Adolescence is widely defined as a distinct phase in the life-course during which an individual completes their biological development and transitions from childhood to adulthood. This article presents a debate, conducted in 2018 at a scientific symposium in Mwanza, Tanzania, of the appropriateness of this for Africa, and by extension whether health interventions and global health policy that are shaped by such concepts can be universally applicable and relevant. The proponents for the motion argued that adolescence is indeed a distinct developmental phase when puberty is achieved and the neurocognitive development that occurs shapes behaviours that impact health outcomes. This occurs universally, is marked by cultural rites, and recognised in legal frameworks and therefore geographical distinctions in understanding are unnecessary. The opponents argued that adolescence is more than a biological or legally recognised transition to adulthood: instead, concepts, including that of adolescence, are shaped by beliefs, values and expectations founded within a cultural milieu. The concept is dissonant to Africa as it prioritises individualism over communalism, and attributes gender and social roles as accepted in the Global North. Thus, many interventions targeted at adolescents in Africa have remained ineffective. The notion that the concept of adolescence, which originated in the Global North but is universally applied, is a consequence of colonialism giving less value to the lived realities and understandings of peoples from the Global South. For achieving both epistemic justice and effective health policy and programmes in global health, acknowledgement and centralisation of context are critical. However, in a more interlinked and open world, there is a massive potential for cross-learning and collaboration across geographies to develop a concerted approach to improve the health of adolescents and for a more equitable global health practice. However, adolescence is also a social entity shaped by beliefs and values within different cultural contexts. A move away from universal, often western-defined concepts of adolescence, to centring the distinct sociocultural factors that shape adolescence in different societies will enable more effective policies and programming.