Second Lancet Commission on adolescent health records some gains; indicates need for more investments, laws to ensure wellbeing

By the end of 2030, at least half of the world’s adolescents (1 billion people) will be living in multi-burden countries where adolescents experience a complex and excess burden of disease. Photograph used for representational purposes only
| Photo Credit: franckreporter

The second Lancet Commission on adolescent health and wellbeing has recorded that despite progress in some areas, without increasing investments, by the end of 2030, at least half of the world’s adolescents (1 billion people) will be living in multi-burden countries where adolescents experience a complex and excess burden of disease. Further it has projected that in 2030, 464 million adolescents globally will be overweight or obese (143 million more than in 2015) and 42 million years of health life will be lost to mental disorders or suicide (2 million more than in 2015).  

The report at the end of the Commission’s term released this week, pointed out that funding for adolescent health and wellbeing is not commensurate with the magnitude of the challenge and is not targeted to the areas of greatest need. For example, specific funding for adolescent health accounted for only 2·4% of total development assistance for health in 2016–21, despite adolescents accounting for 25·2% of the world population.

Diverse group of commissioners  

Initiated in 2021, the Commission brought together a diverse group of 44 commissioners, including 10 youth. The deliberations have been shaped by meaningful engagement with adolescents and youth throughout all aspects, including bringing in 122 adolescents to be part of Youth Solution Labs.  

World Health Organization (WHO) Director General Adhanom Ghebreysus Tedros, writing in The Lancet, said: “The second Lancet Commission on adolescent health and wellbeing shows that significant strides have been made in improving adolescent health globally, while laying out significant challenges ahead. Over the past two decades, adolescent mortality has declined by 27%, owing to substantial reductions in malnutrition and communicable diseases, and expanded access to education—especially for girls. These changes will pave the way towards greater gender equity and better life outcomes.” 

Why is this report significant?

Sheer numbers, for one. The global population of roughly 2 billion adolescents constitutes around 24% of the world’s population. “The current generation of adolescents is the largest in the history of humanity…Projections suggest that by 2100 around 46% of the world’s adolescents will live in Africa, and that 85% will live in Africa or Asia,” the report states. The proportion of adolescents living in conflict-affected areas has more than doubled since the 1990s. An estimated 340 million (18%) adolescents now live in conflict-affected areas. 

Better indicators and improvement in data systems at the national and global level are required to monitor systemic changes in health and wellbeing outcomes and in the circumstances in which adolescents are growing up, the report added. As Dr. Tedros said: “Data matter, too. That is why WHO, together with partners, launched Global Action for the Measurement of Adolescent Health to close critical data gaps and strengthen accountability—including in underexplored domains such as adolescent connectedness.“

Social media impact

Interestingly, the report draws attention to the possible impact of social media on the lives of adolescents who it calls the ‘first global generation of digital natives’. Globally, 79% of 15–24-year-olds use the internet, a much higher proportion than among any other age-group, and more than 95% of adolescents in high-income and upper-middle-income countries are digitally connected. It calls for “enabling laws and policies provide the foundational environments for sustained improvements in adolescent health and wellbeing. These environments should protect adolescent sexual and reproductive health and rights, reduce the impact of the commercial determinants of health, and promote the healthy use of social media and online spaces.” 

The report has also asked for multisectoral actions on mental health, nutrition, sexual and reproductive health, and violence to amplify gains made in adolescent health. Coordination is needed between ministries of health and of education with regard to interventions in schools.