- 5 months ago
Adolescents make up almost a quarter of the world’s population, yet they get just over 2% of global health and development funding. What can be done to close the gaps in their wellbeing? Prof Peter Azzopardi and Dr Marie Habito from Australia’s Murdoch Children’s Research Institute speak on the need to invest in adolescent health.
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00:00Hello and welcome to It's About Youth with me, Fei Kuan. Adolescents today are growing up in a
00:14rapidly changing world that's shaped by digital disruption, climate change and global uncertainty
00:19to name a few. Now over at the Murdoch Children's Research Institute, MCRI, one of Australia's
00:25leading paediatric medical research centres. Adolescents is defined as between the ages of 10
00:31to 24 and from their centre for adolescent health, global experts are calling for stronger investments
00:38in adolescent well-being. Joining me on the show today all the way from Melbourne, Australia is
00:43Professor Peter Azopadi, Head of Global Adolescent Health at MCRI as well as Dr Marie Habito, a
00:50postdoctoral fellow at Global Adolescent Health at MCRI. Thank you so much to both of you for
00:55joining me today. Fei, thank you so much for the opportunity to be with you and your audience,
01:01we really appreciate it. I mean it's a pleasure to have the both of you on speaking about this.
01:06Now firstly, when we're talking about adolescents, this is a group that represents the largest
01:12generation in human history. So I'd like to start off by hearing from you Pete, why are the ages of
01:1910 to 12, 10 to 24 such a critical window? Thanks Faye. Look it's a really great question
01:27and you know like it is exciting to see the interest in adolescent health in global health
01:35action now. You know it's terrific to see WHO, UNICEF, UNFPA, so many different organisations you know
01:43really paying attention to adolescents and adolescent health. But you know that hasn't always been the
01:48case, you know we know and even if we go back to the Millennium Development Goal era, you know there
01:54has been, there was such a focus on children, early childhood, maternal health and adolescents have
02:01been largely neglected. And part of that I think is because people thought that adolescence
02:06is a time of life where people are healthy, you know where they don't have health needs. And that's true,
02:12I mean from, I'm not an adolescent anymore but you know certainly I look back at my adolescence and I
02:17think of it as a time where you know you start to form new relationships, you know you are
02:23transitioning in school, you make new friends, you know you might be active in sport. So it's a time
02:30of great excitement and new opportunities but it's also a time where new challenges arise. And we now
02:39know more than ever that you know mental health problems, you know this is a time of life where mental
02:44health problems and challenges really arise. And that we know that young people have new and
02:50emerging needs around sexual reproductive health. And we know that you know many of the major health
02:57issues that our global community now faces, you know particularly you know non-communicable diseases
03:04like cardiovascular disease and diabetes, like a lot of the risk factors and a lot of the early signs of
03:10these illnesses actually arise during adolescence as well. Now for a long time, you know WHO and a lot
03:16of the global agencies defined adolescence as the second decade of life, so 10 to 19 years of age.
03:23But actually what we know more and more and what I really liked about what you said Faye is that
03:27adolescence is a developmental stage. And just as early childhood is a time of development where people
03:33grow and learn new skills and develop, so is adolescence. And it's not just pubertal development
03:41but it's also brain development as well. And so we understand actually that the brain development
03:47occurs until the mid-20s. And we also know as well that young people are staying longer and longer
03:54in education and transitioning to you know independence and maybe you know even starting a family
04:01well into their 20s. And so many of us now recognize adolescence as a developmental window that
04:07you know starts at the age of 10 and sort of you know maybe concludes in the mid-20s or so.
04:14So a really really important time of life where many of us develop and acquire the skills and assets
04:21that are going to be important for our life into adulthood but also setting the foundation for the
04:27next generation as well. So kind of shifting that perspective of this current age gap, this age
04:35group as something that's really very critical and also filled with its own set of challenges that
04:41we're just finding out now or rather looking into critically now. The thing is that we often hear
04:47that youths are the leaders of tomorrow and yet factors such as digitalization or urbanization,
04:54even climate change is all affecting adolescent well-being. So what would you say are some of
05:00the emerging risks that we're still underestimating? I mean I think you've highlighted quite a few of
05:07them already Faye. I think that you know so I was involved in the recent or the second Lancet
05:14Commission on Adolescent Health and Wellbeing. So you know we had the first Lancet Commission in 2016
05:20was published and that really called for the need to invest in adolescent health and then we just
05:25published this year the second Lancet Commission and it really looked at progress over time and
05:30look we've made some progress in adolescent health but not enough and the reason for that actually is
05:37because of the emergence of you know some really important new drivers of adolescent health and
05:43well-being and particularly you know ill health. So you know many of us would remember you know the
05:49COVID pandemic and you know the disruption that that had on health and social systems or on education
05:55and you know really sent a shock across the globe that really disrupted you know many people's lives
06:05and so I think that's just one example of a big global shock that can really impact on
06:11adolescent health but there are other shocks as well that we know and certainly war and conflict
06:18are really important shocks in that you know there are active wars and conflicts happening you know
06:23in many parts of the world at the moment and certainly climate change and is another you know
06:30really important shock. My colleague Marie is doing quite a bit of work actually in this space. Marie I
06:36don't know if you want to talk a little bit about how climate change and the climate crisis
06:40actually impact on adolescent health. Yeah we'd love to hear from you Marie.
06:45Yeah thanks Pete. So I think increasingly in in our area of work and in global health
06:51there's been this increasing sort of recognition of the importance of climate change and how
07:00how it impacts the health and well-being of people. And this includes young people, adolescents,
07:06because adolescents already face substantial barriers to health care and these are being heightened
07:16by climate change and including climate extremes that we see a lot more of in you know around us but also
07:25in through various media happening all over the world. So climate change has direct and indirect impacts on
07:35on health and these harms accumulate over a person's lifetime and adolescents who, you know,
07:42young people who have contributed the least to the causes of climate change are actually the people who are going to be
07:52living with the consequences of climate change for the rest of their lives.
07:59So I think there's a lot to be to be done in terms of in terms of seeing it from an intergenerational
08:11justice perspective where you know we as adults you know we're no longer adolescents but we owe it to
08:16the younger generation to work with them to be able to come up with the solutions to the problems that they
08:24will have they will be inheriting from our generations.
08:28Definitely more to be done to address the climate crisis and it's actually something that we have
08:33we've highlighted on the show quite a number of times with the youth we featured there's the whole sense of climate anxiety
08:40and then what with social media and their exposure to it there it's it's it's often linked to poor mental health and and lack of digital safety which are some of the challenges that was highlighted in the 2025 year.
08:49Lancet Commission on Adolescent Health and Wellbeing which the MCRI was part of and I just wanted to bring a little bit more towards Australia for it for example Australia has specifically moved on to to ban social media accounts for individuals under the age of 16 I'm curious to hear from the both of you is is this something that's the right move for governments to move towards having age-based restrictions to address the
09:19the kind of challenges the kind of challenges faced by adolescents yeah look it's it's a really interesting policy move and I think it I think it is well intentioned you know I I so I think that's really important to say first you know and I think that you know there are many people that are concerned about you know that the potential harms of social media and and so you know what what it does a response like that look like
09:48but I think but I think what I think what I think what I think what I think what I think what we also need to consider in this is that you know social media also brings many benefits to young people as well
09:58and you know we all now engage through social media in our everyday lives I mean and Faye I mean you know we're actually engaging at the moment you know through a video call
10:14and and so like you know so um technology brings many many benefits to to many of us uh for for
10:23young people you know it brings the opportunity to access information around health um it may
10:30provide some young people you know the opportunity to access care and support at times of crisis
10:37um and for young people who are marginalized you know um you know it often provides the
10:43opportunity for them to engage with other similar people as well um so there are there are certainly
10:52many benefits that um social media bring um but we also know that there are harms in terms of cyber
11:00bullying um and in terms of you know um access to um incorrect or non-evidence-based um information as
11:09well so you know in all of this um you know i do think that um i mean you did talk a little bit
11:16before fay around like some of the things that have changed and that may be driving a change in
11:22adolescent health and certainly the commercial determinants of health or the commercialization
11:28of so many systems um is certainly one of them and i think that you know we know that the
11:33commercialization of food systems is driving a um an epidemic of obesity um we know that um and i think
11:43that we could similarly look at social media and you know that there are huge commercial pushes to engage
11:50young people and to expose them to potentially harmful exposures like um gambling um and
11:58and to other um and to pornography for example so i think that you know it's it's a very it's a very
12:04um complicated space i think that the policies that you know the australian government are seeking to
12:13implement are very well intentioned um i think that um you know there are other policies in other
12:20countries um that have been effective and i think for example in the european union um
12:27you know there have been examples of policies to restrict um harmful media um and i think that's a that's
12:35a very useful um policy um potentially alternative policy so i think um many of us are waiting to see
12:43um how this policy is actually implemented um and any any potential impact it may have look certainly
12:51in the lancer commission you know we we presented the complexity of the evidence around this issue
12:58um and actually called for um for evidence-based discussions and policy making um around this
13:05space and i do think that there is a need um for um for more robust evidence actually and and and on
13:12both sides and really understanding the potential benefits of of new technology and social media as
13:18well on young people's lives uh marie i'm curious to know a little bit more about the studies that
13:24you you might have worked on are there any particular studies or interventions that come to mind when it
13:29comes to being able to meaningfully drive real change in adolescent health systems thanks for that
13:38question okay um so specifically and we do i have actually uh worked on a study that was done in
13:47malaysia as well as in three other countries in southeast asia called the pathways to adolescent
13:52pregnancy study um and uh so in this study we um we worked with a local partner uh based in malaysia
14:02research partners in malaysia to interview um 45 uh girls from urban and rural settings in malaysia
14:10and um the study was really looking to um to understand you know the how girls experience
14:18adolescent pregnancy so what journeys they follow um toward becoming pregnant and in how does that happen
14:26in relation to experiences of of marriage or cohabitation so um in the context of malaysia what we actually
14:34found um was that uh though there were girls that uh were becoming pregnant in the context of uh uh of
14:45marriage or cohabitation um there were also many girls who were experiencing pregnancy outside of union um so they
14:55were uh engaging in sex before uh before marriage or cohabitation um but they were doing so without the
15:03resources that they needed to um to make informed choices i guess uh so they lacked uh uh access to
15:14sexual and reproductive health information services and to contraceptives um and um so a subset of of
15:25the girls that we spoke to actually were living in shelter homes and so for for these girls um the
15:32experience of uh of becoming pregnant um was uh did follow that pathway where you know sex and pregnancy
15:41happened outside of outside of marriage or union um and i think um this study is um has provided us with
15:52such great uh insight like a depth of of uh of data um into you know just how diverse the the experiences of girls are
16:04that they can't just be put into one box and offered a single solution there need to be um interventions uh programs
16:14policies that are tailored to their specific needs so uh through that study um we argued that you know
16:22in order to reduce um unintended adolescent pregnancies in the context of malaysia um that uh that there is
16:31there's a need for continued investment in multi-sectoral interventions um that address key drivers of
16:39adolescent pregnancy at the specific points in girls lives and that will vary depending on which pathway
16:44they follow um but also it's really important to bring girls voices out in the work that we do in
16:52research um such that we are able to share the findings of the research that we do with program
17:00implementers and policymakers so that actions are evidence-based and are responsive to the needs of
17:08adolescent girls thank you for for sharing your experience with that marie uh there's two parts
17:15that i really like to follow up on investments and voices of adolescents we were talking about
17:20investments firstly um the the report the lancet commission um pointed out that investments currently
17:28do not match the the scale of the problems faced by adolescents so it's stated here that while
17:34adolescents make up 24 of the current population only a little over two percent is channeled towards
17:41their global development and health funding uh pete could you you know say a few words here about how
17:47how critical is it that we invest a little more in in this cross-sectoral research that marie was
17:53talking about and early interventions uh before it becomes a bigger crisis thanks faye i mean i think
18:00is critically important um i mean you're absolutely right so you know we did a an analysis in the
18:05lancet commission and it followed some earlier work that we had done as well and we actually looked at
18:10um so not all investments but we looked at developmental assistance for health so that's a um you know that
18:15includes um any foreign aid and any um bilateral investment in health within a country and you're right that
18:23you know less than two percent of that um funding went to adolescent health programs but i think what's even
18:29more concerning is that within that very little funding a lot of that seemed to be mismatched
18:36to the areas of need so mental health many of us would um agree is a really core and critical area of
18:43adolescent health need um received only a small sliver of that already limited funding
18:49and so i think that there's a need for research like the work that marie outlined
18:55to outline you know what evidence-based and effective targets for action would be there's
19:02a need for research to lay out what um effective programs look like and i think you know we need
19:08to invest actually in those programs um and we need to monitor them so we need to measure you know
19:15how they're implemented and we need to measure the impact that those programs might be having on
19:20adolescent health outcomes um which is really important from an accountability perspective
19:24so um i think that if we look at child health for example um and you know i gave the example before
19:32globally of the millennium development goals in most countries most people would be able to
19:36report you know um childhood mortality rates under five mortality rates vaccination rates etc is there
19:43knowing those numbers is really has been very useful in terms of um drawing and targeting investment in
19:51action um we haven't had that data for adolescent health you know we only had mortality data for
19:56adolescents only in the last 10 to 15 years um in many countries you know we haven't we don't have
20:03good quality data on terms of what are what's the mental health status of young people and so i think
20:08that um you know many of us when we're asked to participate in research you can kind of feel a bit
20:13of a um an exciting thing to do but it's really useful it's a really useful way of having your voice and
20:19for actually helping to draw um or bring visibility to the needs of young people and i think that um
20:26you know more and more we do need to be investing in this work so that you know the programming that we
20:33invest in is actually effective so um yeah i just think this is such a critical area of need
20:39um that we should be really focusing on the next five ten years and also for for adolescents to to be
20:45part of that solution right so creating meaningful partnerships here would be key what would you say
20:52are maybe some practical ways that that we're able to engage in young voices when it comes to shaping
20:58these policies and interventions and programs that affect them i think this has been the most major
21:05shift actually um over the last 10 15 years and i think that you know even when i first started
21:11working in adolescent health um i remember there was a un report that talked about adolescence as the
21:18challenge for society you know um and now we view adolescence as an age of opportunity and that we
21:24should be working with young people not just because it's their right to be involved um in projects
21:31or programs that affect them but we also know that as well that young people bring unique unique
21:36perspectives and skills um that can help shape a better future for all of us um so look i think we've
21:44long talked about the need for engaging young people particularly in programs and in research
21:49but it has been less it has been less frequently actually done yeah and i think that um you know
21:57there is now really there are now really good examples and really good models of how to engage
22:02young people and policies and programs and at the very least you know i mean young people should be
22:08consulted around the design and they should i mean that's the minimum but you know um the optimally you
22:14know young people should be involved in every stage i mean marie i wondered if you want to talk a
22:19little bit about the youth hubs that you're involved in and i think that's a really exciting model
22:23um of shifting the way that we actually work with young people
22:27yeah thanks pete um so uh i think um we've touched on this earlier that you know we we um our group um has
22:40a strong commitment toward you know increasing the involvement of young people in the in the work that
22:46we do and this is this is one of those uh the uh recent initiatives um so um we're actually um
22:54hoping to establish a network of youth research um research hubs or research labs across um southeast
23:06asia and the pacific through different projects that we're that we're running uh both at mcri and also at
23:12global adolescent health group at the burnett institute um so um through collaboration between
23:19those two uh groups where um we're using this model as an approach um where we invest in um
23:31conducting co-research with adolescents with adolescent adolescents there alongside us um as we design
23:39uh research projects as we conduct data collection analyze the data all the way through to dissemination
23:47of our research findings so pete talked about it earlier how important it is to have young people
23:53engaged at all through all the phases of the research process and it's you know this has been done
24:01in other settings and we're trying now to implement this in um in papua new guinea in in myanmar
24:11in indonesia um and also in the philippines um so we're exploring topics like you know prevention of
24:20unintended adolescent pregnancy um and uh topics like contraceptive self-care how you you know encourage
24:29and enable adolescents to be able to practice self-care to be able to went to um to use the services
24:41access services and products that they need through sources um within the formal health care system but
24:49also outside of that like community-based um approaches um and we're also looking at using the same model
24:57of co-research with young people to understand climate extremes and how that impacts um adolescent health
25:05and so this is a project in the philippines um so the vision is um you know right now we're the ones
25:14sort of um that have defined uh what the research topics are but um key to the model of working with young
25:23people will be the investment in training them to conduct research with us to work together to learn
25:29from each other on how uh how to conduct research with their peers um but then also um to be able to
25:39hopefully in the future the the topics that will be covered will be defined by the adolescents themselves
25:47um so it's sort of a it's a long-term sort of uh investment and commitment on our part but this is
25:55these are the beginning steps that we're taking to uh more meaningfully engage young people in the
26:02research that we do um and to give them that seat at the table with the adults when it comes to
26:08making decisions that affect them right it's actually really really interesting initiatives there um
26:15the importance of then investing in creating spaces for uh to engage with adolescents and have their
26:22voices heard and we've actually unpacked quite we've covered quite a lot of ground today but um we're
26:28almost at the end of our show and just to very quickly wrap up looking ahead um for the both of you
26:34if there's just one place for us now to or one key action to prioritize when it comes to adolescent health
26:41or to even start a conversation on that what would it be uh marie would you like to go first i think
26:46that um you know just building off of what i was just speaking about like i think working in respectful
26:54partnership with young people and have really investing in that and you know and that means you know
27:01funding resources and making sure that our the way that we work is responsive to
27:10adolescents i think that's that's a key area of that i think is a priority
27:18and how about you pete i mean i totally agree with what marie said i mean i think
27:24you know maybe at a higher level you know i really think that we need to make sure that adolescents and
27:31adolescent health are visible in every policy in every strategy you know be it at a national level in
27:39malaysia be it within the regional region be it globally i mean if you look for example at the
27:44sustainable development goals they have been such an important um driver of action and adolescents are
27:52pretty much neglected in the sdgs you know and so i think that um you know we need to make sure that
27:58in the post sdg era you know so they end the sdgs end in 2030 so it's not that far away you know
28:04following that we need to make sure that there are goals and there are targets that speak
28:08to adolescents but but i also think as well that um you know we can't underestimate underestimate the
28:16important role that young people and youth advocates have in actually calling for change i mean we've
28:22seen so many examples in the past where young people have actually driven really important social
28:27change changes for justice and i think that um you know in part of you know changing our policies
28:35you know to ensure that young people um you know are better represented it's i want to come back
28:41and sort of echo what marie said i think we need to ensure that young people have an equal seat at the
28:46table as well and that their thoughts are heard and valued all right thank you so much to both of you
28:53for sharing your insights on adolescent health i've been speaking to professor peter as a party and dr
28:59marie habito from global adolescent health at mcri this has been it's about youth with me fae kwan thank you for watching and good night
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