EXPERT REACTION: WHO & UNICEF say our kids' future is under threat

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The World Health Organisation (WHO) and the United Nations Children's Fund (UNICEF) have released a report declaring the health and future of every child and adolescent worldwide is under immediate threat from ecological degradation, climate change and exploitative marketing practices that push fast food, sugary drinks, alcohol and tobacco at children. The report includes a new global index of 180 countries comparing performance on child survival and well-being, based on health, education, nutrition and sustainability, as well as greenhouse gas emissions, and equity or income gaps. While Australia is ranked 20th for its performance on child survival, we are ranked as one of the top ten worst greenhouse gas emitters. The authors call for a new global movement for children that drives the reduction of CO2 emissions, achieves sustainable development, improves policy and investment for child health and rights, and regulates commercial marketing.

Journal/conference: The lancet Commissions

Link to research (DOI): 10.1016/S0140-6736(19)32540-1

Organisation/s: The University of Queensland, University of Auckland, The University of Adelaide, Monash University, The University of Melbourne, Australian National University, University of Wollongong

Funder: This Commission was funded by the Bill & Melinda Gates Foundation (Seattle, WA, USA) and all authors received support from the foundation via WHO to attend meetings. For full funding information, please see the paper.

Media release

A landmark Commission report convened by WHO, UNICEF and The Lancet has found the health and future of every child and adolescent worldwide is under immediate threat from ecological degradation, climate change and exploitative marketing practices that push fast food, sugary drinks, alcohol and tobacco at children.

No single country is adequately protecting children’s health, their environment and their futures, according to an accompanying global index of 180 countries, comparing performance on child flourishing, including measures of child survival and well-being, such as health, education, and nutrition; sustainability, including a proxy for greenhouse gas emissions, and equity, or income gaps

Australia ranked 20th in the Index for survive and thrive metrics – performing best on survive rather than thrive measures (0·95 vs 0·85). However, it performed poorly on creating an environment fit for the future of its children – with CO2 emissions projected to be 524% above its 2030 target, and fell within the bottom 10 countries for emissions. [top and bottom 10 countries globally listed here] [Global top and bottom 10 countries listed here].


Peer-reviewed / Literature review, modelling

World failing to provide children with a healthy life and a climate fit for their future: WHO-UNICEF-Lancet

As climate and commercial threats intensify, WHO-UNICEF-Lancet Commission presses for radical rethink on child health

No single country is adequately protecting children’s health, their environment and their futures, finds a landmark report released today by a Commission of over 40 child and adolescent health experts from around the world. The Commission was convened by the World Health Organization (WHO), UNICEF and The Lancet.

The report, A Future for the World’s Children?, finds that the health and future of every child and adolescent worldwide is under immediate threat from ecological degradation, climate change and exploitative marketing practices that push heavily processed fast food, sugary drinks, alcohol and tobacco at children.

“Despite improvements in child and adolescent health over the past 20 years, progress has stalled, and is set to reverse,” said former Prime Minister of New Zealand and Co-Chair of the Commission, Helen Clark. “It has been estimated that around 250 million children under five years old in low- and middle-income countries are at risk of not reaching their developmental potential, based on proxy measures of stunting and poverty. But of even greater concern, every child worldwide now faces existential threats from climate change and commercial pressures.

“Countries need to overhaul their approach to child and adolescent health, to ensure that we not only look after our children today but protect the world they will inherit in the future,” she added.

Intensifying climate change threatens every child’s future

The report includes a new global index of 180 countries, comparing performance on child flourishing, including measures of child survival and well-being, such as health, education, and nutrition; sustainability, with a proxy for greenhouse gas emissions, and equity, or income gaps. [Top & Bottom 10 countries; Interactive Index, Full Global Index on pp. 35-38] [1]

According to the report, while the poorest countries need to do more to support their children’s ability to live healthy lives, excessive carbon emissions –disproportionately from wealthier countries - threaten the future of all children. If global warming exceeds 4°C by the year 2100 in line with current projections, this would lead to devastating health consequences for children, due to rising ocean levels, heatwaves, proliferation of diseases like malaria and dengue, and malnutrition.

The index shows that children in Norway, the Republic of Korea, and the Netherlands have the best chance at survival and well-being, while children in Central African Republic, Chad, Somalia, Niger and Mali face the worst odds. However, when authors took per capita CO2 emissions into account, the top countries trail behind: Norway ranked 156, the Republic of Korea 166, and the Netherlands 160. Each of the three emits 210% more CO2 per capita than their 2030 target. The United States of America (USA), Australia, and Saudi Arabia are among the ten worst emitters.

“More than 2 billion people live in countries where development is hampered by humanitarian crises, conflicts, and natural disasters, problems increasingly linked with climate change,” said Minister Awa Coll-Seck from Senegal, Co-Chair of the Commission. “While some of the poorest countries have among the lowest CO2 emissions, many are exposed to the harshest impacts of a rapidly changing climate. Promoting better conditions today for children to survive and thrive nationally does not have to come at the cost of eroding children’s futures globally.”

The only countries on track to beat CO2 emission per capita targets by 2030, while also performing fairly (within the top 70) on child flourishing measures are: Albania, Armenia, Grenada, Jordan, Moldova, Sri Lanka, Tunisia, Uruguay and Viet Nam.

Harmful commercial marketing preys on children – with childhood obesity increasing 11-fold

The report also highlights the distinct threat posed to children from harmful marketing. Evidence suggests that children in some countries see as many as 30,000 advertisements on television alone in a single year, while youth exposure to vaping (e-cigarettes) advertisements increased by more than 250% in the USA over two years, reaching more than 24 million young people.

Professor Anthony Costello, one of the Commission’s authors, said: “Industry self-regulation has failed. Studies in Australia, Canada, Mexico, New Zealand and the USA – among many others – have shown that self-regulation has not hampered commercial ability to advertise to children. For example, despite industry signing up to self-regulation in Australia, children and adolescent viewers were still exposed to 51 million alcohol ads during just one year of televised football, cricket and rugby. And the reality could be much worse still: we have few facts and figures about the huge expansion of social media advertising and algorithms aimed at our children.”

Children’s exposure to commercial marketing of junk food and sugary beverages is associated with purchase of unhealthy foods and overweight and obesity, linking predatory marketing to the alarming rise in childhood obesity. The number of obese children and adolescents increased from 11 million in 1975 to 124 million in 2016 – an 11-fold increase, with dire individual and societal costs.

A manifesto for immediate action on child and adolescent health

To protect children, the independent Commission authors call for a new global movement driven by and for children. Specific recommendations include:

1. Stop CO2 emissions with the utmost urgency, to ensure children have a future on this planet;
2. Place children and adolescents at the centre of our efforts to achieve sustainable development;
3. New policies and investment in all sectors to work towards child health and rights;
4. Incorporate children’s voices into policy decisions;
5. Tighten national regulation of harmful commercial marketing, supported by a new Optional Protocol to the UN Convention on the Rights of the Child.

Dr. Richard Horton, Editor-in-Chief of The Lancet family of journals, said: “The opportunity is great. The evidence is available. The tools are at hand. From heads-of-state to local government, from UN leaders to children themselves, this Commission calls for the birth of a new era for child and adolescent health. It will take courage and commitment to deliver. It is the supreme test of our generation.”

“From the climate crisis to obesity and harmful commercial marketing, children around the world are having to contend with threats that were unimaginable just a few generations ago,” said Henrietta Fore, UNICEF Executive Director. “It is time for a rethink on child health, one which places children at the top of every government’s development agenda and puts their well-being above all considerations.”

“This report shows that the world’s decision makers are failing today’s children and youth: failing to protect their health, failing to protect their rights, and failing to protect their planet,” Dr Tedros Adhanom Ghebreyesus, Director-General of the World Health Organization said. “This must be a wakeup call for countries to invest in child health and development, ensure their voices are heard, protect their rights, and build a future that is fit for children.”

Local author, Professor Peter Sly, Director of the Children’s Health and Environment Program at the University of Queensland, said:

“The Prime Minster, Scott Morrison, dubbed the summer of 2019-2020 and “Black Summer” related to prolonged drought and an unprecedented early bushfire season, yet prominent members of his Government deny any human “responsibility” for our changing climate. Our politician need to abandon their ideological position adopted along “party lines” and face reality. The continued mining, exporting and burning of fossil fuels represents an abrogation of our Global responsibility.

“Climate change and especially the effects of ocean warming and sea level rise present real and current threats to our Pacific Island Nations neighbours. Our politicians accept this as a “theoretical possibility” but refuse to act.”

“According to a recent poll, 67% of the Australian population want increased action on emissions and climate change. Our youth actively engage with the Global “school climate strike” movement, yet are discouraged by our leadership. Recommendation 7 of the commission report recommends that children should be given high-level platforms to share their concerns and ideas and to claim their rights to a healthy future and planet. Australia could do with encouraging this “child-led” activism. Maybe our politicians will listen!”.

“The various Governments and regulators responsible need to impose restrictions that truly protect children. Self-regulation is not working and did not work with the tobacco industry. A complete ban on advertising for all forms of alcohol and all forms of gaming during any program, including all sporting events likely to be watched by children, broadcast before 8:30 pm will be required to protect children. We did it for tobacco, so why not alcohol and gambling?”

“The other aspect of harmful marketing that is ignored by the Australian Governments and regulator are chemicals, especially those with suspected or proved neurotoxic potential. Australia lags well behind Europe and even the USA in regulating of banning of harmful chemicals in products intended for use by children or that children are likely to come into contact with. The best examples of this are bisphenols and phthalate-containing products.”


  • The Lancet
    Web page
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Expert Reaction

These comments have been collated by the Science Media Centre to provide a variety of expert perspectives on this issue. Feel free to use these quotes in your stories. Views expressed are the personal opinions of the experts named. They do not represent the views of the SMC or any other organisation unless specifically stated.

Stephen Lincoln is Emeritius Professor in the School of Physical Sciences at the University of Adelaide and a director of South Australian Nuclear Energy Systems.

A sobering and extensive report, “A future for the world’s children?” was  published on February 19 by a commission composed of the World Health Organization, WHO, and the United Nations Children’s Fund, UNICEF.

The report defines children as being between 0 – 18 years old and unsurprisingly finds children in the poorer nations to be substantially less well-nourished, healthy and educated than those in the wealthier nations. The rights of children are asserted in the in the UN Convention on the Rights of the Child which has been ratified by all countries except, surprisingly, the United States.

It is found that, while there have been substantial world-wide improvements in children’s nutrition, health and education over the past fifty years, the well-being of all children is now seriously threatened by climate change, ecological degradation and conflict; all of which generate further hazards through forced migration.

By 2030, 2.3 billion people, many of whom will be children, are projected to live in fragile or conflicted regions of the world.

In addition to these threats, commercial promotion of unhealthy food and other products are identified as a major threat to children’s well-being. Dominating everything are the huge threats of climate change and ecological degradation. The world’s nations agreed on the Sustainable Development Goals in 2015 and yet few nations, particularly the wealthy ones, have achieved much progress in their attainment.

Embarrassingly, Australia ranks a lowly 174 out of 180 nations on the environmental sustainability index, between the United States and Saudi Arabia at 173 and 175, respectively.

Increasingly, the voices of children, the Earth’s inheritors, are being heard as illustrated by Greta Thunberg who said at the World Economic Summit, Davos, Switzerland, in 2019 “I want you to act as if our house is on fire. Because it is.

Last updated: 18 Feb 2020 9:58pm
Declared conflicts of interest:
None declared.
Dr Paul Read is Senior Research Fellow at the Monash Sustainability Institute at Monash University and a Co-Director of the National Centre for Research in Bushfire and Arson

Am I really surprised that Australia is in the bottom 10 for the Children's Future report by the WHO-UNICEF-LANCET?  Absolutely not.  Even though Australia has recently been one of the wealthiest nations on Earth, half a century of other datasets confirm the same results as the Children's Future report by the WHO-UNICEF-LANCET. In fact, I defy anyone to disagree with me that this report is the most important piece of research in at least two decades, outside of Malte Meinhausen's ongoing work on carbon emissions and Sandra Diaz' Mass Extinction Report last year. 
In each case, Australia manages to disgrace itself and has done so for several decades - it's the drunken uncle at every wedding that doesn't seem to realise what he's doing wrong. He is Sir Les Patterson. If every person on Earth lived like him, we'd need three planets. Older Australians are now so wealthy they have 70% of Australia's assets and yet seem blind to younger people struggling to survive, house themselves, pay or prostitute themselves for their education. The global level of inequity has become inhuman under their watch and the Australian dependency ratio expands as each generation becomes poorer, heading for negative growth. My work also shows Australian suicide peaks either side of what might these days be called the Trump generation. 

Former Aussie of the Year and founder of the Australian Research Alliance for Children and Youth, Professor Fiona Stanley, warned us that we were seriously failing our kids almost a decade ago now, and it's just getting worse. One third of primary school children think the world will end before they have a chance to grow old.
For those Australian citizens who care, I'd suggest watching three things in detail this year - the government's response to carbon emissions, its response to bushfires, and its response to China - in all cases focusing on the future of Australia's children. Nothing else truly matters. It's way past time for older Australians to fess up and do the right thing on behalf of their own children and grandchildren. Our new cars, fine wines and international trips don't make us intrinsically interesting at dinner parties - our concern for our children is much more important. Have a look at those three reports and then vote according to your integrity and not your own bank balance.  Otherwise give world government to Greta Thunberg so our kids have even half a chance at a rapidly dwindling quality of life.

Last updated: 18 Feb 2020 9:53pm
Declared conflicts of interest:
None declared.
Associate Professor Grant Blashki from the Nossal Institute for Global Health at the University of Melbourne

This landmark Lancet WHO report is another game changing Lancet commission that will reverberate through public policy around the world.

In many ways this timely report quantifies many of the common sense  global health principles that recognise the powerful social determinants of children’s health and specifically the need for a safe climate and a healthy food environment for children to thrive.

For Australia it’s a reminder of the need for a long-term public health perspective when seeking to protect the health of our children and future generations. So what’s really at stake amongst our political debates about action on climate change is nothing less important than the future health of Australian children.

The global index acknowledges Australia’s excellent performance in the child flourishing dimensions of health education and nutrition, but at the same time reports Australia’s bottom 10 status of 180 countries on the sustainability index and is a real wake up call for Australian policymakers.

The truth is that a dry continent such as Australia is especially vulnerable to climate change impacts as we have seen over this summer with severe drought and bushfires and now flooding, and in the longer term as a country, the long-term well-being of our children needs careful attention to these global upstream determinants such as climate change.

The report also highlights the need for tighter regulation on food advertising to children and Australia like many countries around the world faces an epidemic of the noncommunicable diseases such as diabetes, obesity and related illnesses.

Last updated: 18 Feb 2020 2:29pm
Declared conflicts of interest:
None declared.
Senior Professor Anthony Okely is a researcher of child health and education in School of Education, and Director of Research in Early Start, at the University of Wollongong

This report reinforces that all Australians need to think more about the future of our country – our children. Australia is performing well on the flourishing index, but more needs to be done here to reduce health and education inequities, especially among our Indigenous children and those who are poor.

While we like to believe we are putting our children first and meeting their needs, our ranking on the Sustainability Index shows that our actions are not meeting our words. Australia’s very low score on this Index is eroding many of the advances we have made in ensuring our children are flourishing. Our children are growing up in environments that are not supporting their right to an active, healthy life. The high levels of child obesity testify to this. Children are living more sedentary lifestyles, spending large amounts of time using electronic media for entertainment. This exposes them to marketing of unhealthy foods, displaces time they could spend being physically active, and compromises healthy sleep patterns. 

With the vast majority of our children living in cities we need to pay greater attention to their needs and give them a voice in the planning of our urban environments. More needs to be done to promote active transportation. Our reliance on motor vehicles has resulted in deteriorating levels of air quality and long periods of time spent sitting. Better infrastructure in the form of footpaths, cycleways/bike lanes, and the rights of pedestrians is needed. Our children need better access to parks and playgrounds and to be able to move freely around their neighbourhoods without fears about safety or the traffic.

Last updated: 18 Feb 2020 2:23pm
Declared conflicts of interest:
Anthony has declared no conflicts of interest.
Dr Liz Hanna is Chair for the Environmental Health Working Group at the World Federation of Public Health Associations, as well as is from the Climate Change Institute at the Australian National University (ANU)

This rigorous study married the voices of children with global metrics. It further explains why the world’s children are uprising, demanding governments protect their future. Australia’s poor ranking provides powerful evidence that Australia has lost its way.

Decades of wilful neglect of the environment and the erosion of compassion have transformed the lucky country to an international laggard that is failing its children. By taking our natural advantages for granted, Australia is squandering its opportunities to secure a safe and healthy future for our children.

Pandering to the sugar industry, and refusing a sugar tax, needlessly renders children at high risk of obesity, diabetes and a life plagued by chronic disease and disability. Sacrificing our children’s health for electoral wins is nothing short of dereliction of duty of care at best, and I would argue, reflective of criminal neglect at worst.

Similarly, steadfastly clinging to fossil fuel industries, against solid scientific evidence, unfolding climatic crises and environmental degradation knowingly accelerates climate change and robs children of their future.

Ranking 174th out of 180 countries on the Sustainability Index is as shameful as it is stupid. Ecologically ignorant economic rationalists fail to recognise that sustainability of planetary environmental attributes also sustains humanity. We cannot prosper without clean air, clean food, clean water and a stable climate. Economies cannot prosper amidst environmental meltdown as the summer of horrors has so tragically revealed.

The “Where the bloody hell are you?” campaign promoted Australia’s easy, friendly eco-tourism. Alas, the bleached Great Barrier Reef now offers little intrinsic value to tourists, burned, scarred landscapes are unlikely to attract visitors when our wildlife is effectively disappearing.

Unlike the climate change denialists who permeate the airwaves and print, and pull rank in the halls of power, the rest of the world understands climate change presents an existential risk… it risks our very existence. They think we are stupid to let our emissions rise 524% above target.

I ask myself again - Who is running this country? Representatives who serve the Australian people, or the coal industry?

Let’s learn the salient lessons of this summer of horrors, turn this country around, and prioritise our children’s future. Children deserve a future. Their demands are reasonable. We must not fail them.

Last updated: 18 Feb 2020 2:22pm
Declared conflicts of interest:
None declared.

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