Brazzaville, 16 June 2008 -- The Day of the African Child has been celebrated on 16 June every year since 1991, when it was first initiated by the Organisation of African Unity. This day honours the memory of the children who, in 1976, were brutally shot down while marching in the streets of Soweto, South Africa to protest the inferior quality of their education.

This year the African Union’s theme for this special day is “Right to Participation: Let Children be Seen and Heard”.  On this special occasion, the WHO Regional Office for Africa wants to draw attention to the issue of the unfinished agenda of child survival in the African Region.

Children in sub-Saharan Africa face the gravest challenges for survival. The Region has 10% of the world’s population but accounts for 50% of the world’s under-five mortality. Out of the 46 countries which constitute the WHO African Region, only five are on track to meet the target for Millennium Development Goal 4, to reduce by two thirds, between 1990 and 2015, the under-five mortality rate.

The average under five mortality rate in the African region is 165/1000 live births compared to 6/1000 live births in the industrialized countries.

Good progress has been achieved in the Region in some areas: 84% of young children receive measles vaccine, thus measles mortality was reduced by 91% between 2000 and 2007. Also, 79% of full coverage has been achieved for vitamin A supplementation in children 6 to 59 months. However other key child survival interventions are not reaching children who need them most: only 40% of under-fives with suspected pneumonia are taken to an appropriate health-care provider; only 39% of under-fives with diarrhoea receive oral rehydration therapy; only 37% of under-fives with fever receive antimalarial drugs in malaria-endemic countries; only 30% of infants are exclusively breastfed; 14% of children sleep under mosquito nets despite malaria being a major childhood killer.

The majority of these children also live in environments that do not adequately support their survival, growth and development. Only 55% of the people in the Region use water from improved sources, and only 37% use adequate sanitation facilities.

The WHO Regional Office for Africa in collaboration with many partners has provided technical and financial support to countries aimed at improving newborn health, child survival and adolescent health. The support has been aimed at stimulating partnerships and work with UNICEF, the African Union and the World Bank to develop the Regional Child Survival Strategy and subsequently to support the implementation of national child survival strategies.

The Regional Office has continued to advocate for scaling up priority interventions such as Essential Newborn Care, the Integrated Management of Childhood Illness strategy, Infant and Young Child Feeding including micronutrient supplementation and deworming, use of insecticide-treated bednets and intermittent preventive treatment for the prevention of malaria, immunization of mothers and children, prevention of mother-to-child transmission of HIV, and treatment and care of exposed or infected children with HIV/AIDS. Mobilization of resources to support the scaling up of these interventions has continued.

On the occasion of the celebration of the Day of the African Child, we call upon leaders in the African Region to fulfil their commitments so that all children in the Region who need the above life-saving interventions can access them.

In the 21st century, we cannot allow 4.7 million African children to die each year when most of these deaths can be avoided.

We cannot allow countless children, to be excluded from the health care to which they are entitled.  African leaders readily agreed that we cannot allow this to continue, but in many countries the situation is either improving too slowly or not improving at all, and in some it is getting worse. Children represent the well-being of our society and its potential for the future. Their health needs cannot be left unmet without harming the whole of society.

Families and communities themselves can do a great deal to change this situation. They can improve, for example, the position of women in society, parenting, disease prevention, care for the sick, and uptake of services. This area of health is also a public responsibility. Community case management of childhood illness, especially for pneumonia, diarrhoea and malaria should be scaled up where access to health services is poor. Public health programmes need to work together so that all families have access to a continuum of care that extends from pregnancy (and even before), through childbirth and on into childhood, instead of the often fragmented services available at present.

It is not satisfactory to provide care for a child while ignoring the mother’s health, or to assist a mother giving birth but not the newborn child. To ensure that all families have access to care, African governments must accelerate the building up of coherent, integrated and effective health systems using the Primary Health Care principles as the backborn of their health delivery systems. In this way we can move towards the attainment of the Millennium Development Goals as well as project beyond them