A future for the world’s children? A WHO-UNICEF-Lancet Commission

19 February, 2020

Dear CHIFA (child health and rights) and HIFA colleagues,

This important Lancet Commission has just been published. Citation, summary (1st paragraph) and a comment from me below.

CITATION: A future for the world’s children? A WHO-UNICEF-Lancet Commission

Helen Clark et al. The Lancet 2020

Published online February 18, 2020 https://doi.org/10.1016/S0140-6736(19)32540-1



Despite dramatic improvements in survival, nutrition, and education over recent decades, today’s children face an uncertain future. Climate change, ecological degradation, migrating populations, conflict, pervasive inequalities, and predatory commercial practices threaten the health and future of children in every country. In 2015, the world’s countries agreed on the Sustainable Development Goals (SDGs), yet nearly 5 years later, few countries have recorded much progress towards achieving them. This Commission presents the case for placing children, aged 0–18 years, at the centre of the SDGs: at the heart of the concept of sustainability and our shared human endeavour. Governments must harness coalitions across sectors to overcome ecological and commercial pressures to ensure

children receive their rights and entitlements now and a liveable planet in the years to come...


The paper notes that 'High­ quality services with universal health­care coverage must be a top priority' and the need to 'empower subnational and local governments to take multisectoral action', but I could not find any discussion of the importance of empowering parents, families, caregivers and children themselves with the basic healthcare information they need to prevent and manage common illnesses and first aid situations appropriately, and to ensure early referral as needed. This is especially important in underserved regions such as rural sub-Saharan Africa, where previous research has shown that the majority of child deaths occur before reaching a health facility, with lack of basic healthcare information predisposing to indecision, inappropriate treatment, and delays in seeking care. Countries such as Bangladesh have reduced child mortality from diarrhoea thanks to community health education, and on HIFA we have made the case for many years that more should be done to increase the availability and use of essential healthcare information, in the right language, on mobile phones. See for example our 2015 article in The Lancet Global Health: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(15)00054-6/fulltext

I shall liaise with the CHIFA Steering Group to see whether and how we might address this apparent critical gap in the paper, which is otherwise very comprehensive.

Join HIFA: www.hifa.org/joinhifa

Join CHIFA: http://www.hifa.org/joinchifa

Best wishes, Neil

Let's build a future where children are no longer dying for lack of healthcare information - Join CHIFA (Child Healthcare Information For All): http://www.hifa.org/forums/chifa-child-health-and-rights

CHIFA profile: Neil Pakenham-Walsh is the coordinator of the HIFA campaign (Healthcare Information For All) and assistant moderator of the CHIFA forum. Twitter: @hifa_org FB: facebook.com/HIFAdotORG neil@hifa.org