United Nations General Assembly Special Session on Children. -- "Meeting the Needs of Adolescents and Families"

More than a decade after the 1990 World Summit for Children, the challenge remains the same: to improve the lives of the world's children and adolescents and respect their human rights.

Children and adolescents everywhere have a right to survival, health and education. And yet despite progress, millions of children continue to suffer from preventable causes, 13 million children have been orphaned by AIDS and the numbers continue to rise, and 120 million children remain shut out of school.

Today I will focus on the special needs of adolescents, young people under 18 who are not yet adults. Adolescents need basic education skills. They also need more sophisticated education, to prepare them for adult responsibilities, with the support and guidance of their parents, and in line with the Convention on the Rights of the Child. Among these skills is responsible sexual behaviour, which of course includes abstinence. Young people need to be in control of their lives. Correct and appropriate reproductive health information and services can save their lives, and protect their health.

In 1994 at the International Conference on Population and Development and again in 1995, 1999 and 2000, most nations agreed that adolescents have a right to information about their sexuality as well as counselling and guidance so as to ensure responsible behaviour. As leaders and delegates, you agreed that programmes should help build the self-confidence of adolescent girls and boys' respect for the rights of girls. You agreed to develop adolescent-friendly health services, and the education and training that will give young people healthy minds in healthy bodies for healthy lives.

You have made progress in this sensitive area. There is a discussion in all countries. Sometimes it is a difficult discussion-but surely we all agree that this question is too important to remain without a response. Each country must find its own answer-but an answer there must be. The young people are counting on us, their parents and adults and leaders in their communities: we cannot let them down. Our children should not have to die because we could not decide what to tell them.

Today, nearly half of all the world's people are below the age of 25. In many developing countries, nearly half of the population is under the age of 15. In absolute terms, this youth population is expected to grow by a further 17 per cent in the next 30 years.

For many young people protecting their reproductive health is not a luxury; it is a matter of life and death. Every day, 7,000 young people, many of them teenagers and many of them girls, are newly infected with the HIV virus that causes AIDS.

Approximately 15 million adolescent girls give birth each year, more than 10 per cent of all births worldwide. A very high proportion of teenage pregnancy is unwanted. Each year, teenagers seek about 4 million abortions.

Girls aged 10 to 14 are five times more likely to die in pregnancy or childbirth than women in their early 20s. They also face an added risk of malnutrition, anaemia, injury and infection. Despite these risks, every year 82 million girls between the ages of 10 and 17 are married.

Many young women giving birth too early are afflicted with obstetric fistula, a devastating condition that is the result of trauma during childbirth. Fistula is a tear in the birth canal that constantly leaks bodily wastes. The sufferer is usually left alone-ostracized, abandoned and ashamed. Fistula has been eliminated here in the United States and the rest of the industrialized world, but it continues to strike 50,000 to 100,000 adolescent girls and women in developing countries each year. The shame of fistula does not belong to the girls; it belongs to all of us that allow fistula to continue and to destroy the lives of many young girls.

Ladies and gentlemen, discussion of the reproductive health of adolescents belongs here at the Special Session on Children because we need to understand and support the needs of adolescents in a comprehensive manner. Adolescents need the guidance and support of adults and parents to help them navigate the passage to adulthood. They are not a homogenous group-some are in school, some are not; some are married, some are not; some are sheltered and some are not. The solutions they need are not the same either. But all of them need youth-friendly education, information and services that meet their individual needs. This is our responsibility as parents, adults and leaders.

Since the Cairo Conference, we have increased our efforts to support governments and civil society around the world to put in place bold initiatives to delay marriage and pregnancy for girls. They have acted to ban harmful traditional practices. They wish to end the tragedy of child abuse and violence; they wish to prevent unwanted pregnancy and HIV infection. They have great and growing support-from educators, from religious leaders, and above all from women, whose voices are more and more heard when public policy is discussed.

The United Nations Population Fund works in partnership with communities, governments, non-governmental organizations, and private foundations. The projects vary, but most of them involve adolescents during the planning phase. They cover such issues as family life education, rights and responsibilities, life skills development and income generation, gender issues and the importance of equality and mutual respect. Many projects focus on helping girls improve their status in traditional communities. Some address the needs of adolescents in crisis situations, where there is an increased risk of sexual violence and abuse.

The programmes we fund have been approved by the governments themselves and they all help teenagers to protect themselves and their future-to stay in school, to communicate better with each other and with their parents and the adults around them, and to learn the life skills they need to lead a productive and dignified life and to succeed. The Reproductive Health Initiative in Asia, which is a joint partnership with the European Union and European and local NGOs, has created innovative programmes through theatre, families, radio, and religious institutions that provide young people with life-saving information, skills and services. The United Nations Foundation has provided funds to improve the reproductive health of adolescents in Bangladesh, Benin, Mozambique, Jordan, Haiti, Nicaragua, Ecuador and other countries. The African Youth Alliance, a creative partnership with government, non-governmental organizations and the Bill and Melinda Gates Foundation, is currently working to improve adolescent reproductive health and reduce the spread of HIV/AIDS in Botswana, Ghana, Tanzania and Uganda.

Just as young people, especially teenage girls, are the most vulnerable to HIV infection, they are also the best hope to turn the AIDS epidemic around. Today nearly half of all new infections occur in those aged 15 to 24.

Today teenage girls in some parts of Africa are more than five times as likely to become infected with HIV as boys the same age. Many girls do not feel they have the right to say NO to an older man. The result is unwanted and unprotected sexual relations. Many girls are married before the age of 18, often to older men who may expose them to HIV and other sexually transmitted diseases. Similar patterns are common in many nations where HIV is rapidly spreading.

Around the world, the well being of women and children is inextricably linked. To create real and lasting change in the quality of children's lives, we need to invest in the health, security and well being of women.

The interventions needed to save mothers' lives are basic - yet 515,000 women continue to die every year, one each minute, almost all in poor countries. This is unacceptable: under no circumstance should giving birth be a sentence to death. Safe motherhood requires simple interventions: care in pregnancy, care in childbirth, including access to emergency obstetric care, and care after delivery. It also requires that couples can time and space births properly, through voluntary family planning.

An investment made today in girls and young women will save many women's lives and help break the cycle of poverty. It will also save the lives of an estimated 8 million infants each year.

The Millennium Development Goals state that we can decrease maternal mortality by 75 per cent by 2015. Let us keep that goal firmly before us. Just as we are scaling up efforts for basic education and infectious disease, let us also scale up efforts for reproductive health and gender equality. Let us protect and care for our young people. With them, we have a present and a future. What lies ahead may not be easy, but if we act now with realism and foresight, if we show courage and compassion, if we think globally and allocate our resources accordingly, we can ensure that the present and future generations will enjoy and inherit a more peaceful, healthier and equitable world.