WMA Statement on Providing Health Support to Children in Street Situations

Adopted by the 66th WMA General Assembly, Moscow, Russia, October 2015,
and revised by the 76th WMA General Assembly, Porto, Portugal, October 2025

PREAMBLE

The WMA believes that in the 21st century, life on the streets for children left to their own devices, to poverty, or to any form of exploitation or crime, is unacceptable. It is concerned about this phenomenon, which is becoming increasingly prevalent in many countries around the world, with UNICEF currently estimating that several tens of millions of children are affected.

The concept of “children in street situations”, developed by the United Nations[1], includes children or individuals under the age of 18 who depend on the street to live or work, whether this be alone, with peers, or with their families; it also refers to a wider population of children who have forged strong ties with public places and for whom the street is an essential part of their identity and daily life.

The health of these children remains critical and has been exacerbated by global economic inequalities, the geopolitical situation due to the development of numerous conflict zones around the world, as well as the climate and environmental crisis, which contribute to family break-ups, social upheavals, violence, and rising school drop-out rates; all of which seriously hamper access to healthcare.

Children in street situations, even more than other children, may be victims of discrimination. They are also particularly exposed and vulnerable to abuse of all kinds, violence and to the risk of exploitation for commercial or sexual purposes, or recruitment into armed forces or armed groups.

The WMA firmly believes that the minimum conditions for a child’s development and education cannot be met in such circumstances and that physicians must work to address situations that could seriously compromise a child’s future by hindering their development, safety, and health, which is defined by the WHO as a state of complete physical, mental and social well-being.

The WMA emphasizes that life on the streets carries many additional health risks (barriers to prevention and access to care, difficulties in follow-up, vulnerability to serious pathologies and trauma).

This is a complex, multi-factorial issue that requires strong commitment from all societies and relevant stakeholders, including healthcare professionals, and in particular physicians.

Facilitating contact between children in street situations and caretakers should be seen as a first step towards preserving or restoring these children’s health and re-socialising them through an established bond of trust. Once achieved, a more multidisciplinary and multidimensional approach can then be put in place to provide more comprehensive care and support, particularly educational and social.

The WMA emphasizes that the health of young people shapes the health of tomorrow’s population, and that young people play a part in social cohesion and are an asset to any country.

RECOMMENDATIONS

The WMA:

1. strongly condemns any infringement of the rights of children in street situations, in particular through discrimination, stigmatisation, and exposure to abuse, violence, and all forms of exploitation.
2. calls on governments to intensify their research into the factors that result in children living on the streets, and to work to minimise the impact of these situations on children’s overall health. National authorities have an imperative duty to take charge for all these children and to support their return to a living environment appropriate for a child. National authorities must also do everything in their power to protect children living on the streets from the health risks associated with various addictions and drug abuse (tobacco, alcohol, medicines and drugs), and those associated with transmissible diseases, particularly sexually transmitted ones.
3. calls on the national authorities to carry out more research and collect data to assess more accurately the number of children in street situations. States must ensure that the collection and use of such data does not stigmatize and is beneficial to these children.
4. calls on governments, medical associations and healthcare professionals to become more aware of the scale of the phenomenon, and to organise targeted prevention and awareness campaigns so that these children have access to the full range of necessary health and social protection.
5. urges all medical associations to collaborate with governments and public authorities, and with other professionals in the health and social sectors, to ensure that the fundamental rights of children in street situations, in particular the right to health and education, are respected at all times. Every effort must be made to provide these children with housing, healthcare, and access to clean drinking water and nutritious food. Prevention policies, and in particular vaccination programmes as defined by the WHO, must be supported and implemented effectively. Appropriate information on health and the specific risks associated with precarious living conditions must be provided to the children concerned and to all relevant stakeholders and decision-makers.
6. calls on physicians to advocate for the rights of children, especially the most vulnerable ones, and to commit fully to their protection.
7. encourages physicians and local health providers to get involved in health and risk screening, information and prevention initiatives, and particularly in vaccination campaigns directed at children in street situations.
8. urges physicians to exercise caution and express appropriate reservations when asked, through clinical or paraclinical methods, to estimate the age of young individuals for legal or administrative purposes, given the importance of ensuring that adolescents benefit from their status as minors until they reach adulthood, as recognized by the UN International Convention on the Rights of the Child. In particular, the physician must state the scientific uncertainties and specify the margin of error of the age estimation techniques used. These methods should only be used as a last resort.

[1] General comment No. 21 (2017) on children in street situations – United Nations Committee on the Rights of the Child