This is a superb report, and more timely than could have been imagined when it was begun. A significant number of people worldwide are on the move and a significant number of them they are being left behind in every sense articulated by the SDGs, and needed for global health. I want to speak of the adolescents left behind.
In much of the discussion of people on the move there is talk of families, of women, and – usually only by specialist agencies and organisations – of children. The problem is that not all children are only children; children between 10 and 16 years of age are adolescents. And adolescents, Madam Chair, are not small adults nor are they large children. The state of adolescence is a unique developmental stage about which we have learned a great deal in the last 10 years.
And of course for the HIV response, and for sexual and reproductive health and rights, we are all clear that adolescents face unique vulnerabilities, unique burdens of ill-health, and unique threats to their wellbeing, including their mental wellbeing, and their sexual and reproductive wellbeing. Consequently we in this room and in this response are clear, and are acting to place adolescents at the centre of the HIV response. We are doing this at many levels. We are increasing the protectiveness of the environment & removing legal barriers, including age of consent barriers, to autonomous adolescent access to the sexual and reproductive health and HIV education, information, counselling and services. We are all also working to increase the agency and participation of adolescents in health, and their access to services.
And yet in populations on the move, the agency of adolescents if often stripped away. Officially ‘recognized’ heads of families – almost always men – are positioned by welfare agencies, health services, & humanitarian services, as decision makers, and resource allocators within families. The enabling of men in this position over women is always wrong. The positioning of adults over children on these matters is appropriate. But, to return to an earlier statement, adolescents are not only children. Adolescents have emerging, necessary, and healthy sexual and reproductive needs, and sexual and reproductive rights.
A migrant adolescent, documented, undocumented, or in a humanitarian setting, is no more likely than any other adolescent to discuss with a parent issues of abuse or sex, pregnancy or HIV, abortion, transactional sex or sex work, sexual orientation, gender identity, drug use, mental health, suicidal thoughts, self-harm, girlfriends, boyfriends, or contraception for Friday night’s teenage party.
Not enough is being done to recognize this, and not enough is being done to provide the information, education, counselling, and SRH services needed by adolescents on the move. Steps need to be taken – led by UNAIDS, & co-sponsors UNICEF, UNFPA & UNHCR to increase the effectiveness of the environment, to increase formal and legal recognition of adolescent health autonomy, and to increase adolescent access to HIV & SRHR services in situations involving people on the move.
I thank you.
Intervention on the NGO Report by SRHR African Trust (SAT)
Tags: 43rd PCB Meeting