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The world is experiencing one of the most turbulent periods of the twenty-first century. International cooperation on global health is declining, and major agencies—including the World Health Organization, the United Nations Population Fund (UNFPA), and UNAIDS—are grappling with  severe cuts.

The second Lancet Commission on adolescent health and wellbeing, launched at the World Health Assembly in May 2025, points to concerning trends impacting adolescents, who are already facing unprecedented challenges. As Youth Commissioners, we are gravely concerned that:

• This generation will be the first to live their entire lives under the effects of climate change, with the planet projected to warm by 2.8°C by the year 2100.
• Adolescents are increasingly exposed to harmful products such as alcohol, tobacco (including e-cigarettes), sugar-sweetened beverages, and ultra-processed foods – all of which are contributing to a rising burden of non-communicable diseases. Rates of adolescent overweight and obesity have increased up to eightfold in parts of Africa and Asia.
• The number of adolescents affected by conflict has more than doubled in the past 30 years, and they now make up a growing share of refugee populations.
• While digital technology opens new opportunities, it also comes with heightened risks such as cyberbullying, online violence, and poor mental health.
• In many places, rapid and unplanned urbanisation adds further dangers, including exposure to air pollution, unsafe environments, and increased psychosocial stress.

These threats to young people’s health, well-being, and future beg the question: What can we do?

In the Lancet Commission, a set of actionable solutions is presented. These were developed in collaboration with ten Youth Commissioners, six youth peer reviewers, and nearly 200 adolescents and young people from 36 countries, who participated in Youth Solution Labs.

Youth movements as catalysts in global health

History reminds us that youth movements play a critical role in shaping change—from resisting colonialism and authoritarianism to advancing gender equality. The same holds true for global health. In the face of escalating risks, youth leaders, activists, and movements have the potential to shift course toward better health for both people and planet.

As evidenced in the Lancet Commission, young people are leading research, influencing policy and awareness, pushing for transparency, and delivering health services in communities. Comparative case studies in the Commission find that, in South Africa and Nigeria, survivors of gender-based violence have become peer educators and community advocates. In Fiji, adolescents are building water infrastructure, planting trees, and promoting sustainable practices. Furthermore, flagship initiatives such as the Lancet Youth Network present young people as strong ambassadors.

Young people and governance: shifting perception and practice

Around the world, practices and perceptions of young people in global health governance are shifting. There is also a growing body of evidence on Meaningful Adolescent and Youth Engagement (MAYE).

For example, Youth Commissioner and Associate Professor of Pediatrics at the University of California, Dr Jason Nagata, led the development of a MAYE checklist for the Commission to support organisations to effectively and robustly engage with youth and calls for equal partnerships with adolescents and youth.

Similarly, as part of the Lancet Commission, Youth Commissioner Luwam Gebrekristos ran a survey of 215 current and former members of Youth Advisory Councils. Findings suggest these Councils help shape priorities, guide organisational work, and support outreach and advocacy efforts. Yet common challenges persist, including unclear roles, tokenism, limited resources, adult bias, and weak institutional integration.

A call to action on youth involvement

The latest data in the Lancet Commission report sounds a clear alarm—urgent action is needed for the sake of today’s young people and generations to come. It is essential that global health organisations, governments, and donors prioritise MAYE. Young people have a stake in driving efforts towards the Sustainable Development Goals (SDGs), and they will grow into the leaders who take us into a post-SDG world. Their involvement in designing a healthier, more prosperous post-SDG agenda cannot be overlooked.

🔗 Access the full Commission report.

Why youth activism in global health is needed more than ever

October 9, 2025