Adolescent Sexual Reproductive Health and Rights (ASRHR) in Crisis? Let’s Rethink Opportunity, Impact, and Responsibility Together
Luchuo Engelbert Bain, MD, PhD.
In our recent commentary, we respond to the serious setbacks triggered by recent U.S. policy shifts, which threaten decades of global progress in adolescent sexual and reproductive health (ASRH) across low- and middle-income countries (LMICs). We do not call for despair—we call for action rooted in clarity, responsibility, and bold rethinking.
We emphasize the need to unpack what we mean by a “moment of opportunity” for LMICs. Who defines the opportunity? Who owns it? We argue that opportunity only becomes real when LMICs lead, set priorities, and mobilize domestic capacities. While more funding is essential, we caution that more money does not automatically mean more impact. It is time to question what we mean by “doing more with less” and ensure it does not become a euphemism for lowered ambition.
We urge a paradigm shift in how we define and measure impact, distinguishing it from donor-driven success. Impact must reflect lived realities, sustainable systems, and local leadership. We also stress that equitable partnerships require mutual respect, transparency, and partnering in dignity. Foreign aid can support, but never replace, a government’s duty to invest in its people.
Despite diverging interests, we see a genuine opportunity for governments and funders to collaborate differently. We must co-create innovative, inclusive, and resilient approaches.
This crisis has shaken our foundations. But if we lead with intention and act in solidarity, we can transform it into meaningful and lasting change.
