Children are the future, but pediatricians, who have devoted their lives to helping children survive and thrive, cannot alone guarantee children’s futures.

The purpose of this paper is to inform all pediatricians of the current global efforts to improving the lives of children.  It is our responsibility and privilege to ensure the future of our next generation, but in order to do this we have to be well acquainted with global, national, and local goals and targets set for children’s health.

Children’s health has been a global priority for generations.  An early instance where countries came together to create a universal understanding to ensure children’s futures was the Convention on the Rights of the Child in 1989.  The intention of the convention was to define the five dimensions of children’s rights:

 

1. To Survive and Thrive
2. To Learn
3. To be Protected from Violence
4. To live in a Safe and Clean Environment
5. To have an equal opportunity to succeed

 

In all we do as pediatricians, at the core are these five basic rights for every child, which we attempt to achieve through direct practice and advocacy.  In that light, goals set at the national and global levels have used these rights as a standard on which to build targets.

Adopted in 2000, the Millennium Development Goals (MDGs) were designed primarily for developing countries to achieve eight specific targets by 2015.  The Goal most related to Pediatrics was Goal 4: Reduce Under-five mortality by two-thirds from 1990 to 2015.  During this time, major progress was achieved: the development of the Neonatal Resuscitation program and related trainings led to a decline in neonatal mortality of up to 50% in China, where it was called the Freedom of Breath, Fountain of Life program.  Immunization rates increased, nearly eradicating Polio and reducing the global incidence of Measles and Rubella by 85-90%.  During this period new challenges arose, such as vaccine refusal and a sharp increase in Non-Communicable Disease, which required new global initiatives to be developed.

To expand on the MDGs and address the ever-changing landscape of challenges, the Sustainable Development Goals (SDGs) were formed, with a baseline in 2015.  These SDGs include 17 goals and 169 targets, ranging from Poverty Reduction and Health and Wellbeing to Peace, Climate, and Reduction of Inequality.  Health, and particularly Children’s Health, is represented by Goal 3: Good Health and Wellbeing, but in reality, all the goals speak to the Rights of the Child established 30 years ago.  

The SDGs differ from the MDGs as a result of lessons learned in the course of implementing programs to achieve the MDGs.  One difference is that every country in the world has signed on to the SDGs.  This is crucial in a world that is mobile and dynamic, and especially when considering things like Climate, Peace, and Energy, where the actions of one country can have huge lasting impacts felt around the world.  There also was much more rapid improvement in achieving the MDGs once they were more regularly measured, so the SDGs have a focus on measurement and accountability.  Annual updates are collected and targets are reported against so decision makers can monitor progress and adjust policies and programs to stay on track.

Non-Communicable Diseases (NCDs) are an ever-increasing problem for children worldwide, and the SDGs include several related targets.  Goal 3 directly targets NCDs: To reduce mortality from NCDs by 33% through prevention and treatment.  Targets will be achieved through the promotion of mental health, the strengthening of prevention and treatment of substance abuse, reducing road traffic accident deaths and injury, and achieving universal health coverage with access to quality essential health care, medicines, and vaccines.  We must make sure to include NCDs when considering children’s health because 1.2 million deaths due to NCDs (13%) occur in people under 20, and risk factors adopted in childhood result in over half of all NCD-related deaths.

According to the IOM in 2014, Health is “the extent to which children are able (or enabled) to develop and realize their potential.”  Because the SDGs incorporate not only small focused aspects of health, but rather the entire experience of children and their environments, we will be better able to ensure that all children can fully achieve this definition of health.

As pediatricians and pediatric societies, it is our role to advocate for our children at all levels.  The first step is to know about the Rights of the Child and the current global goals related to children’s health.  The next step is to become aware of the individual goals set within your country, and to understand those policies that have been adopted and those that have not, in order to achieve those goals.