Advancing SRHR in Global Health Hinges on Youth Leadership
Authors: Norhan Bader (she/her), Project Manager of Love Matters Arabic and Women Deliver Board Member, and Swostika Thapaliya (she/her), General Secretary of YUWA and Alliance for Gender Equality and UHC Co-Convener
No one, young or old, should be left wondering if they can access and afford the health services they need. This belief is nearly universal. Yet, progress toward universal health coverage (UHC) — a framework which aims to ensure that everyone, regardless of ethnicity, economic status, gender, or other factors, can access essential healthcare without financial strain — is uncertain.
Securing sexual and reproductive health and rights (SRHR) — the foundation of bodily autonomy and gender equality — within UHC is even harder. Despite the commitment of 193 UN Member States to achieve UHC by 2030, and reaffirmations made in 2019 and 2023, many governments are lagging behind. Holding them accountable for meeting the health needs of girls and women within UHC depends on our collective ability to transform and shift power to young people and other traditionally ignored and marginalized voices in the global spaces where UHC decisions are made.
Why does this matter? A gender-equal future is impossible without comprehensive sexual and reproductive health (SRH) services within UHC plans. UHC must meet the unique needs of all people, especially adolescent girls, who have the most at stake in global health decision-making.
The road ahead won’t be easy. The growing influence of anti-rights actors is a significant barrier to including SRHR in UHC at all levels. The UHC-related decisions made in global spaces, once implemented by governments, can either advance or harm the bodily autonomy of girls and women, especially adolescent girls, who are highly susceptible to having their choices restricted and their bodies controlled.
At this year’s World Health Assembly (WHA), some progress was made on securing universal access to SRH services, including family planning, information, and education. However, we also saw conservative governments and well-funded, well-coordinated anti-rights actors attack the inclusion of essential SRH services, such as safe abortion, in UHC. As is often the unfortunate reality in traditional global decision-making spaces, participation in the World Health Assembly (WHA) was restricted to those with the financial resources, geographical advantages, UN access, and language skills to overcome entry barriers. This meant that individuals and groups needed to be able to afford expensive travel and accommodation, navigate visa issues, speak official UN languages, and be located near major international hubs. Consequently, many voices from less affluent, remote, or non-English-speaking communities were left out.
The lengthy and often heated negotiations between political leaders, decision-makers, and civil society organizations that take place in global spaces like WHA may seem distant from the daily lives of adolescent girls, but the outcomes of these discussions affect us all. Words matter. Who gets to speak — and who doesn’t — matters. For example, WHA saw intense debate over gender terminology — ‘gender-sensitive’ versus ‘gender-responsive.’ The difference? Gender-sensitive simply acknowledges gender differences while gender-responsive requires taking real action to address disparities. Anti-rights actors, though unsuccessful, even tried to silence the Center for Reproductive Rights by lobbying to prevent them from gaining official status with the World Health Organization (WHO) due to their stance on abortion.
Girls, women, and gender-diverse people rely on SRH services to make crucial decisions about their bodies, sexuality, and health. Including comprehensive, youth-friendly SRH services within UHC is non-negotiable. Time and time again, we are reminded that the progress we’ve made is fragile. To protect and advance the full inclusion of SRHR in UHC, we need collective action and a shift of power to adolescent girls from the global majority who truly understand the complex challenges of accessing SRH services in diverse contexts around the world.
Young people must become the architects of international frameworks and standards, including UHC, that shape their lives. Coalitions like the Alliance for Gender Equality and UHC, and initiatives like Women Deliver’s Emerging Leaders Program, YUWA’s youth-friendly SRHR initiatives, and Love Matters Arabic’s SRHR training programs show how traditionally ignored and marginalized voices drive significant change when given the opportunity.
For example, the Alliance for Gender Equality and UHC coordinates over 100 organizations from 58 countries to push for gender-responsive UHC policies, programs, and dialogues. Women Deliver’s Emerging Leaders Program shifts power to adolescent girls and their advocates in global spaces, enabling them to take the lead on addressing critical challenges in SRHR. At YUWA, young people sit at the decision-making table, providing strategic direction to the organization. They create youth-friendly and actionable programs and negotiate their SRHR directly with local and national governments. Love Matters Arabic opens the door to the resources and support that young people in the MENA region need to navigate their SRH in a challenging cultural and political landscape.
The future of global health and gender equality is at risk if young people aren’t involved in decisions about their bodies. We must unite against regressive forces that aim to strip control from girls and women. To make UHC truly effective, those most affected by today’s health policies — young people — must be in the driver’s seat.
