If CLAN is going to try and raise International awareness of the plight of children who are living in resource-poor countries with chronic health conditions, it is important for us to ask ourselves some tough questions... "Why should the world care?"... "Does it matter that children are sick and dying of preventable disease and disability?"...

Thankfully, the international community has agreed on some basic concepts relating to human rights, and it is useful to review these in relation to the issues facing children living with chronic health conditions in resource-poor settings:

• Universal Declaration of Human Rights (UDHR) – Article 25 – All persons have the right to health; specifically, children have a right to special care and assistance

• Article 3  of UN Convention on the Rights of the Child (UNCROC) – “in all actions concerning children…the best interests of the child shall be a primary consideration”

• Article 6 of UNCROC and Article 6 of International Covenant on Civil and Political Rights (ICCPR) – All children have a “right to life”

• Article 12 of International Convention on Economic, Social and Cultural Rights (ECOSOC) – everyone has the right to “the enjoyment of the highest attainable standard of physical and mental health”.  State parties should create “conditions which would assure to all medical service and medical attention”.

• Article 24(1) and 24(2)(b) of UNCROC – children specifically have the right to good quality health care and the best health care possible.  State parties have a duty “to ensure the provision of necessary medical assistance and health care to all children”.

• “Access to medicine is a fundamental element in achieving progressively the full realization of the right of everyone to the enjoyment of the highest attainable standard of physical and mental health” (12^th Session of Human Rights Council (HRC) in 2009; ECOSOC Committee and Millennium Development Goal 8)

• HRC resolution (A/HRC/12/L.23) calls for expert consultation on the “realisation of access to medicine” to achieve right of all to “highest ascertainable standard of physical and mental health”. This is the first step to securing formal recognition of the right to medicine

So if children have rights, who is putting these rights into practice?

• At the moment, there are very few International policies or organisations promoting an equitable and systematic approach at a national and international level to help children who are living with chronic health conditions

• There is a lack of global awareness and policy in specifically addressing childhood chronic diseasesin resource-poor settings.

• There is no specific forum at WHO or UNICEF that focuses on chronic disease and children; any discussion about children and chronic disease looks at preventing lifestyle diseases in the future
• Chronic disease discourse at WHO is dominated by a focus on adult lifestyle diseases; statistics in WHO reports are based on “all ages” or 30 years +.
• There are no policies to guide countries in management of chronic disease in children (no equivalent for chronic disease of the Integrated Management of Childhood Illness (IMCI) protocol which is an excellent guide for acute illness management in children)

Clearly more work is needed, and we all have a role to play in effecting change.

Next time you are reading a chronic disease policy, specifically look to see if children are included... Chances are they won't be included - what can YOU do to change that?