Africa?s youth, the continent?s largest demographic, are increasingly at the forefront of social and political activism. Faced with systemic inequities, limited access to healthcare, and growing economic challenges, young people are demanding change. Universal Health Coverage (UHC) is a crucial component of this transformation, ensuring that no one is left behind in accessing essential health services. However, achieving this goal requires sustained advocacy, inclusive policy-making, and meaningful youth engagement.
This blog explores the pressing issues affecting Africa?s young population, the barriers to achieving UHC, and the critical role youth play in shaping a healthier, more equitable future.
From Discontent to Action: Young People Shaping Africa?s Future
There are 420 million youth in Africa, of which 70% are under the age of 30 years old and an overall median age of 19 years old. In 2022, 8.9 million African youth were living in or close to conflicts. Some youth have lived under the same president or ruling party for all of their lives, whilst the majority are grappling with disenfranchisement and inequity. Many have tested the right to freedom of assembly and association through protest action against their governments. Demanding better conditions for securing livelihood and service delivery.
Young people have protested against crisis situations in Tunisia (Arab Spring) in 2011, South Africa (Rhodes & Fees Must Fall) in 2015, Namibia (Shut it Down), Nigeria (End SARS) and Uganda (Pre-Election) in 2020. More recently in 2024, Botswana (BIUST students), Kenya (End Femicide, Reject Finance Bill, Ruto Must Go) and Mozambique (Post-Election) amongst many others.
This not only shows a growing discontent among young people, but raises questions on the legitimacy of African leadership on issues that affect its biggest demographic.
Health Inequities and the Call for Universal Health Coverage
An estimated 90% of the 1.7 million adolescents (10 to 19 years) living with HIV are based in the WHO?s Africa region. This is aggravated by gender as women and girls are 3 times most likely to be living with HIV in 22 African countries. These realities are underpinned by harmful gender norms, social exclusion, and a lack of political will.
Botswana?s history includes having one of the highest disease burdens globally. Its historic election heralded a new government committed to UHC. This positive development not only reflects the power of a healthy democracy, but the opportunities that come with it. As the country transitions from the Global Fund, it is a moment for eliminating corruption, inequity and ensuring meaningful engagement of communities to emerge. Whilst these positives can come from human rights and democratic progress, we do not exist in isolation. Climate, migration and socioeconomic challenges across the region remind us of the challenges Africa is facing.
Meaningful Youth Engagement for Lasting Impact
State debt, income inequality, gender based violence and conflicts have characterised the human rights landscape across the region. These aggravate the socioeconomic challenges faced by women and girls in their diversity. Inadequate reproductive, primary and universal health care systems further polarise gender disparities.
Africa?s youth continue to redefine how impact can be sustained, as social media and activism play a role in public participation. Translating this into meaningful engagement, accountability and civic participation will be key to improving health, economic and inclusion outcomes. There are several upcoming replenishments that could be considered moments for those most impacted and vulnerable to health inequities, communicable and noncommunicable diseases to call on their governments to do better. The 8 African countries that have reached their 95-95-95 HIV targets need to invest in the remaining 5%.The ten additional countries on track to achieve these targets must follow suit.
Key recommendations for sustainable and inclusive progress include:
- Expanding youth participation in country coordinating mechanisms beyond HIV-focused and capital city-based civil society representation.
- Adopting participatory approaches in social participation models to ensure rotational representation in decision-making, thereby promoting equity and sustainability.
- Eliminating harmful practices that tokenize or co-opt youth engagement, ensuring meaningful and transformative participation.
These recommendations lay a foundation for leaving no one behind. Especially since less than 6% of 32 measurable sustainable development goals (SDG) targets have been met. This flags the need for significant corrective, accelerated and resourced actions to leave no one behind by 2030. Young people?s dreams, wellbeing and future should no longer be compromised.
Commemorating UHC Day should remind us all of the importance of the right to health in any setting. This includes a democratic Botswana, where the right to health is yet to be constitutionalized. The universality and indivisibility of human rights should ensure a continuum of care without compromise or stigma. The interdependence and interconnectedness of the SDGs should lead to reduced out-of-pocket costs, improved infrastructure, and greater availability of medicines across all jurisdictions.
Diverse young people must continuously advocate for and demand better leadership from their governments. This is the only way we can guarantee sustained and equitable health outcomes for future generations.
Dumiso Gatsha is Community-Based Organizations Representative on the UHC2030 Steering Committee and the founder of Success Capital, a grassroots feminist youth led, managed and serving organisation working in the nexus of human rights and sustainable development.
Supported by Laura Philidor, Advocacy and Communications, CSEM for UHC2030, WACI Health
