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Why we need a public health approach to end child sexual exploitation and abuse
Professor Elena Martellozzo and Jack Cagney reflect on a landmark symposium in Georgia
In June 2025, a landmark symposium in Atlanta, Georgia, brought together global leaders from medicine, public health, law enforcement, academia and frontline child protection. What united these diverse disciplines was a shared conviction: child sexual exploitation and abuse (CSEA) is preventable, and prevention must be our collective priority. Hosted by Professor Ray Schinazi of Emory University and organised alongside Childlight, the event made the case that CSEA is a complex yet addressable issue – provided we reframe our thinking. Just as we vaccinate populations to prevent disease, we must take proactive, evidence-based measures to stop abuse before it occurs. This blog presents key takeaways from the event and explains why policymakers, academics and practitioners must urgently embrace a public health approach to tackle CSEA. Understanding the scale of the problem Prof Deborah Fry, Global Director of Data at Childlight, opened the event by setting out the essential components of a public health strategy. These include defining and monitoring the problem, identifying risk and protective factors, developing and evaluating interventions and scaling effective strategies. She also highlighted key efforts to measure CSEA, from the landmark 1995 CDC-Kaiser ACE study to the Violence Against Children and Youth Surveys (2007–present) led by UNICEF, the Centers for Disease Control and Prevention (CDC) and several national governments. Despite these advances, Prof Fry warned that our understanding remains fragmented. The internet has transformed abuse, making it fast, scalable and global. Technology-facilitated abuse and the proliferation of online networks, often augmented by AI, demand new methodologies and sustained investment in data collection and modelling. Without reliable data, entire populations of children remain invisible. As Prof Fry put it: “We cannot prevent what we cannot measure.” Multidisciplinary teams are essential Katelyn Stanley from the Missouri Office of Violence Prevention highlighted the critical role of multidisciplinary teams (MDTs) in both preventing and responding to child exploitation and trafficking. Working across micro (individual), mezzo (community) and macro (systemic) levels, MDTs bring together law enforcement, child welfare, victim advocates, mental health experts and housing and community services. Stanley emphasised that CSEA cannot be divorced from broader structural harms such as poverty, structural racism, housing insecurity and damaging policy. Prevention efforts must be holistic, trauma-informed and equity-driven. “Exploitation is not just a criminal justice issue,” she explained. “It’s a symptom of broader social and historical injustice.” Global prevalence and policy blind spots Professor Emmanuela Gakidou of the University of Washington presented new research that shows the global magnitude of the crisis: nearly 1 in 5 women and 1 in 7 men experienced sexual abuse before turning 18 years old. These estimates, drawn from surveys in over 140 countries, reveal the scale of the issue and stark inequalities. Prevalence is higher in low- and middle-income countries, where child protection systems are often weak. The research fills a gap in evidence and strengthens the argument that CSEA must be addressed through policy, investment and global cooperation. If we fail to measure abuse accurately, we fail to design solutions that reflect children’s realities. Public health in action: A case study from the Philippines Dr Bernadette Madrid from the University of the Philippines is one of the most influential Filipina women in the world. At the symposium, she shared a persuasive example of a public health model in action. Women and Children Protection Units (WCPUs) that she helped develop are hospital-based multidisciplinary centres offering medical, psychological, legal and social support to survivors. They work closely with specially trained police and judicial staff to ensure a coordinated response to abuse cases, facilitate access to justice and help survivors heal in a safe and supportive environment. This model demonstrates how cross-sector coordination can be scaled and sustained while remaining population-focused, prevention-oriented and grounded in equity. Dr Madrid’s message is clear: the public health model is not just theory - it works. Reframing child marriage Joyce Sepenoo, Senior Director of Health, Equity and Rights for CARE USA, reframed child marriage as a form of CSEA and a violation of human rights, affecting 650 million women and girls globally. Drawing on evidence from CARE’s Tipping Point initiative, she explained how community-led solutions can shift norms and delay marriage. In Nepal, Bangladesh and Niger, this has translated into increased school attendance, economic opportunity and stronger parental support for girls. Sepenoo stressed: “We cannot end CSEA without ending child marriage.” Estimating the number of missing children Dr Bindu Sharma from the International Centre for Missing and Exploited Children (ICMEC) introduced a global model for estimating missing children. While inconsistencies in definitions (e.g., runaways vs. abducted vs. trafficked), widespread underreporting and lack of coordinated response systems make global tracking difficult, Dr Sharma’s team used imputation and regression techniques to address such data gaps. Their findings point to millions of missing children worldwide. Dr Sharma calls for investment in standardised definitions, cross-border data sharing and early prevention systems to make sure every missing and exploited child is counted. Rethinking online safety Sir Stephen Kavanagh, ICMEC Secretary General, laid out a bold vision for eliminating child sexual abuse material (CSAM) from the internet. Not just removing content after the fact, but preventing it from ever appearing. His three-pillar framework offers a roadmap: Perspective: Frame CSAM as a public health and civic issue, not just a tech problem Accountability: Set enforceable standards for platforms and governments Innovation: Invest in automated tools akin to those used for copyright and malware detection Sir Kavanagh stressed the urgency of a unified, global response that includes tech companies, regulators, child protection agencies and survivors. Fragmented systems, lack of political will and corporate inertia are no longer acceptable barriers. The path forward The symposium reminded us as that we know what works. From national prevalence studies to MDTs, public hospitals to grassroots campaigns, we have effective models to prevent CSEA. What we need now is the political will, sustained investment and cross-sector coordination to bring them to scale. Adopting a public health approach means shifting from treating abuse after it occurs to building systems that stop it from happening in the first place. It means resourcing communities, listening to survivors, investing in data and treating CSEA as a central challenge to human rights and global development. Our collective imperative is clear: the time to prevent CSEA is now. --- About the Authors: Professor Elena Martellozzo is Director of the European Hub at Childlight and Professor of Child Sexual Exploitation and Abuse Research. She is a world-leading expert in cybercrime, focusing primarily on online harms and online safety, and is involved in policy debates at the intersection of technology and human behaviour. Jack Cagney is a PhD student at Emory University, a researcher at the Institute for Health Metrics and Evaluation at the University of Washington and a Global Data Fellow at Childlight, where he studies the prevalence and burden of gender-based violence and violence against children.
September 2025
Why we need a public health approach to stop child sexual exploitation and abuse
Professor Elena Martellozzo and Jack Cagney reflect on a landmark public health symposium in Georgia