WHO SEARO Regional Director’s Inputs during Panel discussion: Investing in early years in emergency and crisis context during UNGA79, New York

Thank you, Sidsel Marie.

What do Emergency, Conflict and Climate Crisis Situations have in common?

The first thing I’d like to speak about is what situations of emergencies, conflict or the climate crisis have in common.

For most of us, we have an instinctive understanding of the human cost and fallout of emergencies situations and situations of conflict.

However, it may be surprising to some that the aftereffects of climate crisis situations are largely the same.

They too lead to the displacement of people, and often the straining or collapse of social structures – including structures that traditionally provide support to children and mothers.

For the victims of such situations, the causes of their circumstances may be different, but the results are often the same:

Disease outbreaks, food and water shortages, extreme psychosocial distress, disruptions in health services – including immunizations, WASH programmes, and vector control activities.

Delayed and Lasting Impacts: The effects often manifest many years later

In situations of conflict, emergencies or the climate crises, very often the price is paid today, but the costs are borne for a lifetime.

What do I mean by that?

Let’s look at the example of nutrition.

Our friends at Save the Children wrote that “children living in a conflict zone are more than twice as likely to suffer from malnourishment than those in a peaceful setting[1].”

The obvious effects of this are a host of different health impairments, but there are other implications also. “There is…evidence that undernutrition in early childhood can affect cognition, language and social emotions, hinder later development and have a negative impact on human capital and economic growth.[2]” Those are a lifetime of costs borne by malnourished children.

The same is true for the psychosocial effects on children of conflicts, climate crises and emergency situations. The mental health toll of these circumstances will often manifest later in life. In adulthood, these can take the form of aggression, self-harm, and other damaging behaviors. 

Beyond the physical: the emotional and psychological toll

I’d like to speak a bit more about the psychosocial effects that I just mentioned.

Emergencies and crises impose much more than just a physical toll. They have deep emotional and psychological consequences also. These mental health impacts on children are often under addressed, or unaddressed. Prolonged exposure to conflict, displacement, and uncertainty can lead to lifelong psychological scars – if they are not managed early. 

It isn’t just children. What happens to adults also impacts children too.

It's not just children. The situations we are describing of course also affect adults in many ways similarly. Those very same adults are often parents, guardians and caregivers for children. Impairments in their physical and mental health and wellbeing will also impact the levels of nurturing, care, protection and safety they are able to give to children. 

Intergenerational Issues

Everything I’ve spoken about till now is a potential intergenerational problem. Think about that for a moment. Think about the lingering legacies of physical and emotional tolls which will get passed down to a generation that hasn’t even been born yet.

This is why we say that health begins before birth.

So, what are we doing about this?

Regional Roadmap: Mental Health

At the WHO South-East Regional Office, we’ve recently unveiled our Regional Roadmap, which outlines our focus areas for the next four years.

One of the five priorities in this roadmap is mental health. We are absolutely committed to moving mental health into the mainstream of our public health efforts.

I want to make sure that mental health is no longer an afterthought. It needs to be a consideration in all our plans, programmes and activities.

In that vein, mental health services must be integrated into emergency health responses, in particular for children, adolescents, and girls. Trauma-informed care, psychosocial support, and community based mental health programs are needed. 

Regional Roadmap: Children and Adolescents

Another pillar of our Roadmap calls for reaffirming investments in those who traditionally suffer from health inequity such as children and adolescents.

I am pleased to let you know that our upcoming Regional Committee meeting next month will host a ministerial roundtable on adolescent health and well-being. This is already on our agenda, and we have started the work towards adolescent-responsive health systems. 

Emergency Nutrition Programs

Investing in emergency nutrition programs (such as supplemental feeding, breastfeeding support, and micronutrient distribution) saves lives. Beyond this, it also fortifies the health of a generation that will rebuild their communities after crises. 

Gender-sensitive

We must invest in gender-sensitive health services, ensuring access to sexual and reproductive health care, safe spaces, and education about hygiene, especially during health emergencies.

I am pleased to say another pillar of our Regional Roadmap is a gender-specific focus for the health of women and girls. 

Essential Health Services

Crises often disrupt essential health services, including immunization, WASH (water, sanitation and hygiene) and vector control activities, leading to the resurgence of preventable diseases like measles, polio, cholera, malaria and dengue, to name a few. By investing in these preventive measures, we protect children's health, reduce mortality rates, and prevent additional burdens on already strained health systems. 

Conclusion

I am running out of time, even though there is much more to say.

Many of the things I have mentioned – such as mental health, and gender-sensitivity – should be addressed regardless of crises. In mainstreaming them, we develop and build structural, institutional and human skills, norms and understandings.

Those are the very proficiencies and understandings which we purpose and deploy in situations of conflict, emergencies and crises.

What is good for society in ‘ordinary’ circumstances is also good for the vulnerable in ‘extraordinary’ circumstances. 

Thank you.