OVERVIEW OF THE PROGRESS OF NATIONS REPORT, UNICEF
Introductory Remarks - Dr. Richard Jolly, Acting Executive Director, UNICEF
This document, the Progress of Nations, which UNICEF will be formally
launching to the press in Berlin on June 8th so if there are any
press people present we, please would ask you to respect the embargo.
We do not want any articles that are quoting material from today
because the launch as such is on June 8th. This said for the professionals
present we have a rare opportunity to hear from the editor, not
only of Progress of Nations, but indeed of UNICEF's main publication,
the state of the world's children report. Here is Peter Adamson,
a close collaborator with Mr. Grant for the whole of the period
in which Jim Grant was executive director for UNICEF. Peter Adamson
so often found the words to express Jim Grant's thoughts and ideas
and not merely to find the words but to give them an elegant polish
and a mobilizing power that made that document the state of the
world's children report so forceful a document in promoting to
the world ideas of what can and should be done for children.
Nine million copies printed
Progress of Nations was Peter Adamson's idea about three years
ago in order to report on progress made towards the mid-decade
and year 2000 goals agreed at the world summit for children. Peter
is one of the most published authors in the world today. The state
of the world's children report goes out in two to three hundred
thousand copies, usually 40 languages or more. He has also published,
I think the largest selling book that was written, ever to be
read. That has gone out in 180 perhaps more languages, nine million
copies when I last counted and it was designed not to be read.
That was a fact of life, many of you have known it and I hope
will have used it in order to inform communicators, health workers,
preachers, politicians, a whole range of people about basic health
knowledge that would make a difference for children. It was designed
to encapsulate this knowledge in a minimum of words so that other
communicators could use it. Nine million copies, 180 languages
is not bad indeed. Peter once said to me when his children were
less impressed than they should have been about 180 languages,
well you start just listing them off. O.K. English, Spanish, French,
Arabic, see how far you get. Prizes to anyone who gets more than
30. Before Peter came to this collaboration with UNICEF and with
Jim Grant he was the founder and chief editor of an international
development magazine the new internationalist and at university
he first displayed that personal commitment that binds many of
us together in this room. In his case he was founder of third
world first. I think I should end with one other word. When our
Lord gave us the Bible he allowed the prophets and the disciples
to put their names at the top of the chapters. The UN tradition
is different so Peter Adamson has published most of this in love
and commitment to UNICEF and Jim Grant but not with his own name
at the top of the page. I hope we will in welcoming him now give
a round of applause that is appropriate for one who has done so
much without putting his name at the top. Peter.
Dr. Richard Jolly:
Thank you Peter for that lovely and important overview. May I
just say to people, don't be alarmed that you won't receive your
copy of Progress of Nations today but you will be receiving it.
We now move to this afternoon's full session to review the programs
problems and opportunities with respect to the mid-decade goals
that in part grew out of the summit and then were codified more
precisely at WHO - UNICEF meetings soon offer. We will be having
nine presentations in all. We will take three at a time. Then
I hope we are moving with enough space to take just two or three
questions from the audience on any points on which you would like
to hear a bit more.
We begin with an overview of the mid-decade goals presented by
Dr. Nyi Nyi of UNICEF and who better indeed to do that.
For about 14 years, in this role he was not only a close colleague
and collaborator of Jim Grant. One might say he was major general
in the UNICEF army, responsible for progress towards many of the
goals and early on in particular towards the goal of universal
immunization by 1990.
Before he joined UNICEF he was minister of education in Burma
and in 1974 he was featured on the front page of Time magazine
as one of the young internationals with most promise for future
leadership. I'm not sure if it was Time magazine or Jim Grant
himself who turned this potential into fulfillment. Dr. Nyi Nyi.
Dr. Richard Jolly
We now turn to some of the specifics and our first within the
overview we have just had is Protein, Energy, Malnutrition and
Micronutrient Deficiency and to present that we have Dr. Jon Rhode
who is UNICEF's country representative for India. UNICEF's largest
country program and of course the second largest country in the
world. Jon Rhode brings a wealth of experience to his task both
country experience and professional public health experience.
He has authored three books the most recent is Village Doctors,
before that is was Reaching Health for All and ten years ago,
Practicing Health for All. What is interesting is that Jon Rhode
went to the Harvard Medical School, no doubt thinking it is much
superior to the Harvard School of Public Health but many in this
room think that public health is the center of health. The starting
point. Interestingly professor Carl Taylor once said to Jon Rhode,
"Unless you go to a school of public health you will not
succeed". There are different ways of learning and Jon it's
wonderful to have you here to present Protein Energy, Malnutrition
and Micronutrient Deficiency.
Dr. Richard Jolly:
Thank you very much Micheline Beaudry for that excellent presentation.
I promised the chance for a few questions and I'm asking Dr. Nyi
Nyi and Dr. Jon Rohde to join me on the platform and we'll have
just under ten minutes for questions on any of the three presentations
we've had so far. I am afraid to announce that we were going to
have a coffee/tea break also for ten minutes, I'm afraid we haven't
got time to delay the next session. So anyone who feels in great
need of tea or coffee you have a choice, you can listen to the
questions or go out but we will start in exactly ten minutes with
the three presentations on Immunization, Diarrhea, ARI, Water
and Sanitation. So the floor is now open, excuse me looking in
this way, it is very difficult to see from the platform but I
see someone who would like to ask a question. Could you speak
loud, and if there is a problem you may need to come up to the
platform. And if my colleagues could join me here with the light
then we can all be seen. Would you give your name and your question?
We can't hear you. If you give your question slowly then I might
repeat the question.
"The question is, whether UNICEF is going to take up programs
for other nutritional deficiencies, specifically suggest Zinc,
Riboflavin one could add Selenium and I suppose there's quite
a number of others. I think the nutrition story in the micro nutrients
is a good example of the marriage of good basic research with
Epidemiology and finally affordable and implementable solutions.
At this stage I think we're still in the first two stages, defining
not only the deficiency in the value one gets such as in Zinc,
the reduced duration of diarrhea and duration of stooling, less
prolonged diarrhea but I'm not quite sure we have found out what
the distribution deficiency is nor how to effectively replete
populations with it but I'm sure we are on that route and that
would be the way we would go. So yes that is in the future but
all of you can advance that through the research you are doing
with Ken Brown."
"I could quibble with your alternative of nutritional stunting
because nutrition usually means a bunch of Biochemists like you
know and its more the caring practices, its more the hand washing,
it's the mothering capacity and the it's understanding, the transfer
of information that women have a right to know. I very much welcome
your suggestion of an alternative term. Urban would say "It's
caring" and I think that embodies an awful lot if we think
about the term and perhaps it's lack of caring which is most afflicting
these children."
"Anyway the competition is open and UNICEF will be glad to
receive all entries for a better name than PEN. Another question,
yes please."
The question as I understand it is, Is there in another language
a better term for breast feeding than the rather blunt English
literal translation of 'Breast Feeding', I don't know what that
conveys. Well I'm going to hand that over to Micheline, I'm still
not quite sure whether the issue is exclusivity of breast feeding
a good term after six months or what. Micheline why don't you
give your best answer.
" Well after six months we are no longer promoting exclusive
breast feeding. We are promoting breast feeding that is complimented
in an appropriate way after six months so it is still breast feeding
but complimented with appropriate foods. The term in French for
breast feeding probably is a bit better but still it does not
convey the exclusive unless you add exclusive to it. So I'm not
sure exactly how you want to do it but we welcome suggestions
that can help to pass the message in a clearer way."
Thank you, Dr. Nyi Nyi is saying of course any of the speakers
would be happy to carry on in a bilateral way but we've probably
got time for one more question. I'm sorry these rather token questions.
Yes, in the corner you'll have to talk up. I'm sorry I wasn't
as clear as I should have been. The problem has more to do with
child caring practices than it does the availability of food or
even the burden of illness, although both of those two also play
a roll. The increase of malnutrition between six months and eighteen
months of age is found in almost every society where malnutrition
exists. This is the time when the child is particularly dependent
upon mothering practices. The child does not eat but must be fed.
The child is also susceptible to what ever is put into its mouth
other than food, germs and the infections therefrom. The mothering
practices, the attention given to the child seem to underlying
that increase in malnutrition more than the classical thought
which usually intervenes after malnutrition has occurred with
a rehabilitative effort to give extra food supplements which don't
give much results. I hope that would clarify. It is that set of
practices. And by the way the more education the mother has, not
necessarily education on nutrition, but just general education
the better she seems to be able to cope. Urban Johnson uses the
term "Coping Strategies" and usually sharing with other
women, how did you grow your baby, how did you get your kid to
eat that spinach my child never will kind of thing seems to be
more effective than food supplement programs."
Thank you very much. I have the painful announcement for the keen
attendees that remain, that the coffee/tea break is now over so
we will continue with the session. If those people at the back
of the hall would like to join in the next presentation would
like to take their seats and we'll be taking the next three sessions,
Immunization first, Diarrhea and Acute Respiratory Infections
and then Water and Sanitation. I am hoping because we're running
a bit late that it will prove possible to run till six, which
will be fair to the speakers who are about to come. If they run
to good speed we may also slip in just two or three more questions.
We will begin if people like to take their seats. This captains
look that I have is the only way you can actually see out to the
audience with the bright lights. So with this can I introduce
our first speaker Terrel Hill of UNICEF, Terrel is principle adviser
of Child Survival he has been with UNICEF since 1978, he first
worked in Indonesia when Indonesia went from 300 to 35 000 villages
practicing an integrated program for child nutrition and he has
also worked a key regional advisor in the middle east and for
the last eight years he has been in New York. He has been a key
figure in monitoring progress towards the goal in 1990 in immunization.
I remember very well when we had the problem exactly where were
we getting to towards the goals and in the way it becomes difficult
in all institutions, how can we get someone who can really give
us the data, can consolidate it regularly, point out the areas
of weakness where we need to take action. Well Terrel Hill came
and stepped in and succeeded in that task where several other
colleagues, who shall be nameless, failed before him. Now after
1990 Terrel has continued with somewhat broader range of issues
in child survival but has had particular responsibility for the
child vaccine initiative adjoined program jointly with WHO and
with several other groups. Terrel it's a pleasure to welcome you
to give us an overview on Immunization.
Richard Jolly:
Thank you very much Terrel Hill. We now turn to Dr. Jim Tulloch
of the World Health Organization to give us an update on Diarrhea
and Acute Respiratory Infections. Dr. Tulloch is director of the
CDD the Control of Diarrhea Disease and the Acute Respiratory
Infection divisions of WHO. He is also focal point for the sick
child initiative. He has been with the WHO for twelve years. I
asked him what did he do before hand in Australia and he said
"Oh nothing", so I take it Jim Tulloch is a laid back
Auzzie perhaps he was surfing, perhaps he was acting in Crocodile
Dundee I don't know. Jim we look forward to your presentation
and in particular let me take the chance to pay a very warm tribute
to the many areas of collaboration with WHO between UNICEF and
WHO its that partnership that internationally that has been vital
for almost all the areas of child health action that we've been
talking about. Dr. Tulloch.
Richard Jolly:
Thank you very much Jim Tulloch. We will now move to the third
presentation of this cluster, from Frank Hartvelt, looking at
the issues of water and sanitation. Frank Hartvelt is Deputy-Director
of Science, Technology and Private Sector Division at UNDP, and
focal point for the water sanitation decade. He can be described
as a flying dutchman. He spent 25 years in the UNDP, has served
in Haiti, Laus, Burma, Afghanistan and Egypt. He was a regional
advisor in West and Central Africa and he's still enjoying it.
For the last ten years he has been in New York concerned with
the topics I've mentioned. Frank, we look forward to hearing from
you.
Richard Jolly:
Dr. Manzoor Ahmed, Associate Director of the Programme Division,
UNICEF, with a presentation on girls education.
Richard Jolly:
Dr. Antonia Novello, Special Advisor to the Executive Director
of UNICEF, formally Surgeon General of the United States of America,
an appointment under President Bush. And before that, Deputy-Director
of Child Health Institute of the National Institutes of Health.
Richard Jolly
What a wonderful Surgeon-General, Antonia, thank you for that
wonderful challenge for us all. The time for action is now. I
just want to say thank you to the speakers. Thank you just as
much for being such a responsive audience. I'm sorry we've run
on a bit. I want to remind us that all we've been talking about
are goals with the promise of saving 2.5 million children's lives
each year. If we realize these goals, and doing so many other
good things besides.
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