Co-creators, not bystanders: Advancing meaningful youth engagement in antimicrobial resistance response in Africa.

Antimicrobial resistance (AMR) is a critical and escalating global health threat, with sub-Saharan Africa bearing one of the highest burdens. Despite young people comprising nearly 70% of the region's population, their involvement in AMR decision-making remains minimal, often limited to tokenistic roles or awareness campaigns. This essay calls for recognizing youth as co-creators and strategic partners in AMR mitigation. We analyze the current state of youth engagement in AMR initiatives across Africa, highlighting systemic barriers such as inadequate access to resources, structural exclusion, and entrenched power imbalances. Through examples of successful youth-led programs, we demonstrate how youth-driven innovation, advocacy, and community mobilization have generated sustainable impact. Building on the WHO's Global Consensus on Meaningful Adolescent and Youth Engagement, we propose a practical framework to institutionalize youth participation in AMR initiatives. This framework emphasizes structural integration, intergenerational collaboration, equitable access to funding, capacity-building, and robust accountability mechanisms. We argue that meaningful youth engagement is both a moral imperative and a strategic necessity to achieve sustainable, inclusive, and context-sensitive solutions to AMR in Africa.