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United Nations, Jun 19: Half of the world's children -- one billion every year -- are affected by physical, sexual or psychological violence, suffering injuries and death because countries have failed to follow established strategies to protect them, the first report of its kind from the UN has said, with experts noting that the coronavirus-related lockdowns have left far too many youngsters stuck with their abusers.

While nearly all countries (88 per cent) have laws in place to protect minors, less than half (47 per cent) say they strongly enforce them, said the Global Status Report on Preventing Violence Against Children 2020 launched on Thursday.

Because countries have failed to follow established strategies to protect children, about one billion are affected each year by physical, sexual or psychological violence, it said.

"There is never any excuse for violence against children," WHO Director-General Tedros Adhanom Ghebreyesus said.

"We have evidence-based tools to prevent it, which we urge all countries to implement. Protecting the health and well-being of children is central to protecting our collective health and well-being, now and for the future," he said.

The report -- launched by the World Health Organisation, the UNICEF, the UNESCO, the Special Representative of the UN Secretary-General on Violence against Children and the End Violence Partnership -- charted progress in 155 countries against the "INSPIRE" framework, a set of seven strategies for preventing and responding to violence against children.

The report signaled a clear need in all countries to scale up efforts to implement them. It included the first ever global homicide estimates specifically for children under 18 years of age -- previous estimates were based on data that included 18 to 19-year olds.

According to the findings, in 2017, around 40,000 children were victims of homicide.

"Violence against children has always been pervasive, and now things could be getting much worse," UNICEF Executive Director Henrietta Fore said.

"Lockdowns, school closures and movement restrictions have left far too many children stuck with their abusers, without the safe space that school would normally offer. It is urgent to scale up efforts to protect children during these times and beyond, including by designating social service workers as essential and strengthening child helplines," she said.

UNESCO Director-General Audrey Azoulay said during the COVID-19 pandemic, and the related school closures, "we have seen a rise in violence and hate online – and this includes bullying".

"Now, as schools begin to re-open, children are expressing their fears about going back to school. It is our collective responsibility to ensure that schools are safe environments for all children. We need to think and act collectively to stop violence at school and in our societies at large," Azoulay said.

Stay-at-home measures including school closures have limited the usual sources of support for families and individuals such as friends, extended family or professionals.

This further erodes victims’ ability to successfully cope with crises and the new routines of daily life. Spikes in calls to helplines for child abuse and intimate partner violence have been observed, the report said.

While online communities have become central to maintain many children's learning, support and play, an increase in harmful online behaviors including cyberbullying, risky online behavior and sexual exploitation have been identified.

“Whilst this report was being finalised, confinement measures and the disrupted provision of already limited child protection services exacerbated the vulnerability of children to various forms of violence," said Najat Maalla M’jid, Special Representative of the UN Secretary-General on Violence against Children.

Of the INSPIRE strategies, only access to schools through enrolment showed the most progress with 54 per cent of the countries reporting that a sufficient number of children in need were being reached in this way.

Between 32 per cent and 37 per cent of the countries considered that victims of violence could access support services, while 26 per cent of the countries provided programmes on parent and caregiver support; 21 per cent of the countries had programmes to change harmful norms; and 15 per cent of the countries had modifications to provide safe physical environments for children, the report said.

Although a majority of countries (83 per cent) have national data on violence against children, only 21 per cent used these to set baselines and national targets to prevent and respond to violence against children, it added.

The report said about 80 per cent of countries have national plans of action and policies but only one-fifth have plans that are fully funded or have measurable targets. A lack of funding combined with inadequate professional capacity are likely contributing factors and a reason why implementation has been slow.

"Ending violence against children is the right thing to do, a smart investment to make - and it's possible. We can and must create a world where every child can thrive," Howard Taylor of the End Violence Partnership said.

May 30: Warning of the tightrope walk ahead as governments battle the coronavirus crisis, Nobel laureate Peter Charles Doherty has expressed concern about densely populated countries such as India relaxing lockdown norms while also describing a complete shutdown as “an economic and social impossibility”.

The Australian immunologist, who cautioned that the number of COVID-19 cases will rise in the coming days, said the earliest time frame for an effective vaccine “going into large numbers of people” is nine to 12 months.

"If all goes well with testing, we could know if some of the candidate vaccines are both safe and effective as early as September/October. Then, rolling a vaccine out will depend on the type of product and how quickly it can be made, put in vials and so forth," Doherty told PTI in an email interview from Melbourne.

The novel coronavirus, he added, does not change fast like influenza and, from what is known so far, “the same vaccine should work everywhere”.

Doherty, who is with the Department of Microbiology and Immunology at the Doherty Institute, University of Melbourne, won the Nobel Prize for Medicine in 1996 for his discovery of how the body’s immune system distinguishes virus-infected cells from normal ones.

Discussing the lockdown, he said, "If it was purely a matter of hard science, everywhere should stay locked down. But that’s pretty much an economic and social impossibility.”

The expectation, he said, is the numbers will rise and limiting spread will depend on people acting responsibly and the capacity for rapid response and extensive contact testing.

“And in a densely populated country like India I think that it will be very difficult," the scientist said.

Several countries, including India, began relaxing lockdown norms in mid-May despite the WHO’s warning about a second wave. India’s lockdown began on March 25 and has since been extended. The fourth phase ends on Sunday.

Asked whether there are any alternatives to a lockdown, the 79-year-old said, "There is no other option other than closing borders. South Korea, for example, conducted massive, intensive testing and contact tracing in a wealthy country with a very disciplined population. Otherwise, not till we have effective vaccines."

He added that he personally doesn’t see the point of closing borders for people coming in if there’s already a high incidence of disease in the community, “unless it’s to avoid the need to care for them and use scarce hospital beds".

According to Doherty, the coronavirus "is a new virus which has come straight out of nature".

“It (the virus) has moved so rapidly across the world because of people travelling on international planes as well as tourist ships," he added.

The immunologist also warned against the use of hydroxychloroquine to treat COVID-19, and said current and planned trials of the anti-malaria drug should be stopped.

“My understanding is that the use of the drug in severe disease is definitely contra-indicated, but it’s not yet clear whether, if taken under medical supervision, it could have some useful effect if taken early on, or as a preventive. Those trials just haven’t been done properly," Doherty noted.

The Indian Council of Medical Research (ICMR) has backed the use of hydroxychloroquine as a preventive against COVID-19 even after the WHO suspended clinical trials of the drug citing safety concerns.

Asked whether plasma therapy can be an effective treatment for COVID-19, Doherty said, "We lack good properly controlled trials but, especially if the plasma has been tested for antibody levels and there’s evidence of good activity, it could be helpful. If I had the disease and was offered plasma therapy I would certainly accept, but I would not take hydroxychloroquine."

Doherty is also very optimistic about herd immunity developing against the SARS-CoV-2 infection.

"We think that (herd immunity) will cut in and have an obvious effect when, say, 60 per cent of people have been infected. Best hope is to boost herd immunity with a vaccine," he stated.

Herd immunity is a form of indirect protection from infectious disease that occurs when a large percentage of a population has become immune to an infection, whether through vaccination or previous infections.

The number of COVID-19 cases have crossed 5.9 million and the fatalities 3,65,000, according to the Johns Hopkins University on Saturday. 

In India, the death toll has risen to 4,971 and the number of cases to 1,73,763, according to the Union Health Ministry on Saturday.

Several states, including Bihar, Uttar Pradesh, Madhya Pradesh, Jharkhand and Chhattisgarh, have reported a rise in number since lockdown norms were relaxed in early May and migrant workers reached home.

In Uttar Pradesh, for instance, the number of infections rose from around 3,000 on May 4 to 6,532 on May 26. Similarly, Bihar’s numbers increased from around 500 to over 2,700 in the period.