By Lou Valdez
Deputy Director
Pan American Health Organization
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The United Nations Decade of Healthy Ageing (2021-2030) is a global initiative bringing together different stakeholders with the common goal of improving the quality of life of older people, their families, and communities. In November 2023, the first Progress Report of the Decade of Healthy Ageing was published. It highlighted experiences and actions from different stakeholders during the first three years of implementation, as well as knowledge and resources that are in development worldwide to support healthy aging.
The report is part of the World Health Organization (WHO) commitment to monitoring the Decade’s results and underscores the significant engagement of countries in the Americas in the movement. The demographic and epidemiological transitions that the world is going through present an unprecedented challenge for health and social protection systems, with accelerated change not only in populations but also in the environments where people are born and live. In the Region of the Americas, the aging process is uneven demographically, resulting in a fast-growing older population, especially in low- and middle-income countries. It is vital to take advantage of the “window of demographic opportunity” to foster actions and target interventions to ensure long and healthy lives for all.
Despite the challenges the world has faced since 2020, progress has been achieved in each of the Decade’s four action areas: combating ageism; developing age-friendly cities and communities; delivering integrated and person-centered care that responds to older adults’ needs; and providing access to long-term care for older people who need it, as highlighted through the monitoring of the 10 progress indicators shown in Figure 1.
The Pan American Health Organization (PAHO), in coordination with countries and other organizations, supports the implementation of the Decade initiative and the achievement of its objectives through the application of methodologies and tools such as the Global Campaign to Combat Ageism, the Global Network of Age-Friendly Cities and Communities, and the strategy for Integrated Care for Older People (ICOPE). Additionally, PAHO’s background resource series, The Decade of Healthy Aging in the Americas: Situation and Challenges, is available to inform action through evidence and it addresses one of the enablers of the Decade’s plan, which is to increase data, research, and innovation.
The Progress Report illustrates the relevance and engagement of countries of the Americas in implementing the Decade. Some of the main findings indicate 91 percent of countries that reported data have a national aging policy, while nearly 70 percent have mechanisms for promoting and protecting the rights of older persons. Additionally, 78 percent have a policy, legislation, strategy, or program for integrating palliative care services into the structure and financing of national health systems at all levels of care. Furthermore, over 50 percent of reporting countries in the Region have implemented actions to support income-generating activities for older people.
Relevant progress can be seen in the percentage of countries with national programs to support the activities of the WHO Global Network for Age-friendly Cities and Communities. In this sense, the Region of the Americas, with over 950 cities and communities, represents more than half the total members of the Network, with the United States alone having the most cities and communities in the Region. Moreover, significant engagement from the Latin American countries has occurred since 2020.
Also, by 2022, more countries had national policies to support comprehensive assessments of older people in health services, despite reporting challenges in providing integrated care, such as human resource constraints. WHO’s Integrated Care for Older People (ICOPE) approach has generated wide interest among PAHO Member States in the Americas, and some, such as Chile and Costa Rica, have undertaken pilot projects to assess their capacity to implement it. Also, countries developed training strategies on the health and care of older adults. One example is the capacity-building program for primary care workers in El Salvador using the course, Development of Competences in Health Care for Older Persons: ACAPEM ‒ Basic Level, available in the PAHO Virtual Campus of Public Health. Other examples from the Progress Report are the active and healthy aging program in Brazil; the creation of a Socio-Sanitary Care Center focused on the “oldest-old“ in Colombia; and the opening of an integral protection center for combatting gender-based violence in Argentina.
The Americas have also made progress in the declaration of national policies, strategies, and plans aligned to healthy aging. For example, Puerto Rico recently presented its 10-year Healthy Aging Plan, aligned with the Decade of Healthy Aging goals, and Paraguay published a national policy for older adults, with six strategic lines including the right to health, social protection, age-friendly environments, and lifelong-learning opportunities.
Moreover, it is important to emphasize the intersectoral and interagency work that has characterized the development of the Decade in the Region, with strong collaboration and coordination between UN agencies and the Inter-American System towards achieving the Decade’s objectives. In this sense, the report highlights several initiatives that can serve as examples to inspire similar strategies in other regions and countries, such as the Inter-American Convention on the Rights of Older Persons, which is presented as a unique legal instrument at the regional and global levels; as well as the “Let’s Go!” toolkit for age-friendly cities and communities, launched by PAHO together with HelpAge International and AARP.
The advancements and limitations in implementing the Decade described in the report indicate how actions could be accelerated in the upcoming years. One of the challenges outlined is the lack of financial resources, indicating the need for political commitment and specific budget allocations to support healthy aging. It is crucial to increase the efforts to consolidate health and social protection systems to promote healthy aging and favor economic sustainability.
Finally, as we advance in the Decade, meaningful engagement of older people, who should be central in shaping the Decade’s implementation, must be guaranteed. The Decade is an opportunity to catalyze efforts towards greater health, well-being, and equity as people age. It will also contribute to social and economic benefits across the Region through the active participation of older people in society.
Achieving a world in which all people can live long and healthy lives is only possible with older people at the center of all actions, policies, and strategies so that no one is left behind.
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1 Progress Report on the United Nations Decade of Healthy Ageing, 2021-2023. Geneva: World Health Organization; 2023. https://www.who.int/publications/i/item/9789240079694.
2 More information and related resources at: https://www.who.int/publications/m/item/global-campaign-to-combat-ageism-toolkit.
3 More information at: https://www.paho.org/en/topics/age-friendly-cities-and-communities.
4 Integrated care for older people (ICOPE): Guidance for person-centered assessment and pathways in primary care. Geneva: World Health Organization; 2019. https://www.paho.org/en/documents/integrated-care-older-people-icope-guidance-person-centered-assessment-and-pathways.
5 More information about the series, The Decade of Healthy Aging in the Americas: situation and challenges, at: https://www.paho.org/en/series-decade-healthy-aging-americas-situation-and-challenges.
6 More information at: https://campus.paho.org/en/course/health-care-older-persons-acapem-basic-level.
7 Let’s Go! Steps for engaging older people and improving communities for all ages. PAHO, HelpAge International and AARP, 2022. https://www.aarpinternational.org/file%20library/unassigned/lets-go-guide.pdf.