The survival, rather than the rights, of children must be the priority of UNICEF over the next decade because 10 million children are dying every year - many from preventable causes, a medical journal said on Friday.

The attack on the United Nations Children’s Fund came in a commentary published online by the editor of the Lancet magazine, Dr Richard Horton.

Horton also criticized how the leader of the organization is chosen.

“Child survival must sit at the core of UNICEF’s advocacy and country work,” said Horton. “Currently, and shamefully, it does not.

“The language of rights means little to a child stillborn, an infant dying in pain from pneumonia, or a child desiccated by famine. The most fundamental right of all is the right to survive.”

But UNICEF said it has indeed promoted survival and noted that child deaths fell 11 percent during the 1990s.

“It is at the center of everything we do and that is reflected in the public record of our own surveys, reports, studies and initiatives,” said UNICEF spokesman.

Half of the world’s 10 million deaths among children under 5 years old occur in six countries - India, Nigeria, China, Pakistan, Democratic Republic of Congo and Ethiopia, according to the World Health Organization.

Horton said the appointment of a new head of UNICEF by UN Secretary-General Kofi Annan next year offers an opportunity to set a course to reduce child deaths.

But he added that the process of selecting a new leader for UNICEF is flawed because there is no agreed criteria to judge a candidate to lead the organization.

“This discredited process threatens to damage the integrity of the UN system and, more importantly, it may well prove disastrous for the future of child health,” said Horton.

He also questioned why outgoing UNICEF chief Carol Bellamy and her three predecessors are Americans and suggests the net for candidates should be cast wider.

“It is hard to believe that the person best equipped to address the global plight of children can only be an American,” he said.

“UNICEF needs a visionary leader, a person of profound ability to make the next 10 years the Decade of Child Survival and Development.”

The UNICEF spokesman declined to comment on the leadership issue.

SOURCE: The Lancet, December 4, 2004.