By Tedros Adhanom Ghebreyesus
Director-General, World Health Organization
Download PDF
The United Nations declared 2021–2030 the Decade of Healthy Ageing, so that everybody has the opportunity to live longer and healthier lives.
The World Health Organization has been tasked with leading the effort to turn that commitment into a reality, in concert with other UN agencies, governments, international organizations, civil society, the private sector, and academia.
The Need to Act Now
Turning that commitment into a reality is an imperative. More than one billion people are age 60 years or older, and most live in low- and middle-income countries. By 2030, the number of older people will have increased by an estimated 400 million people. Developing countries will experience the most rapid increases, with the number of people age 60 years and older growing fastest in Africa, followed by Latin America, the Caribbean, and Asia.
Many older people, more than 140 million, do not have access to even the basic resources, such as nutritious food, medicine, health and social care. Many more cannot fully participate in society due to issues such as poverty, social isolation, abuse, and lack of assistive products, appropriate housing, accessible transportation, and job opportunities.
The COVID-19 pandemic has highlighted the seriousness of existing gaps in policies, systems, and services for older persons. No country, city, or community has been spared; the crisis has laid bare the high degree of ageism in society and the stark weaknesses in almost every health and social care system. Across all countries we have witnessed how older persons in poor health have borne a disproportionate burden of infection and death. But the COVID-19 pandemic has also highlighted how much, as a global society, we must value health as a common good for humanity.
It is time to rewrite the narrative on population aging, which is often thought to have adverse effects on economic growth and is used as a justification for cost cutting. We often assume that increasing longevity is accompanied by an extended period of good health. But there is little evidence to support this belief. There are huge variations between countries; for example, a 65-year-old female in Slovakia could expect to live another four years in good health, whereas a 65-year-old female in Norway could expect another 16 years of healthy living. Approaches that advocate only for cost containment miss the opportunity to make sound investments to reduce the gap between health span and lifespan. It is time to change the paradigm, so that we are not just extending years, but making sure those added years are healthy, quality ones. We can avoid economic slowdowns by “adding life to years” through policy interventions supporting healthy aging,1 such as improving disease prevention, lifelong learning, increasing access to health care, social protection, and opportunities for decent work.
How to Get There
First, to change the narrative around age and aging, we have to take on the negative stereotypes and prejudice surrounding older people and stop discrimination based on age. Ageism can manifest in the workplace, in access to health care services, and in how products are developed and marketed. Ageism is bad for individuals and bad for society, but it is preventable. The UN Global report on ageism outlines strategies that work to prevent and respond to ageism, including education, intergenerational contact, and legal protections.
Second, we need to rethink health and long-term care. Many health systems are poorly equipped to respond to the needs of older people who have one or more chronic diseases. Health systems tend to value hospitals over primary health care while prioritizing treatment over prevention as well as the management of single diseases over integrated approaches. An effective shift, therefore, starts with primary health care. It must be responsive to older people, based around integrated care that provides comprehensive assessments and a single care plan that takes into account both acute and chronic conditions. This means moving away from acute hospitals towards community-based, planned and coordinated care.
Long-term care systems — that is, where they exist, for in many countries they do not — are often under-resourced, neglected, and poorly integrated with other parts of health and social care systems. The COVID-19 pandemic, specifically how it has disproportionately affected people living in long-term care facilities, has underscored long-term care’s systemic flaws. Concerted action is needed to improve the quality of long-term care, including increased emphasis on home- and community-based care. WHO has identified key action points to prevent and manage COVID-19 across long-term care, as part of a broader health and social-care guidance to help countries develop integrated services and pathways for the needs of older people.
The goals of the Decade of Healthy Ageing extend far beyond the health sector. They are focused on building communities that foster the abilities of older people in areas including labor, education, housing, social protection, transport, and technology. The WHO Global network for age-friendly cities and communities supports more than 1300 members from 51 countries covering over 260 million people. One example is Age-friendly Ireland. Established in 2014, it has embraced a vision of every county in the country being a great place in which to grow older, today having in place programs in all 33 local authorities.
Central to the mission of the Decade of Healthy Ageing is that older people must play a central role in the decisions that affect them. Older people, with the support of their families and communities, must have the opportunities to assume responsibility for their own health and well-being.
To achieve the promise of the Decade of Healthy Ageing, we have to work across countries, sectors, and disciplines. WHO, in collaboration with stakeholders from over 80 countries, has developed the Decade of Healthy Ageing Platform, an innovative multilingual knowledge exchange resource that will enable people to find, share, and produce knowledge on healthy ageing. The design of the Decade Platform recognizes that there are many types and sources of knowledge, including those derived from personal experience. To meet different knowledge needs, the platform contains voices and stories from older people, their families and communities, user guides, reports, databases, teaching resources, and research materials, as well as informal and face-to-face learning opportunities.
The Platform is designed for use by policymakers, practitioners, and all other stakeholders working to foster healthy ageing. To maximize the use of knowledge, the Platform also offers stakeholders training and opportunities to share successful initiatives and good practices.
A Global Imperative
During this Decade of Healthy Ageing and beyond, WHO is committed to working with older people and the organizations that represent them to foster good health, improved quality of life, and dignity for current and future generations. Improving the health and well-being of aging populations is not only a moral responsibility, it is a social and economic imperative. Our older generations have given us all so much. We now have the opportunity to give something back. Working together, we can build a healthier, fairer, and more dignified life for all.
——————
1 Health, an ageing labor force, and the economy: Does health moderate the relationship between population age-structure and economic growth? – ScienceDirect https://www.sciencedirect.com/science/article/pii/S0277953621006857