Building a Europe for and with children

Dr Roberto Bertollini, Director, Special Programme on Health and Environment, World Health Organization (WHO) Regional Office for Europe

Message from the WHO Regional Director for Europe, Dr Marc Danzon

Your Royal Highness, (Princess Caroline of Hanover)
Your Excellency, (Minister of State of the Prinicipality of Monaco)
Deputy Secretary-General, (Ms de Boer-Buquichio, CoE)
Distinguished guests,
Ladies and Gentlemen,

Health as defined by WHO is not merely the absence of disease or infirmity, but a state of complete physical, mental and social well-being to which every citizen and every child around the world is entitled. Health is a fundamental right for every child and adolescent around the world.

The right to enjoy the “highest attainable standard of health” is enshrined in the Convention on the Rights of the Child (CRC) and is the ethical and legal basis for our work. The opportunity for children and adolescents to grow and develop in a social and physical environment that provides equitable access to health, social and legal services should be a fundamental policy objective for all countries.

However, social and economic inequalities, a lack of awareness of children’s basic rights, unhealthy and unsafe environments, social norms and traditions which support emotional and physical punishment, as well as interpersonal violence are among the many threats which deprive children of this right.

In the WHO European Region (with its 52 Member States) children’s health is influenced by multiple factors.
Let me give you a few specific examples from the area of environment and health:

On injuries: road traffic injuries and drowning, for example, are the first and third leading cause of death, respectively, in children aged 5-14 years.
On violence: child mortality from homicide is nearly three times higher in the Commonwealth of Independent States (CIS) than in the European Union. Infants and very young children (0-4 years) are at greatest risk, with homicide rates in that age group more than double those among 5-14 year olds.
Above the age of 14 years, self-inflicted injuries (including suicide) are the second leading cause of death.

Let us also not forget that children pay a high price for adults’ inability to provide for a safe environment: for example, it is estimated (depending on the source used) that between 4 000 and 14 000 deaths in children aged 0-4 years annually are attributable to outdoor air pollution.

In addition, there are marked inequalities in the health of children and adolescents.

In general, children in the CIS are worse off than their peers in the European Union. Children in low- and middle-income countries (LMIC) in the European and Central Asian Region are much more likely to suffer ill health than their peers in high-income countries (HIC) in the region. They are more likely to suffer from the consequences of unsafe or unhealthy environments and poverty. They are more likely to be killed or die as a result of violence. For all injuries, for example, children in the age group 5-14 years in LMIC are 4.2 times more likely to die than those in HIC.

The same pattern of inequality in children’s health can be found within countries: children in low-income population groups or lower social classes are especially vulnerable to risky situations, unsafe environments and risky behaviour, much more so than their peers in high-income population groups or higher social classes. In the United Kingdom, one of the wealthiest countries in the Region, children from low-income social classes have a threefold higher risk of a road traffic injury than children from high-income social classes.

Deaths of children and young adults in the European Region, which I am referring to, are extreme events and only the visible tip of the problem: for every lost life, for every child or adolescent who dies, hundreds more need support and services. Hundreds more are enduring days, weeks and months of ill health and suffering, and may be left with a long-lasting physical or psychological health problem or even disability.

We all want Europe to be a safer and better place for children.

What can we do to face the current challenges?

Following the motto “Building a Europe for and with children”, we - representatives of Member States, public and private institutions, civil society, children and parents, and policy-makers - can help transform policy into action. We can strive towards better coordination and collaboration. We can use opportunities and we can build our action on existing policies and commitments. We can capitalize on successful experience and good practice.

The World Health Organization has made a big effort, together with all its Member States and other stakeholders, to contribute to this development.

The Children’s Environmental Health Action Plan for Europe (CEHAPE), adopted by the 52 European Member States of WHO in Budapest in 2004, is an important framework for advocating for the rights of children to live and grow in a healthy environment. During the process leading up to the development and approval of this instrument, a systematic attempt was made to involve young people in the process of making policy on the environment and health and in the official committees and fora.
Participation by young people started at the Budapest Conference itself, with a Youth Parliament and 30 official youth delegates from Member States. A Youth Declaration was presented to the ministers. This called for youth representation on the European Environmental Health Committee (EEHC) and on the CEHAPE Task Force. The third meeting of the Task Force was held last week in Dublin, with the active participation of young people.

In September 2005, a European Strategy for Child and Adolescent Health and Development was adopted by the WHO Regional Committee for Europe, after a two-year process of consultation with Member States. The purpose of the strategy is to assist Member States in formulating their own policies and programmes. A toolkit was also made available to accompany the strategy, providing resources to help countries develop their own proposals for child and adolescent health and development. The strategy and associated tools will enable Member States to determine any gaps in their plans and clarify their priorities for future investment. Furthermore, the document provides an umbrella strategy for the large number of evidence-based initiatives currently being promoted by the WHO Regional Office to support the health and development of children and adolescents.

Also in September last year, the WHO Regional Committee passed a resolution to prevent injuries and violence in the WHO European Region (EUR/RC55/R9). WHO made its message clear: injuries are no accident, and the majority of them can be prevented! This resolution is therefore a commitment by WHO and its 52 European Member States to work on a comprehensive set of actions to respond to the challenges that injuries pose to children and young adults. They include national plans of action, strengthening of capacities, monitoring of progress, as well as networking and partnerships across sectors.

In November last year, national focal points for violence and injury prevention appointed by ministries of health met in the Netherlands, to initiate networking and information exchange across the Region. “A life without violence and injuries in Europe (LIVE)” is the common vision which they agreed upon to guide their future action.

Your Excellencies, distinguished guests,

The physical, mental and social well-being of children in Europe is our capital and basic investment for the future. Not only does it mirror the current state of public health, social and economic development, and the realisation of human rights, it also shapes and projects the status of the generations and population to come.

This conference is part of an important process towards a common goal: to promote children’s rights and reduce violence against children in Europe. The conference is both ambitious and practical. It aims to integrate children’s views, to discuss new challenges, and to pinpoint the action needed to achieve this goal.

I wish you success with this conference and look forward to contributing to its follow-up in the Region.