Avinash K. Shetty, MD, FAAP, FIDSA, Editor

Despite substantial gains made in under-5 child survival, preventable maternal deaths and neonatal deaths continue to occur in low-income countries (LIC). Infectious diseases (eg, HIV, tuberculosis, malaria, and neglected tropical diseases) disproportionately affect children living in poverty. Combating poverty is the key to preventing and controlling infectious diseases in LIC. There is an urgent need to address the needs of orphans and vulnerable children due to HIV/AIDS in sub-Saharan Africa. Besides discovery of lifesaving interventions (eg, development of new and improved vaccines), we also need to do a better job at bridging the knowledge-implementation gap and increase the effectiveness of proven interventions. For example, despite the availability of effective vaccines to prevent pneumococcal pneumonia, rotavirus gastroenteritis, and human papilloma virus-related diseases (eg, cervical cancer), use of these vaccines remains suboptimal in LIC. Emerging and re-emerging infectious diseases (such as the 2014–2015 Ebola outbreak in West Africa) underscore the need for strengthening the existing fragile health systems in LIC, address complex ethical issues, and maintain effective community engagement, governance, and outbreak preparedness response and management.

Children are vulnerable for environmental health hazards (eg, contaminated water, poor sanitation, air pollution, toxic chemicals, and climate change) and unintentional injuries, which can result in mortality, morbidity, and disability. Other unique threats to child and adolescent safety include sex trafficking, sexual exploitation, violence and abuse, especially during wars, conflicts, and natural disasters. The explosion of new-age technology poses a considerable risk to children and adolescents. Pediatricians can play a vital role in promoting child health and development by providing services to the disadvantaged, socially isolated, and impoverished children and families in their local communities. Improving access, equity, and quality of care for immigrant and newly arrived refugee children in the United States remains a challenge. There is also an unmet need for mental health services for children and adolescents in the United States and worldwide.

As pediatricians, we must recognize that the health of children is a fundamental human right and strongly advocate for marginalized, low-income families. To protect children from toxic stress and reduce health inequalities, we must actively engage our patients and develop collaborative partnerships between various disciplines and across research, education, and service. Pediatricians engaged in global health service and research programs need to be aware of diverse sociocultural and ethical issues.

I am most grateful to all the authors for writing the state-of-the-art articles that will inspire pediatricians to remain strong advocates for promoting child health worldwide. I also want to thank Dr Bonita Stanton, consulting editor for this issue, and Casey Jackson and Kerry Holland at Elsevier for their continued support, cooperation, and advice in the preparation of this issue.