3 things we now know – and 3 things we don’t
The UN Secretary-General has warned that, while not being "the face" of the pandemic, children could be its "biggest victims." Indeed, what until last year was pictured as a promising "Decade of delivery" now risks turning into a "lost decade" for development. As things stand now, the pandemic could not only halt, but even reverse progress towards the 2030 Agenda.
We are just beginning to understand more clearly what the potential impact of COVID-19 on children is, and new evidence emerges daily. To keep track of it, on 1 May we launched a Live Tracker summarising the most consequential secondary effects of the pandemic on children at a global level, which we have regularly updated as new evidence has emerged. This blog highlights some striking findings from our tracker, which are representative of some of those major impacts. At the same time, it shines a light on the issues we urgently need to know more about.
1. COVID-19 IS LIKELY TO REVERSE PROGRESS ON CHILD POVERTY BY DECADES
Children make up more than half of the world's poor people. It is estimated that even before the pandemic, the number of children living in monetary poor households amounted to as many as 586 million, almost one-third of children in low- and middle-income countries. However, despite appallingly high figures, poverty had been progressively decreasing globally.
The economic fallout brought about by COVID-19 will likely reverse this trend and turn back the clock by decades. Our joint analysis with UNICEF estimates that, unless urgent action is taken to protect families, the pandemic will push between 90 and 117 million children into poverty. While the global economy is expected to rebound in 2021, analysis suggests the spike in poverty is unlikely to subside in the near future.
2. UNDER-FIVE MORTALITY IS SET TO INCREASE DRAMATICALLY
A growing body of evidence suggests that, while children might be spared the direct, epidemiological effects of COVID-19, its knock-on effects -- such as the disruption of essential health services, food insecurity, and soaring poverty -- will have egregious, sometimes fatal, consequences for children.
Through consistent efforts, child mortality has been dramatically reduced over the past decades: the number of children under five dying from preventable causes dropped from 12.6 million in 1990 to 5.3 in 2018. The pandemic may jeopardise these gains. As we witnessed during the Ebola outbreak, a public health crisis causes both heavy disruptions to the provision of essential health services and lowers their uptake. Research by Johns' Hopkins University covering 118 low- and middle-income countries estimated the additional number of child deaths if this happened again. Based on the severity and length of disruptions to essential health services, under-five mortality could increase by between 10% and 45%, resulting in between 250,000 and 1.2 million additional deaths of children under five.
In addition, research published in The Lancet had bleak results: the number of wasted children under 5 is expected to soar by 6.7 million, a 14.3% increase possibly leading to between 111,000 and 178,000 deaths.
3. THE PANDEMIC IS LIKELY TO WIDEN EDUCATION DISPARITIES AND PUSH MILLIONS OF CHILDREN OUT OF SCHOOL FOREVER
Before the pandemic hit, the world was already facing a learning crisis: not only are 260 million children out of school, but of those children who are in school in low- and middle-income countries, 53% of them cannot read and understand a simple story by the end of primary school, with the number spiking to 80% in poor countries. Lockdown restrictions imposed during the pandemic have exacerbated this trend, forcing 1.6 billion learners out of school. For the first time in modern times, a whole generation missed precious months of education worldwide.
While lockdown restrictions apply similarly to all children, they have very different impacts on their learning. Surveys from Ecuador, Burkina Faso, and Senegal show that household wealth is a leading determinant of a child's TV and internet access, which are essential for remote learning; engagement in learning activities during lockdown; and the opportunity to rely on a household member for home schooling. In short, the pandemic will not only worsen learning outcomes overall, but broaden inequalities.
When it comes to enrolment rates, analysis from our recent Save Our Education report warns that the economic fallout of the pandemic could drive between 7 and 9.7 million children out of school, never to return. This will disproportionately affect children from disadvantaged and poor households. Indeed, these groups, more prominently employed in the informal sector, have been more harshly hit by the economic crisis, and are more likely to turn to children to support the family in income generation activities at times of economic difficulty.
WHAT'S MISSING: LACK OF EVIDENCE ON THE IMPACT OF COVID-19 ON CHILD PROTECTION, INEQUALITY AND HUMANITARIAN CONTEXTS
While a world without COVID-19 hardly seems imaginable anymore, we have to remember that the pandemic actually started less than six months ago. Considering the short timeframe, the amount of evidence that has been collected on the impact of COVID-19 is considerable. However, there are three areas where lack of evidence is particularly concerning: child protection, inequality and emergency settings.
Let's be clear: data was poor even pre-COVID across these areas -- the pandemic simply sheds light on the problem and shows with pressing clarity that we urgently need improvements. For instance, the enormous challenges to doing research in emergency setting mean that, from a data perspective, they have always been something of a black hole. These challenges have been exacerbated by COVID, despite the fact that these areas are hotspots for the virus. Indeed, emergency settings are those where children are likely to be disproportionately affected by the indirect effects of COVID-19, be it because of poor infrastructure, weakened health systems, or impediments to receiving material from external actors. If the response to COVID-19 is to be truly global, it cannot omit humanitarian contexts, where deprivation ran rampant before the pandemic even started.
The same goes for child protection. We had limited data pre-COVID on how widespread harmful practices are -- be it child labour, child marriage, or sexual exploitation and abuse. As a result, we struggle to fully understand its impact now. We know the pandemic enhances risk factors for a number of harmful practices, but have no baseline to start with, so it happens that data is scarce at a time when it is sorely needed.
Finally, while we are starting to understand what the impact of COVID-19 will be on children, we do not have a full picture of how this will play out across different groups of children. Will urban or rural children be hit the harshest? Will the gap between rich and poor children widen -- and if so, by how much? Will certain regions feel the blow more harshly? The truth is that there is simply too little child-specific data: only a small number of countries (42 out of 188) publish numbers of COVID-19 cases disaggregated by age, and those who do report high degrees of variation -- as of June, children make up almost one in four (23%) of all diagnosed cases in Paraguay, but less than 1% in Spain. And disaggregated data on secondary impacts of the virus on children are limited. To be true to the pledge to Leave No One Behind, we need to know who the most deprived and marginalised children are -- so it is vital to go beyond averages and reach those who need it the most first. This can only be achieved with rigorous data disaggregation.
Except for a fleeting drop in air pollution levels, which is projected to save 4,000 lives among children under five in China and prevent 6,000 asthma cases in Europe, the pandemic and its socio-economic implications have had and will have devastating impacts across key children's rights to survival, education, and protection. More and better data is needed to quantify and understand the impact on children, especially those who are most deprived and marginalised.
The World Health Organization declared COVID-19 a pandemic on 11 March. Five months into the pandemic, our knowledge of the impacts of COVID-19 on children has increased substantially, but there is much we still need to uncover. At Save the Children we'll continue to track and summarise emerging evidence, advocate for research on the effects of COVID that includesa child lens, and push for the implementation of our agenda for action to protect a generation of children from this global threat.