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Child and Adolescent Health (CAH) Initiative
Larry Casazza (World Vision)

Larry recently represented The CORE Group at the WHO/UNICEF consultation with NGOs around the new Child and Adolescent Health Initiative (CAH) in Stockholm, called by WHO.

The purpose was to generate worldwide consensus and commitment to a renewed agenda for children and adolescents to be addressed during the 2002-2003 meetings of the WHO Executive Board and the World Health Assembly and to lay the foundation for the role of health in the forthcoming United Nations' General Assembly Special Session on Children (planned for May 8-10, 2002). CORE’s invitation also included an additional one-day NGO Forum preparatory event.

The preparatory meeting allowed Larry to interact with many European counterparts and to hear presentations that confirmed as NGOs the commonality of our cause to support and protect children. The need was recognized to strengthen NGO collaboration at global, regional, and national levels to increase the voice we bring to governments and civil society on behalf of children.

At the two-day WHO session, discussion revolved around the technical issues of CAH. The urgency to go beyond the earlier focus on the under-fives is called for by the alarming global demographics surrounding the number of youth (40% of the world's population under 20 years with 90% from developing countries) at risk, especially for HIV/AIDS. Formal statements were contributed by the NGOs to the WHO session.

It was important to hear what next steps were planned for increased financing of health (addressed shortly afterward in Monterey, Mexico) and to review where we stand globally at the end of the decade with the goals for the World Summit for Children. But the NGOs felt somewhat disappointed with this meeting's agenda that left little time for dialogue and exchange of views. The UN approach remains top-down with the community distant from the concept as a valuable implementing partner in the health system. The focus seems to be on government and its ability to include a greater number within their sphere of service coverage.

The one outstanding exception was the engagement with WHO staff around collaboration in RBM. Dr. David Alnwick, RBM Project Manager for WHO/ Geneva, has offered to introduce key NGO partners from CORE, PLAN International, and Save the Children UK to the respective Ministers of Health when they are assembled in May for the follow-up on the World Summit for Children goals. This step will not only help to pave the way for The CORE Group to interact with the five African countries CORE elects to focus on in RBM, but it combines our efforts with key European NGOs who are also keen RBM partners.

On the final day Larry participated in a small group tasked with exploring the contribution of participation of young people, families, and communities to programming quality and the policies needed to insure their inclusion which produced the following recommendations for the final report:

Ininvestment decisions, governments and development partners should reflect meaningful participation as a fundamental human right. Also, without it, programs are less effective and less sustainable. Going to scale with the participation of young people, families and communities means political engagement, systematic communication between concerned groups and the sharing of decision-making. This requires funding modalities to be flexible with a long-term perspective, including the building of skills of the communities.”

Larry Casazza (MD, MPH) is a technical advisor on child survival interventions for World Vision. As co-chair of the IMCI Working Group of CORE, he has played a major role in promoting the role of NGOs in IMCI, and in advancing the child health and nutrition agenda at the global level. (Continued next page)

He served as a Technical officer with PRITECH and was one of the first Public Health Specialists in the World Bank Headquarters. Larry is a Board-certified paediatrician and actively involved in expanding the role of NGOs in the Roll Back Malaria Initiative.