It has been a little more than a decade since the 1990 World Summit for Children, an historic meeting at the United Nations that brought the welfare of children to the forefront of the global agenda and inspired great hope for improving the lives of children in every part of the world. As a result of the 1990 Summit, the government of virtually every country in the world committed itself to elevating the status of children and achieving a set of goals for improving their survival and healthy development, particularly in developing countries.

Progress has been made

In the eleven years since the Summit, considerable progress has been made. Infant and child mortality rates declined, polio is now near eradication, and the use of simple, low-cost treatment and prevention tools such as immunization, oral rehydration therapy (ORT), and vitamin A supplementation have minimized the impact of diseases and infections. In fact, during the last decade, immunization against the most common childhood diseases is credited with saving the lives of more than three million children every year, and increased iodized salt consumption has prevented severe mental and physical disability in more than two-thirds of children worldwide.

Alongside this progress has been an increase in global awareness of child and maternal survival issues and greater commitment on the part of governments, international organizations, and the private sector to work together in addressing these serious needs. Innovative partnerships among various donor sectors, both public and private, have resulted in more effective interventions and better quality services.

Significant unmet needs and new challenges

Despite these important successes, however, over ten million children under the age of five continue to die every year, the vast majority of them from preventable and treatable diseases such as measles, diarrhea, and pneumonia. In fact, more than 75 percent of these deaths come from just five preventable causes, and over fifty percent are associated with malnutrition. By the end of the last decade, many of the important global goals for children's health and nutrition that were set during the 1990 World Summit for Children had not yet been achieved, and progress in a number of important child health areas had begun to level off. Today, almost a third of the world's children are still not immunized against the six common childhood diseases, a quarter do not receive oral rehydration therapy to treat diarrheal disease, and over half are still deficient in the critical micronutrient vitamin A. There is an important unfinished agenda.

In addition to the long-standing challenges in child health and survival, new challenges such as HIV/AIDS and drug-resistant diseases have emerged in the past decade, putting the lives of millions of children at greater risk and placing a significant additional burden on the already-strained healthcare systems of developing countries.

A time for action

The first five years of life are the most crucial to the physical and intellectual development of children and can determine their potential to learn and thrive for a lifetime. For young children, every single day counts. The challenges that we face in global child health are not ones that can be put off, nor are they insurmountable. We have the tools, the resources and the knowledge to address the world¹s most important child survival problems and build on the considerable achievements that have been made during the last twenty years. What is needed is urgent action and greater global priority placed on these issues so that the significant gaps and growing disparity in child health and survival don't reverse the important progress that has already been made.