Global Public Health

Hepatitis B virus (HBV) is causally linked to acute and chronic form of hepatitis, which due to continuous immune mediated inflammation and scarring may lead to cirrhosis and/or hepatocellular carcinoma. HBV spread via exchange of infected bodily fluids underlie unique public health considerations due to similarities with other community related issues such as sexually transmitted diseases (eg HIV) blood borne pathogens (Hepatitis-C) and perinatal transmissions (TORCH complex).

Prevention vs. Treatment: What's the Right Balance? is a collection of 15 essays on various aspects of the perennial tension in health policy between treatment and prevention. There is also a substantial introduction by the two editors, one of whom (Faust) is a preventive medicine physician and President-elect of the American College of Preventive Medicine; the other (Menzel) is a philosopher who has made important and influential contributions to bioethics, health policy, and health economics. The collection is divided into three roughly equal parts: Part One, "Evidence, Policy, and History;" Part Two, "Philosophical and Legal Analysis;" and Part Three, "Religious and Cultural Perspectives." The volume's introduction invites readers to think of the central issue in rather broad terms. Its opening example contrasts the spare-no-expense urgency displayed when a child falls into a well with the lower priority given to preventing such terrible fates in the first place. Some readers may be disappointed, then, to discover that the empirical essays in Part One focus almost exclusively on the evidence, policy, and history of clinical prevention (e.g. vaccinations, screening, counseling about aspirin prophylaxis, cholesterol management, etc.). One of these essays even remarks in passing that "clinical prevention [is] the theme of this volume" (78). By contrast, none of the other essays in Part Two or Part Three share this narrow focus on the clinical.

With the Millennium Development Goals (MDGs) showing uneven progress, this review identifies possible limitations arising from the MDG framework itself rather than extrinsic issues. A multidisciplinary literature review was conducted with a focus on limitations in the formulation of the MDGs, their structure, content and implementation. Of 1837 MDG-related articles, 90 met criteria for analysis. Articles describe MDGs as being created by only a few stakeholders without adequate involvement by developing countries and overlooking development objectives previously agreed upon. Others claim MDGs are unachievable and simplistic, not adapted to national needs, do not specify accountable parties and reinforce vertical interventions. While MDGs have promoted increased health and well-being in many countries by recognising and deliberating on the possible constraints of the MDG framework, the post-2015 agenda may have even greater impact.

This empirical research documented voices of women and girls in female shelters and prisons in Samangan, Laghman and Wardak provinces who experienced systematic sexual and gender based violence before and after they escaped forced marriages, forced virginity tests, physical and sexual violence. Women who challenged the status quo, fundamentalism and extremism faced imprisonment for up to five years. The research interviewed primary, secondary and territory health care professionals, who carried out or witnessed invasive virginity tests. The evidence suggests that women are being deprived of basic human rights of exercising autonomy and freedom. It shows difficulties some health professionals’ encounter in documenting, reporting and treating cases of violence against women and girls. The research concludes that a survivor-centered approach, and secular framework is required against tyranny, misogyny and oppression. Instead of imposing moral arguments and harmful laws that undermine w...

Weak linkages between health providers and slum communities hinder the improvement of health services for India's urban poor. To address this issue, an urban health programme is implementing two approaches in Indore city, Madhya Pradesh, the demand-supply linkage approach and ward coordination approach. The former is based on the premise that building social capital, i.e. norms and networks within a community facilitating collective action, helps improve the demand and supply of health services for the urban poor. The latter focuses on encouraging local stakeholders to function in a coordinated manner to ensure better health service coverage in underserved slum areas. Findings suggest that the programme has enhanced utilization of services among Indore's slum communities and helped improve immunization coverage and other maternal and child health indicators.

“My niece, Francila Kollie, and my cousin, Jounpu Lowea, both nurses, became infected at work. While they were able to receive treatment, they died in late July. So many of my close friends, university classmates, and colleagues have also died in recent months. Because there is no cure, we provide supportive care to patients, in the form of food, hydration, and basic treatment of symptoms. If treated early enough, their chances of survival are much better. I cannot stand aside and watch my people die. But I, along with my colleagues here, cannot fight Ebola alone. We have seen so many patients die. And they die alone, terrified, and without their loved ones at their side. We are trying to treat as many people as we can, but there are not nearly enough treatment centers and patient beds. We have to turn people away. And they are dying at our front door. Right now, as I speak, people are sitting at the gates of our centers, literally begging for their lives.  They rightly feel alone, neglected, denied – left to die a horrible, undignified death…We do not have the capacity to respond to this crisis on our own. If the international community does not stand up, we will be wiped out. We need your help. We need it now.”
Naimah Jackson, team leader, Médecins Sans Frontière’s Ebola Treatment Center, Monrovia, Address to the UN Security Council, September, 14, 2014.


The goal of this essay is to explore the ethical issues in the spread of Ebola Virus Disease (EVD) in West Africa between 2013 and 2015 and to develop a bio-social theological approach to health and healing in Africa. Most of the data for this essay were drawn from the report of the Independent Panel on the Global Response to Ebola. This significant study was carried out by the Harvard Global Health Institute and the London School of Hygiene and Tropical Medicine working with people from the academia, think tanks and civil society in Africa, Europe and North America. Using the bio-social approach to understanding public health, I will argue that international humanitarian failure to contain the West African EVD outbreak reinforced the negative and racialized representation of African peoples and cultures in global conversation about health, wellbeing, and the good of order. It also shows the need to a more pro-active and holistic approach to healthcare and the wellbeing of people in Africa. This scenario challenges the churches of Africa to develop the needed staff, systems, structures and stuff for effective healthcare ministry which can meet the challenges of recurrent and new epidemics like Ebola, HIV/AIDS, yellow fever as well as the tropical diseases like malaria and typhoid fever which continue to be leading causes of deaths in Africa.

The book deals with the increase in deaths as a result of 'deaths of despair'. The title of the book is Deaths of Despair and the Future of Capitalism. The book was written by Anne Case and Angus Deaton. The book is generally well written and consists of three parts: Part I: Past as prologue; Part II: The anatomy of the battlefield; and Part III: What's the economy got to do with it? The book explains the huge increase in deaths of despair and highlights the social and economic factors that make life more difficult for the working class. The authors use their expertise to present data in a scientific way based on analysis and data. According to them, 'this is an epidemic that is not carried by a virus or a bacterium, nor is it caused by an external agent, such as poisoning of the air or the fallout from a nuclear accident, instead, people are doing this to themselves' (p. 38). Obviously, the fastest-rising death rates were from three causes: suicide, drug overdose and alcoholic liver disease. These kinds of deaths are all self-inflicted, quickly with a gun, more slowly and less certainly with drug addiction and still more slowly through alcohol (p. 2). The authors note that drug overdoses constitute by far the largest share of deaths of despair; however, they do not provide a clear breakdown of how the three categories have changed over time. It is interesting to note that the authors used the average individual age index to denote the increase in desperation-related deaths. The authors recently noted a decline in life expectancy in the United States, at a rate not seen in the United States since 1918. The book offers a disturbing depiction of the vanishing American dream and indicates that for the white working class, America is today a land of broken families and few opportunities. Furthermore, the authors believe that 'much more important for despair is the decline of family, community, and religion. These declines may not have happened without the decline in wages and in the quality of jobs' (p. 183). Capitalism is no longer working for those who used to thrive in America. Ann and Deaton contend that by the year 2000, the life expectancy trend was beginning to decline for white Americans between the ages of 45 and 54 (p. 25). Life expectancy is no longer increasing as it used to be. The authors clearly link the decline

International health funders, leaders and researchers frequently cite 'successes' in this field as validation for past labours and justification for future endeavours. However, the question of what constitutes success Á from both historical and contemporary perspectives Á has been inadequately analysed. This paper reviews and periodises understandings of success in international/global health during the past century and a half, mapping out shifts and continuities over time. It then turns to the implications of these changing conceptualisations for current and future global health ideologies, strategies and activities. It concludes by arguing that historians of global health and policymakers need to interact further, so that historians are exposed to the contemporary problems of global health and policymakers better understand the historical complexity of extracting 'lessons' from the past.

The trade in health services for foreign patients, often termed 'medical tourism' or medical travel, is a growing industry being aggressively marketed across Asia. This paper explores the industry development in four countries: Thailand, India, Malaysia, and Singapore, providing a preliminary review of the political economy of the industry, marketing strategies, and linkages. As yet, there has been neither academic work considering the implications of this trade for public health, nor studies on the medical travellers themselves and their experiences. The final part of this paper contemplates some of the implications for public health in the region, and the ethical issues this globalized trade presents.

Analysing the pandemic through a feminist political economy lens makes clear how gender, race, and class structures are crucial to the functioning of capitalism and to understanding the impacts of the pandemic. The way capital organises production and reproduction combines with structures of oppression, generating vulnerability among the racialised and gendered populations worst impacted by Covid-19. Using global data, this commentary shows that during the pandemic, women experienced relatively greater employment losses, were more likely to work in essential jobs, and experienced a greater reduction in income. Women were also doing more reproductive labour than men and were more likely to drop out of the labour force because of it. Analyses of capitalism in feminist political economy illustrate how capital accumulation depends on women's oppression in multiple, fundamental ways having to do with their paid and unpaid work. Women's work, and by extension their health, is the foundation upon which both production and social reproduction rely. Recognising the pandemic as endogenous to capitalism heightens the contradiction between a world shaped by the profit motive and the domestic and global requirements of public health.

To appear in ed. Patricia Lorcin and Todd Shepard, French Mediterraneans, (University of Nebraska Press, forthcoming).

From Flaubert’s fascination with lesions in the anuses of Egyptian soldiers at Qasr al-Ayni Hospital to the seeming-ubiquity of eyeless, noseless syphilitic death-heads in French military, travel, and medical accounts of North Africa, French travelers and physicians frequently mentioned syphilis among the Arabs.  Yet French physicians 1860-1925 consolidated the various rashes, sores and birth defects observed in North Africa to invent a physiological racial type, the degenerate and diseased “syphilitic Arab.”  The reification and incorporation of racism to biomedical knowledge exists across colonial contexts, but “Arab syphilis” reveals the peculiar role of native bodies to the French mission civilisatrice, the location of irreducible difference between French citizens and colonized French subjects in the French “imperial family” envisioned by Minister of Colonies Albert Sarraut. 

    Arab syphilis suggests how medical science could animate and naturalize French rule in the Mediterranean.  Richard Keller, Kim Pelis, and others have shown that French Pasteurian physicians were a single Mediterranean community circulating between metropole and colonies; indeed, the architect of French anti-syphilis programs in Morocco was Paris venerologist and former chef de clinique at Saint-Lazare, Georges Lacapère.  But as Michel Foucault argues, biopolitics is a way of governing that defines the political subject through his body,  an analytical frame that Ann Laura Stoler extended to French empire.  In French North Africa, Arab syphilis created the Muslim as a cultural, social, and biological inferior, a non-évolué who could only be a non-citizen.  Medicine helped to draw a climatological, biological, and civilizational topography of the Mediterranean, a natural order for the subjects of the French empire.

NOTE: This course was last taught in 2017. Much new work has come out on the history of plague and the late medieval pandemic since then, some of it overturning long-held truisms. Please consult my "Plague Studies" tab and the general bibliography, "The Mother of All Pandemics" for the most recent work in the field.
These readings supplement the main Syllabus for my course, "The Black Death: Pandemic Disease in the Medieval World." The students are divided into groups at the beginning of the semester and work collaboratively for the rest of the semester. The Group Readings form the basis for the special presentations they make to the rest of the class. The Group projects allow them to go deep into specific topics for a short period of time, and will, it is hoped, expose them to both primary sources and secondary sources they can use for their research projects. The ten groups this year are as follows:
- The Invisible Origins of the Second Pandemic: The Qinghai-Tibet
Plateau
- Plague Lies in Wait: What Was the Mechanism of Spread into Central Eurasia?
- Plague Reaches the Islamicate World
- Plague in Southern Europe: Initial Impact
- Religion, Politics, and Catastrophe: The Black Death and the Jews
- Plague in Northern Europe (England)
- Plague in Northern Europe (Beyond England)
- Plague and the Great Transition: Living in a Cold, Diseased World
- Plague Shapes the Early Modern World
- Plague Becomes a Global Disease: The Third Pandemic
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"La nature transdisciplinaire et intersectorielle de la recherche en santé mondiale fait appel à des théories, des méthodes et des pratiques procédant de plusieurs courants de pensée contemporains fort éloignés du point vue épistémologique, mais potentiellement complémentaires. Cette confluence d’approches favorise l’émergence d’interactions dynamiques entre de nombreux acteurs concernés par la recherche tout en permettant de mettre en œuvre une démarche dialectique entre, d’une part, des perspectives plus universalistes, qui prônent l’unicité des critères et l’équivalence du sens, et d’autre part, des approches nettement culturalistes, qui préconisent la cohérence interne et la différenciation identitaire.

Afin de rendre compte de cette complexité et des enjeux qui lui sont attribués, nous avons organisé en 2011, dans le cadre du 79e congrès de l’Acfas, un colloque visant l’alignement d’un ensemble de propositions socio-anthropologiques essentielles au développement de compétences clés pour les chercheurs, praticiens, étudiants et gestionnaires en santé mondiale. Pour ce faire, nous avons compté sur la participation de chercheurs reconnus dans le domaine de la santé mondiale par la qualité et les retombées de leur production scientifique ainsi que d’étudiants universitaires post-gradués.

Tout en suivant la structure proposée au sein du colloque, les parties de cet ouvrage illustrent les contenus touchés au sein des quatre sessions de cet événement. Les deux premières parties sont consacrées respectivement aux considérations conceptuelles et aux approches méthodologiques associées à la recherche en santé mondiale. La troisième partie, quant à elle, est dédiée aux stratégies opérationnelles relatives à la pratique du chercheur en santé mondiale. Enfin, la dernière partie de cet ouvrage est axée sur les enjeux, les défis et les pistes de recherche et d’action pour la santé mondiale."

According to the World Health Organization situation report, since the start of COVID-19 outbreak till 2 October 2020, a cumulative total of nearly 34 million cases and 1 million deaths have been reported. As per the present situation, health is being recognized as a major transboundary issue.  It requires a multilateral approach by collectively combating the diseases that cross national borders. By comparing their nations military expenditure and health expenditure, people across the world were claiming to focus on building modern health infrastructure to overcome pandemic like situation in future.

Deepest gratitudes to all the valiant medical professionals and health care personnel who have risked their lives in some of the world's most tumultuous places to assist those in need. Their selfless dedication is the spirit of medicine and serves as an aspiration to all who are interested in pursuing careers in the medical field. I hope viewers of my profile will take a minute or two to look through the article as it has received high accolades from the publishing journal's (OJAA) reviewers.

Since the International Conference on Population and Development, definitions of sexuality and sexual health have been greatly elaborated alongside widely accepted recognition that sexual health requires respect, protection and fulfilment of human rights. Considerable progress has also been made in enacting or changing laws that affect sexuality and sexual health, in line with human rights standards. These measures include legal guarantees against non-discrimination and violence, decriminalisation of consensual sexual conduct and guaranteeing availability, accessibility, acceptability and quality of sexual health information and services to all. Such legal actions have had positive effects on health and specifically on sexual health, particularly for marginalised populations. Yet in all regions of the world, laws still exist which jeopardise health, including sexual health, and violate human rights. In order to ensure accountability for the rights and health of their populations, states have an obligation to bring their laws into line with international, regional and national human rights standards. These rights-based legal guarantees, while insufficient alone, are essential for effective systems of accountability, achieving positive sexual health outcomes and the respect and protection of human rights.

We examine progress towards the 1994 International Conference on Population and Development (ICPD) commitment to provide universal access to sexual and reproductive health (SRH) services by 2014, with an emphasis on changes for those living in poor and emerging economies. Accomplishments include a 45% decline in the maternal mortality ratio (MMR) between 1990 and 2013; 11.5% decline in global unmet need for modern contraception;~21% increase in skilled birth attendance; and declines in both the case fatality rate and rate of abortion. Yet aggregate gains mask stark inequalities, with low coverage of services for the poorest women. Demographic and Health Surveys and Multiple Indicator Cluster Surveys from 80 developing countries highlight persistent disparities in skilled birth attendance by household wealth: in 70 of 80 countries (88%), ≥80% of women in the highest quintile were attended by a skilled provider at last birth; in only 23 of the same countries (29%) was this the case for women in the lowest wealth quintile. While there have been notable declines in HIV incidence and prevalence, women affected by HIV are too often bereft of other SRH services, including family planning. Achieving universal access to SRH will require substantially greater investment in comprehensive and integrated services that reach the poor.

When most patients visit physicians in a clinic or a hospital, they are asked about their medical history and related medical tests' results which might not exist or might simply have been lost over time. In emergency situations, many patients suffer or sadly die because of lack of pertinent medical information. Patient's Health information (PHI) saved by Electronic Medical Record (EMR) could be accessible only by a hospital using their EMR system. Furthermore, Personal Health Record (PHR) information cannot be solely relied on since it is controlled solely by patients. This paper introduces a novel framework for accessing, sharing, and controlling the medical records for patients and their physicians globally, while patients' PHI are securely stored and their privacy is taken into consideration. Based on the framework, a proof of concept prototype is implemented. Preliminary performance evaluation results indicate the validity and viability of the proposed framework.

Eric Wittkower founded McGill University’s transcultural psychiatry unit in 1955. One year later, he started the first international newsletter in this academic field, which became (and remains) the main journal today: Transcultural Psychiatry. However, at the beginning of his career Wittkower gave no signs that he would be interested in social sciences and psychiatry; he originally trained as a specialist in internal medicine in Berlin. This paper describes the historical context of the post-war period, when Wittkower founded a research unit at McGill University with an American anthropologist, Jacob Fried. Using archival material from McGill, I focus on the history of scientific networks and the circulation of knowledge, particularly on the exchanges between the French- and English-speaking academic cultures in North America and Europe. Because the history of transcultural psychiatry is a transnational history par excellence, but also a literature of exile, this leads necessarily to the important question of the reception of this academic field abroad.

spirit of just such an examination, this course considers public health programs and policy through the lens of contemporary politics and culture of Turkey and the Middle East. Major themes to be explored include the relationship between health systems, the state, and non-state actors (biopolitics, citizenship, social welfare regimes, health and neoliberalism, international aid, faith-based organizations and other grassroots movements), health and gender, and health and conflict. Health topics related to these themes range from fertility technologies and reproductive rights to police brutality against protesters and physicians, health in war zones and refugee camps, and the implications of recent polio outbreaks in Palestine and Syria.

Between 1979 and 1989 the government of the German Democratic Republic provided health assistance to Sandinista Nicaragua. After initial relief aid, the Sandinista embrace of a primary health care-based health system made East German health support difficult. The non-convertible currency, the repressive quality of the East German leadership, and the lack of experience with primary health care processes all limited its
potential to provide support. After 1985, when implementation of this  system stalled, East German health assistance was revitalized with the donation of the Hospital Carlos Marx. Providing medical services to three hundred thousand people, it combined elements of a strictly
East German institution, using German personnel and equipment, with some integration into local systems.

Multidisciplinary teams (MDTs) are conventionally recommended in mental health
care literature as an important way to offer holistic treatment provision to patients. This
study aims to explore multidisciplinary teamwork in contemporary mental health
settings, particularly what aids and hinders the process of multidisciplinary teamworking,
and the social work contribution in such teams. In order to attain an in-depth
exploration of these phenomena, a single case study design was employed. Within this
design, data were generated through semi-structured interviews and structured
observation of a mental health MDT in Ireland. These data were analysed using
interpretative phenomenological analysis. The research highlights how the concept of
mental illness is contested within this MDT, with the medical model dominant within
an environment of fluid working arrangements. Professional role blurring and
stereotyping were found to impact the division of labour on this team, with role
negotiation found to be an integral part of retaining a professional’s practice identity.
This research raises concerns for social work’s capacity to function within mental
health MDTs in Ireland, and highlights ways in which social work educators might
respond in order to empower Irish social workers to meet the challenges of mental
health multidisciplinary teamworking.

Introduction: The World Health Organization (WHO)estimates that together tobacco and alcohol kill about 9 million people annually despite aggressive and widespread public health controls. These legal industries persist because of the demand for their products and their substantial economic influence, which is magnified by the concentration of wealth in the executives of leading corporations that profit from increased legal drug sales.

Materials and methods: This preliminary study quantifies the link between global premature deaths from these legal addictive drugs as a function of executive compensation in order to provide the necessary data to make more effective policy recommendations for preventing legal drug-related deaths.

Results: The results indicate a need to incentivize chief executive officers(CEOs), such that they have a constant marginal utility per life saved.

Conclusions:      An executive compensation incentive that moves to eliminate tobacco use is achieved by a pay structure that increases exponentially with the number of lives saved.

This course provides a critical, practical, and multidisciplinary introduction to the field of global health.  Global health is typically defined by its commitment to understand not just the manifestations and patterns of disease around the world, but the social, political, and economic forces that place certain individuals and populations at greater risk of morbidity and mortality.  Assigned readings, lectures, and visual media will draw from the fields of anthropology, history, epidemiology, foreign policy, nutrition, medicine, bioethics, and public health – and each week, we attempt to put as many of these disciplines into conversation as possible.  By critically examining various frameworks and methodologies for understanding disease and the production of global health knowledge, the class will explore the potentials and challenges of improving health outcomes and medical care around the world. Students will exit the class with advanced literacy in the major controversies, challenges, and scientific concepts in the field of global health, and be able to ask critical and cutting-edge questions about global burdens of disease, popular global health campaigns, global health disparities, and the value of global health work to international diplomacy, peace, conflict resolution, humanitarian response, and development. Additionally, students will have the opportunity to learn to design and conduct primary research on a global health topic of importance here on the American University campus.

This Article challenges the conventional understanding that international crises are limited to instances of direct physical violence. Instead, it argues that the disproportionate distribution of infectious diseases like Ebola is a form of structural violence that warrants international intervention. In the field of global public health, structural violence is a concept used to describe health inequities and to draw attention to the differential risks for infection in the Global South, and among those already infected, for adverse consequences including death, injury, and illness. This Article clarifies how the concept of structural violence can be operationalized in law. It illustrates the ways in which actors can facilitate conditions for structural violence by analyzing the international public health and peace and security regimes.

This Article has several important contributions. First, the way international actors conceptualize crises should be expanded beyond merely addressing direct physical violence, but to also include remedying structural violence. Additionally, this study indicates that the complicated relationship between infectious diseases and conflict deserves more robust attention and resources. Moreover, this study examines the limits of the law governing international responsibility and concludes that shared international responsibility norms should be developed to assist in expanding the tools available for the protection of human rights. Lastly, this Article finds that the burgeoning field of international disaster law holds promise for responding to the challenges posed by infectious diseases like Ebola and the alleviation of large-scale human suffering caused by such diseases.

It is pivotal for non-healthcare organizations to clearly understand their functional roles in the delivery of an effective and efficient healthcare program, especially in a post-conflict setting before embarking on such venture. Non-healthcare actors must understand the importance of collaboration and integration in healthcare delivery system in order to meaningfully contribute to the delivery of a transparent and accountable healthcare program. The objective of this article was to examine the important roles that non-healthcare organizations played in healthcare delivery programs. Content evaluation was conducted among various non-healthcare entities that engaged in healthcare programs in a fragile healthcare environment. Research results indicated that in order to have efficient, accountable, and transparent healthcare delivery system, non-healthcare providers must honor the separation of responsibilities or functionalities. In a practical sense, those involve in healthcare service delivery must understand their roles and a line must be drawn to separate their functions to avoid mismanagement of scare resources, corruption, and the lack of accountability.

The new coronavirus disease, or COVID-19, was first identified in late 2019 and declared as a pandemic by the World Health Organization (WHO) in March 2020. Turkey and Iran have been heavily affected by the outbreak, with over 460,000 and 890,000 cases reported respectively, so far. Even though these two countries have similar political and ideological approaches and are roughly the same size in terms of population density, as well as despite a high number of reported COVID-19 cases, a fast infection spread rate, and mismanagement of the crisis in both countries, Turkey's death toll remained lower when compared to the death toll in Iran. Deploying a comparative case study methodology drawing on an analysis of secondary sources, this study investigates Turkey and Iran's official responses to COVID-19 to further understand authoritarian reactions to large-scale crises and how distinctions between the actions taken by authoritarian regimes might impact crisis management in such contexts.

Very young adolescents (VYAs) between the ages of 10 and 14 represent about half of the 1.2 billion adolescents aged 10-19 in the world today. In lower-and middleincome countries, where most unwanted pregnancies, unsafe abortions, maternal deaths and sexually transmitted infections occur, investment in positive youth development to promote sexual and reproductive health (SRH) is increasing. Most interventions, though, focus on older adolescents, overlooking VYAs. Since early adolescence marks a critical transition between childhood and older adolescence and adulthood, setting the stage for future SRH and gendered attitudes and behaviours, targeted investment in VYAs is imperative to lay foundations for healthy future relationships and positive SRH. This article advocates for such investments and identifies roles that policy-makers, donors, programme designers and researchers and evaluators can play to address the disparity.