A/HRC/37/33 16. In particular, situations of crisis can exacerbate gender inequalities, which have been linked to higher rates of mortality from natural disasters among women and girls. The security and bodily integrity of girls can be threatened by displacement, and evacuation to shelters lacking safe facilities for them has been shown to heighten the risks of sexual harassment, violence and human trafficking (A/HRC/35/13, para. 22). 17. In addition, emergencies disproportionately affect persons with disabilities. Children with disabilities may suffer higher rates of abuse, neglect and abandonment in emergencies, while programme assistance, adequate shelter, communication and means of transportation tend to be inaccessible, resulting in violations of their rights. Insufficient attention paid to accessibility considerations in evacuation, response and relief efforts renders children with disabilities particularly susceptible to injury and disease. Barriers to access to food, drinking water and medical relief can worsen children’s health problems and exacerbate the effects of children’s disabilities. B. Best interests of the child 18. A rights-based approach should always underpin the planning and execution of responses to humanitarian situations. Article 3 of the Convention on the Rights of the Child requires the best interests of children to be a primary consideration in all decision-making concerning them; for this reason, they should constitute a guiding principle in all actions taken by States, international organizations, non-governmental organizations and private actors. According to the Committee on the Rights of the Child, the expression “primary consideration” means that the child’s best interests should not be considered on the same level as other considerations. Such a clear position is justified by the special situation of the child, characterized by dependency, maturity, legal status, and often voicelessness. Children have fewer possibilities than adults to make a case for their own interests, while those involved in decisions affecting children should be aware of their interests. 7 Impact assessments should be conducted to identify the likely impact of decisions on children’s rights, and to determine the extent to which the best interests of the child have been taken into account in decision-making. C. Survival and development 19. Children are among the persons most vulnerable to danger and injury in emergencies; in fact, children in countries affected by humanitarian emergencies account for nearly half of all under-5 deaths.8 In humanitarian situations, children’s surroundings often change rapidly, introducing new risks into their environments, and families may be forced to move to areas more exposed to hazards. Moreover, basic services are often destroyed, and systems previously in place to protect children are compromised. 20. In humanitarian situations involving armed conflict, children are exposed to even greater risks. In 2016, more than 8,000 children were killed or maimed in conflict situations. This included 3,512 children killed or maimed in Afghanistan, the largest number since the United Nations began to document civilian casualties in 2009, and an increase of 24 per cent over the previous year. At least 1,340 children were killed and maimed in Yemen, and 1,299 in the Syrian Arab Republic (see A/70/836-S/2016/360 and A/72/361-S/2017/821). 21. Article 6 of the Convention on the Rights of the Child not only requires States parties to recognize the inherent right to life but also to ensure the survival and development of the child. The right to survival and development goes beyond a child’s physical needs and protection. Humanitarian situations affect mental, social and environmental development, as well as physical well-being. Children who have 7 8 Committee on the Rights of the Child general comment No. 14 (2013), para. 37. UNICEF, Children in Humanitarian Crises (see footnote 2), p. 10. 5