The world Health Organisation (WHO) defines adolescence as "the progression from the appearance of secondary sex characteristics (puberty) to sexual and reproductive maturity; development of adult mental processes and adult identity; and the transition from total socioeconomic dependence to relative independence". The definition of adolescence varies from one context to another. Many programmes regard it as the period between the onset of puberty and marriage/child-bearing.

One in every five person in the world is an adolescent - defined by WHO as a person between 10 - 19 years of age. Out of 1.2 billion adolescents worldwide, about 85% live in developing countries and the remainder in the industrialized countries. There is enormous diversity among adolescents, regardless of where they happen to live.

The diversity is manifest in the level of physical, psychological and social development, and on factors in the individual’s immediate environment and within the culture of the wider society.

Health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity. Although the adolescents are generally thought to be healthy yet so many adolescents do die prematurely. Every year, an estimated one million young men and women between the ages of 10 - 19 lose their lives - mostly through accidents, suicide, violence, pregnancy related complications and illnesses that are either preventable or treatable. Millions more suffer chronic ill health and disablement that may well endure a lifetime. Among the many causes of death, disability and ill health among adolescents, WHO has identified four as being of crucial importance. They are sexual and reproductive behavior, tobacco use, suicides and road traffic accidents.

Adolescents’ health is influenced by the strengths and vulnerabilities of individual adolescents and the character of the settings in which they lead their lives. These settings are schools they attend or not attend, families that do or don’t nurture them, friends, the communities in which they live (at micro & macro levels) and play and other related surroundings.

Most mortality in adulthood has its roots in the adolescent period. WHO estimates that 70% of premature deaths among adults are due to behaviours initiated during adolescence. The major threats to adolescents health is HIV/AIDS, violence -homicides, wars, declining opportunities for the population at large to earn a living, inadequate/inappropriate education, accidental injuries & deaths and, malaria. About 300 million young people smoke and half of whom will die of smoking related causes later in life.

Sexual & reproductive health is a state of complete physical, mental and social well being and not merely the absence of disease or infirmity in all matters related to the reproductive system, its function and processes. Adolescent Sexual & Reproductive Health refers to the physical and emotional well being of adolescents which includes their ability to stay healthy and remain free from too-early pregnancy, unsafe abortion, STIs, sexual violence and coercion.

Each year 1:20 adolescents contract an STI and each day 7,000 young people (10-24 years) become infected with HIV (one every five minutes) globally. Each year up to 4.4 million women aged 15 - 19 undergo unsafe abortions, most often carried out illicitly by unqualified practitioners. As with pregnancy, the younger the women the greater the risks associated with abortions. Whether or not an adolescent girl is married, childbearing at early age is profoundly disempowering. Especially for the unmarried young woman, childbearing cuts short her education, severely limits her income earning capacity and impairs her ability to make well informed choices about life.

Considering the needs and alarming situation governments, in collaboration with NGOs are urged to meet the special needs of adolescents and to establish appropriate programmes to respond to those needs. Such programmes should provide information to adolescents and make a conscious effort to strengthen positive social and cultural values [ICPD Programme of Action].

Adolescents are less likely than adults to use a condom because of lack of access or inability to insist on its use. Fewer than five per cent of the poorest young people use modern contraception. Every day more than a quarter of a million young people become infected with an STD. About 80% of HIV transmission worldwide occurs through unprotected sex. If one partner has an STD as well as HIV, the transmission is three to five times greater. In some African countries, surveys have found one in every ten pregnant adolescents to be HIV-positive. World wide, at least 2.5 million youth were infected with HIV during 1997. More than half of all new infections occur in young people. An estimated ten million young people are now living with HIV or likely to develop HIV within the next three to fifteen years. Even if they are not infected with HIV, millions of adolescents in developing countries, particularly in sub-Saharan Africa, are physiologically scarred and educationally disadvantaged by having to care for their HIV-positive parents and younger siblings.

Suicides are among the three leading causes of death for adolescents. Of all deaths among adolescents, suicides are perhaps the most devastating. At least 100,000 adolescents commit suicide each year and these rates are rising faster than among other age groups. For every contemplated attempt at suicide, there are at least forty unsuccessful attempts. Young men are more likely to commit suicide than young women.

In many countries, suicide rates among young people are on the increase. In South Africa, suicide among young people under the age of 25 increased three fold between 1976 and 1997. There are also rising rates among adolescents in Asia, the Caribbean and within Africa.

The untimely loss of a young life leaves not only a legacy of unfulfilled promise, but also feelings of shock, guilt, grief and despair among loved ones and friends.

The use of alcohol and other drugs is a major contributing factor to accidents, suicides, violence, unwanted pregnancies and STDs among young people in many countries.

These substances are often used with tobacco. Alcoholic drinks help to relax social constraints and to lower inhibitions, but also they may increase the chances of risk-taking behaviour. The adverse consequences of illicit drug use by young people include dependence, overdose, accidents, physical and psychological damage, and premature death.

Road Traffic Accidents and road crashes are the main cause of death among young people worldwide.

All too often poverty deprives adolescents such basic elements of development such as schooling, health services, recreational activities, vocational training and economic opportunities. In developing countries, Sub-Saharan African, in particular under nutrition and stunting are prevalent in adolescent boys and girls. Family size in these countries is above six. Competing needs in the family results in under investment in young people. South Asia has the largest concentration of young people in extreme poverty (106 million) followed by sub-Saharan Africa (60 million), East Asia and the Pacific (51 million) and Latin America and the Caribbean (15 million).

Structural adjustment programme have had a telling effect on these countries economies. Formulae that were developed to right the wrongs in our ailing economies have if anything done, quadrupled the problems. Unemployment has reached record highs in history. Quickly hatched and implemented privatisation programmes have resulted in massive retrenchments, adding to the spiralling unemployment figures.

Since its formation in 1990, the WHO’s Adolescent Health and development programme has been developing the knowledge base and devising and testing new approaches to promote the health and development of adolescents worldwide.

One of the main lessons to emerge is the commonality of the root causes of risky health behaviours, health problems and disability among adolescents.

WHO, UNICEF & UNFPA are advocating an accelerated approach to promoting the health and development of young people in the second decade of life. The action needed to provide adolescents worldwide with the support and the opportunities to:

• Acquire accurate information about their health needs,
• build the life skills needed to avoid risk-taking behaviours,
• obtain counseling, especially during crisis situations,
• have access to health services (including reproductive health), and
• live in a safe and supportive environment

Since young people problems have common roots, they can be addressed most effectively by a combination of interventions that promote healthy behaviour. Adolescents have specific health problems and needs, which generally are not being adequately met in most countries. Effective strategies for addressing these problems and needs do exist. Yet these strategies are still not being applied widely enough, or in a sufficiently cohesive, mutually supportive manner. There is need to reiterate the WHO’s AHDP goal once again with new spirit: To ensure that adolescents are able to acquire the information, build the skills, access the health services and live in the supportive environment they need for their health and development.