A/HRC/35/13 mortality in children under 5.24 By 2030, it is projected that climate change impacts will result in 48,000 additional deaths from diarrhoeal disease in children under 15. 25 17. Climate change is also likely to expand the seasonal and geographic range of vectorborne diseases, including insect-borne diseases with hosts sensitive to variations in temperature, humidity and precipitation. Malaria is expected to expand into tropical highland regions where the medical and immunological responses of populations may be ill-equipped to cope.26 Infants and young and poor children living in areas with substandard health facilities are at particular risk. In 2015, roughly 300,000 children under the age of 5 died from malaria; 27 the majority lived on the African continent. Outbreaks of other diseases that affect children, such as dengue, Zika, leptospirosis, viral infections, meningitis, varicella, viral hepatitis, leishmaniasis and pertussis, have been linked to climate change.28 E. Impacts on mental health 18. Climate change and the impacts of traumatic stress connected to climate change, such as war/insecurity, sexual and physical violence and witnessing deaths and injury related to extreme weather disasters, negatively affect children’s mental health. Children who lose a family member or experience life-threatening situations as a result of the impacts of climate change have a higher chance of experiencing post-traumatic stress, anxiety disorders, suicidal ideation and depression. Disasters can also affect children’s cognitive capacity with corresponding impacts on their emotional well-being. For example, children affected by El Niño during early childhood posted lower scores in language development, memory and spatial reasoning than other children of a similar age. 29 Lower cognitive functioning in early life has been shown to increase the risk of future mental health problems.30 19. Children may also experience anxiety related to fear of separation from their families and heightened household tensions resulting from the loss of family livelihoods. 31 Children whose families are affected by climate change may be exposed to higher risks of violence, physical abuse, child labour, trafficking and exploitation. Their needs for rest and play may be subordinated to basic survival interests. In cases of displacement, separation from traditional lands and territories, from communities and from family members can have impacts on children’s education, cultural identity and access to social support systems. All of these climate impacts have potentially severe mental health repercussions. F. Disproportionate impacts on children in vulnerable situations 20. According to the Intergovernmental Panel on Climate Change, “people who are socially, economically, culturally, politically, institutionally or otherwise marginalized are especially vulnerable to climate change and also to some adaptation and mitigation responses”.32 The negative impacts of climate change will disproportionately affect poor children, indigenous children, minorities, migrants and other children on the move, children 24 25 26 27 28 29 30 31 32 6 WHO, “Diarrhoeal disease”, Fact sheet No. 330 (2013), available from www.who.int/mediacentre/factsheets/fs330/en/. WHO, Quantitative Risk, p. 44. UNICEF, Unless We Act Now, p. 48. WHO, “Malaria in children under 5” (2016), available at www.who.int/malaria/areas/high_risk_groups/children/en/. A/HRC/32/23. Arturo Aguilar and Marta Vicarelli, “El Niño and Mexican children: medium-term effects of earlylife weather shocks on cognitive and health outcomes” (2011). Chuan Yu Chen and others, “Mild cognitive impairment in early life and mental health problems in adulthood”, American Journal of Public Health, vol. 96, No. 10 (October 2006). Agnes A. Babugara, “Vulnerability of children and youth in drought disasters: a case study of Botswana”, Children, Youth and Environments, vol. 18, No. 1 (2008). Field and others, Climate Change 2014, p. 50.