A/HRC/32/32 I. Introduction 1. Adolescence (10-19 years of age) is a life stage when inequities become more sharply differentiated in terms of access to services, life decisions and future trajectories. Foundations laid down during adolescence, in terms of emotional security, health, education, skills, resilience and the understanding of rights will have profound implications for the social, economic and political development of adolescents. The costs of failing adolescents are high, which is why a powerful case exists for paying greater attention to the right of adolescents to the highest attainable standard of health and development. 2. There is a growing focus on adolescence within the international health and development community, as reflected, most notably, in the Global Strategy on Women’s, Children’s and Adolescents Health 2016-2030. These are important and welcome commitments that now need to be translated into action on the ground. 3. The population of adolescents globally is estimated to be over 1.2 billion, 88 per cent of whom live in developing countries. 1 Adolescents represent 18 per cent of the world’s population. Although adolescence is inherently characterized by relatively low mortality compared to other age groups, it is associated with emerging and complex risk factors, resulting in patterns of behaviour that affect long-term morbidity and mortality.2 Likewise, adolescents are one of the groups that existing health services serve least well. 3 4. It is estimated that 1.3 million adolescents died in 2012 from preventable or treatable causes.4 Road traffic accidents, suicide and homicide, violence and war, drowning and firerelated incidents account for about 40 per cent of all deaths among youth (people aged between 15 and 24 years).5 A small percentage of adolescents suffer from life-limiting and sometimes terminal illness, of which a majority are estimated to have no access to palliative care.6 5. Lack of access to safe reproductive health services and information contributes to adolescent girls among the most at risk of dying or suffering from serious or lifelong injuries associated with early pregnancies and childbirth. The lack of effective adolescent mental health policies and services leads to significant failures in emotional and social development, including violence against and among adolescents. Nearly all these risks are preventable, with outcomes grounded in physical and social environments and frequently mediated by their behaviours. 6. The rate and breadth of developmental change during adolescence is second only to that experienced in early childhood.7 While investments during the past 20 years have resulted in enormous gains for children in the early years,8 far less recognition has been 1 2 3 4 5 6 7 8 United Nations, World Population Prospects: The 2010 Revision (2011). World Health Organization (WHO), World Health Statistics 2014. WHO, Health for the World’s Adolescents. Available from http://apps.who.int/adolescent/seconddecade/files/1612_MNCAH_HWA_Executive_Summary.pdf. WHO, “Adolescents: health risks and solutions”, factsheet No. 345 (2014). George Patton and others, “Global patterns of mortality in young people: a systematic analysis of population health data”, The Lancet, vol. 374 (2009), pp. 881-892. Stephen Connor and others, “Assessment of the need for palliative care for children in South Africa”, International Journal of Palliative Nursing, vol. 20, No. 3 (March 2014), pp. 130-134; and WHO and the World Palliative Care Alliance, Global Atlas of Palliative Care at End of Life (2014), p. 19. R.M. Viner and others, “Adolescence and the social determinants of health”, The Lancet, vol. 379, No. 9826 (April 2012), pp. 1641-1652. A/70/213. 3