On 28th October 2021, WACI Health launched an African youth advocacy and leadership program for global health, which defines, creates, and implements change while equipping young African advocates with skills to make a global impact on health.

Under the Tree brings together all of WACI Health’s youth leadership programs, including AfNHi Youth Cohort, YL4H (Youth Leaders for Health), RUN4TB Youth and AGYW Voices. Through these programs, we have witnessed the power of youth advocacy and leadership in policy change.

Rosemary Mburu, executive director at WACI Health, says, “By fostering youth leadership, WACI Health acknowledges that young people should lead today, not wait for tomorrow. As an organisation that mentors youth to drive advocacy, we help develop knowledgeable, bold and accountable youth leaders for global health.”

We are inspired by Youth Leaders for Health, a joint program by WACI Health, RESULTS UK, Health Promotion Tanzania-HDT, Hope for Future Generations, and CISMATSL. In addition, YL4H was an 18-month journey of skill development, mentorship, and influence for policy change, which demonstrated the power of youth voices in advocacy.

The project ended in March 2021, and 25 Youth Leaders passionate about health and healthcare systems were trained to advocate for policy reform. Under the Tree will contribute to the YL4H goal of more decisive youth leadership for better and more equitable systems for health in Africa.

Under the Tree will apply three key strategies: (i) structured module-based training (ii) continuous group coaching (iii) facilitates and connects young people to advocate for policy change at crucial national, regional and global advocacy moments.

Currently, Under the Tree is training and mentoring a group of 12 young people drawn from the AfNHi Youth Cohort. These12 young people from Nigeria, Ghana, South Africa, Zimbabwe, Tanzania and Uganda attend weekly online classes covering a range of topics from advocacy, engagement with communities, policymakers and civil society, media engagement, data advocacy and understanding the global, regional and local financing mechanisms.

The module-based online classes are combined with group coaching on specific skills to expand their capability to advocate for policy change at key national, regional and global advocacy moments. Additionally, Under the Tree hosts a monthly virtual Youth Forum, which is open to all young people passionate about health advocacy. It is a space for peer-to-peer learning and mentoring.

Using youth voices to advocate for and create community change is an outcome we strive for. Youth, adults, and their communities can potentially benefit from these interactions in significant ways.

Close to 4,000 people die each day from tuberculosis, which is the fourth leading killer among infectious diseases. There have been 10 million tuberculosis infections in 2019 alone, and 1.4 million have died from the disease. There were approximately 140,000 cases of TB in Kenya in the same year.

Around 32,000 TB-related deaths occurred in Kenya in that year alone. This could have been prevented through more targeted programming.

Male tuberculosis survivors from Kenya, Nigeria, and South Africa participated in the Just Men forum to share their stories with celebrities and become Male champions for TB advocacy. A live Facebook session complemented the event with Ambassador for Youth and Adolescent Rep Health Programme (AYARHEP), which is an adolescent and youth reproductive, health rights organisation, focused on gender advocacy on TB.

It is estimated that TB is more prevalent in men with approx. 60% of cases are diagnosed in men. According to Kenya’s 2016 prevalence survey, the disease killed the most productive population (18-44 years), and men were two times more likely to be infected than women.

The 2018 High-Level Meeting of the United Nations (UNHLM) focused on eradicating TB by 2030. To contribute to national and global goals, the commitment recommends gender-sensitive programming and innovative TB response strategies.

Due to men being more susceptible to TB, addressing gender-related barriers that prevent access to and treatment adherence is crucial. As their first remarks, Dr Waqo, Head of the National Tuberculosis Program, and Dr Kinyanjui, Country Director of the African Health Forum, highlighted financial barriers and societal norms that force men to prioritise income-generating activities over their health.

Furthermore, low levels of awareness of TB suggest that TB messaging for men needs to be creative.

As we continue strengthening the conversation around TB in women, it is crucial to ensure that men who carry the most considerable disease burden are not excluded from the discussion.