The Lancet Commissions
A call to action: the second Lancet Commission on adolescent health and wellbeing Sarah Baird, Shakira Choonara, Peter S Azzopardi, Prerna Banati, Judith Bessant, Olivia Biermann, Anthony Capon, Mariam Claeson, Pamela Y Collins, Nicole De Wet-Billings, Surabhi Dogra, Yanhui Dong, Kate L Francis, Luwam T Gebrekristos, Allison K Groves, Simon I Hay, David Imbago-Jácome, Aaron P Jenkins, Caroline W Kabiru, Elissa C Kennedy, Luo Li, Chunling Lu, Jun Ma, Terry McGovern, Augustina Mensa-Kwao, Sanyu A Mojola, Jason M Nagata, Adesola O Olumide, Olayinka Omigbodun, Molly O’Sullivan, Audrey Prost, Jennifer H Requejo, Yusra R Shawar, Jeremy Shiffman, Avi Silverman, Yi Song, Sharlene Swartz, Rita Tamambang, Henrik Urdal, Joseph L Ward, George C Patton*, Susan M Sawyer*, Alex Ezeh*, Russell M Viner*
Executive summary Adolescents are the future leaders of our world. Ensuring their health and wellbeing—now and in the future—is one of the strongest mechanisms available to safeguard the collective future of humanity and to secure a more just society and a healthier and more productive planet. Investments in the current generation of 10–24-year-olds will reap a triple dividend, with benefits for young people today, the adults they will become, and the next generation of children they will parent. These potential benefits are particularly relevant for Africa and Asia, where around 82% of the world’s adolescents currently live , a proportion that is projected to rise to 85% by 2100. Adolescence is a key developmental phase when dramatic biological growth and psychological maturation have the potential, if nurtured and supported, to unlock the capabilities of young people to be the innovators, educators, advocates, and leaders of the next 50 years. But globally the health and wellbeing of adolescents is at a tipping point. Progress in adolescent health has lagged well behind the improvements that have been made in the health and development of young children across the 21st century. The benefits of progress in children’s health risk being undermined by an increased burden of morbidity and mortality in adolescence, which could jeopardise the prospects of future generations. This increased burden includes rapidly escalating rates of non-communicable diseases and mental disorders, accompanied by threats from compounding and intersecting megatrends, including climate change and environmental degradation, the growing power of commercial influences on health, rising conflict and displacement, rapid urbanisation, the aftermath of the COVID-19 pandemic, and risks of future pandemics. Yet opportunities are also immense, with growing engagement in education, economic development, and digital innovation providing prospects for even the most marginalised adolescents. To tackle these compounding challenges and take advantage of all that the 21st century has to offer, it will be necessary to draw on the power, ideas, and leadership capabilities of young people to reimagine and recreate a healthier, fairer, and just planet. This Lancet Commission comes at a crucial time for adolescent health and wellbeing. Initiated in 2021, it brings together a diverse group of 44 Commissioners who span disciplines, geographies, and generations. The
Commission sets the global tone for shared and inclusive authorship, with a concerted prioritisation and approach to meaningful engagement with youth experts via the inclusion of ten youth Commissioners. Grounded in a set of workstreams co-led by senior Commissioners and youth Commissioners, we have embedded meaningful adolescent and youth engagement throughout all aspects of the Commission, including by bringing together 122 adolescents across the world to engage in what we termed Youth Solution Labs and appointing a
Published Online May 20, 2025 https://doi.org/10.1016/ S0140-6736(25)00503-3 *Joint senior authors Department of Global Health, Milken Institute School of Public Health, George Washington University, Washington, DC, USA (Prof S Baird PhD); Johannesburg, South Africa
Key messages • Investments across adolescence—ie, the period between age 10 years and 24 years— will reap a triple dividend, with benefits for young people today, for the adults they will become, and for the next generation of children whom they will parent. • Despite progress in some areas, without increasing investments, our projections suggest that by the end of the Sustainable Development Goal era in 2030, at least half of the world’s adolescents (1 billion people) will be living in multiburden countries where adolescents experience a complex and excess burden of disease. We project 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). • 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. • Today’s adolescents are the first human cohort who will live their entire lives under the shadow of climate change. Intergenerational justice demands that current and future generations of adolescents have the resources they need for health and wellbeing. • Central to effective action is the meaningful engagement of adolescents in policy, research, interventions, and accountability mechanisms that affect them. • 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. • 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. • Multisectoral actions on mental health, nutrition, sexual and reproductive health, and violence are required to amplify gains made in adolescent health. Coordination is needed between ministries of health and of education with regard to interventions in schools.
www.thelancet.com Published online May 20, 2025 https://doi.org/10.1016/S0140-6736(25)00503-3
1