THE STATE

OF THEWORLD'S
CHILDREN
1992
United Nations Children'sFund
(UNICEF)

1992
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_ 0l91·lHZIl
THE STATE
OF THEWORLD'S
CHILDREN
1992
o
James P. Grant
Executive Director of the
United Nations Children's Fund
(UNICEF)
UNICEf
Oxford University Press
CONTENTS
THESTATEOFTHEWORLD'SCHILDREN1992
Introduction:
Agenda for a
new order
I. Keeping the
promise
2. First call
for children
3. Fewer deaths,
fewer births
4. Investing
in people
5. Aid and need
n., p<>Iitical on<! =>nomk chan&<:s of rttCtIl ~ ha"" made it
dear that .. J><W "vrl d order II evolving. UNICEF "'bmil:$ ten
propositions for the qt'I>da Qf lila! ~ ordtt - from the point of
view of .. world wide 0fll0JIizati<m wlUch comes in'o <biIj' <:<>Dl.lI<I
wiIh lOnle of h\lIrlanily' s most ocute problems.
'n.. 1990 W'orlo:/ S""""il/<1T CAildml mad, a 8=" prom;'" to tho
childrm of tho 11'900. It ..... . promise, lIIIKI!IK other Lhi..,., l<>
dnWcaIJy n > d ~ clIild deatho ""d c h ~ d malnutrition, and to cmure
tha 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 mmillions of !he
world' , childrtn io in . ynngy with, n<>I oppositi<>n It>, 1be off""" to
oIow population 1lfOWlh.
T<J<by'. <""'$en"" on .. '1tI3fkrl (ri"'ldly' "ll Pl'OKh to d"",lopmen,
dItluld be """"",panied by .. <'tlff'OSp<lBding COI1$M$UJ on the -.l
to guo.nm'" bIl' i< ,," -ntmenU in poop," and paItkularty in the
IIea1Ih and education of child=>.
Irn......... in irnematiorud aid shoold he: based "" I . ",..ined and
IIIClISWlIble cornmiunem to mectiJl& minimlll1l human needs.
- - - - - - - - - - - - - ---"
6. The economic
environment
7. Disarmament
8. Setting
Africa free
9. The apartheid
of gender
10. Planning
births
Statistical
tables
M1ion by th< 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 a
docen'
Dmtiliurizltion in the developing wo,ld. .lltd miliwy
' p<ndins in <he: world , ohOll!d be linlo:d '" incn:ues in
lh< I'<OOW'C<::S ..'lIiIobl< fOl" dcvclopmm, ond 1M =oIution of
""""""" gl obal probl......
Mos' of Africa", deb'" ohould be fOl"gh-m and int<mal «<>nomic
n:fonn should be gi>-cn • <:han"" to .ucceed by inc:n:ucd e><lemal
IUppon.
A ocw world <:>nI<r ohouJd op""",, lh<: oporth<id of . ,
vigorously .. the apmheid of nee.
The wcll informed plannioa of birth< ........ of th< mOlt rifocti>"I:
. nd leos' e:<pcn.ivl: of improving tho quality of life on oorth.

Fluio indi...ton, nutrition, t-lth, roOClllWn, d<mognphio
iIl d;""",... economic indica''''", W<lmm, le$o populout wun\tkt;, "'"
of progrnI.
PANELS
The year 2000 goals :
1
Reducing povltl'ty:
9
one lorai, allor one
WOtld ~ l Repor1
Mexleo:
2
Educ811on:
10 kaepi'og the prWioo llChooI Sla;.*lg powur
Imrnunlzllltl on:
3
South Korea:
11 stJ a bErg8io rTIOl'lI ed.Jca1ion per doIar
-
Eastern Europe:
4
Baby-friendly hospi t als :
12
ba oslIiol , with a tunan lace
a rriIIion &vas to seve
The United Slales:
5
Clllna :
13 !he rise Mel riseof dild pQYBrty -...."",
Wer on children:
6
Super-shots:
14 Ihe 2OIt1 CEIllu'y's shame ctilcieo rs vaccne i1iliatM!
Ce8re:
7
HepllUtls B:
15 shoIWlg ~ (3l be dor'e the SEMlldh vacc::ilo
ReshUffling the pack :
8
Facts for life:
16 Ht.manne.lllop '160 ,t RaporI " ::: ;00 lor rriIons
TEXT FIGURES
Fg. 1 r_;, ......""'fI"O"laity.byregict>, 11l6O- 1990
Fg. 2 d*:I "..nNilicn: PBSl t....,. on:l U>.nI <:nrJlrie&. _lnl tr\f M'oIlricas.
' 975·2O(X)
Filii. m-., C<:N«39". c:I'*;hn ..... """ _ . .. "'" ',-'1/ DllI.Tl:rioa. 11ll31-1190
F __di ' , , ' ...
<>:U1II1M, 1991
"
s
"
0
"'
,
"'
0
"
,
"
"
F",. 11
',.
"
"'
ra
F'II' 14
E$lmated ...... '" ORT to InJlII $'1..- .. ' ..... " IIQOd ().4 --. 1964-1968, by I'IKJ "9'"'

l.li"o:l!r.!Mlr'rlOI'IaiI'I rate lOLOIlMiiIy rate(mlI. 1960. lQll(l rw;I 1999....
en _ ""'" rod pmwy rd...... 001 e<U::loIO\ ... a petOOn\IlglO '" tOlal_
lI'J'II!ff"ffli """"'_, lle'>dc«'11 1968
PeroenIage '" lCGEl lllooaled toh """"'Y, neaJm ..,
amOld III '" CGE. by """""" 1_
ChM>r}es n mal __ond <:t*l heollIh (i(:m(Jo .. e-... 19t&11l9Sl
_ n pm-.y oct>ooI, by "'Il""', 1996-1_
P8roIInlago '" l cllll bI-_ rid mft._ 1lId aIDcaIed to -."""_ -.1_
Ilaslc_ .. ol lOllll ." _ d<>"a (:(U"I!I'JM" 19B9
No!""""1nrOl!<n _ <blCII' ord <:oo.n!riee, USS 19E1O-1989
Po!roontage '" """"" g<MlIM'l8I"II lIlIocaled to <lOl<I'lCe• .,.; ootiIII _ ...__
1009
SUMMARYOFISSUES
The IX*t>caI a"ld ecoo100 ,.:; ....... iQ8S Q! th!t las1 l/Yee t>aw IT*M il .-. IhaI .. rew WQI1d erda' ..
emergO>g. 1'Ns SWte 01 the Wa"<r a Chilhit1 raport....n ICI to!he;lQ9i'lda dIM! reworder
flQm 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.
1
Th9IIt1o prQrnisu oI1he WOI'o:J s..rm. let Cttillr1 sI'IcUd be Ilnd 1M! II new world Of'do!t st>ouId
Dring "" 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)IIfIt
6 -. 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! - =,*" p:.:t:;:etlc::1
oIll'01l )'OISlIl 01..91110 have II i\rsl C8III CO lOcieties' _ • _ bo,looma on ""'""'P'1IC1 aItIc 01a
new worldorder.
FOCI: of lho lOOtt, II>e '"'* 011M _ l/le <*:f aioiI aN Il/6ll1 /laS
ll60Wl i'l/O nsi'lIl_ Of r:Nd llfId aoIIi'Ig _ of _ ......,.... I'l trIIWI)' rlihe
n<1l$l , r , _. the bel< af rtG ....... JfIBI file riJ,ng!llJlMlal dIM 19l1Os /ISS IlIWI
byII S/IarJl 01 CIlitnrl M'lg IIfJIA'fJfIY.
3
ThaI the issues Ii rnaIrlItriIlcln Osoaase. lind wid8spreed ilile<ac:y ..... not ca-oImmed ""
(I rewWCf1d otdIlf' fMlIve9. Ihen il wiI be Io9Y IYliJCI' rroe diIIicUl to rlld""" the lllI8 01 pop<Jation
(1tIWlIl ard make ltollnVl!lili<lr1 to ""","","Ie
Fact cH<J _ gi>oe$ mont CO'4Iw"",;, M:>sf oIlh11 Ila/IO'>S ""'/lOW
l>"Ilri>sI fJf h SllI9O«""'" _ </!Iot>a.. child _ .... _lOilnmt.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.
4
lhal me growing cu_osus arOUl'ld ltoI 0TipclrIar'ce 01 f1WI<tI! pcIiciIls _ be
00'lC0 i iflllIli9dbv II oon&IlI'ISU!l on lNl 0/ QtM'!rl'Vl\ef'110 go.a'lI<lleEI b8sic
'" peoplo.
Fact ll'l--. la th!t ..... ,_11/_" rJtto'<X.fJti '" OB9C"","",'&ltS
Wd> aspTTIIlfy -....... _ t>' IhII P<'O' rrwP*r.
5
lhal increases In 1n18r'l\alional l'id - be basedon1\ aJSl8i'llldend..-..ablll 10
mininulll'un&r1 _ 80d lor InliIIIClAIl.,... Ihe prh:;pIo oI a lWst CIlII 10I
"""".
Faol: t_!tMn ltl" d IJ# lIidis JJb:;aJoo 10"""""'" !I'll Dai: .-d I1IIJ poor br -.. JriMrl' M.--.n. "*-
.... _ Wr#f p/IrrirIg.
6
Thal intOOllllkloal aetJon 00 delli, aid. and trado atlII\Il etMr/lfVT'lIlI' Inwt'Iid'IllCOnOn'ie
I'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.
PrcldGlblilm tI !Ill _ a:>sn /1lII poot _1I1i.<ltlw$5DIl6>rr II r> bol
7
TlIalIl proosss of !ItIDIAd bego in the OOoalopi"ll world and th!ll. ... SI8P with Itral
process, la11n9 day expencit.... ... die FdJslriIlized nations SI'"<>.Ad bII linI<8d to "II' aca
i .... rl l'll8maWnalllld lor de\ I ..-.dlor 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

- - - - - - - - - - - - -
8
Tl\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 _ <b> at il:r delJI:t. bm _ 8 808OItli", II
at ", iii eow-t ..,qprdCOSIi1g rho co. ..'" """"..-.' '""'" rn.. it$1ot8I...,.idi'O M thItt".Jth_
"'"........ of ftSpetpI1.
9
FllCI: I.Icre amI;::rI 0i1s .-fl/ldl)'OW b«:aJwlhIJy ..... 1xm BmIo; me C3lJS8 at_iS lfJe_ ct
""".'.WIOI'
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& grmtasl
I,listal<ai 0/ 0l.I' tims is thelBik.nIlO rBllige!hal potootiaI.
F8cl: 0.... a,gsI ........... _1JOft>"lO/1 00(11 day. CIIbmdo """"" ,-bI!caI.<w lhIJy__
bQ7l tooIll:lCr' ..,. II Ili'lI'I or oecause lhIJy wnIxm 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


---1- - -
THE STATE
OF THEWORLD'S
CHILDREN
1992
James 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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@ § @
i

Agenda for a new order
This report is issued a l a time when the
world or der which has dominated the PQliti-
cal and economic life of the 20th century is
visibly dying. It is offered, from me parucu-
lar perspective of UNICEFs experience in
working with some of humanity'. most
acute problems, as 11 contribution 10 the
debate on the ot:'W world order which ill
struggling to be born.
In the blink of an historical C)"C, the
world has witnessnl the beginning of the
end for apartheid, the liberation of Central
and Eauem Europe, the Cl'lding of the 40-
year cold war, lhe beginning of significam
reductions in arms expenditures, the virtual
abandonment of the idea of state economic
monopoly, the narrowing of ideological
divid"", th" . rn:ngthcni ng of the economic
heartbeat of Asia, the tum away from dina.
tonhip in vinualll' every republic of J.arin
America, and a new impuJ5<' toward.
democracy, pluralism, and eccncmtc re-
form in Africa.
n" period of history mal is most diffi.
cult 10 understand is always one's own, but
the suddenness and SC1IIc of ~ changes,
in a landscape previously considered glacial
in its rate of progress, suggests that we are
living through a revoludon. If so, it is a
revolution significantly differenl from 1'1:\' 0-
lutions past. It is different, first of aU, in
that irs principal agcm is not violence hUI
communication. And as ends arc often
inherent in means, it is also diffel'l:J\l in that
it ill a revolution which appears to be trans-
ferring power nOI 10 the few but 10 the
many.
These arc profound differences In the
process of historical change, differences
which gi\'e a new meaning 10 the idea of
the oomrnunieations revolution. For in the
many coumne!< "'heR' poli tical and ec0-
nomic change is now unfolding, it is the
power of communication that is allowing
the judgements, pro\' olting the comparisons,
heighlening the frustrations and posing the
alterTUltivn. Mtv- y " , , ~ of somewhal ~ p t y
talk about the global villagc, it is as if the
first \il1age rnttting Wef'C being held and
people were voting almost unanimously to
reject the political and economic aUl<x raeics
which have deprived them of choice with-
OUI meeting their needs.
Then: have been unpleaslll11 rnnindcn of
the \'Ulnerabilily of this precess of change,
bUI recent e\'enlll in the Suviel Union, and
THE STATE OFTHEWORLD'S CHILDREN 1992
particularly on the strn'tS of M OSI.'Q\\' and
51. Pctcrsburg in August of 1991, ha,.., sent
a message of courage to people< aU over the
world. in many capital cities today, meee is
an almost umgiblc sen$(; that some vital bal-
encc mlill' 1:><: shifti ng, that the contour! of
Iile possible mal' be: changing, that people
lll'l." finding a new confidence in their own
rights and abilities to participate in the man-
agement of their own alTairs. And h may
a1ro be, although it shoul d be said only len_
tatively, that thCTC is a new ncrvOUSJlC$l, a
nev.' he<;itam:y, amo ng those who might be
tempted to suppress those rights.
This advance for democracy is not excju-
si':dy led by, or ccnrsec to, xeecm end
Central Europe. Ten yean ago, mOSt of thc
22 republics of Central and South America
were gripped by dietll.torsrups; today, all but
one ha\'!: an elected govcmmcm, 1\ also
appear> that Afric:iI may no\\' be embarked
on a gradual political trlInsformation. 'The
shock W3\'<:S from Eastern Europe and the
Soviet Union afl' rc\'crlxniting through that
contincm " i!h a resonance because
tocy are coincidin8 "ilh the sudden llJ1d
painful Ializaoon of the moral and fmancial
Inadequacies of many of its elcisting em-
nomic and political systems. Simulumeousl)',
the endi ng of the roId w"r is raising new
hopes that the destinies of many nations in
Africa, omd in other pam of the dc'doping
..-orId, may """,' be: detached from the super-
power rivalries which have so distorted
international relationships in the POSI-"'l!1'
era. Those ri'"lIl1ies have had mueh to do
",ith !he llVt:I'-miliwi7.a.oon of the developing
world and "'i th the perpetuation of the kind
of regimes which, in so many counnics and
fOT so many decades, have denied human
rights and crushed human hopes.
,
Despile an imcmational agenda that is
crowded with pressing political, economic,
and environmental problems, there is there-
fore mere cause for hope on the human
horizon than perhaps at any other time in
this It may be that the } 'eal'll ahead
will sho"" such optimism not to have been
justified; hut what is not in doubt is that a
neworder is emerging in our times.
A new order for children
This repo rt s('Cks 10 conlribute III the
agenda of thai new order from the pen;pcc-
rive of a worldwide which
comes ;mo daily contact with some of the
greatest fll.iling$ of the old_
Those failings were the cemral issue of
me WorM SummJi fur Children held in late
Scpu:mbc:r of 1990 al the United Nations
headquancrs in New York.. 11>c timing of
!he S"",,,,il, which brought lDgt:ther IS9
nations, more than 70 of them represemed
b)' their Presidents or Prime Ministers, could
not haye bttn more propitious. The ou!-
come - an programme for, among
oiher things, ending mass malIIUuitiOIl, pre-
' 'CI1lable disease, and widespread illileraey
bc:fore the end of the d=.Ide - amoumcd 10 a
dclailed description of a IIl'W enter for the
world's children (panel I ). 1bc
of this agreement, at a time when the exist_
ing ",-orId order is rapidly changing, means
that then: is today a bcucr chance than ever
bc:fore offmding a place 0 11 the world's polil-
ical agenda for the right.s of duldrcn and for
mttting the minimum needs of all families.
It is therefore obligatory, al this for
all individuals and org:ani7.ations charged
...im rqpoo$I1JiIi{}' {Of lucb issua 10 emer
lIS CuDy lIS pos!ibk inlO tho: dcbal<:! WI lie
ahead. For • new pace in work! hUtory is
being turned, and if the needs or the poor-
CSI quartcr O{ mankind, and o{ Iho: childrm
....lto an: the JIl()$1 ,'IIlnerable or all, llrl:
again to ihe (ootnotC'l of thaI
page, then the new world order which is
writte n there will be: neither " 'orth)' of illl
timn ncr capabk: o{ mcctilli me ehal1cllics
of the future,
Amid the many voices and Iho: many
danlorous issues thai wiD compete {or pri-
ority in Iho: debatcs 10 eeese, !his year's
S_ '" W WlIrld', CAildmo rcpol'I is
Ihrrdon: • pka for Iho: ino;:hWon of the
mucs wtlidI lend to be ipoml and W
voices wbic:h normally silenL II is a
Plc:a> particularly, {or me inclusion of ml*
,"Oiccs silenced by pon n y and ilfucncy,
for ecse woo arc silmecl by the effeeu of
malnuuitiOll and pKVenllbk disease:, for
those who are silenced by being born
fema le, and for those many millions who
an: silenced hy death a1mosl bcfon: thcir
lives have begun,
Specifically, !he rqxlI'IsubmilS 10 propo-
Ioitions {or lbc conaidcn.1ion of aU lbosc + be:
they hca:hof Slale 01' mcmbm of tho: public:
- who arc concerned to bcoomc invm"Oll in
tho: d;"' nrim of the new world order ...1lidl
...ilI ",'(I/,,, O\'ft d'E Do:Xt lew )ftrS. Taken
Wp:Ihcr, theyadd up 10 a popos:allhar. end-
ina ee abIolIlle po'I'Uty of QDC quanc:r 0{
mankiDd - tho: ITlOfC than orlC' bi1Iion pcopk
who 5IilI Ij"" m>d die 'Aim prc;.'alIJ.bk
hunga', divav, and illil:eracy • $houId rank
IIongsidc tbc issues of prcson-inr; the pc.cc
and prolCCIing the environment lIS priority
itcmll "'" the agenda of IIw. newwerid order.
Coouvy to widely held opinion, this
IJ'l:IlI cause is far from bcing hopcksa, We
lui,.., a1rcad)' thn:c of lhc
" 1Iy tQY.wds a world in which C"o'CI')' man,
WIlman, and child lin adcquate food, dean
water, basic health cere, and al least a
primary education. And then: is 00 techno-
logical or financial N rner to prevent the
completion of thaI jnumcy in our times,
Reaching these qt:-o/d goal, is not a dis-
eeee cause and don not stand as a
dislrKtion. from tho: eew challenFs of our
times. CRating the conditions in " irich
people can lIIC'Ct tbcir own and thriJ {:mti-
lies needs for adequate nutrition, beahb
and education is lID e:uc:ntial under-
pinning of cfforu to meet those
dWJc:nFs. As that mvcstmCl1t liber.les pee-
ple's productiYity, 10 it hdps ID 5Iimulate
KOllOl"ic gro....th; aa it includes rather than
excludes people from political Ind ecunom-
ic life, 10 it helps 10 ounure tho: democl1l1lc
plQUSl.; .s it gi"cs peuple tho: confidence
and the means to reduce family size, 10 it
helps to 510w population growth; and as it
Ji ves the poor a stake in the future, 10 it
Ilelps to safeguard the en\'ironme nL
For almost half a ccntwy, the w<lrld has
been distracIed from these J1ClII\asb by mili-
- - "" - "" • I "'-"-,- W
l2tY UJr1WU ;onu ..... pi .... 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:flft
QOOI'IC fclr 1be lIutd 10 U.....'dl .. ird' ID 1be
task cnting the ...,ki C\" absoItne
pll\'CIty, IrllIInutriOOn, iIiIaacy, and 1ft-
' 'mIallIc disease and to build ... 1tM'Z'ds a
new " uk! order ....hicb wil rdkcI manI::ind'.
brighteslllOpQ r.othcr than ita darkest fan.

THE STATEOF THEWORLD'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 ntW
wurld ardn . hould bring '''' md 10 ",ulmlln"·
liIm, pl"tUmahk diuau, ,,,,<1 illilnYUy amonK
SiJ many millions of the world'. child"".
2 Thai the pn'ncipk of 'jim call JOT chil-
dn:,,' - meaniug Uw./ proI«lion for Iht growing
bodie. and mind. of 1M. ymmg OI<;:/n '0 haw II
Jim caU on r"'C'l' rus _should bao_
llIl a.:«pIM of" nftll rrorld order.
3 1NJI if IN iJ",a 0/ "'a/"mn/ion, pno-
lIOl/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 smrainabk
rkwlopnumt.
4 111m rhe It"JU'irrg ro"SmSl<S around Ik
imporlona of marlul teO""",it; polioo should
lie UUOt" panied by " =fKmding conse",,,.
On tlw. responsiMily 0/ govmnnenu wgUOl'll1l-
l<'<' basic in f>Ulpk.
5 Tlral in<:TellUS in imemooon,,1uid should
1M 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, w
priMipk 0/ ajim 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 iu PMPk If} tarn a
d«e>l1living.
7 Thor tJ proaSJ 0/ dm,iJiUln'ztJ,ion llumld
btgin in rhe ckwfopi"l: worldand 1M', in lItP
wilh Ilw/ PrfJl't!SS./aJiing mi/iw.ry a".,ldiulUJ
in i"d"mializtd ""Iiom should fi"Ud
10 slrnijiaJ.m in aid/or
dewlopmem amIfor lhe ftSofulum oj ",,,,,moll
global problems.
8 ThaI uJe <haim oj AfrW's deb, $Inuit
oJ! ""d lhal lhe amli,rem bt. K'Wtl suJficimI
aum...l ,';;;;;,);7. to iUlirw i;;4"oiil to
sue:eud in regenerating rM momem"m "j
daotl<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 mid /ea.1I e"f'tn.iw
lC<Iys ".f i",prur;ing the qllalily 01life Oil ta,,},
- btJl1, ,,,,.. and i" fulure - mid /halO'''' <>f
W grtaleSl ...iJwk4 1)/ "'" lima iJ 1MI"il"re
10 rtaUu lhal pounlial.
Keeping the promise
Proposition: Th<J1 W promise pj 1M World
Su",,,.,;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=y
among SO many ", illimu of IN; wur/d's dt.iJdrm
A quarter of a million of the ...'Odd's
young children dying every Wttk,' and
millions moee Ill"e surviving in the hal f-life of
malnunition and almost permanent ill hc:aIlh.
This is not a Ulrealencd lnIgedy or an
impendi ng crisis. II happened today_It wiU
happen again tomorrow. And by any objec-
tive SlaIIdard of scale or severity, this issue
would rank in importance wi th any on the
human agenda. But in practice, such prob-
term have had utue purchase on" priority
because they llJl' pri marily the problems of
the poor and the powerless.
The childKn who an: the virtims of pre-
,'entablc malnutrition, disease, and iUitcnlC)'
arc being moot shamefully failed by the pre-
scm wurld order. BUI in the last two yeln,
thai failun: has begun [0 feature on the
political agenda in a way that is unprece-
dented in UNICEF's 4Q-year history.
The most irnponam signal of IDaI newpri-
ori!)' was UK: convening of !he WCWU Summil
for ChiJdrm on 29 and 30 Septanbcr, \990.
Over those two days, thc laJ&cst CVCT 1PIthet"-
ing of healh of stale met to consider !he
possibility of to an =1, in our times,
me long-running tTagedy docnbed in the
opening paragraphs of!his chap'''''.
C10ling fbi gap
The Summit me t at a point when it W:RS
becoming clear that one of the greatest
humanitarian gOllls of this century - immu-
ni7.ing 80% of the wo rld's children againsl
six major diseases by the cnd of 1990 _ was
going to be met (pllncl 3), That achieve-
ment i, now saving the lives of eve r J
million children each year .' II has also
demonnraied, ailer a deca de-long effort,
mal the worl d now has the outreach capaci-
ty 10 bridge the gap between mass-scale
problems and inexpensive solutions.
lntluenced by that cxample, the Sun,m;1
concluded with a commioncnt,' now signed
by more than onc hundred and twenty
heads of state, to begin ap plying today',
=u1aled knowledge and inexpensive
techniques 10 a range of basic problems fac-
ing thc world's children (pa nel I).
Thc immunization achievement had also
shown the usefulness of having a quantifi-
eble target as B focus for national clfOlU and
support. The Summ,i therefore
formulated its conuniunenls lIS a range of
specific goals which all nations would strive
to 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 by
atleast one thint (lig. I); a halving of mater-
naI mortality rates; a halving of severe and
mooetlltc malnutrition among the under-
lives (fig. 2); 90% immunization CO\'=l&C
(panel 13); a 95% fan in deaths from
meas1ea; an end 10 polio and IC!llllus.;
v..aler and safc sanitation fOT an families; a
bal;ic education for an children and comple-
tion of primary school for at lcasl 80"A.; thc
availabmty, 10 all couples, of family planning
services; and ohser.1OIl<:C hy all nations of the
Com.<mlion .... 1m Riglusoft1u OHM.
These goals were arrived al by a proc ess
of COIlsullation betw<:cn KQvemments and
,
THE STATEOFTHE WORLD'SCHILDREN 1992
The year 2000 goals:
one for all and all for one

FOl'the lWOs. !heIe Is a broadagreEmIIl rt that
os beslllClilMld IY\iII'1<et Jctoes dowhal
morI<oIlorc8s <10 beSI and go.ten'O'I1llOI 00 wh8I
.... pa<ticUar.
that m,IS1 guornnt.. !hII 1oog-tem1 ffleslrnefit ...
pe(lpI8, 11 IIlei" haaIth. nulI1tion and eau::ation.
wlltocuI IOI1ich 1ltO... ,1iC progess will be both
K>wfld i\ pece MIl lleprMlll oi PlIJ)OOO.
10 Seplember 1900 II'e W<;:r1d Smmt Iof
CIlben, lOgelhe< lIlIIdB's !rom """" , 50
naliooll Includiog 71 PrllSidellts and Prime
Mi'llsl"". translated the id9a 01 ill
peopIe' lntoaset rJ speclIic goals kr theyeIlr:zon
1hII s.......m 0edamIi0n IIIsO pooo,ised a rew
IX'6C8lCOI'IYIi\menI.Ioog
wtllIt car> be 0\lI'leand _ ...... be d<:tle. Pro-
Qi 8l' .,,,"01aetiontorr-**'QIl18jUr2000goals
wi be drawn up by mos1 naIicns OOfonllhll.ro 01
1991 (peneI2).
The gotlIS. lwerJlV·_iI'l ... ' nduo:la " on&
It*d rea.octl::#l nd*.l deaths. II 01 CllIcl
manutriIioII. a hlIMnll 01 <ieaIt'III ,...,.".". women
drng and . ........,.saty avai-
abI8 ""'" watll" and SIrilatieJrl let
Ill, WId baIlic «lJCatIon b' aI dtien. Mom
speollic ChJd haaIth goeIs Ql:m iItm..nza.
liM. po(o 9ildcali<Wt, !he /lWrinaIiOtl 01 reonataI
tetanus. • 95% raductioo " mo'laSIes deBthe
iaJmlrJI/)' abDuIll4O.lXXl '**' yeIlI) , a hllMng of
ctikl dealtlsCWl"d by ITilklnayeor),
and a OI'"e-ltWd nDJctIon n ctiId lIeolltos from
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:rneirIIerlls'.ll(l In!amlypm.
Mom arty pi<ning rnaKlmIIIlWld
ctit:I haolIIh. leId->:I ln nmto berl... 1"lJlIi!ion and
Iew9rdealhs. The mot<! that .. """""'" abDuI "'-'Ch
synergisms. thestJoo 091 !hIIcaseb' alId
11>3 yeIlr 2000 g<;o.IIs llithIlr \QgIllhIlf 01 il r;tlSII
.......
1nseni1g 1hoSummir A::rC'tiwJ
was er'lCI:UIIglId by II ......... i'I rllBdling811 00I1iBr
gIOOaI tatgeI- fIO'Ilo CllIcl • had
e-,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'rrulzingBO'Ib has ITl!Ia'ItD<.tdingasystem
1halCI>"l deiMlr...wms to l 00million W""ts Ic:u
<:II Mt Ii"ne5 a \"<Y. 1hBorgarizatilnal legacy 01 III
lIis. !IUSIahld rod lJIi eo oglIe led i\ Ihe 1990s.
(:OJd h8t> ac:tIo:Ml rTWlY 01 hl new Am ""
YoMlrmu"izaIion.
lira rt:1H avaIabIo lor a t1ealing 1h8
pl<ble<'''1h8l ClI<I5CI iI1lNi1l ttTtlll quBJI\lflI 01 illI
lOday', <:tiki o:IaaltIs.m <:tiloj rMrolIri!ion.
AI !hII St.monI 1h8 world', -..
lII:!Io !9"d '10'" III 1 ' .. lhil _ 10
meeI_'XJmmillT_ts". The1Ol3lCOSlhEIS
aetimled at $20 biIion a ;wv 1tnloJgto.JI 1h8
199O!lone! III _ """ lhi1:l 01!NlI r.oo10
come tom i u tn, 01' a ,_ . a" OJ01, !nI8'.

TlisIlXlnl aidreq..-edllITlOI.f'IlS 10less 1h8I11%
0I !h11 worId',CU'n!<'il rniIaIy expen.
so,noymltooNgh aprice, in!hllposIcdj
_ ...", 10 _ Ire !MIS at II1!lI>j rrilIiors 01eNd-
Al'1. many """"'Il"O'e,
lIbw 1h8 world's 'lila 01 populaIia1 growth. and
mel<e thegeE'll$Sl 01all the future.
Fig. 1 Child deaths
l'fbrld Summit for ha'I \et the target 0/
one lhlrd O'ftItxtion In UnMf·""" d9th. by W
year 2000 (Of reduction to 70 I"" 1000 birth< _
illowt<).
The chon <how1 the .. in ff'dudng child
dNth. from \%0 to 1990. The whl!l! UIll"I
the progreso N<:h region will 10 ad>_ l the
)ONr 2000 ,,10 be m<"l .
the sP«iaJized agencies of the United
Natiuns. ThC)' are based on a review of the
specific, IOW<051 opportUnities now avail-
able. They therefore represent a comp-
rehensive programme for narrowing the p p
that has bc:cn allowed 10 open the
availability of low-cost lechnologies and
their application to those in need.
Trendsin tJndef-five mortalify, by region,
1960·1990
The ch.1n doe< no! relIect ch¥Ige< in
unde!.fwe "' the <KOfld of 1960<a<
Ilgure.ve noI avaiIlIbIe lorJT\iII1yCCiOJlltrie<, 10
p.1IticuI,I<. the of <in(e
1985 .... But in_
((IU1lrie<, the dednt N> by the _ (mi<
;nl dumglhi<_period.
_ lH:U _ _
------ _-_.-
Thc agreemera to that programme, by
virtually every nation, marks the rejection of
the long-held notion that the problem of
malnutrition and disease is so vast and
ineviUb\c that nothing significant can be
done. In its place has come the recognition
that the great majority of child deaths, and
of the vast weight of iUnC$ and malnutri-
tion which lie them, can nO'" be
prc\'emed rclath·ely cheaply and easily.
One of the first consequences of the
Sum",i, has been 10 accelerllle the progress
of the Comoenlio" m, ,I.. Riglr/./ oj 11..
Child.' The Clmwmio" seeks 10 establish
minimum standards for children's
health and nutrition and minimum stan-
dards of protection against aU forms of
exploitation and abuse. In the twO yean
since the text was adopted by the General
Assembly of the United Nations, it has
been ratified by ever 100 nations - a pro-
ccss which commonly rcquiTC5 a decade ur
more. The C.",vcmio" therefore takcs ilS
place alongside the commitments made at
the Wur/d Sum",i, J07 Childrc" as a sign of
a new p<;Ilitical priority for children and of
a new promise of protection in the decade
ahead.
From promise to practice
,
2000 80 85 90 70
300
i
200
8
THE STATE OFTHE WORLD'S CHILDREN1992
It is too early to tdl 10 ..'hat enax dx
dcdaralionI of the 5_ .., and the si&nina
of tbc ecmw.u,;", represent rhetoric: whidI
111;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 intent
which i, already being trsnslatcd intO prac-
tical action (panel 2).
One of the firsl tests will be the drawing
up of the dctailc<l NJfit;maJ procrammcs of
action for achieving W S um"';l pis. AU
<;Ol,Irltric. at the Su",...u I&J'CCd.
10 formulate such p rogrammell by the end
of 1991. By Oaobcr 1991, 60 counlric:s
had rc:adl£d this first saco: and tNt num-
ber is ItltpCCtUI to surpas$ 100 early irl
i 792. Sc:JrM llJiddie.iDoome dc-\'dopinc
Q;IIlnU'irs web as Pml and MGieo hal'''
begun impIcmcnting thcil' procn.mrllQ
knowin& lhat mosl of lhc funds "ill ha'"l: to
rome tIU'ou&h Ibc difficuJl PfOCe'" at re-
aUoa.tins inR:maI 0\heT pro-
graJllJIXS, espccially those being m-wn up
by the countries of $ul>-Sahatln Africa,
will have little chance of bcinl put into
practice unless at lcall SO% of the cost is
mel by inCT<'a!led aid . In lotal, it is est -
imated lbal the fmandal n l Oultt$
required to reach all of the year 2000 gooh
amOunt 10 an additional 520 billion • yaT. '
Of that sum, twO dIirdI might be found b)'
the deYdopina councries themsdws and
one thin! micfu be maoX .vU1Ibk in addi-
liorW aid (Ihouch dx ",,,poilion. will \wy
from "'cion 10 rqioo) . The 520 billion
wtaI 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 counuies
and examining their aid progn;mmes lO tee

how thty micht sen"l: the S_Mii
pis. The okci:sion by ee
Netbmands 10 panl 57.5 million for debt
rdid for chiJdrm's progmnmes in
Ecuador, Honduras, and Jamaica (whidl
will buy b.ek dd>t of II leaSI twice thai
amount in local cum:ncies) is one of the
first tangible l'e$Ulu. To monitor tbe process,
the I.)(,velopmem Assislltl1ce Comrranee of
the Oriani :Q\tion for Economic: Coopenltion
and Developmenl (OECD), which loosely
ooordinata the aid policies of the indusai·
atiud natioN, is eonsidcrina Ktting up the
mo:d>&nisInI 10 analyse aid aIIoalions in
rdation to tht goals.
In ee Iut 12 months, most "-k of
SI:ID: ita\ 'e m:onftnned 1beir commitmenrs
II rqiomI poIiticII ga1hc:riop, induc1in&
\hi: 1990 rroenina of lhc: South Asian Ass0-
ciation for Coopc::nIinn, Ihc: jIInc
1991 SIllJUllit of the ()rganilatiIllI of
Afrie&n Unity, the Jwy 1991 Ibao-
Americ::an SI1ll'tmiI in Gtiao:\aIaPn., !he
October 1991 Commonwealtb Confercna:
in Zimbabwe, and the December 1991
Summit of Cenlrlll American leadet'1.
Children • and an end to the wont
upem of . bsol ule poverty - .rl:
on the politi<;aI agenda as no:va" eercre.
And if mectinp, d«bratioN and resolu-
tions could impnm: nuaition. heIhIt, and
td\Ic:ation, thm Ihc: priority of dUIdren in •
Dewworld ordc.'r wtJuld be assured.
n- unprccedc:nttd politic:al eornmit-
IDCllU l'CplQC'Ol ID oppoI'tllllity not to be
misxd. It has b!& bf:.", bmm.trd that whal
..... I:adtina ...... not lbc InI:lIN or C'\'aI the
but the political vrilI 10 tickle
these areal problems. TIle: C'\=tI of thc "I
two >-eIn represenl the: gratest promise
80
70
60
Rg. 2 Progress
The 1990 World s" mmir lot ClUJdrm tile goa l at
haMng child ....Inurritioo by rhe yeo, 2000. As rhe
chart W>ws, this wm 1'1\ Kcl!l",ation at past
pt<>greol. Almo>! no compotative em! fOf Africa.
Halving childmalnutril ion: post trend5and
fulUrerequiremenls, 5tlf'(ted coonlrie5,
Mia and the An1<;>rica5, /915·1000

...
tronIl

5%
---
--...
7%
90 95 2000
The IeYtI at malnutrition fOf l!19O i. by tile mon
recenl ",Umate IOf each coonII)'.
Malnutrition b defined al rTIOfl! Uwl two nandard
bdow tile de$ita ble we;ght lot age, and
cil ikl ....fnW ilion rdl!fS 10 tile child poputatioo
unde< tile 19" at 1M.
- '-»- ''''
that has ever been made to the world's chil-
dren, and the gTCatCSI opponunil)' for
building sus tained politiaJ suppon for their
cause. It is now time for all concerned indi -
viduals and organiutions in all countries to
mobilize behind that commitment.
Participation
lbe World Summit few Childrm and the
Co.rwmie" on IIu Rights of IN Child arc
pan of a process thai has alrea dy yielded
extraordinary p",ctical results in the last
rew year.<. The key to that process has been
political commi tment rrcm national leader-
ships roU"''''ed by the mobilization of a wide
range of n:s<>W"C(S to see tha t commitment
through . 'fbe immunizatinn achievement,
for e=pk, began in the 19805 with decl e-
rations and publie commitments by political
leaders; n has since been mmslated imo
action with the support of many hundreds
or thous:mds or people in both developing
and indus trialized worlds.
By the mid-19805, most heads of stale in
the developing world had made and signed
politil;al oommitments 10 the 80% immu-
nization goal (lig. 3). The sheer scale of the
professional and public mobilization that
foUowed is sometimes difficul l 10 grasp
from the pcnpccti\'e of the industrialized
world. From lowly beginnings in the late
19705 and early 19805, a system has been
built which now rc-..ches OVer 100 million
infants - and their parents - on live separate
occasions each yea r. Againsl aU logistiOll
difficulties, this means that O\'CT 500 million
separate contacts are now being made each
year between modem health services and
children.' The n:sull of this elfon - the

THE STATEOFTHE WORLD'S CHILDREN1992
-
Mexico:
keeping the promise
rc
Most 00U'IIt'iaare00'i preperr,g Nal:icw'>aI Pfo.
lI"". '''''' 01 Acllcn (NPAa) b ,ee::hillll lhe gem
8QIged III trl!I 1990 Wcn1&nmt b 0'\iIcnItl. By
ceeee1991,6000JI1ItIElS had IiM2ed1hei' plans
tnd 1hal rurber Is to Iaachaim:lst 100
by the tnd oI ltle _ . The targel!5 Ir>ct.dIl B ore-
1hi'd .9dlt::loonIn d"il<l dMths. a I'dW>g 01 eNd
<Ind schooIlI<l.ocation lor at
1eas1l3O'Jli (page 61),

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$<llll'l 5ahls
caIed a mae\i'lg 01serb mnislerstodllClda row
Me>ck:o 'o'«I'..tl \10 about lldleYfJg lIl8 SamiI
llOi*. was 10be Ihelirsl lnaseries or
C8bioel reWows - CIlElinId by ltle - to
monitor ",ogress for Ihe MI""'·. dlIid'...., To
ooordi1a1a pilJrlI'ln;j, thot Mf1is1er1I 01 Health iIJId
!'do "'8""" ;nj 0Iher -*" goverrmBIll ol'k:ials
were appoXlIed toa NaIionaI Coo," ' ! S':lO I tor the
Ad.",,,,, oIlheSUrront Goals .
By Novermer 1991, M""",o's own NPA.
wilh b<IseIinII data b 1990.
Me:><lcarl twge19 lor 1994..-.l 2000. one! """"""
,' ... ll<llo1$forasysltm10Il'lOI'Ill;o- prog<6SS- _
"IlJIf(Mld by !till g<MII l ' tOOII.
t.m.wI'lileJ. UNICEFwas alSObei'IQ"""ca::l18d
by!he Mayor of Mal:ico 18"*"'l.
pUs <>!t'e' rnayors<lnd Ie< assisl ·
llIICe Ina renewed na1ianaI el!OIIloI'
In all (XJJlIria:l , ..-00 restrl.CllJ:ing of govem-
men! bu<lgel' WllI be recessary• l!le _ 2000
goaIa _10 One ol INfirst prooIical
llC\r.lNl n Mw<io:> has boIIrla40% ; ... = In tho
budget of PRONASOI... ,.... """""'mefll pre>-
g,mwhichaims1<> pr<l'I'idebasic_toIhe
POOtest ftlItl or Meo<lco'sl)(lq)lB and wtich 1010 be
a mainvW1ida for IIlCJVJlg !hoCOU"llry towa'ds Ihe
j'6Ilr 2OOOgoals.F'FlONASO.- WllI OOW
b5cn in 1991 - 8% of !he QOI'& i " .d'SlOl8I
-_.
Other Il(:bomlor<;IiIdrqn n t9911"d.lde:
o IWlh 5\lo'\Ooo$
PflONASOLhoMIbeeo1"'-lI' " ... to15 _
n Ihe IXXlr8Sl viIages tnd city
0YIl'19'ilO.
o Se.m0Ul 0131 _ .... plIs Melcioc 0It)', _
IU'hed imllrilat (>;N(lr3glI tQ 90% of ......
Iiws. MmOro's t'f"A al
byOclOb.... l002.
o DIstrbJdon otORS - 10 ctb9n iIg<WlsI
ca.osed by m i l ...... -has ,......, to 20
rnfioo pa;:keIspar 'fOOl.
o AMoxica"t >«'SIioo of Facts /0( IJfe has 0000
produced(pInIl16) Wdh390,00:) wpies po..dshad
l o;> dat a End 1",.., pl!n'>ad bVend 01 ' 004.
o The \YHClo'l..N1C£F code - r., Jl;I
Sl'C'C"JS'"'U'1:veas1Hldng -l!l beirog rmde!lWl<D'd
proctiQa In..... hc>&pital ln ...mSlalII and """'In
Cty lJuB '21. n- 36 '-
' bab'i' -!ri<n1'y tIc>spoIaf SIalIlS End .... acl B5
Il'l(l(laIIJ lorIII matIlrJ'ltV urrISIntrle <XlU:ltry.
o T!nle mi5cn rn::>m paope WIli'9 pr<Md8d with
ctW<Ing _ t... ., 1991, Dmging tha tolIlI_ to
7lJll, of Me>ooo's JXlIl'.*ItOt n., am III 84%by
1004End 100'10 by 2QX),
n In III 0Iher C(UIlileJs. retrI8IOJs to be soon
whelhef Mexico's COill ; bl.d to /lCtIieWlg Ihe
&m-nl goals cal be lIUSIaInad Intile Iai::$ 01 al1Ile
\OotOch Il& 8Ilead Inthe 1990s. Bul in 1118
fnI 'fOOl alter ItJ8 WOItI&mnIl /0( Cttilln. " l!l
dear It>al tha ives End tha IlOI'l\"I8I
oe.. :'», "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 achievement
In 1.Iu. 1970:1, ""' ... immuMtion reachedodt
ob<>ut
till: (ommurnty !he ambitiou. target
01 80 po;r<:...t Immunll.llion by 11M! ....t of 1990. The
durt sI\oWl. till: resuluof till: t.... elfDtt.
Increase in immunization(Overage,
childrtn under one year, all developing
CWnlries, 198 1-1990
'0'

The)'eM' 1981 to 1985a, duderogures for China
• for pregnant ,.,..,.".."
_ ""'" _.-:t<, _ ",..
largest international operation ever mounted
in peacetime - is that tk liva of a/moJl
9.000 chi!dmo a lll «ing sawd It!try day
(fig, 4) , Another result is that there are
today almost 2 million children who are
walking, ronning and playing normally in
the developing world who would ha\-e been
crippled by polio wen: it not for the intmu.
nil<ation effoRs of the last ten Y"an. And as
child malnutrition is caused mon: by the
frequency of infection than by the lack of
food,' the prevention of disease on r.his
seale has also helped [0 protect the normal
growth of c"cn larger numbers of the
world' s children. For the furnre, the Immu-
nization CffOR has laid the foundations of
an outreach system which can now begin to
make a"ailable other key elements of pri-
mal)' hCll!th care as well as delivering new
vaccines "" and when they become a,'ailablc
(panels 14 and IS).
Also in the early and mid- I980s. mon:
than SOof the devc!oping world' s heads of
stale made a commitment to making widely
available a method of preventing dehydra-
tion known "" oral rehydration thmpy
(ORT). This simple and almost cosuees
technique can enable patents themselves to
prevent or treat the dehydration induced by
diarrhoeal disease. At the time, ORT waS
lime knov.n outside scientific circles.
Today, the participation of millions of pee-
ple has carried this life-saving knowledge to
at least one third of aU the families in the
developing world (fig. 5) . The result is the
SlI\ing of over I million children's
eaeh year.'
The practical importance of this achieve-
men!, too, can easily be overlooked from
the balconies of affluence: . Dehydrati on
induced by diarrhoeal disease has killed an
"
THE STATEOF THEWORLD'SCHILDREN1992
c:mmated I so million }'UUD& dIildrm in dlc
fony yean of UNICEF's .
!han !he combined ch'ilUin and military
dcWts of both 'oI'Orld wan. II rmWm one
of dlc bigesl killen of chi ldTen in !he mod-
em world. A simple and inexpenli,..,
melhod (If ueating or prevcnlinll thai dchy.
dtDtion hll1 been available for 20 yean. In
sak, II is I I if a cun:: for cancer had been
discovered and then TIOI used. But today.
the lona-<lVerdue move to put the knowI-
edic and lhc: llU,:lln$ of pm'cnnne the
deaths and tho: malnutrition !;auKd by diar-
rhoeal dix:asc: has now bqun in amcst.
Such achievnnmts demonsnte: the
pocmtitl of poIiriaol com-
biixd ....i !h the dcrliarioo of tnt peo-
fessional KfVica and tho: participation r:L
Iaqc nwnben of peopk. 11M: expense and
the '-knhip of tho: health llenices has
obviously been indispcmbk, but the halth
sc:rvica alone could no! brou&ht abo.n
on this scale. R.cadUng 0\1\ to
lTWly hundreds of millions of with
infonnltion about QRT, or information
about tho;: when and the when,: and me why
of immu nization. has been achieved wim
the participation of the IChools and the
man mcdiI., !he: chutcha., mosquea and
tanpln, the poliDcal. and pro-
fe:uional bodies, lhc business OCImmuni[)"
and the n des unions, the IIOn-lO\'ml-
mmta! and vOOmm)' otpnim:ionI. W
womc:n'l If'lllIP' llIld 1ht JlC'OPc:'. l'Il(M:D'Jl:Dl1
Many in dlc industria/iz.ed
on;rid ha\"e cn-en financial and u:ehniad
suppon ( n<ll Ieut Ihrougb UNICliF which
is lhl: largest mterlUllional 5IIpp!icr of Ihc
vaccines used in roching the immuni7.ation
soaJ) and many noo-smOCl'TllnalIai 011:-
anizations in both industriali1.td and
"
Ag." Three million saved
The ld1Oe,o'", . <If lhP: 110 irnrnlriLItIon
tar!Jd ...!he dl:' 5 , • '9......te1 i.._ proaolil'9
CMt ttne million d'OlcI clNW NIdI 'fNII.
DtooIhJ andJl iH occurring, from
I'OCcine prevrnrabk distastJ, in milliom,
all dewloping coonloo, 199/
....
....'
1.7 MILUON DEATHS
rnu OCCURRl Nc;
'--_ .... _-,..,.
(ko,'eIoping natiom NYc mobili=! ,"wort
from ...ilk "",bliI;. To cite the moN 'pro-
tKIl1ar example, ROW')' lnremaliorW has
mobilized htuKltt<ll of IbouutKk or its
members in a1rnoM .n counlric:s, indudinc
ilJ; dupt/:Q in Africa, Asia, and LltiD
A:neria, to provide vahllnee:r1 and raise
..d O\'a S200 miIIiorI in IUppol"l of "*CCi-
natilxl Ipimt polio lbe ~
fund-raisina dfon evel" undaukm by •
voI\Intuy KI'Vice orpniution in IUpporl of
• specifIC Cl.ux..·
Mobilizaticn on • IimiIar $CI.II: ...-ill be
n ......, in all oountriet., if !he C'OmllliIr1lmtS
malk by die: WlIrld s-.ir /tw Orildmt are
abo 10 be convmed into acme, mu,
"The ptllCXA of wt\idl !he S-.it if
I*t. and !he MKW dwl&a it bas IIready
broogIu Iboul, iI 1hem0ft &nOlher dirrlm-
lion of !he commllllia.liom revolution and
the tncreuina: pvtic:ipIitilxl of people: ..'hich
is . , the eenrre of alntmlponr)' politial
and economic ctwJce.
Ptople' , promise
The incrasc in both political commiI·
man and IOC:W mobiliu.tion for chiJdrm in
= 1 )-ean offen ru$On&bIe I.;)pe that the
needs.oo the richu of the ..'Ol'id', dUIdTen.
and particularly of tbosc bwJdreds of mil-
Iioos who 1Kk e\'m lbe bti>a of bWth,
t1utririon, and education, w:ilI fir>d • pbce
on 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 1991lL
It ...... 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 of
mamutritiol:l and ':1" Ie and iDiterIcJ. And
it "'U • promise to I:ttp thei:r IIC"C"lb and
the rigttts on the in[C'fNItitlnal qencb u •
_ work!. lll'de!' C'\"OI\-es itt ee lkClIde
"""'.
1lw promise must tlllW be kept.
"
THE STATE OF THE WORLD'SCHILDREN1992
Immunization:
still a bargain
The i.9s of 3.2 chilii'en8 ';fiJIII!' llnl f\OIN
being S8'>'8d by \he i'mu'lizalIor1 9IlortlI of Ihe
1980s.31nadcIti::ln, lha<e..... IIhlO!Il 2...... d\id.
"'" who "'. ".".. waI<rIg, ",.....;ng 80d pIayhg
n:::tmlItt ...!hi OIl'> ' . _1\1 waId who would hlMl
oo.J by IX*' ware Il(Il t:< Ihe lIdlieY&
mon1
Bol • irInI..ftz8tion W8$ the groolest p.Jtk
he3/lh SlJlXlI!I'SS S10IY of \he 19!IJs. raTlllins lh9
g&.tlest I>eaIth c"r' eog&oIlhe 1990s. By
tUdi'>g onv.haI has t-1 """""""I, is possible
10p«MlI'II 8 fuoIhor 2 miImc/"joj deBths
BIId 10
ceeeee on o;ttI mahIIriIion BIId 0salliIIy.
No! only the d9YeIoping ""-""d SllrIdo to gan
Pdio ..adicalb .. tor exan IPl&. would save Ihe
lJrj[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 torllIS8 nmnzatlon IBveIs
whenl CIMlfagI!I stl lags. l'l easImI mel !lOUIhlm
AIri::a. i'\"mrizabon reach&80I'l0\I 00ll.."1hlIllimin
tho 1990s n'UII be .. 1tI8 ""
Iha1Ihe Y-200llatgel <i IlO'l' isac!'IieI«l n
poM'ol and. -.. poesbe, in &tnct.
The SOICOnd d r '99is 10begi'l rronIIorIng I'<lI
;unlrmlu:1iultlon lo:MlIs I>.Jl Ihe<:l8::kVt 01 <lisease.
ThegeMset bythe IVI:I«ISLmn/! lorCIliI::h-l"""
......naticn '" IlIIOOalaI lal!n;S l536.lXXI _
8. eradicatlQIO (J/ pOljo 1116,0):) cases a
yew), and 8 015% redl.dic:n in rr--.. _
(84O.0c0 ayoor).
TlTll. lhOOi ill lheer r "'" of vooci1es
Il.dJ as hepallt\I B (panel 15) to Ihe 1r'rIrAlrizmior
sysIem nn::l Sl"llJlir9 .... """"""" on!he d*lren's
VllCCir<I ntiaIMIIp<nlI14).
8ul by tar me oIlhe decade
,.. be to bIlgIn l:1uid'1g on the orgonizational
01 00'iIL O'rm.nizalion in ordll< to
PfC"'iOa m:;lIlI ..... i ipI"oS J6 pIkroery -.an.
The Iegoacy ill 8!1)'S'
tern!hal 00'i makes rl'<)/flliloln500rriIIion oopera18
COt1tocts bel-. h8allll lIOlr\o'ic8s lrld diIdmn
fMJf\j yeer.' Thal system .. ""'" bego ' .(l to be
used to09iver 0llWllital* ...""01prirmfy_
are suchas ¥ilM1io Aond iodne .......... ,..,1>1••
Mucnmen remsins totl8 tlaOfI. Andthe mortI1he
system is used, !he _ II1lI ...-.II CQGI 01 each
servao oeivers and tll9 mom SUS\<iI'IllllIe
!l«:ol'l(ll.
EYen rT'I(Y9 lhe lrnn'ulizatIon
9lIM has m;ld;I 8 towards prrl'i!lOV
h8aIItl an> by "_og "OCiaI 80d
cherooIs bd'nl • mejor heolIth
It has d... lIb. hoIpad """'" heo/lh
i1Io8 so::iIlIon<! not jus! 8 rTI(I<iQII raspooiSItikIy.
Formany cI thet-Ilh""""""'" irwoIYed. <each-
ilg for iYtn..rlIzoti;)n goeIlIes "-'I
alSO 10< " newIdes cI wt1Q Ihe .... <;USl<lITl!n In-
nD1 lhIl pIlQpio \\tooWIll< It'roI..91 c:hc doooi bill
poplJalloncl" QMlI\MlB. Goi'lgOOJI 011o
lh8 lUreccu I!NI¥YItVai1inl Wl need
01 .......... ldlio:>, has bl9-fl lh8 IlI"')CeSS ol <::tdMld
MIl rtq.bt oontact hea'th sevcee a'Id
werytmfoJ.
'The 6Ibt II8Snot GW( ¢leollMJ ti'lg
ptrnlItyhedlt>CMIS)'S1&m'. saysalJNlCEF....
__on lh8 irm.ni>alion lllIort nIIIe 1geOs,
has IIJSIJ • tar ........ llElCIicrl of sociIlly
/awards " 100000WJ sodBI goal . A new l!M<I of

stn't:es I¥ld!he ctm'IU>'ly I!Ji!IN/!D ... atel' kMII
'"""poc!8lion _ COf1mtm8m10_. TI>/IIsa, r.
lhe/ongIt'!, lO'lI /1'18 ba'III/iIsoI lhei'rVrJtri.
zati;)n II/IIcrI, _ lhe/at:.1cfs mostIhIy 10acetlU'll
lot _ 9>'9I'll<a' lU"
tnij urNrn;Ji P "9' ",,"'''' fa' il'IO<'lt I1IIIIl
seM;es 10lIaO'lllftdlMll'YdiId."
First call for children
Proposition: Thai 1M pri,lCipk 0/ 'fiTS! t;a/l
for chiJdrttl ' - mttlning Ural prol«/wn fin 1m
growing IJodia and ",ina. of 1M young ought
10 haw a fin! f all 011 $lXitrUJ' rl.!()un:t.l -
Jlwuld b«.ome 'Ill uue(llcd emU; tJ/ " new
n..md order.
The World Summit for Clri/drm called
upon all runions 10 be guided by the princi-
ple of a 'fIrst caU for childttn' _ "" principle
thaI 1M. wmriol 'Iuds of all children should
be giwH high prioniy in lht. allm;IlW" of
in IHui '1'- as wtU as in good
tim. s, at national and i" umalimuJ kwh as
as a/ family kwh. " lI
Til" principle of fIrSt call for children is
founded not only on the sands of senti-
ment. M 05[ of the mental and phpical
of the human being occurs in
the lirs! (1:';\' years of life. Those yean are
me child' s one and only chance 10 develop
normall y in brain and body and 10 grow 10
his or her &\'oetic potential. If the ,'lllious
Stages of !hal de...dopmcm arc not comp-
lctcd at !he appropriate time, then lasting
Wunagc may be done \0 the complex pro-
cesses of growth . There is no Sl'cond
chance. It is on the bedrock of this physio-
logical fact that the principII: of flf'St call is
And it is lherefore a principle whieh
demands that, even in the wcrst of rimes,
the protection afforded to children should
be the last clement of social prolection 10
be relinqui shed fIIther than the first to be:
sacrificed.
·111e principle of first call is pflletiscd by
many parents in all countries. But the pro-
cess of advancing civili7.ation is C'Sso:nlially
a process of instirutionalising th""" [mer
feelings and Jtighet principia which human
beings int ermittently show themselves
capable of. And it is in institulionalising the
ethic of fint can, in automatically embody-
ing that principle in the conduct of its
affairs, that manki nd has SO far failed to
tllItc the step folWllt"d for civilization which
sueh B change wo uld represent.
the child has only onc opportu-
nity for growth, and because the proces s of
that growth is so subtle and susceptible, the
essence of the principle of fll'St ClIU is that
protcctioo should be not juSt B priority but
an absolute. 1n other "'-ortis, the ehild
should be: able to depend on that commit-
ment at all timet and through all difficultiet,
rather than being at the mcn.J' of shifting
circumstance and competing priorities.
In particular, the very essentials of
development + love and caring attention,
normal physical growth, immunv.ation
against disease, basic health care, and the
opponunity 10 go 10 school - should be a
wmmitrncnt which all societies make and
maintain in good times and in bad . That
commitment should not waver in times of
economic recession; it should not give " 'ay
to the short_lenn demands of structural
adjustment programmes; il should not bow
to the pressures of panlculu interest
groups; it should not fluctuate with the for_
runes of particular political parti es; it should
not be shaken in times of turbulence or
IrBnsition; it should not be: subordinalCd to
any ideology; il should not even be sus-
pended in times of "''aT or civil . trife. It is
in such times of stress that the principle of
fint call should be most tenaciously
adhered 10 bUI is in practice most frequently
relinquished.
From UN1CIi.F's perspecevc, il is the
events of the last decade which demand
"
THE STATE OFTHE WORLD'SCHILDREN1992
that this principle of fin ! call be vigorously
advanced as a new world order begins to
take shape. In crisis after crisi$, and in
country after country, Utis organiz:ltion has
the consequCIu;n of that princi-
ple not being in place. Whether the cause
be the debt crisis and structUral adj uslmem
in Africa and Latin America, or me turbu-
knee of political and economic transition in
Central and Eastern Europe, or the shifl in
the political of many industri-
alized countries (panel 5), or the outbreak
of 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 ultimate
price with the loss of their one opportunity
to grow normaUy, (0 be educated, and 10
acquire the skills necessary to earn a living
for themsel ves and thei r families in the 21st
century.
So little heM is paid 10 the consequence
for children of the mistakes and excesses of
the adult world that there are virtually no
ffie.:halilims for smsitively monitoring their
nutritional Status, their patterns of diKa5e,
or their IC'o'C'ls of enrol ment in school. Even
in times of turbulence and transition, when
aU experience thai ehildl'tJl will be
most at risk, it is still easier 10 asccrtllin
how many video recorders have been
imported Or sold in any given month than it
is 10 find OUt what has happened (0 the
health and nullition of a nation's children.
Wc do m ow that it is children who have
paid the heaviest price for the developing
world's debts. FragmenlJlrY evidence,
pic<:cd together by UNICEF over the last
decade, " has shown a picture of rising
malnutrition, and in some cases rising
deaths, in some of the most heavily indebted
"
countries of Africa and Latin America."
SlII've)'$ b}' UNESCO" have al.w shown
that the attempt 10 adjus t economics lO the
debt crisis has caused school enrol ment
ratios among 6 tc 11 year-olds to fall in at
least 50 of the most debt-ridden naOOM of
the dC'o'doping world.
We also m ow, !O mke another example,
that it is young children who an: at this
moment paying the heaviest price for the
Gulf war, In the first study of il:$ kind C'o'U
undertaken, it has been found that child
mortality rates have increased steeply in
Iraq 01'eT the last year." Without wide-
spread acceptance of the principle of first
call, modern warfare will continue to be I
war againsl children (pand 6),
Simi1arly, it is children who an: bearing
the brunt of the hardships being endured
by Central and Eastern Europe as old eco-
nomic SystClm finally collapse under the
weighl of their own inadequacies and
nation after nation make' its brave transi-
tion (panel 4). A special study by
UNICEF's International Child Develop-
ment cenee in Aorcnce," published earlier
this year, has shown that hc:lIth and eduea-
rion services have been subject to some of
the deepest spending CUI:$ and that the
nullitional staNs of many chil drl:I\ may
already be threatened. In Albania _ the
won t case • approximately 20% of aU chil-
dren an: now malnourished and infam
mon ality has doubled from its 1989 Ie>·d. "
AI described in panel 5, chiIdrm have
also suffered most in the less dramatic transi-
tions in political and economic philosophy
which have 0CCUlT'Cd in many of the: industri-
a1Ued nations over the last dcaKlc. " In the
United States, for example, the proportion of
, Exduding China
ORT specilIy lorolI.Uled 0J3j rehydrollion Sollls.
sugar <oIutionl. ood rewmmt'Oded IUd$.
-.,, - - ---.:-.,,-
In the past, il !MY have been in some
degree inevitable that the weU-being of ehil-
oren should be subject 10 the vicissitudes of
the adul l world. But lodlI.y the very
of ehild protection, which Ire AI the same
time the very basics of protection for soci-
ety' s need not be so
relinquished. With today's new Cltpacities,
low-cost protection for the health, nutriti on,
and educatinn of almost all children is pos-
sible in almost aU circumstances. By
national action where possible, and with
international support where nOI, conscious
and specific policies can be put in place to
protect the basic needs and rights of chil-
dren even in the worst of times .
A new "..orld order, if it is 10 represent
progress for civilization, must therefore
absorb into itself the principle that the
shocks and the set-backs, the mistakes and
the mismanagements which will always play
SOme part in human affain, mUSI never
again be tra nslated into malnutrition,
disease, dnth, and illiteracy among the
most vulnerable mcmbcn of society.
childmlliving in poverty has risen from 14%
in me, 1960s to approximatdy 22%today. "
Some nations have shown, in recent
years, that it is to begin putting
this principle into practice. The Republic of
!(on,a has ensured, in each of the tempo-
rary economic revcrsa1s of the 19701 and
19805, that specifIC policies were in place to
prevent rising 0;1 prices or falling agricul-
tural output from being traI1slalcd intO
worsening levels of health, ouuition, or
education among ;ts children. Th" govero_
ment of Indonesia, under economic
pressure from the slwnp in oil prices io the:
1988 1987 1986 1985
Fig. 5 One third use ORT
ORT Isao ioe' pt'JIloM: mf!1hodby which
ClIn itOd Ir eal
"*' k:h more INn two yotJr.g dlildl'M
NCh yelr. The le<;hnique hil ' t.1ughl to one
third oi l,," devoelopir.g worl<h fami lies 10 \he
1980. 00<1 b now .,....,. one million
d>ikl dn ths each yelr .
Elfimated USf> of ORT10 treot diorrtlMo
in children oged0-4 yeotJ,
1984-1988, by WHOregion and910
0
1984
"
as
I<
30
..
/#

a

25
,
,
.' •
l

E
zo


e

$ J

is of :
,<7
z
"

. ,

to
"
THE STATEOFTHE WORLD'S CHILDREN 1992
Eastern Europe:
transition with a human face
..
'Frs! is _
tirrwI o! crioos. 'M>olher .. IlCOtlOII'Iic ,ec . •..
POlitical upheaval. 01 l'i"Il"Ifld conl1ic:1. "l"'C'f1C
poIoC:ies 10:& needed tG prolecl h ctikj's a..
opport\Iity toflOWnorrnaIy ... rrind lI"Id body.
UNICEF hils a<Mx:aIed ItOs 1>' w;:ipIe lor th8
dMlIopi"g CO<.fIlt\e$ ... they ad<JIlC "'*""""'"
policies lQIOQP'.II'<iIh \lebIlW'Id '.... if;. Bull
UNICEF stu::!)'... PUbIst'Jed i'1 1991. !lhows!hat tho
Pl; qie IS also reIevan1 lO ew...," II
CenlnllWldfastem Wope.
The two pt. . '-1t1ICh in COO II'lOO', i'1
bolh. . has irl\IoMld 8P9"dogaJt8 51d
!hit d Sl'bSidies (rI Ioo:l and 0IhIW
p
s
• otOlls. Arldinbolh. lh8 capad\'y 01 fanikls to
mae! lhlir .--:Is by lhlir OW" etbU 119$
"''''''' '' 'Old fllling i":'o"_
and .-..g prices. N. the same lime. CUIS .., llOCial
_1llMl-.d1ho "seJetynetS' JUSt \OA'1en
th& SII'airl on eenW!lS ircroosi1g.
_ • ...
be\w8erllate 1989 and May 1991. n Poland. lhe
lnloll991
2 miIIorI - aim::lst IS'll> d lh& latlout fotce.
r81a n-.oo
by 1ha erd o! 1992 For those i'I v.QII<. ina:lm9s
hawfaliotl Sleaply. real lOCO,.In Poiand
lei by 25% ., lh8 Ii'!! nine months 011990. .,
8<Ag;lria. !he • has _ 50%. n
ltie rurblr <:A oIl::i9IIy pool is
ll>lPeCteod to in 1991. IrI PoIMcIlI"Id !he
USSR.4O'llo nowlve belowlheo/fd<ll poYllItv line.
Q.Itlng has cr.>giId rlIlaliW prices
_ rra1V "....... '"' now!iP8 do'Ii 5O'Ilo to 6O'llI
01 Tno;me on food lIIOno:I. The 01
bt8i I!'AI. lI"Id _ ba'licfoods is """""" 10haw
de<:W0l0' in B<Jg;ria.. 1-k.flgIwy. Poland. !hit USSR
a'Ill Yug<lIlIa\oIL In AI'laniIl • ltlIl WllfSl caN -
2O'lb of III ct1Jclren ..-0 now
maIn::uished. lI"Id i1lllnt m:;:t1lIity is more th8fI
doI.tllo its 1989 lM!I 01 15 pet 1.QXJ 1liI'tt'I5."
"S<xSlIl n::<>m&' hits also de<:il >ad. Mroirrun
beneIiIs. oId·aoa
lIB' '"""... onddislllllltl' Pi')' . __lhooreIJcaJ)'
mantained. to..l: ... po8ClJCe they haYlI '-' pored
byWtalJoo.
IorrT'e1y providad
!lmiIies. czec:tIosbJakiaCUl sperdngoo l"eallhby
20%n 199:) lI"Id 00 e<:lUCalIOrl by 10'l6Ine!lCIl 01
eelast two .-s.
... paol. !he 1'lEld<q"")f 01 sctiIlIsafe!l' nets IS a
rE&lIl 01 fJ'liscslc!o'aliorls abOVl the we9't they
wouldhaw to bew. PcIard. for
!or risng 10 400.000 and i";:o",,,,,
tali-og by 10 10'J1,: irlltoa8'o'EIf'lI.
roseto 1.4 mIi::l1by Dec8,blo 1990und_aga
i .::o",es IeII by 27%.
lhe""l<Sl ... Iti!ICOIAd
<*mstl,B'.any IlaY8 beenlMlicl8d.l.WorMa1eIy,
there ..... !ligIs !hal It"e balJjIIII ..........., ...........
mooso.res ;ll bang It\l'own ou1wilt! !he bathWIll...
01state CXlnlllll.
floosonabIo indemg III benifu. SEII'llOtNemorj.
torir.gIII cha"lgosil ctlIkl ......bEIOlg, aweIU targeI.
r.;; III iMlIIabIIl fnllI schooIl"I"l!lEa. food
S\llI11lS 10 ........... m1nirrun roJIIitloMI S1anderdS,
baSic lloHIhand.........oo
SIWVIoes · ... oIl!leseCOlAd NMl prtl!tlCIed 1hemost
VIklerabiol. and eo;peo ie' f !he chidren, 8!1 Easlem
Euope _ its bfave lrin8it>on to d!Io'QOatic
l)OIIicIland _ma1<oI....."",-.
P-s il the oa..: ' '-i{I world. It"e nc:n nations
COIAd !MY 0 101& by 10 mai1Ill/n
..........., !lIa'IdO'dslll-.andf"lllfiDDn lit 0 tmll
wher1l1'J'1'8' "'''1IS lQ '-'0 lICU1e dtficljly il
dOi"Ig ISO. In (I\IlO' woros. i"JIemali<rIllI ..:l ocUd
"-' 10 It"e Gi6 by makng
S<Q It"et lNdren do r(l\ """"'" mosI In on- III
1lrt>uIi!!tlC8and lnJ'lSiIioo. Andil o:lOnG so. ""'OlAd
aI:oo help 10 -..e that loro;:I·term progress is <'iOI
l.ndeI., io IlId by short·terme.igoao 60s.
early 19805, took a conscious decision to
CUt back spending on industrial projecu
and on hospital building in order to main-
tain expenditures on rural health clinics,
immun ization programmes, and primary
schools ," In thc 19805, Chile" and Costa
Rican succeeded in maintaining the down-
ward trend in infant mortality by
estahliming specific nutrition and health
programmes to protect the poorest children
from thc h ~ r s h <:conomic ride of that
decade. Also in the 1980s, Botswana has
managed to shield its children from thc
WOf'St effect s of severe drought by . etting
up semitive moni toring s}'!Ilcms in order to
target government support, including food
subsidies. Zimbabwe, also, managed to pre-
vent any increase in cluld malnutrition
during the droughts and recessions of the
1980s and it has done so by means of spe-
cific low-cost policies which have included
primary health care programmes, immu-
nization services, diarrhoeal disease comm1
measures, supplementary feeding pro-
grammes, and NTal water supplies.
There is also some evidcnce to suggcst
that the princi ple of Ilrst call may be begin-
ning to cstablish itself even in times of war
and civil strife. EI Salvador has not aUowed
its long and bitter civil war to waive the
rights of its children to the bencfits of
immuniu.tion; on three separate ' da ys of
tranquility' each year for the last 5CVen
rears that war has been suspended so that
almOSI all the nation' s children could be
vaccinated. More recendy, the ide;, of 'cor-
ride rs of tranquility', through which
essential supplies can reach civilian families
and their children, has been accepted in
Sudan (the Nile is also now open as a route
for relief supplies), In Ethiopia, two similar
corri dor.! of peace were kept open until the
end of the Wlf earlier this rear. (n Angola,
six such COrridOMl " 'eTC opened in 1991. In
Iraq, UNICEF and WHO were able to
open a channel for shipping the meet
essential health supplies even at thc height
of the Gulf conmct,
Such C>lamples strike the sparks of hope
for a princi ple which must become a steady
flame in the )'CITS ahead. In every set-back
and crisis, in every period of tr:ansition or
turbulence, whether caused by natural dis-
aster, c i v ~ war, mU:l1Ia!ional conflict,
cccncrnic mismanagement, or political
change, ;t should be axiomatic, nationally
and mterrul!ionaUy, to asi::: what the effect
on children is likely to be and what specific
policies arc needed 10 shield their growing
minds and bodies from the sharpest edges
of change,
In the atte mpt to i:::i ndle that flame, the
w(lrld now has the advantage of a virtually
universar agreement on the minimum pr<>-
teelion which mould be guaranteed 10
children, In the goals of the World SJi",m;1
for CJti/drrn and the provisions (If the
Conwnlion on w Righu of w Child, are set
out the agreed minimum standards for the
protection of children's survival, health, and
education and thc agreed minimum protcc-
tion required by all children, in all nations,
against exploitation and abuse whether in
war, at work, or in w horne,
The world therclore now has a set of
agreed criteria against which any and aU
nations can meaSure practical progress
towwds a lICW order for children.
"
THESTATEOFTHE WORLD'S CHILDREN 1992
400
Under·five mortality rate(USMR) andI ~ a l fertility rore (UR), 1960,1980and 1989.
,so
'00
100
'0
""
\
I"""- I 1989
,"-
,"' ....
,... ,-
,"-
lU "'""
1 2 a
, 4
Total ferti lity rate
6
,

0" -----.--,----""T--C--.------,------,-----,,----
'-<.. """""--- - .. ....... _--

Fewer deaths, fewer births
Proposition: Thai if /he wues of mI,l/nulri-
rUm, (1f'efJmlabk di..."" and wilWpruuJ
iUiUYrJ0'. <:ITt tiel r;o"jro"ud as a new world
tmkr ewJws, thm Ii 'IOiUbe WI)' mud. more
difficuh 10 mUla 1M rllU oj /JI)/JuWIWn J:ro1Clh
and Iff<Jlu 1M Irwuilioll u> tmlironmmUllly
,w/airulbk dewlopmml.
Public support for the csuse of protect-
ing children agains t malnutrition and
dis<:,.,., has sometimes been inhibited by the
qwnCIll thaI, inlllimuch lIS IUch efforts
wen: IUc«ssful , they would ultimately be
self-defeating bccaUSl: me)' would $CI'VC
only to cx.acerbatc the problem of rapid
population growth.
This argument is mora1ly and demo-
gnIphically unsound. As last years Swu oj
the World 's Childmo showed in lome dcmil,
reducing child deatlu is one of the most
pmo.'el'fuI of the forces which make up the
rein. of population growth.
Four factors are mOl! strongly associat-
ed with falling birth l"lItcs. Thol e [our
h=men of the non-3pocalypse arc: rising
incomcs, female education, reduced
deaths, and the availablHty of family plan-
ning. When pulling together, they exert
many times more control on birth rares
than any one of them acting alone. There
is therefore no conflict between meeting
the need, of pe<>pk and controUing thc
growth of population; indeed all of thc
propositi ons in thi' report would
contri bute in some way toward. a mote
rapid in thc rate of populati on
gl'O",'lh.
The particular link beN,ccn reduccd
child deaths amt reduced births is one of
the lu.t unden tood and most vital of
contemporary issues. In general, lowering
the ratt of child deaths helps also to lower
the rate of births because it increase.
parental confiden"" in the pn::dietability of
family building and reduces the need for
many binhs as a means of insuring
against, or compensating for, uie possibili-
ty of child death." "11 mighr tJumghl, n
sal'l the 1991 Hllm{Jn RtfXll1
from the Uni ted Nati ons Development
Programme, Klh<>I, if morw childrm Sur-
fliwd, f>OPulalwn probkms fCl]uld gtl fOOn e.
Quilt (he r<lJtl"St. Ferlilil)' Itn<u 1<1 drop
ttilun fHl'"''fIls 'In' m,.,.. ctmfidtnt that <hel'r
childrm ttiill survivt. n
But the strength of this n::lationsbip
betwec:n faUing deaths and falling births
depends on the particular stage which a
count!)· has reached (ftg. 6). In the earlier
stages, when under-five mortality rates flnt
begin to faU from a vcry high level, parental
confidence remains low and birth ratcs tend
to change little. Most countries in the
developing world have now completed this
phast. In the nc.>:t stage, when under-five
mortality rates begin to fall below 200 per
1,000 live births, the correlation between
falling deaths and falling binhs is still weak.
But il is when countries begin to bring
child mortality rat es down below 150, as is
happening now in countries such as India,
and to mo,'c towards and through the 100
ban'ieT, that strong and consisrem panerns
of fertility change begin to emerge. At this
stage, most countries begin to see a much
more rapid fall in the number of births for
every furthtr advance thaI is made in
reducing child deaths.
This is good news which has so far gone
unheard. For the great majority of coun-
"
THE STATEOFTHEWORLD'S CHILDREN1992
The United States:
the rise and rise of child poverty
'FiliI cal llllDI*l roIbe a probiem
lornch 8ul .. !he mosI P'0!lP'l'0UlI1l8l1on
olal,ctilddeprivaliontoas i 0
hlos lisen lnl lmOIIgoctu
"'"
1n1h8196Os, ltIep'4X> lU,ol USchb""liW"og
In IXMl'tv was haMld Iran 27% 10 14' lI.. In !he
19700 . aepllB:I< 10 17%. Then.:n !he , !leOs,
rose lIlll"" kI 22'll>" . In a deeade 01 '*"':IIll
urint_ed IlCOrJOmic lJtlWIIllnl a .- Z5'lli
i (> elS " .., America's GNP.
0vIr lh&sarre :xl yearperiod, 0'0'Ilt8I 1lO'IIl'IY;,
ltJ8Uri1e<l lheelda'ti.
has dedioOld. [)MIn I1'IIintt by llCti<::<l,
lhepo oporIioo ,or older<;:lIimm(fl5<.)M-og InI"""'"'Y
III by IOOnl thenl"'O 1ti'd:I.
So WfroJ has a fl81ion with lhe demonslraled
capedIy to 'e<:U::e PO"'l'IY !lliIed to do 110 b' Its
<hIdf8rl7aIIrJ .. Amori::lr. " a report /rtw'n
lhe ChIdmn's DefooI!Ie FI6Id
(COF), deers the- wayfor lts __by e><;:>Iodi>g
--
ThIt i\QI;I< i'ro1ge QltheblIId< (;fjd born 10 an
" ",,"Iied, rnottIt:o" Wilg on __in
abig dl\I s a filsfawIlf Ihiln croe
in W'I 01 America's cI"ildrfn 1nnBr.,;ry_
and bul a
of America's 12 pool ...
'Mile. Most 1M!' out3d9 bog dIiee. Mosl i'l
hlfTiIies _ <:rif 0I'lII Of lv.o c!lben. And most
belong 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, lhe
S!IlIIdy fill Inreal WOQIOS lWTlOI'IQAmerica' 8....sl<i1ed.
ThlI lI'YlItll9" ""'9" 01 ncn-superviooI'y
WCIlkln lei by 20% 1973
and 1990. AI the _ line. Ihl g'7>\"w..u's
eoo,., ;h,.. 10 a ............... 'famIy WlIgIl' "IlJI'lfn
to he>ttladed: even llft(I' reoanI i IQ : l US. the real
..........., ...... .. 1990 Is 2O'll. _ then _ ..
196:1. for a \'8BI',ra.nd WO'kef. ltilI rrh-
....... W8Q8 st1 __alatnlywith one
$2lXXJ below tNpoyerIy Ina.
As IaIro i ICOITOEl& haw • 10eased the rDXl
OOri'r" 08Id faClibenhasbeengra<lld\l
wilIOawn. The real ....... '" AId b FzmolieII with
\o'FDCl h!!o!o (IIQ!.'!-"!I:l !l')'
""",,20__. TDdBy, loss then
10'll0 0111I casIl benelits go10poor llmI8s with
chiIdrer\. ClII'wgrOUpS havefaradrru::l1b9tter: <:NfJ(
hall ol " peoplil nIlOO' lfI'l'iias wilI1ol.t Cl'Iilt8n
helpto P<A tt8Tlabc:J,te
iroI - as C>XlO98d to rrl'f 14'll. ol people n IlOO'
........".•,"'
AlIIrnpIing to """91Ilhe!le lac1<n. !he repon
anrbJlas t-JS! _ 4O'll. 01 !he rise...cf"id
tolhItdedioe01gc>YIltI'YJMlrl support.)usI- 3O'lll
tola&-1grealWlI98S """"'6I1he poor. lWl l;l!llL.W1dBr
3O'lI> to1heriseoIl1lClltlef-«tt
CaIhg onItJollk'ilecl SIaIes touselts
to ....., ctjd by thoI year 2000. h co=
1lIet .... (III HfIl iXN"rtY
wIrh IfI9 -.y lWl flGt.C9t01 of
of flU dli'immd lImatM!l thel'l8lb<l's
e<>:n:mic anrJ9OtS8! ruruv. "
"Sili etilg 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
suI>s/!n:;lea'luse.
cri'ne, md<Xher pOO/Ems l/Igl.seemsocilwti'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 up
10lhapc:wertyi>a\. Ths" less then19l1 ol AmioIca's
G/IP: is alSO less Ihsr> 1heam:A.t'1l each
.,.. tr; lilarid1Ilst 1'lIl ol 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<lentate
... pmditu.... in countrlf:> with feder.1 S)':Iterm.
......."""'\, ..,
elf,," 10 miua dlild illness and
nutri tion and 10 mWr. the goals of 1M World
Summit far Chi/drm", says Mauria: Strong,
Secretary-General of the first World
Envirrmmmi C<"' fnmu in Stockholm 20
years ago and of the World Corifnmu On
Envirrmmenl and lNw/opmml to be held in
Rio de Janeiro in 1992, "is crucial .ICI
for in own .ake bul abo w a means of hdping
10 JIow f>01'Ulal ion gmwlil and maRe pouihk
mvirrmmmlO1Jy rrmoilflJbk tkvelopmml in
IN. 2hl cmtury and beyond.. "
A renewed commitment to protecting
the health and the lives of the world' s chil-
dn:n is therefore in syn<Jgy with, not
opposition to, the effort 10 cope with
those other great issues on the hu man
agenda for the 1990. - the slowing of
population growth and the protection of
the environment .
tries in Asia and Latin America have now
passed through the earlier . rages of this
1JlIn,ition, when birth ""tes mayor may not
be affected, and are approaching or enter-
ing the Slage during which further falls in
child deaths could be expected to be asso-
ciated with much steeper falls in births. In
other word" reductions in ehild death.
have now reached the point wherc signifi-
cant in falling binh ""tes arc
]jltely to be paid out for any further reduc-
tions in child d<:lths that can be achieved.
In Africa, where under-five mortalilY ratcs
in mOSI countries n::main in the 150 to 250
band, it is essential 10 hasten this U'ansition
in order 10 quickly bring to a close the
period during which population growth i,
at its moot rapid.
10
8
7
22
11
11
""
"15
12
12
8
8
Fig, 7 SpendIng on basin
hNlth CM1' and primary<.'<location art' two
01 tho m<»t important wayo 01 'inwning in people'.
!Iut 0/ 21 for which rom""rat*
figuf'fS "'" ,,"illblo, only tIIrft gowmm<1lts alloclt<:
"""" thon Ml' fifth 01 .... to
!»sic
Expenditure on primary health care
and primary ond 5ec:onOOry education,
cs a percentage of totol centrol
govemmemexpenditure5, 5elected
developing coomfies, / 988
0%
ZIMIlA8WE
BOTSWANA
SIERRA LEONE
MAURmus
TANZAN1.0\
NI GERIA
SlJb-Saharan Africa
MOROCCO
JORDAN
KUWAIT
MiddleEast & Nonh Africa
BANGlADESH
SRtLANItA
INDIA
South Asia __==
n
THE STATEOFTHE WORLD'S CHILDREN1992
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/
'" plrnUtl« lNuic irrvulmmu in
"",.
Whether for idra1i5tic or sc:lf-inlcrulcd
reasons, monopoly state control of eco-
nomic life is an ide<! which has been given
field nials in the 20th century.
BUI U that I;C'fltury end$, it is an idea
whole time has gone. In panKular, if
stands d.iscredircd amana die minions of
pc:opIc whose it bul '111Josc
n«ds it failed 10 meet.
11'£ ul ttiit is iCiui'lOO
llII;III (lI'IIy O\'tt F.&Stml Europ: and !he
Soviet Ullion bur 1M:!" cvm Iargcr UQS of
eM de\"tloping "''Oriel. Free nwkd:
ewnomics, thaugb many .mous
problem. of their ewn, havc
shown lb:nuclv,," ID be: lIlOft' successful in
Mini the living standanls of the majority.
It .. therefore a truth now almost uni-
venally Icknowledgo:d that the energy and
enterprise of peoples an: Iibented only
when people an: free to rmkc their own
decisions and miswkes and 10 reap
in rell.lion 10 lhcir 1aboofS.
The: idf:oloP-al cbums inlO which so
much alCf'IY and has disap-
peared ill the po5l-war paiod aR'
TWTOWina to aIJow moA COWIlries to sand
on !he: oommon pound of. mvUt-£rin>dIy
approKto 1<1 1lIis )ur'1
Woria' Rq#n from dle World
Bank, for cnmilG manhab fow dcodcs
of UI\'IIStmft'l1 L1pCiicilce in support of tim
l."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:$idcrn
of Tanzania, has condudc'l1, "7M
fWClU/IJ of i" w
.so..u. <karl>' .1touJ !hal K"I"Wu. Q
tJi,roroIIJ in Q in ",hid! 1M bwi-
....ss J«UII'"", rJrriw. ....
of COVtnUll.tIll
The /"Ok of in dcvclopmml
is therdore brin& in many
nationlI " presenl time..
Certain Qp«U oi mal roie :Itt obvious
bur. oucm IXJI 10 be forgotten.
foroes QlIIII(l( economic JfO"'Ih in
a poIitialI VlC'UltIII. I>umbk peace, .--
IbIc l iability, gu&I1Ulltt:S of Iepl and
propcrt)' n,:h1S, a reISOOIbly
ci>oil !he: cko.'dopmau of infraltruc-
rare, sound policie§ on money supply,
taxation, inlcrnl and rilles - aIr
are the 1'Oponlibilil)l of government
and aU I re pan of the framcwor!c withOUI
which Ihe polenti al oonmo ubon of market
roren is di.sipl tcd.
BU! il is I1so important W ROle lNl the
kssons of m:enl experience - and psnicll·
Iatly the IUccnso of HOD« Kong, Japan,
M.aIa)'sia, Sinppon:, South Korea,
Taiwan, and Thailand>" - SUliQI IXJI thai
IboWd recre from ceo-
nonUc fJdd in order 10 allow the free pia)'
of market forcc:s nor thai tome: linck
' riplt NJancc' sbou1d be Khicved bctvo-een
go·..emmau and numts ("'h.id! impljc,s
thaI 1M IWtl muM a1wa)'S be in opposition).
'The chief lesson il rather !hal progrtll is
Fig. 8 Arms, debt and people
About Jltf(e<l1 0/ ')OV'tmmtnl 'Pffiding in tho
WOIId .. _ 0<1 10 the milila!)' and the
Ol'rYi<ing 01 dKIt. In IOmII! lIli' i' lWIce a,
mud' .. JPf"d on Malth and
fduc:alion combinfd.
Percentage of centrol government
(CGE) allocated to the
military, debt urvicing, heallhand
education, and aidreceived
percentage of CGE, by region. 1988
---,;;;;:r
OTH(R-
OU T
,
MILITARY
AI DREC£IVED
• loo\ld<$ I"",
__----,-,...""-- _ '..,......:..-__._,,,..
__ '. ' " .., 0lW,
,.i.;::,.-....r_
m01t rapid when governments .nd markclS
woO: in intclligcnt partnermip with each
other."
In the rethinking provoked by events in
Eastern Europe and the Soviet Union, an
equally dear if Its' widely proclaimed cce-
sensus is also emerging aboul what market
forces cannot do, and therefore about what
governments must do.
It is the responsibility of the State to:
o ConstrUct social safety nets to protect
the most vulnerable members of society and
set a minimum level of well-being which
will be maintained even during economic
downturns.
o Ensure basic investments in people and
especially in bask education and health
care.
o Prcmcre fuU emplo}mem so that the
great ma;or;ty of citizens are able to meet.
their own and their families neros by their
own drom and thcir own earnings.
o Counterbalance the long-teno tcndency
of market forces to confer marc opportunity
on the already advantaged, thereby setting
up a momentum rewards increasing
inequality.
o Intervene in those instances where the
Ieee play of market forces is dcmonmably
COunlCT 10 the public imerest. From
UNICEF's particular perspective, for exam-
ple, it is 110\ in the public interest 10 allow
millions of ehildren to become malnour_
ished because the free play of market forces
has persuaded millions of mothers to aban-
don breastfceding in favour of commercial
infant formulas (panel 12) , Nor is it in the
public interesl for peer families the world
THE STATEOFTHE WORLD'S CHILDREN1992
War on children:
the 20th century's shame
"
PooIec\IrlIl the IlWds IWld bodios of
\'<UI9ctill;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..
'&$I cal' is lh&c:haIenge ci1ll8 199011. And
rroa OOsparBl&)r.-:led ltWlln ee
WOI!d' s war
... the Iasl dec:ade. more !harl ooa llr<l • Noll
rriIb"lcttillnhawboonkiIod InW3fS. .. Mete tn(lrl
4 miIIon have boon ""'Hod . li"rtls
brains <DrorJed,Il\'llIIV11 rdtumg
10'11 - 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",,' ill a 20Ih """""ylrMImion.
Oriy 5% 01 the <::as<8\I9s in the FI"SI WQI\d Wet
W(!«I d\oiIilns. By theS8con;l Wor1d War, theprQ-
p:>"Iion hadrigetl to5O'lIo. Md. lISlhe centu'y
the cMiIn lIl'o!n is IIOtITIEIIy about 00'll0 • IT(lSI 01
Ihem.....:wnen III1d
Thu Indirect etrects InaIfoost as CliMISIali'>lI.
Schools at>d cirics are dD!;ed or 00slr0yed. Food
IIUP$llY "- are brol<en. Walll< lind sanrtalion
$)'.18= bn.lal< dawn. MAon$ fl8e' to
CWfl.'II. Nwj 1WilIy$. hi r-.w is !)l)ToI
by <:M::tren • d*:hn.-.ho miss lhI!IIr onlI d>lnoe10
grow normiII\I n mnct 80Id boct)', to be educated
lnd to a<:QlOre!he _ to hi a pIooB In !lOCI6ly.
The PSYd>c:logic8I WOI.o'lds _lessVi:Iille. 10COle
s!lKti 0150 di' ... e1ctti'en n M:lm'Ttique, 42
hadlosl afathero< rrott>a< b')I\OioIeno!I. 11 had seen
01heard aparetlI beO'lg l<iIBd. 29 had I<iftr lised.
rruoer, 16 had boon kidlllIIlPEId, III hall boon
tmlalened Of be9t"" or staN8d.
SlIid tQ be .reprooenl8\Ml.... In \OIaI, on estmated
10 fl'Ii6Ion d1IldOWl In \Ile world r- sutrered
lraIn18incMI ondimemarJonol wn.
ThesemanymiIions of chidren, 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 • aogalnst
lho!le who """ the W<>apOM and those who
""PPIt tlMlm. H_. must be fooqtt , tIIIwl, IIllhe
·"i'j eest, to; j)iViOC' .wnom".otii
IOOtSt .fleets.
1her& n """'" sil1IS 01hope. Armed oorAct
seems to be ' m io og with lh!IlIfl(i-,g rJ ItlIl ookl
WfJI. ThIl W<rt1 S<.mml: for O!tim opec;ticaIy
r.3lled fa ltla
;., am. r:JWfJI end;" _ •. kid
lt1e .- Cot»mriot> 0tI J1>IJ Rights of rhe ctrId,
WhoCfl dao:rerds 081/ 1'IlasibIII_
to ......... pra/IlC:tiJtl endewe atc'lottm wile In!
fI!/oc:ted by I'mIt:ld <n'Ilfct', Ili'IlIV'I beI:r1l'l1lift8d
by 100 r'Iations.
Sc:ml na':icns beg<I1 lh!I .....\Oi(;le
Into p:actk:e. In B Sdwdor, eM WfJI has tleen
!UIIPE" ided 0lI ltne sapeoale days 8'o'EII'Y b'
InIIBs1 seven so tha1 cI'ilchn can be i'n-
mtrized. "l.ebarIc::o'l,'days rJ ""-d
chldrQr11C be wccio "led 8'«1 81ttle cl1tl8
_InSudan, bcIh tq-' to
'culkh. rJ .-co', Itrn.!;JI'l WhoCfl-.ilaI "'-P"
pliloa o;:cUd machrriIons cf cMiaroa.1'I'IOStIy wcrroen
;oj c!*lftln, IRlpped In lI18 WfJI zilIl&. SimiBr
lIgi 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 !heI\lIliI ralIw
u.. lt1e WOIldwdI,! P'i*: ilIlinKln will
need lOhaoden llQlli'\SIlt1e _ en d*hn';oj
imisllhat lhiI ......... IQ Olllin on J1>IJ 20lh CIInll.o:y
s/"IctJd roJl be aIcwed lOseep <Mill Wo the 21.1-
over 10 be persuaded to spcnd 5500 million
a year on useless anti-diarrhocal drugs
",tK:n oral rehydration therapy, the medically
OOlTCet treatment, is so low in cost that it is
of little commercial interest.
o Defend those elements of a humane
and sustainable society to which the Is"" of
the market place attach little or no value.
This responsibility includes the protection
of the environment, the protection of the
future, and the defence of mose who do nor
have sufficient influence or purchasing
power to translate human need into eco-
nomic or political demand.
Invalio!: in people
The other hll1f of the development con-
sensus which has grown more solid as
ideological divisions have narrowed is that it
is a of governments to ensure
that vinuall y aU members of SOl:iety have
adequate nutrition, primary health can,
clean water, safe sanitation, family planning
services, and at least a primary education.
These basic investtnentS in people arc
essential not only for humanitarian reasorn
and for the creation of civilized societies
but also as the foundations for sustained
economic growth. A!< the outgoing
President of the World Bank has said, in a
ICIICT 10 the Secretary-General of the:
United Nations following the: World Summif
fi1r ChiMrm, "/mJeSlmenr i" hu"..." Cllpila/,
iM/udi", importamly baJir: IwJIth Clln and
primary for (hildren, is o"e of lhe
moIl tfft<:Jiu means of slimulming Iong-IeTm
wmomic growth and imp_;"1 ,eneroJ wtl-
f a" ." The same conclusion was reached by
the Sol/Ih Commirri<m', review of recent
development experience which concluded:
"salirfyitlfJ bark needs .""uM /raw priority
holh 011 grounds of C'1Uily and 10 =rai" ta>o-
IIO>IIic grMJIth III <l rapid fXJCt. "'"
In recent years, research has demonstrated
the power of that investment in many dif-
ferem ways. World Bartl< studies bave
shown thai raising the average educational
level of the labour force by one year can
raise GDP by lI5 much as 9%." Other stud-
ies have demonstrated thai four year! of
education, as opposed to none, can increase
agriculrur:al productivity by 10%.'" Research
OVer the year! in Australia, Bra;r,il,
Colombia, F.thiopia, Guatemala, India,
Indonesia, Kenya, and SielTll Leone have
shown that improved nutrition can increase
work productivity by IIp to 20%. Better
adult and child health has been shown 10
save millions of lost workdays. COlTCCting
child malnutri tion and iron deficiency
have been shown to reduct: absen-
teeism, increase anention spans, and
improve school results) '
But for the present purpose, such
ies are like striking matches in daylight. The
evidence that investing in people lays the
foundations for e.:onomie growth looms
large before us in the shape of mose coun-
tries which have succeeded in achieving
rapid and sustained progress in the post-
....·ar world. Liberating people's potential via
land reforms and univcn;al health and edu-
cation services has been fundamental to
that success in countries and regions sucb
lIS Japan, South Korea, and Taiwan
(panel I I) . All of these have shown that
basic education and health for all are not
jusl socia1 expenditures but e.:onomic
investments, nOI just indulgences which can
only be afforded after countries have
"

X l I . - . . l K l l P l O Q I l · O c ! J " O O l I . . . . , q
t o 0 C I U l l \ I 0 < i . u i l I l j I l l l l S J E l u e w l P ' ! ' l 1 " < l Q I ! ' l . O ! l
- W l J O J U ! : > o G I l q 4 l \ M f l
" 1 S & \ e e . t l . . . . P 9 Q I J - . . . . 0 1 p e ) S / i l e l
P r O O s s e . . 6 : I > d \ l l l 4 l O S
I I 8 l l u e i p O J d 1 l 8 S & e M W E l l S A s 8 ' ! X 8 N
' l l J > I > O o ' o ' • U 9 9 S . . . . . .
P 8 I l p G J l < l I . i " ' - " ' W P " 4 l . . j O 1 l I l I l - o " 1 I ' I ' l S ! " O U
' ! N l 8 J f W I I I I j O % S l l ! l l l l p u e ' I l ! l f i U I I I l U d
P U l l _ I ; ; ! p I ' ! ' i I O ' l " " ' l l G I l l . . . l / l U 8 P t o 1 l Q S I 1 W
U I l l W E I < i I l 9 . l I ' ! I I / l J I Q 0 0 0 " . I i l d i s I I I S l I M
l U I 3 l U I l 8 . I I • • - . " . . . 0 0
j O e l l l l S , E I < i I j O < * 1 ' $ J I . . , .

• u o J 9 l / I l l 6 O l " " " " O l l 1 W O O p o . j l I O U l I p " ' I I ' ' ' ' ' O N
" S P O ! o J d " " " " u o £ I O l N ' l ' I I ! ' " P I ' > I " l " "
P 8 ' l C J . f " e p : > e d f U l o ' 9 $ ' 8 W I J / 8 I I O l l 1 1
" " " ' l > d " I I l t l n < > I C l E l q l " " , " O l l l l l l 9 E l 6 I I l • . . - : l
" l $ O O 1 l f ' l I I P " l / O " ' 1 1 l P N l I l 1
J 1 l ! X 1 l " " " " l U Q 1 ) " ' l I " . . - . . . ' 1 \ 1 ' " ' 0 0
I . O ' ! € ) " > j S 1 l l 1 l < l l < > l p w
B I l l S J I l P I ! 8 I S l I " U O . J I * + I j O . . . . . l I 4 l " " "

1 ' 1 8 " l I U ! l . \ w o l O O " ' l I M I J l 9 Q a o . a 9 I d < > O d S l ! j O
" " ' l I 8 ! 0 1 l d S O I l W I l 1 l A l 9 O
w : : l 1 1 9 o O O d l l l O O l l l l l M " ' l I
t J l l l l S 1 l I I l O 5 l 1 l f 1 l ' 1 t l P N l 1 l < l l \ l ! 4 l 1 l l - ( l M " ' l I \ l M O I . l $
1 l l l I l F ' 9 J E I j O l i O l O O 1 S 8 1 l " ' l l X l U 1 l 4 l " " O I 8 l $
P ' " j i i ; ; ; ; ' ; ' - ' " ! W i o m - P i i i i i i i W I . q • • • . . . . . . . P H i
p o : : I ! ' 1 l 8 l p w ' ' ! l . O t < > l k I S J 1 l ' i l
p 1 l 1 9 C I ( l Q ' j I l I I l k I s a ; I ; I I ' 1 I l 9 O " ' ' ' ' J ' ' W C I J I
P N l I l l : l ' P J P . l I 0 U C l k 1 0 l l l J ' I l B l l P \ U I l I J I S l ! p o c q : o l J
S 8 \ l D . I S e : ) ' 6 0 0 < > l 9 B 6 W C I J I s : . - I 1 l < I I " I
" 1 I e N . . C N J C I l 1 J 1 ! W l 1 S ' O J C I
' 1 . t J l I : l l l l S C O J ( ) B s o " ' l I l d o d B J C U J S !
" 0 I d 0 0 d . . . . . . . 9 l l l ! ' J 1 1 1 ' 8 " . < J i l r < X l a l O U ' !
. , 0 6 6 1 8 \ i l I 8 P G l d O P 8
i j e o O ( X X £ l O O o I E I < i I 1 0 I ' J - . . . o t I l W ! l l l U I l W
- < . U 9 N J 6 & l 8 l S e o . u . ' ' l U I W J W . ' q , " ' f f l ' , I I . Q ( )
I I I B " W I . . . . . . . . . . : > I G 8 Q , . - I f D l I ! M . . . . . . .
U I l . l J r o I : I I l l I O J I l I l I S 1 I h a u S I l l l U l l ' W O J j
" ' I I I ! . . . . . : l M ! u r J , ; ! ' < t l N O O J . . . . . . . . " ' l J I l 9 I l
I O U C l - - o J O l . U J I l l I . I ' l " 4 I J O I l I j ( 1
' u t . ! . e J 3 0 9 / l ! l u o l l J " 4 1 1 0 P t A !

P O O l S O ! l O . l p u l l 1 0 l l J ' \ I C l C l t ; l 3 > f U l 0 1
t o U l a I i j
q I I i O I S - ' J . j O a P . : J o . ) d I I t I I l > l < . l
I f l d S l ! \ l R J e e O ' C , & ; ; : 6 '
' 6 ' f \ ! U O O $ _ a u . w e 6 : > o : l 8 l l l 1 J S I f ' S W l l l U
-
- \ l l . ' O U " ' l I ' " _
8 U ! U " ' l I 0 \ l l U l ! l 4 " " l I t l l J l U I ' I " " 0 1 I l J 9 > I l ' ) ' l ' 4 l I l ' l ' 4
' l ' J I I I I O O O ' S ' 0 1 l M I I d H o O J
V l O Q I l . l E l l j l l l i J ! l l O O l l p e 8 -
O J a 1 l J 9 C 1 , 1 . f t . 1 ' p e o ' ! " Q 9 '
Q . l 9 M l l I " " , ' O O l S O l U O I l I l J O O O l ' l
" 1 l > i I l I - " M W * l ' " p I I l ' ! ' l J l u q P f : ' O ' o '
. , . , . . . . U O I U I O M J O O d O J . $ Q O ! k u 9 8 . o e o . u o , 0 0 0 ' 9 - e
1 " " ' ' ' ' $ \ 0 1 ) 8 l l \ ' ' l U . I . I J 8 . t I o J d b J 9 l ' i
. . . . . I I l U U O I J 8 I l l J O P I 1 8 l S U 1 I I I p w . o l l
_ ' ) f : l e q ' 1 O O e ' L I l 6 \ 1 0 8 I i J .
. _ E I < i I J O - . . . I O O . I O O d l l 4 I " ! " I ' l O O d
1 0 1 0 O J l n O l l u \ p o o J p u e
J O _ _
I , f : l n I : l : l I O t I I 8 O 8 \ i l 1 O " ' 1 \ . " " ' 0 " " ' 1 1 ' h o l o o s
. . . . " " ! " ' : ! U 8 ' J " 4 1 p u B
l M : I p a . - I d 8 " " " l l . . . . . I I 6 ! J " " l I I S ' * ' ' Q ) N / I . n u
- c e e S S G ' J l $ I I Q 8 l l l O J ' e p l W l l S l l W E I < i I C l ' 1 U O f l
l l 4 l O J ' , p n p i I \ l l 0 1
I l l ' I ' d d v O J p e p p i P e q a O l l l l G l l l l S l l t i 1
U O ! I U ' 9 o t . l p l J l l E l ( i a J I ' l O ' l O O O ' e l l " ' " * "
I I t l l . . . . . . . I O U P J I ' l l I 8 8 I l 8 I I l ' P I J O M E I < i I
j O S l . e d 1 9 l 1 l O h J 8 w U ! 6 l I \ 1 1 8 ' . I l ! J O l l C l c e
o e M ' 9 S l l 9 ! l P 1 6 ' 8 4 p u l l O J I f > ; ) Q I l p u e
a u o p a q U e : l l ! I ) U ! M 0 4 S
: e J e a o
Z 6 6 1 S , C I T l i O M . a H . L . ! I O : i I . L V . L S : i l H . L
become prcepercue but the foundations
without ,,'hich prosperity will
not be achieved.
In other the of the lasl 40
years suggest that development proceeds
mO$t steadily when it walks on the IWO legs
of a eeonomie policy and a
government commitment to ensuring
investment in people. And as the eensensus
on market-friendly economic policies villibly
gathcn momentum, it is even more essen-
tial thal the other leg of the developmem
consensus is also exercised.
Unfortunotcly, ' investing in people' has
been the battle hymn of the international
development efron for futeen years without
battle ever really being /Oined.
All for lome
The governments of the developing
coumnes spend, On average, about one
quaner of their budgeu on directly im'esting
in people via health and cducation services
(but no! including government expcndi=
on agriculture and creation) ,
HcaJlil and education together daim 17%of
go\'ernment expenditures in Latin America,
21% in the Middle East and NOIth Africa,
23% in South Asia, and 25% in East and
South East Asia (figs. 7 and 8).
In ccuneics where high employment and
reasonable wages mean Wt the majority arc
able to meet their own needs from their own
earnings, such It:\'cb of sociaI expenditure by
govcrnrnerua might be adequate if allocated
according to need. But of the sums which are
allocated directly to health and education,
more than half ;s allocat ed to relative!}' high
COSt services for the few, and IC$S than half is
lI1Iocalcd to low-cost services for the rrumy
(fig. 7). In other ,,'OIds, only about 12% of
all government spending in the del'eloping
world is devoted to imocsting in the: health
and education of the 000'1" majoritv.
Fig. 9 It can be done
World Summl! for Childrm loti.
goal ' for Ihe l'H' 2000. But Ihe Br.lilO.on . tote of
Cea,. {popul.ltlon miUion) h. l achiPled IOIlll! of
Ihe mon bam 9011. Inonlythree l'H" (ift panel 7).
in rekcled motemal and child
healthindicotOfS, Ceara, 1986-1989
Indiutor
Od/""
lun/Aug
charoge
,...
""
InfantfTlQItaIity 57 39
-' 2%
"""',,,"''''''
28 B
-S<"
""""'"
"""""""
"""'"-
23 32
.,,.,
""-
SaI:ts il the last
_.
""""""" 0Mk:lre112·23 se 81 .-
rnonthl; rt«'Mng
BCG vaa:ne (%)
Children 12-23 SO 63 +26%
Il'IQrltho; IKeiving
3dolesdDPT
vacrne(%)
Mahubitioll - 2nd e.o SA -33,*,
"'" "" """
"'Gomo.<
dasslication (%)
Unln. othctwi>e . \.Jted.1lgute< .ppIy to
child,,," "9fd 0.36 month.
..... _..... _-
..-.,-..... ".,
THE STATEOFTHE WORLD'S CHILDREN1992
Reshuffling the pack:
Human Development Report

ThI l Qll' I-UrWl J'IIJ:01 lmm
UOOP ill..........,.; up by Jts0W!'l Pflied'ol'Si iQ Ii.
AbrIhwn I..h::c*l • 'oe. l' P'''' ''' of /111I Pf/OPI8. by
INptItJfie. lot /111I J'fIfJf*'. 1'he b lItb, <J JlIIO"
.. lX)IIrlIllIl a"IdII'e WlCIlri"II {)lit-. 1*ll4Ar
Iian_ til h .... 01010 _il
TI'i& ... WI lI'II lIllrTU:a aD01.. growIh. EU
_u,iclJOMlliinol ....,ilblll ·I.I_
b,. who;rl UNg,*>s............ ' . ,••"-
1.-_. a GrooooIll ..l'IIlicnIIn.::ore .
'... ,tIUI .... ..-.._ -..
.. kI'Idof 9'O""Ih . _ • co I ot. I'lC7W ril
aJ" c. """'.....lrun ..
To _ Pi"""_ ... loi"cl of
.. 5. '...l,N;lPpo •
.......... 011'0. .... ccuwilII ....
on ....... 0 ' .. 01 100II ,,"'''eiOf tIA. on I
........rei WI' ..""'*""
• rroMo.'" of pIlI" GOP. -.gil III
._'.cy.a"ldjftnuid "".
Hul.'" C the Cr'IltIria 01 il ,.'-t
tWurI8I .. d8' ' v ,. « pIIdI. b'
_ '1llIe. iI *ed661!1 nn World Bonk lIIblBo
...... a;unrIes by pel' CIIlO11 GNP) bul sliPs
10 102r1d Inthe lNJP tebIN, whIi::1l ...... Q:lUlII'ieo
by Srlla'lka it llWlked 1201h
by por tlIllOl.a Gt.P to l'ltOfl1llIed to 15th on ee
i'O .... - aI its ad...."eilll .. h!IelIh..-.d
1dlC8licn
1llew,,*"P''' cllv!*>de> l'll)''''''1l.

IiltUrd poItaI .IMb, nol'" IItIIll)..
biI:I' of lP4"" ......... 8LI. _ h rigl'a
a'ld \he to .. ....,pIIy CII'1 bI-t-
_ 01 '. '<M«l by"'" ljlN6ji'.'. ;
____l.f,()F' • • e .. ll""a"'"
............" .... """"'tlI I ,tJ,r ...ot
-- o !/Ie (J<dc. ....,.. ..... .-0 d
llIlIClnIl incorI'e ljlOr9 Qo ;UlIie dIn
PO' *WM'* IbcU2S"I
o 11»-*1'" ...
_ 111<1 10 IOCilII MlMc:a lie I'I8II/lh

o rtII sociII ¢cnty IlIIio • d ..x:ili
_ odtIn 10 1lflor1lII ru..._a.ch
..pm.yhMlllannlpriomry" """"l!O'J'
I"X ,
Tht _ CII'1 til co,ibi.-l'" Clf*'
IUnon MPI' ....... . ,. 1*.....,. or
__W_I"
__
",1_ 1ing ...... Zi"_•. lor
CII ;2.; .
-.:I PlII : ,cnr OA 9I.C ...c:o.¥*iII .........
.... _ ,.. b\I dtIINrf
_ .....-.:ITh*odbl*>_IUrWl ......
......III 2..$Wo ... ""'-VI"'* pJk. ..
.--.......-yd.'II!Ir8"( • 31'llo -.:I Ill'I'
,...«"'-v.1'1-...:1_ l4' "'"
po.dc "",do'll lJf IiIt* ICICIIl • • ,. ,
-.:I D::WprlcrIy mioL
ThIl "'IXtl M'llll"" -' tIidfuntIn--....
ntIio (Ihll po oporliol , cI a dDra's GNP to
l'k.mIwI prioIfty needI n !he d<I> :' • • ",
lOprl&rllllld PfOIl'Q1I. f.....
rroo. a l'il;t1 III 0, 128'1lo n Ihe _
n to. lew III O.Q1l'lo in 1ha
U'Iiled St-. _ 0.011'llo",bt,t,
n _.,..., l.NCEF r-l.lSOICt I/IifIWtfdl'llr.
on: CO"""'Pll. eIIoing. hi, _ .......... ID1clIP""
..,....,.... ""'"'*91l':- 10 _ IulWI _

Ic7oo-a* _ -.at1_ lOhll. po:tIpolI'.
ID'Id., lUCI'I_lIgL
11indIa
...
• SIIIl<VI' t:I _ ' '1 ""-' c»4IOP-
..... '-' ......... oN: paIi:m1'lilII- QlI"I
5co'-. ceonrlIa _ K1 ' -.1 -."O'e
Wllhrn.ch.... Cllt.-t............1hIl __
llUt*: _lCiIlA '- 10 ba CUI. liiOi"'1I09
......... (8)'' *""po""...
It ill estimated, for example, that 80% of
the 812 billion allocatc<! each year to water
supply systems is spent on putting private
tap. in the homes of the relatively well-off,
at a cost of approximately 5600 per person
served, and tnat only 20% goes to the pub-
lic ",cU. and s\lInd-pipes which can bring
clean ",ater to the poer majority at a COSI
of 530 to 550 per person served. '"
Reallocating even a proportion of total
cxpendi1\ll'CS in favour of the poor could
therefore liberate enough resources to
achievc thc goal of safe water suppl\' for
almOSt every community in almost every
country by the year 2000.
A similar argument, with similar statis-
tics, could be built around the themc of
health caJ'C'. For many times m<)rC money 10
be Spc1lt on curati"" than On preventivc
health is the norm; for 75% of public
spending on health to serve only the richest
25% of the population is 001 unl)'Pical;Jl for
mOn.' to be spent on sophisticated opera-
tions than on the 10w-cDSt control of mas.
disease is nOt uncommon;" for J()'% of
health budgets 10 be spent 00 sending a
privileged few for eeaeneru abroa d is not
unknown....
The necessary rcstru<;turing of . ueh
expenditures may be difficult but it is n01
impossiblc. On becomi ng independent, for
example, Bangladesh found itself wi th a
health system which devoled only 10% of
its expenditure to rural health clinics serv-
log the great majority of its popul ation.
Today, that figure has been raised to 60%."
Ednation
Such distortions of public spending in
favour of the better-off lll'C; aI!Io evident in
national education systems.
Depite decades of research findings
"'hich regularly dcmonsUlIte that invest-
ment in priIMry education yields
signifiClllltly higher rerurns in both social
progress end economic growth," govern-
ment . pending in almOSt all de.-c:loping
counuies is heavily biased towards higher
education for the few rather than basic cdu-
cation for the many.
lltis i. not the path that has been fol-
lowed by those countries " 'hich have
achieved the mutually reinforcing goals of
universal education and sustained economic
growth. In both Japan and South Korea, for
exampic, universal primary edUl"lltion pre-
ceded economic takc-off. And in both, this
basic invcsnncnt in people was made at a
stage when their per capila incomes, in real
tenos, wen: lower than in most developing
countries today. Japan moved rapidly
toward. universal primary education at the
end of the last century. South Korea
ensured that almost all its children were in
primaty school at a s t a ~ when its per capita
GNP was little more than SlOOper yClU"
(panel II ) . Emphasis on serondar}' and
higher education came later and was not
made at the expense of primary education
for the great majority. Nor did it run ''CrY
far ahead of the cwnomy'. capaeity to
absorb inelnsing numbers of more highly
educated people.
Many other counuics have taken the
opposite course, fuumcing higher education
disproportionately with the result that up to
half of all children fail to complete four
THE STATEOFTHEWORLD'S CHILDREN1992
rcan in primary school while secondary
and tertiary education absorbli an exagger-
ated shan: of me budget in order to
produce many more graduates than the
economy can u""fuUy absorb. In India,
where 60 and 70 children could be
given primary education for the 0011 of
training one unh"eniry student.'. approxi .
mately half of the nation's children fail to
fmish primary school while the country as a
whole produces more graduates than it can
productively employ. Inevitably, one of the
,(fem is a brain drain of uncmplo}'Cd but
highly qualified peopk to the industrialized
nations. In this way, a significant of
government spending on education is used
10 subsid.i2c the rich nations rather man to
achieve basic edacerion for all which, as aU
experience suggests, is one of the corner-
stones of development.
For reasons of both justice and efficiency,
Ute overall effeel of educational expendi-
rurc should be: (0 ",distribute incomes and
equalize opportUnities. In most developing
COUntries tOOllY, its effect is a1m0!11 me
opposite. Most government nn
higher education is on the
already advantaged; in Chile, the
Dominican Republic, and Uruguay, for
example, mOre than 50% of all govern-
ment spending on higher education is
devoted to the children of families who
belong 10 the richcsi 20% of the popula-
tion. tn India, 50% of all government
spending on education is used 10 subsidize
the best-educated 10%."
Within these inequities lies the potential
for a degree of R$tl'UCTIlring of educational
expenditures which could help 10 finance
progress tow2t"d5 the goal of access 10 basic
education 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 will
have 10 be found of retaining or munting
erose who now drop OUI of school in the
r,"t year or two of fonnal education.
Considerable PT'0KTC5S has been made in
enrolling cllildren in school ; the more diffi -
cult problem i. that up to half of those who
do enrol leave before be<:oming litel'llte (fig.
10 and panel 10). Those children arc CSScn-
tiaUy being locked 0Il1 of the 21st century.
Pioneering efforts in Bangladesh,"
Colombia, am! in many ether
countries in recent years, have shown lhat
access 10 a basic education for all children,
and completion of primary scnoot for the
g=lt majority, can be achieved at an
affor dable COSt. Using such new methods,
the extra financial cost of reaching these
goals can be estimated at approximately
S5 billion a year throughOUt the 1990s. The
costs of not achieving that goal "in be far
higher. World Bani: research over the Last
10 )'ears has demonstrated many times thaI
"/Ill produaifniy of an uJuwud wor* f= is
Ihl moll rtlioble. mgine of IrWno", ic grotJ!/h. ""
But the investment in education yields its
dividends in many othcr fonns. It confers
the ability 10 continue learning, from a wide
faIlge of SOUTCn, throughout adult life. It
modernizes attitudCS'" and builds confi-
dence in change. II stimulate. broader
panieipation in political life. It assists the
process of allowing what is good in the I\C\\'
to replace what is bad in the old. It brings
an al'.'3TCness of new ideas and new choices.
It raises the average age of marriage, makes
family planning more likely, and reduces

Lower eo"
birth Tates. As Japan's Prime Minister,
Toshiki Kaifu, told me aS$emblffi heads of
Slate at me World Summil to!" Childrm : "II
is "" aagpratimr To lily IMT TM policy 0/
prc"'()IUrg ro'urilllled lhe vtry foun-
<lalion of Japan's rkwlopmmL 1" devtloping
countries rMJim priorliy should be ro inj/ilult
and i",prow btuk tdual /ion and raiu rJu liT-
no<:y mit am""g d1ildrm .10 m To maNe IMm
To liw wilh dignily. Norio",,' """
10k. p/aa only whtn all pecpk hav< rk
Q/'POl'IU"i/y To rtaiw tducallon."
In addition to c<.:onomic growth in the
de':eloping world or increased aid from the
nations, both of which are to
be hoped for in !he IWOs, the "'sourccs for
investing in people might come from three
other sources. Thc first is IIOme dcgrco: of
restructuring of government spending in
thc developing world 10 shift rerourttS in
favour of !OW--<:t)ST services for the many
rather than high--<:t)St services for the Iew.
In many countries, for example, even a rel-
atively modest shift in this direction would
Ix: enough to invest in a basic education for
aU. The second possible lIOurCC is 3 similar
restructuring of existing aid programmes in
order to devote 3 larger proportion to the
IJISk of investing in people's health and edu-
cation. ThaT notion is the subject of the
next chapter of this report The third possi-
bility would be to tal<c full advanTage of the
fact that the greater knowledge, technology,
and communications capacity now available
holds Out the elcar possibility or investing in
the health, nutrition, and education of the
rising generation at a much lower cost than
SlIrvivcll rates in primary school, by region,
1986· 1989
AAABSTATU
Rea<:hing gr_' 2 .. 99'lII l .. 95'111 4 .93'111
Percentage of those starting primary school
who ruch grades 2 , 3 . and 41!J
SOtlTliUN ASIA
llo!aching graoe. 2 .. 69'l11 3.. 65'10 4 .. 59"l6
EA5TERNASIA
llo!oching g''<lt> 2 .. B7"III l .. 83'111 4 .. 78'l!>
Fig. 10 Disappearing pupils
Over 90 Pft'(ftIt '" child..." now uart in \he
""'IIid. BlIt do 001even ruch lhe
fourth gr_. """'t 10<1 in \he f"'lt two.
THESTATEOFTHEWORLD'S CHILDREN1992
Reducing poverty:
World Development Report
"
Tho
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\lfC0ITIIlI
by<tiredllO""" ".g odlon and IM1lhe <::cUl1:I'ies
wtic:I1 Ihio were IIIso to 8d'49Y8
t"iCt* rates d ecoooo,oic grOWl!>.
It! IhII decade 9iloa l/'e'I. ee emuaI World
Dev8l:lpml'rI! has dweIed n'Oe 011 IhIl
P'Sat1...... Q 1L poIiaos Yotic!>1hIl BonklXIfl5lllooo
8 Of 8 hi< d .. iOe togowth.
h its 1991 f9IlClII. lhe Benk relums to lhe!hemll
d <:lied JXl"fl'1Y argui'Ig fQr 00 """Ion
and _ """""'" and amtion pm-
g:;nvnes. "1tMIsIi'lg ;, peotJIe' , says !tI& repM,
"rtW<EtS_ r(JI;.JIll i1 tmns tJut i'l1J8n1-
_&<1 economic r"""s· . Tho wol·known
Q:<amplllol ol..laP;wl and IhIl of Kt:woo"8
died. And as i'I 1980. _It>eBenksho:1lMld I!"Oll
fmners with -. ku 01 pMwy ooOl!lo:wl
....... sY......1lly ""'"' prodlx:tlve. Ihe 1991 report
(J>OIes SIIdas /rom h:Ia end lhe Plilllpp nes 10
show !hal bet teN 1OI..rished c:ttilIn I1l7'"UP10be
notjo.ISI hea'tt"ieI bvI tigtw..mg iIl1ils.
The 1991 _0.. ' , ........, Rt!po#lllwetore
CI'lI'llIbJles 10the<XlIlftuIlnl:e rJQPi"io:l !haIllC(Jl-
omic growth and tu:natl -b<iIl9 lII'lol.ld be
lU$UIId and !hal lhe two 10'(1
rnrtuaIV,.. ,lucir 'll. But sticks cIoseIy tolt"otview
thai pIooo is in the -.ad 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$ii IIw!s<I
!WO dicta, !he f9IlClII \he growth reo::td
ot inci>icblI O&.al:\liog o:JulIries VIilIl lhBif
cooIo'mily 10 this EIIM:e CMIf !hi Iasl 20 yen.
T--.g price listortioos as . of 'mar\<8l
i'1wrlerenoe' and ooo:;aOOn as a Il"IElllSUfe 0(
'ifMlstmenl i1 1l"CJllle'. the B<ri: lhaI
COI.llII'es 1hiIl dd bid,' on bolh criI9:ia lJaI', on
"""ll'ag!l. boI :11% 8 i9<Jr. The co..o:1lries ...ti::Il dd
wei OIlortt one CIlteoonorly (regIrdess or vohich
onaj er-by 3.8%It l"*_80.( lho8e CO\.I'lIIies .....
'""-'l1l 10 anticipate Ihe Benk's 8lMce and
perform_1lQIlfYlI bolhoriIIri:t. hade m.dl mor<I
1",1l'96$Va growth rate of 5.5% 8 i9l<. .., other
wiKiii, i/o; w10< iiOO;; up iUca.......w;.,. moot
1IW1lhe IUn d irspert, .
Yellhs aar.. ill r'lOI 8'V<In-11llnjod Inlis !ICIUli1)o
e eese two 83Pf!Cl' 01 de\ ' • • fll)icy. Its
(;(l<"(i'ues10Dethai m2fflIIsC8IldOiI1Je
'M'CIIl\IlI'ld thai alllCQlOI l lc: growthill M ; li
IOttoegood ltoa!<rod oIlJowthvotlic::fl!he
World Bori. has assisted Inthe A-nemn feQiorl and
IOHch has beneIiIad rlililhetlhs poor Of ltie
........0lWl'lent) . Govemmao1 1n1...-.,11oo In lhu
IlCOIlOITlf, on100othllrhero, is8lw<r)<ll 1"fl\lll"ded as
gUtty \.ltd pro.eo i'nlcenl.
lNs ill arodds ..;m lhs which lhs
6aIiI row a::NocBIes. lI'ld Ihe0Cf"IlIIldic1b1 ecce-
sionett:!Ufacas. As. rtfffl SIUdy" pcinlsOUl, IO'd
8lllha Barl<iIWl acIo 'OdE "'ges, l!le state has had
atI8El'uy handin the rn:>sI ,. o::>:llmfU 1lCOl1Ol 11ies 01
lhaRilpublic
oIKoma. Ta!wmgoyerrtnrllllSh!t'<9
hllo , ::: : I prtvale enterprlsetoen<MtaI diMiiOP-
rnt>"11SIffiIeQf, They hlwe. !of e><arrPe. enacled
f\lndamenld lindI'llIOtrns. proteclllddoo ,IIlOSlic pIl)-
l1aIrs. PfOO"(lIed E: ' Ecled iro:UI;';nes.. andascrm-
nat<Kl agejns! IIfOIl8flY and IirIInciaI hoIdngi'I In
lavout <:J fldustnalllSllEts. Bo. 1 as eeB¥Jk righIty
",*,15 DUl. lI'IBir gtMlil". '1S ., goeneraI,
lM:lidod iha two crucliII the'( hawI no!
aIQwed >J pricvs lI'ld 6lCCl"IIlO go
rates; lIld the'( hawI rOCIl aIowed
poIIcias 10 De captUred lI'ld arrSt·jacketed tr,o
_......
hu previousl y been thought possible (sec,
for example panels 5 lUld 16). Put in
another way, the gap between the experi-
ence and technology now available and its
large-scaie application is an opportunity to
wring considerable social and economic
rctum$ from relatively small investme nts.
The year 2000 goals ado pted at the
World Summit f(11" Children reflect these
Aid and need
Proposition: 11Ial iro:rt= i" in/.tmQ.IioMi
aid .1wu1d be bauJ (»l <I nmailltd <1M mM-
I Utabk cammitmlnl to mUlillJ: ",i" imum
lu<man IIUIh and fDr maimaining, in dijfiroll
rim,s, 1Mpniwipl4 of <I fin! «JiIfor dlildmr,
The public in the industrialized world has
long believed that the great majority of the
aid it gives to the developing world is
spent On directly meeting the basic
of the poor. In fact, the proportion of the
industrialized world' s aid that is used for
such purposes is only 10% to 15% (figs. II
and 12) .
If aid 10 secondary education, liS
opposed to primary, is excluded, then that
proportion drops 10 below 5%. Only about
I'll, of international aid goes to the prim&ry
health care syslems which could pn:venl or
10W<o$1 opponunities and represera a
practical programme, a significant
pol itical ccmmienern behind it. for 'invcat-
ing in people' over the neX! decade. Tholt
programme, adapled to rultiOnai needs llI1d
supponed by the inlem.atiOn.al CQmmunlty,
should become the essential complement to
the economic refurms that an: now begin-
ning in many countries of the de"e1oping
world.
treat 80% of the disease, mlllnulJition, and
early deaths in the developing world. Only
about 1% goes to the family planning ser_
\\'hieh could do so mueb 10 improve
the lives of millions of wome n and children
(sec pages 58 to 60), And considerably less
than 1% goes 10 primary education" which,
liS ,,' ..e have SCCII, is both a b3sic human
need and one of the best possible invest-
ments that any country can make in its Own
future.
If a renewed elTort to end absolute
poverty is 10 bea pan of a new world order,
then the proportion of international aid
which is devoted diTcctly to this task mUSI
rise significantly over the next few ycars.
l"e final declaration ado pte:d at the
W<>r/d SWlm;l f or Child.", called on the
"
THE STATEOFTHEWORLD'SCHILDREN 1992
industrialized nations to review present aid
budgets in the light of the goals adopted.
Na tional programmes of action, which meet
industrialized countries are preparing as a
follow-up to the Summir, will not be avail.
able until after this report is published, but
""vera! donor countries are known to be
seeking 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 appropriations
in fillCal 1992 totalling some S500 million
for international follow-up on the commit -
ments made II the World Summit for
Childrm and much largn- appropriations
for domestic programmes. In AusOlllia, aid
allocations are being examined with a 'iew
to shifting the balance in favour of pro-
grammes which support the Summit goals.
In Norway, a white paper will be: submitted
In parliamau On this subiea blc ;n \991.
In Germany, an a11-pany agreement in the
Brmdl!Slng has commined the Development
Ministry to the policy that povcny aUC\ia.
lion, with the participation of the poor
will be: the central purpose of
the aid programme. Switzerland, Canada,
and the Netherlands ha"e all mken initiali,'es
t""=tIs debt_n,:licf for the speci fic purpose
of programmes to bcnefit children and
accelerate progress towards the Summit
goals.
Pwpole or aid
Aid which is allocated to meeting the
basic needs of the poor, and particularly to
the nutritioo, health, and education of the
children, would receive growing support
from the public in the industrialized

nations. All the evidence, most rttently
from a major survey of public opinion in
Au. tralia," suggests that many "'ouId
l1'\lIreh in the cause of abolishing mass mal-
nutrition, preventable ill-health, and
widespread illiteracy among the world's
childml.
It is especially important, at this time,
that this concern is expressed and thaI the
non-governmental organizatiotu and the
concerned public in the indu.miafu:ed
nations should also mobilin behind the
commitments made and the goals ag.=d at
the Summit for Chi/drm, And one of the
most important wa\"s in which that public
can contribute towards the achievement of
those goeis is through inL",asing the pres-
sure for aid to be used for invC'Sting in

'ille particular importance: of this poten-
tial contribution from the industrialized
world lies in the fact that man\" of the pro-
posals diSC11Med in this report, and many of
the goals adopted at the W",./d Summi' fqr
Childrrn, have a fundamental political
weakness. In many cases, they are asking
governments to give priority to
needs or 10 the poorest and mt influential
"""tors of society. It i. Oftl'11 difficult for
governments, confronted by short-term
pressures and po"'erful vested interests, to
adopt changes whose political Or eeonomic
benefits are often nOt visible above the dec-
lora! horizon. Making international aid
available specifically to finance such
changes is one of the very few ways of
helping to compensate for this inherent
weakness. With sufficient public commit-
ment in the indu.triafu:ed nations, aid could
culm the specific role of boosting the politi-
cal a11ractivCl1""S of programmes whose
• This figuredill.... ''''''' figuro 12 innddng<>II donor
<oun\rie. ....,.. of heiilh c_.IT<llti-lol....... ...... ..
bi-lmfil <tid prograOTVM>, m in UIing 'MlrId Bankdata
.. ........ OECD doti(ondfor 1988 ralho< lhon1989).
Problems of d8iniIion;nl incornpalbililie> of feporting
mMod mNn lha1 tigum.... approximate only.
___ <>0<:0 11000) r"' l
Fig. 11 Where aid goes
Onlyaboul 15 of , n. id goo 10hei lth ,r"ld
(olI leveb) on<! 10
0Mt 2 pm:f!1t to pntNl)' IltalthUI'e 'M
primory odu<:otion whidl on' the most 'und,omtnlal
.......us ,Of the poo< majority oIlhe developing world.
Percentage of 10101bi·lateral and
multi·laleral aidallocated to heollh
and education 1988"
1.5%
to primary
llealth care
principal beneficiaries would be the people
and the causes with the least political rever-
age _ the poor, the uninfluemial, the future,
and the environment.
Aid could, for example, be used to
case the frictions that would inevitably be
involved in the restructuring of govern-
ment expendi rures discussed in chapler
the previous chapler. The principal diffi_
culty in shifting social expenditures in
favour of the poor majority is usually a
political one; increasing the proportion of
the budget spent on primary health care
or primary education represents, in effect,
a transfer of resources from the bener-crr
aod the politica.Uy influential 10 the poor
and the powerless. Where affluence is
inseparable from influence, thai transition
will be very difficult indeed. Undcr thc
increasing number of democratic systems,
in which the greater numbers of the vot-
ing poor give them a degree of political
leverage, the transition will be easier. But
even where govcrnmcnts arc willing 10
restructure budgetS in favour of th" poor
majority, they arc often inhibited from
doing so by the pressure of entrenched
veered interesls. Aid that is made avail-
able specifically for the purpose of
in\' esting in primary health care or pri_
mary education, for example, could mean
that thc rebalancing of alloca.tions inter-
nally is madc politically easier. And it is
in the easing of such political obstacles to
essential change that the support of thc
international community could play a
particular and vital role in the years
ahead.
Similarl)', aid could help to maintain the
principle of first caU for children (page 15) .
3.'"
10 other
health care
1.3%
to population
programme
'"
to .recondary
and higher
education
0.5%
to primary
education
"
THE STATEOFTHE WORLD'S CHILDREN1992
Education:
school staying power

Tho 19f1011 walla' I bws decade lei edl.w;a.
lion. OJ! 01cwr 100 dIMIloplng<:<>.nriIIis..........,..m
by l.A'lESCO. two lIWdII Sfffl a dIlC:hl inll:<j>IlIlIi-
II.<ilOI per Irld t>Illl saw a &II in IhoI PI''it''"lioi'
of !heir ctildn:J1 nokIdInprimryschooL'
Thecaee. nrro8I CIISOO, was !he CVl in pWIIc
SPEll doIII forced on "*'Y <:oo.r>tfies by the oeoI
crisis. ill!hil1...-...s 01
"*
opportIrity to become ibnle ard to th8
bMIc _ ..... 'ry to _,_ Irld !hili'
l1OC>8lies i't the yearsahead.
A1rica ha<l baIn til !"(lrd.
.................. e>peodtlUwas cut by /III"nOSI in
tho lYst halloIlt<Il98Cls. Asar8!ll.fl. !h&proporIion
of Alr!ca's chiI\ht1 em>Ied in lhe f'o'ol 01
pri'nary Iet1OolIelIrom 84... In 1geO lO llpflfOlCi.
m:J!flfV 1Q9i, in 1990."
Deb! was not !he only cause. Educational
POIcies ond nta:nalJonB' aid po"","'"'. <XUd
hIl'I6 dooemora :0 proI«:t primry .... oratm.8o.J
100 otllf\, _ hIrY9-. deYol&d
to higher Illication for lhe 1llw ral!1ll<!tl;lr\ basi::
eQ.lcaIionb' 1M"'""Y.
EvM 11'0..91 50 or more dtilIn canbe pn:>-
..ood IOlIh Gliocatoon lot !he COS! or cniI
8<ld--.lt'oltq1 tl>o<.osardsol
l.ri.vsilygr8<ioBles JTlJSIchoose .....,.,.
nl8t' igoalioo .. mlnyCO\llb'lElll COI'tO.le
to dlMlte lisproponionalo "'6"'.. "''''' to hol;fe'
9l1lc:aIion! ' A ,elabYfll) smaI shll in IhIsbaIanc»
;;o<Jd, In "'""Y ClISIIS, IId'ioMl lI"IMlfsal priTlBry
llWcalIon IIIlll proWoo Ill.lCf1 \1OOtllr flIlIicl1al
tlerJIms In bO\I'I ec:on:::orroc: growth Irld soci8I
..,.....
AIdPfCQI'anmoo '-r8flklrcold lhe biw. Less
ItIlII'l I,", "' aid llO'" to educIIlion md I8!ls lIwl
5'" cl lhls goes toprimtry ect..ocation.'" The 19l1O
WorldSt.mmil fr;f0ltimSOI1ho1a'g9l ofllChloM1g
a basiclBveI 01 8OJcatiolI lor8l1eas1 00'll.01 dtim
by the Yl'l"' 2000. lt1a1 gooI can be mel, as Ihlt
llXli'aOfdirwym:! Lis. $ 1"" ':sorT.......1nth819708
In! ZinbBbwtI in the 1geOs ha'w9 :mwn, The
"""""Clle altha BRAG sct>ocisin has
aIao dIic'QlSlJal9d h;lI ill ei VfIY lew
cost, l e> prrMdea __lOlho&ectti'en
(In:l gi1s) \lotio hlNe diopped M 01. 01'
......... Sla/Ied... .,
Most 01 the ctildn:J1 atlOldlg lhe 6AAC8d>ools
lslllI' re;on fQnTeI ec:lI.o;alion.
8>.!! rc ee 200D ::oel
edo 'Cric>"l ... I'otoooe to 8S!UI""l a.-priorIly Inlhe
j'lIlWlIlmlOOiaIety lhIltd.
lhe la$k is rJ)t pmWfy 0IlII of t.J.*.Ing IIlIW
sd100is Irld IrlIifing newtoaclD's. is tm QUBfly
01 lhe educaIJon on oilier wt'ich wll cletermino
l!II.lC(:$SS 0< l3iUlI "' ttl& 199Oe....
S , ,,,.. "' ttl&list at PfO'narY IlCh;)OIhae
Ilhwty n>a<:h8d high IeY8ls n aI mgocns '" Il1e
<jeo,e ':pi'lllOOlld e><cepl AAIca.'" The ....,.,1caI
capacity to 8COJO" ,iOdoll" all is IIl8feIor8
no! me pr'. dpaI prot:Wn. ls el, aln"'l ", lI1e:fnlr
01 prmary IlCh;)OI voIIicI\ COlr'IlS. AAd cI the
reIiMrll age In each cooni..n. final yew
pr1naty Id>ool el 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
CIlIi:h'l n ttl& 1990s ... be I.O"iEdlcated no!
bA<'a""It'"'flidnol goto Id>ooltull>e<'a.... It'"'f
did not stay thera
lmm poo.:erty r;j !till need lor ctiIdmn' s
helpill homeIn!ill work.ttl&ITIilin"*"""lor these
det:*tating 18l8Sis 1hII '" 1hII
Il(U;:aIioo ptl)Jidad. 11 \0)0 manycases, Ih9 ......
IIf1C6....., SIWlll;:nI '" ttl& lICkI<:alb> onallof Is so
olMousI)o poD" that, lIS a 1OlCIIO'lt tJt.ESOJ tepctl
puts. .p;ntlts and r- no 0ftJ/Ilr I8IionIII
dIOictJ /han Ill.."., wIIhIhiJ6fee(' .OJ
That impUa protcetin&: the Iong-
tam inlCf'eSa of children IpinJt C\"Cn the
_ shDn-tcnn ptUIUrClI for
spmdinc l:\ItI in nutrition prograJnlDe$, pri-
l'lWy health scrvi«s, or primary e<tuCllUon.
In the same way, many of the actions nCC'dcd
10 pn:ltm thc environment and achiC\'e SUlI-
lainabk de-'dopmc.u also I
cornrnitmenl to the Iorl& ICmI wtridl _
hard-pralCd by
considenuions, filId difficult to make. Aid
can nuke thlt commitment mol'\' poUticaUy
feasible. Similar Ifl\1dlCfltl apply, in Yal}"-
in&: dqrecs, 1<1 such cumtial invatmcnO in
people as primary health can: SCfViccr.,
basic .-ducation, land !'donns, Idnndng
equality, Or govern-
ment budll':tS in favQW of buic Knica fill"
"" ,.,..
In otbtt words, the essence of this pro-
pos:al is that, in a new world creo,
international aid should be consdously and
speci6aIIy U$C(J to hdp Jlf'e\'l:DI the: Impof_
tanl from bcine l ubftmd by the

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 by unn:asonable aetitudes
towards ' conditionali ty' on cithcr
Withoul 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. That support will IKl1 be forth-
coming "ithOllt 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
to the tas k of enhlncinl the of the
pooresl, their health and nutritioo, 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 STATE OFTHE WORLD'S CHILDREN1992
The economic environment
r'ropooitiol1: 1'001 immKllionai UCMn on
tkbl, (lid, und INok ,hcu/d CTrQIt on mvircm-
-..1 in which mmomiG rtform in IJuJ
Ikwloping world am ma:wJ in aJloT1!ing iu
pegpk 10 wm .. tkcml filing.
Although average incomes have
substantially in Asia (ind uding China and
India), the 19805 nonethdcn a dij.ll$_
Q'OUS decade fQr the maj"rity or countries
in developing world. A,-cnge incomes
reU byapproxinUlldy 10% in Latin America
(and by much more among the poorest )
and 1»' 25% in Africa (whcre lnCllmes were
already the lowcsl in the world}."
In 1990, this uneven j»ltcm has cont-
inucd. Iii iIi" l8 counmes of East Asia, fit'
capita income. ro"" by OVeT 4% in 1990;;n
the eight countries of South Asia (including
Bangladesh, India, and Pakistan) per capilli
incomes rose by 0'1:' 2%. But in the
[yo'o most debt-ridden <;<>ntinents, the
decline of the 1980s has continued; per
capita incomes fell again by over 2% in
Africa li nd by o\'CX 2.5% in Latin America
(and even more sleeply in counmes such as
Acgentina, Hmil, and Pem, whkh have
IUgh levels of dcbl ),"
The economic environment within
which the developing world must earn its
living is nOI the primal)' responsibility of
those organizations and individuals who
wor l< directly with the probl<:ms of children.
But for a decade UNICEF has watched the
t1eterio....tion of that economic environment
bC'ing translated, in I1llIny COUntries, into
rising ma!numnoo, disease, and
falling Khool enrolments, Proposals to
reverse thi. deterioration would therefore
have an air of unreality if they failed to
also acknowledge the enormous economic

difficulties under which so many countries
are still labouring,
It is panicuIarly impon.ant to address
those difficulties at !he present time. Shaken
into .. new realism by the harsh economic
ride of the 19801, and aw= of the e"peri-
em:e of Central and Eastern Ew'oJ>e, many
if not most dCl'eloping nations have begun
10 adopt the kind of economic reforms thai
could bring prosperity 10 their
peoples in the yean ahead. This change in
attitude and economic has passed
almost unnoticed in a world pr=ccupied by
more dazzling changt (although somc com-
mentators lut\'e noted that these changes
reprc$CJtt II "q'<kt m>oIurion" with a "poIn1-
tiaJ for advw,cin,g human ••It!l/aT/! IMI "",
_MY But it is an
oppommiry not to bC' missed.
At the moment, it is unlikely thai this
potential will be fulfilled because too many
of the factors which brought disaster in the
1980s arc still present in the 1990s, Even if
economic policy and management were to
improve, the problr:ms of external dehl, of
declining terms of [)';Ide, of prOll'Ctionism in
the rich world's markell;, and of excessive
miliUll)' spending, still n:main. In ether
words, the deve!opil'g world "'ill lind it dif-
licult to fmd a plae<: in a new world order
because it is still chained to the mistakes of
the old,
World prices for raw materials, on which
so many developing rounmC'l arc depen-
dent, remain at their lowest levels since the
depression of the 19305, In the last decade
alone, the price that Africa is paid for its
primary products has fallen hy approxi_
mately 30% in relation to the price it has to
pal' fOT its imports.
The degree of dependence on such com-
modities, and the steady deterioration in
their rdIl ,'lllue, ill one of development's
most intranSigent problems. And it is going
to get worse. As new t«hnologics, synthet-
ics, and management systems continue to
increase maoufacrurin& efficiency, fewer
raw materials wiD be needed. And in the
l'eal'S ahead, the increasing usc of biotech-
nology could further undermine the trading
position of agricultural raw materials.
It seems that there is link the developing
world can do to prevent this steady erosion
of its prices and markets. It can attempt to
coordinate production, at least regionally, to
avoid dep=sing prices funher by cverpro-
duction. It can also anempt to strengtheo
its Oll, n research and development capacity
for proccssing more of its own raw materi-
als into semi_manufactured Or manu-
factured goods, But at the s.ame time, it
must attempt to diversify i15 exports to
reduce ill dependence on a crumbling
ecooomie base.
Tht: problem with divenification of
exports is that the indllstriali7.e<l world,
which so enthllsiastically urges f= marka
policies on thc d",'eloping world, protects
its own producers by surrounding itself
\lith tariffs, qUOtaS, and subsidies which
effectively close the rich world's lI1l1rl:ets 10
a whole range of possible exports from the
devcloping world (including a wide range
of agricultural and tropieal produce, steel,
textiles, clothing, leather goods and
foorv.ear).
Estimates of the COSt of such protection-
ism to the developing world "ary widely,
bur the total is not less than SSS billion a
ytat'" - mere than all the aid recei\'ed, A
dismantling of those tariff and non-tariff
barricrs wollld, according to lMF managing
director, Mjchel Camdessus, raise the
growth rate of del'eIoping countries by
nearly 3 percentage points, so yielding ben-
efits l:QuaI to twice the aid urev recei\'(C,"
Fig. 12 Aid for basin
fhI! twf/ve indUltNUZed (ountrie! rOf whkh
InlonNtion I, ""alloble giveabout 9 "'1(""101
lhtir 10110dir«tIy I'IIel!ting the most bask ~ ,
01 people In Ihe dewloping _ ,
Basic needs ' allocation aJ percentage of
folol aid, selecled donor counlrie5, 1989
• 'Basic needl\PCOdlng' II df:Ifned hmoa,
expenditure> on ""maryt>e.ollh caP'l' , ""mo'Y and
SKoodlry eduutlon, ramily planning, ~ n d ru"r
watt< >UppIy and oanitation.
__<><<0_,""" , ..,
THE STATEOF THE WORLD'S CHILDREN1992
South Korea:
more education per dollar
"
n. rT"Il:-t -"'''''''' 'C1' deiOl"l8tor of l!>e
........ III.lCC:IIa IIIOries • Hor9 Kcrtio JIIplwl, ee
.. Swl/'lKcne.. T...... -eece
IhlI welIIh rJlhIli' _ IllIl;U'C8I tu,.'MIIIfth
01 ,.,. l'u'rw> f--..olIOJ. Fram \IlIo __tI8gRS
d tc(lI(),1i(; de< ' p,e.... QI....", .... !
'-"'I' 'n'"canon.
"'b-'119501.
Kow...._ ' b".at..-=o'ld
hIIIldIN-.uy. • t.. _n
_ .... _ . Wtne. lis 'iI' S I

i ... __.
Y-.l7r .....,.19501. .........., __
two Of ... In-. l'qllr (:(Ud be
.,. !WI let &co.r4ty-..GNPd
c.pU. Arcl bV l lilll. ,.. .. lXUlWs
_ o,1ie llIk&-oll.l107' III d'UW'I __
Fog gm'Wy KI'lIXlI Ir'd tn1IWd __P"G
on 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 ltWl
p 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 '11
m:-. .......... ....
.. • ..n
Fir.. pei\i'.' bolt> -..:l WId
....d&d on • ..- IlXlIIl • •• " b'
........ IIflIdI •• I rlIll • ..-v of
_lID/lIV. From 195010 le7S. ....... ..,
_ pidold '4l ........ ,.-,
...' Ilk
In PlI'I. lDmakB oaalfIoBIecItI'*
lvm • 2.000 yM' -oid CC:nII.cia1 lrlldition III re·
'P'C! lor 1tIIl.,;lul;:r,*l1*WOJ\. 'n;:.t"" ton
oIlhe IIlIA wcri:I\Illfll't::IlJti(:J1 lhlll ec:a ''''
_____• t ' i.edlt'O'flbot ........
.... ...
SCo"O. -. paley - t i ..... _
lersslnCl.... 31" 'j' ilMll dtfflD'II
lTOItoltl-...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..... .....
...-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 ....... ,

WI\tI ,... ...,.ies. 10 nuic. tnd
TileCIllirS dlllOOI hiMllOWf¥f'/
IIllool dii::IPii ... tnd lhey ....e co' .... lStIIed for
Iow.....t¥hql -...
FcuI\, SculIII<crIe clIcid!Id on • .,...... ",
80*'","""" CWO,I(llIIliI IraTI one 10
h -. .. .. ' , ' 1(1 <:o:Ju*iI&, rruch
pm-.y ICflOCl (lIllIICIfy • diIlocJlIId 10 -'-"'
...,1O ...... Of_ ..
$l:Ulh K<ne. 11-. .. ehIoIt 110 ' II: ' 'I Of
o..... , I0 .......
10 "" 1>.1-.10_01.,·· ,
...... ,...,.,.", -*y.
l'i-iIII' , .
_lid101I'lII _ pr8Cbol )\I<iO'V....
• lor__ uIcn. TliI ........clod.>-

....""'*OOII"V'" -
DimIantlin& such Iralk baJricn, t!lrouIh
a SlIlXft·fu1 completion ol the Jlft$ml
Uruauar round ol I1Ib undor the GmeraI
Aareallelll on Tariffs and Trade,
thm:flll"l' proyidr mud> llCC<kd ox)"ICI' to
the pi ........ of cccnomic mann in lhl:
dc.clopini 1O'Orid..
"",
In addition to lbesc problatu, lIWly
d':n:lopina nations are prewnle<:! from
moving Iorward and taking did. place in
any new world order because an: held
back by the seemingly immovable ....'eighl of
lhcir de bt .
In total, lhc developing world O"''a
approximately S\ ,300 billion to govern-
menu and banks of !he industrialiud
I\lIion$ and III international fllWlcial insriru-
Iiont. £ad! )'ai, the: rcparmem of capi(al
and inleltSt amounts to apJIf'lDimatcly SISO
bil1ion - 1'OUibIY thrco: times as mudt as the
worid rroefo,a in aid. A5 il is
impon,'Ne III IIXIl:( tbcse i=dwJa in
ruB, lhc lU1lOUnl UI'IPbd is added 10 !he Iaa1
debt 10!his WlII Y. thc: debt burden has
pdv:t-cd its 0W1I Dlonleunun which hal
tUm it tll !he p<lim lrilcrc noI only can the
debt _ 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 to
bWnc as irTaponsible borrowint. Scc;ond,
il is not llCting in good faith 10 llrIC' dcvcl .
Clping C(lUnmc. to earn their .....y out of
the crisis by divm;;fying and exportina
moR' orhik al tho: AmI: mairnainin&
lariff and other tnde whkh pre-
YmI. the dtio"'dopina wortd from Incce..
fuDy foDmtting !his ad\ia:. T1tirIl, the
am:ring indmdtW blnkrupu:y and debe in
molt industrial eounlria act limill on cred-
itors, IlOl: aIJoy.in& so much 10 be:
as 10 Ica\"e the dcbtoc unabIc to feW his Of
her family OJ ('VUl. 10 afford the lI'ICanI of
eamina a living; il is time !hal lhil COfI«pt
was applied to international uansactiom.
To lJK)',"e forv."ard, the world
dnpcntely needs til invot in ;11 infrasuue:-
rure, i1l indusaializarion, I nd its pcopk.
When its raw materiall cllTlin&t ue ;n
decline, when inlCll'I1 on ilS debu
I bsorbs a quarter of III ill eaminas, Ind
when new export I n: closed. by
protecti onism, then these cssenrill im"CSl-
mcn1l in the future limply CIIUlot be made.
FOJ 1C\"CTllI d«adcs, the dt:\.cIoping
world has I1so been Ibk to count on aid
and concessionaJ. finance for I I kUI a Part
of the in\-emnml il needs. BUI the debecri-
... bas now n:acb:d such I poUll of
absun:lily Dt L'lc I\lDons In:
lining ttl lrIDSfer fllllDCial to Ihc
Dxhmrializ:cd IlIIion1 rather thin 1bc otbcs'
...y round.. Wbo:n all lrIlnaCtioorI In: takm
inlO account - !he ImOWII that all IICJUIU:S
in !he induRriaIizcd nationt lend to Ihc
OC\ dopina: counlrics minus 1bc amoutllS
tIw the dt:\'dopina counlrics Ply bKIt in
' .....1S of capilal. and inlCRSl • the neI
dfm is thaI the dc-.'dopinc ",,-orId is oow
ll"Imfo:ning SolO ttl 550 billion I ynr to the
indumialiud (fll. \3) .
It ....ill nnl; be l;I$y to l'C\"tnC !his fmancial
!low in 1m earl y 19901 ....ttcn inVCSlII1CTli
finance is liI<cl.y 10 be in shon supply. The
.,
THE STATEOFTHE WORLD'SCHILDREN1992
Baby-friendly hospitals:
a million lives to save

I'M lrcm ,.,.... oA hcoIP\aIII
ttm:qIDUl lhe v.ortd <;(l\j:j teve e by !he
/rorII . 'b.lCe • 'bIrly.lIlIndy',
n. kl8ll it Ihe eres. aMn::e L'I • dIc8:;IHlnQ
...'.....,'10lXlUlUlt' IhII """ towerdI
--
ill _ i ii< . fTQlI _
"",-*, - ii ' ... ' • __..
..-moe.. • ...'r--
.,.. ...01_....,.-Ion...-.:-
0IiIlliII1I ... to F '"'-da:tI cl •
_ ......
III \IICltI<,...-.;n t :car.»K-'.iI-
trd men _ ' i ... ..-,._
fId'9 it ..modlrn Mr.
hnl $ll
". 11 oIIIn _-dl.Md we. _ .,
...-- bclllla So • I*lI' ., • POOl
eotmVlty_ tw,o-,15_mortIIo:eIy1O
It.tomdIi 'I '"'" men..,.
10 <ill frompnounoniI. Itoon • bIrly _ it .....
.., l..e J!led,- WI«) 8Itlr!'el. 1Nl
men IIw1 ....... d'tieo' ClllJd t.. _
-., V- I .. IIllllhIQ ""* tlOIliIs roo\tW'o;l
1M b; BBI ,"I<:< !he fa-sl W 10 "" morwr. of ile.
r.... ago. WHO ...., l.MCEf drew up.
'code d pr8dIce' b Ihe 01boll l, iI<
._... The c::odR .,.q,c 10 tIIo'I II p.bIc

J\br,oo, INf'IIO... ll"' up
••• •••
__doil'll'''' ?
B,"' ID rrA:r-.oIlTlClhn. k'd""*
In " hi ..ton...bd'I CII'1 dICiOI"",,*,-
' .,. bt l 5 I 1lI: ..
....., NACA:'* 1oXllly. I I' .... Iclt ..

__ .. tlI1I\. I I .. ' _ ....... _01'*>
fil"WI _ • •..-.. crdIf' 10p G' '''
llI'Ir'td oIl1l1n1lcrn'la.
lhe.-c:x:w_out.,..... SlolopIIO S< : •
III N. """'111 IN code
wil bIIlleIV OIled '1J8Oy-f\ien<tf. lhIIl0__....,
1. _ . wrItIIn to_I_ \!

2. '*' .. te.IIh _in.""'IlO"'""- *,,••C'iii pcIcv
3. ....... II po""' .,.,... h ....
and"• ..,.. ••• oIb 9
• . .......... iQWilI'Inhlll ..
--- 5.. "..., •• _ ICl to h*d, .-.d "- ICl
" ,.......'_ ' I!'W\I -.cucl t....
tgm"..-.
&. gNel. W" ........, laodOl<i'ri<or. _
b ,....
1. pr8dill1UOI'1"",," "*"" "r::cr • •n ....
110_iUijid.) htu'i. doV
S. ........... bt .....iQOIl' .. ""' .
9. Il'o"' i'IO -*'II _ 01 CIIIild
0' bo f "..:llill inla'U
10. toeIa" !hi 01 b" tfell(jl\l
IIIPIX'1 Qi'CII.C» llIId reIer moIhoinI 10 ltoI!irn OIl
disc:hage from '"" 0' <:::friCt
Manyworneni'l tnfd6' :
I*1h .. I .. t, Thoee..no do _ It<<i
b <TIf 481lCtn. So !he WO'ktM:le 'b!II:Jt:""""
to.. ,* t ....,"*9. Iln:hed i:lV lNCEF Inll
VM:linArNrl",frid,. 1991," ar r:ri1t.__
""""II ..... _ 10 po..,.... bt ......,.
McJIte:If-.d lhI all...-• ...,..lIO
gNe" bIt*..bt!It Pi'" "'*-1: Ilia'
.. 110 b ' .... It'll' wi! ... '-'
h IUJll101 tJ ndI I,nCIrI. QCm:

Wl* .. G "-' _ .. bIibJ-"'-'dy
I'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 1Mn d l\1ln.
Soviet Union, iIC...craI of illl Republics, and
the nations of !::astern Europe will aU absorb
wst amounlll of investment capital. AI the
same time, reconstruction COSIS in Kuwait
and [raq arc estimated at between 5150 and
5300 billion." But only by a mOn: dTastic
resolution of debt crisis than any $0 far
proposed, and a reversal of nct financial
transfers to the developing world, can much
of the dcvctcplng world hope to n:gain me
ground lost in the last decade.
If the ....·ars and means can be found to
CUI natio,," free from thill l.",den legacy, then
Disarmament
Proposition: ThlJl a prow, of dffl,ili"'ma_
rum should btgi" i" w. dewlapi"l[ world o,ui
I1ltU, in sup wilh lhal p1'OUSj, faIl,,,! ",i/iUlry
apmdiluns in W. i,uJ",lrialized "",it""
lltould be /i,,1«d 10 signifiwtU ,-"=ases ;"
inumammal aid far ckwlopmml and for
me/mitm of """,non gWba/. probIeml.
Military spending in thc dcvelcplng
world, although vaf)·ing widely from region
to region, is running at approximately SI 50
billion a )·ear." [n Africa, a contincm still
dcspcr:lte!y poor and despel1lle!y in ntt<! of
diversifying and industrializing illl eamo-
mica, one third of an the maclUncty imponed
each year is destined for me In the
the economic rcforTrul now in evidence could
coincide with other favourable drcumstences
10 aUow an unprecedented period of gl'O"1h.
As the World Bank's review of prospects fot
development in the 19905 has said: "The
l1f>PUrTI",ily for rapid dew/opmelll il fmlUr
today J1fil1I al any Ii"", ;" hislDrJl. f"rnnaritmal
links, in w/om! of lTlMk 0JJdflow' of ;"fomw-
tWn, imJeslJHl'Jl' ",ui udt,"""'gy, IIrt
""'" dum fimy yoal"S ago. M"dicirw, uUna,
and mginemng """" all mad. grtQl SlridQ; W.
all' (luulabk And fJO/icJ'
mm.m """" a bel/no undmranding J1fil1I bef"""
of 1Moprilms for rkulopmml. ,,>,
developing world as a whok , ju.t the
import of armamcnlS absorbs an amount
equivalent (0 75% of au !he aid received."
In general , it is in me very poorest coun-
tries where .pending on the milimry ill
highcsi (f'i. 14) . The 46 least developed
countries - the poorest group of countries
in the world - spend as much on their mili-
tary as on health and education
combined.
The cue eo'lS of this massive military
spending, year after year, go beyond the
destruction of war (panel 6) and the
divenion of SCllr<:c resources. Stimulated
and sustained by superpower rivalries, a
"
THE STATEOFTHEWORLD'S CHILDREN1992
China:
reaching 90%
After .... eIlort ... lhB 1980&, the
largo! 01 t!le"""""'fschildren by
tIlI'* fnt biUidaJ'S hall been rtlllC:!llld by most
countries. 8uI is not 1lIlllU\1l.
...oIl '-to rlsa f\rthIlf l <iseas<I b81 "" Mb, isto
lXI o;fsIupIed. measles <!elms areto tal by the
QS%. rdOis tobe erlrlelI!lld. l eee-
natlll llllllnUS;,,1Obe .......ted. and l lhll poorB!Il
and m::>st ct'tien .... 10be ptO«lCtoo.
Ttat 'tItr; ee!'\':n:tS::,,,nii!()r e:lCP'.e:!
!he """'" latlJ8l 0190'11> iT"m.ri1;Ilion lXMII'l'Cl" In III
CI.UlU'oes by the yew 2lXXl.
llJI(l !V$18io"Ir9 lflIl extnI 10'lli vM
proW'*"'*lISbig a1aSI<lor Ihe 199011... react'IIng
80%wasto!tle 1900s. Bullis feBsibilir}' has l!IIready
o:leo,OOO OSI r'llled inIh8 world". most f4'" .....
-In 1985. Q'Ii'Ia selltgeIIl!le lagel oI,_Hllg
85% of III - i'l lIle nalic:n as e _ by
1988. ... (MjI('f I"'l""'CO by 198!1. Md i'I tN&1'J
<XXrty by 1990 . Today irnrruization ClCIWr8O!I II'I
Ct*Iio. 8Irn::Islit !l9%lor 8CG""'OOt>e. !la'll. lor tIlo
I!YfIe """"" 01 pc*' YIlCCO'1e. 91% fa 11>0 _
ooees01 [pT. 8nll1l6%lor lfl!I!lrlI)I&measles shaL
Tl"e _ ..... atDIIdY eYidenI In a "enp tal In
lhaf'UTiMoIrret5Iil6
cases,lor """"""'. has atlppodfran <Mlf 2 ".",
a \$.""tolas$lh;,in l00.(XXI. PllIIo isa>:PllCl9d 10be
eoll<laWld by 1995."
lha_ lor IICfYIM'lg \lO'li, ha!I beo<llhBS)'Sl1llTl
01 -Vbir1h: tal docla's 1hefl rcIiIy
III PIQ"llS. EMIly line me int80l is ()J8
lor..aeeiNliot\. Many00U"IlrillshawIlIC!'IieWld 90'11>
coYllI'I'I99 lor the o:bse of OPT(It JX:6o (lI'iy to
Ial IJeIWld""*' do 00l rel...... lor me secco:l
Of Itwd doses or lor !he U1gla"""""*'" iiecIion at
lhBage 01 rIne monltIs. In 0:W1a. lhII
notIicaIionsyslern moonsthaidrop-oul ra!elll'8've
been reWt:ed to less
In lIbOuIa tfi1:I 01 an'. COU1!lBs, Ite S\'SIIlm
is ,,,;, ofuo oed by51 ' 1rmu'IllIlI;)ncontraeI ' . Pa'l!f1IS
P8Y a <nHlII' lee as soon 8ll a cHd
is born. and 1MguIlr.ltltooslhB cHd III ..... f
._lito os. 1hereaIter, 1he CIlild contJ1lClS 8IlY
VBOCir&pruvmtabIe dsoosiI. (he taniy rec:eMls
m.nciIII cornpensaticn."
Incrfmf in immunization COvtrage, childrM umkr one, China, 1986· 1990
'"
"
es
" ""
- - BCG
DPTl
- Polio3
--- Measles
milif1l)' culrure has come to predominate in
many developing nations in "",ent decadcs.
Such a culture rends to be contemptuous of
democracy, indifferent to human rights,
and threatened by political, pcnonal, and
press freedoms. The total military biUin thc
de,."loping world woul d therefore have to
include the direct destruction of war, the
divernon of resources from investment in
people, the undermining of democracy, the
growth of intemil oppress ion, and the
SQUllndering of much of the support for
development among the public of the
industrialized world.
With the ending of the cold war, hopes
arc higher than for a generation or more
that this biU mighr soon bereduced.
The industrialized world can do mueh
to hel p. It can convert military aid into
economic aid in the interests of both peace
and development It can rclItriet arms sales
and try to prevent arms suppliel1l from
expanding sales in the developing world to
compensate for declining markets in the
industriali zed nations (the five permanent
members of the United Nations Security
Council account for 90% of the world's
arms sales)." 11 can also begi n to insist
that debt relief, aid, and new loans, be tied
to red uctions in mililary spending,
progress toward, democracy, and invest-
mentS in the infrastructure of health and
education rather than in the infrastructure
of war .
But the current disastrous levels of mili_
tary .pending arc the one wall of the
t'Conomic prison thai it B within the devel-
oping: world'. own power to push back.
And nothi ng Ie.. than a mll!;.ive pro-
gramme of demilitari7.ation wiU enable
many of the developing counaies to fulfil
thm potential of the years ahead.
Demilitarization i. easier said than done,
not least because of the shCCT importance of
the military II!; employer (there arc eight
times as many soldiers in the dt\'eloping:
world as there arc dOClOrs) ." To Case the
transition, and reduce the conflier bctw«n
military and social eKpCnditwcs, more
thought might be g i l ~ n to the potential role
of the armed forces in the war on poverty.
It is not uncommon for the military, with
their organizational capacities, their skilled
personnel, their rcchnologies, and their
tnlIIspon, to COme to the aid of civilian pop-
ulations in time. of emergency or natural
disaster. In the process of demobilization, it
may be useful to extend that role by trans-
fusing the skills of the military into society
through the construction of infrastruClUrC
and tlte training of civilians in such areas as
literacy, engineeri ng, electronics, mcdlanics,
and communications.
The conversion to development purposes
of the massive investment in, and the
resources and slcill. of, the anned fOTCCS
may yet be a long way down the TOlId. But
were that journey to be mken, then many
nations would find themselves ahle III
march more quickly rewards a more PTO$-
percus future and a more dignified place in
an e"ol"';ng new world order.
The indultrialized naooDi
In the industriali:oed nations, whose
annual mililary expenditures arc approxi-
mately equal III the combined incomes of
THE STATE OF THEWORLD'S CHILDREN 1992
the poore$( half of mankind, arms ,pend-
ing hu fallen by approximately 3% a year
for the last four yean. Following the dra-
malic disarmament proposals announced
or agr«d to by four of the five permanent
members of the Security Council in
September 1991, even largcr culS may be
eXPf' clcd in the ~ 1 ' : a r J ahead. Three quar-
len of all the industrialized world',
milhary expendltuTCs of approximau.'ly
5800 billi on a year are cum:mly devoted
10 me defence of Europe where me mili-
tary land scape has been transformed. The
potential for cuts in the 1990s i, therefore
enormous.
Hut what is missing is any coherent and
agreed pian 10 link even a small part of
these potmtiaU)' vast savings with 1M del-
pcratc need of the dc\'Cloping world for
renewed aid and invcsnncnL The aUocauon
of cvw S% of =01 milirnry spending in
Setting Africa free
Proposition: TlJaI lhe dwim of A.fri<.a'l tkbI
IN. Jlrudt off and lilal 1M Clmfinml be givt.,
mfJi&im1 a wnal support w allow i"fn7lal
rtjrmn II' suand i" rtgerwo/;tlR ~ mqmen-
fUm of dewlopmetU.
For mc fIr!lI timc in me modem era, a
subcomincm is sliding bac): into poverty.
The number of families in sub-Saharan

\he industrialized world would be sufficient
10 allow a doubling of aid budgc!s (0 the
!lIrgct of 0.7% of GNP, - a tatgCt that was
first agreed (0 in the 1960s.
In particular, a proportion of military
savings should be allocated to achieving \he
basic humaII goal. agreed al lasl year's
World Summ,i fot Chi1dretl. As a reminder,
\hc flnanclal cost of reaching all of these
goals - induding drastic reductions in mal-
nutrition and disease and a basic education
for all children . would require additional
resources of approximalely 520 billion a
year throughout \he 1990s. ' rnc dcveloping
"'orld's proposed oonUlb utiun of tWO thirds
of ihai amouni would require the allocation
of approximately 10,," of its current military
expenditure. The industrialized world' s
one. thin! share would amounl 10 I"" of its
milillu'y spending,
Africa who aTC unable to meet their most
basic needs has doubled in a decade.
Avemge incomes ha"e fall en by a third.
The proportion of children "' 00 are mal-
nourished bas risco. The proportion of
children who are in school has fallen. This
year, drought again threatens 27 million
peoplc in 14 counnies. In lotal, 40 million
Mri cans are now ' displactd' b}' mili!llt)'
conflict or environmental disaster. And as if
in a frnal ane mpt to brea k the spirit of a
continent, almosl 3 million African women
are also infected with the AIDS and I
million childreo been born HIV posi-
tive; in the dCCllde ahcad, it is estimated
that 2 milli on children will die and 10
million may be orphaned by the disease.
lDtentaI nalon
In addition to the economic losses and
the eonfliets caused by apartheid, the eeee
principii internal reasons for Africa's
decline arc economic mismanagement,
environmental degI'lldation, and milillllj'
conflict.
Autocratic governments, indlicient .tate
corporations, larglMea1c corruption, unpro-
ductive investment of aid and loans,
distortion of prices, markm, and exchange
rates, lack of in\"CStmenl in food production
• all these have been paid for in the falling
living standards of millions of ordinary
Africans. And most of the victims have had
no sa)· whatsoever in the political and ceo--
nomic decisions that have led to the decline
in tlIcir incomes, the rising ",,"I of their
essential purchases, the absence of teachers
in thei r schools, the bare shcl,·es in their
health centres, and the increasing malnutri-
tinn among their children.
Meanwhile, the effort to mel'CU(: agricu1-
rural e"ports hal; claimed the most fertile
soils and pushed desperately poor and ever
growing populations onto ever more
marginal lands. The result has bee n the
o\·CTCUlti,·alion and overgrazing which have
led to the l,nIgcdies of soil el"O$ion, falling
yields, mass hunger, and mass migration to
the refugee camps where the problem Ilnally
becomes vi.ible to the oUllide world.
As. if these trials ""<.:1'C insufficient to
exercise the talents of government. Africa
has aIio been a theatre for long-running
wars and frequent coup, d'iuu which have
Fig. 1J Revenlng the flow
The w n.\hoWl. the lid \"nsfffl b8ween
InduUtiali«'d and """r tM lIIU
deu<lo!. 'Net [I,n>len' mo.", all loan.. k:>ng.term . nd
!I>o<I term, publi<. . nd privott, minu. oil int......1. nd
"" pltoI ""yrnents on prcYiou> 1000$.
Net finom:ial uamlers betweendonor
and recipient coon/rie5, USI billion5,
/980·1989
to
developing countril!$
t 1980
1985
1989
from
developing countries
..
THE STATE OFTHE WORLD'S CHILDREN1992
Supershots:
children's vaccine initiative
3 ...", cHd daBIh!IllIlI rlCM'
bIIing llf"!"6"lled each year by i'IYnrizatIorI. BuI
Ihill IepIl'IS(II\tS less than a IIWd of fmuizaIioo's
poIenliaI oonlI'tlutIor1l<1 'MlfId 00Blth.
Two ........ ctti'tIn ci!I each 'r- be<al'lG!tIBy
t>eIDng toIt>e 209j; wI>O 8<fI still rlClI wittl
a.nar>ltt """"""lIl A !unIw5 to 6 miIion
people die .....-....ely !rom d 5: ; : 51 """'=" eece
llIrnosl ca18inIy be by tre doM!kopnilia
of ...,.... vae:dr'tes.JI
/he ChithJn's vaeen. In/IiatNe. ta.nchad boo
.......... ,.. ..... ...... ,.. ,.....,., .. ,,_ -........
,,, ..... "'..... "'.. " ,.."..... .. '...... "''''''
aims to .-row INs Q8Il bel--. the aetu8llW'Id
POlW"IIiaI CCIl'1I:ributio of inrnurilaIion
14. present natlonaI chikl ITmnzaIion
gnm-nes ס Ylt'JCi>ee againsl !IblIrI::uIOSis
diI:trttIIlfia. fda. v.iooplllg Clllli'J'. and
m ':. wiIt1 someCOI.W'!lr'Ies Biro oIIlri'lg ye6:Jw
lVId, mora Ole
(lllteel s
is to llX\lWId ItO:o ""'9" to inc:UloI _ dallkI
vaccines rI\ilIIJI'e (cl.mndy "*"'" Wf!( 1
"..,., Nric8n ct1iI:hn """" YIBI. """"",t<:<y
In1ectrlns (3 "..., chikl <lolaIfllI a j'tlIW). 111IlI 1iigiti.\
oerIlIin_·S
as fOl!rVinJ!; (8CXl,OOl de9I!ls a .-}. as I\GI
lIS hepall!isA.""""'"
In;! AIDS.
De. !,_1\1 the vacdrIes is h!I/l1he batde. Then
come the Iogoslo» pooblems 01 ...........-.g wI<ltt-
spread use. Today'! veccoes eogains1 mm';!
polo. ......... bII k.apl
,eiigelated!lom POflI of manuIaclure to pginl of
1r'ieC:tQl. eeerooui'es lcu'or1Ml
' 'lEICIiO' IS dlri'1g "'" Ibl yearof """
lhildfop<llllatebet...-.1h9ht and ilJection
is1llernai'l
/he CN:nIr!'s Vao::nt In/Iiati>ol lIIbo am. to
lrin rElClll1l In biotootJlOlcg)' 10
<MJrCCmIl some at ltleSe po 0IlIi0 los."
1$<'ON p::>sslbIa to.lCO/pol alol....,.,."......ccinoo
onlO OM eaniolr:" Vaecms e:I"l also rlCM' ee
packaged n .... wI'ic/'l releasil !her
comoots ....... trne. lIiIIw 17aduo1v or in pUses.
IwJ !ItlDIAd IlIso be p::esllle to mBke mosl
""""'- less dopoIndIInI on ,«. igao aliooc
Tho POI 01 gctj aI till! ....-.d 01 Ito!I 'i 5 d ,
rartxNI is B singIo-slnI '!IUpIIf wocine' wI'*:h
<.:><>Ud OOgMlntochillhlosoon oft... bnhand wI'ic/'l
W<J\.Id pru!tlCIlte'n ltgIinsllll oIlJ ilJo.xx:fsn1lIP'
lnIeclions m-Vlow COSI.
n.n gaO may lIlke two deeados or """' 10
&Ii n.U:d•..w"gy h ...... ,00."" and
\hle-, :' . '" VllCCines is 8lJlo8(ly 8YllieIPJle. By the
endof!hilldIc9de. tna)' be possille10ad! rIii ;mr
III 01 to<lay's "llCci'wiI sirlgIeiieCIiOr'.
By tl>!I mid-l990s. toohooologl'
c:o.Jd 8loobe i'rm..rWtioo. KX'M1 in the
MlI'IlI 01 its talU'e - !he JlI'6'9"IIioo of
neco;lllllteI8IUI wtlich klIs lin llSIinated 536,000
il1allslW>:.l anlIlkr'lOwr1 t'UJ'Cler 01 e-9Y
_ . The .-.bOrn CIliId ClII\ be protected bl'
ilmriMg the moIhllr. EklI1Nll .. SllYlI1ll
i Ijeclioi os e--tiTle (Of, two_spaced
ir1e<:tIOnS firill and III present, less
!Ilan 5O'If, 01 ""l)'TlEIIl ere prcI8Cted- A.-tme-....
_ V3CCII'8 roNlftl8r dIMIlopmo<ll oIhnlIi>QIe:
SIJ::It protec'.ioo end c:o.Jd IllfJicIY raise """",age."
&an 1I>ese.- lOCh iOlogiea leave rntJnI prol)-
I8ITOIS lnSC1Mld • how to t:mg .-vaoc:ines i1Io
end inexPeNMl how to
prodI.o:bon Ind <:lUll!)' CCW'JtrO', how to
speed I.l:'IIeId trBs and k:e ... 'll proc:eo::Ues. l'llll
01 __ PlIIboeo$lipwilbeneeded
berween go:MlOI ' IellSIWldthe f800lItCh enddlMll-
opmant 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'roiIts
01 the richi'I8lIO<lI. ., !he on& 01 the ITlOel
<illic>A wll bit 10.... ltlal -..ltMl to

lUiti8s, 01tl>!IpoorWOlId.
been pan cause and pan result of the fact
thai Sub-Saharan Africa as a whole hall
been spending two and a halftimes as much
on its miliiarY as on its health. services.
&t enia! ftllSODI
The three principal eXlernal reaso"" for
Africa' s decline have been the use of the
cominem as a board for games,
the relative faU in world prices for il$ raw
materials, and the unsustainable weight of
il$ debts.
Much of Africa emerged into indepen-
dence just in rime to be ....'OOCC! by two
representing rwo competing
ideologies. Long perceived by many African
leaders as an advantage, it is elear that this
superpower rivalry has in faa made a tt'2gie
contribution to the o\'Cmlilitari7.ation of the
continent and to the emergence and perpet_
uation of the kind of military and autocratic
regimes which have led so many African
nations imo the abyss.
Economic dependence on raw materials
has been a quieter calamity. The majority
of African countries havc been urged to
increase their earnings and pay their debts
by exporting more of their primary com-
modities. The response has been a 25%
increase in the volume of erose exports
during the difficult decade of the 19805.
BUI the steady faU in prices for Africa's raw
materials, in relation to the cost of its
imports, has mcant that its have
fallen by approximately 30% in the laSt 10
years."
Ancmpts to from this tr.lp by
d;'-cmfying exports have quiddy run uno
the sands of tariffs and quotas by which the
supposedly fm:-marl::et cronomics of the
Unite:d States, Japan, and thc
Community continue to protect their own
producers.
The third external factor in Africa's crisis
is one which represents one of the greatest
international failings of this century.
A nCWslavery has shackled the Afrk an
continent and its name is debt. The coun-
tries of Sub-Saharan Afriea, including
most of the world' s least developed coun-
tries, now o....-e s total of approximately
5 150 billion. Each year, Afri<."ll muggles to
pay about one third of the interest ..... hich
falls due; the real is simply added to the
rising mountain of dcbt under which the
hopes of a ccnrinent lle buried.
The total inhumanity of what is now
happening is reflected in the single fact th.at
even the small proportion of the interest
which Afriea does manage to pay is absorb-
ing a quartcr of all its export earnings" and
costing the continent, each year, """" Ihon
iu total sfi't7lding "" dre health andMuastilm
Df;/j ptopk (fig. Il).
To date, the results of the Paris Club
debt re-scheduling exerd sc and the
Toront o Agreement arc <:TItirely inade-
quate." Exeluding Egypt, the total of
African debt written off is approximately 57
billion out of thc S280 billion owed. The
consequent reduction in interest payments
amounts to about SO.2 bill ion out of the
S32 billion falling due and the 512 billion
lICIually being paid each yelr." Between
now and the end of the century, even the
full implemcntation of the Toront o Terms
is unlikely to reduce Africa's outflow of
illlerest payments by any mon: than 5%."
"
THE STATEOF THE WORLD'SCHILDREN 1992
The most recent debt reduction prop-
osals, the Trinidad TCrTll$, still do not
represent even beginnings of a ,.,lulion
commensurate with the scale of the prob-
lem. The most generous notion on the table
(and it is a long way from being
.....,uld reduce Africa's total indebtedness by
bet ween 520 and 530 billion. That would
mean a reduction of perhaps 53 or 54 bil-
lion a year in the due, but very little
rWuetion in the actual interest paid. The
greatest hope on the present there-
forc, is that Afril;ll will be slightly bener off
on paper willie in practice me financial
haemorrhage will continue unstaunched.
In one of the most recent and cump...,·
hcnsi\"C analyses of Africa's debt and !he
cffom to reduce II, the economist Percy
"'\istry comes \0 the "inaw.pabk amdusitm
!hal lhese t/fr:tr14 1101 b«n rom
<!Itaivl in Qdti4fJing w objectiw of I'fiieving
fddnf In,r<fms mJfii:imdy for Afriam roumrio
ILl Itavt! a T!aJOIwbk cha'laI <if r= in
adlinling J,""'IUra! a4iustmmt, nraJt'tI)'. or
grmcth. ill l1u fommdile futurt, ""Ius prroiotu
tW."twry af>prf1Qdla 10 <WI rrlit! .,.,.,
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 as
the rcsr of th" world struggl.,. towards a
new peace and a new prosperiI)', lhen
cxtnordinaf)' mcasurn an" aaw called for.
T en yean of prevarication over this
problem has al"""dy damaged not only the
Africa 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 cone-
nem in imCTCSI repa yments, lens of millions
of children arc losing meir ooe oppommiry
to grow nOrman}" to go 10 school l1JId
become l1JId 10 a<:quin: the slriI1s
necessary for meir own and their cOlmm",'
developmem in me yean to COme.
It is daimed mat the industriali:l.ed world
can do no better al the present time. YC1
ways have: been found to halve Egypt's $40
billion dcbl following me Gulf Waf and 10
make a similar to Poland follow-
ing the liberation of Eastern Europe:.
It is claimed mal a more drastic reduc-
tion in Africa's debts would constitute a
'moral hazard' by rewarding these who do
nOI pay their debts. But the real moral haz-
ard is surdy 10 the soul of a world which is
prepared 10 condemn a conunem 10 con-
tinued poverty, and a generation of its
children to malnutrition, fot me u ke of col-
lecti ng 'meresl on moneys which were oflen
ilTcsponsibly len! and moSI of which cannot
possibly be repaid.
It is also claimed mal debl forgiveness
would help to sustain failed economic poli-
cles. ROI the ma jority of African eountri""
have already begun implememing basic
economic reforms.
Events in Eastern Europe and the
Union, coinciding \'li th a clearly marked
'end of the road' fOf the kinds of pol itical
l1JId economic systems that have prevailed
across so much of Africa in recent decades,
have had a profound effect on the eomi -
nent. eoontries have now begun 10
lJlke the: firsl steps towards dcmocracy, plu-
ralism, and mafl<et-om.n!"d economic
refofTTl . The prospects for renewed eco-
nomic growth and social progress should be
Perr:entage of centrol government
e)(pendt/ures allocated to defence, and
Jociol welfare, JeJected African countries,
1971 0nd 1989
Fig. 14 W. r venus welf. re
The gr.ph (QIl\fa,u 1Mri... in military
(dWlM line:!.), v.ith 1MdKline in -Vore
(solid in of 1M p<lOf8t Afric.n counm..
1M " 'I two decadM.
zs

Welfare
__"Defense
"..
stronger in the 19905 than at any time in
the Last two decades.
Wim these: changes, me hopes of a con-
tinent have again been If mose
hopes cannot manage 10 escape from unde r
the weight of pas t debts, then the result will
again be the despair and frustra tion which
arc Ute natural habitat of dictatOR and
demagogues. If Africa is 10 evoh..:: !o"..ards
a new internal order, and to fInd a dignifIed
place in the new world order, men the pre-
sent opportunity must not be lost. The
ways and means should now be found 10
absolve Africa of the great majority of its
bi-laleral and international debtll.
The democratie tboiee
The new spirit moving in Africa today
was summed up in a recent address 10
Africa' s heads of state delivered by me
Nigerian Presi dent, Ibrahim Babangida:
u
f!W ind«J wraud from lIS as
a ptop/t. Thai faa is rootd ;" OIlT huWry.
Equally undcniabk, hownJer, u me ftv;1 m.u
'/Jim 1M <Ill of fflVIJt:rillg thaI ...
Afti=' kadenhip ii, gmeral did HOI git>t »Uldl
thaughl W rk logic and juslia of reinwsring
thai sqvertigruy in ilS ptoples.
"Dmlf" .rlCy is nos DIlly (m llu""tiV/l
oplwn bul a raliMulJ ami inA'iwbk OII/!. This
is 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 (ammilmoll ," home CD
re<mUlilUU our wcU.IW, W rt:fomr Our poHIild
JYsu:ms, ami 10 rtsfJ1l(IUrt: our «.onomw ...
Wtllore irlduIle houJing and )/urn
de.m>nco!; <(lfrII'J'IIJr'W df:>ei<ll>< ,.eo ,t Jlo'YI"f'I'I> Ie the
lick, !he <fo>abled. II>e elcSerty andthe
family. malemity and d>iId aIlow.nce<; wer.. "",,",eo
lor the elderly, the disabled, . rod tM:lren; poIution
._t_I", "'l'll!Yand $<WI.OLOon.
---.-.. .. .._,-.'.... ,..,
0
1972
e 20
e
I
,
- 15
i
10
c
L
THE STATEOFTHE WORLD'SCHILDREN1992
Hepatitis B:
the seventh vaccine
The global system. buII lb'Wlg the
19l1Os 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 control
hepatitis 8 • one ollh& world's gt8iIlesl
........
HapQt/till B ds rnn Pl(:(liIl I.MTf 11m
AJC:6 "*ina Kis I'"'I"" aoble for abwI 809!.
of!II ""'" and more casell oIlYer do,I_
(60 1lIoOI:1cI."
One '*""' insix.., 1IIe world !'laSr:-'I h'ecled
wi:h and '"'uo'«ely300rriIon ....

body may rid itseII ollh9 i ,!ectioo lWld is lI'SnS-
rmted try a I'a"Ig8 01 bocIl' r-..ids. fl"tllO"iV ltJouj:1
sexual acIMly bul abo via CQ'llaCI YlOth """' .Mi.
natedt:bxi,
to oobomchiI<1l1f1d tryskinlMIons. _!he
main If--.sof ' "incI'id<lln.
Abou1 a It'irdof a1 1holiEt Ir69ctlld with hep!ltIlis

has passed, abaul ffil, to 10'll. 01 IICtins
bol<x>o'", carriers of 1M <:Iisee8e." AII!Il:Jo.ql not
....-swlIy sI'owi'lg any 8Y" "'*"' tS. 000pi«l ptO-
QI ass:.,. lW'Id possibly fatal lF.w da'nage, they join
Ih& 300 milIioI'l pool 01 ctworic ca-I\Qv.OO SP<llOO
lh3 Wus In! perpeluale from one lJIII"'O[O'1O

hBpaIIIisB
lll.lIB lor !IOITIll 1inl!. &l! bec!u'le !he II8CCire was
deriYed frombloodgiverl by acarrieroI lhev'tus,
c:ooJd b/l prodJoold in smaI q.oantltlils. The
cost. lJ'lliIlh&IaI8 1900s. was $110 par1h'9ft.$'ItIl
coo.rse.... Now.ll"fl'lIK: ""'-'1\1 !'laS rnado
IiQ'lUbIe 10pI'lXb:e Iwgar oIthevacQoe
III 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), lheolIIIl
cost e<:Ud IaII llSlowas $1.50....
HEIV irmuizsIi<>ol .. particUarIy irrclcrtMt lei'
dtiflll. Not 0I:'tf 8f8 InleClI.:l c:tlil:tlln I1'llItI
hIlpelitisBandai'nOslfoor
trnes rro-e _ to d9WIOP lMlr CO'lOOr. 1hey ee
also Il1L.ldl more lI<eIy !hBn _ to become cur·
riIn ol lho a-. One quarter <:J lilOSII JdecuId
belotto IIle IiI(/&of ...... be<xlme caniers (ard 70'lli
to 90'11o 01_i'1Iecle<l tlelore bftt> by pIac«lIaI
QWj.lO-<tild illIeclIoI .. wIlid1 can
0CC<.r <bI".g play CJ" bed·S/I!W'o"lg "'" SIIi'II8Sions
IUd1BIl 'i IiP8IillO. !lCltlies. cuts lIld intect«l insacI
biles, is "'" ...... Bil d
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&' inill nationalcI'id
pmgt.. ".OlS. So!.., 22o:unries, mai-Iv"SaJIh.
EasI Asiaandlhu _ East. h!MI bIVJn rouIi'IO
HSV_ . ArIoltIeI' 00 COIrItries hlIYe pIoI
pn:jecIs ..... ..",., Of planned....
So lao. genIIIicaty .. Igi_eel HBV r. been
used OOfl'lOo"e
t>M bgeI\ la.nt! kI be""" 01the sales1 ancl m:>BI
efI8clMl 01 ill we:Qnes. NId boca.... hepatitis Bis
a rro8Ijco" causeol ..... caroer. ther"lllW"3Cdnesara
i1 eIl9CI the W genel'<:allv engil'oo'ed C3lIOOI
.........,.
is tnerelote le<:l:"ricaI'I' !aasIlIo kI ..-..cicala
tIepetItis B. The woMW:Ie COSl is IkeIy10be lP"
wards 01 $100 miIm a )OOO". WrtI> the ""'PIIfl'IM!
1*1 - tile deIvery systoon - I!iteadi in pIaoe. and
wilh 90 rru:::h .......... hea/l:tl a l siese, v.o::Ud Sl.nI\I
be 1I1IhilI<atJla . the """ nollol.n::l.
"Today, the clanumr fur
O1ld pony pluralism is 011 W aswu/n.ncy i"
Ajrial. A. 1eaderJ, W<1 "1...10iUp1 and «Imply
rriu. W wU/le$ of lJrost whom IN reprlWll.
No amoum of for« W" flmWr Jrifk W righl
of W gorxmed te al 1Jniodi4 fr« and
fair UulilmS, 1Mfau af o"y gql!ft"'mnIl.
rawgu Qf civil u"rul righl <la"OSJ
/!fir tcltlinDll, lhe reurrdaliml of
tre4litJity far our human [>Qlnllwl, 1M imoler-
ab4 flow Qf milIiOlu of our humanily turned
rtfttgttS from tMir />W" I<mds ... COfUlilUle a
pmIfaIInll rtbuM 10 uur poliliuJl judgnnnu
OM will ... only 'l:iahlit 1Ji1nltlJ1;W is a
n..are mrbroa of lhe OPlilm. UI
US taJu W ruol.... 1WfC, and amtmil ourulveJ
10 1M dismam!ing of all apparalUI of U""fJU-
WI/alive Jl<'Wn, Sl ll ing a dau before lhe md
of this cenlury/or Its
Pn::!lideru Babangida's call for ,;"umaJ
rtparolWtlJ ' is the 10 his call 'Jor
AjriallU a whok 10 fiehl ill ali pwible ways
W ;USI balllit for i"ttmaliotIaJ rtparotiorn
llIa,,,,1 W centuria of humilia/ion arid
txp/(,iul/I·oll III whidl il /ta$ bun subjrcud ...
For AjriaJ, he colldutkd, "lJrol ./wu.1d be W
Prot- J/arli"e poinl of a 'lUO"i"gful N=
World Ortkr."
(n response 10 such call, and 10 the new
spirit evident in Africa, and as a gesture of
reparation for exploitation in the past and
preparation for a new pannership in the
future, Africa should nOW be absolved of
mOSI of ilS debts.
The COSI to the industrializcd world
would be by no means crippling. Sub-
SaJtarv,n Africa·s tollII debt amOunts 10 only
about 12% of the debts of the developing
world as a whole. BU! fQl" Africa, the sheer
weight of the ball and chain of debt and
interesl repaymenlll now means that there is
no realistic possibilityof forward rncvement
until illl financial shackles are struck ofT.
Aconfmace for the Mricm child
Whilc attempting to lackle these funda-
mcnllII problema, most African nations arc
also preparing National Programmes of
Action with the specifie aim of meeting the
goals agreed at the WMId Summil fM
Childrrn. The process of fimding progrestl
(awards such gools u halving malnutrition,
reducing the impact of the most common
diseases, bringing clean water 10 all cern-
munities, and ensuring that aU children
have access 10 basic education, "ill be most
difficult of all in the Sub-Saharan African
region. Latl': in 1992, the Organization of
African Unity inlends 10 call an internal-
ional conference to dmw attention 10 the
action whieh Africa is already taking to try
10 reach those goals and 10 5ttk the support
of the international community in sustain-
ing that action in the 1990s. Africa will
need to find at least SI. S billion a year
from lrs own resources, via a rc-ordcring of
illl inlemal priorities, but wiU need aboul
the same amounl in international aid if
progress lowards these goals for its children
_ and its future - is 10 be maintained. 11Ic
response " ill be one of the fint oppornmi-
ties for the world to reach OUI the hand of a
new pal'l:nl':rllitip with Africa, and 10 signal
that Africa, 100, has a place in a new world
order.
THE STATEOFTHEWORLD'S CHILDREN1992
Facts for Life:
messages for millions
Thafo II lcxl!ry a I:IOOjI f1 CI*:I IIelWIt>
i"IlllrrnlIlio. abwl8ale1T'IOlt 1"'""'"bhhIl*i"g.
to "*"0. cHd llJIl'Mh 1"' 80110.. 0faI
,....,.,.tIon, •..0AJOS • ...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 b
LA_ in IllSbr I..NCS', I.tESCO
In:lWolOin 'OOd .. _.:
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
'" 120 _1lOaueiIL

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

l.WIQFa:t3IorUl9. '" I rT'iIIlQn 1IolIIiIb8l'lCl
.... crI 01 f_ b' L.iIII n
114_ ....- -.I __10..,;11
......... n the pl .... , r- t->
.... _ b .. r--.,.-.Inea.-.
_medal.........
..., lDT"tIV"OCYserw;e. '"SIenalM:J'le. I'Iet'eIlln
....0:. ill nri'Ig l ,Q -.I... """"'-a
..... WI;lIlonIO....F.:Ist7
LJlII. Ito VIIt NiI'n. 25.0lXl Faa. ""LADllImV'ir:a-

to.... .-,co.nry. .. ..-INlia_
........ dId...." ....TY __-.......
_01.. tlCd<llW.. _ 000 ..
_ .. • J\l'U'OtdtallOllP
<II*M _ popAIr redo """""'.,"'_
PoiIlcal ....tIa'.eIl!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(p1Q
DIllie Pl oiRli __ 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. ltIe
o 7 '9" d ,.., b' tJIII b' '"
lwUJi_dr#..-noiAtwr.

nl2i1rV...
In Ihd.. II'IIP' ...... " . '- d-..,. pt,.I
Fa:l5FatJIII" ""'0tl120....... llIIIIIct.gl..
lO....-an".....
ageL In T.n.y. ll'lI\' '-...-«l on 2 mIion
mo..-
In .... FtJati b' Ult I\eo!I bM1 UIpled b Ihll
NI!IllofIIII L.iMncy CIr'r1laign '-=:tJio 'li 2 ......
PIqlIIt • II'lIi1ti women.
In to'e«.:O. 3eo.CIXl C(lpiI:ls 0I1heIIllli:IlIII Yonb'I
_ diIlrtlulId CIA 01 e pler..ecHc. 1rriIi;n
In M,." • . 2OO.oo:l <Xlpieol oIlhe netIonII
'- prob::ed b IlChxis, I'IlIIllII

0\11*......
........
.. !Du' ".." b ......
o:lIIgiIIrd ........
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:l
1,500 Il:tOlI L <>.00< • ....", F_tr
UillI '-'-' .-l by 65.000 "'-..
.." ..
The apartheid of gender
Preposit ion: 17wr a IItW world urder shuuld
lJu aparlJreid oj gmder as viglmJusfy as
lJu apanMid of rau.
The one constant of the dc"clopinjj
world, whether in Africa, Asia, or Latin
America, whether in ciry slum Or rural vil-
lages, whether in the depllu of ewnomic
or at the height of economic activity,
il that women will be working from fin!
until after dark to meet their families'
many needs.
It is a corrunonplace that the developing
wmid·s women bear and care for 113 chil-
dren, fetch and carry its fuel and waler,
cook its meals and shop for iu needs, wash
itll clothes and dean its homes, and look
after 11$ old and its ill. Ii is leu widely
known that wOmCn alS<l grow and market
most of me developing world' s food, cam
an increasing proportion of ilS income, and
work, on average, twice as many hours a
dar as men."
In return for this disproportionate con-
uibution, the women of the developing
world are g.:neraUy "",'Wdcd "ith Jess food,
less health care, less education, less training,
less lcisun:, less income, less righu and less
protection.
So heavy is this weighl of discrimina-
tion that il even sways the survival chances
of the girl child. All other things being
equal, girl children have 11 better natural
chance of survi\ing the early, vulncrablc
years. But all other things are not equill. In
several countries of South Asia, (ewer girls
survive than boys." And in this gap
between natural 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 each
year because !hey are born female.
If a new world order is to anempt to
PUt right the most glaring failings of the
old, then this issue of discrimination
againn WQrnen cannQt be Qmined from
the agenda. Yet the severity and Kale of
this injustice has not yet been widely
lleeepled. It is, fQr example, an injustice
Qn a far grealCT scale than the apartheid
system that has aroused the fervent and
sust ained opposition of the international
oommuni ly in reeent decades. The abhor-
renee with which the whole WQrld has
rightly regu ded aparth eid is an abhor-
rence born of thc simple moral
propositiQn thaI a peoples' rightS and
QppQnunities - where they can Ii"e, what
edu cation and health care the}' will
receive, what job they can do, what
income they can cam, what legal standing
they will have should not depend on
whether they are born black or white. Yet
il seems thaI the world is prepared to
accept, with none of the depth and
breadth of opposition thaI has been seen
duri ng the apartheid years, that all of
these things can depend upon the acci-
dent 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 as
girls are brought to health centres fOT treat-
ment. Employment rights, social security
righlS, legal rights, property rights, and
even civil and political liberties an: aU likely
to depend upon !he one, crud chromosome.
THESTATEOFTHE WORLD'S CHILDREN1992
Tbe prlCtic:al costS of Ibis bias are !be
m:l1KC'd dl"c"ti...<:nesI of almost e:ver)' Olhc:r
aspect of lIM: de;.'dopmcllI pUllX....
BUI 10 di.aimiIllllC qainll girls in UH:
matter of educational opportUnity is per-
haps !he: biggest practical mistaltc of all.
Ova many yean and in many
the education of women hIlS been shown 10
be: associated with me confIdence: to adopt
new ways, the prop(ll:Sit)" to make ueater
UK of IIXiaI service:J, U>c: ability 10 earn
hightt incomes, the of dtild
Planning births
Proposition: TIoaI the raplmtibr. pla.,mi", 0/
bil'lJu ;. _ of 1M moJ/ dJU;:liw and /eml
apemiw fMj'1 ofimptwing the quality "/ lift
"" fQ.rlh - /Ioih now and in 1M /uIUrI - imd
IMI 0ftlI! fJ/ 1MpmWl mis", 1w D/ GUT Ibm. is
1MjDiW,., 10 'Ir41iu dial po-w.
Family pIannin£ could brine lOOR' 00w::-
firs 10 man: >'COP'"' aI "'" CO$! than any
Olhc:r sinIk 'tc:dmoIozy' now a\'tilabIc 10
Ibc human nee. But it is noll appttciau:d
widdy mooch dlal this would ItiD bc: IrUe
t\'en if then: .. DO such thina .. I popu-
IlItion plObltm.
10 pan, an . .. Iltlle... of the run mnae of
the bmdiu avaiJabk from the .uponsiblc
planning of familic:s hn bem hidden from
tho public \icw by thc douds of t'OlltreWenY

care md nutrition, tbe mfuctioa of child
dc:alhs, the aettptaDOe of family planning,
tilt: mNction of &mil)' size, and
the: litenlc), of lIM: sl.lCC«din& JC'ntnotion."
The education of girl . is therefore
another of 1hO$e extraordinary points of
which could advance the world
towards many of !he other goah: dUo;uucd
in thilI report. 11 is allO a principal means of
rishtina; one: of !he IJlOIl. evident of an
wronp in the aisting ...odd onkr.
which have IOn&: hung ever this II1UC. But
such is the n.ngc of mmods now available,
and such me experience mat hal been
gained in recent yean, thaI family planning
can now be promoted and pn.ensed in
"''')'S which an: to tk reJiaious
and contours of almost aD toeierin.
The benefits of planninc lIC'Cd be
denied to 110 one.
1lJosc bendits 1nll1 be bridly _
""""'"
F.... family plannina ccuJd ..se tbe:
lhu of peffiapI ODe: quarter 10 ODe: third of
tbe: soo.ooo women " 'ho DOW die ew:ry
)UT from e. uxs re\aled 10 and
s:i-ing binh." II could ll1so prevent
unk:nll'q" millions of diubiliuO$ • 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 50,000
iIkpI IIbortiQns which DOW performod
on women twry sm,,1.- dIzy and whieb raull
in the deaths of 150,000 )"OWII women
every year.-
Third. hmily pbnning can dtastically
inlpl'O\'e the quality of WOlIKn·' I.ivc:I _ in
both lhort and long term - by reducin8 the
phys ical and mental burdCIU of h1vina 100
many tOO elose loaether. or al 100
early OT 100 lilt<,: an It can tncreese the
time available for women' , education. for
vocational tnIining, for cantina incomes, for
impmvilll child care, for community activi -
ties, for pcnonal development, and for the
I'CII and leisure which il vinuaUy unknown
to millions of women in the de\"dopina;
worid today.
Founb, famiJy pbnning eouId !he
lives of million children CKb year.
Family planninc would pK'VClll, precbni-
nantly, 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 who
a1l'c:tdy hi,..., three 01" four or moR
chiIdlm.- Becaus: the CJQt mtjority 0{
child dcathlI an:: nooate!d with thac risk
facton, the _"dJ-informed limine and spac-
ina: of births Il:SUh in a far more thaD
p oponionau: rcductioIl in child dealha.
Fifth, family planning can signifK:ll\t1y
improve the nutritional health of childn:n
tJu-ouahout the developing world. Fe\\'U and
more 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! maInutri-
lion Ihm'litnn. rhc earticII yean oflifc."
Sixth, family pIanninc improva the
quality of life for dIiIdrm. The quality of
child CIIl: - indudinc play and stimulation
.. wdI 1$ halth and cducalioD _ inevitIliy
rixs .. paIl:rtts arc able 10 invat moR of
their time, CDCTI)'. and money in brin&in&
up a smaller number of children.
For an of these a renewed dTon
U) pUI Wnily p1arutirtg I I the disposal of aU
'NOU.Id advance not one but many of the
bllic human goals for the year 2000 which
WCTC agreed at the World Sum",i, /fir
Childrm.
These benefits alone woul d be sufficient
to justify the claim of plannini for
all' to a spc:cial priority in a new world
order. But it. would, of coone. aI,o hdp 10
raol\..., one of the Olhtt CJQI problems on
the human agenda - the pobk:m of nlpid
population growth.
A...ph,.....,...tdy en: prcanarw:y in du'CI: in
the de\dopirc world thia yar ...;a be IlOl
ooIy UlIp/:IlaJat bur. Ufl';l'lllted." TIx:n: ill
I ,__ lJIlIneI dl:mand for ibl:
b .... lt:d&e and ibl: me:anI oHarniy plannin&.
EYickncc from the w...u FnriJI·ry
Sl<fW)I sugem that if all ..-omm in the
oo.-eIoping ..uid who do IlOl -.ish to
bcCOlTlC pregnant ....."., 10 eser-
eee that choice then the nlto: of population
c,.,w..1h ..·auld fan by approxirnalely 30%."
By the: Yeal" 2025, mal fall would translate
into I .] billion fe\\'eI" • rouahIy the
equivalent of the population of China
today."
..
THE STATE OFTHEWORLD'S CHILDREN 1992
E\= this long lilt of bmdil:li dca not
capture the potential comribution of family
plannlns to the imprlWCmelli of the human
ccndltion. For it fail, 10 record the syner-
gisms which mean tha t the: total ben..fi t
WOI1Id be vcry much jp"Ct= !han the sum
of the parts. WiUli n lM $phere of human
hcallb, family planning and i5
mmol'CC'd by, P''4l- IOwwds almosl: all
cxha imprtl\'t:mO:DlS in the beahh and ....d!-
beina: of bodl mothas llId childtm.. Tbe
timina: 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 plannine
and the lmdency lowards more widely
spaced births. An upward spiral is therefore
Jet in motion. But there it also a wid.... circle
of synergisms of which birth spacing and
family planning stand dOK to the eewe.
l.'cwu and IIlOn: widdy spaced births
impnl\U thc: quality of women's of
dlild ean:, at Wnily life, of edlQUon; .nof
thcs<: c:ontributt to IOcia1 and " .......nie
pl .... _ . whX:b in mm conaibuus 10 the
aider Ku-ptana" of family pbnniog

nu, pmnu\:&tions of such 1)'I1C:J'Iisms
lIf'e almost limitksl. And uniting them aU is
the fact that family planning gi,'n people
more control over Iheir own lives and
eJUlbla them to brini aboul otlu:r improve-
ments in almost C\'ef)' asP«t of those lives.
h means better tlealth and wider opportuni-
ties for hlllldrros of millions of women. II
means fnr.:r demhI and be=r physical and
mm.tal lP_d, for hundn:ds of mil60ns of
dtiIdn:n. It mtarII improved IItIrldmh of
Iivin& and lea w.in on II
abo memI sIowtt popWaDon growth and
an easinc of rlwiroruneDw !="Wft in tIx
CO$lJ, in rdarion w bmt'-
lits, IlTr almost absurdly .maD.
Whrn 110 much stands to be achieved by
the mtttina or an demand and at
110 \ow • roIt, it I«mJ 10 pro-
pose, for !he aamda of any lin' world
order, tlw In drOIt now be made. on In
c:ntirdy new seale, to pill tIx
and IN ...,.,.. of family pIanninc at the
dispoq' 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>! for
0>t1Im on $epIe'bo XI 1000. A/IlIr ""de9peed 0CI"IIl.CIllli lV'r'O"\iI QCM!O", eots Bn:llte...,.....:ills "' !he
ll'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 A0IlIHhrtl mct..w;lm" .......-!lve deiIlh rates p-
I rm..ot:lIcn to bebIOI 70 per 1.1XO t.9 tlO1hI

o A I'olM'O01 J'OIl18ml!l rrooaitv rat....
o A hEM'g '" savere end IOOderaIe I'I"lIlhnr1Iio
tmo"Q !he wo:\d', 1.I"Ider-tves.
5afIl_1rIdsri8tb"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
01 eopII e-
---
) ProleclIcn b' !he rrmy rroIona cI d*.1rI:rl n
d!b'I l:lI(UI\'l_ In:! !he ...-..plIO r::e
Bn:l In III comies. 01 lhe m<:erIl)r
aclOflI9Cl 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
pIarri"g .... NJtim and -.;o"s to tl8
mads 8WiIallllI to 81 e:a.pes to them to
peg.eocieiSso::! 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. 8
tranedIItl6ndIlrlI d liti di er>:l .-nr b t'l9'-
tIskptego .. oc:ies 8J'ld otlsteIric "" 8 9l"des.
( U"Mlrs>II 01 1he SPllCiPI nootlh Bn:l
rutrIboreI .-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 dlloo080 S-
o AI 10 kI'lOw Ihe 1"1'0,18"08 01 "'4'lX>'to"<l
.....:wr6"\ Tn Ihv tasl< of .....". ..... tnllIStleedng b Iho
fnfbs to Ilil< ITD"Ilhs" 01 • crik!'s lie WIll 01 <T1lIBIJJg
lhe speciej 10edng _ of . )tUlIl ct*l1hrol.o\tllhe
.......-
0 """" mlll"oo ;lCt "" i'ii' Bn:l to be
in.. CCUlIIIIls.
o C' ' liiG!b, oIlaiOd9i,)e 10 enebIe III
lQIlfl5U'U food llOO.X1IY.
Child heII/lh
o Tha polio.
o 1995).
o A 9O'llo reclIClic:I'1 I'l roeaIIieS cases rid • 9MIo
tod.>::Ilon l'1 "*"*'" -. 00''-00 to pr&-

o ActOe.flU8111 and d aI iIl8S1 llO'Il.
CO'Mef89lI d 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 by
a<: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.I
10 "'.... .... and itll $kiIso::Ul be PJl aI lhIl o:isposaI
d III familios by "1Cbizir og toe:Iay'. wslly i "",I I I

"
References
1 __0"", ' r " e.- Ol o.. -.
__$v--. Dr ll1111i_
lea ' 181
2 __0"", - • p......",. <II
--. <JIOIlol 0...- 9'1 _ --,

3 u-- _ Fu'IcI, _ Oodoo..... , ...
.. _'_oo. .
.".., Cl _ b' ..." 11-. _""'-' ""
... ...-. ..«.......,..., .. ' ,1• • "'_"
.,.. llMlO1', n. SIMI 0/.,.. a-. lllll' .
l.NCfF. _ V"""19\10
• ... --.a-. ll8l.
Oobll PI-. ll1l1O
__
Do ,....... 111\10. ... IJf«:EF JIOU •
lICS'._YQ'lo,,:llIl
, ge'll. lUI _ -,. ..., _
--
7 _ _ Or • 6"1 to' .. ' Illao, _
1'l. ''H18C. 'f""lll*tl 0.- .. !iD......
_ .....-,Pw;y.''' DU , &Ie-
...... 'IotC). E>oi8<111ol Pw;y."' __

• "-ODor. u.. Wort --, .. a- Ftca<
h · 6'll ... _ .. .,.....
"..,...... YoI. vr. 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,

PIlIll. 'Jrtoio_l_.b' f'Iqor;l: lM9'
"' ll ' • . _""'_.. ..,......
.... DI .... IlIl. l ($.U l, lI1IIlI __
, ,_
__0 "", ' " ."""' _ _
_ Of •••"""',. C __ .,... ......
SCNwc_..
, - - c>gor-. 1'lc9."'. lOt '"
Dioo...... rr ....... "<va",. Itopcn'.
a:JD91 a Po 1" 1l1li)
10 "-y I.' $Ill ' . 1 al
ct>oo_. '-'lIQ, """
11 __ _', ' _.go
.. -.= ,- = " ,.. ... -... ...
_da:llO'll:>' o, _ _ .""
.... ...-. ...-.., rei dIr ' ; , •• 111 _ ..
INI 1'-' , Il'II sa. Of N -.. ,.,,
1.HCEF, __191lO
' 2 u..o _ 01lIiw1... ".nil. lI" .. Fnnr
, -
0'1-' tI -..-.;J Aoto::& lHCB', _
YC<1l.
13 l..NCeP. lIr$l .... 5luOI eefliI1OPiC. 11.- Of
_ "" , lI" 0-.. _ p ' otll .. '11&1 A
..- -
,.., ..... tIr _ ea.-. ""'-_
.., -,. - - £nolion "
_ .......
,. --.t,&,-,E..Cc:mio.IU._ .... E..
&:0_... DII*oJ _ O>llf n.,... Ofl-.
........ tI ... IMCU, 1••_0Il 0IiII
D. ' I ,• • On;, -.:.. _ c OIl
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 n
CaonI __fuI:¥>o. lHCB'. 1.,_0Il CNo
Do • """-'<: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 • .. ..
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 ...IIlIi ...
Goooon CcmiIl. GA, JtIfI, R r<l _ . f .
69-118, Olc!<lfd u--aty ,981
23 _ Ct. E<lgIr. a..-IllooyOlPllJiOJllt'di'l,-.,
Ifooptol_0Il!f(a" s.,..-, CoolaAco
!.JDw<l, c,a r<l _ , S" 'lIw E1/8cu; 01
CN:l &.r.MI on ffmIt PIrmg Prac:Iicoo _ FfJ1tIy'
_ i'! 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<l
l'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
........
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 __ _ _
S/nl1Ilial I:I:ado ,.. . ,
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 _
.. _ Y'''''
3ll lhIed __ 000 j' . " . . Plago." ,oo. -..
09. N!wV.....
37 Gooltge,
- • "*'....... "..,., - --
E<1ICSlIOrF _ 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."'" '' 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,

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 ...'.
___08. I •••• _ ND. 6.
Roport """' ltiII __S6!oral SuM!I', .........
d_$tuc>oos. __
4:l Con'ia, GA. 'GIooei ••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- Clvog
Elt.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. 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.,
_ Sori<. CIll.ee. ,1lI> ' 0.11
8IoIG'lI•• 01.
53 SIuc:Iod" • • ' ....iiliIJ-. P
l_tiOCJo 1119(1" _ Au.,.,." _ Oiiio". '.(
SJJ'N. C/IdCrIl lililO

56 -....01.
$I FGn.R.. .. .. _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. "'*""'. -....
a- _ ....... 'II C\Iolr:oU. ..........
DitIl ... 'Plco_ , '" PI _
_"" .. __O'I DitIl
-.Rooo 9) rei Coo......... -....,»1111i1
_ 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'"
...... ---"'.",.; ... ..-
_, 'II Clopaltr'Itr'iI 'II Ewor.....

s_
...
1IO HItrw, ...
III Mcy.OPo'"
Il2 _..,.Glo.-EIIor»vao. 0Il> '"
tl3 , 'oI:II,P'O ........z.
___.... 0. . ..... __'"
..aa- p."
i50I _-.. .... 1_32. _ ...0 , .....
.-
IiIi! _-........ p. '"
lIII 'otII.Oll.ut
_-. .. .... More. 0. _
1 5
"- -.. lolA. ....Ullf}rioll. 8 _
O...m J.. _ or I!M"I' pIomrlJ __
_ ",.0'1 .... _ ......... _
",*,,_"""""'" 1lIl21' ·:ug
_ 8.. CIrIJtwl. C- 8oo,_dl<, E. _ sao,••"
'..-:eo _ " _ """'*". _ "-
...._ .. " 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 __._._.
;:,;.uu..-
lIU P .'
.............. .....-
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:n1IIy
J\ _ ton 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..
... p , ...... 0= Np'lli ton tot _ f'MlIl1
••
1'1. rei sov>. S. ... GW\ U , .".
_ ,... ll.nor: o-rv CJo1JoI 0'" V'
A;oo • • --.. \Ill. 31. ,." 1. III • R.....
-.. ... ... D.C.. 11112
................ __
__ n , • • • 0 .. l95OI',_....
__ ....... _ DIjO'I:i, pp. 175-1 U-
-,-
1'3 ... !WI. _ ..... ..-y. _ allWora
.-.:I_..-,,_.....
9atc P,' , PI: j " , _
Panel references
F<lt tno u _ CIl1hll'Sunni! D&c>o...., """ PIon CIl
Acton' ..,.., _ 2000 goolOj, ""'" !Nt _ <II
1M ontro!I R\1U '" INt Oil:l".
"'" S/.1fe atINt 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_-. 1991
Kim-F;wto,t. t)' , PI....",..
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'om
CO'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 11l1l 1
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'mfJfocIS 01"""*'" Q:nlicl (>l _ a.....:
__
'991, -...., ...., lNCEF.
PKy . "' 1O lor no LnIecl _
e-'"D<sabIocI _llll83-1992l
15 LN:;£F,_
16 Tho I ... "..., ,, .....
.,.., Il<U GWv 10 I1lO et>ftj AI """" _ ,
lNCEF, Ilnul. 1\111\
17 ..I*'J'1Io<vy
__atGi:>47lo•• "" "&st__ ' *'
Pli_:..
18 _o._OIn-Hl.,R., '-.,. __
.........., ,. , " "'" : ,-'Ii """" ....,.
1000'.• -=- :IlUD\' InUf«l tlr INI 'M>1(l
Coo".U on b AI. r-. M Mo<cI'I
1990.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', IUrM
Doo " ,e. iI II-. l!lOO1l/1tl1 Po 121, lI'>IIocI
--.. Dopooa.ed 01 __&::00..,"" 8ntl
Sot>oi ....... _VO'\<, l Q6ll
21 C. 8ntlllMln 11-.-"':
II-. eooo..,ic b Ire 19!1Os' , a ....,...,
_ b' Ire Wor1a Coo ... . .. OIl -.... b ,..,
19!1O, HfJw V(J'\<. 1000
22 ftllO"",," ' "p. CII.
23 __to....J.\>4' " 1111I SldiJIJ d
Ire _ . 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' __
2l:I Mool cl II-. ... ,, __, in IN _ • _ tom
Mc:Gm. N.f" Sr<:loi1_ Ft. Kin, Y.e. nllQm. s-e. ,

p. 185, \980
:19 mo.:.ntI llio::/Qlo'I, l1:I ....lti<M.. II InI
VMQUICEF pCIIcy..-.s' OIl Bo_!oo<lo",
fl Ire 1!lQOs: A 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', 11III16Joot
B""4'Sl llWll, No>.
31 "'-' F'r!:ImPIn;I. _
a.... _ ... Tho .
A jco'IllYHCl/l.UC9' 1IIal........ 'M-IO. _
3:1 Tho __ 000 ''''''' ' _ lfu1C:NICI ac .,..,
i ilG' __ eo....... on Bi__.. _ tI'f
lNCEf, Wl<l .., .,.., iile''''''' -.,
AS...' , 28.u-. ' 99'
3:l 'ora: PI.CI01g -.."" _ ' , _
,-., Y<il No. A, -Uy.""'VAl '98Il
:w "".iCi.. a*l n O*l8', WOrt1
__ ,_
35 o.tIaielioli 01 New VOIle INl CN<:li'M'. _
_ . Wl<l , u.-, So\JIlO, .... 11l9O
-
37 Wl<l.Got-. Mon>'I 19Q!
38 E>Don<Iod PI ....... " ,. on aotlol
-... Gn::>.Q lWIlOfl, WHClIEl'\IGIn'l' ,3, WHO,
Goo'-.lWl
39 "'"""'*"'" n INl CHItnn', _ recom-
__ l<l II1e lHCEf E<eo.AiYo ee.u.
EJ1C€F/ 1Wlil"1\..31, lNCeF, Now YorI<. 15 """"*'I
Iw 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, '" ....-BYao::dno Wo II1e EPr, ..-..g
01 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....... __t 98ll
4:l $onllfIt"".,;os '" /'«:to lor UrI .., Ito w' ..... ,
_ N b' _ """ 01 _ tI'f wrIIi'1lI 1O
LNCEl' _ H-t l F. I10cts Ify UrI lhf. 3 UN-.
..... Yori<, N-; iOOi7, lJSio.
----n· ·----
STATISTICS
Economi c and social st ati stics on the
nations of the world, with particular
r eference to children's well-being.
G<nonI no« "" ..... Sil<m on<! aj>I&nII.....
lNUI!X TO COl.lNtlUES
TAllI.F-S
1, Balk indlta lon
USMlt 0 lMR J population lJ binht and under Ii,·.
dealh$ 0 GNP per apila I I exp«:tancy 0 adult literacy
U Khool enrolment r I income d;'tn1>u1ion
2: Nlllritioll
l.ow birth wei ght r ) , I malnutrition
I I food production n calorie intake n food 5pending
3: Bealtll
Access 10 waler I I acccss ' 0 health >l:r\'icn
11 immunization of dUldr'l'n and pr<:gnanl women U ORT use
4: EdUtllliOll
Mole 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 ilIdiaolon
ChiJdpopulation 0 popu1lltioo grov.1h rate I I crude 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 cxpcnditwe r 1 aid U debt sc. rvi<:<:
7: Womea
Life cxpecuncy I I litcracy I ! mrclmcnl in <dlool I con\rllttpti".
I I tclWlUl immuniu.tion U train«! allt'lldance at births
n 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 reducti on rales
General note on the data
1M 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.mIs
dl!eIelllroTl !hIl 006'ti<> I PJerQ used. TIIbIes
dillrtwd ivT1 "" JrOI'IY OOI.IOOS • eIoMln major lIOlIl:eI
are bled In !hIl ""l**OIlOy rnat8"a • wi
CC7>9 a V>ic:lIl r8<l(l8 of daIa ""olI:liIly. CllIciII
goo.9'''''llOl oo:a rec:eMld by tI>o ,espoustio lhlad
I'IIltlOnIlIQIlI'Cy hiM beer> used ...-posst*> In
"'" ......,. a>!lBlI """"'" Itue ..... no reIebIIl Dlk:ieI
figI.rvs, Il5lmIIe6 mooe l7; \he '''''''''''' ISti3 U"iIed
Naticns I3fiPV:'I hiM beer> used W>ere Il.dl
iIllemMiorIaly staldaIliled eslInat<lI!I 00 not 6>Os:L ltle
_
""'" IhII "IlP<4>i&II LtICEF ftIIId l,lIka E>alpt tor!hi!
'i.-Jl::a!osd lI'"(ier fM! fill. (l...lSMI'O, ecessto
S8Ie _ • .,.,."..\0 _ ......u.s ond II'Ield::alos
01 0XI'09'8QIl, ....nere tN:::EF is idantfoed
lIS a mai'1 !IOtICII, III UNICEF -... ..... mor1<ed
WIIh an •ony.
"""'" 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 Po:+x:tOlS lrlderIa<oo by trlEI
lhted Nat<nI PoI>.Aallor1 DII<oiiln n- In! _
ilIomaoonat; proo:1.oBd -... ..... ""'""'l
Piliioxl<:al)', e:<pIainI whysorre of Iha data .....
dillol< lItlrn IhcBI bn:I n <Bier LN::EF1".............
In!hIl e8!lIl d G/I.P per ClllJiIa $r<I QOo\. IhlIdIItaare
,.., ....ut 01 a <:a1Ih.<:u!I prtlCUlO 01 0Ild
bV h WOI1d Bor* 8I"Id
Thlt _ ltis )'8iI' i"d:.de llXlBl1IMl f8YlSicnllO ttIfI
dataonMera:::y, wasti1g. lllXl9SIl
Icl_Md
Tho \IlIO,.oe <II 70 ..... <lea!l"III Pili 1000 br1hs
used Ie ddi'18iIle ee IWD t"o!t8' U5MR IJO'.'lS d
a;ulIrIes ""'" "'" two re6lctsh WOI1d
&mrrit tor Otiel m:::<UIly QOI!II la1I8t. The U5MA
llO"l'*"" 818 of "'" In:Ie<M rro1aiIy rate
In" o:YItries o.ri-o;llN 1990s by onot-hd Of kl 70
per ICW M biihs. 18 iess. Hln:e, i' Iii
00<.I'lIrii!00 .a- !hIllllllar M JTO:'taIil)o \IOIlI. by IIlII
and db1990s.. lXU'III'iI>!Is'"<>.jd bo!loroIllO1h81WD
'""-....
\Ih.!re lhfmare a IEwge ruT'tIlO" ol iIIms d daIa WIIh a
rnngII. as Is !he CII:'Ilt ;, tt- -. ""'<l I'm
lhe <A not bIlilll b\' Ih8 ..,.., smaI
OIh'oI/6i 8glI t:Olf1lries.
51gnsand expla"-n"-acclicc0"-n"s_ -,----,---_ -,----,-----,,-
l.k'Iitl&ll Ol! i& _ stalOO. !hIl SU'IYI'Olfy _ b
!till "'" U5MR (Lndar five mortaiIy rat8/ """"'" of
<;:<;Id"IIIle$ ..... It'll ".,.,.,.., "lLes lor ead1 gra..p. lh8
ITlllliIn is !hIl rrGte \lIIll8 01 a diila lI!lI .'IIYld;'
0'dE0' l is !he rT"IlIllS'.'"lI ..... " , ... ty...-.
......
""""-
T
" 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 DlMIon
on .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.nIor
AdYI_, Sl8t lstlc. Md Monltomg, UNICEF, 3 U,N, Pla2a, N8W Yo<It, NY 10011, U.s.A.
"
Index to countries
tl hi Cl:U*-arel8'i<ed n __diG0'dIJ d lt8' esti, I lllllO<nIlJ ... "0....·_
lht i. aql\6l'tler$.o:Ic$ 9 hllllJ'k nh ....... liIl do::ar.-.bl*JW.
AVe.,
,
G.i.e
,
aa
--
82
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eo ......... ea ............. ..
-
3
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...... tta ....
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-
n. hb II I
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--
icc
Blii QIit::ltliIl , za l'a'\,..-...c FlIp. d
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n.
no 56 ......
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ta Ftot.adti
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53
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TABLE l' BASICINDICATORS
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An Introdudlon 10 r...9
• da\ 'I " "U 11 !hll 19906 .. l<J -..m a rmre
tur81la::e It>EJ1 !hlIAl ....... 8 ...... ' ....... do""'.--:! b'
a........,. 0I..........r.g tumn as as ecoO'1c
progo-. Fn7n LNCEF"s pci1T 01 VfilW, ;,
llvu Isa.--:! for "" 'V"'ldmalt'od oIll'llll1:Slri"l the
JIMlj 01 d*l Inl its rwtol d'oIr'ge.
The In:Ieo' l'Jto(Ilt'IOf1*v rate (U5MRl is n r.... 9
I"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» lflClISlnCl
POP' 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 srd
OAT.-; 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 ""'" ... . a'lCIlho <MtaI salely "'!he d'tiB
_i,..'.H.
Thim, is _ Itwl.!!at. _ ClIIPIII
G/'.J> 10 Ih9 faIocy 01tho IIIIllrOQO. n.s .. beQula IN
_ !lQlII'I doesnot '*'" !he ctti"81 01 "'" ridllO
be 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, ill
rru:h ITIC<1I dtrIcUl fof I I'I'EIliM1 rrilanly to atre<:I a
01110'1". I.J:5I*l. IIJld a..... u B mom
Il<XU'aII!. • fa" mm pertuer. po;llnI oIlt"ol S1<llU!l
cJ!he rA<tIIo78l \lind 01 asB"""dlII-
Fera-feB9O"I!. 1IIll1J5IIt'I is CI'QlEf1l71' LNCEF as
11$ .-.gle mosI f>ck:alcr 01 the stale cI B
nation's cttien. ThaI Js vmt!he stallS!IC8I &"fleX Isls
eerooons 01 !hll1'101:l not 1189COIdil 9 oroer 01 !her
per 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
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lIIt9 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. lor
e:<an"4lIB, Ite """'" 8bIloOJ:e reo:b:ti:rl
'llj>,*, '10 II goo:e.- peiwiIll\JlI 01 fllI:1.cIg\, The
A/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 0110
peWlls from 100 to !J:l,epo_... BreWcIol 01 lCl'l',
v.nereas ee _ 11).poim !pi lrOO1 20 III 10
J(lpr8:l8nIs a...o..:fu1 aI
We> \.ISIIld ii CO"j<n:!D'1 ""'" G/IP Ir"WIh -. tte
U5MR...-.:l irsMl1lo::liQ1 """ emIneIabeg.ll a pictJn
aI h "\09_ 00iIg rl'lIdt blIlln\' <XU'IIrY a regicr\
...-.:llMll' tJnf pI1Md cf eee. 1ONa'de It'e sarish " " aI
s:me cf 1hIl mosl m lIBcf Iunln00IIds.
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 tte
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be saar1 tha1 mEI'lI' ':Jtte retions whid11'1fMl
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Table 1:
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Main sources
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S.s,... __
tISICD' 06>0
n.... _n 1.......... S--..,
I -I , 1-a..-,,,.......lC., To03'I< 101• .101-
THE STATE OF THE WORLD'S CHILDREN 1992
The 1992 SWle of 1M World'. Child_ repon
.. issued al a time when the wolid order
wltich has dominated 1Mpolitical and
economic lifeof the 20th CC11tury is visibly
dying. The repon is offm:d, from the
panicular J>e"pcctivc of UNlCEFs
expc:rimco: in worI<ing with some of
humanity' . most lICUlC problctm, 115 I
oonmbution 10 the debate on the world
order whicb is Stl'\lgalina: 10 be born.
The repon submits 10 propositions;
taken together, lbI:y add up to I Jlf'OPCliW that
ending the absolUle poverty of ()rlt quanti" of
mankind - the man: than one biI1ion people
who sliD and dk with prevaltabk
hunger, disease, and illiteraCY - should rank
alongside the rdated is$u., of Preserv1na the
peace and pnxectina the environment as
priority items on lhe agenda of that new
WQrId ordtt.
Thc report suggcsl$ that oneof the most
tlwneful failings of the old world order .. thaI
a QIWttr of a million childtm :m being
10 die, every and that millions
more """ being alII<Immed to I half-life of
malnulririon and AIrtlo$t pr:nnanenI ill ht:ahb.
By any IWldard of scale or severity,
tim isan issuI: whic:h sbouId rankin
impor1lll'lCle " ith any on the human agenda.
But in the plIlI!, sud! problems have had little
purchase on priaity bca.usc lhcy ..., primariJy
.\he pi "blahS of the poor and the powerioss.
Coinciding with the other great d1anga
occurring 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 on
the pclitial agcndJ, in • way that is
in UNICEF. 4O-year btoey.
TIle most imporwlI signof thai new political
priority WlII the holdinjr; of the $eptemba"
\990 World S......",iljor ChildrPr. With O-"er
70 Presidcnlll and Priml: Minimn in
1I.ttendanc:e, it WlII \he largest plhcrin&of
IIeads ofStalC in history. And it met
Ip.elkally to di:scuss childrm.
Tbc outcome was • oommitm<:nt, now
signed by Illfm than 120 of state, to
an ogrccd progrvnmc: for, among other
lhings, ending lllIU malnutrition, »='Cfllllble
disease, and widespr=! iIliteraey before the
end of the de<:a<k. The Hnt of the 1q>On',
propositions is dUll this great promise 10 the
world', children ohouJd now be kept.
Governments must lead. But the report
ttrettQ the imJ)OftatlCe of Il'IObili%ing aU
pottible toeial resourc:eo behind the
commitments WI have beenmadt and calJs
on aU concerned organizations and
individuals ttl become involved in
the promise' .
'"A ..... IX'If ;" Wt1rld Iriswry is bM,
rondudeI UNICEF, "and if IJw -as ofIJw
poI)tf:S' quatUT 11/ --..:t, and of W: dUIdretr
UJht> "'" 1M ....., ofaIJ, an <>,pin
rtkgaud ID IN100_ oflhal IJwn 1M
..... Wt1rld <mJn ",1Iidl is"""/1m u.n. will 1M
MiIMrwonhy11/ iss lima ..". capahk 0/
-rUtt IJw 0/ IN fimire.
ISBN 0- 19-262228-5

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