The United Nations Children’s Fund (UNICEF) has just released its annual “The State of the World’s Children” report for 2005.

Using words like “catastrophe,” UNICEF’s Executive Director Carol Bellamy warns that the “triple whammy” of AIDS, conflict and poverty has reversed previous gains on children’s survival, health and education.

But critics of UNICEF claim the agency and Bellamy have contributed to the crisis by focusing on political causes and steering UNICEF away from the “core business” of ensuring children’s survival.

Richard Horton, editor of the prestigious medical journal The Lancet, has published a blistering editorial, which calls Bellamy’s direction “shameful.”

Bellamy’s “rights-based approach” (focusing on children’s “rights” as opposed to their simple physical survival), Horton said, has also been devastating to children, an estimated 10 million of whom die from preventable causes before the age of five every year.

Horton noted, “All the indications are that the fourth Millennium Development Goal of reducing by two-thirds, between 1990 and 2015, the under-five mortality rate will not be met in many countries.” No sub-Saharan country in Africa, he said, appears to be “on target to reach that MDG.”

What is the “rights-based approach”?

UNICEF was created in 1946 to provide emergency aid to the children of Europe who were starving after World War II. In 1989, however, the U.N. adopted the Convention on the Rights of the Child, a legally binding, international document that extends to children “civil and political rights as well as economic, social and cultural rights.”

The CRC launched a fundamental shift away from UNICEF’s original role of ensuring children’s raw survival. This steady drift away from UNICEF’s core purpose can be seen in two protocols added to the CRC in 2002. One addresses the issue of war; the other, child prostitution and child pornography.

Horton said the “language of rights means little to a child stillborn, an infant dying in pain from pneumonia or a child desiccated by famine.”

He urged a “reorientation” toward the child-survival policies of Bellamy’s American predecessor James Grant. Grant’s “Child Survival and Development Revolution” stressed “four simple interventions: growth monitoring, oral rehydration therapy, breastfeeding, and immunization.”

The Lancet credits Grant with saving the lives of over 20 million children.

UNICEF’s implementation of its “children’s rights” vision is also vulnerable to criticism. Indeed, UNICEF’s Medium Term Strategic Plan is more of a blueprint for social engineering along radical feminist lines. The plan states, “UNICEF will advocate for legal reforms and adoption of policies and programs that will raise the status of girls and women both in the family and in society.”

Often, the programs it champions seem to have little connection to basic rights.

A specific example of how UNICEF’s vision is being implemented under Bellamy is the International Children’s Day of Broadcasting. This program includes:

There is clearly a conflict in Bellamy stating, “We believe AIDS is the worst catastrophe ever to hit the world,” yet having UNICEF focus on programs such as ICDB.

In a world of unlimited options and bottomless pockets, there would be no conflict between pursuing children’s health and children’s rights. But UNICEF’s new report cries out for increased funding precisely because money is limited and all goals cannot be pursued in tandem. Indeed, overall funding to the U.N. may well tighten due to the backlash surrounding recent corruption scandals, especially the Oil-for-Food one.

Horton’s criticism of UNICEF is not merely a statement of conscience. It is also a matter of strategy. Next year, U.N. Secretary-General Kofi Annan will appoint a new leader for UNICEF. Traditionally, the appointment has gone to an American. (Even though the U.S. is not a signatory to the CRC, it is the U.N.’s largest donor.) The appointment is made basically at Annan’s discretion and the selection process is not publicized.

As Horton commented, “This mysterious procedure leaves open the possibility of crude political deal-making in identifying an acceptable candidate.” Clearly, Horton wishes to surround the appointment with a debate heated enough to melt away mystery and permit no deal-making.

Bellamy’s appointment was controversial and occurred only after a campaign on her behalf by President Clinton. Then-Secretary-General Boutros-Ghali had preferred a European candidate.

Next year’s appointment may be the most controversial in UNICEF’s history. In part, it will be a struggle for the soul of the agency. But, as in all things U.N., it will also involve jockeying for political position. Members from the European Union seem particularly eager to diminish America’s role in UNICEF without, of course, diminishing its funding.

Horton’s concern that “the next executive director of UNICEF is likely to be an American, irrespective of the person’s skills or experience” is understandable given how ill-equipped Bellamy was for the job. But it would be easy for the goal of saving children to become lost in the politics of the U.N., especially with its increasingly anti-American atmosphere.

It will be interesting to watch events unfold.