In the last 100 years, small pox has been eradicated. Widespread iodine supplements have eliminated a major cause of mental retardation. Most children receive a basic education. Millions of children have been freed from labor. And in a critical indicator of children's well-being, the mortality rate for children under five is declining in developing nations.
But wars, poverty and the spread of AIDS are major obstacles to these advancements, UNICEF executive director Carol Bellamy said in an interview Sunday.
Despite a $30 trillion global economy, 600 million children live on less than a dollar a day. Some 130 million children -- two-thirds of them girls -- are denied a quality education. Child laborers number 250 million.
Military action increasingly focuses on civilians, threatening millions of lives, as opposed to earlier wars where soldiers faced the greatest risk.
"The impact of HIV-AIDS and of conflict is in some places now not just slowing the gains but also has the potential for reversing the gains," Bellamy said.
Every minute, five young people are infected with HIV, the virus that causes AIDS. Eleven million people ages 15 to 24 suffer from the disease.
Conflicts, meanwhile, have spread to encompass 56 countries where UNICEF works, making it difficult and sometimes impossible to deliver the fruits of 20th century science: vaccines and immunizations. Approximately 540 million children -- one in four -- live in dangerous situation, the report noted.
"For all the difficulties, children go into the 21st century better than they came into the 20th century," Bellamy said. "That's not good enough."
"I think when 11 million-plus children still die around the world every year from totally, totally, totally preventable causes, then it's not good enough to say, 'Gee things are better off than before."'
The UNICEF report appeals for leadership on the national, community and family level in AIDS education and in preventing conflicts.
"The failure of leadership is reflected in the increased amount of conflict," Bellamy said. "The failure of leadership is reflected in the growth of the HIV-AIDS pandemic and the unwillingness to recognize it as something that really does require a broad commitment from a governmental perspective and a community perspective."
AIDS and conflict sometimes intertwine, increasing the negative impact on children. One graphic example of this is the trouble UNICEF and the World Health Organization have in eradicating polio and Guinea worm. Both are prevalent especially in Africa.
Aid workers have difficulties reaching children with vaccines in such strife-torn nations as Angola, ierra Leone and Somalia -- not only because of fighting, but also because in some places AIDS has claimed the primary caregiver who would bring a child to be vaccinated.
"... the biggest single problem is access," Bellamy noted.
In order to vaccinate children in Afghanistan or Sudan or the Democratic Republic of Congo against diseases eradicated elsewhere, Bellamy said UNICEF and other nongovernmental organizations must negotiate so-called "days of tranquility."
The state of the world's children in 1999 contrasts starkly with a decade ago, when the 1990 World Summit for Children set out such goals as eradicating polio and reducing mortality rates for children under five. In many places, goals that then seemed plausible have been overwhelmed by the realities of the post-Cold War era, which has brought greater instability and disparities between rich and poor, Bellamy noted.
But also surprising to Bellamy was "the enormous contrast between a 20th century that has seen such technological, medical and scientific advances and a 21st century that we still enter with a sixth of the world's population virtually illiterate."
By Colleen Barry
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