A quarter of the world's population are adolescents: major report sets out health and wellbeing trends
The report noted significant improvements in some aspects of adolescent health and wellbeing since the 2016 report. These include reductions in:
communicable, maternal and nutritional diseases, particularly among female adolescents
the burden of disease from injuries
substance use, specifically tobacco and alcohol
teenage pregnancy.
It also found that there had been an increase in age at first marriage and in education, especially for young women.
Despite this progress, adolescent health and wellbeing is said to be at a tipping point. Continued progress is being undermined by rapidly escalating rates of non-communicable diseases and mental disorders, accompanied by threats from compounding and intersecting megatrends. These include climate change and environmental degradation, the growing power of commercial influences on health, rising conflict and displacement, rapid urbanisation, and the aftermath of the COVID-19 pandemic.
These megatrends are outpacing responses from national governments and the international community.
Born between 2000 and 2014, this is the first cohort of humans who will live their entire life in a time when the average annual global temperature has consistently been 0.5°C or higher above pre-industrial levels.
At roughly 2 billion adolescents, they are the largest cohort of adolescents in the history of humanity. And this number will not be surpassed as populations age and fertility rates fall in even the poorest countries.
They are the first generation of global digital natives. They live in a world of immense resources and opportunities, with unprecedented connectedness made possible by the rapid expansion of digital technologies. This is true even in the hardest-to-reach places.
Growing participation in secondary and tertiary education is equipping adolescents of all genders with new economic opportunities and providing pathways out of poverty.
These opportunities, however, are not being realised for most adolescents. Increasing numbers continue to grow up in settings with limited opportunities. In addition, investments in adolescent health and wellbeing continue to lag relative to their population share or their share of the global burden of disease.
Investments in adolescents accounted for only 2.4% of the total development assistance for health in 2016-2021. This was despite the fact that adolescents accounted for 25.2% of the global population in that period and 9.1% of the total burden of disease. We use development assistance as a measure because, while governments also invest in adolescents, it's difficult to account for how much this is. For example, when a government supports a health facility, it serves the entire population.
Yet, the report provides evidence to show that the return on investments in adolescent health and wellbeing is highly cost-effective and at par with investments in children.
The report recognises the special place of Africa in the global future of adolescents. It notes that, by the end of this century, nearly half of all adolescents will live in Africa.
Currently, adolescents in Africa experience higher burdens of communicable, maternal and nutritional diseases, at more than double the global average for both male and female adolescents. They also have a higher prevalence of anaemia, adolescent childbearing, early marriage and HIV infection. They are much less likely to complete 12 years of schooling and more likely to not be in education, employment, or training.
Female adolescents in sub-Saharan Africa have the highest adolescent fertility rate at 99.4 births per 1,000 female adolescents aged 15-19 (the global average is 41.8). They have also experienced the slowest decline between 2016 and 2022.
Globally, there was progress in reducing child marriage between 2016 and 2022. But in eight countries in 2022, at least one in three female adolescents aged 15–19 years was married. All but one of these eight countries were in sub-Saharan Africa. Niger (50.2%) and Mali (40.6%) had the highest proportion of married female adolescents.
The practice of child marriage is declining in south Asia and becoming more concentrated in sub-Saharan Africa. As the report notes:
it continues because of cultural norms, fuelled by economic hardships, insurgency, conflict, ambiguous legal provisions, and lack of political will to enforce legal provisions.
Beyond adolescent sexual and reproductive health concerns in sub-Saharan Africa, obesity is increasing fastest in the region. This illustrates the vulnerability of adolescents to the power of commercial interests.
Since 1990, obesity and overweight has increased by 89% in prevalence among adolescents aged 15–19 years in sub-Saharan Africa. This is the largest regional increase.
The absence of data on adolescents is a problem. Adolescents in sub-Saharan Africa are absent in many data systems. For example, data on adolescent mental health in sub-Saharan Africa is virtually absent.
Stronger data systems are needed to understand and track progress on the complex set of determinants of adolescent health and wellbeing.
Another area of concern is the massive inequities within countries, often gendered or by geography. While female adolescents in Kenya are experiencing substantial declines in the burden of HIV and sexually transmitted infections, adolescent males are experiencing increasing burdens. In South Africa, years of healthy life lost to maternal disorders show more than 10-fold differences between the Western Cape and North West provinces.
Where there's been strong political leadership, remarkable changes have been seen. Take the case of Benin Republic. The adolescent fertility rate in the country declined from 26% in 1996 to 20% in 2018 and child marriage from 39% to 31% over the same period. Strong political leadership has also led to substantial reductions in female genital mutilation or cutting. This fell from 12% of girls in Benin in 2001 to 2% in 2011–12 among 15–19-year-old girls in Benin Republic. Political leadership also facilitated the expansion, by the national parliament in 2021, of the grounds under which women, girls, and their families could access safe and legal abortion.
But for every country that takes positive steps to protect the health and wellbeing of adolescents, several others regress.
The last decade has witnessed regression in several countries. In 2024, The Gambia attempted to repeal a 2015 law criminalising all acts of female genital mutilation or cutting. In 2022, Nigeria's federal government ordered the removal of sex education from the basic education curriculum.
The report calls for a multisectoral approach across multiple national ministries and agencies, including the office of the head of state, and within the UN system.
Coordination and accountability mechanisms for adolescent health and wellbeing also need to be strengthened.
Laws and policies are needed to protect the health and rights of adolescents, reduce the impact of the commercial determinants of health, and promote healthy use of digital and social media spaces and platforms.
Strong political leadership at local, national, and global levels is essential.
The report also calls for prioritised investments, the creation of enabling environments to transform adolescent health and wellbeing, and the development of innovative approaches to address complex and emerging health threats.
It calls for meaningful engagement of adolescents in policy, research, interventions and accountability mechanisms that affect them.
Without these concerted actions, we risk failing our young people and losing out on the investments being made in childhood at this second critical period in their development.
The current adverse international aid climate is particularly affecting adolescents as much development assistance relates to gender and sexual and reproductive health. Concerted action in addressing adolescent health and wellbeing is an urgent imperative for sub-Saharan Africa.
This article is republished from The Conversation, a nonprofit, independent news organization bringing you facts and trustworthy analysis to help you make sense of our complex world. It was written by: Alex Ezeh, Drexel University; Russell Viner, UCL, and Sarah Baird, George Washington University
Read more:
Canada must take action to prevent climate-related migration
We design cities and buildings for earthquakes and floods — we need to do the same for wildfires
Eating wild meat carries serious health risks – why it still happens along the Kenya-Tanzania border
Alex Ezeh is a fellow at the Stellenbosch Institute for Advanced Study (Stias).
Russell Viner and Sarah Baird do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
The Hill
2 hours ago
- The Hill
Credible scientists can't hold up Kennedy's charade for much longer
How much longer can responsible people work for President Trump's Department of Health and Human Services under the leadership of Secretary Robert F. Kennedy Jr.? That question arises every time Kennedy pulls funding for vaccine research or purges respected scientists at the Centers for Disease Control, the U.S. Preventive Services Task Force or the Food and Drug Administration. For a while, it looked like even vaccine critics weren't safe in the Trump administration. During the COVID-19 pandemic, Dr. Vinay Prasad established his reputation as a contrarian, expressing reservations about pediatric vaccination and several common mitigation measures. It was thus no surprise when he was appointed director of the FDA's Center for Biologics Evaluation and Research, which covers vaccine policy. Prasad didn't last three months on the job. He resigned abruptly in late July following attacks by right-wing figures such as Laura Loomer, who labeled him a 'progressive leftist saboteur.' A Health and Human Services statement cited Prasad's desire to spend more time with his family. It has been widely reported, however, that Trump himself forced Prasad's departure, despite the objection of FDA Commissioner Dr. Marty Makary. In another abrupt move, only 10 days later, Prasad abruptly returned to the FDA, evidently at Makary's request but otherwise without explanation. While some of Prasad's views remain quite controversial among many highly regarded physicians and scientists, it is certainly reassuring to see Loomer's malign influence diminished at the FDA. Nonetheless, Kennedy is still in charge of the entire department, and it is likely only a matter of time until he resumes appointing resolute anti-vaxxers, if not widely discredited would-be 'scientists,' to key committees. Makary and Prasad, and other well-credentialed scientists, no doubt believe they can overcome Kennedy's destabilization of medical research, while still contributing to public health. Maybe they are right, and the wisest course is to hold on as long as possible, trying to do good. After all, there is no telling who would replace them. On the other hand, it seems inevitable that Kennedy's pronouncements will increasingly become intolerable. Some CDC employees already worry that the recent deadly attack on their building in Atlanta was motivated by 'RFK Jr's lies about vax safety and CDC scientists.' Meanwhile, Trump has announced that political appointees will soon take over scientific research grant approval, displacing actual scientists, i n order to 'advance the President's policy priorities.' At some point in the degradation of science, there must be a line that ethical administrators will not cross. There is no single answer to whether an official should stay or withdraw from a compromising position, but history does provide cautionary tales. In 1854, a Massachusetts judge named Edward Loring reached a sincere but tragic decision. I described the events in my book, ' Fugitive Justice: Runaways, Rescuers, and Slavery on Trial.' Late that spring, a fugitive from slavery named Anthony Burns, was arrested in Boston and brought before Loring, a federal commissioner under the Fugitive Slave Act of 1850, as well as judge of the Massachusetts Probate Court. Burns's arrest sparked mass protests in Boston, where anti-slavery sentiment was strong. Many Bostonians called upon Loring to resign from the federal commissioner's position. As a probate judge, he administered the estates of widows and orphans, which required compassion, and it was intolerable for him to be involved in the heartless business of slave-hunting. Loring took the criticism to heart, responding with a published statement. 'It is said that the statute is so cruel and wicked that it should not be executed by good men,' he wrote. But that would create a paradox. If humane judges were all to resign, 'then into what hands should its administration fall? Will those who call the statute merciless commit it to a merciless judge?' Although he had deep misgivings about the Fugitive Slave Act, Loring believed he had a duty to preside. Otherwise, judging would 'be confined to those who are reckless of that right in others, or ignorant or careless of the means given for its legal defense, or dishonest in their use.' Those who wish this, Loring continued, 'are more cruel and wicked than the statute, for they would strip from the fugitive the best security and every alleviation the statute leaves them.' Despite his protestations, Loring ruled in favor of the slaveholder, holding that it was required under the law. He sent Burns to Virginia in chains, where he was starved and abused. Burns's supporters, meanwhile, demonstrated the true meaning of humanity by raising funds to obtain his freedom. Burns returned to Boston and later studied theology at Oberlin College, no thanks to Loring. It turned out that a 'good judge,' as Loring believed himself, could not honorably enforce a pitiless law in a racist regime. He was dismissed from the Harvard Law School faculty, and the Massachusetts legislature removed him from the Probate Court. Loring is remembered today, if at all, as an enabler of slavery. Perhaps health officials are currently echoing Loring's lament. 'If I resign, someone very bad will take my place.' But sometimes, complicity is complicity.
Axios
4 hours ago
- Axios
Washington sees surge in COVID rates
Washington is among a dozen states seeing elevated levels of COVID as a new variant ripples through the nation. Why it matters: The XFG "stratus" variant is driving up cases just as kids return to school — and as Health Secretary Robert F. Kennedy Jr. unilaterally alters federal vaccine guidance. Driving the news: The CDC updated its regional data for COVID-19 test positivity on Monday, Aug. 11. The data accounts for the week ending Aug. 2. By the numbers: Washington state saw 11.1% of tests come back positive in the week ending Aug. 2 , compared to 5% to 9.9% in the rest of the country, per regional data from the CDC. Emergency room visits and hospitalizations roughly doubled from mid-June to the beginning of August, according to the state Department of Health's respiratory illness data dashboard. Detection of the virus in wastewater is listed as "very high" or "high" in several Puget Sound cities, including Seattle, per state data. In King County, the positivity rate clocked in at 12.5% for the week ending Aug. 2, according to Public Health - Seattle & King County data. What they're saying:"It's a good reminder for people not to let their guard down" and to use the tools we have learned so far, says Public Health-Seattle & King County spokesperson Sharon Bogan. Yes, but: The XFG variant isn't currently linked to more severe illness, according to WHO and CDC. Zoom out: Oregon, Alaska and Idaho share the same comparatively high positivity rate of 11.1%, per the CDC, joining New Mexico (12%), Texas (12%), Oklahoma (12%) and others at the top of the chart. The big picture: Overall, the CDC reports that the COVID-19 epidemic trend is "growing," with 45 states experiencing an increase in cases. No state has seen a decline in cases as of Aug. 5, per the CDC. The XFG "stratus" variant was first detected in January. It now accounts for 14% of cases in the U.S. and is the third-highest among all variants stateside, according to the CDC.
Axios
7 hours ago
- Axios
As Virginia's kindergarten vaccination rates rise, so do exemptions
As kids head back to school, Virginia is bucking the nationwide trend of declining vaccination coverage among kindergarteners — but while coverage is increasing, exemptions are too. Why it matters: A growing portion of families actively opting out of vaccines causes pockets of vulnerability that risk outbreaks, even with vaccination rates rising overall. By the numbers: There were 84,335 kindergarteners in Virginia's public schools during the 2024–25 school year, per the state Department of Education. New CDC data shows that 2.7%, or about 2,277, had either medical or non-medical exemptions in that year. In the 2023–2024 school year, it was 2.2%. In 2014–15, it was 1.1%. Zoom out: Virginia's exemption percentage for kindergarteners is lower than the national rate of 3.6% and U.S. parents still overwhelmingly support childhood vaccinations. Meanwhile, Virginia's vaccination rate for kindergarteners steadily increased between fall 2023 and fall 2024 from 88.9% to 90.7%. The big picture: There's a slew of factors for why parents get vaccine exemptions for their kids. An Axios review of Virginia Department of Health data found that Virginia parents largely seek them for religious reasons, which requires only a signed form. Medical ones need documentation from a licensed medical professional. Anti-vax sentiments, once considered a liberal trend, also gained ground among conservatives during the COVID pandemic. The top 10 elementary schools with the highest religious exemption rates for kindergartners in 2024–25 were all in counties that voted for President Trump, per an Axios review of VPAP data. Zoom in: None are in the Richmond metro, but the state's second-lowest kindergarten vaccination rate was reported last fall at Henrico elementary school Fair Oaks. It's in a precinct that voted for Kamala Harris, and is near areas that went for Trump. And while no Richmond-area school districts pass the 95% threshold generally accepted as high enough to make outbreaks unlikely, some individual schools do and Hanover is close. Some local elementary schools also have religious exemption rates higher than the state average. Case in point: Hanover had the highest local vaccination coverage among kindergartners last fall at 94.9%. The school with the highest religious exemptions: 7.5% at Pole Green Elementary.
