Making space for young people’s outside-the-box solutions

Brian Wong’s introduction to global health came as an 18-year-old, when he established a Model World Health Organization (WHO) chapter at his university in Canada. As global health shifted from an extra-curricular activity to his passion and primary focus, Wong came to realize that young people were not meaningfully engaged in global health governance and decision-making processes. And when they were included, they were often engaged in a tokenistic manner, for one-off engagements or short periods of time.

Wong has dedicated much of the last ten years to changing this.

In 2017, he founded the London Model WHO Simulation, an international conference for young people, regularly held in London, that simulates the annual World Health Assembly (WHA), the decision-making body of the WHO. It is now the flagship conference of UK Model WHO, an organization he established with the goal of not only promoting youth involvement in global health initiatives and campaigns but also equipping young people with the problem-solving, conflict resolution, and advocacy skills they need to meaningfully engage in and influence global health discourse.

Wong is a founding member of the WHO Youth Council and was a youth officer for the Lancet and Financial Times Commission on Governing Health Futures 2030: Growing up in a Digital World. He has authored or co-authored a range of advocacy articles, including in The Lancet, on why health governance needs youth voices at the forefront, and in Human Resources for Health, one on the key role of young professionals in the public health workforce and another on harnessing the digital potential of the next generation of health professionals. Wong also joined a cohort of young global health scholars and professionals who published a letter in Nature Medicine calling on G7 and G20 leaders to urgently address the COVID-19 pandemic, antimicrobial resistance, and the climate crisis.

Ahead of International Youth Day, Exemplars News spoke with Wong, now 28, about how and why health systems can and should empower, engage, and leverage young people.

You have been an advocate for meaningful youth engagement in governance and policy. Why is it important?

Wong: The Partnership for Maternal, Newborn, and Child Health, the International Youth Alliance for Family Planning, and Family Planning 2020 together spearheaded the Global Consensus Statement on Meaningful Adolescent and Youth Engagement, which has been endorsed by over 200 organizations. It outlines meaningful youth engagement as an “inclusive, intentional, mutually respectful partnership between adolescents, youth, and adults" where power is shared, everyone's contributions are valued, and young people’s ideas, skills, and strengths are integrated into the design and delivery of programs, policies, and organizations that affect their lives, communities, countries, and the world.

It's really important that we integrate youth perspectives into health governance and policymaking, because young people bring a lot of innovation and outside-the-box solutions to the table. And because when young people are involved in these discussions, they yield more effective, comprehensive, and equitable health strategies and interventions.

We've seen youth engagement result in improved services and more effective health promotion campaigns. It also makes policies more relevant to young people's needs and circumstances. And meaningful youth engagement fosters a sense of ownership and commitment among young people, as well as trust and buy-in in the policies and the solutions and interventions. Not to mention fostering trust in health decision makers and program implementers.

How can health leaders better engage youth in health policy decision making?

Wong: Engaging young people requires creating enabling environments and safe spaces for meaningful dialogue where young people are heard, respected, and empowered to have these discussions. This requires going to places where youth already are, and then not being tokenistic or extractive. Making sure that you're getting diverse youth perspectives and voices.

It also requires making sure there's transparency in the processes of engagement. How and why are their inputs being used? And sustained engagement. It's not just a one-off process where it's ‘Okay, thanks – we've heard your perspectives,' and that's it. It's important to actually close these feedback loops.

Then, we need to take it a step further and institutionalize mechanisms for young people to constantly feed back into policy discussions. Such as the establishment of the United Nations Youth Office, for example, which is dedicated to taking forward youth issues.

The Major Group for Children and Youth is the official youth and children constituency at the UN and another example of progress in institutionalizing input from youth. That’s a mechanism through which young people can contribute to policy- making processes and implement development plans at the global level as well as ones that trickle down to their local communities and constituencies.

There's also the WHO’s Youth Council, which held its first meeting earlier this year. It advises WHO senior leadership and provides perspectives from youth and youth organizations across the world. The Council is not only involved with departmental work on mental health, noncommunicable diseases, and universal health coverage, but also with youth leadership in global health governance through capacity building activities and setting up and trying to expand upon youth delegate programs.

Initiatives like this, where we're slowly but surely institutionalizing youth participation, youth expertise, and innovation in processes, are where the needle has started shifting and needs to continue to shift.

A few countries are making progress on this, too. Canada, where I’m from, established the Youth Delegate Program. And a LMIC example is the Center for Indonesia’s Strategic Development Initiatives – one of their pillars is encouraging active youth and community participation in development issues.

How can the global health sector better serve young people and how can it better leverage what young people have to offer?

Wong: The health sector can better design and implement policies and programs that are youth friendly. For example, programs and services that address health issues that disproportionately affect young people and provide them with youthfriendly services, meeting youth where they already are. Addressing concerns that young people are raising, like mental health and climate change, is crucial.

And young people have a lot to offer, especially when it comes to things like tech savviness and innovative thinking. They can drive the uptake and adoption of digital innovations in healthcare and are more open to adopting new technologies.

For example, in Rwanda young people have been instrumental in implementing digital-first healthcare, through the telehealth platform Babyl.

Young people’s energy and networks can also be harnessed. An example of this was the WHO's #YouthAgainstCOVID19 campaign, which really leveraged the power of young people to spread accurate and trustworthy information about the virus.

Another example of leveraging young people is supporting them to serve as positive outliers and champions. Young people can be empowered and engaged as health ambassadors and changemakers in their communities.

We've seen a lot of this in the climate change movement, and we see young people being supported to demand sexual reproductive health rights and gender equality. They are creating change in their communities by influencing these sociopolitical structures.

Capacity building is key for all of this. A good example of a grassroots organization supporting capacity building globally is Youthtopia, a network of youth from around the world that offers free peer-to-peer courses, master classes, and talks to teach change-making skills.

How can health systems gain the trust of young people?

Wong: Earning the trust of young people is foundational to creating health systems that are responsive, inclusive, and effective. It underpins the willingness of young people to seek care, disclose health issues, follow medical guidance, and engage in health-promoting behaviors. This trust is earned and built through consistent, transparent, and respectful interactions.

This requires making sure there is systematic and systemic inclusion of young people in the discussions and decisions that directly and indirectly concern them. Also, demonstrating a genuine interest in understanding and addressing young people's needs.

One way of gaining this trust is through youth-friendly health services that are accessible, acceptable, appropriate, and effective for young people. We can also use digital technologies to foster trust. Young people are today's digital natives, and they really feel comfortable navigating digital spaces.

One example of leveraging young people’s voices is UNICEF’s U-Report, which is a global platform to engage young people in program priorities, emergency response, and advocacy. The data from youth are analyzed in real time and mapped on a public dashboard, ensuring the young people's feedback can be tracked and actioned by local and national decision makers.