Pretoria News - - OPINION - MARK TOM­LIN­SON, ASHA GE­ORGE AND TANYA DO­HERTY | The Con­ver­sa­tion

RE­MARK­ABLE progress has been made in the health and well-be­ing of chil­dren and young peo­ple since 1990. But pro­found in­equal­ity means lit­tle has changed for many in the world’s poor­est re­gions. Chil­dren around the world also face un­prece­dented dan­gers from cli­mate dis­rup­tion and un­reg­u­lated com­mer­cial ac­tors.

These are the find­ings of a re­port re­cently pub­lished by a WHOUNICEF-Lancet com­mis­sion on re­defin­ing and ac­cel­er­at­ing progress on child health and well-be­ing. The com­mis­sion is made up of child health, cli­mate change and health sys­tems researcher­s and ad­vis­ers from uni­ver­si­ties, non-gov­ern­men­tal or­gan­i­sa­tions, UNICEF and the World Health Or­gan­i­sa­tion (WHO).

The com­mis­sion de­vel­oped a new “flour­ish­ing in­dex” which as­sessed chil­dren’s health, ed­u­ca­tion, growth and ex­pe­ri­ences of vi­o­lence.

It also cre­ated a sus­tain­abil­ity in­dex which ranked coun­tries based on their ex­cess green­house gas emis­sions. Strik­ingly, no coun­try did well on sus­tain­abil­ity, flour­ish­ing and the ab­sence of in­equity. All three are es­sen­tial for se­cur­ing the fu­ture of chil­dren and young peo­ple.

The com­mis­sion re­ported on the per­for­mance of 180 coun­tries and gave them a rank­ing. As com­mis­sion­ers from South Africa, we have fo­cused here on how South Africa per­formed.

The coun­try was in 127th po­si­tion on the flour­ish­ing in­dex, lower than coun­tries with much fewer re­sources. For ex­am­ple, Viet­nam is a lower mid­dle-in­come coun­try but is in 58th po­si­tion on the flour­ish­ing in­dex. On the sus­tain­abil­ity in­dex, South Africa ranked 150th and Viet­nam 85th.

This means that chil­dren face many more health, de­vel­op­ment and sus­tain­abil­ity chal­lenges in South Africa than in Viet­nam, de­spite South Africa be­ing more eco­nom­i­cally ad­vanced than Viet­nam.

South Africa stood out as a unique ex­am­ple of a coun­try that per­formed poorly across both the flour­ish­ing and sus­tain­abil­ity in­dices.

The in­di­ca­tors cap­tured in the flour­ish­ing in­dex high­light the enor­mous gaps that re­main for chil­dren and young peo­ple in South Africa.

The sus­tain­abil­ity in­dex in­di­cates that the prob­lems don’t end there. The coun­try has ex­tremely high car­bon emis­sions, un­usu­ally for an up­per mid­dle-in­come coun­try. South Africa’s car­bon emis­sions are driven by the heavy re­liance on coal for en­ergy and heavy in­dus­try.

The coun­try is al­ready ex­pe­ri­enc­ing the im­pact of cli­mate break­down. Keep­ing emis­sions un­der con­trol re­quires ac­tion on new poli­cies that al­low for re­new­able en­ergy pro­duc­tion.

In ad­di­tion to in­equal­ity and cli­mate dis­rup­tion, the com­mis­sion found that chil­dren were tar­geted by harm­ful mar­ket­ing prac­tices. Large com­pa­nies that dom­i­nate the food and bev­er­age en­vi­ron­ment have be­come more wide­spread in.

Chil­dren and young peo­ple face un­prece­dented threats to their health and well-be­ing from in­equal­ity, com­mer­cial mar­ket­ing and cli­mate break­down. Dras­tic ac­tion is needed to ad­dress this. Steps iden­ti­fied by the com­mis­sion in­clude:

● Con­trol­ling emis­sions: With­out change, there is a 93% chance that global warm­ing will ex­ceed 4 de­grees Cel­sius by 2100, with cat­a­strophic con­se­quences.● Con­trol­ling harm­ful mar­ket­ing: Chil­dren face in­creas­ing ex­po­sure to com­mer­cial ad­ver­tis­ing and so­cial me­dia pro­mot­ing in­ap­pro­pri­ate foods, al­co­hol, to­bacco and gam­bling. ● In­volve­ment of chil­dren: Chil­dren’s con­tri­bu­tions lead to im­proved so­cial co­he­sion and more equal com­mu­ni­ties. It is their fu­ture; their voices must be heard and they must have the means to hold adults ac­count­able.

● Lead­er­ship: Coura­geous lead­er­ship is called for at all lev­els. Child well-be­ing is of­ten del­e­gated to smaller de­part­ments, bun­dled with dis­abil­ity and women’s is­sues. This must change.

Tom­lin­son is a pro­fes­sor at the In­sti­tute for Life Course Health Re­search in the Depart­ment of Global Health at Stel­len­bosch Univer­sity. Ge­orge is the South African re­search chair­per­son in Health Sys­tem at the Univer­sity of the Western Cape. Do­herty is the chief spe­cial­ist sci­en­tist at the South African Med­i­cal Re­search Coun­cil

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