International adolescent health: realizing his vision:

herbert friedman, ph.d. (1936–2000)1
      Respectfully submitted,
      Today, adolescent health and development is viewed as a priority area of concern in many nations of the world. Such was not always the case. The increased attention to adolescent health is reflected in this remarkable edition of the Journal of Adolescent Health which includes submissions from every continent of the globe save Australia and Antarctica.
      There are many reasons for the increased attention to adolescents. Certainly, the efforts in child survival over the previous 2 decades have resulted in the largest number of adolescents the world has ever seen, nearly 85% of them who live in developing countries. Changing conditions are bringing about changes in behavior and countries have recognized that behavior formed in the 2nd decade of life has lasting implications for individual and public health. But there are other factors as well. The rise of HIV/AIDS has increased global concern. Rural to urban migration has swelled many cities of the world with young people. Increased access to family planning has shifted family structure and size. The rise in education, especially that of women, has not only created new opportunities but has also shifted social relationships between men and women as well as among the generations. For many countries of the world, the last 20 years have also brought with them radical political change initiated, more often than not, by the actions of young people.
      But such forces in themselves would not have put adolescent health and development on the international agenda. Rather, it was these forces coupled with the dedication and skill of a small number of world leaders who made it happen. One such individual was Herbert Loeb Friedman, Ph.D.
      Herb was an unlikely individual ever to play such a central role on the world stage. Trained as a clinical psychologist, his soul was in helping the individual young person cope with life’s adversities. He came to the World Health Organization (WHO) as a consultant, bringing to bear his conviction of the centrality of human behavior in sexual relationships to family planning through the development of methods and tools for research and planning to specifically address adolescents needs, and stayed to build a Programme on Adolescent Health and Development recognized by the World Health Assembly.
      Some who are unfamiliar with WHO and its vast global influence may see this as merely the expansion of bureaucracy. But nothing could be farther from the truth. The credibility that WHO recognition gave to adolescent health much as it had given to child survival a generation before, has had a profound impact. That recognition legitimized an approach to adolescent development and health, stimulated by Herb Friedman. He believed in the power of positive regard and respect; that adolescents, given appropriate support and opportunities by adults, would act in their own, and in their societies’, best interests. The importance of eliciting from adolescents their views became paramount in approaches designed to assist them and involve them in health promotion. He believed that the social environment, traditions and culture provided important stability and guideposts for the passage of adolescents to adulthood.
      He believed that relationships shape human development through feedback with others; that they become more complex, demanding and rewarding with maturation; and that it was often unfulfilling relationships at the root of behaviours causing both health and social problems. Vital to the establishment and maintenance of relationships is interpersonal communication, another area he championed and elaborated well in advance of others in public health.
      The footprints of Herb’s work are seen in the towns, villages, and capital cities of the world’s nations. Where there are Ministries of Youth Affairs, Herb is there. Where there are national Adolescent Health Policies and Plans, Herb is there. Where there are youth-friendly health services, Herb is there. And where there are health providers who value young people and who take the time to listen to their concerns, Herb is there. Where there are research efforts to advance adolescent health, Herb is there as well. And most importantly, where young people are actively engaged in planning and developing adolescent health services, Herb is there.
      Whether they know it or not, those who wrote the articles in this issue—from Mozambique to Dakar, Uppsala to Santos, Brazil—are the beneficiaries of Herb Friedman’s efforts. If anyone of us is successful, we stand on the shoulders of giants; and if collectively we advance the cause to which we are dedicated, it is because we build on those who have come before. Such is the case of what is reflected in the present collection of articles.
      Recently the world celebrated the 10th anniversary on the Convention on the Rights of the Child. In this 2nd decade of the Convention’s existence, it is only fitting that we now devote increased and focused attention to that period of human development Herb considered so crucial for humanity. The world is a better (or at least a healthier) place for young people today than a decade ago, not because of such documents in and of themselves, but because of those like Herb Friedman who have provided us with such inspiration to guide our work. We are still striving to actualize his vision of harnessing the force of adolescents for themselves and their societies.