A/HRC/32/32 afforded by policymakers to the implications of development in the second decade of life. Over the past 50 years, health has improved far less among adolescents than it has among young children.9 7. While there are many health issues of concern during adolescence, in the present report the Special Rapporteur focuses on mental health, substance use and drug control, and the rights to sexual and reproductive health, in view of the particular challenges they pose in balancing adolescents’ emerging autonomy with their right to protection. Using the rightto-health framework, the Special Rapporteur underlines the importance of valuing adolescents’ strengths and engaging with them as partners in informing and shaping the measures needed to realize the right to health and the optimum development of adolescents. 8. The Special Rapporteur recognizes the heterogeneity of adolescence and that definitions vary by country and region. However, to promote consistency and facilitate the measurement of adolescent health, this report adopts the definition of the World Health Organization, which views adolescents as persons between the ages of 10 and 19 years (until the twentieth birthday).10 II. Understanding adolescence and its implications for the right to health A. A period of transition 9. Adolescence is a life stage of intrinsic value, not merely a transition between childhood and adulthood. It is a critical developmental stage characterized by growing cognitive abilities and emotional competencies, during which the brain has substantial neural plasticity.11 The physical, mental and social potential established during the second decade contributes to enhanced intellectual ability and emotional functioning throughout adulthood.12 10. Adolescent health is the result of interactions between early childhood development and the specific biological and social role changes that accompany puberty, shaped by social determinants and by risk and protective factors that affect the uptake of health-related behaviours.13 While adolescents themselves have the capacity to contribute to their own health and well-being, they can only achieve this goal if States respect and protect their rights and provide them with access to the necessary conditions, services and information. 11. Adolescence is a period of development towards increasing capacity for independent decision-making, moving away from the protective environments associated with earlier childhood. It is accompanied by greater experimentation, risk-taking and impulsivity and by the increased influence of the peer group. These behaviours contribute to building resilience, character and self-confidence and to the exploration and understanding of boundaries, and reflect the gradual adjustment from protection towards autonomy. Accordingly, while adolescents under 18 years of age continue to be entitled to protection from violence, abuse and exploitation, as well as to consideration of their best interests, 9 10 11 12 13 4 Susan Sawyer and others, “Adolescence: a foundation for future health”, The Lancet, vol. 379, No. 9826 (April 2012), pp. 1630-1640. See www.who.int/maternal_child_adolescent/topics/adolescence/en/ and www.who.int/maternal_child_adolescent/documents/frh_adh_98_18/en/. Susan Sawyer and others, “Adolescence: a foundation for future health”. WHO, Health for the World’s Adolescents. Susan Sawyer and others, “Adolescence: a foundation for future health” (abstract).