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Two billion people older than 60 years by 2050, warns UN Secretary General
POLICY AND PEOPLE
Two billion people older than 60 years by 2050, warns UN Secretary General tion shifts in developed and developing countries. The first UN World Assembly on Ageing took place 20 years ago in Vienna. However, many recommendations of that meeting’s action plan were never fulfilled, noted UN offi-
Rights were not granted to include this image in electronic media. Please refer to the printed journal. AP
he number of older people will increase from 600 million to almost two billion by 2050, Kofi Annan, the UN Secretary-General, told the Second UN World Assembly on Ageing on April 9. The implications of this demographic shift will be that, for the first time, there will be more people older than 60 years than people younger than 15 years and 80% of older people will be in developing countries, he warned. “Not only is the number of aged people rapidly increasing, but health expenditures per person per year will increase correspondingly. Without changes in the structure and priorities of our health system, it is likely that total health expenditures for the aged will rise rapidly, said WHO’s Director-General, Gro Harlem Brundtland. The 4-day assembly, which was held in Madrid, Spain, aimed to respond to the “opportunities and challenges” of a larger older population. In the past two decades a declining birth rate coupled with increasing longevity have led to major popula-
T
Older people must have equal rights
cials. The assembly’s new plan aims to help law makers balance national health policy priorities for the growing, ageing population. The main goal of the plan is to ensure that people are able to grow older “with security and dignity” and continue to participate in society as citizens with full rights. The assembly recommends that older people get full access to health-
care services, including rehabilitation programmes and sexual health care. The plan also calls on policy makers to improve quality of life and access to care for older, disabled people. To achieve these aims more resources are needed and more health-care workers must be trained to meet older people’s special needs. National governments must also develop social support systems that allow families to care for older relations with the support of community care programmes. Luis Alfonso Davila, minister of foreign affairs of Venezuela, proposed an international organisation for older people, similar in design to the UN Children’s Fund. The body could be funded by 10% of the world’s military expenditure, he suggested. Annan noted that the population shift should be seen in a positive light, “as more people are better educated, live longer, and stay healthy longer, older persons can and do make greater contributions to society than ever before”. Xavier Bosch
Older people must be on the health and development policy agenda
A
ll societies discriminate against older people on the grounds of age, health care, legal services, and education, according to a report published by HelpAge International at the World Assembly on Ageing on April 8. The international nongovernmental group found that governments and policy makers ignore older people, who as a result do not get equal access to health-care resources in, for example humanitarian crises. The State of the World’s Older People report, a survey of elderly people in 32 countries (http://www.helpage.org), put forward three key message for policy makers: “equal rights for older citizens, a fair share of national and international resources, and inclusion in decision-making and in civil society.” In recognising the rights of older people, the report suggests that international donors, relief programme makers, and governments must give priority to older people in resource-poor countries. Most older people would like to continue being actively involved in their communities. “Evidence suggests this role is
being expanded as older people care for other older people who need support, and increasingly for younger generations as a result of economic migration, conflict, and HIV/AIDS.” Policy makers must “respond to and support greater longevity and its wider benefits to society”, says the report. Many older people are forced to work until they are very old and their efforts often have to support large families. However, many older people are marginalised by society and prevented from working in the formal sector many years before their working lives are over, found the study. Although research on poverty and living conditions of the elderly is limited, the report suggests that “current policies should be extended so that national budgets invest in the productive capacity of older people, which will enhance independence and enable older people to contribute to their households”. International and national plans to provide social protection for all are not reaching the older population, says the report. Where social assistance mechanisms are in place,
THE LANCET • Vol 359 •April 13, 2002 • www.thelancet.com
the elderly often find they do not qualify for aid. For example in Ethiopia, only 3% of people are eligible for a pension. The report suggests that development programmes for poorer nations should include social protection mechanisms including minimum income schemes; and to this end dono countries must deliver the 0·7% target of development assistance. Older people often get less than their fair share of health care, said the report. “The assumption that older people make disproportionate use of health care provision needs to be challenged.” WHO echoed this point in a policy framework published at the meeting (http://www.who.int/hpr/ageing). Alexandre Kalache, coordinator, of WHO’s Ageing and Life Course Programme, said “rather, it is disability and poor health—often associated with old age—that are costly. Good health in the older population saves money, freeing it up for other needs. Healthy ageing is therefore a central component of the development agenda”. Haroon Ashraf
1321
For personal use. Only reproduce with permission from The Lancet Publishing Group.
Two billion people older than 60 years by 2050, warns UN Secretary General tion shifts in developed and developing countries. The first UN World Assembly on Ageing took place 20 years ago in Vienna. However, many recommendations of that meeting’s action plan were never fulfilled, noted UN offi-
Rights were not granted to include this image in electronic media. Please refer to the printed journal. AP
he number of older people will increase from 600 million to almost two billion by 2050, Kofi Annan, the UN Secretary-General, told the Second UN World Assembly on Ageing on April 9. The implications of this demographic shift will be that, for the first time, there will be more people older than 60 years than people younger than 15 years and 80% of older people will be in developing countries, he warned. “Not only is the number of aged people rapidly increasing, but health expenditures per person per year will increase correspondingly. Without changes in the structure and priorities of our health system, it is likely that total health expenditures for the aged will rise rapidly, said WHO’s Director-General, Gro Harlem Brundtland. The 4-day assembly, which was held in Madrid, Spain, aimed to respond to the “opportunities and challenges” of a larger older population. In the past two decades a declining birth rate coupled with increasing longevity have led to major popula-
T
Older people must have equal rights
cials. The assembly’s new plan aims to help law makers balance national health policy priorities for the growing, ageing population. The main goal of the plan is to ensure that people are able to grow older “with security and dignity” and continue to participate in society as citizens with full rights. The assembly recommends that older people get full access to health-
care services, including rehabilitation programmes and sexual health care. The plan also calls on policy makers to improve quality of life and access to care for older, disabled people. To achieve these aims more resources are needed and more health-care workers must be trained to meet older people’s special needs. National governments must also develop social support systems that allow families to care for older relations with the support of community care programmes. Luis Alfonso Davila, minister of foreign affairs of Venezuela, proposed an international organisation for older people, similar in design to the UN Children’s Fund. The body could be funded by 10% of the world’s military expenditure, he suggested. Annan noted that the population shift should be seen in a positive light, “as more people are better educated, live longer, and stay healthy longer, older persons can and do make greater contributions to society than ever before”. Xavier Bosch
Older people must be on the health and development policy agenda
A
ll societies discriminate against older people on the grounds of age, health care, legal services, and education, according to a report published by HelpAge International at the World Assembly on Ageing on April 8. The international nongovernmental group found that governments and policy makers ignore older people, who as a result do not get equal access to health-care resources in, for example humanitarian crises. The State of the World’s Older People report, a survey of elderly people in 32 countries (http://www.helpage.org), put forward three key message for policy makers: “equal rights for older citizens, a fair share of national and international resources, and inclusion in decision-making and in civil society.” In recognising the rights of older people, the report suggests that international donors, relief programme makers, and governments must give priority to older people in resource-poor countries. Most older people would like to continue being actively involved in their communities. “Evidence suggests this role is
being expanded as older people care for other older people who need support, and increasingly for younger generations as a result of economic migration, conflict, and HIV/AIDS.” Policy makers must “respond to and support greater longevity and its wider benefits to society”, says the report. Many older people are forced to work until they are very old and their efforts often have to support large families. However, many older people are marginalised by society and prevented from working in the formal sector many years before their working lives are over, found the study. Although research on poverty and living conditions of the elderly is limited, the report suggests that “current policies should be extended so that national budgets invest in the productive capacity of older people, which will enhance independence and enable older people to contribute to their households”. International and national plans to provide social protection for all are not reaching the older population, says the report. Where social assistance mechanisms are in place,
THE LANCET • Vol 359 •April 13, 2002 • www.thelancet.com
the elderly often find they do not qualify for aid. For example in Ethiopia, only 3% of people are eligible for a pension. The report suggests that development programmes for poorer nations should include social protection mechanisms including minimum income schemes; and to this end dono countries must deliver the 0·7% target of development assistance. Older people often get less than their fair share of health care, said the report. “The assumption that older people make disproportionate use of health care provision needs to be challenged.” WHO echoed this point in a policy framework published at the meeting (http://www.who.int/hpr/ageing). Alexandre Kalache, coordinator, of WHO’s Ageing and Life Course Programme, said “rather, it is disability and poor health—often associated with old age—that are costly. Good health in the older population saves money, freeing it up for other needs. Healthy ageing is therefore a central component of the development agenda”. Haroon Ashraf
1321
For personal use. Only reproduce with permission from The Lancet Publishing Group.