A/HRC/33/41 42. The violation of a child’s physical integrity from toxics cannot be undone. Causation presents a largely insurmountable obstacle to remedy, with numerous variables and missing information enabling perpetrators to escape accountability. As information is made available, the hazardous substance exposure levels previously considered “safe” continue to fall and increasing numbers of industrial chemicals and pesticides are identified as hazardous — helping to prevent harms in the future, but of far less use to child victims of the past in realizing their right to an effective remedy. Businesses that have left the present generation with contamination are often no longer in existence, financially unable or unwilling to pay for complete remediation. 43. States have a duty to prevent recurrence of human rights violations. The inadequate emphasis on prevention and precaution, in favour of an emphasis on risk management without adequate information on which to calculate the risks, has failed to protect human rights, including children’s rights. F. Right to the highest attainable standard of health 44. States have a duty to protect and realize the right of the child to the “highest attainable standard of health”.67 This includes measures to prevent disease and other health impacts, as well as to ensure access to health care for treatment. 45. States have a duty to ensure the social determinants of health, including safe food, water, and housing, as well as healthy occupational and environmental conditions, for children.68 Moreover, the rights to food, water and adequate housing are inextricably related to the right to the highest attainable standard of health, and should also be seen in conjunction with the rights to human dignity, life, survival and development, among others.69 46. The best interests of the child in attaining his or her right to the highest standard of health require the prevention of exposure to toxic chemicals and pollution. 70 While the magnitude depends on the age of the child, as well as the level and duration of exposure, exposure to toxic chemicals or pollutants reduces the likelihood that a child will attain the highest standard of health. Adverse health effects from childhood exposure to toxics are often irreversible and may not manifest themselves for years or decades, affecting the full realization of the right to health later in life. Health impacts are linked to industrial activities of the present and to the toxic legacy of past decades that persists in food, water, air and soil — a serious challenge to accountability. 47. For certain exposures, the risk of death, injury or illness can be reduced or avoided with timely medical intervention, in parallel with interventions by communities, health-care workers, government officials and other actors. However, for children of the communities most at risk, particularly indigenous, low-income, rural or marginalized communities, access to the necessary health care is often physically or economically unattainable. For example, 53 per cent of countries do not have a poison centre,71 let alone mechanisms to enable access to costly cancer and diabetes treatments for all. 67 68 69 70 71 Convention on the Rights of the Child, art. 24, and International Covenant on Economic, Social and Cultural Rights, art. 12. Committee on Economic, Social and Cultural Rights, general comment No. 14 (2000) on the right to the highest attainable standard of health, para. 11. Ibid., para. 3. Ibid., paras. 15 and 21-27. WHO, “The public health impact of chemicals: knowns and unknowns” (2016). 11