World Health Day is celebrated every year on 7 April, with the aim of increasing global awareness of health issues the world is confronting. It is sponsored by the World Health Organization (WHO), and the date marks the anniversary of the founding of WHO in 1948.

Themes of previous years have included a focus on food safety (2015), diabetes (2016) and in 2021 the creation of a fairer and healthier world. The theme of World Health Day in 2022 is Our planet, our health, emphasising the urgent need to keep our planet healthy (and by extension ourselves) and to “foster a movement to create societies focused on wellbeing”. The WHO has estimated that more than 13 million deaths around the world each year are due to environmental causes — and even more importantly — avoidable environmental causes.

Last week, in commemoration of World Health Day 2022, the world’s premier medical journal The Lancet published an editorial titled “Planetary health for the ages”. In the piece, the word “child” does not appear once. This is startling given that the future we are so concerned about is the one that children and adolescents today are going to have to live in. 

Unfortunately, failing to consider the opinions and needs of children and adolescents is a common occurrence. How we have treated children and adolescents during the Covid-19 pandemic is a particularly good example. We are now over two years into the pandemic which, according to The Economist and other sources has resulted in the deaths of over 20 million people. The answer to the question about the extent to which we even considered, let alone prioritised, the needs and the future of children and adolescents is a painfully sad one.

Public health and the difficult decisions that need to be made are always about balancing risks and benefits. And as Covid-19 has shown, there are rarely easy answers — only the extremely difficult task of weighing risks and benefits. However, on the Covid-19 pandemic “balancing scale”, children are nowhere to be found. Understandably, given the massively increased risk of death from Covid for people over 60 that is where early preventive efforts had to go. We did that and, in some places, we did it quite well. 

But what was the cost?  The economic costs are clear. But it is abundantly clear that the costs that children and adolescents have had to bear were never (or rarely) part of the equation. The long-term damage to their developmental potential was never considered as one of the risks when considering an approach of zero Covid.

Instead, we took control, circumscribed their lives in quite authoritarian ways, halted their education, limited their play and engagement with peers, and demanded they make these sacrifices for the control of a virus that posed a small risk to them. All this was done in the name of protecting others.

Of course, bearing a cost for others is a noble thing, an altruistic response for the benefit of us all. But when we want somebody to pay a steep price, surely we need to weigh up the damage we might be doing to them, and most importantly to ask them about how they feel about, and in so doing get their buy-in? Where were youth representatives on governmental advice bodies? Where were the voices of youth activists that could advocate for keeping schools open?

Given that the global track record of listening to children and adolescents by governments, scientists, public health practitioners is largely abysmal, is there an industry, a body that really listens to children and adolescents?

The answer is yes — and it is the marketers. The marketers of sugar, junk food, clothes, trends and consumer goods that none of us needs. Juliet Schor in her book Born to Buy describes how at the height of its influence the children’s television channel Nickelodeon would speak to and interview 5,000 to 10,000 children per year.

Other marketing companies routinely conduct school-based surveys engaging with over 4,000 children. In the 1990s Levi Strauss hired Josh Koplewicz as an official consultant when he was only 10 years old. He advised the company on design, production and named trends for them. Company executives would also routinely rummage through his cupboards to get ideas.

Leah Mosner was 12 years old when she consulted for Microsoft, and was flown across the United States to a party to launch their Magic School Bus software. The use of consultants such as these, coupled with the extensive surveys described above, followed years of scepticism in the marketing industry about whether children themselves could provide useful “marketing” data. Today, they are a key information source.

They listened, they took note and they acted on what they heard.  Commercial marketers targeting children really listened, but instead of using this engagement for good, they weaponised the information they gathered so as to better exploit children. The result has been an unprecedented and highly effective juggernaut of advertising and marketing targeting children across the entire life course. 

Children in some countries (such as the US) will see as many as 30,000 advertisements on TV alone in a single year. The spending power of children and adolescents and what has become known as their “pester power” has also been weaponised. This is bad for children and it is bad for the environment. 

Unlike the marketing companies, and the advertising juggernaut for largely toxic products that are the antithesis of wellbeing, public health practitioners, scientists, academics, parents, schools are, I would argue, routinely failing to truly speak to and listen to what children and adolescents have to say. We think for them. We plan for them. We assume we know best. Even when we speak of taking their opinions into account it is often little more than a tick-box approach.  Engage with children — tick — move on. Most often we have already decided what we are going to do, and we are simply calling on them to agree. 

We are in the midst of a climate catastrophe as a direct result of our rampant exploitation of the natural world. Our children are experiencing the highest levels of targeted advertising and commercial marketing in history. This is resulting in record levels of obesity and online gambling. We must stop paying lip service to listening to what children and adolescents have to say. We have to do better and we need to wrest control from the commercial marketers. 

As Greta Thunberg has so forcefully shown, the voice of a single committed child activist that routinely speaks truth to power, can have global ramifications for good. DM

Professor Mark Tomlinson is co-director of the Institute for Life Course Health Research in the Department of Global Health, Stellenbosch University.

[hearken id=”daily-maverick/9317″]