executive summary
Today’s adolescents (defined here as those aged 10-19) face serious challenges in a rapidly changing world – from the impacts of demographic and age structures, to the impacts of climate change on their mental health and well-being, to a learning crisis, and persistent inequalities, violence and disregard for their human rights, especially those experienced by women.
The world urgently needs a new investment programme to improve adolescent well-being. The costs of doing nothing are too high. This investment must cover all five areas of adolescent well-being: health, connections, safety, learning and employability, agency and resilience, and all the connections between them. Investment must support global programmes at the local level, tailored to national realities and involving young people themselves, enabling them to express their specific needs.
Transformative investments are needed in three key platforms or systems: Universal Health Coverage (UHC), including Primary Health Care (PHC); strengthened schools with a focus on learning, health, nutrition and student wellbeing; and community-based support systems. These platforms are not only key points of program delivery, but are essential to ensure that all adolescents are covered and the complex linkages involved are fully realised.
The purpose of this report is to make the case for this much-needed investment in supporting the well-being of adolescents around the world. By investment we mean planned programs of spending on interventions that are known to be effective in improving all dimensions of adolescent well-being. To this end, an extensive review of the literature focused on intervention evaluations was conducted and new modelling work was completed.
As is evident throughout this report, there are significant economic and social returns to be gained from broad-based investments in addressing adolescent well-being. Such investments would help reduce inequalities and protect adolescent human rights. Given the current demographic and epidemiological transitions globally, and the fact that there is a large body of evidence showing that specific interventions for this age group are highly effective, such investments have never been more timely. Finally, investing in adolescents and their well-being strengthens a country’s human capital, which in turn enhances its potential for future development, eradicating extreme poverty, and creating more inclusive societies.
Many affected countries are already heavily indebted, so investment on the scale required will require significant support from the international community, while interventions will need to be tailored to take into account specific needs and local knowledge and expertise on effective programs.
The model presented in this report was for an intervention introduced and scaled up in stages from 2024 to 2035. Where the intervention was extended in time, it was maintained from its 2035 level to 2050. The main quantitative measure used for the investment case is the Benefit-Cost Ratio (BCR). This is the ratio between the value of the benefit and the investment costs required to achieve that benefit. For the various investments analysed here, the BCR is 10 or more, and in many cases much higher. An investment whose benefits are 10 times its costs is indeed a very strong investment.
For some domains (e.g., connectedness, agency, interpersonal violence) it is not possible to estimate the BCR. [IPV]) are unavailable due to the unavailability of underlying empirical research. This does not negate their importance to adolescent well-being, but rather calls on researchers to strengthen knowledge. The presentation of BCR results in this report reflects the availability of studies in the literature.
Amid the need for a major investment programme to build a universal platform, based on the BCR research and other evidence collected here, we have identified six priority areas:
- Malnutrition: hunger, undernutrition, micronutrient deficiency, overweight/obesity.
- Mental health: both prevention and treatment
- learning, skills and employment;
- Improving the status of women, including reducing child marriage and unplanned pregnancies.
- Preventing violence and injury
- Preparing youth to deal with new realities.
While a return of at least $10 for every dollar spent would be great, the costs of the entire set of investments described here are high. Total costs through 2035 are estimated to approach $2.8 trillion, averaging about $230 billion per year in present value over the 12 years from 2024 to 2035. This equates to about 0.25% of the average projected global Gross Domestic Product (GDP) over this period.
Large-scale and immediate investments in enhancing the capabilities and well-being of young people are now critical. These investments will empower them to face the challenges ahead and thrive for decades to come. The costs of inaction are very high. We estimate the average annual cost of inaction (lost gains) for the period 2024-2050 in the regions and countries studied in this report to be USD 4.1 trillion. This equates to an average annual 7.7% of the projected total GDP of emerging and developing countries over this 27-year period. As this report shows, the returns on these investments – the returns on action – are also high, both in terms of the BCR and in terms of realizing human rights and reducing inequalities around the world. The time to act is now.
