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A participant takes part in a group session at a Youth Against AIDS training camp organised by the Jesuit AIDS Project in Domboshawa, around 80 km (49 miles) north-east of Harare, April 13, 2012. The Jesuit AIDS Project was launched in Harare in 1996 to fight the alarmingly high prevalence rate of HIV/AIDS in Zimbabwe and now focuses on prevention and youth development, according to organisers. Picture taken April 13, 2012. REUTERS/Darrin Zammit Lupi

Why is so little global funding devoted to adolescent health?

Adolescents make up a quarter of the population in developing countries, but on average receive less than 2 percent of all global health funding, according to a new report.

A total of $3.6 billion went toward nearly 20,000 projects targeting adolescent health between 2003 and 2015, according to an analysis published Friday in JAMA. That funding covered 1.8 billion young people between ages 10 and 24, but amounted to a drop in the bucket — just 1.6 percent — of global health aid.

For this study, researchers based their findings on information pulled from the Creditor Reporting System, a publicly available database that tracks how, where and why aid is spent. The research team relied on donor descriptions to capture projects, a limitation noted in the report. The largest donors included organizations such as the United Nations Population Fund and the Global Fund to Fight AIDS, Tuberculosis and Malaria, as well as countries such as the United States and United Kingdom.

These dollars make a huge difference, especially in low-income nations, according to the report, which looked at spending across 132 countries. The amount of money spent on each adolescent in these nations rose from $0.06 in 2003 to $0.24 in 2015, the report said.

Yet while donor organizations gave more money during the 12-year study period, the total amount given to adolescent health projects never topped 2.2 percent.

“This inequity is perhaps not surprising given that adolescent health has not been a priority during the era of the United Nations Millennium Development Goals,” the report said, referring to a global commitment to achieve eight goals, including reducing early childhood mortality; fighting HIV-AIDS, tuberculosis and malaria; and improving maternal health, especially during pregnancy and at birth.

What kinds of adolescent health issues received the most money?

Sixty-eight percent of the funding in this study focused on adolescent health went to fighting HIV-AIDS, especially in sub-Saharan Africa. Other issues prioritized in global aid included interpersonal violence, tuberculosis and diarrhea-related illnesses.

But spending patterns show that the global development community has a narrow view of how to provide for young people and their health needs, said George Patton, chair of the Lancet Commission on Adolescents and Health and co-investigator for this report.

“We have traditionally seen adolescence as a healthy time of life. It is only in the past decade that we have come to understand that it is in fact a linchpin for most aspects of health across the life-course,” said Patton, who also serves as professor at the Centre for Adolescent Health at the Murdoch Children’s Research Institute in Melbourne, Australia.

The public health community will tell you that critical development unfolds during adolescent years, Patton told the PBS NewsHour by email. Good nutrition greatly matters during these years, when massive brain development is underway. Mental disorders often take root during adolescence, and life-altering injuries also tend to take place at this time in life.

The impact of more funding

By ramping up how much global aid goes to adolescent health, Patton said economies in low-income nations could receive a boost they can’t afford to pass up.

“A failure to invest in the health of adolescents jeopardizes the demographic dividend — a healthy and well-educated generation of adolescents presents an extraordinary opportunity for economic development in today’s low-income countries,” he said.

The development community has taken recent steps to improve funding for adolescent health needs. In 2015, the World Health Organization, United Nations-affiliated groups and the World Bank created the Global Strategy for Women’s, Children’s and Adolescents’ Health to focus specifically on better meeting those groups’ needs. In its 2018 report, the organization suggested that adolescent mortality has dropped 17 percent worldwide since 2000, but mental health remains an issue for many adolescent girls and boys; suicide was a leading cause of death in this age group.

While the group’s formation is a positive step, Patton said it is too soon to know if its efforts will direct a more meaningful commitment to better global outcomes for young people and their health.

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