A/HRC/39/25 B. Underlying determinants of child mortality 38. The Special Rapporteur on the right to the enjoyment of the highest attainable standard of physical and mental health, Dainius Puras, stated that although remarkable achievements had been made in the right to survival globally, the right to holistic health and development was equally important. Healthy and responsible adults, including parents, were instrumental to breaking the cycles of violence and hopelessness. He pointed at asymmetries in health-related policies and approaches that were often too medicalized, adding that greater attention to underlying social determinants was needed in order to realize the right to health. He pointed out that non-biomedical interventions, such as psychosocial interventions, were also very effective, and highlighted a thematic report addressing the human rights of infants and newborns, who were also equal rights-holders deserving of dignity. Retrogressive measures globally with respect to women’s rights were cause for great concern. The Special Rapporteur then stressed the importance of implementing the right to health while also realizing rights as a means of attaining health outcomes. 39. The Special Rapporteur on the human rights to safe drinking water and sanitation, Léo Heller underscored how underlying determinants were key factors in addressing child mortality, and the well-documented relationship between improving water and sanitation and child health. If water, sanitation and hygiene measures were improved, the incidence of diarrhoea could be reduced by 25 per cent, and child mortality by up to 65 per cent. Initiatives to improve the supply of water and sanitation services that were based on the human rights framework had the greatest impact. Hand-washing with soap could reduce cases of diarrhoea by up to 50 per cent. Regular access to safe drinking water prevented unsafe storage practices, and its supply to schools and health facilities was a key to child health. The Special Rapporteur had observed in several countries unaffordable systems for providing water and sanitation in urban areas. For successful outcomes, affordability was therefore essential. 40. According to the Special Rapporteur on the implications for human rights of the environmentally sound management and disposal of hazardous substances and wastes, Baskut Tuncak, there was currently a human rights crisis due to exposure to toxic chemicals and wastes, responsible for substantial mortality rates of children under 5 years of age, with serious effects for their development. Paediatricians had referred to a silent pandemic that started before babies were born. Childhood diabetes, cancer, impaired neurological development and asthma all pointed back to exposure to hazardous substances and waste. In his report on trends in this regard (A/HRC/33/41), the Special Rapporteur had explained that States had a duty to prevent childhood exposure, which violated different rights at multiple levels. Children could be irreversibly affected by exposure from very early in life. As policymakers could not pinpoint the risk factors causing high disease rates, no rights violations were identified, so no action was taken. The poorest were discriminated against because they were subjected to the greatest degree of exposure, but had no access to their rights. A new policy perspective was required, beyond risk assessment, where States could (a) assess toxic threats and prevent exposure; (b) require that businesses conduct human rights due diligence assessment; and (c) implement an effective global framework of treaties on hazardous substances and wastes. 41. The discussion focused on cross-cutting issues affecting underlying determinants, including behavioural change through access to information. All people, including children, had a right to be properly informed through health education and information. Rights relating to essential resources and a healthy environment were a question of equality and non-discrimination; States therefore had to provide effective protection to children in this regard. Participants asked how the value of human rights could be demonstrated through relevant data, tools and arguments, and noted that general comment No. 24 (2017) of the Committee on Economic, Social and Cultural Rights on State obligations under the International Covenant on Economic, Social and Cultural Rights in the context of business activities would be informative on the obligations of States and the responsibilities of private companies. 12