Jan 11, 2020 Volume 395Number 10218p89-164, e2-e5
Join the Lancet 2020 Campaign on child and adolescent health
We started science-based advocacy with our first ever global health Series on child mortality in 2003. The 2003 Series pointed out that of the 10 million annual deaths of children younger than 5 years worldwide, two-thirds were preventable. The recommendations then were to reinvigorate the child survival revolution of the 1980s by ensuring equity in access to health care and preventive interventions; creating clear leadership for child survival; strengthening health systems; and providing adequate and targeted human and financial resources for child health. However, now in 2020, we see an urgent need to make child and adolescent health and wellbeing the focus of a special campaign across our journals as progress made is stalling or reversing and new political and environmental realities are emerging.
Much positive change has happened in the past 17 years in child and adolescent health, which might be seen as a beacon in achievements in global health overall. Under-5 mortality has more than halved since 1990, to about 5·3 million deaths in 2018. Maternal health and early child development have been recognised as important foundations for lifelong health and wellbeing. The adolescent years have been discovered as a time of unique opportunity to extend the gains made in early childhood and in some cases to provide a second chance to foster and strengthen health and wellbeing, with far-reaching consequences into adulthood and the next generation. Adolescents and young people have taken the initiative, joined global health discussions, and, in the past year in particular, have been vocal advocates for actions to address climate change and environmental degradation, and to protect planetary health.
The Millennium Development Goals agenda that concluded in 2015 provided clear targets and achieved measurable—albeit uneven—progress. The then UN Secretary General Ban Ki-moon’s focus on the Every Woman Every Child Global Strategy for Women’s, Children’s, and Adolescents’ Health, launched in 2015, was a welcome focus on the groups that arguably matter most for the subsequently agreed Sustainable Development Goals (SDGs). But now, at the start of the fifth year into the SDGs, there is cause for concern. The UN’s leadership’s focus has moved away from health. WHO’s prioritisation of universal health coverage has weakened the attention given to maternal, child, newborn, and adolescent health.
In addition, the economic, political, commercial, and environmental determinants—so essential for child and adolescent health—have changed dramatically. A child growing up today faces an unprecedented threat to health and livelihood, let alone wellbeing, because of a climate emergency. Migration, increasing conflicts, political agendas moving away from provision of social safety nets and poverty reduction even in high-income countries, the continued commercial exploitation of children and young people leading to unhealthy diets, and exposure to alcohol and tobacco products mean that children and adolescents in 2020 need special attention if we are serious about a sustainable and healthy future for all.
With this editorial we start our Lancet 2020 Campaign on child and adolescent health. Throughout the year there will be milestone publications and events. In February, a new WHO–UNICEF Lancet Commission will put children firmly at the centre of the SDGs in the hope to kick-start a new global movement. Global Burden of Disease papers will provide new data to monitor progress. A Commission on Women, Children, and Adolescent Health in China will place a spotlight on a country where many children and adolescents live and a rapid transition of determinants of health and the health-care system is happening. A Series on physical activity will include new findings and recommendations for adolescents and further Series will aim to unify the fields of maternal, neonatal, child, and adolescent health around the goal of a lifelong attention to health and equity achieved through intersectoral collaboration. At the Tokyo Global Nutrition Summit, we aim to launch a Series on adolescent nutrition. Our specialty journals have plans to publish Commissions on institutionalised children, paediatric cancer care, youth mental health services, and pain control in children.
A special communications strategy will be developed to support the campaign and facilitate partnerships with as many other communities as possible. We aim to engage and galvanise political leaders, policy makers, civil society and non-governmental organisations, researchers and clinicians, funders and responsible commercial organisations, and children and young people themselves. Please join us to make a difference with our 2020 Campaign.