For active ageing

The U.N. Second World Conference on Ageing emphasises the need to promote the rights of the aged, especially in poor countries.

A MAJOR achievement of the 20th century was the breakthrough, made through advances in medical technology and better nutrition and healthcare, in extending the human life span. The 21st century must therefore live with the consequences of that far-reaching achievement. One million people cross the 60-year mark every month, and of them 80 per cent are in the developing world. According to United Nations figures, the fastest-growing segment of the older population is also the oldest one - comprising persons who are 80 years or more in age. This group numbers 70 million, and it is projected to grow to five times its present size over the next 50 years.

Today, the world faces the many-sided challenge that a rapidly ageing population presents. As with every other global issue, this too will be experienced differently by the developing world and the developed world. The phenomenon of ageing, of growing numbers of persons crossing the age of 65, has transformed the demographic profile of world populations. While the increase in life expectancy has added tremendously to human happiness and human capabilities across all social groups and cultures, the consequences of this demographic change in a context of sharpening global inequality are posing a major challenge to individuals, families, communities and governments. This is particularly so in developing countries, where poverty, gender discrimination, urbanisation and - in sub-Saharan Africa - the Human Immunodeficiency Virus-Acquired Immune Deficiency Syndrome (HIV-AIDS) pandemic, have increased the hardships faced by the aged.

It is in this context that the U.N.'s Second World Conference on Ageing was held in Madrid, from April 8 to 12, 2002. The First World Conference on Ageing was held in Vienna 20 years ago. At that conference, an International Plan of Action focussing on the economic, psychosocial and health needs of the aged was prepared, and it called upon governments to approach the issue of ageing with a new sensitivity. Since then the world has changed; the needs and concerns of the ageing population have also altered dramatically. New issues have emerged, such as the impact of globalisation, HIV-AIDS and recurrent armed conflict and displacement. These will surely increase the hardships of aged persons.

The U.N. General Assembly resolved to hold the Second World Assembly in 2002. As in the case of most U.N. conferences, a preparatory committee was established to prepare a draft Plan of Action on Ageing. However, some issues remained unresolved in the draft document. Among them were the role of debt relief and aid to developing countries in addressing this problem; a human rights-based global approach to ageing; the economic options, including pension rights, before an ageing labour force; the special healthcare needs of the aged; and a monitoring mechanism for the implementation of the Plan of Action, including resource mobilisation through aid.

After four days of intense debate, delegates from 160 nations resolved to promote the rights of the aged, with special focus on poor countries. The problems of developing countries, where most of the aged people live in rural areas and where better healthcare and nutrition may quadruple the numbers of the aged by 2005, were highlighted. A 44-page International Plan of Action and a Political Declaration were adopted. Both documents committed governments and policy-makers in international forums to implementing a set of 117 recommendations revolving around three central themes. The themes are: older persons and development, advancing health and well-being into old age, and ensuring enabling and supportive environments for the aged. The primary responsibility for implementing the Madrid Plan of Action lies with governments, which must bring the concerns of aged persons within a policy framework in partnership with civil society, the private sector and the aged persons themselves. According to Juan Jose Lucas, president ex-officio of the Assembly and Minister of the Presidency of the Government of Spain, the Plan of Action is a "framework of development and combating poverty, which emphasised the importance of active ageing, of inter-generational solidarity and the necessity of helping developing countries".

Some of the issues highlighted in the Plan of Action are to:

* Achieve 'secure ageing' by pursuing the goal of poverty eradication and to build on the U.N. Principles for Older Persons;

* Help older persons participate effectively in their social, economic and political milieus;

* Guarantee the economic and political rights of aged people;

* Ensure the elimination of gender-based discrimination amongst aged persons;

* Provide for the special healthcare needs and support for aged people;

* Harness scientific research and expertise towards the individual, social and health implications of ageing, particularly within developing countries.

The Plan of Action urges governments to implement policies that promote access to training for older workers and sets a target date of 2015 for a 50 per cent improvement in adult literacy. Since many of the problems affecting the aged in poor countries are linked to problems of national debt, the Plan of Action recommends that developed countries make concrete efforts towards achieving the target of providing 0.7 per cent of their Gross National Product (GNP) as development aid to developing countries, while developing countries reach the target of providing 0.15 per cent of their GNP as aid to the least developed countries. The Political Declaration provides the international perspective on the issues of ageing and reiterates the necessity of cooperation in addressing them.

The demographic global context to the issue of ageing was provided by a report prepared by the U.N. as a background for the conference. The report suggests that we are moving into a future where the aged will soon outnumber the young. The report says: "The ageing of the population today is without parallel in the history of humanity. Increases in the proportions of older persons (60 or older) are being accompanied by declines in the proportions of the young (under age 15)." By 2050, the report says, the number of aged persons in the world will grow to almost two billion, exceeding the population of children (zero to 14 years) for the first time in human history. This historic reversal in relative proportions of the young and the old took place by 1998 in the more developed countries. By 2050, the proportion of aged persons is projected to reach 21 per cent.

There are marked regional differences in the numbers and proportions of older persons. The highest percentage (54 per cent) of the aged population lives in Asia. The pace of ageing in Asia is much faster and this is evident at the lower levels of socio-economic development. In fact, the fastest growing age group is the oldest-old, which comprises those aged 80 years and above. They are currently increasing at the rate of 3.8 per cent a year and comprise 12 per cent of the total number of aged persons. By the middle of the century, one-fifth of the older persons will be 80 years or older.

Another significant aspect of the demography of ageing is that the majority of the aged are women. Because life expectancy is greater for women than for men, today there are 81 older men per 100 older women. Among the oldest-old there are only 53 men for every 100 women. The ratio of men to women at older ages is lower in the more developed regions (71 men per 100 women) than in the less developed regions (88 men per 100 women), since there are larger differences in life expectancy between the sexes in the more developed regions. Aged women are likely to be far more vulnerable to socio-economic hardship than aged men.

The potential support ratio (PSR) is the number of persons between the ages of 15 and 64 years to one older person aged 65 years or above. This ratio indicates the dependency burden on potential workers. According to the report, the impact of demographic ageing is visible in the PSR, which has fallen and will continue to fall. Between 1950 and 2000, the PSR fell from 12 to nine people in the working ages for each person who is 65 years or older. By mid-century, the PSR is projected to fall to four working-age persons for each person 65 years or older. The PSR is an important indicator in the planning of social security schemes, especially pension schemes where current workers pay for the benefits of current retirees. The work participation levels of the aged in developed and developing countries tend to be different. In the less developed regions, older persons participate more in the labour markets, particularly in the informal sector.

The conference addressed the issues of the three global processes of globalisation, urbanisation and ageing, their impact on developing regions, especially on rural areas, where already a majority of the aged live. Apart from the major divide between the developed and developing countries, within the developing regions themselves factors such as regional and cultural specificities, national laws, the effects of armed conflict and the presence of refugee populations, droughts, the HIV-AIDS pandemic, and so on will impact differently on older populations. Migration processes where young adults leave their villages to seek jobs in cities, leaving behind the older members of the family, have greatly affected the status of the aged. Once remittances from the younger adults of the family dry up, the economic uncertainty combined with the breaking up of traditional extended family support structures will leave the old in rural families very vulnerable.

In sub-Saharan Africa, the HIV-AIDS pandemic, which has wiped out large numbers of young adults, has created new responsibilities for the aged, as child-carers. The issue of the ageing of the rural population, the conference noted, had to be addressed by the developing nations through a range of innovative policy actions. Rural ageing will have implications for food security, patterns of land-holding, health services, labour markets and so on. However, older persons bring to their social and economic environments a wealth of skills, experience and wisdom that are enriching and irreplaceable, the conference noted.

Traditional perspectives on old age as a phase of dependency, sickness and lack of productivity have today been overturned. With better standards of health awareness and nutrition, the elderly are making vital contributions to their societies. The U.N. has put forward the concept of "active ageing" and has called for governments to put in place policies that will keep aged people active for as long as possible, with more opportunities, a supportive environment and a better life.