Changing the Game for Young People in Health and Development



This summer, hundreds of millions of people around the world followed the twists and turns of two major football tournaments: the 2016 Copa América Centenario in the United States of America and the Union of European Football Associations (UEFA) European Championship 2016, hosted by France. It is a testament to the enduring power of the beautiful game that matches played at such venues as the Rose Bowl Stadium in Pasadena, California, and the Stade Vélodrome in Marseille were followed by fans from far beyond the Americas and Europe people from all corners of the globe cheered on their favourite teams and players. Football crosses borders and continents like no other sport, and as such can be deployed as a significant force for change.

In September 2015, the United Nations General Assembly adopted the 2030 Agenda for Sustainable Development, which identified sport as an "important enabler" of development and recognized its growing contribution to the promotion of peace. We know that in local communities around the world, often all that is needed to bring a group of young people together is a ball and a patch of grass or urban concrete. Wherever I travel, I come across girls and boys teaming up, marking out goal posts and playing football.

The Joint United Nations Programme on HIV/AIDS (UNAIDS) has long realized that football can play an important role in raising awareness of HIV, especially among young people vulnerable to infection. In 2010, the Protect the Goal campaign was launched to raise awareness about the virus ahead of that year's World Cup in South Africa. It continued during the African Cup of Nations tournament in 2013, where HIV prevention messages were disseminated on giant screens at all stadiums hosting matches. The captains of each of the 16 teams participating in the competition read out a statement calling on players, fans and young people to support the campaign. During the World Cup in Brazil in 2014, 2 million condoms were distributed in cities where games were played, while free, rapid HIV tests were offered at local fan sites. UNAIDS International Goodwill Ambassadors, Michael Ballack and David Luiz, have used their influence to help UNAIDS disseminate key messages about HIV testing and prevention to millions of people.   

Grassroot Soccer is another powerful initiative that recognizes the potential of football to inspire hearts and minds. Developed by a group of former professional players, in collaboration with the United States Centers for Disease Control and Prevention, the Zimbabwean Ministry of Primary and Secondary Education and public health experts, Grassroot Soccer combines three effective principles of education:

  • Young people learn best from those they respect. Adolescents listen to and emulate their heroes. Grassroot Soccer engages professional players and other role models as HIV educators.
  • Learning is not a spectator sport. Adolescents retain knowledge best when they are active participants in the process, teaching others what they have learned themselves.
  • It takes a village. Role models can change what young people think, but lifelong learning requires lifelong community support.

This fantastic programme has now reached more than 1.3 million adolescent girls and boys with comprehensive HIV prevention and life-skills education. The skills that empower young people to navigate the particular challenges of adolescence are essential. This generation of youth is the largest in history and presents developing nations with both a big challenge and a tremendous opportunity. If countries invest in adolescents now to keep them healthy and strong, they will receive a significant demographic dividend 10 to 15 years down the line, helping to build resilient societies prepared to meet future difficulties.           

The knowledge and skills conveyed by role models and peers through football and other sports help young people build self-assurance, share experiences, take control of their lives, make choices about their sexuality, protect themselves from HIV and other infectious diseases, avoid unwanted pregnancy and stride into adulthood with confidence.

Adolescents should have the world at their feet, and be strong, healthy and full of life and expectations for the future. Unfortunately, too often this is just not the case. In fact, the world is currently failing adolescents, particularly adolescent girls. They are being left behind in the HIV response.

In 2015, there were an estimated 250,000 new HIV infections worldwide among adolescents between 15 and 19 years of age, with girls accounting for 65 per cent of new infections among this age group. AIDS-related illnesses are the leading cause of death among adolescents in sub-Saharan Africa and the second leading cause of death among young people globally. Gender-based violence, gender inequity, harmful gender norms, stigma and discrimination often prevent women and girls from knowing their HIV status and accessing HIV prevention and treatment services. This is a moral injustice that simply cannot be allowed to continue.

Football and other sports are helping to equip our youth with the knowledge to protect themselves and make informed choices about their health, but we need to go further. The world urgently needs to readjust its thinking on adolescent health and well-being. Young people no longer want to be passive beneficiaries they are becoming change-makers in their own right. They can serve as powerful partners for policymakers in building effective responses to the HIV epidemic that are evidence-based and proven to work. Adults in positions of power must also make urgent adjustments to their own attitudes and mindsets after all, acquiring new life skills is a lifelong process and not confined to adolescence. What is needed to end the AIDS epidemic by 2030 is comprehensive sexuality education for all, respect for young women's sexual and reproductive health and rights, and recognition that everyone everywhere has the right to health. Young people must be involved in the design and delivery of programmes and services that address their needs. 

There has been significant progress in reducing the impact of HIV over the past 15 years. There were more than 17 million people on antiretroviral treatment at the end of 2015. AIDS-related deaths are down from a peak of 2 million in 2005 to 1.1 million in 2015. Four countries—Armenia, Belarus, Cuba and Thailand—received certificates of validation from the World Health Organization for eliminating new HIV infections among children. There has been a 60 per cent decline in new HIV infections among children since 2009 in the 21 countries in sub-Saharan Africa that have been most affected by the epidemic. The number of new HIV infections in 2015, however, remains stubbornly high at 2.1 million, scarcely reduced from 2010 levels, with young women and key populations remaining especially vulnerable. 

The new Political Declaration on Ending AIDS, adopted by Member States at the United Nations General Assembly High-Level Meeting on Ending AIDS held in New York in June 2016, provides countries with an actionable and progressive mandate to put the world on the fast-track to end the AIDS epidemic by 2030, as part of the Sustainable Development Goals. To accomplish this, the world must reduce both new HIV infections and AIDS-related deaths to fewer than 500,000 globally by 2020 and eliminate HIV-related stigma and discrimination. We won't reach these goals, however, without reducing infections among young people and key populations.

During the High-Level Meeting, leaders recognized that no country has ended AIDS and no country can afford to let up in its response to HIV. Sport is playing an important part in mobilizing young people to take on leadership roles in the development agenda, to protect themselves and their peers from HIV and other infectious diseases, and to make their own contribution to ending the AIDS epidemic. Unfortunately, that in itself won't be enough. The world needs to push forward with approaches that cut across health, education and justice to remove all obstacles to health programmes and services for adolescents.    

To use another sporting analogy: it's time to fast-track the HIV response to meet the Political Declaration's 2020 targets and end the AIDS epidemic as a public health threat by 2030.