IJAB: Firstly, in a nutshell - what is Youth4Health in practice?

Hans: The world currently has the largest generation of young people in history. In the WHO European Region, every third person currently is under 30. This reality demands that young people have an equal role in building a healthier and sustainable world for all. Youth4Health exists to amplify and embed youth voices and perspectives into all areas of WHO/Europe’s work and ensure young people are engaged in decision-making at all levels, on health and well-being issues that impact them directly.

Youth4Health in practice means we collaborate across all areas of our work. Young people are represented in our technical committees and working groups. They co-create events, campaigns and publications that target young audiences; and participate in the development of outcome statements at WHO events. 

Hilaire: I reflect on one of our recent success stories that perfectly captures how meaningful youth engagement can be sustained beyond one activity. In 2023, WHO/Europe‘s immunization team invited young people to work on an event that would promote collaboration between students and young professionals interested in this topic. Participants, recruited both via the open call we shared with the network and through nominations from WHO Country Offices, co-created and co-led the sessions.

The impact continued well beyond that initial event. Through European Immunization Week 2024, the immunization team extended this collaboration with these young people. They helped record podcasts and videos on vaccine topics and delivered interactive workshops for children and adolescents across the region. 

IJAB: The goal of WHO is ‘Health for All’. What are the specific benefits of involving young people in health and well-being decision-making processes?

Hans: Partnerships in health are essential to tackling the current challenges we face in the region, including conflict, climate change and the long-term impacts of COVID-19.  We must leave no one behind and work together with young people as they are the key champions in advocating and promoting health and well-being priorities at national and subnational levels.

Young people bring innovative ideas and fresh insights to the table. They understand best the resources and needs of their peers and how to reach them, motivating change in health behaviours. When we foster genuine partnerships with young people, we build mutual trust and create health policies and services that truly respond to their needs. This leads to better understanding and acceptance of health recommendations, and, ultimately, better health and social outcomes for everyone.

IJAB: In Germany, the National Action Plan for Child and Youth Participation is currently being developed as part of the Federal Government's Youth Strategy. One of the main questions here is what is needed for meaningful youth participation. How does WHO/Europe answer this question?   

Hans: I commend the Federal German government in prioritising youth leadership and engagement. The key is implementing any plans for youth engagement together with young people, as an ongoing process, not isolated interactions. Success comes from identifying interests both youth and decision-makers would share, while setting clear expectations about roles, responsibilities and realistic engagement opportunities.

Another key lesson learned from establishing the Youth4Health Initiative is the importance of investing in building the capacity and equipping policy and decision makers with the skills and knowledge to meaningfully and safely engage young people in your work. At WHO/Europe, we provided training for our workforce and have recently developed a toolkit that summarizes everything our teams need to know about meaningful youth engagement from start to finish. 

One way the German government can ensure youth participation in health decision-making, is by including a youth representative in their official delegations to WHO events. This gives young people a direct voice in policy discussions and fosters transparency, trust and accountability between them and decision-makers. 

Hilaire: WHO/Europe is continuing to learn and grow from our youth engagement opportunities. Our approach draws on the Lundy model of child participation[1], which focuses on 4 elements: providing safe and enabling spaces for young people to form and express views, facilitating their voice, ensuring they are heard, and acting on their input. Therefore, we make sure our communication is youth-friendly, occurs on their preferred channels like social media, and recognizes their contributions through mentorship and training opportunities when direct compensation proves difficult to provide.

IJAB: Multilateral cooperation not only brings opportunities, but also many challenges. The structures in the participating countries differ, as do the youth structures, and the problems and needs in terms of health and well-being are different. How does the initiative meet these challenges? 

Hans: Yes, we do face challenges – even the definition of ‘young people’ varies from country to country. However, health knows no boundaries. Therefore, when engaging with stakeholders on health and well-being issues, be it youth or decision-makers, it is important to be respective of political, cultural and linguistic sensitivities.  

When we launched our Youth4Health network in 2023, we discovered something striking: despite different contexts, our network members across the region shared many of the health and well-being priorities and participation challenges. This is why our network serves both as a platform for meaningful engagement with WHO/Europe and a safe space for youth activists and youth organizations to connect, share best practices and brainstorm on possible solutions to common challenges.

Hilaire: At WHO/Europe, we have our own institutional constraints to meaningfully engage with young people. For example, there are difficulties with arranging travel for those under 18 to attend WHO events. To address these challenges systematically and bring them to the attention of WHO executives, we created an internal youth engagement community of practice.  This group meets bimonthly, providing space for the WHO/Europe workforce to discuss concerns and challenges to meaningfully engage with young people and we work together to come up with solutions to overcoming those problems as a collective.

IJAB: What are your most important findings from the last four years of youth participation in Youth4Health and how do these findings affect the future direction of the initiative? 

Hans: I am proud that in just three years, we have set up strong foundations for meaningful youth engagement at WHO/Europe and formalized the mechanism for this through our Youth4Health network. Today, we connect 39 youth organizations and 213 individual youth representatives, from 36 countries across Europe and Central Asia.

Ensuring diverse youth participation beyond traditional partners like young health professionals and students has been challenging. We’re making progress through partnerships with youth organizations that help us build connections and trust on a local and subnational level, particularly to reach vulnerable and marginalized youth and those with lived experience. 

Hilaire: We continuously evaluate feedback about our youth engagement practices and the impact they are having towards achieving the Tirana Youth4Health statement commitments (this document is a  blueprint of actions to strengthen youth engagement and improve youth health and well-being in the Region). 

Internally, our experience from engaging with young people has taught us five crucial lessons:  fairly compensate young people's contributions, create genuine ownership of initiatives, recognize that meaningful engagement takes time, trust youth perspectives, and maintain continued engagement beyond initial activities.

IJAB: How will youth engagement fit under the priorities of the new European Programme of Work (EPW2) and how does this align to the priorities of Youth4Health network members and their demands to the WHO?

Hans: A message from our network member for International Youth Day campaign earlier this year captured it perfectly: „We don‘t just need health in all policies, we need health of young people in all policies“. We are building our new EPW2 around the tenets of trust and equity at the heart of everything we do. Staying true to these principles means ensuring open, effective two-way communication with those directly impacted by our decisions – young people are no exception. They face distinct health challenges and experience crises uniquely: we continue seeing it now in different spheres – from rising depression rates to declining condom use and physical activity. The only way to tackle these challenges is to co-create solutions together.

We strive for young people to be our equal partners not only because they are disproportionaly affected but also because they feel the zeitgeist like no other. When the Youth4Health network was created, our members highlighted three priority areas they would like to engage with the Regional Office on: mental health, environment and health, and sexual and reproductive health and rights. I’m proud to say that we truly listened. Since then, to name a few examples, we have together developed a new framework for engaging youth in policy, research and programming on mental health and embedded young people’s ideas and calls for bold, resolute action to address the health dimensions of the climate crisis within the European Environment and Health Process. 

These three areas, among other things, are reflected in my vision for the next 5 years of my mandate as the Regional Director for Europe, which I shared with the esteemed delegates at the 74th Session of the WHO Regional Committee for Europe in October 2024.  We will continue supporting our Member States in their efforts to ensure young people’s active participation from the very beginning. We have already seen tremendous strides in Albania, Armenia, Lithuania, Slovenia and France, and have every intention to continue deepening these connections. WHO's support amplifies youth advocacy at every level, while their insights are essential for building resilient and sustainable health systems that truly serve current and future generations. 

IJAB: What else is close to your heart at this point?

Hans: As I begin my second term, I'm both inspired by our region's resilience and acutely aware of the challenges ahead.  As a physician and father of 2 daughters, I'm gravely concerned by both the urgency and complexity of addressing violence against women and girls in our region. The statistic that one in four girls experience violence from an intimate partner before the age of 20 is not just a number – it represents millions of lives impacted, dreams disrupted, and potential unfulfilled. There is a lot more we can do within the health and care sector to make sure we are not failing these women and girls at a time when we see increasing gender inequalities in the region.

It is essential that we educate healthcare workers to better identify survivors and provide trauma-informed care, create safe spaces in healthcare settings, and build networks of support that extend beyond hospital walls. But this will be a drop on the ocean unless the access to essential sexual and reproductive health services is improved for all women and girls, including those in vulnerable situations and crisis settings. 

IJAB: Thank you! 

Anyone interested in participating in the Youth4Health initiative can find more information on the initiative's homepage:  

• Youth4Health Initiative
• Youth4Health Network
• Youth4Health Invitation
• Youth4Health Statement
• Youth Delegates at the WHO Regionalcommittee for Europe

[1] Lundy L. ‘Voice’ is not enough: Conceptualising Article 12 of the United Nations Convention on the Rights of the Child. Br Educ Res J. 2007;33: 927–942. doi:10.1080/01411920701657033.