UNICEF 75 Report
UNICEF 75 Report
For 75 years, UNICEF has delivered for children. From The world stands at a crossroads. We have a
armed conflict, natural disasters and humanitarian decision to make. Do we rally and unite to protect
crises to long-term survival and development years of progress on child rights? Or do we allow
programmes, our staff and partners have been on the the unequal recovery from COVID-19 to further
ground working to provide essential services for those marginalize the disadvantaged and increase
in need. Through the decades, UNICEF has helped to inequality even more?
develop healthier and safer environments for children
and their families. UNICEF was created at another moment of crisis.
Much of the world lay in ruins following years of war.
Take one example – vaccines. In the 1980s, UNICEF Then, as now, marginalized and vulnerable children
and partners embarked on a bold mission – to were most affected. In this context, UNICEF was
immunize every child against preventable diseases. created with the mandate to uphold and defend the
Together with governments, we facilitated one of the rights of every child.
greatest logistical mobilizations in peacetime history.
By the early 1990s, global childhood immunization So as we commemorate UNICEF’s 75th year, we
levels reached 80 per cent. must also take stock of the work yet to be done
for children. Now and in the years to come, we
Before the pandemic, we had made great strides will continue to strive to create a world where
toward helping all children realize their right to health, children’s rights are fully realized, and where we open
education and protection. At the start of 2020, more opportunities for every child. This is an ambitious
children were living to see their first birthday than undertaking that depends on new and strengthened
at any time in history. Child mortality had fallen by partnerships with governments, civil society, our
50 per cent since 2000. Maternal mortality and child UN sister agencies and business. But together, we
marriages were on the decline and more girls were can build on the foundation of 75 years of results
going to and staying in school than ever before. for children.
Yet multiple crises are now threatening those hard- In the aftermath of the Second World War, the
fought gains for children. The COVID-19 pandemic private sector was instrumental in helping to rebuild
has been the biggest threat to children in our 75-year economies, services and systems for children.
history. While the number of children who are hungry, In the years to come, the private sector will be a
out of school, abused, living in poverty or forced into pivotal partner in driving innovation and technology
marriage is going up, the number of children with to help us provide better services to more children
access to health care, vaccines, sufficient food and and families.
essential services is going down.
And of course, children and young people are
The COVID-19 pandemic, a worsening climate crisis, the most important partners of all. They are more
armed conflict, displacement and other humanitarian than voices and beneficiaries – they are integral
emergencies are depriving children of their health and participants in creating and implementing solutions.
well-being. These developments portend an even more Their strength, creativity and courage give me hope.
challenging future – a future in which the world could fall By working with them, we can respond to and recover
short of meeting the Sustainable Development Goals from the pandemic equitably and reimagine a better
(SDGs) to end poverty, reduce inequality and build more future for every child.
peaceful, prosperous societies by 2030. In September,
UN-Secretary General Guterres laid out the stakes to
an audience of world leaders: “I am here to sound the
alarm. The world must wake up. We are on the edge of Henrietta Fore
an abyss – and moving in the wrong direction.” UNICEF Executive Director
CONTENTS
Foreword 2
Key messages 4
Introduction 6
1
A protracted pandemic with unequal impact 9
A reimagined future 11
75 years of delivering for children 12
Poverty 16
Health and immunization 19
Education 20
Child protection 21
Nutrition 22
Mental health 24
Humanitarian emergencies 25
KEY MESSAGES
• COVID-19 is the worst crisis for children in UNICEF’s • For the best-case scenario to become a reality, we
75-year history. Without action, the world faces a must take action now.
lost decade for children, leaving the Sustainable • Even before the pandemic, around 1 billion children
Development Goals an impossible dream. worldwide, and half of all children in developing
• In less than two years, 100 million more children countries, suffered at least one severe deprivation,
have fallen into poverty, a 10 per cent increase since without minimum levels of access to education,
2019. health, housing, nutrition, sanitation or water.
• In a best-case scenario, it will take seven to eight • The world stands at a crossroads. We must decide
years to recover and return to pre-COVID-19 child to either protect and expand the gains made for
poverty levels. child rights over years, or suffer the consequences
• The deep disparity in recovery from the pandemic of reversed progress and a lost decade for today’s
is widening the gap between richer and poorer children and young people, which will be felt by all of
countries. While richer countries are recovering, us, everywhere.
poorer countries are saddled with debt and
development gains are falling behind. The poverty
rate continues to rise in low-income countries and
least developed countries.
• Far from feeling powerless in the face of challenge, • Make our collective future – our children – first in
today’s children and young people welcome line for investment and last in line for cuts.
change and challenges, forging ahead with • This agenda for action is based on UNICEF’s
resilience and courage. Rather than consigning 75 years of experience, research and practice and
themselves to an already determined future, 75 years of listening to children and young people.
they are taking action. Today’s young generation • To respond and recover and to reimagine the
are more hopeful and confident that the world is future for every child, UNICEF continues to call for:
becoming a better place. › Investing in social protection, human capital and
• Today’s crises also present a unique window of spending for an inclusive and resilient recovery
opportunity for the world to reimagine itself – › Ending the pandemic and reversing the
as a fair, safe, interdependent whole in which alarming rollback in child health and nutrition –
every child’s potential stands an equal chance of including through leveraging UNICEF’s vital role
fulfillment. in COVID-19 vaccine distribution
• For 75 years, UNICEF has been the world’s leading › Building back stronger by ensuring quality
architect and advocate for child rights, whose work education, protection and good mental health
in delivering for every child, especially in times of for every child
crisis, is as critical today as ever. › Building resilience to better prevent, respond to
• This is not a moment to be cautious. This is the and protect children from crises – including new
time to work together and build a better future. approaches to end famines, protect children from
climate change and reimagine disaster spending.
Rukaiya Abbas, a
UNICEF Nigeria
Education Officer,
talks with children at
Kulmsulum School in
Maiduguri, Nigeria.
© UNICEF/UN0322355/Kokic
6 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
INTRODUCTION
COVID-19 is the worst crisis for children in UNICEF’s By September 2021, schoolchildren around the world
75-year history. Almost two years into the pandemic, have lost an estimated 1.8 trillion hours of in-person
its widespread impact continues to deepen, increasing learning due to COVID-related school closures, which
poverty and entrenching inequality. While some will have profound long-term, unequal social and
countries are recovering and rebuilding in a ‘new economic effects.
normal’, for too many, COVID-19 remains a catastrophe.
Essential nutrition and health services such as routine
The global response so far has been deeply unequal immunization programmes and maternal and childcare
and inadequate. The world now stands at a crossroads. continue to be disrupted.
The actions we take now will determine the well-being
and rights of children for years to come. School closures, job losses among families and
increased stress and anxiety have affected the mental
The unequal rollout of COVID-19 vaccines is putting health of children and young people.
entire communities at risk. And as new variants
continue to emerge, children and their communities COVID-19 remains an urgent crisis for children that
continue to face health risks. requires sustained, focused action.
Increases in poverty have set back progress toward As we commemorate UNICEF’s 75th year, this report
realizing children’s rights and achieving the Sustainable lays out the work in front of us by taking stock of the
Development Goals. ongoing impact of COVID-19 on children and the road
to respond and recover to reimagine the future for
Children’s diets have deteriorated, and families struggle every child.
to find ways to find enough food and safe water for
their children.
INTRODUCTION 7
Children today are growing up in a world facing and taking heavier toll on civilians, disproportionally
multiple crises. affecting children. Women and girls are at the highest
risk of conflict-related sexual violence. Eighty per cent
The costs are not affecting all children equally. The of all humanitarian needs are driven by conflict.
most marginalized and vulnerable are hurt the most
and vast disparities in health, education, mental health, 50 million children suffer from wasting, the most life-
poverty and migrants remain: threatening form of malnutrition, and this figure could
increase by 9 million by 2022 due to the pandemic’s
In 2020, over 23 million children missed out on impact on children’s diets, nutrition services and
essential vaccines – an increase of nearly 4 million feeding practices.
from 2019, and the highest number since 2009.
Approximately 1 billion children – nearly half of the
At its peak, more than 1.5 billion students were out world’s children – live in countries that are at an
of school due to nationwide shutdowns. Millions of ‘extremely high risk’ from the impacts of climate
children are either not in school or not learning the change.
basic skills they need to build a better future.
More children are displaced than ever before. Last
Mental health conditions affect more than 13 per cent year, more than 82 million people worldwide were
of adolescents aged 10–19 worldwide. forcibly displaced.
A PROTRACTED PANDEMIC
WITH UNEQUAL IMPACT
Around the world, the pandemic continues to Nowhere is this clearer than the roll-out of COVID-19
wreak havoc on young lives. COVID-19 has affected vaccines. The triumph of science and human
essentially every child in the world. But it has not inventiveness led to the creation of life-saving vaccines
affected all children equally. Governments are in record time. Yet as those in richer countries have
scrambling to accelerate vaccination programmes access, many in poorer countries still wait for their
while prolonging or even reintroducing public health first dose. As of 1 November 2021, over 80 per cent
measures. of administered COVID-19 vaccine doses have been in
high- and upper-middle-income countries. Just 1.5 per
A survey of UNICEF Country Offices from March cent have been given in low-income countries.
and April 2021 report that all countries – not only
those with ongoing humanitarian response or that At the Global COVID-19 Summit in September, world
are off-track towards reducing child mortality rates – leaders set a target that every country should vaccinate
continue to face some severe service disruptions due 70 per cent of its population by mid-2022. Yet according
to the COVID-19 pandemic and response. Countries to one estimate, the more than 85 low-income
with Humanitarian Action for Children (HAC) appeals countries will not reach a vaccination rate of 60 per
are more affected. Lockdown measures that restrict cent until 2023, or even later.
mobility, access and transportation are a leading reason
for service disruptions. This unjust rollout not only affects those who lack
access to vaccines but it also affects the entire world.
The economic recovery has been deeply unequal. As the virus continues to spread, the more it continues
While richer countries are expected to regain all to mutate, potentially into more dangerous variants.
pandemic losses before the end of 2022, low-income
countries face a fiscal and economic crisis that could The pandemic will not be over for anyone until it is over
last for years. And while richer countries are spending for everyone.
trillions on stimulus programmes and rolling out
COVID-19 vaccines, low-income countries face slower
economic growth, vaccine shortages, food insecurity
and deepening poverty. With many lower-income
countries in debt distress, the pandemic is widening
the gap between rich and poor countries.
10 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
A REIMAGINED FUTURE
A year ago, we urged the world to take action to avert Children should be first in line for investment and
a lost COVID generation. One year later, it is clear that last in line for cuts. We are starting our 76th year by
far from being powerless in the face of challenge, calling for urgent action to respond to and recover from
today’s children and young people are the ‘welcome’ COVID-19. An equitable recovery will not only reverse
generation – welcoming change and challenges, the effects of the pandemic, but also build a foundation
forging ahead with resilience and courage. Rather for responding to future crises and reverse the deep
than consigning themselves to an already determined inequalities that affect children:
future, they are taking action and opening new
opportunities. 1. Invest in social protection human capital and
spending for an inclusive and resilient recovery:
Today’s young generation is more hopeful and • Ensure an inclusive recovery for every child
confident that the world is becoming a better place. • Invest in the untapped potential of young migrants,
UNICEF’s Changing Childhood project surveyed over refugees, and internally displaced people.
20,000 people across 21 countries and found that
2. End the pandemic and reverse the alarming
instead of despairing in the face of inequality and the
rollback in child health and nutrition, including
climate crisis, the young are instead more confident
through leveraging UNICEF’s vital role in
that the world is becoming a better place compared
COVID-19 vaccine distribution:
to those aged 40 and older. The survey also found
• Ensure fair and equitable access to COVID-19
that today’s young people are more likely than the
vaccines
older generation to recognize the progress made as
• Protect children from deadly but treatable
living standards have risen and access to services has
diseases
expanded.
• Reverse the child nutrition crisis.
1946 1980s
1970s 1990s
On a global scale, children’s health and well- Following the 1989 adoption of the Convention on the
being have improved significantly since 1946. Rights of the Child – the most comprehensive international
Together with partners, UNICEF has developed legal framework on children’s rights – UNICEF brought
life-changing innovations for children: the India nations together under the banner of children’s rights and
Mark II family of water handpumps developed in adopted a human rights-based approach to programming,
the 1970s is still the world’s most widely used placing human rights principles at the centre of its work.
human-powered pump. In the 1990s, UNICEF also developed School-in-a-Box, which
continues to keep children learning in emergency settings.
Photographs: top left © UNICEF/UNI43138/Unknown, top right © UNICEF/UN0300443/Bannon, bottom left © UNICEF/UNI43280/Wolff, bottom right © UNICEF/ UN0339499/Frank Dejongh
In the 2000s, UNICEF brought to scale a ready-to- And in 2020, as the world grappled with the
use therapeutic food, which has become the global COVID-19 pandemic, UNICEF played a key role
standard to treat children suffering from malnutrition. in the UN-wide response and led efforts to
From 2000 to 2019, scaling up of coverage of malaria procure and supply COVID-19 vaccines so that all
prevention and treatment, such as insecticide-treated countries have fair and equitable access to the
nets, malaria rapid testing and drugs, reduced global vaccine as part of the COVID-19 Vaccine Global
malaria mortality by 60 per cent. Access Facility (COVAX).
2000s 2020s
2010s
A decade later, UNICEF took a leading role in But there is still much to do. Deeply ingrained
challenging systemic inequity around the world. In discrimination, poverty and inequality are leaving too
2015, the world began working toward a new global many children and young people behind. UNICEF
development agenda, seeking to achieve, by 2030, is dedicated to continuing to reach children from
new targets set out in the Sustainable Development the poorest, most disadvantaged households,
Goals (SDGs). communities and countries.
Photographs: top left © UNICEF/UN0519450/Upadhayay, top right © UNICEF/UN0528415/Sujan, bottom left © UNICEF/UNI187128/Noorani, bottom right © UNICEF/UN0546107/Contreras
14 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
COVID-19’S ONGOING
IMPACT ON CHILDREN
POVERTY
The COVID-19 pandemic is reversing progress in the is a stark inequality. While richer countries seem to be
fight against child poverty. Although in much of the improving, the poverty rate is expected to increase in
world, child poverty levels in late 2021 are not as high low-income countries and least developed countries
as in the early months of the pandemic in 2020, it will compared to 2020.
take at least seven to eight years to recover and return
to pre-COVID-19 child poverty levels. Simply put, the In developing countries, the percentage of children
recovery is not fast enough. living in multidimensional poverty is projected to have
increased from 46–48 per cent pre-COVID-19 (around
UNICEF calculates child poverty by two distinct but 1 billion children) to around 52 per cent in 2021. This
complementary measures: children living in monetary is equivalent to a projected increase of 100 million
poor households and multidimensional poverty additional children living in poverty compared to 2019.
(deprivations in at least one of the following: education, In the least developed countries, the increase in
health, housing, nutrition, sanitation and water). poverty is projected to be even more dramatic, rising
from 48 per cent in 2019 to around 56 per cent in 2021
The percentage of children living in monetary poor (an increase of over 40 million children).
households is projected to have increased dramatically
in 2020 compared to 2019. While globally, 2021 is In addition, lower-income countries are recovering at
expected to see a modest decrease from 2020, there a slower pace and continue to have higher levels of
FIGURE 1 FIGURE 2
The share of children living in monetary poor The rise in multidimensional poverty since
households is projected to continue rising in before the pandemic is expected to be more
low-income countries dramatic for the least-developed countries
Children living in monetary poor households (%) Children living in multidimensional poverty (%)
30 30
20
20
10
10
0
0
2019 2020 2021
2019 2020 2021
unemployment, prolonging the suffering of families and Some of this increase is projected to be reversed in
children. The unequal distribution of the COVID-19 shock 2021 as schools reopen and health services recover.
will likely deepen inequality between countries and However, as the pandemic continues, lagging and
particularly impact children living in low-income regions. cumulative effects of the economic disruption on
Children already living in monetary poverty are more nutrition are becoming evident, leading to a change
likely to suffer a greater depth of poverty, while a new in the composition of child poverty. These changes
pool of children is more likely to increase the prevalence include both a different set of children and different
of poverty due to the unemployment rate increase. problems. Underlying many of these challenges are
significant gaps in social protection. For example, only
Even before the pandemic, almost half of all 1 in 4 children have access to any form of child or
children in developing countries suffered at least family benefit.1
one severe deprivation such as education, health,
housing, nutrition, or water and sanitation. In 2020, 1 Note: For more on the assumptions, analysis, and methods used to
expand and update the projections of the impact of COVID-19 on child
multidimensional poverty increased 15–18 per cent poverty and children living in monetary poor households carried out last
due to immediate impacts of COVID-19 such as school year by Save the Children and UNICEF, please see Impact of COVID-19
on children living in poverty: A Technical Note <www.unicef.org/reports/
closures and health services disruption. unicef-75-preventing-a-lost-decade>.
18 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
According to data from the first quarter of 2021, more • Of those 23 million more than 60 per cent live in just
than half of respondent countries reported some level ten countries (Angola, Brazil, Democratic Republic
of reduction in routine vaccination services compared of the Congo, Ethiopia, India, Indonesia, Mexico,
to the same time in 2020 and more than one third Nigeria, Pakistan and the Philippines) and 17 million
of respondent countries reported disruptions to both of them did not receive any vaccines (zero-dose
routine facility-based and outreach immunization children).
services.
• Most of these children live in communities affected
Years of progress in childhood immunization were by conflict, under-served remote areas, or informal
eroded in less than two years of the pandemic: urban settings where they experience multiple
deprivations, including poor access to basic health
• In 2020, over 23 million children missed out on and social services.
essential vaccines – an increase of nearly 4 million
from 2019, and the highest number since 2009.
EDUCATION
Richer schoolchildren have access to digital technology Disparities in access to the internet are even starker
that allows them to learn remotely, whereas children between rich and poor countries. Only 6 per cent of
from poorer households are at risk of falling further children and young people aged 25 years or younger in
behind in their education. The combination of low-income countries have internet access at home,
prolonged school closures and inadequate remote compared to 87 per cent in high-income countries.
learning could translate into substantial learning loss, Globally, among the richest 20 per cent of families,
further exacerbating the learning crisis. 58 per cent of children and young people aged 25 years
or younger have internet access at home compared to
Stark inequalities in internet access remain across and only 16 per cent of children and young people from the
within countries. Globally, 2.2 billion children and young poorest 20 per cent of households.
people aged 25 years or less – two thirds of children
and young people worldwide – do not have an internet
connection at home.
20 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
FIGURE 3 A higher percentage of in-person instruction time was disrupted by full school closures in low- and
lower-middle-income countries
Schools that are fully open Schools that are partially closed Schools that are fully closed
High income 29 51 21
BY INCOME GROUP
Upper-middle 27 33 40
income
Lower middle 13 34 53
income
Low income 36 22 42
World 22 35 43
South Asia 3 40 57
Latin America
3 18 79
and Caribbean
North America 0 97 3
North Africa
Eastern and 32 24 44
Southern Africa
East Asia
and Pacific 33 39 29
Eastern Europe
41 26 32
and Central Asia
West and
42 21 38
Central Africa
Western Europe 46 25 29
Percentage of in-person instruction time disrupted by school closures over the first year of the pandemic (11 March 2020 – 11 March 2021)
Note: Schools are considered ‘fully closed’ if the closures institutionalized by the governments affect at least 70 per cent of the students (in pre-primary through
upper secondary education) in a country; subnational school closures affecting a smaller share of students are considered as partial.
COVID-19’S ONGOING IMPACT ON CHILDREN 21
CHILD PROTECTION
Even before COVID-19, violence was all-too common increased rates of sexually transmitted infections,
in the lives of children, affecting at least 1 billion intergenerational poverty, and the disempowerment
children every year. All indications suggest that the of married girls. The pandemic is undoing years of
disruptions and public health measures associated progress in the fight against this practice. Up to
with the pandemic may have increased the frequency 10 million additional child marriages can occur before
and intensity of this violence. At the same time, the end of the decade as a result of the COVID-19
children have been cut off from many of the positive pandemic. Poverty reduction along with access to
and supportive relationships they rely on when in education and jobs are key to ending child marriage.
distress, including at school, in the extended family or
the community. At the peak of the pandemic, 1.8 billion Global progress to end child labour has stalled for
children lived in the 104 countries where violence the first time in 20 years. The latest global estimates
prevention and response services were seriously indicate that the number of children in child labour
disrupted. While the immediate health crisis will has risen to 160 million worldwide – an increase
eventually wane, the impact of violence and trauma of 8.4 million children in the last four years. At the
in childhood can last a lifetime including serious social beginning of 2020, 63 million girls and 97 million boys
and economic costs. were in child labour globally, accounting for almost
1 in 10 of all children worldwide. An additional 9 million
Child marriage is closely associated with lower children are at risk of being pushed into child labour by
educational attainment, early pregnancies, intimate the end of 2022 as a result of the increase in poverty
partner violence, maternal and child mortality, triggered by the pandemic.
NUTRITION
COVID-19-related lockdowns
made those living in marginalized
communities even more vulnerable.
In South Africa, moderate and severe
acute malnutrition remain a significant
underlying causes of child mortality.
Many families say the frequency of
caregivers’ home visits have decreased
and clinics haven’t been consistently
open. Pandemic-necessitated travel
restrictions further exposed a sharp
divide between those who can afford
adequate diets and services and those
who cannot.
© UNICEF/UN0488697/Sobekwa/Magnum Photos
24 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
MENTAL HEALTH
Even before the pandemic, in almost every country, By October 2020, the pandemic had disrupted or
mental health remains stigmatized and underfunded halted critical mental health services in 93 per cent
– and poor mental health is limiting the life chances of of countries worldwide, while the demand for mental
children and adolescents around the world. health support increased. National lockdowns have
piled pressure on vulnerable children, as well as
• More than 13 per cent of adolescents aged 10–19 parents and caregivers’ ability to protect and nurture
live with a diagnosed mental disorder. them.
• Suicide is the fourth leading cause of death for
young people aged 15-19. According to UNICEF’s Changing Childhood project
• Half of all mental health conditions start by 14 years across 21 countries in the first half of 2021, 1 in 5
of age. young people reported often feeling depressed or
having little interest in doing things.
COVID-19 has exposed the extent and severity of
the mental health crisis. The disruption to routines, In fact, we won’t know the true impact of COVID-19 on
education, recreation, as well as concern for family children’s mental health for years.
income, health and increase in stress and anxiety, is
leaving many children and young people feeling afraid,
angry and concerned for their future.
COVID-19’S ONGOING IMPACT ON CHILDREN 25
HUMANITARIAN EMERGENCIES
Current humanitarian trends are deeply concerning. On top of this, the worsening climate crisis is also
A steep rise in the number of countries and people a deepening child rights crisis. Increasingly severe
affected humanitarian crises, including natural and frequent weather events and natural disasters
disasters, armed conflict and infectious disease are exacerbating chronic vulnerabilities. Globally,
outbreak continues. United Nations inter-agency approximately 1 billion children – nearly half of the
appeals reflects the growing scale of humanitarian world’s children – live in countries that are at an
assistance and protection needs. In 2011, ‘extremely high-risk’ from the impacts of climate
14 consolidated appeals aimed to reach 112 million change.
people. By 2021, this number has grown to nearly
160 million people across 27 consolidated appeals.
The COVID-19 pandemic risks devastating long-term economic consequences for children, communities and
countries around the world. Children who were already marginalized are the most affected, as they suffer the
impact of living in poverty, lost education, poorer nutrition and disrupted mental health.
One way to grow human capital following COVID-19 is to invest in talent on the move, a unique, yet largely
untapped pool of talent, ideas, and entrepreneurship.
© UNICEF/UN0349604/Canaj/Magnum Photos
32 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
© UNICEF/UN0556774/Htet
AN URGENT AGENDA FOR ACTION FOR CHILDREN 33
All people must have an equal opportunity to receive the COVID-19 vaccine regardless of who they are, where
they live, or their migration status, nationality, gender, social status or ethnicity.
While the virus remains unchecked, it will continue to Reaching all people with the COVID-19 vaccine
mutate, cross borders, spread the disease, damage requires:
the global economy, and disrupt essential services
for children and young people. The longer we take to • Aid donors fully funding ACT-A and COVAX – a global
vaccinate everyone, the bigger the risk to the entire coalition of organizations developing and deploying
world and the harder it will be to prevent a lost decade. the new diagnostics, treatments, and vaccines
needed to end the worst impacts of the pandemic,
To slow the spread of COVID-19 and reduce its including providing support to country vaccine
devastating impact, all governments must take delivery.
concerted global action to ensure fair and equitable • Countries receiving more doses than needed
access to COVID-19 vaccines. Despite progress over to vaccinate their entire adult populations to
the past year, the rate of vaccination in low-income immediately loan, release, or donate most or all
countries is shockingly low. Wealthier countries excess doses to COVAX.
must step up to ensure the same inequities do not • All governments ensuring their vaccine strategies
characterize 2022. are inclusive – prioritizing the most vulnerable
regardless of their status and making an extra
This is not only the right thing to do, but it is also effort to reach these individuals and communities,
essential for global recovery efforts. Estimates suggest including refugees, migrants and internally displaced
that inequitable access to COVID-19 vaccines could people.
cost the global economy $9.2 trillion. • Countries prioritizing vaccinations that will save lives,
protect public health services – starting with the
most vulnerable and frontline health workers, while
the number of available vaccines remain limited.
The world faces a historic opportunity to both end the COVID-19 pandemic and set out a pathway for the
eradication of preventable diseases. But this requires a collective effort to reach every child and community
with vaccines and realize the right to primary health care for every person everywhere. This is the only way to
accelerate progress towards the Global Goal target of ending preventable child mortality.
Along with handwashing with soap, immunization is • Investing in Primary Health Care, including
unequivocally one of the most cost-effective public Community Health Care as a wrap-around package
health interventions: vaccines prevented 37 million covering health, nutrition and water and sanitation.
deaths over the last 20 years in middle- and low- • All governments developing and implementing
income countries. Yet in 2019, 7.4 million children, ambitious national plans to reach every child with
adolescents and young people died from preventable essential vaccines.
or treatable causes. • Prioritizing communities with ‘zero-dose’ children who
still go without basic, routine vaccines every year.
Reaching every child and community with vaccines • Ensuring current political commitments on
and health services requires: COVID-19 vaccines lead to investment in primary
health services that can reach every person in every
• Strengthening health systems in the poorest community.
countries by increasing targeted investment, • Building confidence in vaccines – both COVID-19 and
protecting aid budgets, and fulfilling existing the routine immunization that saves children’s lives –
commitments to support lifesaving child health with development actors, communities, governments,
services including routine immunization. and health care workers working together.
© UNICEF/UN0517742/Poveda
AN URGENT AGENDA FOR ACTION FOR CHILDREN 35
Ensuring every child has access to nutritious and safe diets is vital to ensure we genuinely build back stronger
from the pandemic and safeguard the health and well-being of future generations.
Poor nutritional intake in children’s earliest years can Just as the drivers of poor diets are multiple, so are
irreversibly harm their rapidly growing bodies and the solutions. To deliver nutritious, safe, and affordable
brains, impacting their schooling, job prospects, and diets to every child, governments, donors, civil
futures. society organizations and development actors must
work together to transform food, health, and social
While we have known this for years, there has been protection systems and to improve the prevention and
little progress on providing the right kind of nutritious treatment of the most severe forms of malnutrition.
and safe foods young children need for healthy
growth and development – and the ongoing impact of Delivering nutritious, safe and affordable diets to
COVID-19 disruptions risk making the situation much every child requires:
worse just when we urgently need things to improve.
• All with power and influence taking action to
increase the availability and affordability of nutritious
WHAT IS DRIVING THE NUTRITION foods – including fruits, vegetables, eggs, dairy,
CRISIS? fish meat and fortified foods – by incentivizing
their production, making them more affordable and
accessible.
• Growing up in poverty. Families living
• Governments implementing national standards and
in low-income countries and low-
legislation to protect young children from unhealthy
income households often struggle to
processed and ultra-processed foods and to end
afford nutritious and safe foods for their
harmful marketing of unhealthy food and drink
children, including fruits, vegetables, milk,
targeting children and families.
fish, eggs and meat.
• Governments and development actors renewing
• Conflict, climate change and the
action to end child wasting – including training
COVID-19 pandemic are also playing a
community workers and caregivers to detect the
major role in making nutritious and safe
early signs of wasting; concerted and localized
foods less available and affordable to
action to prevent wasting in hotspot areas; and
millions of young children.
mobilizing new funding for life-saving treatment,
• The abundance of nutrient-poor and
including ready to use therapeutic foods.
cheap processed foods rich in sugar,
• Development and humanitarian donors – at a
salt and unhealthy fats. Junk food is
minimum – doubling their financial commitments
ubiquitous both in large cities and in
to fighting child malnutrition and committing to the
rural areas and is often accompanied by
solutions we know work.
misleading marketing strategies targeting
children and families.
36 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
The pandemic upended education for millions of children. Even before COVID-19, the world was grappling with a
learning crisis. We now have a once-in-a-generation opportunity to fix this crisis – starting with getting children
back to school.
Access to quality education is both a right and a crucial Ensuring access to quality education for every
opportunity for every child. Basic literacy and numeracy child requires:
are a prerequisite for quality learning. These skills
ensure children can thrive in primary and secondary • Protecting education budgets in the face of the
education and transition to the workplace. economic impact of COVID-19, and prioritizing the
most vulnerable children, not only for the sake of the
Investment in pre-primary education, particularly for current generation of children, but also for the future
marginalized children and those affected by learning workforce, economic growth and social cohesion.
poverty, can transform the lives of children, their • Aiding teachers and facilitators to deliver solid
families, and their communities. Access to digital foundational literacy and numeracy.
learning in low- and middle-income countries can also • Prioritizing school reopening and providing enough
act as a great equalizer. support to teachers and schools to make this viable.
• Governments and private sector donors allocating at
To address the learning crisis, we must therefore least 10 per cent of their education budget, or aid,
ensure every student gains the skills to reach their full to pre-primary education. This will ensure children
potential, including through quality digital learning. arrive at school ready to learn.
• Developing lasting solutions at scale with
partnerships between the private sector,
governments and other partners to connect every
child and young person – some 3.5 billion – to
the internet by 2030. This means every corporate
provider of digital learning increasing access to their
content and platforms; the international community
– particularly the private sector – lowering the cost
of digital devices; all Mobile Network Operators
developing solutions to allow digital learning content
to be accessed anywhere; and every government
creating opportunities for young people to play a part
in reimagining education.
• Ceasing all attacks on schools, and respecting and
protecting education personnel. Member States
must endorse and advocate for other states to
endorse the Safe Schools Declaration, and put in
place the necessary measures to ensure its full and
Students use laptop computers
effective implementation.
provided by UNICEF during
learning skills activities at the
Al-Nasr secondary school in
Sana’a Governorate, Yemen.
© UNICEF/ UNI346679/Alansi
38 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
With children and young people facing so many challenges to their mental well-being, the pandemic is a vital
moment to drive transformative action on mental health.
The COVID-19 pandemic has underscored just how Protecting and supporting the mental health of
critical mental health and well-being are for all children, every child and young person requires:
adolescents, caregivers and families, in all countries.
The pandemic has also highlighted the fragility of • Governments investing in more and better
support systems for mental health in many countries, protection, mental health and psychosocial support
and once again underlined how these hardships services across all sectors and community services.
fall disproportionately on the most disadvantaged • Governments and relevant national and local
communities. services supporting families by scaling up parenting
programmes that promote responsive, nurturing
The most marginalized and discriminated against caregiving and support parent and caregiver well-
children and adolescents, including those exposed being and mental health.
to poverty, violence, neglect, or living through • Governments reinforcing education and community
humanitarian crises and displacement, are at the care providers to ensure that all schools support
highest risk of mental health concerns. But they are mental health through quality services and positive
also the least likely to have access to support. relationships, and that children and adolescents
learn and interact in safe and secure environments,
While the long-term impact of the pandemic on both on and offline.
children’s mental health remains unclear, the global • All relevant actors responding to abuse and neglect,
recovery offers a rare opportunity to overturn the ensuring children and their families have access to
mental health crisis. response services, care and justice and prevent
reoccurrence.
Early prevention is key. It has the potential to break • Governments and relevant national and local
the inter-generational cycle of poor mental health and services playing an active role in addressing
transform mental health outcomes for current and stigma and promoting better understanding of
future generations. mental health. This will partly be achieved through
meaningfully involving children and young people
To emerge stronger from the pandemic and guarantee in the design and implementation of policies and
every child a better future, governments must invest programmes.
in quality support to protect children from neglect and
abuse and promote the mental health of all children
and young people, with a particular focus on ending
the childhood adversities that drive poor mental health
outcomes.
AN URGENT AGENDA FOR ACTION FOR CHILDREN 39
“Some girls did not go back to school after COVID-19 because they are afraid…
The pandemic changed my way of seeing the world because, now I find that the
world is not as calm and stable as it used to be…. My wish for all girls in Chad is
that I ask the girls to fight for their future.”
© UNICEF/UN0469276/Dejongh
40 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
• Hunger is on the rise. Nearly one tenth of the • More children displaced than ever before. Last
world population – up to 811 million people – went year, more than 82 million people worldwide
hungry in 2020. And famine, which should be were forcibly displaced. A shocking 42 per cent
consigned to history, looms again. were children. Disasters, many driven by climate
• The last 10 years were the hottest on record change, water scarcity and conflict were amongst
and the number of climate-related disasters the biggest drivers.
has tripled in the last 30 years. These disasters • War continues to take a devastating toll on
have a disproportionate impact on the most civilians including children. As well as forcing
vulnerable children and families – threatening food families from their home, attacks on children,
security, increasing water scarcity, forcing people including civilian infrastructure critical for their
from their homes, and increasing the risk of survival, are continuing at an alarming rate. In
conflict and public health emergencies. 2020, the United Nations verified a total of 23, 946
• Today, over 400 million children live in areas violations against children in conflict situations.
of high or extremely high-water vulnerability. This corresponds to 72 violations occurring every
This is likely to worsen as climate change single day or three violations every hour.
increases frequency and severity of droughts,
water stress, seasonal and interannual variability, The world was not ready for COVID-19 – and too slow
contamination – and demand and competition for to respond to many other climate- and conflict-related
water increases. disasters of the past few years. Millions of children are
at imminent risk if we fail to respond to these needs
urgently and unswervingly.
42 Preventing a lost decade: Urgent action to reverse the devastating impact of COVID-19 on children and young people
© UNICEF/UN0505792/Rouzier © UNICEF/UN0460328/Al-Basha
A broad re-thinking of how we approach Conflicts are the leading cause of humanitarian crises
humanitarian financing is needed to sustain these globally and progress in most countries affected by
changes. conflict has stagnated or reversed.
Being properly prepared for the next crises and Ensuring peace and protection for every child
spending money in a way that protects the most requires:
at risk children requires: • Humanitarian donors and actors investing in child-
• First and foremost, donors must keep their inclusive peacebuilding locally, nationally, and
promises on humanitarian funding so we can internationally and at a minimum reaffirming the
save lives and avert a lost generation. This means need for a temporary ceasefire to support safe,
flexible, long-term humanitarian funding now and effective, and inclusive COVID-19 vaccine delivery
avoiding donor conditionalities that may impede and pandemic response and recovery efforts. Peace
access to life-saving support. is the best protection.
• Donors should commit to pre-arranged finance so • All actors with influence increasing pressure on
humanitarian and development organizations like parties to conflict to end grave violations against
UNICEF can mobilize resources much more quickly, children in war, including those that prolong war and
well before devastating and irreversible damage to exacerbate food insecurity and famine. This should
children occur. include a robust political declaration to avoid the
• And we cannot wait to better protect and support use of explosive weapons in populated areas and
children and their communities. All humanitarian renewed efforts to reintegrated children into their
actors must ensure the meaningful participation communities after displacement or conflict.
of vulnerable countries and vulnerable groups • All parties to conflict redoubling efforts to both
and communities within these countries in future respect and ensure respect for international
humanitarian planning. humanitarian law and all with influence must
condemn any action or inaction in conflict that
prevents children and their communities from
accessing food, safe water and sanitation, and other
urgent relief in conflict.
FOR EVERY CHILD
Whoever she is.
Wherever he lives.
Every child deserves a childhood.
A future.
A fair chance.
That’s why UNICEF is there.
For each and every child.
Working day in and day out.
In more than 190 countries and territories.
Reaching the hardest to reach.
The furthest from help.
The most excluded.
It’s why we stay to the end.
And never give up.
© UNICEF/ UN0488988
Photograph on front cover: © UNICEF/ UN0488988