specifically to finance suchchanges is one of the very few ways ofhelping to compensate for this inherentweakness. With sufficient public commitment in the indu.triafu:ed nations, aid couldculm the specific role of boosting the political a11ractivCl1""S of programmes whose

• This figuredill.... ''''''' figuro 12 innddng <>II donor<oun\rie. ~ ....,.. of heiilhc_.IT<llti-lol....... ...... ..bi-lmfil <tid prograOTVM>, m in UIing 'MlrId Bankdata.. ........ OECD doti(ondfor 1988 ralho< lhon1989).Problems of d8iniIion ;nl incornpalbililie> of feportingmMod mNn lha1 tigum .... approximate only.___ <>0<:0 11000) r"' l

Fig. 11 Where aid goesOnlyaboul 15 ~f!11 of , n . id goo 10hei lth ,r"ldeduc~tiofl (olI leveb) on<! 10~tion ~rETIfJle$.

0Mt~I 2 pm:f!1t~ to pntNl)' IltalthUI'e 'Mprimory odu<:otion whidl on' the most 'und,omtnlal.......us ,Of the poo< majority oIlhe developing world.

Percentage of 10101bi·lateral andmulti·laleralaid allocated to heollhand education 5ervk~, 1988"

1.5%to primaryllealth care

principal beneficiaries would be the peopleand the causes with the least political reverage _ the poor, the uninfluemial, the future,and the environment.

Aid could , for example, be used tocase the frictions that would inevitably beinvolved in the restructuring of government expendi rures discussed in chaplerthe previous chapler. The principal diffi_culty in shifting social expenditures infavour of the poor majority is usually apolitical one; increasing the proportion ofthe budget spent on primary health careor primary education represents, in effect,a transfer of resources from the bener-crraod the politica.Uy influential 10 the poorand the powerless. Where affluence isinseparable from influence, thai transitionwill be very difficult indeed. Undcr thcincreasing number of democratic systems,in which the greater numbers of the voting poor give them a degree of politicalleverage, the transition will be easier. Buteven where govcrnmcnts arc willing 10

restructure budgetS in favour of th" poo rmajority, they arc often inhibited fromdoing so by the pressure of entrenchedveered interesls. Aid that is made available specifically for the purpose ofin\'esting in primary health care or pri_mary education, for example, could meanthat thc rebalancing of alloca.tions internally is madc politically easier. And it isin the easing of such political obstacles toessential change that the support of thcinternational community could play aparticular and vital role in the yearsahead.

Similarl)', aid could help to maintain theprinciple of first caU for children (page 15) .

3.'"10 other

health care

1.3%to populationprogramme

'"to .recondaryand highereducation

0.5%to primaryeducation

"


Education:school staying power

•

Tho 19f1011 walla' I bws decade lei edl.w;a.lion. OJ! 01cwr 100 dIMIloplng<:<>.nriIIis..........,..mby l.A'lESCO. two lIWdII Sfffl a dIlC:hl in ll:<j>IlIlIiII.<ilOI per~ Irld t>Illl saw a &II in IhoI PI''it''"lioi'of !heir ctildn:J1 nokId InprimryschooL '

Thecaee. nrro8I CIISOO, was !he CVl in pWIIcSPEll do III forced on "*'Y <:oo.r>tfies by the oeoIcrisis.The~ ill!hil1...-...s 01ctOIa~~inAlllcaa'ld~AmeOca.I\lM'IIosl "*opportIrity to become ibnle ard to~ th8bMIc _ ..... 'ry to _,_ Irld !hili'

l1OC>8lies i't the yearsahead.

A1rica ha<l baIn til~ !"(lrd. T~.................. e>peodtlUwas cut by /III"nOSI~ intho lYst halloIlt<Il98Cls. Asar8!ll.fl. !h& proporIionof Alr!ca's chiI\ht1 em>Ied in lhe f'o'ol ~ 01pri'nary Iet1OolIelIrom 84... In 1geO lO llpflfOlCi.m:J!flfV 1Q9i, in 1990."

Deb! was not !he only cause. EducationalPOIcies ond nta:nalJonB' aid po"","'"'. <XUdhIl'I6 dooemora :0 proI«:t primry .... oratm.8o.J100 otllf\,~ _ hIrY9-. deYol&dto higher Illication for lhe 1llw ral!1ll<!tl;lr\ basi::eQ.lcaIionb' 1M "'""Y.

EvM 11'0..91 50 or more dtilIn can be pn:>..ood IOlIh~Gliocatoon lot !he COS! or cniI~stU<lerJl, 8<ld--.lt'oltq1 tl>o<.osardsoll.ri.vsilygr8<ioBles JTlJSIchoose~ .....,.,.~ nl8t' igoalioo .. mlnyCO\llb'lElll COI'tO.leto dlMlte lisproponionalo "'6"'.."''''' to hol;fe'9l1lc:aIion! ' A ,elabYfll) smaI shll in IhIsbaIanc»;;o<Jd, In "'""Y ClISIIS, IId'ioMl lI"IMlfsal priTlBryllWcalIon IIIlll proWoo Ill.lCf1 \1OOtllr flIlIicl1altlerJIms In bO\I'I ec:on:::orroc: growth Irld soci8I..,.....

AIdPfCQI'anmoo '-r8flklrcold lhe biw. LessItIlII'l I,", "' aid llO'" to educIIlion md I8!ls lIwl5'" cl lhlsgoes toprimtry ect..ocation.'" The 19l1OWorldSt.mmil fr;f0ltim SOI1ho1a'g9l ofllChloM1ga basic lBveI 01 8OJcatiolI lor8l1eas1 00'll.01dtim

by the Yl'l"' 2000. lt1a1 gooI can be mel, as IhltllXli'aOfdirwym:! Lis. $ 1"" ':sorT.......1nth819 708In! ZinbBbwtI in the 1geOs ha'w9 :mwn, The"""""Clle altha BRAG sct>ocis in~ hasaIao dIic'QlSlJal9d h;lI ~ ill~. ei VfIY lewcost, l e> prrMde a__lOlho&ectti'en(In:l ~..., gi1s) \lotio hlNe diopped M 01. 01'.........Sla/Ied...lhoollicilll~!CI"o:;ICIIsystem.,Most 01 the ctildn:J1 atlOldlg lhe 6AAC 8d>oolslslllI' re;on fQnTeI ec:lI.o;alion.

8>.!! rc~ ee~ 200D ::oel :'::;':e:~edo 'Cric>"l ... I'otoooe to 8S!UI""l a.-priorIly In lhej'lIlWlIlmlOOiaIety lhIltd.

lhe la$k is rJ)t pmWfy 0IlII of t.J.*.Ing IIlIWsd100is Irld IrlIifing newtoaclD's. ~ is tm QUBfly01 lhe educaIJon on oilier wt'ich wll cleterminol!II.lC(:$SS 0< l3iUlI "' ttl& 199Oe....

S , ,, ,.. ~ "' ttl&list~ at PfO'narY IlCh;)OIhaeIlhwty n>a<:h8d high IeY8ls n aI mgocns '" Il1e<jeo,e ':pi'lllOOlld e><cepl AAIca.'" The ....,.,1caIcapacity to 8COJO" ,iOdoll" all~ is IIl8feIor8no! me pr'. dpaI prot:Wn . ~ ls el, aln"'l ", lI1e:fnlr~ 01 prmary IlCh;)OI voIIicI\ COlr'IlS. AAd cI thereIiMrll age~ In each cooni..n. final yewpr1naty Id>oolel l 01/ 1• ~ IS stlI t:ri; 47'l'. n Africa.539b n Asia (ro:ll nctIdi>g~ r;j 64'11> n l.aIWl-"ItI Olhet""lfOS . ttl& gr88l1T'lljorlly 01~adCIlIi:h'l n ttl& 1990s ... be I.O"iEdlcated no!bA<'a"" It'"'f lid nolgo to Id>ooltull>e<'a .... It'"'fdid not stay thera

~ lmm poo.:erty r;j !till need lor ctiIdmn'shelpill home In!illwork.ttl& ITIilin"*"""lor thesedet:*tating~ 18l8Sis 1hIIpoor~ '" 1hIIIl(U;:aIioo ptl)Jidad. 11 \0)0 manycases, Ih9 ......IIf1C6 ....., SIWlll;:nI '" ttl& lICkI<:alb> onallof Is soolMousI)o poD" that, lIS a 1OlCIIO'lt tJt.ESOJ tepctlputs. .p;ntlts and~ r- no 0ftJ/Ilr I8IionIIIdIOictJ /han Ill.."., wIIh IhiJ6 fee(' .OJ

That princip~ impUa protcetin&: the Iong

tam inlCf'eSa of children IpinJt C\"Cn the_ in~ shDn-tcnn ptUIUrClI for

spmdinc l:\ItI in nutrition prograJnlDe$, pri

l'lWy health scrvi«s, or primary e<tuCllUon.In the same way, many of the actions nCC'dcd

10 pn:ltm thc environment and achiC\'e SUlI

lainabk de-'dopmc.u also ~ I

cornrnitmenl to the Iorl& ICmI wtridl _

~tI, hard-pralCd by shon~crm

considenuions, filId difficult to make. Aid

can nuke thlt commitment mol'\' poUticaUy

feasible. Similar Ifl\1dlCfltl apply, in Yal}"

in&: dqrecs, 1<1 such cumtial invatmcnO in

people as primary health can: SCfViccr.,basic .-ducation, land !'donns, Idnndngfcmal~ equality, Or ~muctUring govern

ment budll':tS in favQW of buic Knica fill"

"" ,.,..In otbtt words, the essence of this pro

pos:al is that, in a new world creo,

international aid should be consdously and

speci6aIIy U$C(J to hdp Jlf'e\'l:DI the: Impof_

tanl from bcine lubftmd by theirnmcdia~

Public I Upport

Tbe lise of tid in tttil _-:ay Yt"OUld ortd.1<1 be .orltt:d OVI in pal'tna'Ship 'lith dx

rc:«iving nations. 11$ pcxmlial shouJd not

be dissipat~d by unn:asonable aetitudes

towards 'conditionali ty' on cithcr lid~ .

W ithoul dx support of polil:icianf, press,

and ptIb1ic: in the inc!.UIlriaIiud W'Orid, lh=:

.iD be no significant inc:rnsr in aid in the

years alw:ad. Tha t support will IKl1 be forth

coming "ithOllt ~gard to the purposes:

which aid serves. llu: nttCSSaTy incla.sa

in internlllionaI ax! wiII thcrdort: depend 00

• sustained and tkmonstnbIc coounitmcnt,

on the pan of aid donors and aid ~Vtt$,

to the tas k of enhlncinl the CI~city of the

pooresl, their health and nu tritioo, their

tdUCltion and 1rIiniDg, their ability 10 Qa1

more exatrol 0'1'0" their own Ih<a, and 10

cam • faiT reward for thcir bboun, and 10

meet their (lItt'n and their families' llCC'ds.

h id that rulfds thai purpose is the kind of

aid which the majority of people in the

dcvdopinc world Yt-anl 10 rca:M:: and kind.of aid whidi tbt mjority of people in tbt

industriali;ced work! wanl to give.


The economic environmentr'ropooitiol1: 1'001 immKllionai UCMn ontkbl, (lid, und INok ,hcu/d CTrQIt on mvircm-..1 in which mmomiG rtform in IJuJIkwloping world am ma:wJ in aJloT1!ing iupegpk 10 wm .. tkcml filing.

Although average incomes have ri~n

substantially in Asia (ind uding China andIndia), the 19805 wc~ nonethdcn a dij.ll$_Q'OUS decade fQr the maj"rity or countriesin ~ developing world. A,-cnge incomesreU byapproxinUlldy 10% in Latin America(and by much more among the poorest )and 1»' 25% in Africa (whcre lnCllmes werealready the lowcsl in the world}."

In 1990, this uneven j»ltcm has continucd. Iii iIi" l8 counmes of East Asia, fit'capita income. ro"" by OVeT 4% in 1990;;nthe eight countries of South Asia (includingBangladesh, India, and Pakistan) per capilliincomes rose by jU~1 0'1:' 2%. But in the[yo'o m ost debt-ridden <;<>ntinents, thedecline of the 1980s has continued; percapita incomes fell again by over 2% inAfrica lind by o\'CX 2.5% in Latin America(and even more sleeply in counmes such asAcgentina, Hmil, and Pem, whkh havee~ln'Illody IUgh levels of dcbl ),"

The economic environment withinwhich the developing world must earn itsliving is nOI the primal)' responsibility ofthose organizations and individuals whowor l< directly with the probl<:ms of children.But for a decade UNICEF has watched thet1eterio....tion of that economic environmentbC'ing translated, in I1llIny COUntries, intorising ma!numnoo, prl:'l~ntable disease , andfalling Khool enrolments , Proposals toreverse thi. deterioration would thereforehave an air of unreality if they failed toalso acknowledge the enormous economic

•

difficulties under which so many countriesare still labouring,

It is panicuIarly impon.ant to addressthose difficulties at !he present time. Shakeninto .. new realism by the harsh economicride of the 19801, and aw= of the e"periem:e of Central and Eastern Ew'oJ>e, manyif not most dCl'eloping nations have begun10 adopt the kind of economic reforms thaicould bring in~asing prosperity 10 theirpeoples in the yean ahead . This change inattitude and economic thinlci~ has passedalmost unnoticed in a world pr=ccupied bymore dazzling changt (although somc commentators lut\'e noted that these changesreprc$CJtt II "q'<kt m>oIurion" with a "poIn1

tiaJ for advw,cin,g human ••It!l/aT/! IMI "",_MY ~ ~/lXr,01) But it is anoppommiry not to bC' missed.

At the moment, it is unlikely thai thispotential will be fulfilled because too manyof the factors which brought disaster in the1980s arc still present in the 1990s, Even ifeconomic policy and management were toimprove, the problr:ms of external dehl, ofdeclining terms of [)';Ide, of prOll'Ctionism inthe rich world's markell;, and of excessivemiliUll)' spending, still n:main . In etherwords, the deve!opil'g world "'ill lind it diflicult to fmd a plae<: in a new world orderbecause it is still chained to the mistakes ofthe old,

World prices for raw materials, on whichso many developing rounmC'l arc dependent, remain at their lowest levels since thedepression of the 19305, In the last decadealone, the price that Africa is paid for itsprimary products has fallen hy approxi_mately 30% in relation to the price it has topal' fOT its imports.

The degree of dependence on such commodities, and the steady deterioration intheir rdIl ,'lllue, ill one of development'smost intranSigent problems. And it is goingto get worse. As new t«hnologics, synthetics, and management systems continue toincrease maoufacrurin& efficiency, fewerraw materials wiD be needed. And in thel'eal'S ahead, the increasing usc of biotechnology could further undermine the tradingposition of agricultural raw materials.

It seems that there is link the developingworld can do to prevent this steady erosionof its prices and markets. It can attempt tocoordinate production, at least regionally, toavoid dep=sing prices funher by cverproduction. It can also anempt to strengtheoits Oll,n research and development capacityfor proccssing more of its own raw materials into semi_manufactured Or manufactured goods, But at the s.ame time, itmust attempt to diversify i15 exports toreduce ill dependence on a crumblingecooomie base.

Tht: problem with divenifica tion ofexports is that the indllstriali7.e<l world,which so enthllsiastically urges f= markapolicies on thc d",'eloping world, protectsits own producers by surrounding itself\lith tariffs, qUOtaS, and subsidies whicheffectively close the rich world's lI1l1rl:ets 10a whole range of possible exports from thedevcloping world (including a wide rangeof agricultural and tropieal produce, steel,textiles, clothing, leather goods andfoorv.ear).

Estimates of the COSt of such protectionism to the developing world "ary widely,bur the total is not less than SSS billion a

ytat'" - mere than all the aid recei\'ed, Adismantling of those tariff and non-tariffbarricrs wollld, according to lMF managingdirector, Mjchel Camdessus, raise thegrowth rate of del'eIoping countries bynearly 3 percentage points, so yielding benefits l:QuaI to twice the aid urev recei\'(C,"

Fig . 12 Aid for basinfhI! twf/ve indUltNUZed (ountrie! rOf whkhInlonNtion I, ""alloble give about 9 "'1(""1 01lhtir 10110dir«tIy I'IIel!ting the most bask~,01 people In Ihe dewloping _ ,

Basic needs ' allocation aJ percentage offolol aid, selecled donor counlrie5, 1989

• 'Basic needl\PCOdlng' IIdf:Ifned hmoa,expenditure> on ""mary t>e.ollh caP'l', ""mo'Y andSKoodlry eduutlon, ramily planning, ~nd ru"rwatt< >UppIy and oanita tion.__ <><<0_,""" , ..,


South Korea:more education per dollar

"

n. rT"Il:-t -"'''''''' 'C1' deiOl"l8tor of l!>e........ III.lCC:IIa IIIOries • Hor9 Kcrtio JIIplwl, ee~ds;,..,....... Swl/'lKcne.. T...... -eeceIhlI welIIh rJlhIli' _ IllIl;U'C8I tu ,. 'MIIIfth01 ,.,. l'u'rw> f--..olIOJ. Fram \IlIo __ tI8gRSd tc(lI(),1i(; de< ' p ,e .... QI....", .... !

'-"'I' 'n'"canon."'b-'119501. 'fIOlUlt_~SCUIl

Kow...._ ' b".at..-=o'ldhIIIldIN-.uy. • t.. _n_ .... _ . Wtne. lis 'iI' S I~

~~;=:dJ..-=;;:::b=f.~~~. i ...~__.

Y-.l7r .. ...,.19501. .........., __~ two Of ... In-. l'qllr (:(Ud be., . !WI let &co.r4ty-..GNP d CIf'l\IIIIlO~

c.pU. Arcl bV l lilll. ,..~ .. lXUlWs_ o,1ie llIk&-oll.l107' III d'UW'I__~.Fog gm'Wy KI'lIXlI Ir'd~ tn 1IWd __ P"Gon to 18C00.1 eo:U:riDn.

In h Il'ne dec8del 1i"Ol~~ Korea",_ iIOi O", "'" grOWIl by ~.~ . ... ttwo_ etrtott.l't8ticn

T...oIe8tlnsIl"ek8So.Ih 1«Qol'. erie ••••o.riqu&, FQt. ~~ prWr-.y .,;to _ III

....... llIgenils ......... '.... ' , ' . ll ltWlp a:tic:ItI' "'tor.co.I""t,s.ccnct. •<Id., ........•*' ItIlll rn. ::alli.' b\' lliD"6'OI'." Far 30.,...,4*di'llon..........._ .... '3"dGNP . .. ....1hB-Vbhdf i._",....

In II'ICIr'l, SCUll~. .h' n '11m:-. ..........CUld~~o.,.I",........_~.H:w_~w:J • ..n

Fir.. pei\i'.' bolt> -..:l WId....d&d on • ..- IlXlIIl • •• " b'........ IIflIdI •• I rlIll • ..-v of_lID /lIV. From 1950 10 le7S. ....... ..,_ pidold '4l ........ ,.-,~ol"...' Ilk

In PlI'I.tt.~ lDmakB oaalfIoBIecItI'*lvm • 2.000 yM'-oid CC:nII.cia1 lrlldition III re·'P'C! lor1tIIl.,;lul;:r,*l1*WOJ\. 'n;:.t"" tonoIlhe IIlIA wcri:I\Illfll't::IlJti(:J1 lhlll ec:a ''''_____ • t 'i.edlt'O'flbot ............by~...

SCo"O. -. paley - t i ..... _

lersslnCl....~ 31" 'j' ilMll dtfflD'IIlTOItoltl-...lO.-rtlll pri'I-.y ...........lor iii .-d IICW"O .. Ill'- _ p;d< "" ..Ie 'II........blt....coo"""• .-.cl....,.............. Eo.I _ 2S"-ollhe CCIIIIl of IIIi'IWy.. ........-.-r.....I:¥~ho."1' ........-y_.- .'.,~

IN'd.tqI ro:ltw_ ......_ 1alPl"'OOIIClI..........,b/oIw,...,...-noIl..., _ dIr , _ 1(1 CCM'ItfY. Fer Xl~ ".-. .....n- ... pm., dloss ,.,..........-.:;l M. Thill _ I'I'lede " • ....."..... t¥.~ rIgicl 'I" _ ro:l Slricl .a"i ....... ,~.SC!loOIiIe\lfl'ged onlhl!l Pll'arn1lIary.

WI\tI ,... ...,.ies.~ 10 nuic. tnd~lOl\iilId.l, TileCIllirS dlllOOI hiMllO Wf¥f'/IIllool dii::IPii ... tnd lhey ....e co '.... lStIIed forIow..... t¥ hql -...

FcuI\, SculIII<crIe clIcid!Id on • .,...... ",80*'","""" CWO,I(llIIliI~ IraTI one~ 10h -. ..~ .. ' , ' 1(1 <:o:Ju*iI&, rruchpm-.y ICflOCl (lIllIICIfy • diIlocJlIId 10-'-"'...,1O ~CU......Of_ ..$l:Ulh K<ne. 11-. .. ehIoIt 110 ' II: ' 'I Of~,. o..... , I0 .......~ 10 "" 1>.1-.10_01.,·· ,...... ,...,.,.", -*y.

l'i-iIII' ~IO~1 , ._lid 101I'lII _ pr8Cbol )\I<iO'V....•~ lor__ uIcn. TliI ........ clod.><*ionIIa:lII,.~...,~'.a-...I'

....""'*OOII"V'" - ~"

DimIantlin& such Iralk baJricn, t!lrouIha SlIlXft·fu1 completion ol the Jlft$ml

Uruauar round ol I1Ib undor the GmeraIAareallelll on Tariffs and Trade,~thm:flll"l' proyidr mud> llCC<kd ox)"ICI' tothe pi ........ of cccnomic mann in lhl:dc.clopini 1O'Orid..

"",In additio n to lbesc problatu, lIWly

d':n:lopina nations are prewnle<:! frommoving Iorward and taking did. place inany new world order because th~y an: heldback by the seemingly immovable ....'eighl oflhcir de bt.

In total, lhc developing world O"''a

approximately S\ ,300 billion to ~ governmenu and banks of !he industrialiudI\lIion$ and III international fllWlcial insriruIiont. £ad! )'ai, the: rcparmem of capi(aland inleltSt amounts to apJIf'lDimatcly SISObil1ion - 1'OUibIY thrco: times as mudt as thedt:\~ worid rroefo,a in aid. A5 il isimpon,'Ne III IIXIl:( tbcse i= dwJa inruB, lhc lU1lOUnl UI'IPbd is added 10 !he Iaa1debt~ 10!his WlIIY. thc: debt burden haspdv:t-cd its 0W1I Dlonleunun which haltUm it tll !he p<lim lrilcrc noI only can thedebt _ be repaid bul thc: lIlUmPl to lTftI

C\'a\!he imam dIarJe is ofu:n cripplinc 10

ee mo,..aDII:III towardl ............ldr: rcfonn.

So far, the indusuialiud world's role in!he debt crisis has not: been • vinuWI one.rll'Sl, irresponsible kndina is as much tobWnc as irTaponsible borrowint. Scc;ond,il is not llCting in good faith 10 llrIC' d cvcl.Clping C(lUnmc. to earn their .....y out ofthe crisis by divm;;fying and exportina

moR' orhik al tho: AmI: ~ mairnainin&lariff and other tnde barri~n whkh preYmI. the dtio"'dopina wortd from Incce..fuDy foDmtting !his ad\ia:. T1tirIl, the Ia~"$

am:ring indmdtW blnkrupu:y and debe inmolt industrial eounlria act limill on creditors, IlOl: aIJoy.in& so much 10 be:~as 10 Ica\"e the d cbtoc unabIc to feW his Of

her family OJ ('VUl. 10 afford the lI'ICanI ofeamina a living; il is time !hal lhil COfI«pt

was applied to international uansactiom.

To lJK)',"e forv."ard, the d~IClpi1li worlddnpcntely needs til invot in ;11 infrasuue:rure, i1l indusaializarion, I nd its pcopk.When its raw materiall cllTlin&t ue ;ndecline, when th~ inlCll'I1 on ilS debuI bsorbs a quarter of III ill eam inas, Indwhen new export mlrlt~1I I n: closed. byprotectionism, then these cssenrill im"CSlmcn1l in the future limply CIIUlot be made .

FOJ 1C\"CTllI d«adcs, the dt:\.cIopingworld has I1so been Ibk to count on aidand concessionaJ. finance for I I kUI a Partof the in\-emnml il needs. BUI the debe cri... bas now n:acb:d such I poUll ofabsun:lily Dt L'lc ~cIopina: I\lDons In:

lining ttl lrIDSfer fllllDCial~ to IhcDxhmrializ:cd IlIIion1 rather thin 1bc otbcs'...y round.. Wbo:n all lrIlnaCtioorI In: takminlO account - !he ImOWII that all IICJUIU:S

in !he induRriaIizcd nationt lend to IhcOC\ dopina: counlrics minus 1bc amoutllS

tIw the dt:\'dopina counlrics Ply bKIt in~) ' .....1S of capilal. and inlCRSl • the neIdfm is thaI the dc-.'dopinc ",,-orId is oowll"Imfo:ning SolO ttl 550 billion I ynr to theindumialiud ~"or\d (fll. \3) .

It ....ill nnl; be l;I$y to l'C\"tnC !his fmancial!low in 1m earl y 19901 ....ttcn inVCSlII1CTlifinance is liI<cl.y 10 be in shon supply. The

.,

THE STATE OFTHE WORLD'SCHILDREN1992

Baby-friendly hospitals:a million lives to save

•

I'M~ lrcm ,.,....~ oA hcoIP\aIIIttm:qIDUl lhe v.ortd <;(l\j:j teve e~ by !he/rorII . 'b.lCe~!hIIm • 'bIrly.lIlIndy',n. kl8ll it Ihe eres. aMn::e L'I • dIc8:;IHlnQ...'.....,'10 lXlUlUlt' IhII_~ """ towerdI--ill _ iii< . fTQlI~ _ ~

"",-*, - ii ' ... ' •__..

..-moe.. • ...'r--.,.. ...01_....,.-Ion...-.:-

0IiIlliII1I ... to F '" '- da:tI cl •_ ......n-.-IO--._~goOLIIII \IICltI<,...-.;n~~ t :car.»K-'.iItrd men _ ' i ... ..-,._

fId'9 it ..modlrn Mr.

~ hnl~ inlIIrior"~ $ll". 11 oIIIn _-dl.Md we. _ .,...-- bclllla So • ~1Id I*lI' ., • POOleotmVlty_ tw,o-,15_mortIIo:eIy1OIt.tom dIi 'I ~..., . '"'"men..,.10 <ill frompnounoniI. Itoon • bIrly _ it ......., l..e J!led,- ~ WI«) 8Itlr!'el. 1Nlmen IIw1 ....... d'tieo' ClllJd t.. _-., V- I .. IIllllhIQ ""* tlOIliIs roo\tW'o;l1M b; BBI ,"I<:< !he fa-sl W 10 "" morwr. of ile.

r....~ ago. WHO ...., l.MCEf drew up.'code d pr8dIce' b Ihe~ 01 boll l, iI<._... The c::odR .,.q,c 10 tIIo'I II p.bIc~rd.~01 ~lcrn'la.

J\br,oo, IN f'IIO... ll"' '-~_up.~d~IDr"P,, · ' ••••••__ doil'll'''' ? _.~

B,"' ID rrA:r-.oIlTlClhn. k'd""*.~.In" hi..ton...bd'I CII'1 dICiOI"",,*,ornau~",." ' .,. bt l 5 I 1lI: ......., NACA:'* 1oXllly. I I' .... Iclt .._._.-d~.~"'r.lIrCbn'UI.__ .. tlI1I\. I I .. ' _ ....... _01'*>fil"WI _ • •..- .. crdIf' 10p G '' ' '~llI'Ir'td oIl1l1n1lcrn'la.

lhe.-c:x:w_out.,..... SlolopIIO S< : •III Iw"V.~' N.~ """'111 IN code

wil bIIlleIV OIled '1J8Oy-f\ien<tf. lhIIl0__....,

1. _ . wrItIIn to_I_ \!~-1llUIt'oely

~edlO"_SllIIf

2. '*' .. te.IIh _in .""'IlO"'""-*,,••C'iii pcIcv

3. ....... II po""' .,.,... h ....and"• ..,..••• oIb 9

• . ..........~bt iQWilI'Inhlll..---5.. "...,•• _ ICl to h*d, .-.d "- ICl" ,....... '_ ' I!'W\I -.cucl t....tgm"..-.

&. gNel. W" ........, laod Ol<i'ri<or._b ,.... ~"........,.""-:l

1. pr8dill1UOI'1"",," "*"" "r::cr• •n ....110_ iUijid.)~ htu'i. doV

S. ...........bt ..... iQOIl'..""' .

9. Il'o"' i'IO -*'II _ 01~ CIIIild~ 0'~1l1lObo f "..:llill inla'U

10. toeIa" !hi MIdtAIiII".~ 01 b" tfell(jl\lIIIPIX'1 Qi'CII.C» llIId reIer moIhoinI 10 ltoI!irn OIl

disc:hage from '""~ 0' <:::friCt

Many worneni'l tnfd6' : '·lQworldllOnoI~I*1h .. I .. t, Thoee..no do~ _ It<<i

b <TIf 48 1lCtn.So !he WO'ktM:le 'b!II:Jt:""""to.. ,* t ....,"*9. Iln:hed i:lV lNCEF InllVM:linArNrl",frid,.1991," ar r:ri1t.__""""II ..... _ 10 po..,.... bt ......,.McJIte:If-.d lhI~all...-• ...,..lIOgNe" bIt*..bt!It Pi'""'*-1: Ilia'~.. 110~ b ' .... It'll' wi! ... '-'h IUJll101 tJ~ ndI I,nCIrI. QCm:~·Inllal-.

Wl* .. G "-' _ .. bIibJ-"'-'dyI'OIllUlI idII, IN:E' Ind WrtO ..-.0~01'1 lIIIi ...... Il;ImUi CCliI""-' _ '-.......dId. " ... IIO-.pIl ...rd ......dislI'b..rdon 10" ,,,, -..is Inll t _lIOIbi 1M n d l\1ln.

Soviet Union, iIC...craI of illl Republics, andthe nations of !::astern Europe will aU absorbwst amounlll of investment capital. AI thesame time, reconstruction COSIS in Kuwaitand [raq arc estimated at between 5150 and5300 billion." But only by a mOn: dTasticresolution of ~ deb t crisis than any $0 farproposed, and a reversal of nct financialtransfers to the developing world, can muchof the dcvctcplng world hope to n:gain meground lost in the last decade.

If the ....·ars and means can be found to

CUI natio,," free from thill l.",den legacy, then

DisarmamentProposition: ThlJl a prow, of dffl,ili"'ma_rum should btgi" i" w. dewlapi"l[ world o,uiI1ltU, in sup wilh lhal p1'OUSj, faIl,,,! ",i/iUlryapmdiluns in W. i,uJ",lrialized "",it""lltould be /i,,1«d 10 signifiwtU ,-"=ases ;"inumammal aid far ckwlopmml and for 11~

me/mitm of """,non gWba/. probIeml.

Military spending in thc dcvelcplngworld, although vaf)·ing widely from regionto region, is running at approximately SI50billion a )·ear." [n Africa, a contincm stilldcspcr:lte!y poor and despel1lle!y in ntt<! ofdiversifying and industrializing illl eamomica, one third of an the maclUncty imponedeach year is destined for me mi~tary. In the

the economic rcforTrul now in evidence couldcoincide with other favourable drcumstences10 aUow an unprecedented period of gl'O"1h.As the World Bank's review of prospects fotdevelopment in the 19905 has said: "Thel1f>PUrTI",ily for rapid dew/opmelll il fmlUrtoday J1fil1I al any Ii"", ;" hislDrJl. f"rnnaritmallinks, in w /om! of lTlMk 0JJd flow' of ;"fomwtWn, imJeslJHl'Jl' ",ui udt,"""'gy, IIrt lll'O~

""'" dum fimy yoal"S ago. M"dicirw, uUna,and mginemng """" all mad. grtQl SlridQ; W.~filJ all' (luulabk worldof~'idt . And fJO/icJ'mm.m """" a bel/no undmranding J1fil1I bef"""of1M oprilms for rkulopmml. ,,>,

developing world as a whok , ju.t theimport of armamcnlS absorbs an amou ntequivalent (0 75% of au !he aid received ."In general , it is in me very poorest countries where .pending on the milimry illhighcsi (f'i. 14) . The 46 least developedcountries - the poorest group of countriesin the world - spend as much on their military ~apacilY as on health and educationcombined.

The cue eo'lS of this massive militaryspending, year afte r year, go beyond thedestruction of war (panel 6) and thedivenion of SCllr<:c resources . Stimulatedand sustained by superpower rivalries, a

"


China:reaching 90%

After .... e>:b llOi ti"81 ~ eIlort ... lhB 1980&, thelargo! 01~8O'Jj,ol t!le"""""'fschildren bytIlI'* fnt biUidaJ'S hall been rtlllC:!llld by mostcountries. 8uI ~ is not 1lIlllU\1l.~icn""""

...oIl '- to rlsa f\rthIlf l <iseasst~ ct'tien .... 10 be ptO«lCtoo.Ttat~ 'tItr;ee !'\':n:tS::,,,nii!()r~ e:lCP'.e:!!he """'" latlJ8l 0190'11> iT"m.ri1;Ilion lXMII'l'Cl" In IIICI.UlU'oes by the yew 2lXXl.

~ llJI(l !V$18io"Ir9 lflIl extnI 10'lli vMproW '*"'* lISbig a 1aSI< lor Ihe 199011 ... react'IIng80%wasto!tle 1900s. Bullis feBsibilir}' has l!IIready~ o:leo,OOO OSIr'llled in Ih8 world". most f4'" .....-In 1985. Q'Ii'Ia selltgeIIl!le lagel oI,_Hllg85% of III~ - i'l lIle nalic:n as e _ by1988. ... (MjI('f I"'l""'CO by 198!1. Md i'I tN&1'J<XXrty by 1990 . Today irnrruization ClCIWr8O!I II'ICt*Iio.8Irn::Islit !l9% lor 8CG ""'OOt>e. !la 'll. lor tIloI!YfIe """"" 01 pc*' YIlCCO'1e. 91% fa 11>0 _

ooees 01 [pT. 8nll1l6% lor lfl!I!lrlI)I& measles shaLTl"e _ ..... atDIIdY eYidenI In a "enp tal In~~ lhaf'UTiMoIrret5Iil6cases,lor """"""'. has atlppod fran <Mlf 2 ".",a \$.""to las$lh;,in l00.(XXI. PllIIo isa>:PllCl9d 10beeoll<laWld by 1995."

lha _ lor IICfYIM'lg \lO'li, ha!Ibeo<llhBS)'Sl1llTl01~~ -V bir1h: tal docla's 1hefl rcIiIyIII PIQ"llS.~. EMIly line me int80l is ()J8

lor..aeeiNliot\. Many00U"Ilrillshaw IlIC!'IieWld 90'11>coYllI'I'I99 lor the~ o:bse of OPT (It JX:6o (lI'iy toIal IJeIWld""*'~do 00l rel...... lorme secco:lOf Itwd doses or lor !he U1gla"""""*'" iiecIion atlhB age 01 rIne monltIs. In 0:W1a. lhII~notIicaIionsyslern moonsthaidrop-oul ra!elll'8'vebeen reWt:ed to less than~,

In lIbOuIa tfi1:I 01 an'. COU1!lBs, Ite S\'SIIlmis ,,,;, ofuo oed by51 '1rmu'IllIlI;)ncontraeI ' . Pa'l!f1ISP8Y a <nHlII'~8tion lee as soon 8lla cHdis born. and 1M guIlr.ltltooslhB cHd III ..... f._lito os. 1hereaIter, ~ 1he CIlild contJ1lClS 8IlYVBOCir&pruvmtabIe dsoosiI. (he taniy rec:eMlsm.nciIII cornpensaticn."

Incrfmf in immunization COvtrage, childrM umkr one, China, 1986· 1990

'"

" es " ""

- - BCG

DPTl

- Polio3

--- Measles

milif1l)' culrure has come to predominate inmany developing nations in "",ent decadcs.Such a culture rends to be contemptuous ofdemocracy, indifferent to human rights,and threatened by political, pcnonal, andpress freedoms. The total military biUin thcde,."loping world would therefore have to

include the direct destruction of war, thedivernon of resources from investment inpeople, the undermining of democracy, thegrowth of intemil oppress ion, and theSQUllndering of much of the support fordevelopment among the public of theindustrialized world.

With the endin g of the cold war, hopesarc higher than for a generation or morethat this biU mighr soon be reduced.

The industrialized world can do muehto help. It can convert military aid intoeconomic aid in the interests of both peaceand development It can rclItriet arms salesand try to prevent arms suppliel1l fromexpanding sales in the developing world tocompensate for declining markets in theindustrialized nations (th e five permanentmembers of the United Nations SecurityCouncil account for 90% of the world'sarms sales)." 11 can also begin to insistthat debt relief, aid, and new loans, be tiedto red uctions in mililary spending,progress toward, democracy, and investmentS in the infrastructure of health andeducation rather than in the infrastructureof war .

But the current disastrous levels of mili_tary .pending arc the one wall of thet'Conomic prison thai it B within the developing: world'. own power to push back.And nothing Ie.. than a mll!;.ive programme of demilitari7.ation wiU enable

many of the developing counaies to fulfilthm potential of the years ahead.

Demilitarization i. easier said than done,not least because of the shCCT importance ofthe military II!; employer (there arc eighttimes as many soldiers in the dt\'eloping:world as there arc dOClOrs) ." To Case thetransitio n, and reduce the conflier bctw«nmilitary and social eKpCnditwcs, morethought might be gil~n to the potential roleof the armed forces in the war on poverty.It is not uncommon for the military, withtheir organizational capacities , their skilledpersonnel, their rcchnologies, and theirtnlIIspon, to COme to the aid of civilian populations in time. of emergency or naturaldisaster. In the process of demobilization, itmay be useful to extend that role by transfusing the skills of the military into societythrough the construction of infrastruClUrCand tlte training of civilians in such areas asliteracy, engineering, electronics, mcdlanics,and communications.

The conversion to development purposesof the massive investment in, and theresources and slcill. of, the anned fOTCCSmay yet be a long way down the TOlId. Butwere that journey to be mken, then manynations would find themselves ahle III

march more quickly rewards a more PTO$percus future and a more dignified place inan e"ol"';ng new world orde r.

The indultrialized naooDi

In the industriali:oed nations, whoseannual mililary expenditures arc approximately equal III the combined incomes of


the poore$( half of mankind, arms ,pending hu fallen by ap proximately 3% a yearfor the last four yean. Following the dramalic disarmament proposals announcedor agr«d to by four of the five permanentmembers of the Security C oun cil inSep tember 1991, even largcr culS may beeXPf'clcd in the ~1':arJ ahead. Three quarlen of all the industrialized world',milhary expendltuTCs of approx imau.'ly5800 billi on a year are cum:mly devoted10 me defence of Europe where me military land scape has been transformed. Thepo tential for cu ts in the 1990s i, thereforeenormous.

Hut what is missing is any coherent andagreed pian 10 link even a small part ofthese potm tiaU)' vast savings with 1M delpcratc need of the dc\'Cloping world forrenewed aid and invcsnncnL The aUocauonof cvw S% of =01 milirnry spending in

Setting Africa freeProposition: TlJaI lhe dwim of A.fri<.a'l tkbIIN. Jlrudt off and lilal 1M Clmfinml be givt.,mfJi&im1 a wnal support w allow i"fn7lalrtjrmn II' suand i" rtgerwo/;tlR ~ mqmen

fUm ofdewlopmetU.

For mc fIr!lI timc in me modem era, asubcomincm is sliding bac): into poverty.The number of families in sub-Saharan

•

\he industrialized world would be sufficient10 allow a doubling of aid budgc!s (0 the!lIrgct of 0.7% of GNP, - a tatgCt that wasfirst agreed (0 in the 1960s.

In particular, a proportion of militarysavings should be alloca ted to achieving \hebasic humaII goal. agreed al lasl year'sWorld Summ,i fot Chi1dretl. As a reminder,\hc flnanclal cost of reaching all of thesegoals - induding drastic reductions in malnutrition and disease and a basic educationfor all children . would require additionalresources of approximalely 520 billion ayear throughout \he 1990s. 'rnc dcveloping"'orld's proposed oonUlb utiun of tWO thirdsof ihai amouni would require the allocationof approximately 10,," of its current militaryexpenditure. The industrialized world'sone.thin! share would amounl 10 I"" of itsmilillu'y spending,

Africa who aTC unable to meet their mostbasic needs has doubled in a decade.Avemge incomes ha"e fallen by a third.The proportion of children "'00 are malnourished bas risco. The proportion ofchildren who are in school has fallen. Th isyear, drought again threatens 27 millionpeoplc in 14 counnies. In lotal, 40 millionMricans are now 'displactd' b}' mili!llt)'

conflict or environmental disaster. And as ifin a frnal ane mpt to brea k the spirit of acontinent, almosl 3 million African womenare also infected with the AIDS ~'irus and Imillion childreo h.a~"( been born HIV positive; in the dCCllde ahcad, it is estimatedthat 2 million children will die and 10million may be orphaned by the disease.

lDtentaI nalon

In addition to the economic losses andthe eonfliets caused by apartheid, the eeeeprincipii internal reasons for Africa'sdecline arc economic mismanagement,environmental degI'lldation, and milillllj'conflict.

Autocratic governments, indlicient .tatecorporations, larglMea1c corruption, unproductive investment of aid and loans,distortion of prices , markm, and exchangerates, lack of in\"CStmenl in food production• all these have been paid for in the fallingliving standa rds of millions of ordinaryAfrican s. And most of the victims have hadno sa)· whatsoever in the political and ceo-nomic decision s that have led to the declinein tlIcir incomes, the rising ",,"I of theiressential pu rchases, the absence of teachersin their schools, the bare shcl,·es in theirhealth centres, and the increasing malnutritinn among their children.

Meanwhile, the effort to mel'CU(: agricu1rural e"ports hal; claimed the most fertilesoils and pushed desperately poor and evergrowing populations onto ever moremarginal lands. The result has bee n theo\·CTCUlti,·alion and overgrazing wh ich haveled to the l,nIgcdies of soil el"O$ion, falling

yields, mass hunger, and mass migration tothe refugee camps where the problem Ilnallybecomes vi.ible to the oUllide world .

As. if these trials ""<.:1'C insufficient toexercise the talents of government. Africahas aIio been a theatre for long-runningwars and frequent coup, d'iuu which have

Fig. 1J Revenlng the flowThe w n .\hoWl. the lid ft~nciaI \"nsffflb8weenInduUtiali«'d and~ng~tiOI'" """r tM lIIUdeu<lo!. 'Net [I,n>len' mo.", all loan.. k:>ng.term . nd!I>o 1000$.

Net finom:ial uamlers between donorand recipient coon/rie5, USI billion5,/980·1989

Tr~nsfers todeveloping countril!$

t 1980

1985

1989

Tr;mM~ fromdeveloping countries

..


Supershots:children's vaccine initiative~.". 3 ...", cHd daBIh!IllIlI rlCM'

bIIing llf"!"6"lled each year by i'IYnrizatIorI. BuIIhill IepIl'IS(II\tS less than a IIWd of fmuizaIioo'spoIenliaI oonlI'tlutIor1l<1 'MlfId 00Blth.

Two ........ctti'tIn ci!I each 'r- be<al'lG!tIByt>eIDng to It>e 209j; wI>O 8<fI still rlClI~wittla.nar>ltt~ """"""lIl A !unIw 5 to 6 miIionpeople die .....-....ely !rom d 5 : ; : 51 """'=" eecellIrnoslca18inIy be~ed by tre doM!kopniliaof ...,.... vae:dr'tes.JI

/he ChithJn's vaeen. In/IiatNe. ta.nchad boo.......... ,.. ..... ...... ,..,.....,., .. ,,_ - ........~,,, ..... "'..... "'.. " ,.."..... .. '...... "''''''aims to .-row INs Q8Il bel--. the aetu8llW'IdPOlW"IIiaI CCIl'1I:ributio of inrnurilaIion~.

14. present natlonaI chikl ITmnzaIion ~gnm-nes >1liiס Ylt'JCi>ee againsl !IblIrI::uIOSisdiI:trttIIlfia.~. fda. v.iooplllg Clllli'J'. andm ':. wiIt1 someCOI.W'!lr'Ies Biro oIIlri'lg ye6:Jw~ lVId, mora ~1'Mlll<lliliS B/pMeI 15~ Ole(lllteel s '9"$ofth&~·sVll<X:ti'lehWlMl

is to llX\lWId ItO:o ""'9" to inc:UloI _ dallkI

vaccines~ rI\ilIIJI'e (cl.mndy "*"'" Wf!( 1"..,., Nric8n ct1iI:hn """" YIBI. """"",t<:<yIn1ectrlns (3 "..., chikl <lolaIfllI a j'tlIW). 111IlI 1iigiti.\(2OO.CO)dm1toIa~ . oerIlIin_·S~ as fOl!rVinJ!; (8CXl,OOl de9I!ls a .-}. as I\GIlIS hepall!isA.""""'"~~~~!<MIt. In;! AIDS.

De. !,_1\1 the vacdrIes is h!I/l1he batde. Thencome the Iogoslo» pooblems 01 ...........-.g wI<lttspread use. Today'! veccoes eogains1 mm';!polo. """!lbeI~1or~, .........bII k.apl,eiigelated!lom POflI of manuIaclure to pginl of1r'ieC:tQl.fUI~ eeerooui'es lcu'or1Ml~a ' 'lEICIiO' IS dlri'1g "'" Ibl yearof~ """lhildfop<llllatebet...-.1h9htand~ ilJectionis1llernai'l ~totqler~OC\YtII'IIg&.

/he CN:nIr!'s Vao::nt In/Iiati>ol lIIbo am. tolrin rElClll1l~ In biotootJlOlcg)' 10<MJrCCmIl some at ltleSe po 0IlIi0 los."

~ 1$ <'ON p::>sslbIa to .lCO/pol alol....,.,."......ccinoo

onlO OM eaniolr:" Vaecms e:I"l also rlCM' eepackaged n~ .... wI'ic/'l releasil !hercomoots ....... trne. lIiIIw 17aduo1v or in pUses.IwJ ~ !ItlDIAd IlIso be p::esllle to mBke mosl""""'- less dopoIndIInI on ,«. igao alioo c

Tho POI 01 gctj aI till! ....-.d 01 Ito!I 'i 5 d ,rartxNI is B singIo-slnI '!IUpIIf wocine' wI'*:h<.:><>Ud OOgMlntochillhlosoon oft... bnhand wI'ic/'lW<J\.Id pru!tlCIlte'n ltgIinslllloIlJ ilJo.xx:fsn1lIP'lnIeclions m-V low COSI.

n.n gaO may lIlke two deeados or """' 10~. &Ii n.U:d• ..w"gy h ...... ,00."" and\hle-, :' . '" VllCCines is 8lJlo8(ly 8YllieIPJle. By theend of!hilldIc9de. ~ tna)' be possille10ad! rIii ;mrIII 01 to<lay's "llCci'w iI sirlgIeiieCIiOr'.

By tl>!I mid-l990s. ~release toohooologl'c:o.Jd 8loobe~ i'rm..rWtioo. KX'M1 in theMlI'IlI 01 its ~esl talU'e - !he JlI'6'9"IIioo ofneco;lllllteI8IUI wtlich klIs lin llSIinated 536,000il1allslW>:.l an lIlkr'lOwr1 t'UJ'Cler 01~ e-9Y_ . The .-.bOrn CIliId ClII\ be protected bl'ilmriMg the moIhllr. EklI1Nll~.. SllYlI1lli Ijeclioi ose--tiTle (Of,~, two_spacedir1e<:tIOnS firill~ and III present, less!Ilan 5O'If, 01 ""l)'TlEIIl ere prcI8Cted- A .-tme-...._ V3CCII'8 roN lftl8rdIMIlopmo<ll oIhn lIi>QIe:SIJ::It protec'.ioo end c:o.Jd IllfJicIY raise """",age."

&an 1I>ese.- lOCh iOlogiea leave rntJnI prol)I8ITOIS lnSC1Mld • how to t:mg .- vaoc:ines i1Io~ end inexPeNMl~ how to~ prodI.o:bon Ind <:lUll!)' CCW'JtrO', how tospeed I.l:'IIeId trBs and k:e ... 'll proc:eo::Ues. l'llll01__e~PlIIboeo$lipwilbeneededberween go:MlO I ' IellS IWld the f800lItCh end dlMllopmant cepscilies of the commercieJ WO/Id.""

So llr, the de'. EI "P' re ~ of new VIlCCi'Ias .....been d'iYen WgBIy tit !tie needs rd theIflBI'roiIts01 the rich i'I8lIO<lI. ., !he l~ on& 01 the ITlOel<illic>A~ wll bit 10 .... ltlal -..ltMl to1he~needS.buI~COiI'llSicisloppor.lUiti8s, 01tl>!IpoorWOlId.

been pan cause and pan result of the factthai Sub-Saharan Africa as a whole hallbeen spending two and a halftimes as muchon its miliiarY as on its health. services.

&tenia! ft llSODI

The three principal eXlernal reaso"" forAfrica's decline have been the use of thecominem as a board for SU~rJlO"'er games,the relative faU in world prices for il$ rawmaterials, and the unsustainable weight ofil$ debts.

Much of Africa emerged into independence just in rime to be ....'OOCC! by two

su~rpowe., representing rwo competingideologies. Long perceived by many Africanleaders as an advantage, it is elear that thissuperpower rivalry has in faa made a tt'2giecontribution to the o\'Cmlilitari7.ation of thecontinent and to the emergence and perpet_

uation of the kind of military and autocraticregimes which have led so many Africannations imo the abyss.

Economic dependence on raw materialshas been a quieter calamity. The majorityof African countries havc been urged toincrease their earnings and pay their debtsby exporting more of their primary commodities. The response has been a 25%increase in the volume of erose exportsduring the difficult decade of the 19805.BUI the steady faU in prices for Africa's rawmaterials, in relation to the cost of itsimports, has mcant that its camin~ havefallen by approximately 30% in the laSt 10years."

Ancmpts to csca.~ from this tr.lp byd;'-cmfying exports have quiddy run uno

the sands of tariffs and quotas by which thesupposedly fm:-m arl::et cronomics of theUnite:d States, Japan, and thc Euro~an

Community continue to protect their ownproducers.

The third external factor in Africa's crisisis one which represents one of the greatestinternational failings of this century.

A nCW slavery has shackled the Afrk ancontinent and its name is debt. The countries of Sub-Saharan Afriea, includingmost of the world's least developed countries, now o....-e s total of appro ximately5 150 billion. Each year, Afri<."ll muggles topay about one th ird of the interest .....hichfalls due; the real is simply added to therising mountain of dcbt under which thehopes of a ccnrinent lle buried.

The total inhumanity of what is nowhappening is reflected in the single fact th.ateven the small proportion of the interestwhich Afriea does manage to pay is absorbing a quartcr of all its export earnings" andcosting the continent, each year, """" Ihoniu total sfi't7lding "" dre health and MuastilmDf;/j ptopk (fig . Il).

To date , the results of the Paris Clubdebt re-scheduling exerd sc and theToronto Agreement arc <:TItirely inadequate." Exeluding Egypt, the total ofAfrican debt written off is approximately 57billion out of thc S280 billion owed. Theconsequent reduction in interest paymentsamounts to about SO.2 bill ion out of theS32 billion falling due and the 512 billionlICIually being paid each yelr." Betweennow and the end of the century, even thefull implemcntation of the Toronto T ermsis unlikely to reduce Africa's outflow ofilllerest payments by any mon: than 5%."

"


The most recent debt reduction proposals, the Trinidad TCrTll$, still do notrepresent even \~ beginnings of a ,.,lulioncommensurate with the scale of the problem. The most generous notio n on the table(and it is a long way from being a~)

.....,uld reduce Africa's total indebtedness bybetween 520 and 530 billion. That wouldmean a reduction of perhaps 53 or 54 billion a year in the ;n(C~1 due, but very littlerWuetion in the actual interest paid. Thegreatest hope on the present hori~on. thereforc, is that Afril;ll will be slightly bener offon paper willie in practice me financialhaemorrhage will continue unstaunched.

In one of the most recent and cump...,·hcnsi\"C analyses of Africa's debt and !hecffom to reduce II, the economist Percy"'\istry comes \0 the "inaw.pabk amdusitm!hal lhese t/fr:tr14 ~ 1101 b«n rom mnD~Jy

<!Itaivl in Qdti4fJing w objectiw of I'fiievingfddnf In,r<fms mJfii:imdy for Afriam roumrioILl Itavt! a T!aJOIwbk cha'laI <if r= inadlinling J,""'IUra! a4iustmmt, nraJt'tI)'. orgrmcth. ill l1u fommdile futurt, ""Ius prroiotutW."twry af>prf1Qdla 10 <WI rrlit! .,.,., aban~dtmed in faoour of _ dramam 11I.1

ubsoluuJy 'IU;4W.ry and IOllg~ =ion. ',"

Moral huard

If a cuminem is not to be left behind asthe rcsr of th" world struggl.,. towards anew peace and a new prosperiI)', lhencxtnordinaf)' mcasurn an" aaw called for.

T en yean of prevarication over thisproblem has al"""dy damaged not only theAfrica of today bul the Africa of lomorrow.WM e more than SI 0 billioo a ycar is hcing

"

sluiced OUI of that desperal d y poor conenem in imCTCSI repa yments, lens of millionsof children arc losing meir ooe oppommiryto grow nOrman}" to go 10 school l1JIdbecome ~Ienl\e, l1JId 10 a<:quin: the slriI1snecessary for meir own and their cOlmm",'developmem in me yean to COme.

It is daimed mat the industriali:l.ed worldcan do no better al the present time. YC1ways have: been found to halve Egypt's $40billion dcbl following me Gulf Waf and 10

make a similar ~"(}flcC$sion to Poland following the liberation of Eastern Europe:.

It is claimed mal a more drastic reduction in Africa's debts would constitute a'moral hazard' by rewarding these who donOI pay their debts. But the real moral hazard is surdy 10 the soul of a world which isprepared 10 condemn a conunem 10 continued poverty, and a generation of itschildren to malnutrition, fot me u ke of collecting 'meresl on moneys which were oflenilTcsponsibly len! and moSI of which cannotpossibly be repaid.

It is also claimed mal debl forgivenesswould help to sustain failed economic policles. ROI the ma jority of African eountri""have already begun implememing basiceconomic reforms.

Events in Eastern Europe and the So\"i~1

Union, coinciding \'li th a clearly marked'end of the road' fOf the kinds of pol iticall1JId economic systems that have prevailedacross so much of Africa in recent decades,have had a profound effect on the eomi nent. M~t eoontries have now begun 10

lJlke the: firsl steps towards dcmocracy, pluralism, and mafl<et-om.n!"d economicrefofTTl . The prospects for renewed economic growth and social progress should be

Perr:entage ofcentrol governmente)(pendt/ures allocated to defence, andJociol welfare, JeJected African countries,1971 0nd 1989

Fig. 14 W. r venus welf.reThe gr.ph (QIl\fa,u 1M ri... in military~~iturt,

(dWlM line:!.), v.ith 1M dKline in -Vore ~.pencf~""",

(solid ~nes). in «I~ of 1M p<lOf8t Afric.n counm..~ 1M " 'I two decadM.

zs

•

Welfare __"Defense

"..

stronger in the 19905 than at any time inthe Last two decades.

Wim these: changes, me hopes of a continent have again been awaken~d. If mosehopes cannot manage 10 escape from unde rthe weight of pas t deb ts, then the result willagain be the despair and frustra tion whicharc Ute natural habitat of dictatOR anddemagogues. If Africa is 10 evoh..:: !o"..ardsa new internal order, and to fInd a dignifIedplace in the new world order, men the present oppo rtu nity must not be lost. Theways and means should now be found 10absolve Africa of the great majority of itsbi-laleral and international debtll.

The democratie tboiee

The new spirit moving in Africa todaywas summed up in a recent address 10Africa's heads of state delivered by meNigerian President, Ibrahim Babangida:u

'~y f!W ind«J wraud from lIS asa ptop/t. Thai faa is rootd ;" OIlT huWry.Equally undcniabk, hownJer, u me ftv;1 m.u'/Jim 1M <Ill of fflVIJt:rillg thaI~{lI ...

Afti=' kadenhip ii, gmeral did HOI git>t »Uldlthaughl W rk logic and juslia of reinwsringthai sqvertigruy in ilS ptoples.

"Dmlf" .rlCy is nos DIlly (m llu""tiV/loplwn bul a raliMulJ ami inA'iwbk OII/!. Thisis 01'" act of our i"u:mal reparations whir),kadenhip on this ronl;nOU "''' no IongD"

""""

"'17Jue is no w ling subJliwu for a ~fqlmd ami painfill (a mmilmoll ," home CDre<mUlilUU our wcU.IW, W rt:fomr Our poHIildJYsu:ms, ami 10 rtsfJ1l(IUrt: our «.onomw ...

Wtllore~wrt> irlduIle houJing and )/urnde.m>nco!; <(lfrII'J'IIJr'W df:>ei<ll>< ,.eo ,t Jlo'YI"f'I'I> Ie thelick, !he <fo>abled. II>e elcSerty andthe ~PIOYm;family. malemity and d>iId aIlow.nce<; wer..~ "",,",eolor the elderly, the disabled, . rod tM:lren; poIution._t _I", "'l'll!Y and $<WI.OLOon.---.-.. .. .._,-.'.... ,..,

01972

e 20e

I,- 15

i~ 10c

L


Hepatitis B:the seventh vaccine

The global~ system. buII lb'Wlg the19l1Os 10 deA\'lJ' voo::ines llQ!IinsI~dip/'IIIIeril, POlo. teIa"JuS• ...noop1'l1 00Jllh. a'ld" ' CO<Ad be lJ9ll(l in IhB 19!1Os tc controlhepatitis 8 • one ollh& world's gt8iIlesl~........

HapQt/till B ds rnn Pl(:(liIl I.MTf~ 11mAJC:6 "*in a~. Kis I'"'I"" aoble forabwI 809!.of!II ""'"~ and more casell oIlYer do,I_(60 mIion~)!hBn 1lIoOI:1cI."

One '*""' in six .., 1IIe world !'laSr:-'I h'ecledwi:hthe~. and '"'uo'«ely300rriIon ....d'roric~.TheWus"'~(lIIIhcl.qllhebody may rid itseII ollh9 i ,!ectioo ~ lWld is lI'SnSrmted try a I'a"Ig8 01 bocIl' r-..ids. fl"tllO"iV ltJouj:1sexual acIMly bul abo via CQ'llaCI YlOth """'.Mi.natedt:bxi, bVpIace1tal~II"""""'i!'llmmolherto oobomchiI<1l1f1d tryskinlMIons.~ _!hemain If--.s of~a., ' "incI'id<lln.

Abou1 a It'irdof a1 1holiEt Ir69ctlld with hep!ltIlisBdMIlopdvoric~AI'larlhllllCU1el)!laoo

has passed, abaul ffil, to 10'll. 01~ IICtinsbol<x>o'", carriers of 1M <:Iisee8e." AII!Il:Jo.ql not....-swlIy sI'owi'lg any 8Y" "'*" ' tS. 000pi«l ptOQI ass:.,. lW'Id possibly fatal lF.w da'nage, they joinIh& 300 milIioI'l pool 01 ctworicca-I\Q v.OO SP<llOOlh3 Wus In! perpeluale ~ from one lJIII"'O[O'1O

~-mnuvalioo~ hBpaIIIisBtIaS~!MiI·

lll.lIB lor !IOITIll 1inl!. &l! bec!u'le !he II8CCire wasderiYed from bloodgiverl by acarrieroI lhev'tus, ~c:ooJd~ b/l prodJoold in smaI q.oantltlils. Thecost. lJ'lliIlh& IaI8 1900s. was $110 par1h'9ft.$'ItIlcoo.rse.... Now.ll"fl'lIK: ""'-'1\1 !'laS rnado ~IiQ'lUbIe 10pI'lXb:e Iwgar~ oIthevacQoeIII a t:OllI 01 S2lKl per C(U!l8, K1tlIl nt'NI """""'

goes 0'1l0 WOIlo:twicIe '*' .. chid 'nuorizsion~ t<lW ,tlIiiCl • 'll1Il% dill inI51Is), lheolIIIlcost e<:Ud IaII llSlowas $1.50....

HEIV irmuizsIi<>ol .. particUarIy irrclcrtMt lei'dtiflll. Not0I:'tf 8f8 InleClI.:l c:tlil:tlln I1'llItI~lodBvelop~ hIlpelitisBandai'nOslfoortrnes rro-e _ to d9WIOP lMlr CO'lOOr. 1hey eealso Il1L.ldl more lI<eIy !hBn _ to become cur·riIn ol lho a-. One quarter <:J lilOSII JdecuIdbelotto IIle IiI(/&of ...... be<xlme caniers (ard 70'llito 90'11o 01_ i'1Iecle<l tlelore bftt> by pIac«lIaI~."QWj.lO-<tild illIeclIoI .. wIlid1 can0CC<.r <bI".g play CJ" bed·S/I!W'o"lg "'" SIIi'II8SionsIUd1BIl 'i IiP8IillO. !lCltlies. cuts lIld intect«l insacIbiles, is "'" ......_01~B ild iU~.

InYIew of lt1e laIIing cost of llle """""' and lhe~ olell!y iTm..rilalh:1. Wl-K) has oow.8<XlO'". dad thai hepatilill B be Jd.ded as ltoa'_ 1Il'IOOin&' in ill nationalcI'id~pmgt..".OlS. So !..,22o:unries, mai-Iv"SaJIh.EasI Asiaandlhu _ East. h!MI bIVJn rouIi'IOHSV_ . ArIoltIeI' 00 COIrItries hlIYe pIoIpn:jecIs ..... ..",., Of planned....

So lao. genIIIicaty .. Igi_eel HBV r. beenused OOfl'lOo"e lhlio OOn'Aonpeople~and

t>M bgeI\ la.nt! kI be""" 01 the sales1 ancl m:>BIefI8clMl 01 ill we:Qnes. NId boca .... hepatitis B isa rro8Ijco" causeol ..... caroer. ther"lllW "3Cdnesarai1 eIl9CI the W genel'<:allv engil'oo'ed C3lIOOI.........,.

~ is tnerelote le<:l:"ricaI'I' !aasIlIo kI ..-..cicalatIepetItis B.The woMW:Ie COSl is IkeIy 10be lP"wards 01 $100 miIm a )OOO". WrtI> the ""'PIIfl'IM!1*1 - tile deIvery systoon - I!iteadi in pIaoe . andwilh 90 rru:::h .......... hea/l:tl a l siese, ~ v.o::Ud Sl.nI\Ibe 1I1IhilI<atJla . the~ """ nollol.n::l.

"Today, the clanumr fur ~lizatWnO1ld pony pluralism is 011 W aswu/n.ncy i"Ajrial. A. 1eaderJ, W<1 "1...10iUp1 and «Implyrriu. W wU/le$ of lJrost whom IN reprlWll.No amoum of for« W" flmWr Jrifk W righlofW gorxmed te ~, al 1Jniodi4 fr« andfair UulilmS, 1M fau af o"y gql!ft"'mnIl.

"~ rawgu Qf civil u"rul righl <la"OSJ

/!fir tcltlinDll, lhe «I~UPlI reurrdaliml oftre4litJity far our human [>Qlnllwl, 1M imolerab4 flow Qf milIiOlu of our humanily turnedrtfttgttS from tMir />W" I<mds ... COfUlilUle apmIfaIInll rtbuM 10 uur poliliuJl judgnnnuOM will ... ~ only 'l:iahlit 1Ji1nltlJ1;W is an..are mrbroa of lhe ~Iic OPlilm . UIUS taJu W ruol.... 1WfC, and amtmil ourulveJ10 1M dismam!ing ofall apparalUI of U""fJUWI/alive Jl<'Wn, Sl ll ing a dau before lhe mdof this cenlury /or Its~I.~

Pn::!lideru Babangida's call for ,;"umaJrtparolWtlJ ' is the l;Ouru~ 10 his call 'JorAjriallU a whok 10 fiehl ill ali pwible waysW ;USI balllit for i" ttmaliotIaJ rtparotiornllIa,,,,1 W centuria of humilia/ion aridtxp/(,iul/I·oll III whidl il /ta$ bun subjrcud ...For AjriaJ, he colldutkd, "lJrol ./wu.1d be WProt- J/arli"e poinl of a 'lUO"i"gful N=World Ortkr."

(n response 10 such call, and 10 the newspirit evident in Africa, and as a gesture ofreparation for exploitation in the past andpreparation for a new pannership in thefuture, Africa should nOW be absolved ofmOSI of ilS debts.

The COSI to the industrializcd worldwould be by no means crippling. SubSaJtarv,n Africa·s tollII debt amOunts 10 onlyabout 12% of the debts of the developing

world as a whole. BU! fQl" Africa, the sheerweight of the ball and chain of debt andinteresl repaymenlll now means that there isno realistic possibility of forward rncvementuntil illl financial shackles are struck ofT.

A confmace for the Mricm child

Whilc attempting to lackle these fundamcnllII problema, most African nations arcalso preparing National Programmes ofAction with the specifie aim of meeting thegoals agreed at the WMId Summil fMChildrrn. The process of fimding progrestl(awards such gools u halving malnutrition,reducing the impact of the most commondiseases, bringing clean water 10 all cernmunities, and ensuring that aU childrenhave access 10 basic education, "ill be mostdifficult of all in the Sub-Saharan Africanregion. Latl': in 1992, the Organization ofAfrican Unity inlends 10 call an internalional conference to dmw attention 10 theaction whieh Africa is already taking to try

10 reach those goals and 10 5ttk the supportof the international community in sustaining that action in the 1990s. Africa willneed to find at least SI. S billion a yearfrom lrs own resources, via a rc-ordcring ofilll inlemal priorities, but wiU need aboulthe same amounl in international aid ifprogress lowards these goals for its children_ and its future - is 10 be maintained. 11Icresponse " ill be one of the fint oppornmities for the world to reach OUI the hand of anew pal'l:nl':rllitip with Africa, and 10 signalthat Africa, 100, has a place in a new worldorder.


Facts for Life:messages for millions

Thafo II lcxl!ry a I:IOOjI f1~ CI*:I IIelWIt>i"IlllrrnlIlio.abwl8ale 1T'IOlt 1"'""'"bhhIl*i"g.to "*"0. cHd llJIl'Mh 1"'80110 ..0faI,....,.,.tIon,~ion •..0 AJOS • ...nct'l mall__ ce:U:l eel 00 a>d ...todI otUd proMct

......ol<:tti9o. ~ il1herlllco~~IIII1rniieol flON _ al\lh to"'-.

To""',... .. t9't. .... ..-Ity, F-=a bLA _ ~ in IllS br I..NCS', I.tESCOIn:lWolOin 'OOd .._.:18l~Ogliil:ibJi. w::M'lg b' c:ttiWI.1hI booIdrII .. a. _ • _ at 55 .."..ff' QiI" 1OdI(.......w_ .mpw:tt.OIl. ""'"'"'*' lIi,"lr"' I~ 01 p--"'!!~' _~

n.. t-. Idwdo'_.IOr-bU-.o-3..5 oapiII'-_~

'" 120~ _1lO aueiIL

F-*"'UlI."""'l*tof"lChool~..-G'DrIillrlCyP'OQO ,llgInLe.V--"~ IUud. Cape VwdI, Djbco.Ii. e:..-.Eirfpt.EtrooopiI. ..............~M· .... .~. Me>dco. NeptoI, ""'*....~.F'l iippli •• AwRja, SiIJlaLeooe.SUClM. SNa6....,. T......... Th8Iilao"¢ T~. ~ Nam and,-n-et1lBlJl.-.bsofmosl~"-~

l.WIQFa:t3IorUl9. '"T~. I rT'iIIlQn 1IolIIiIb8l'lCl.... crI~ 01f_ b' L.iIII~ n~ 114_ ....- -.I __ 10..,;11......... n~ the pl .... , r- t->.... _ b .. r--.,.-.In ea.-.~_medal.........~trUl9lar-.eu..., lDT"tIV"OCYserw;e. '"SIenalM:J'le. I'Ie t'eIlln....0:. ill nri'Ig l ,Q -.I...~ """"'-ard~_.....WI;lIlonIO ....F.:Ist7LJlII. Ito VIIt NiI'n.25.0lXlFaa.""LADllImV'ir:alCn_~nndbr"~d~

to.... .-,co.nry. .. ..-INlia_........dId...."....TY__-......._01.. tlCd<llW..~ _ 000 .._ ..~a1,' • J\l'U'OtdtallOllP<II*M _ popAIr redo """""'.,"'_

PoiIlcal .... tIa'.e Il!o helped. The ThII ·aior1 _ lulched by !till~ Pr\mtI ",....., .wt"(l RId "F_ fer IJie ilaPlBClicaI (jI! of~~ tblll p8ff1fltS'. P\......~ Cora«ln Jl(p1QDIllie PloiRli__ ~ kI be lra1IlIled Into ..10"...~ _ t8wlw,1IAMlid III 111'.r.-d ChisHno 01~lilu'IdllId lIlt....uw-...on and CIIId en" .....,.,'. CCI'm'U'lica:n 10 ,,00 '_ .." __In VIIt,.,.., .. ....,.P,..... f11f'111 Coo.rd d,._. In"ICU"C*l. '11!e G:;o$,.,•• d "'"....... b __ 01 '4ll ....", lo.... ' I. ltIeo 7 '9" d~ ,.., b' tJIII b' '"lwUJi_dr#..-noiAtwr.

lno...1_~"-~~

nl2i1rV...In Ihd.. II'IIP' ...... " . '- d-..,. pt,.I

Fa:l5FatJIII" ""'0tl120....... llIIIIIct.gl..In~ lO....-an"..... C8Il'\'''~ageL In T.n.y. ll'lI\' '- ...-«l on 2 mIionmo..-

In .... FtJati b' Ult I\eo!I bM1 UIpled b IhllNI!IllofIIII L.iMncy CIr'r1laign '-=:tJio 'li 2 ......PIqlIIt • II'lIi1tiwomen.

In to'e«.:O. 3eo.CIXlC(lpiI:ls 0I1he IIllli:IlIII Yonb'I_ ~ diIlrtlulId CIA 01 e pler..ecHc. 1rriIi;n

In M,." • . 2OO.oo:l <Xlpieol oIlhe netIonII~ '-~ prob::ed b IlChxis, I'IlIIllIICIfllIW,_....,_.....".....n:l~

0\11*......

........3lXI.lXXlroc-'-~~.. !Du' ".." b ~ ......o:lIIgiIIrd ........

InSri~ 8 • UCopoo.,t.0111'""'" __ Fa:l5 lor Ult<rM b 10JX10..-

In T.n.y. __ tr Ult .. ,ea:t_U .1Cf'Ioo:f.~ hfWlg of 250cm _. n:l1,500 Il:tOlI L <>.00< • ....",F_ trUillI '- '-' .-l by 65.000"'- ..~.." ..

The apartheid of genderPreposit ion: 17wr a IItW world urder shuuld~ lJu aparlJreid oj gmder asviglmJusfy aslJu apanMid ofrau.

The one constant of the dc"clopinjjworld, whether in Africa, Asia, or LatinAmerica, whether in ciry slum Or rural villages, whether in the depllu of ewnomicd~pair or at the height of economic activity,il that women will be working from fin!

~ght until after dark to meet their families'many needs.

It is a corrunonplace that the developingwmid·s women bear and care for 113 children, fetch and carry its fuel and waler,cook its meals and shop for iu needs, washitll clothes and dean its homes, and lookafter 11$ old and its ill. Ii is leu widelyknown that wOmCn alS<l grow and mark etmost of me developing world's food, caman increasing proportion of ilS income, andwork, on average, twice as many hours adar as men."

In return for this disproportionate conuibution, the women of the developingworld are g.:neraUy "",'Wdcd "ith Jess food,less health care, less education , less training,less lcisun:, less income, less righu and lessprotection.

So heavy is th is weighl of discrimination tha t il even sways the survival chancesof the girl child . All other things beingequal, girl children have 11 better naturalchance of survi\ing the early, vulncrablcyears. But all other things are not equill. Inseveral countries of South Asia, (ewer girlssurvive than boys." And in this gapbetween natu ral and aClUal survival rates,discrimi nation can be measured. In&ngladesh, India, llnd Pakistan il adds up

to more than a million dcaths every year.In other wOTds, a million girls die eachyear because !hey are born female.

If a new world order is to anempt toPUt right the most glaring failings of theold, the n this issue of discrimin ationagainn WQrnen cannQt be Qmined fromthe agenda. Yet the severity and Kale ofthis injustice has not yet been widelylleeepled. It is, fQr example, an injusticeQn a far grealCT scale than the apartheidsystem that has aroused the fervent andsustained opposition of the internationaloommuni ly in reeent decades. The abhorrenee with which the whole WQrld hasrightly regu ded aparth eid is an abhorrence born of thc simple moralpropositiQn thaI a peoples' rightS andQppQnunities - where they can Ii"e, whatedu cation and health care the}' willreceive, what job they can do, whatincome they can cam, what legal standingthey will have ~ should not depend onwhether they are born black or white . Yetil seems thaI the world is prepared toaccept, with none of the depth andbreadth of opposition thaI has been seenduring the apartheid years, tha t all ofthese things can depend upon the accident of hcing born male or female.

There is link exaggeration in this 0001

parison. In the de\"C!oping world today,many mOTe boys bttomc IitCI1lle than girls.In somc CQUlUrieS, twice as many boys asgirls are brought to health centres fOT treatment. Employment rights, social securityrighlS, legal rights, property rights, andeven civil and political liberties an: aU likelyto depend upon !he one, crud chromosome.


Tbe prlCtic:al costS of Ibis bias are !bem:l1KC'd dl"c"ti...<:nesI of almost e:ver)' Olhc:raspect of lIM: de;.'dopmcllI pUllX....

BUI 10 di.aimiIllllC qainll girls in UH:matter of educational opportUnity is perhaps !he: biggest practical mistaltc of all.Ova many yean and in many ~ounlriC$>

the education of women hIlS been shown 10be: associated with me confIdence: to adoptnew ways, the prop(ll:Sit)" to make ueaterUK of IIXiaI service:J, U>c: ability 10 earnhightt incomes, the imPfO'~1 of dtild

Planning birthsProposition: TIoaI the raplmtibr. pla.,mi", 0/bil'lJu ;. _ of 1M moJ/ dJU;:liw and /emlapemiw fMj'1 ofimptwing the quality "/ lift"" fQ.rlh - /Ioih now and in 1M /uIUrI - imdIMI 0ftlI! fJ/ 1M pmWl mis", 1w D/GUT Ibm. is1MjDiW,., 10 'Ir41iu dial po-w.

Family pIannin£ could brine lOOR' 00w::firs 10 man: >'COP'"' aI "'" CO$! than anyOlhc:r sinIk 'tc:dmoIozy' now a\'tilabIc 10Ibc human nee. But it is noll appttciau:dwiddy mooch dlal this would ItiD bc: IrUe

t\'en if then: ..~ DO such thina .. I popuIlItion plObltm .

10 pan, an . .. Iltlle... of the run mnae ofthe bmdiu avaiJabk from the .uponsiblcplanning of familic:s hn bem hidden fromtho public \icw by thc douds of t'OlltreWenY

•

care md nutrition, tbe mfuctioa of childdc:alhs, the aettptaDOe of family planning,tilt: mNction of.~ &mil)' size, andthe: litenlc), of lIM: sl.lCC«din& JC'ntnotion."

The education of girl . is thereforeanother of 1hO$e extraordinary points ofkv~ which could advance the worldtowards many of !he other goah: dUo;uucdin thilI report. 11 is allO a principal means ofrishtina; one: of !he IJlOIl. evident of anwronp in the aisting ...odd onkr.

which have IOn&: hung ever this II1UC. Butsuch is the n.ngc of mmods now available,and such me experience mat hal beengained in recent yean, thaI family planningcan now be promoted and pn.ensed in"''')'S which an: sens.i~ to tk reJiaiousand~ contours of almost aD toeierin.The benefits of f~y planninc lIC'Cd bedenied to 110 one.

1lJosc bendits 1nll1 be bridly _

""""'"F.... family plannina ccuJd ..se tbe:

lhu of peffiapI ODe: quarter 10 ODe: third oftbe: soo.ooo women " 'ho DOW die ew:ry)UT from e.uxs re\aled 10~ ands:i-ing binh ." II could ll1so preventunk:nll'q" millions of diubiliuO$ • many of

them painfuJ, pennanau.~and _ - which ~ the common 00Il:te'

qumec of hi&h-risk and oftm unwante!d........Seeond, famiJy pIanninc eouId pn:wrll

many if not most of the ID(lI'e thaD 50,000iIkpI IIbortiQns which ~ DOW performodon women twry sm,,1.- dIzy and whieb raullin the deaths of 150,000 )"OWII womenevery year.-

Third. hmily pbnning can dtasticallyinlpl'O\'e the quality of WOlIKn·' I.ivc:I _ inboth lhort and long term - by red ucin8 thephys ical and mental burdCIU of h1vina 100many eh~dren tOO elose loaether. or al 100early OT 100 lilt<,: an a~. It can tncreese thetime available for women', education. forvocational tnIining, for cantina incomes, forimpmvilll child care, for community activities, for pcnonal d evelopment, and for theI'CII and leisure which il vinuaUy unknownto millions of women in the de\"dopina;worid today.

Founb, famiJy pbnning eouId III\~ !helives of~ million children CKb year.Family planninc would pK'VClll, precbninantly, m.- births ..-hicb Ill: l:nown to be'hiP mk' • IlK: births ..1Ud\ ;m within two)"Can of a prcwious birth, 01" to momen..ilo Ill: UDder 18 or avc:r 35 or whoa1l'c:tdy hi,..., three 01" four or moR

chiIdlm.- Becaus: the CJQt mtjority 0{

child dcathlI an:: nooate!d with thac riskfacton, the _"dJ-informed limine and spacina: of births~ Il:SUh in a far more thaDp oponionau: rcductioIl in child dealha.

Fifth, family planning can signifK:ll\t1yimprove the nutritional health of childn:ntJu-ouahout the developing world. Fe\\'U andmore widely Ipf;ced births allow mothcn

ID(lI'e time for bttasIfecdin& and ftallin&,and bdp$ 11,> pmmt the low birth Mi&ho'lriJich an: mongIy <iated wid! maInutrilion Ihm'litnn. rhc earticII yean oflifc."

Sixth, family pIanninc improva thequality of life for dIiIdrm. The quality ofchild CIIl: - indudinc play and stimulation.. wdI 1$ halth and cducalioD _ inevitIliyrixs .. paIl:rtts arc able 10 invat moR oftheir time, CDCTI)'. and money in brin&in&up a smaller number of children.

For an of these~, a renewed dTonU) pUI Wnily p1arutirtg I I the disposal of aU'NOU.Id advance not one but many of thebllic human goals for the year 2000 whichWCTC agreed at the World Sum",i, /firChildrm.

These benefits alone would be sufficientto justify the claim of 'fam~y plannini forall' to a spc:cial priority in a new worldorder. But it. would, of coone. aI,o hdp 10raol\..., one of the Olhtt CJQI problems onthe human agenda - the pobk:m of nlpid

population growth.

A...ph,.....,...tdy en: prcanarw:y in du'CI: inthe de\dopirc world thia yar ...;a be IlOl

ooIy UlIp/:IlaJat bur. Ufl';l'lllted." TIx:n: illthl:ft:f~ I ,__ lJIlIneI dl:mand for ibl:

b .... lt:d&e and ibl: me:anI oHarniy plannin&.

EYickncc from the w...u FnriJI·rySl<fW)I sugem that if all ..-omm in theoo.-eIoping ..uid who do IlOl -.ish tobcCOlTlC pregnant .....".,cm~ 10 esereee that choice then the nlto: of populationc,.,w..1h ..·auld fan by approxirnalely 30%."By the: Yeal" 2025, mal fall would translateinto I .] billio n fe\\'eI" ~le • rouahIy theequivalent of the population of Chinatoday." ..


E\= this long lilt of bmdil:li dca not

capture the potential comribution of familyplannlns to the imprlWCmelli of the humanccndltion. For it fail, 10 record the synergisms which mean tha t the: total ben..fi tWOI1Id be vcry much jp"Ct= !han the sumof the parts. WiUlin lM $phere of humanhcallb, family planning rmu~ and i5mmol'CC'd by, P''4l- IOwwds almosl: allcxha imprtl\'t:mO:DlS in the beahh and ....d!beina: of bodl mothas llId childtm.. Tbetimina: and spKina: of bi:Uls, for aample,kads 10 impt'O\'l:d hcaltb and nutrition,""hidI in tum leads to fC\\'tt dc:alhs; thi.helps to build confidc:na in family plannineand the lm dency lowards more widelyspaced births. An upward spiral is the reforeJet in motion. But there it also a wid.... circleof synergisms of which birth spacing andfamily planning stand dOK to the eewe.l.'cwu and IIlOn: widdy spaced birthsimpnl\U thc: quality of women 's l,,~ ofdlild ean:, at Wnily life, of edlQUon; .n ofthcs<: c:ontributt to IOcia1 and " .......niepl...._ . whX:b in mm conaibuus 10 theaider Ku-ptana" of family pbnniog

•

nu, pmnu \:&tions of such 1)'I1C:J'Iisms

lIf'e almost limitksl. And uniting them aU isthe fact that family planning gi,'n peoplemore control over Iheir own lives andeJUlbla them to brini aboul otlu:r impro vements in almost C\'ef)' asP«t of those lives.h means better tlealth and wider opportunities for hlllldrros of millions of women. IImeans fnr.:r demhI and be=r physical andmm.tal lP_d, for hundn:ds of mil60ns ofdtiIdn:n. It mtarII improved IItIrldmh ofIivin& and lea w.in on~~ IIabo memI sIowtt popWaDon growth andan easinc of rlwiroruneDw !="Wft in tIxfU~. Th~ CO$lJ, in rdarion w~ bmt'lits, IlTr almost absurdly .maD.

Whrn 110 much stands to be achieved bythe mtttina or an ~xistinll demand and at110 \ow • roIt, it I«mJ~e 10 propose, for !he aamda of any lin' worldorder, tlw In drOIt now be made. on In

c:ntirdy new seale, to pill tIx~and IN ...,.,.. of family pIanninc at thedispoq' of nuy eclUPk or dlild-beving• bd"on: tIx md of this present ttnfUlY.

Year 2000 goals

The fc6:Mr,g is1heU isl 01 QOEIls, to be IIIllIinsd t,.,. lhII ,..... 2(0), ""*:t1 wem adopUld by lhe lM:ri1 $tim>! for0>t1Im on $epIe'bo XI 1000. A/IlIr ""de9peed 0CI"IIl.CIllli lV'r'O"\iI QCM!O", eots Bn:llte...,.....:ills "' !hell'iI8d Nalions,~ lIJgQtS .......... ooeldoted to bB 1eBsbIe r<l ' . dalf .......diKJo r:M!t!he o::w..<9Il of tnI!I-_.OvenIQ !lOllI' 11190-2000

o A 0IlIHhrtl mct..w;lm" .......-!lve deiIlh rates pI rm..ot:lIcn to bebIOI 70 per 1.1XO t.9 tlO1hI~islusllj .

o A I'olM'O 01 J'OIl18ml!l rrooaitv rat....

o A hEM'g '" savere end IOOderaIe I'I"lIlhnr1Iiotmo"Q !he wo:\d', 1.I"Ider-tves.

5afIl_1rId sri8tb"l fa alllmI8s.

U Ba$i(: 1Kl":;lI!(r1 !or III tHd'''' Bn:l 0XfT(Ilati00 o!$ri'r<lr/ ndI"",,", t1f 1Il1eesl 8al6.

o A NM-.g cI lh8 IK1JI hr8c)I rat8 .-.d thB~,flllllilt 01 eopII~~ e----) ProleclIcn b' !he rrmy rroIona cI d*.1rI:rl n~ d!b'I l:lI(UI\'l_ In:! !he ...-..plIO r::eBn:l~. In III comies. 01 lhe m<:erIl)raclOflI9Cl ConYMbon on Ihe~ '" 1he Ctid. Lo!psrt\I::UW, 1tlII 1990s _ .....~ groM-og&:>::4X&'" 01 It>e ide& of~ P'Q\8CtiOrl fa<:>'1iIInn n \OnIl '" WBI.

ProtKtIon lor IIIrls I nd women

F~ pIarri"g ....NJtim and -.;o"s to tl8mads 8WiIallllI to 81 e:a.pes to~ them to~~ peg.eocieiS so::! tlOthS...r;cfl1<8"too rrmy Bn:llOO close' Bn:l to womoo ...m ..... 'too\'O'Sl\I 0' too Oid'.

') AI womoo 10 have access to~ ClO'8. 8tranedIItl6ndIlrlI~ d litid i er>:l .-nr b t'l9'tIskptego ..oc:ies 8J'ld otlsteIric "" 8 9l"des.

( U"Mlrs>II~ 01 1he SPllCiPI nootlh Bn:lrutrIboreI .-os fA JemIIIes llri'lg 88rIy d IidIiClOC,"' ..... a .... P"9&"" and Rc:Iatfon.,-

A ...a.dIcn "' 1he i ""*""... 01 lew blnn """1'1(lBss!hlw1 2.5 1<gJ Ie> less!tl;w1 1Q%,

a A cr.e-tI'ifd r80JcIicn n ia1 dekieo Ci lW1lI:lrf/lI....~o VnuaI ei"r1natoo 01 Wamh A dota:Jer IC\' an:!bjne dBfIaeo iCY dlloo 080 S-

o AI~ 10 kI'lOw Ihe 1"1'0,18"08 01 "'4'lX>'to"<l.....:wr6"\ Tn Ihv tasl< of .....". ..... tnllIStleedng b Ihofnfbs to Ilil< ITD"Ilhs" 01 • crik!'s lie WIll 01 <T1lIBIJJglhe speciej 10edng _ of . )tUlIl ct*l1hrol.o\tllhe.......-0 """" mlll"oo;lCt""i'ii' Bn:l~ to be~ in.. CCUlIIIIls.

o C' ' liiG!b, oIlaiOd 9i,)e 10 enebIe III~lQ Ilfl5U'U~ food llOO.X1IY.Child heII/lh

o Tha"~"""""~Iol polio.

o The~oIneonalll'1elEnoSPf 1995).

o A 9O'llo reclIClic:I'1 I'l roeaIIieS cases rid • 9MIotod.>::Ilon l'1 "*"*'" -. 00''-00 to pr&

~-o ActOe.flU8111 and mIint~ d aI iIl8S1 llO'Il.~ CO'Mef89lI d ~-(lId e:tti9'I and......... tel!nJI i'rm..f'Wzation lor~ .... the """'"--o A hlWrg d child d8lllhscaused by cia'tola and• 25% RIIioction .... lhIl l iCidal iOll d cia'illeal•o A <Te-1titl reWction ., c;hkj _ caused bya<:Wl 'espfalory lileclia•.

a n.. "" . ..Iia,dll'*-worm ..........

"""""'"o In a:lChOO til lhII ..".::a'.IiOO or IlI'irTlIlry sc:tOO_ and its eqriHlS. lOday's -u.I10 "'.... .... and itll $kiIso::Ul be PJl aI lhIl o:isposaId III familios by "1Cbizir og toe:Iay'. wslly i "",I I I

~-".

"

References1 __ 0"", ' r " e.- Ol o.. -.~__$v--. Dr ,,~ ll1111i_

'lIlIO~.'IottO.o.-g lea ' 181

2 __ 0"", - •~ p......",. <II--. <JIOIlol 0...- 9'1 _ --,~. Y.tCl.a.-ll»1.~_",,2

3 u-- _ ~'. Fu'IcI, _ Oodoo ..... , ...1NI~ .._'_oo. .'.Clll~_

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• "-ODor. u.. Wort --, .. a- Ftca<h · 6 'll ... _ ~. ~ .. .,....."..,...... YoI. vr.~2.pp. 51.f1l5._AI>I ll181l

~ M U.__• 1<.. ".YIIrO' II III Food~

~ Mojor 1oWU . ""CIl F-.;~ .. Ilii.,.,..,., 0-', or TroPc*"-ru. YoI. 32. IlIl. 5T-el. _ '. O><lo<d..--~~ f'lqram,~ .._.0--',~ """""" \IOl _ . Ni>. 1,_HDPr&~.e .,O).

~ PIlIll. 'Jrtoio_l_ .b' f'Iqor;l: lM9'"' ll ' • . _""'_.. ..,......",~.... DI ....~ IlIl. l ($.U l, lI1IIlI __~FIiIIl._F<XXl"". , ,___ 0 "", ' " ."""' _ _

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, - - c>gor-. 1'lc9."'. lOt~ '"Dioo...... rr ....... "<va",. Itopcn'.a:JD91 a Po 1" WHO.~ 1l1li)

10 "-y I.' ~~ $Ill ' . 1 al~'.~ ct>oo_. '-'lIQ, """ 1~

11~ __ ~f\nl,_', ' _.go..-.= ,- = " ,.. ... -... ..._da:llO'll:>' o, _ _ ."".... ...-. ...-.., rei dIr ' ; ,•• 111 _ ..INI 1'-' , Il'II sa. Of N -..~ ,.,,1.HCEF,__ 191lO

' 2 u..o _ 01lIiw1 ... ".nil.~ lI" .. Fnnrl.I-.lhtir1:llctOf~"" , - "~_0'1-' tI -..-.;J~ Aoto::& lHCB', _YC<1l. '1lI!IliI~

13 l..NCeP. lIr$l .... 5luOI ee fliI1OPiC. 11.-~ Of_ "" , lI" 0-.. _ p ' otll .. '11&1 A

..- - ~tlU:II',~_./oUnIf>,.., ..... tIr~ _ ea.-. ""'-_..,~ -,. - - ~., £nolion "_ .......bJew:.a~_

,. --.t,&,-,E..Cc:mio.IU._ .... E..&:0_... DII*oJ _ O>llf~ n.,...Ofl-......... tI ...~ IMCU, 1••_0Il 0IiIID. ' I ,• • On;, -.:.. _ c OIl~"I;), 1, :':;;;:; :;S;

' $ ..E , ....... : ... __,.,., .." b" .. _ eo....... 0'1_ AI" n...a. ~ _ '1illO. l.'E9CQ,_YGrIo. 19l1O

1& 'fIIaDI d ... ' ' ' '_0Il SlutJjI r..." eo_ ..:..<I. oc-: 'W,',~ .. "'" 1_ ...~ 20s..,j)II 11191

' 7 CorriI 0 .10, a'ld SO>oI. s.. Otia'> _ .. r,..".., tll""~ £cO'Iomy. s.I«y NIII .-.;I :Sell*' Alit:iII nCaonI__ fuI:¥>o. lHCB'. 1.,_0Il CNo

Do • "I~ """-'<:e. 'W',1 -... IJI'«:U " . :...-. .. <Xli .............

lHCB'_1O-' Jo.Iy 1W1

1; C<mIL GA, O>llf ~ .., "" , ...... _= Co =_ _ T_ .., I"l:oli;y~ IMCU, I . . III 0IiII O. I •••On;, Cl<:c:aw!0Il "-5 No. Z.-,..~, $. "' Siam, J, 11lI ea- _Co • : _d Oltl~ .. .. ~.w..,lHCU'• • • •_ ... 0IiII De : 1 :.1 c.....__ _ CI<:c:aw! . ~ No. ' 0.Ng .j)II '9IlO

21,1 .............. CM.. MIo1rIo:lO. L., StMrnwt, .... rd ........ J.D"CN:l Pl>l9ly ...~ O'1brI'. on-... F<rcI.l Z2C $lr8ll, N,W.•Wast1Iogt<> , D.c..lOOOl

21 G1lfIn, I(. rd Krighl. J. 'ru- 0Ir • '. Il: n.,e- "" -.....~'......... a.. '",•• i'!lIlI 1960s_ B<I}<nt Po Z2. l.\iI1ICl NaIkn, I.'I.O-.quII!IW'I'. Iho 6:uo",", Po 25, '0 hq.oI:t 19111

22 Roc<:r...... 0"._ ooo::iIl.~ Y~...-..

llIoo: ~ ......,. crw.' ~ ...." • I'u-F__t "' li lIlI~_A...IIlIi ...Goooon CcmiIl. GA, JtIfI, R r<l _ . f .~~ 69-118, Olc!<lfd u--aty~ ,981

23 _ Ct. E<lgIr. a..-IllooyOlPllJiOJllt'd i'l,-.,Ifooptol_0Il!f(a" s.,..-, CoolaAco

2~ !.JDw<l, c,a r<l _ , S" 'lIw E1/8cu; 01~CN:l &.r.MI on ffmIt PIrmg Prac:Iicoo _ FfJ1tIy'_ i'! r~""""",,, Val. ,g. NIl. 3, pp. 1<,.,&1,Mirt'.,l,nlI ,96e

lJ"iileo;l ,...... .fftIIy IUI;Irog blt F* Ot llefil1\'. "Sluloi 01 _10"'" _ CHd &..- r<ll'fInk(, STIEWSERRI7<, lXIl8<l NM.icnII. Dto:& ~ , .d . ....._. E<:ornrrOc _ $oOol-... _V.....

25 _ Co......... , n.,~ ..., lIlI .:;.xm,""-_.vmw)'d hi SwlI'I Q)..."""', RIf;oI

2ll _ , FIol>In,~ "'" _ , 1>:00'''' "-Y_lIlI_oi~ i'I&st ........~P1,,,,,,,,,,~FT8:os, 199\

V see, "" ~. ~, J.P, ..., ~. V..0.. . • ••• ~ 5n!tgier ~. 0...

De ' ." •• Co.n:t. WUIi'JlCl' D,C.

:zg _ -. _ 0.. "" . ' ~ 1991. p, 43,_ -.WMIIi1glon, o.C.. lWl

:JJ .lOrI'wOon. 0" _ la>. L.. _ E<\.aIli:Io _ "..",BlIcirn:y• ....,.,.,. HcpIh;~ -. _ ,oe,,~

31 S. _ 19E16 r<l1.lcG.n..., .......... ' 9&7"Cc:ItrOt, GA• ....-.g .. tVrw1~, .~ _ !leo ' . ,•• "" !he Hi llis', _

Del ",..... l1II'I '9lIJIl _ 8II)<:wld; p. 179. Ln!I!Ia_ 'IIEI9,AIoo, Ol>. cil.. Po 43

32 __ ~I""""'''_ _S/nl1Ilial I:I:ado 19/1H~ ~ ~ ,.. . ,VH:l,~ 1990

33 cemo. tIP_til" I'P_ 175-17l1

34 Ol>_ cit.. p_ell

~ __ \OlIl1 Dr. _ ~ ont:oo<-GoorwW,__ ClII"'_' .. 09. ,••,..~ rm.m,Val. >MI, No. 2, _-'l:<I, lli1llO. llileO _

Do<w" .'oI~ '''''',,_ .. _ Y'''''3ll lhIed __ 000 j' . " . . Plago." ,oo. -..

09. ',".~RIf;oII991, p.~l . l1U, N!wV.....

37 Fsicl.~ Gooltge, 'O'iI.<:aI_;'~"

- ~', • "*'....... "..,., - -E<1ICSlIOrF _ T~~~ D.C,,w,:lEI o-t>om. J, ..., 011~ J..~ 1ho <JaIiIy d_ .. .... '..... .....-',_0... ,I. '

i'! "'" Illlllls _ ~ Po 121 . l.hI><l _ ,DopiIo.,• • 01 . ........". E<lOt'orric: _ SOOOllAtlaB,_ Yo:l<, 1ge9

39 _ 6BI1<, tIP. at., pp , 501«;

40 LnIo<l __ 01ib'<In'. fI.nlj, n.~ .-0>-_Irit*I' _1>011."'" '' Bto~ UNICEF,"""" Yo:l<, 1ge9

• , Addteu bl'_B.ee.-._, _ _to I!lo Boon! 01 G<Mltr<n 01 ltiII _ _ GroLo>.-. 27Solll_I96ll

42 s., "" ....,.., McGR1. Noll f .. Sro:lgtaoa, R , Km.I''''Q ~, ...., ""'" Shn-Bcl<, _ _Dio< : ., '•• n ""'-. _ 5. p . 1M,~~Press.lllllO

43 f1«U"., Bi'ger.....WSO Q f1no71.l1<l "" F'I1tIwy_ n.,~ 10 Oon:o'I' ,~WOOIll !lin<. E<:l..eolion ...,~ CM!ion,~ r<l _ -..- Do<w"."WWiyoo, D.C.. '1I9O

.. ._ ' 8IIJCI,.<loo l<>.--IIil;lan;l <lro I ~ " ...'.___ 08. I •••• _ ND. 6.Roport """' ltiII__ S6!oral SuM!I', .........d_$tuc>oos.__~

4:l Con'ia, GA. 'GIooei So ~ioo<; ••0.;C~ iO>ll 01ilI;I-.: _ ... ltiII 21>1~ lld'il ...-r n 0.."Eleny Po-Kng, lMJ. ""'" 0*h1al TllO\Ili'l1 l1II'I 2151~ " - ~..,.,.,- Y- ClvogElt.o:alion P\.l:lb"IIng~, ttl<"9 Ko<"Q. IlI!lO

~ WOOIll I!lW*. _ ~ 11191, _ I!lW*.WlIsI W",Ii>.. D.C,

U 'A P\'oopod d Go"""'" n. 6:u_ p. 1~ . 13 JIll''00'

"

... Dr_ CIa . ........ 0.-:.

"' ...., _ .Kn:I"" -... ..._T_ _r '0i0 1N)

~~----......._.h&:oo,.. Po21, 2 _ lW'l

~ f .-.:I I'8rul:Q, P. , 0lII0 [:.l GoArno"A"• • •• • lIP 10.11 . 2Q -.:Il l.,

~1 _ Sori<. CIll.ee. ,1lI> ' 0.11

~ 8IoIG'lI•• 01.53 SIuc:Iod" • • ' ....iiliIJ-. P d'~~

l_tiOCJo 1119(1" _ Au.,.,." _ Oiiio".'.(SJJ'N. C/IdCrIl~~ lililO

~-56 -.... 01.$I FGn.R.. ..-.J..~.. _s.r-.J

Ou rI g.m "'* Ai .........,e ... __1wiIftitJ·. Da q, '. 1_1IboWV".... .... ,..r__Q;obd.ea-.., ..... or·] =0...--l6Iorr. "-w s... s...c. "'*""'.~.,_iiliI -....a- _ .......~ 'II C\Iolr:oU. ..........DitIl ... 'Plco_ , '" PI _ ~_"" ..__O'I DitIl-.Rooo 9) rei Coo.........-...., »1111i1

~1 _ OJ a..- __ 3 ,.. _vat.PI . .. __ f'o<>..ilIc 'II HgotG ... 2/'1'1 au»'*'"= 'Cf\' 'II ('W).- 'II SIrt.-.:l~/lI;:\IlJ, ..... 3 ..... 1991

IllI _, GX. Ille IMF. ,. _ 8n:; _ A/rb'"...... ---"'.",.; ... .._,~ 'IIr~ Clopaltr'Itr'iI 'II Ewor.....,~

s_--..~ ...

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_-. .. .... More. 0. _ ~. "

1 5 .1l.."...Ibt~ 13~'_

"- V~ -.. lolA. ....Ullf}rioll. 8 _O ...m J.. _ or I!M"I' pIomrlJ ___ ",.0'1 .... _ ......... _",*,,_ """""'" 3fl~ 1lIl21' ·:ug

_ 8.. CIrIJtwl. C- 8oo,_dl<, E. _ sao,••"p~ '..-:eo _ " _ """'*". _ "...._ .. " -..one .-no:~, lIG:lqo.r<I_ 0 SIll MdI . " wd . ..,_ . Coi....,.,W<>ld 6arit.~. 10.13 f«lIIay lUl11

117 __ nv-...., 'TN; SlaG '" ______Mcw\oII(._::o_m... Silt ""-.,_ ...,.... Coi.......-. , o.13"""'-Y '5lI7

I\lS __ lUll.. _ Ott, M.. _ c:.. d _ ...,

aou.. ... Da • ... 0lIMii0I, Ill> 1•• T1va"""'__CliIIomiiii- - O>p • Sift ._~__._._ .

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_e-.......,.~ .............. .....A:riDlI. YlII. .. Jot:l. 3, _ ~~.

'0 '1..-, J- _ I'idof. ,t,.R., 'Tho _ ...- 'II~ il f«Iir, rei wn. o.s. .-.:I _~. __ ... '*"'" -.... ..... ,5. t4U. Il,1lP. :lll7.2lIO. _JDte. ,.

10~ Jon, $nIuceC 0~__ At:n1IIyJ\ _ tontot~.LNCU. _ lloIri, lQU '

Clc:VWI, S. ou. 'UM' !lirWl WIo9'l'. '" w-....., IlO'I,op. llL. pp. 252..:100

71 _relGoI,op. .... pg.15S-151

CI*'<l.J-..., i'tlltOiIt. J..~~o.vo... p , ...... 0= Np'lli ton tot _ f'MlIl1~p. laOobll~~ ••

~ 1'1. rei sov>. S. ... GW\ U , ."._ ,... ll.nor: o-rv CJo1JoI 0'" V'A;oo • • --.. \Ill. 31. ,." 1. III •R.....-.... . ... D.C.. 11112

12~GA.." ................____ n , • • • 0 .. l95OI',_....__ ....... _ DIjO'I:i, pp. 175-1 U--,-

1'3 ... !WI. _ ..... ..-y. _ allWora

.-.:I_..-,,_ .....~--9atc P,' , PI: j " ,_

Panel referencesF<lt tno u _ CIl1hll'Sunni! D&c>o.... , """ PIon CIlActon'~ ..,.., _ 2000 goolOj, ""'" !Nt _ <II1M~ on tro!I R\1U '" INt Oil:l".~_

"'" S/.1fe at INt Wcri:fs~ '99r,"- ""'"l.t«:Ef _ or rn:m O><forll~~

2 IWG GolrlM.. ""VA 1991

3 '-""- Q*:I~ 191Kl'. P"JllI'M' I8lXI'I '"11'1I Econarnoc _ Sociol Co.n:I of 1tIO lWOIO<I """"""\.NCB'. _ YaII, l'll "'-ell 199 \

• 0M0icIn al~ c.w. Itl' e- ee.r..o.u.s.ftilIC_-. 199 1

~ Kim-F;wto,t. t)',-.~.~ PI....", ..QtI~WHO.a.-

6 LNICEF, NoiroI:t 1991

1 W<lI!I:l _ O..., 'U1I''''~ PI<y_"'" al~ GioboIl o...Mow'. EPl GoboI~G-<>o,.ip, WHO,GonYo. ' SIll , EPvGoMIl .3

6 I'" 000""', 0.. RH.• Kim-Fooloy, Or. R. ..., O'er!, c..'Rool>inII "" !lnlOtI; Oioo&se ConIrd ~~" ..... 1Il1ll:1o', I'IIC.o.-. ! goo

!l 1'10IOo. Or Jon, .~ ~ a...l'mu'ilIbon'. lHCff. ""'" [letj, Ai.4lSl 199J

10 _ '" hi ilb" ..... , ... N pan,j II --. I'omCO'nIo GA rod Sipoo., s..0-> It"<:! !Flo r_IO..... MirtaI. E<>:itI<:my. SJloII)o Nett _

~ Conl1lII WId~~. 1.UCEf, __

0.. 0.. t •• , "' . c.onr.. Fknn::e, .W'11 """"""....".-.., .. """Gb:>' -. ... lHCEF

..-'"__ .iJy 11l1l1

12 _ of !No'''''- ' tno!Vn lor lllOO~_ N __ to.,.....;j ""'I'~ Zl'llo <>'24,.

13 ....,....."" C......~ l..~ A. ..., WtiI.J.D" Ct>Id IWorly ;,Mwbl, CtoIa'.,'. DeIer-.e F1.n:l.122C-' NW .•W io..... ' D.C. 2000 1

" Mut11 "'!hi> _ ,,"""".... II'IiI~ 11 _frt'm fJfocIS 01"""*'" Q:nlicl (>l~ _ a.....:__~hWa"-'~.10."'"

2~, '991, -....,~ ...., lNCEF .T~~ PKy . "' 1O lor no LnIecl _

e-'"D<sabIocI _llll83-1992l

15 LN:;£F,_

16 Tho I ..."..., ,, ..... prool._~c.....fIbV>..,.., Ilftj AI """" _ ,lNCEF, Ilnul.~ 1\111\

17 _,_.~""'_ELoi..I*'J'1Io<vy__atGi:>47lo •• "" "&st__ ' *'Pli_:..~Plwt.1Qlll

18 _o._OIn-Hl.,R., '-.,.__.........., ,. , " "'" d~ : ,-'Ii """" ....,.1000'.• -=- :IlUD\' InUf«l tlr INI 'M>1(lCoo".U on~ b AI. r-. M Mo<cI'I1990.l.N£SCO. _ yO'\<, 1000

I ii MIlO..... . Borgor, '1.,_ ... Fcn9' A;:l to"~_ Tho~ to l:\on:>rs'. PIt'lEEIWI3O,_ 8P, E4ICIIbOII 8ntl~ I;lM$o(vI,

~ 8ntl ~ FIwJ<Jrt,oo DoIwa,...WW. ...'''' , D.c., 11190

2Q o-ren. J. 8'\d <lfI ..Io<Q. J..'~ II-.~ 01~ ~ <lfIo ' ..... <:<l\.O'lI'eI', IUrMDoo " ,e. iI II-. l!lOO1l/1tl1~ Po 121, lI'>IIocI--.. Dopooa.ed 01 __ &::00..,"" 8ntlSot>oi ....... _VO'\<, l Q6ll

21~ C. 8ntlllMln K., '~"11-.-"':II-. eooo..,ic d'~ b Ire 19!1Os', a ....,...,_ b' Ire Wor1a Coo ... . .. OIl -.... b ,..,~~_ 19!1O, ~ESCO. HfJw V(J'\<. 1000

22 ftllO"",," ' "p. CII.

23 __ to....J.\>4' "~', 1111I SldiJIJ dIre _ . O>itt'otl 'm P. «l, urc::EF, __ v""'"'e

2. o.i'M18ntl (1ll..Nlng. "". CII,

25 /l;.'I$C «l.o:l!Itb>6"lI:I1l--=r:__iIdcaln'$,

WESCO,-. 11100

~ -2' __ c.r·~Olhdl.

2l:I Mool cl II-. ~ ... ,,__ , in IN _ • _ tomMc:Gm. N.f" Sr<:loi1_ Ft. Kin, Y.e . nllQm. s-e. ,~_Doo 'l'. ~ " ~ _~,

p. 185, HIlMIftj~ProA. \980

:19 mo.:.ntI llio::/Qlo'I,~ l1:I ....lti<M.. II InIVMQUICEF pCIIcy..-.s'~ OIl Bo_!oo<lo",fl Ire 1!lQOs: A Glor>aI~. se-degi ImocottI.A>rorco, :J) #r1 ""4'Sllll9O

:J) W::IorL c,G. SrNtI, P.G" \I&q'G'I, J.P. .. lit'EWlonc:e b' """""""" .... to..,,_ .... ~__ tom n.c:.o... _ in 1Ioazl', 11III16JootB""4'Sl llWll, No>.~a1~22

31 "'-' .~ F'r!:ImPIn;I. _ ~a.... _ ... Tho~_01~_'.A jco'IllYHCl/l.UC9' 1IIal........ 'M-IO. _

3:1 Tho __ 000 ''''''' ' _ lfu1C:NICI ac .,..,i ilG'__ eo....... on Bi__.. _ tI'flNCEf, Wl<l .., .,.., i ile '''' ''' -.,AS...' , 28.u-. ' 99'

3:l 'ora: PI.CI01g -.."" _ ', _ ~,-., Y<il ~ No. A, -Uy.""'VAl '98Il

:w "".iCi.. a*l~ n O*l8', WOrt1__ Y<ilA, ~.3.~ ,_

35 o.tIaielioli 01 New VOIle INl CN<:li'M'. __ .Wl<l,u.-,So\JIlO, .... 11l9O

~ -37 EPI~Wl<l.Got-. Mon>'I 19Q!

38 E>Don<Iod PI ....... " ,. on~ aotlol-... Gn::>.Q lWIlOfl, WHClIEl'\IGIn'l' ,3, WHO,Goo'-.lW l

39 "'"""'*"'" n INl CHItnn', _ ~ recom__ l<l II1e lHCEf E<eo.AiYo ee.u.EJ1C€F/ 1Wlil"1\..31, lNCeF, Now YorI<. 15 """"*'IIw i

AO PI....... ,.,. oI llCIIOn b'~ ItJO gools b'-"....... ' I ' . ' n ... l lillOo, EJlCeFI1991/12,LNCEl'. NowVorI<.Z2 _1991

41 ~ .- 01 INl i1llIi''''_ c..re b'DIo<moeoII~ n "" Eloi ....... , Y<il l ! . No.3, Mav..Ar8 1981l

ol.2 Ka'lI, Ct. MA, cw-u 01 C.J. ... I'M 01. O.J"'li llllgi liliOi, '" ....-B Yao::dno Wo II1e EPr, ..-..g01 II1e Wl<l aotlol~ Gtoup on EF'l c.e,EQypt, l A-18 0Cl<:t>0< 11100

43 _ tmu1IlaIb'Il\llws, Vol 8, No, 5, StiiX& 'il&'~,~

oU _ B VllCC:O'It:~ ., &oido,.... " EPI,Wl<l LbOoto. WI<l, 0....... __ t98ll

4:l $onllfIt"".,;os '" /'«:to lor UrI .., Ito w'..... ,_ N b' _ """ 01 _ tI'f wrIIi'1lI 1O

LNCEl' _ H-t l F. I10cts Ify UrI lhf. 3 UN-...... Yori<, N-; iOOi7, lJSio.

----n· ·---STATISTICS

Economic and social sta ti stics on thenations of the world, with particular

reference to children's we ll-being.

G<nonI no« "" ..... Sil<m on<! aj>I&nII.....

lNUI!X TO COl.lNtlUES

TAllI.F-S

1, Balk indlta lonUSMlt 0 lMR J population lJ binht and under Ii,·.

dealh$ 0 GNP per apila I I Iif~ exp«:tancy 0 adult literacyU Khool enrolment r I income d;'tn1>u1ion

2: Nlllritiolll.ow birth weigh t r ) breaslf~ding , I malnutrition

I I food production n calorie intake n food 5pending

3: BealtllAccess 10 waler I I acccss ' 0 health >l:r\'icn

11 immunization of dUldr'l'n and pr<:gnanl women U ORT use

4: EdUtllliOllMole and fem.ale Utcracy n nodi" and lrlcvillioo WU

I primary ochool cnrolm<:n. and <:<)mplelion I J 5<:C<1f1<1ary school enroIrn.,u

5: DelDoppllic ilIdiaolonChiJd population 0 popu1lltioo grov.1h rate I I cru de death ",Ie

n crude birth rate ' life cxpeOU'ltC)' I I fmiliry roUe I I u..mnization

6: EcOllOmic indkat....GNI' per capit a and annu.ol iJ\IWlh rat.,. 0 inflation U poverty

U 8O~mrnent cxpcnditwe r 1 aid U debt sc.rvi<:<:

7: WomeaLife cxpecuncy I I litcracy I ! mrclmcnl in <dlool I con\rllttpti".~

I I tclWlUl immuniu.tion U train«! allt'lldance a t birthsn lnlltl."rllal rnlllUliry

8: Buic Illdiulon 011 leu popul..... roualri...

9: The rale of Pl'OCl"'U5MR r'tduction rat.. I J GNP PC' capil•• growth tal.,.

U f~lilY reducti on rales

General note on the data1M dBUllJI""'idad In !I"8:le _ ..e mo"", IoBd by"-..... os. scuces,~ 01 so- 8I"Id~ fo:JIrclI8s _!hIl co\i6l!io I cI !he dalI.mIsdl!eIelllroTl !hIl~ 006'ti<> I PJerQ used. TIIbIesdillrtwd ivT1 "" JrOI'IY OOI.IOOS • eIoMln major lIOlIl:eIare bled In !hIl ""l**OIlOy rnat8"a • wi~CC7>9 a V>ic:lIl r8<l(l8 of daIa ""olI:liIly. CllIciIIgoo.9'''''llOl oo:a rec:eMld by tI>o ,espoustio lhladI'IIltlOnIlIQIlI'Cy hiM beer> used ...- posst*> In

"'" ......,. a>!lBlI """"'" Itue ..... no reIebIIl Dlk:ieIfigI.rvs, Il5lmIIe6 mooe l7; \he '''''''''''' ISti3 U"iIedNaticns I3fiPV:'I hiM beer> used W>ere Il.dliIllemMiorIaly sta ldaIliled eslInat<lI!I 00 not 6>Os:L ltle_ ~<I100.SI<:UOBS, ~<IaIa~

""'" IhII "IlP<4>i&II LtICEF ftIIId l,lIka E>alpt tor !hi!'i.-Jl::a!osd lI'"(ier fM!~ fill. (l...lSMI'O, ecess toS8Ie _ • .,.,."..\0 _ ......u.s ond II'Ield::alos01~ 0XI'09'8QIl, ....nere tN:::EF is idantfoedlIS a mai'1 !IOtICII, III UNICEF -... ..... mor1<edWIIh an •on y.

"""'" possibia <:rit CO"'Pe/'Ieoo$'09 Of~Ililt>:nII daIa _ been~. """"" IhII dma _ to

odi aP!"'1 of!hll COJ¢ry rlis ill Oicated nabaln:l\e.

The <iIlB tor ilI!rll mortaiIy m:es. IIIl a<pectan:y.0\Jde twill 8I"Id 000lIl rIlleS, etc on pM 01 tte~\OOl( cr1 ",,~iatus:nl Po:+x:tOlS lrlderIa<oo by trlEIlhted Nat<nI PoI>.Aallor1 DII<oiiln n- In! _

ilIomaoonat; proo:1.oBd -... ..... ""'""'lPiliioxl<:al)',~ e:<pIainI whysorre of Iha data .....dillol< lItlrn IhcBI bn:I n <Bier LN::EF 1" .............In !hIl e8!lIl d G/I.P per ClllJiIa $r<I QOo\. IhlIdIItaare,.., ....ut 01 a <:a1Ih.<:u!I prtlCUlO 01~ 0Ild~ bV h WOI1d Bor* 8I"IdC£CO~.Thlt _ ltis )'8iI' i"d:.de llXlBl1IMl f8YlSicnllO ttIfIdataonMera:::y,~ wasti1g.~, lllXl9SIl

Icl_Md n'Ol!ImIll~.

Tho \IlIO,.oe <II 70 .....~ <lea!l"III Pili 1000 ~ br1hsused Ie ddi'18iIle ee IWD t"o!t8' U5MR IJO'.'lS da;ulIrIes ""'" "'" two~~ re6lctsh WOI1d&mrrit tor Otiel m:::<UIly QOI!II la1I8t. The U5MAllO"l'*"" 818~ of "'" In:Ie<M rro1aiIy rateIn" o:YItries o.ri-o;llN 1990s by onot-hd Of kl 70per ICW M biihs.~ 18 iess. Hln:e, i' Iii00<.I'lIrii!00 .a- !hIllllllar M JTO:'taIil)o \IOIlI. by IIlIIand db 1990s.. lXU'III'iI>!Is'"<>.jd bo!loroIllO 1h81WD'""-....\Ih.!re lhfm are a IEwge ruT'tIlO" ol iIIms d daIa WIIh a~ rnngII. as Is !he CII:'Ilt ;, tt--. ""'<l ~ I'mlhe~ <A not bIlilll~ b\' Ih8 ..,.., smaIOIh 'oI/6i 8glI t:Olf1lries.

51gnsand expla"-n"-acclicc0"-n"s_ -,----,---_ -,----,-----,,-l.k'Iitl&ll Ol! i& _ stalOO. !hIl SU'IYI'Olfy _ b

!till "'" U5MR (Lndar five mortaiIy rat8/ """"'" of<;:<;Id"IIIle$ ..... It'll ".,.,.,.., "lLes lor ead1 gra..p. lh8ITlllliIn is !hIl rrGte \lIIll8 01 a diila lI!lI .'IIYld;'0'dE0'd~. l is !he rT"IlIllS'.'"lI ..... " , ... ty...-.

"'"~......""""-T TQ\aI{as~lOarTlllCfai.

" see IooInote 811h!1 end 0I1he_

y l.NCEF 1lSl>Toate; _ txllnoIe at !he on! d ""-.

USMReatimaIes lor inlflYidulol counlria .. derMd from do.. produc:ed by 1M UN Populatlan DlMIonon .n 1nt1lrTl/llloM1Iy coo, .......ble bnt8 using -tou!I soun:ea. In ...... "...., theM esIJm8l... 1M)'_ Ircm 1M ..IHl ...._ ng....... In~ _ .-during "PP""x1ma.ty 1M _ two yeMf,

.... not blCOlllOlaled ~ theM HtimlItft.

..... lnIomIIItIon on 1M <Ioriv8tIon 01 1M U5MR IIgwn C8n be obIaInIIll by wrltlng to G"""-, s.nIorAdYI_, Sl8t lstlc. Md Monltomg, UNICEF, 3 U,N, Pla2a, N8W Yo<It, NY 10011, U.s.A.

"

Index to countriestlhi~~Cl:U*-arel8'i<ed n __ diG 0'dIJ d lt8' esti, I lllllO<nIlJ ..."0....·_lht i. aql\6l'tler$.o:Ic$ 9 hllllJ'kn~nh~ ....... liIl do::ar.-.bl*JW.

AVe., , G.i.e , ~. aa-- 82 - .. ........ ...,.. eo ......... ea ............. ..- 3 ...."'" ". ""- """\110•• ea ...... 'm - ........ tta .... '" A"","_ ..- n. hb II I " -- iccBliiQIit::ltliIl , za l'a'\,..-...c FlIp. d ,. -.. ""...., n. no 56 ...... '"..., se - ta Ftot.adti ".... " ... ". ""'- 53.... ea .. '" ""'" za• ,aa eo ....... .. -- •... .. - '" 50 .......... 6' n....... io .....,

" """'" ta.....,~ ,"""" " -- "..... " -- .. - '"Cllo'txdB " - ... " ...... ..

c.reoo' 36 .... ss - """'" ". '"" '" - ".e.- Ah:a'l Rep. ,.,"""" " 9o\tdlolOiid "."'" " -. ., ..... """ .. ""'" " ,~ ".,.. .. ~""-:!~ .. -.. ..

"'*""" n Ma ....... •,. ''''' """'" .. -- • TIilllId8"d TdllIgo ''''-- '" ..,.,. 82 T.,.. n

""'..... ., .... • '.... .."'" ,a; ....... .. - "(;z1lC.......... ". ........ sa ~Jqb&11i so

"'""" '" -.. '" -- '"();vi ..... i Rep. .. - 82 "'- .....- .. -= " ..... '".... .. r.ba't:cJ,e , ..... ..• SO h ee It,.". ss -- .,..... n ..... .. ""- '"..... '" - ., y~ """" '" NIlI...~ '" '(I.. '. ..•..... eo ...-.. '" - "..... '''' - " ...- ~.... " - rc ...- "<>-- 'm -- "G , i. ea - '"""" • "'"' rs

"

TABLE l' BASIC INDICATORS .-- - " .--, - - ., '. '. •• -- • " •• - , • - - _. --• _. - - - .- .- ... ---- - - •• - .. • --• • - • - '. '. - • • •• --......-_<_1001- - ,. '. ". ,~ ~ m . - • • •, - ., _ ,.'" ", ~ - • • • •, ..- ., - '",. '" - ~ ~ .. • •, - -m ee '" '" on ,. ... • " •• - -- ,.. '. " on ,. = .. • ", -- - m .. ,. " .,

" = " " "e - - m m ,. u ~

" - .. ", ...... ' -- -,. .. " .. - .. •• ~ - .' ~,. .. - " - • .. •• -- -- soe '. M ~ .. - • " "" ... ., W ", ,. U ., • - • • •

" - -- .. ,. ., ,,,. m '" • •" - - ..."

m " ,. • '" " • "" - - '" ," ,. ,. - " '" • ,. ".. - .' ,.. ", ,. ,. • " - " • "" - .., - ,. ,. " '. • - • • •" - - '. ,. '" " - , - • • •" - ... ,. ,. ," .. - ea eo •.. ~ -'" '" '" .. .' .. m • .. .... - - '. ..' '" U • " ,- • • •" - -,. ,. ,. ", m ,. ,. • • • " .." - m ,. ,.. ". '" - ,,, - " W .... - -," '" • U - .. - • • •• - m ,. ,. ". 11U •• - ,. " • " • "• '" • -,. m '" '" ., • m • • ..• - - '"

,. ,. = "",. - " " •• ,- m ,. ," ," "' '- - ,oo • ... se

" --- .. '. '. ,. ao ,." - .. • •• - m '"

,. ,. .. .. " ,. •• ~ ,.. '. ,. ..' ,= ". - - ea " •.. - '. ," • " • • ~ " ,... 'i::" m '. '. • ,U - ," - " • n• ~,.

'" '" " - • ~ M , .. " ..• - .. ,. '. '. .., ~, ~ .. • M • ",

• - m ,. ,M ,. .. ", , '. • ,"M - .. ,. ,. • ". - • ,. • • '"• - '" ," ,. • .. m • - ., za •" '- - ", '. • ~ '. • - • • '"• - ~ ," ,. • m , - - - • • • .. "--~(71 .,00I

-~m • '. • ~ - ",. - • • • " •

• - m ,.'" • ". ~ • - M • " " •• ~- -'. '. • 12.0 • • ~ • • • " •.. - ,ro ,. '. • u m • - • • • • ..

• - - ,. '. , ~ '- '" - • .. ,• - - '. '. • .. .. • •• " '"• - = ,. '. , U - • • .. , • ". "." - m ", ," • ' U .' , '0'0 • • ," " •• --- -'" '. , .. 'oo " ... • •" ~ - '" '. , " , - • - • • 0 • •• """ .' ", ,. • " ,oo " - .. ..• - - ,. ,. • •• ". ," - • • • • ~• - ,. • '. • •• 0' • ~ • " •" - m 0 ,.

",., -, - - " " '" • ..

" ~ m • ,. • U - • ". • M " " M.. -- - " ," • '" - • - • • "• -- ,. • .. 0 ~ ". • •• •• - - • 'M • .,., 'm '" - .. ",.

• ,- ~ • ,. • U '" " 'm • , • • .... - ", 0 ,,' " " - • - • " ,.• - W • '. • ,~ m • - • • •" re:' .. .' • .. " ~ ". '. - • • • ". ...• '" • '" • " "

, ,- • " '" • •" ,- m • ,. • •• ... '. ,m • " ," ". ..• -- ,. • ,. • " ", - • '.• - W • ,. • ., ,. " - • , - " ..

____" ............" <>ao' rX"- IllO;IIl__"," """""'Y__" ..... lfI>IlI.

"

.-- - .- .-_. - - •• " ,. -- -- • ~ •• _. - - - _. --• _. - - - .- •• ---- - - •• - - • ------ - - - ~ - ---• M

• - '. • ," • '.. m • ,m • • '"• - ,. • ... • '50.' .,,~ .. .. • .. •• , •• --- ,. • ,. • " ,.. .. ~ • " n.. :e.'!:._ " • .oo • " ,. ,~ • • >T •• '. • '. .. " ,.. .. ~ .. • ..'--_l:tHOl- ,. • • • - - ,- ,m • • •• .. ..

• - .. • • " ... - •• '" • • om ..' •.. -- " • '. • OO' .. .. ~ • • ••.. .- .. • '. • u " " '" • • ."• :;:..""'" .. • • .. ., '. • 'm .. • ••n ,.. • •• • '" " • " • • ,"" ..,,-_<# .. • 'oo • ., ,,, • - • • ..." - .. • • 0 u • • "w • • ,." - ,.. " .. • •• '. , .- .. • •.. ~ '" • • • ., m • ." • • ... " •• - ,oo • • • oo, ,- '" ... .. .. '" ".. - m • ,.. " " .. • = • .-• - ,.. • .. • ,., ~ • = .. • 'oo .. ".. ~ " • •• • 11:» 1 - ,010 " • , .. ~ •• - ," .. '" " aa " • n 'oo• - • • .. "

., m " ..oo .. • '"• -- '. • • • » eeo .. ~ .. ,oo• .~ ,.. • .. • .., " " m n • 'm " •• - 'oo • 'oo • OO' ... • 'm • • • ,. w.. - • • • .. = " " ,~ .. ..• ~ • " • za - .. '. - " 'oo• - ,oo .. • ,

" • , ,m • • ,.• --- " • ,oo " .. • , ,- .. " ••.. -... ,oo • • • ., m • - .. • 'oo w •• - 'oo • "

, ... " .. "oo .. • '. .. "• - '. • • , " .. , ,- • 'oo " "• ~ •• .. ... • '" " • 'm n • ,oo " .'• - " .. .. ," • , .. n • '. " 0 '

• ~~ ," .. • • = ", .. • • • .. .... ... .. • .. ao .. , ,m " • 'oo .. •

~--..--- • .. • • - ..- ,., .- • ,. .. •• - • • • .. " • , ,,,

" • ,oo " •• - '. .. • " ao • , '6\~ " ra •,. - ro .. • .. ~ ~ .. ,~ n ..' " •.., "- • .. • .. " '", = " '.'. h'_WIIT_ .. " • .. .. • , .. n ,oo ~ w

,oo~ " .. " .. ,.. ~ , .. .. .. " •'. '" .. " .. ," .. , .~ .. • ,,,

,oo .. .. • " ,.. 'oo , ..w " • ~'. 0"" .. _ • " " .. ,s.> '", = " •," -- • .. " .. " • , ,.. "

., .. ..'OO - • .. • • ., • , .. " • .. ~'oo - • .. " .. '" '" • .. • • ,oo'.. w • .. " • ~, - • ~.. " ,oo .. •'" .. " .. .. • "' w , 'SIlO • .. • .. ...., - • .. .. , " .. , am " • .. "," - " .. "

, ,~ ,oo , ,.. " ,oo .. •... - .. , ., , ., - , .. " • '" .. "... -- • ", .. .., , 'moo " ,oo ~ F.., - • , • ,. • , moo • ..',,, -- " • , '" ~

, ,..'0 • 'oo '" ~.., - .. ",

" " • ,om .. •• " ..... - .. • , ., .. , 'om • '" .. '"'oo _..... • .. ,~ • , - " " ..",~ • • ," .. , - • • " •on - " "

, " ", .... " 'OO

' W ...... • .. , ". ~, - .. ,. ~ F

". - .. • ,~ - • ,moo " '. .. •'. '......... " .. ,'"

,. , ,om " ... " •'. :t::"' 0 , .. , .. ", ,- " 'OO .. "'" • , • ,

~ • • .,. • '.. .. •,. - • , .. • " 'W ,"~ • .oo " ..'. - • • " • .= ,~ • _.. • '. ~ F

"

TABLE 2, NUTRITION

" ,,- "·_.fII__ -- ~ ,.-- - - - - .- .- ---. _.-~- - - - -- _.- 10-__- .- m- • • • - - - -" - •- - - - ,- - .- .- - - • -_..-.......~- " • • • • 0 .. • • • • •, , • ~ • • • •, .... • ,. ",' •, - " IT ", - .. "' • • .' • • - • • • •, -- .. • • • • r •• • • • •

0 - ~ • .' 0 .. • • • •• 0.-.' u ~ ~ • • - •0 - • - • • .. •0 -,- >0' • • • - ..• .,.. • • z • • ,. • " ee

" - • • • • ,. .. • "' • •" ~ • •e - ~ • .' • .." - " " • .. " .' 0 • ,... - .. .. "' n •.. - • 0 ",' • .' " .' " IT so "" ~ '. • rr ,. •.. - • .' ~ • ,. .. • • .... - • .' w •" - • • • ,. • .. •>0 - ,. • - • .. '"

, •• : ..... " • " • • • 0 • ~ • " "• • • • • • ,. • • • • • •• " .. • • • • • " • • • • •• ,..; .. • • , • • .. • •• ,- • - • • • • • • • •u --- .. • •• - • • ,. • • • • • •• - ~ • .. • • , • • ,. • • •• - • -• =.. • • • • • • ,. • •• .. • • • • 7 , ",' ~ • "" - • • ,. • • • .. - - • .. ".. .. • • - • " .. - ,.• ~ .. • - n .. 7 .. • • • •• - • • • , "" • .. "• - ~ • • .. • • • • • •• - " ", ' • •• • • ....--{".,...- • • • , .. • • .. • ,. • "• - .. • • " " 0 " • ,. • ee• ~- .' " • ,

", " • • ,. • •

"' - '" • • ,"' 7 .. ," ' • •• - " '. '. • • • • ..• - " • • • "

, • • , ,,,• - • ,. .. .. • • • .. •• - • • • • .. r , • • " • •• --- - ,... - " IT • .. • • .' '. m • "• -- ,. - • • • " • • ,. U ..• - " • • • .. ",' - • • "• - • .. • • • "."' - " • • • "', " m - .. "• • .a .. • , • - • • • • - • •• -- • .' • - m.. -- " • - •• - .. • • • • " .. • ,.• .- .' • IT " .. • • • - • "• • • • • .. • , .' • • • •• - • .. • .. • ,.• F. • • • • .. • • •

_ '. • •• • • • " " ",' .. • • U.. ,- " • .. • • ,. • 0

• - • • • -• - • ,. • " • • • • • •___ _ ~_"" .. _ ot.... '1IlO~ ...mu1IIIt1_ "'_'J

"

.. ..- ~--~--- -- ~ ..-- -- --- - •• .- -,-•• - --- - - - -- _.- IIMI _ lI"lt_ .- ...- • • • - - - --- •- - - - .- - '- '- - - • -"' - ... • ta " " • • • •• .ro •• - ,

~ ~ .' , , , .. •• ." • •• --- ~ • •• •" - .. " • • " • ••• -~ " .. " " " r , ~ .. •• • "--_1ft·1OI- • .. .. • .. , , • • •• • ,• - " ", • • .. • • •• .. •..~- '" ~ ~ • " .. .. • •• .oo

" .- , • .. • io- r • ~ 'OO •• • ," ;:...... , • • " • • • " •• m eo •" '" ..' rr • ••" ---'" • ..' " .. ' q ~ ~ .. •• .. .... - .. sc- .. ..' ••.. - • se • .. •• ". •n ~ e- • • • .. , s .. '" '" •.. - .. " • • .. , ~ • •• •.. - ,

'" .' eo-

• - • w q ~ , .' r- • •• •.. ~ , OO' e- '" e , ". •oo ." ..• - , • 'u-• ~ • • .. • ,. • •• -- ..' .oo• .- " • • ra ~

," .' • ,. • "• - " • • "' ~ • " ~ .., .oo • •

"' - • .. .. ,.• ~ • ." ,~

• - • • sa • .. • • • ,. .. •• --- ,.. _.. • - • ", • •• , ..• - .. • .oo ,. •• - , .. • .. • "

~ •• '.. • ,• ~ , .. ' or eo- , • .. ". ,. • •• tzt:

, ~ q r r ., m ,." •• • • ,.".. , .' ~ .' • , • • .. .. •---lZll_~- • " • •• •• .. ,

• - , • • .. , • , • ". •• - " '" ~ .. • , ..•• - • ~ ~ •• '" •... =_1_ • • .".oo • .. tr r , • .' • ,"•• :::= .. • •• ," •,. • • " • ." ,. ••• ~ • .' • ,.•• ClW .. • ." ,.m -- e • '" " ••• - , • '" "•• - • • •• ..... ~ , • • • ,.

" •m ~ • .. " •'" - • •• ". .. •." - • " • " • '" " •... ... , ". ,. • ,'" - • ... ,. .. •". - • " •• ,. .. ,'" -- • • " •• •• "

,". - • ... • ., ..n. - , • ." " e•• ~ ",.. • .oo •• "". - • ,. •• "

,'" -.. • ". .., " •'" - • ".'" - • • • '" •• "

,," _.......

~ '" '" " ••• ::"'.:~ • • '" ",

'" • r ". ." .. ,'.- • " " •• ." ",,. - , • ." .. •

"

TABLE 3' HEALTH

..- "--_. -_. _...--_. --- - _.- - -- -- - --- - - - - - • • - - - -......-_.._~- • • • • • • - - - .. - •, • " " •_

• - - - - = •, • • " • » " ~ - - ~ 0' ", • .. " 0 ~ = = = = "• .. • • " .. "' ~ ~ ~ .., • » • .. ,- .. - - •• - • '" 0 » - - - - ~,., tu. s • " • = = = ~ .. •• - • • • •

_» .. "' "' ~. ~ »• -- • " .. '" ... • ,- .. .. - '... "• .. .. _

• .. • • - ~ •• - - •.. - " • " • -, - ,- ,~ "' •" - • M = = = "' •.. - • • • • 0 " ", ~. '" OM .. •" - • • • • .~ ,.. ... ~ ~ .... - • • • • • • .- - - - ~ •" - • • • '" '" • .~ ". .- - .. •" ~

," • • » • M ,. - ~

, •" ~ • = • " - - ... - - •" - • • • • .. '.. .... .~ "' »• - • • • - - ... ... - ".. - • • 0 • ,~, ~ ,~ •• "

,• ::7"" • • • • M = M • ~ ..• • • • • ... ... ... • w. •• , • • .. • .. - ~ = = "• ~ • • • • • • .. ... '. ... •• •• ,- • .. • • '" • .. - - .. - •• --- .. • " • • ~ - M - •• - • - - .. =• ;""~ • • • • .. - - - ,- •• • » • 0 • = = = • •• ::- .. • " .' 0 '" .. - - _. .. •• • tr • • » • - -, .. ". - •• - • • • • • • '... .. .. ... ... •• .. • • • • .. 'M ,~ rn. ~ •• - • • • .. • • ... .. .. .. • •• - • • • • - - • = = •• '- "

_ .. • - "' ... ON •• •• - .. • .. .... .. '. - - •..-"'" (1'1.,.- .. • • • • • •• .. .. - .- •• - • • • • • • .0. - - .. "m •• Cbo d·..... 0 .' ". - •• •• •• .- "• - • • .. • - .~, .. n' = •• - • • " • • " .. .- ,., =, m •• - • • • • ... - - - , •• - • " • • ~ 0 - - "~

,... M •• - .. • n • .. .- ,~ .. •• ro• --- •

_• - - - .~ •• •.. - .. ~ .. .. ~ • M -, -, = ~ •• - • • • • • .. - .. .. - M "• - •• ~ A' M no PO M ~ »

• - n' w '" • ~ • .. - - ". no ..• - • • • • .. - ~ • -, •• • o. • • .. .. .. • .. .. _. - - •• -- •

_ .. •_

• - - .. .- - •.. -- • - • - ,• - • • • •

_" - - .' ~ - "• 0- • • " • • • ... .. .. - ~ •.. • • • • "

_• - .. - .. = "• ~ •

_" • • • - .. - .. - ..

• - " w • - .. .- .. - •• - • -• w ~ w - .. - - .- •• ,- ~ w w •_. _. .. ,"• - • • .. - .. .. • , ..

• - " • • • » • - - •• .. , ~, •__"_...--....._d_ 191/0"....""""""'___ ' /

..

..- ..-~_. -_. _...- ..-...-- --- •• ..,..- - ~- ---- - - - - • - - - '- • •0 - " • " • • • .. •• ,- 311O!' ., ro• - "

,. • - "M il .. - . ~ •• --- , • • • .. .. .. m ~ •" =- " " " " '. " -, - .. .. m •" " • • eo .. .- - ,,- .. ea--_12t.101- " - • " • • _. - ". - - "• - " • " ". ,- .. • "M ,• -- " se " • '. • • • •• •• ~. •" '- • .. " ~ ,~ ~ .. no ". .. - •" - , • ,

" - .. .. ,- - ", .. • • " W ~ ~ .. ,.. ,.. ,.. ~ •" --..... '" • • • • • • .. .. "!IIl .. ... "" - , . ~ ~ ., '. "• - • '. • " • • , •• ". - .. •" ~ • • " " ... .. .. .. •• •, - "

, • , • • ..~ ,- roo - '" "• - .. • " ",. • .. .. .. .. 2l!ll' "• - ~ ~ ee- n. .. wn .- , •" - " " • • ,. • m ., •• • ,. •• - .. .. roo .. ,

• ..... • ," " • " .. .. .. roo , ro--- .. .. ... ,.. m "• -- • • • ~ .. .. .. ., .. "• - " " • • • • ". .. .. .,

"~ •• - .. · J. . .- •• m • 1- •• ~ ~ .- ~, .. ,• - 0 .. • ~ e- O' ""' - .. .. n r •• ...-....- so- ,.. WN .- m , ,--- ,

" • • " • m G'"' ~. - ·,• - , • • ,.. ..' ,.. .sa .., •• ~ • ,. • ,ro '. .. _. roo roo ., '. ,0 ~ • ,. " • ,.., •• - roo , ,• ~~

, • • • .. ". .. .. 111'13 •• .. ..,. - .. ·,." • '. 0 ~ ,~ ~ ". roo roo ". ., •~--..--- -, .. •• .. • •

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TABLE7' WOMEN

..--- -- -_.. --- --'-"- - -- .- -_. _.. - - -- - -- _.- , - - •• • -- .- - •• - • •..,...-~t-U·l- ,~ • 0 • , 0 • -, - ,~ " • " • • • -, ...- '0. • • • > , • ~e :::- ,~ • • sa ,. • ..• ,~ • • • , .. " =, -- 1100 • 0 0 •• n • -• - ,., 0 • r 0 • ,.

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,., • • • • =• ~ '., " • .. ,." • -• -,- ,~ • • • , • • ..0

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" '.0 " • • " " s m

" .... .. ,., 0 • • • .. o.• ~ ,... • ". " • n ee -• ,- 101./ ~ • ee ,. 0 • ~

"e.-......_

"O-ll 0 .. • .. • m• - 1011.' • ...• - ,~ • • • • 0 ~ m• ,- ''''',9 • e • 120.. :::- ,~ se • ee 0 .. • -• ,= • • • • • " m• - '00.0 0 0 " • .. ~ m• - ,., • • "• ~ ,~ • • • > • " -• - '•. • • • • • • reo-0 ::I: '0' • • • " .. ". -• 100.0 • " • 0 n • -....--(7"'""1- ,., .. • 0 • • • -• - '0' n .. .. " 0 • ,m• ~- ,~ • " 0 a 0 •.. - '0. • 0 • , , • ~

" - ,., " • • ,. • -• - "'.0 ,. ,. • 0.. - '0' • • ,. 0 • ,.e - ,~ • 0 • 0 • .. -• ,,-,"'lb"""""'" ,., 0 • • •.. ~ '.' 0 • • • • • -• - ,= 0 ~ • seo-• .... ,~ " • • " " • ,.M - '.' 0 • .. " " "

,... - ,= " .. .. • " • ee0 - ,= .. 0 • za • 0 =• -- ,., • • 0 0 •0 -- n~ .. ~0 - ,= .. • 0 • se " -• ,- "'~ • ,oo n, .. .. eo

" - '.' .. .. • .. • 0• ~ '0' • 0 0 0 .. '.• =.. ,., 0 • , • 0 .. =• n~ ",. n• 0 0 .. =.. ...... '.' .. • • '" .. '" 'oo

0 - ,~,. ,oo • ,"• - ,~ 0 ,. '. • " • =

__..._.,.....,...9«*«". l!lllO~"'''''>"lOIIy_''''_ ,~

•

..-"- -- -_.. --- _.'--- - -- .- -_. _., - - -- - -- _.- N - - -• • " ,- -- ,- •• - ••" - ,", • • ,.

" 0 • 'M• - ,., • ," • • • ~• --- 'W, • • • • .. • sco

" -- ,., '" = " " ".• -- ~ • ,. • " •--- (21.""- ' 07.1 " • • " • • •• -- ,~ ,oo ,oo ,." " .. 'oo.. -- ,~ " • • • " oo· ,oo

" ,- ,~ " " • • • • •n -- ,~ • • " " • • =n ... ,~ • • • M " " ,oo

" --........ '., • • n e- " M ,oo" - ,., • • •" - -, " '" • • " • ~n ~ ,w, • ,. ,oo • • " ~

" - "M " " • • • • '"n - '. , • .. " •• - ' OII ,~ ~ '" • •" ~ ,., .. • .. .. " •" - 'Oil • • •• ..- ,.. • ,.'" .. ,oo

" -- ,.. ,oo '. • ,."• .~ ,~ • " '" " • • •• - '., • • • • " n

" - ,~ ,. • ,~ ,.• ~ ".. • "• - 1(11.1 icc • '" • n • •• ..- ....- ,,,, • ' OO ,. •" -- ,~ • ," " n- • •• - ,~ • ' OO " " n • •• - '.. ,,, 'oo " • • •• ~ "M • • '. • • "• - 110.' • • ," " • •• - ,~ " • • • ee- 0

" -- ,~ ' OO ",. .. • " •---"'--- ,~ 'oo '. n • 0

• - ,(l!j,S ~ ,oo '" " • '"• - ,.. " " • " • 0,oo - 1" ",OO ,. W ,~ "'. "- ,~ • ,. w 'OO ,

'oo T...-....,,_W'~

,. ,. • • ,"'OO ::::;: n U l 'OO '" n • "'. ~, " " ," • on ",. ~ m•., • " '" • • • •,. eo", • '. '11'- .' ,,, • ' OO ",. -- ,~ • ,oo M • ra'. - ,.. 'OO ,,' • ,'OO - ,". " 'oo • • 0," ~ '"11,1.1 • '" • • 0

'" - ,~ • ,oo " •,,' - ,", 'oo ,. ". ,'" - ,.. • 'oo on • ,'" - '"' • 'oo ". • • e'" - ,. ,

'" ", ". ,oo ,'" - ,~ • ,. n ' 0," -- lQlI.2 ,,, '. • ,~ •,,' ....... ,~ " ", " ,~ "'" - Ill.' • ,. M • ,,oo _." ,~ n' • 0

'" ....... ,.,'" ", ,~ ,

'" - ,", ,oo '",

'" ....... ,.. • • ~

'" - ,~ • 'oo n • ,'" ....... '.. '. • • ,~ "'OO -- ,", • '" n ,~ ,'" - 'au • ," • ,~ ",.- ," , ee 'oo n ,~ 0' N - ,", ,oo ,oo " ,oo "

ss

TABLES' BASIC INDICATORS ON LESS POPUWUS COUNTRIES

- " "-, - - •• ,. '. .- -- - •• ••_.

~ - -_.-• • - - - .- .- - -- -- - - •• - - '- ----- - - - - - - ---, - m ~ ." •• ., .' .. •• .. " "' "• -- v. ~ ,. .. ~ ,~ .. ~ .. • .w •, - ~ ... '. .., ~ "' M m "' w ,. •• - ,. •• ." G 'M .. '2'0' - .. - •• ~ m ." '. • -' = .. G .. ~ • "'• - "' • •• M " ~ • ~ w •, - • • • xo " reo • • '. ..• - • "' "" ~ G • •• ~ •• "-,.

" '. • - = •• ~ .. .. .. ,.. - • - •• M .. .. • .. ",' .... -- - • .., .. m '.. •• ~ "' ~ ", .."

So<>r....__ .. .. ". •• " ~ • ~ .." St.eh' .- .. " • ,.

M ... .. • ,. •" ,- .' .. - • .." ~ • • .. " 0 ," .. ,~ .. • .. •.. - • .. • ae •• ,m .. .. • •" ~- • .,

'" ~ .. ". .. .... - • • " M .. .. " ~ .. •.. - ~ • ,. • ~ 'M .. ,.. • • ", ..• --- V " " ". .. .. •.. • .. .. " • - In ",~ • ~ ,. .., r........ CIoa>o_ • .. " - .. "'" - • ~ .- ,,~ .. ~ ..

" - • u •• .. .. .~ • • • "'• ....._..-- • .. • " " " .. '0' "• lIl._l..~ " " ". an .. '.. .. .. • •V - U .. us- - ,.. " .. •.. -- • • " ... ~ .w· ~• ,- • • • ,. .. .., .. ~ ,w •• - • • tr •• .. .. .. •• ,w •.. -- • .. .. '" .. .. 18te .. .. .. ..• ...- " .. • ,. .. ... • .. •• .... - • " • t o OJ! ''Y':'' " ". '00 .... -- " .. .. ... .. •• ••• - ~ ",. .. ". ", ca .. " n .., •• - .. .. " " ssa .. •• .. " • .. •.. - • " • " roo ," .. ... .. • '. ..• - • " .. " ~ '.' ., ssec • .. ". ..• -- • ~ ~ .- • ~ •• -- .. • • r m " .. ,,~ 0 "... - • • " • ~ '.' .. ,- 0 ~ •

__...._ ..........0''""'"' '''_,_ ...... ........,._.......""_ ...~_._

Measuring human development

An Introdudlon 10 r... 9

• da\ 'I " "U 11 !hll 19906 .. l<J -..m a rmretur81la::e It>EJ1 !hlIAl ....... 8 ...... ' ....... do""'.--:! b'a........,. 0I..........r.g tumn as~ as ecoO'1cprogo-. Fn7n LNCEF"s pci1T 01 VfilW, ;,~,

llvu Isa.--:! for "" 'V"'ld malt'od oIll'llll1:Slri"l theJIMlj 01 d*l~ Inl its rwtol d'oIr'ge.

The In:Ieo' l'Jto(Ilt'IOf1*v rate (U5MRl is~ n r.... 9I"e>d PitiJel as lheP'I"dI:le irdc8tor oIll.d'l po ago-.

LI5M'l has -..~ ffsl. • _ lI'l

IlI"d~ '" lhll d!:Mlk;p'''''l pnx:ll8I f8lher!han ..'~' ll.d'l assc:t'ooI .. , ,,, ,e ........,pere:apm_10> "...,., CO' tho IUl1blIr 01 o:x:ten I» lflClISlnClPOP' 101m." oI..tO::1l n moons ICl "" srd,

8e<::oxl. !he U5/"IR is l<n::J,yn 10 be !hII >e!lJI cI a _ViII'er'j 01~ the f"IUll'iIicMI _ srd me _~ d~ lhe ....... cI iTm.rizubon srdOAT.-; 1tlIt~ 01 rmltmIIl ;n:l d*I heal\tI!ll'r'vIOtl!I (i'lc1d'Ig pm.reUII c::lQj: r.::on& Inl Jood""" "'f n lte ImWy: lho It ' 'Alf 01 dean "'9le.

and ""'" ... . IiII1o~ a'lCIlho <MtaI salely "'!he d'tiB_i,..'.H.Thim,~ is _ ~ Itwl.!!at. _ ClIIPIIIG/'.J> 10 Ih9 faIocy 01 tho IIIIllrOQO. n.s .. beQula IN

_ !lQlII'I does not '*'" !he ctti"81 01 "'" ridllObe U'I8 1I'o.I!iinllmCl: as lIcdy10 SU\1Ie, lM!I1 'the~~ does p<rniI I!lem Ie hIM llOII~ _ 15 """"" i-cx:rre. In eltw 'Ml'dIs, ~ illrru:h ITIC<1I dtrIcUl fof I I'I'EIliM1 rrilanly to atre<:I a01110'1". I.J:5I*l. IIJld ~ a.....u~ B momIl<XU'aII!. • fa" mm pertuer. po;llnI oIlt"ol~ S1<llU!lcJ!he~ rA<tIIo78l \lind 01~ asB """dlII-

Fera- feB9O"I!. 1IIll1J5IIt'I is CI'QlEf1l71' LNCEF as11$ .-.gle mosI~ f>ck:alcr 01 the stale cI Bnation's cttien. ThaI Js vmt!he stallS!IC8I &"fleX Isls

eerooons 01 !hll1'101:l not 1189CO Idil 9 oroer 01 !herper capite GNP bJl h deooei odi 'II 0IdiIf oIl18" L.ndef"--Moeaunng !he m a 01 progrea

The~ 01 progo .... ;., re<l>:;lng flo U5MfI <8'l be..........-ed by~ Is IMJ8g!llW'nllll rll<1cticl'1lIIt9 VlAAAl. U'*<8 Ite 00""",,,'00" 01~chInga$, ee~ nllIects the facI IIu; lhB ImIs lO~ we f«lI'ooct'Old orfI """ h. I III <:iIfo.IIy.As bMlr .... '" ..... IMI mortaIir\I ..... read1ed. lore:<an"4lIB, Ite """'" 8bIloOJ:e reo:b:ti:rl~'llj>,*, '10 II goo:e.- peiwiIll\JlI 01 fllI:1.cIg\, TheA/lHlltlB<tllor& ,..."..., a h9>er >lIle 01 poogoass b',S<\)'.a len POi'I AlCio::tion , !hal rec1JcIiotl Mopens at B_ .......of ...... M rratafly, lA!pi ;, U5MA 0110peWlls from 100 to !J:l,epo_... B reWcIol 01 lCl'l',v.nereas ee _ 11).poim !pi lrOO1 20 III 10J(lpr8:l8nIs a...o..:fu1 aI 5O'9l.~

We> \.ISIIld ii CO"j<n:!D'1 ""'" G/IP Ir"WIh -. tteU5MR ...-.:l irsMl1lo::liQ1 """ em IneIabeg.ll a pictJnaI h "\09_ 00iIg rl'lIdt blIlln\' <XU'IIrY a regicr\...-.:llMll' tJnf pI1Md cf eee. 1ONa'de It'e sarish " " aIs:me cf 1hIl mosl m lIB cf Iunln 00IIds.

As Tablo 9 lI'1cY<s, Itere .. no fiI<ad ,'*40 01 '"t:et-. 1M am.JlI nd.cuon Illla cf tho w.f'lln!1nII .- cf gtlWIh n ll8'~ G/IP. SudI<D1 roo ..~ 10 Itmw 1M "IP ! UI 10 ttepr:ti:l$,~ ...-.:l ot'1oo" la:;tcrs Yorich dOOnYh1M mIlO """-'an ... ' tic lnl .9OOIlI po \09.....

ffI!IIy. the tme """ !he 10:11 IriiI:y rmo for ili!dl<::<:u'fr'/ lnlll$ sYerlIQ!l ........... tato cf 'llCi.o:::ticn _.....be saar1 tha1 mEI'lI' ':J tte retions whid11'1fMl~Iigo tka ( nld.Jcticno J1 IJ5MR '- also at1'OIMldsigl i6:a' ( red:lcIict'IS iilerllty.

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Footnotes to Tables

Table 1:

""'",,"'....-----~-.,~--------'-T_&T_~------

---- -------,----------- -.... --... --

,w'lI"J-~'.--____a.-__ _ _ ..o.o.nr_---------,-"'w,.,.,.,.""..",....'w--

Table 2:......._, • • • ---- -......., - -- --- ""' '' _i' (>'?..",.-,::- ""-.... ~-- --- -~ • . •

_.1.1&_, --- -- -- 0_- .a_- --.... --- ..... ;YO ,--.... "~-- .... --- • , • ---,. --- ....- --- ......-"'''-' ,--...... ,."'-

~ -- ,.-~ --- --• • -u...._ . _14'_- -.... --'-~ "'=-'

c. .. _.... ~,-~ u ..~ .-- .-.... .-~- --- ---- - _J_

-~-- - --llD.....' _

u__, --...... --- u.. ; . ,~-...... -- --

~"""'9 ......l>U_9_DolO ""'"9_,m..--~,--'m'91$;_~.........,m...-.__1211_8__._----_w_.w_ w'9'11_w_.w'1118'ilIa.",'lIfV;~_"'",giloro_12-2:1_

~-,.-.~-1~"""""~-..-._-~~-'".~-0 ·303_7'..:ll\_--BIIl _HO__..,,_BIIl _....&::ulng_ .0011 .........._--__ '3~·___",m _....0.11_,.,-..._-----_....•__ ':\-201 -.; _

--~-"'"..-.~-191""'B,9ft·/II.n_3·3lI_2<-OO"",*"

---~fl.SIl__!lao1

,m'"-2"""_2<136 .336 ....2<-311 _ ...

~-;::::.. ' . ~

1.0 .... """"-~---;::::........,.,...... ..09.

1>_",-~;::::~-... ..... .,,,.. _ ...... 11

... "'" 09 '

-no •

-

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-

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--

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•

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--....----.---'-'--....-------

"_ c_~_..~.-r::._...-~-------..-

,.,,,,,,,,~,,,.'..,~.-----------,--------------,--••-_......,,--

..-,--"""c"" _~....:toN _--0 _---------_a.___ A _ _----------

_..__.._... lll'I. ....... __10-_._IlJ. [JOT,___.._-_ lO__lll'I.___.._....-..__......_._DPl,___.._1Pl.__

~_.._-III, lPI' ....... _ T-.._._-"'lll'I ___.__..__..__._-_.-_.-_._-llPf,___.._-~--~_.__.__..__.__10_--,--_.._-_..__._-_.._-"'llf'1 .___.._-

•...........:::.. '.u.. , .

:::Va 00; '

:::....._,...._&_._I!o"lo._ ::~:::.:.~ ._~~"_.__..__ _-~---

....--

Table 3:

""""

--

Table 4: - -- -~N_-~EducatiOn .... -- -~N_-~"' .... ""'- -- -~- -- -~

"""'"' N.-~- N_-~- """ _I'WQ ,~"_...

....... ""'""I' I,m ,.,~ .....- '.- N_

-~- ......_ I't1Ct "'10 '0... ...,_- -- -~N.-~- N.-~- N.-~- --- '.'...... ......._M1Ct ,.,- -- -~N_-~- N.-~- ,.--~~ -- -~- -- '.~ -- '.- N_-~- ... -. -~,- -- ,.- ....._~~IQ ,tiS- -- ,.--- ,.- -- -~N .-~

Table 6:

''''''''''''IncflCalors

--""--

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THE STATE OF THE WORLD'S CHILDR EN 1992

The 1992 SWle of 1M World'. Child_ repon.. issued al a time when the wolid orderwltich has dominated 1M political andeconomic lifeof the 20th CC11tury is visiblydying. The repon is offm:d, from thepanicular J>e"pcctivc of UNlCEFsexpc:rimco: in worI<ing with some ofhumanity' . most lICUlC problctm, 115 Ioonmbution 10 the debate on the~ worldorder whicb is Stl'\lgalina: 10 be born.

The repon submits 10 spWf~ propositions;taken together, lbI:y add up to I Jlf'OPCliW thatending the absolUle poverty of ()rlt quanti" ofmankind - the man: than one biI1ion peoplewho sliD 1,,~ an d dk with prevaltabkhunger, disease, and illiteraCY - should rankalongside the rdated is$u., of Preserv1na thepeace and pnxectina the environment aspriority items on lhe agenda of that newWQrId ordtt.

Thc report suggcsl$ that oneof the mosttlwneful failings of the old world order .. thaIa QIWttr of a million childtm :m beingaIIO\Io~ 10 die, every~ and that millionsmore """ being alII<Immed to I half-life ofmalnulririon and AIrtlo$t pr:nnanenI ill ht:ahb.By any~ IWldard ofscale or severity,tim isan issuI: whic:h sbouId rank inimpor1lll'lCle " ith any on the human agenda.But in the plIlI!, sud! problems have had littlepurchase on priaity bca.usc lhcy ..., primariJy

.\he pi"blahS of the poor and the powerioss.

Coinciding with the other great d1angaoccurring in the world, 1.h<:rl: are now signs

OXFORD UNIVERSITY PRESS

£4.00 net in UK 57.50 ill USA

!hat these issues are I>eginnin& to appear onthe pclitial agcndJ, in • way that isun~ttd in UNICEF. 4O-year btoey.

TIle most imporwlI sign of thai new politicalpriority WlII the holdinjr; of the $eptemba"\990 World S......",iljor ChildrPr. With O-"er

70 Presidcnlll and Priml: Minimn in1I.ttendanc:e, it WlII \he largest plhcrin& ofIIeads ofStalC in history. And it metIp.elkally to di:scuss childrm.

Tbc outcome was • oommitm<:nt, nowsigned by Illfm than 120~s of state, toan ogrccd progrvnmc: for, among otherlhings, ending lllIU malnutrition, »='Cfllllbledisease, and widespr=! iIliteraey before theen d of the de<:a<k. The Hnt of the 1q>On',propositions is dUll this great promise 10 theworld', children ohouJd now be kept.

Governments must lead. But the reportttrettQ the imJ)OftatlCe of Il'IObili%ing aUpottible toeial resourc:eo behind thecommitments WI have been madt and calJson aU concerned organizations andindividuals ttl become involved in '~

the promise' .

'"A ..... IX'If ;" Wt1rld Iriswry isbM, rumed~rondudeI UNICEF, "and if IJw -as ofIJwpoI)tf:S' quatUT 11/ --..:t, and ofW: dUIdretrUJht> "'" 1M .....,~ ofaIJ, an <>,pinrtkgaud ID IN100_ oflhal~ IJwn 1M..... Wt1rld <mJn ",1Iidl is """/1m u.n. will 1MMiIMrwonhy 11/ iss lima ..". capahk 0/-rUtt IJw~ 0/IN fimire. ~

ISBN 0- 19-262228-5

Documents

UNICEF: The State of the World's Children 1992