Adolescent health programs receive only a tiny share of international aid, finds research

Melbourne's Murdoch Children's Research Institute, in partnership with Harvard Medical School, has discovered that adolescent health programs across the developing world receive only a tiny share of international aid, even though young people make up 30 per cent of the population of low-income countries.

Published in JAMA Network Open, researchers from the US and Australia examined how much international donors spent on youth health projects in 132 low-income countries over the 14 years from 2003 to 2015. (89 per cent of the world's adolescents live in low and middle income countries.) Co-author University of Melbourne Prof George Patton, from MCRI's Centre for Adolescent Health, said the research found that only 1.6 per cent of global investments in health over those 13 years were spent on projects for adolescents even though adolescents account for 12 to 13 per cent of disease burden in the developing world. "Of the little invested, most funds go to adolescents indirectly through programs for HIV particularly in sub-Saharan Africa. However a large number of young people in low-income countries are being disabled as a result of depressive disorders, self-harm and car accidents," he said.

Prof Patton said these youth challenges received almost no investment, yet expenditure in neglected areas such as mental health and car accidents would bring huge benefits for adolescents - for their future health, their productivity and the healthy growth of their children. "The international donor community has been 'asleep at the wheel' in failing to keep pace with changing demography and health needs," Prof Patton said. "Despite supporting the UN's 'Global Strategy for Women's, Children's and Adolescents Health', international investment from agencies have so far failed to make serious investments in the world's young people. "Adolescence lays a foundation for future health, quality-of-life and economic productivity. And it is therefore remarkable that this group has been so undervalued in international development."

Study senior author Chunling Lu, assistant professor in the Department of Global Health and Social Medicine at Harvard Medical School, said the world now has the largest group of adolescents in human history. "Considering how important young people are for the future wellbeing and economic development of low- and middle-income countries, international donors need to reconsider both the levels and the patterns of investments that they are making," Dr Lu said.

Dr Lu is also affiliated with the Division of Global Health Equity, Brigham; the Women's Hospital, Boston, Massachusetts; the National Research Foundation Centre of Excellence in Human Development; and the University of Witwatersrand, Johannesburg, South Africa.

Additional findings of the 'Development Assistance for Adolescent Health from 2003 to 2015' study:

• As a global community over the 14 years, we spent $0.15 per adolescent each year on developmental assistance for health ranging from $0.46 in low income countries to $0.11 in low and middle income countries and $0.05 in upper middle income countries
• Adolescents in Sub-Saharan Africa have received the most development assistance for health, but the annual investment remained only $0.40 spent for each adolescent each year.
• The Western Pacific, including Fiji and Papua New Guinea, received the least donor health development assistance with only $0.02 per annum per adolescent spent since 2003.
• 50 per cent of projects funded in low and middle income countries were in sexual and reproductive health, including HIV/AIDS prevention and treatment.

Almost 57 per cent of all adolescent-targeted development assistance have come from these top five donors:

• Global Fund to Fight AIDS, tuberculosis, malaria $806.8m
• UN Population Fund $401.3m
• United States of America$389.9m
• United Kingdom$251.8m
• International Development Association$218.6m
• 19,921 youth-targeted health projects were funded from 2003 to 2015 with total funds of US$3,634 million.
• Overall HIV/AIDS was the health problem that received the largest amount of international adolescent-targeted health assistance followed by interpersonal violence and tuberculosis.
• Other lead causes of disability for youth were road injuries, depression and other mental disorders, self-harm, skin disease, iron-deficient anemia, and low back and neck pain received little or no health investment.
• Data from the Creditor Reporting System was used to assess aid spent per adolescent. (Maybe include a hyperlink if it is publicly accessible). This publicly accessible system receives reports from four categories of international donors:
• The 30 members of the UN Development Assistance Committee
• 32 multi-lateral organisations (including the United Nations and World Bank).
• 20 non- Development Assistance Committee countries (including the United Arab Emirates)
• The Bill and Melinda Gates Foundation.