PERSF'ECTIVE Nawal M. !\lour+ Despite international agreements and national laws, marriage of girls <18 years of age is common worldwide and affects millions. Child marriage is a human rights violation that prevents girls from obtaining an education, enjoying optimal health, bonding with others their own age, maturing, and ultimately choosing their own life partners. Child marriage is driven by poverty and has many effects on girls' health: increased risk for sexually transmitted diseases, cervical cancer, malaria, death during childbirth, and obstetric fistulas. Girls' offspring are at increased risk for premature bi1ih and death as neonates, infants, or children. To stop child marriage, policies and programs must educate communities, raise awareness, engage local and religious leaders, involve parents, and empower girls through education and employment:'-·-----~· A wareness of reproductive health issues in dc\'eloping nations is growing. Critical issues are the high prevalence ofHJV/AJDS among young people; childbearing by young girls, which can lead to obstetric fistulas and death of the mother; and child marriage. Child marriage, defined as marriage of a child <18 years of age, is an ancient, worldwide custom. Other terms applied to child marriage include "early marriage'' and ''child brides." Early marriage is vague and does not necessarily refer to children. Moreover, what is early for one person may be late for another. Child bride seems to glorif;,· the process, implying a celebration and a bride who is happy to staJi a lO\·ing union with her spouse. But for the most part, girl brides do not know-and may have never met--their groom. ln 2002, "'52 million girls <18 years of age were married. With "'25,000 girls <18 years being married each day, 3ll estimated 100 million will be married by 2012 (J). Child marriages occur most frequently in South Asia. where 48';-f, of women aged 15--24 ha\·e bcen married ·Brigham and Women's Hospital, Boston, Massachussetts, USA 1644 be?fore the age of 18: these figures are 4:2''·o for Africa anJ 29% for Latin America 2nd tl1e C::uibbean (.:' ). Although the definilion of child marriage includes boys. most children married at <18 years of age are girls. For exCimple. in J\1ali the girl:boy ratio of marriage before age 18 is 72:1; in Kenya. 21:1; and ewn in the United States, 8:1 (3-5). \Ve therefore focus on the social 3lld health consequences of child m:JrriC~ge for girls. And although we focus on African countries, similar arguments over what drives child marriages. how they affect girls. and ho\\' to stop them may be applied to other continents. United f~ations Efforts ;;nd !~R.tional Laws Since 1948, the United Nations and other imernational agencies haw at1empted to stop child marriage. A1iicle 16 of the Universal Declaration of Human Rights states that persons must be at "full age'· when married and that m3rriage should be entered into "fi-ecly'' and \Yitb "full consent.'' ln other words, any country that allows child marriage is commitiing a violation of human rigl1ts (6). Articles 1, 2, and 3 of the 1962 Convemion of Consent 10 Marriage, Minimum Age for Marriage, and Registration of Marriages require that countries establish a minimum age for marriage and that all marriages be registered (7). A1iiele 16 of the 1979 Convention on tl1e Elimination of All Forms of Discrimination against Women requires minimum ages for marriage to be specified and says th3t child marriages are illegal (8). However, not until 1989, at the Convention on the Rights of tl1e Child. did international law define children as persons <1 S years of age (Article IJ (9). ln 1994, the International Conference on Popul:nion and Development stated that the minimum age of marriage should be raised and enforced. all forms of coercion and discrimination should be eliminated. marriage should be entered into with free consent and as egual panners. and the education and employment of girls should be encouraged (Principle 9, Action 4.18, Action 5.5) (1 0). Emerging Infectious Diseases • www.cdc.gov/eid • Vol. 12, No. 11, November 2006