Author’s name | November 17, 2008
"The global ageing century: challenges &
opportunities"
Silvia Stefanoni
Interim Chief Executive Officer
HelpAge International
2 | HelpAge International | Presentation title | Author’s name | November 17, 2008
The Century of Ageing
•
The 21st century is the century of ageing –
“The new millennium closes the first chapter in human
history: when we were young”
(Paul Wallace: “Agequake”)
•
Life expectancy is extending worldwide, fertility
rates are falling, and ageing is accelerating.
“The ageing of humanity across the world is a defining
stage in history. It will change everything from
business and finance to society and culture”
(Wallace)
Author’s name | November 17, 2008
Demographic transition
• In 2009, the global number of older people passed 700
million.
This is projected to be 2 billion by 2050. Already two-thirds live
in low & middle income countries
• In the “more developed” regions over 20% of the population is
60+. By 2050, nearly 33% of the population is projected to be in
that age group
• In the “less developed” regions, older people account today for
8% of the population; by 2050 they are expected to account for
over 20%
Author’s name | November 17, 2008
Longer lives everywhere…
Author’s name | November 17, 2008
The future that’s here already
18
16
% of population
14
12
10
8
6
4
2
0
1950
1960
1970
1980
Older people
1990
2000
2010
Young children
2020
2030
2040
2050
6 | HelpAge International | Presentation title | Author’s name | November 17, 2008
The poorest and the oldest
•
The pace of population ageing is fastest in
low- and middle-income countries
•
The population of older people is itself
ageing. Among those aged 60 years or over,
the fastest growing population is that of the
oldest-old, those aged 80 years or over
7 | HelpAge International | Presentation title | Author’s name | November 17, 2008
Asia has the largest, fastest growing older population
700
600
500
1950
1990
2025
400
300
200
100
0
Oceania
Nth
america
Sth
america
Africa
Europe
Asia
Author’s name | November 17, 2008
Why global population ageing matters
“Despite the…evidence, the significance of population aging and its global
implications have yet to be fully appreciated. Preparing …for longer lives and
finding ways to reduce age-related disability should become national and
global priorities. For nations, as for individuals, it is critical to address
problems sooner rather than later. Waiting significantly increases the costs
and difficulties of addressing these challenges”.
Paula J. Dobransky, Under-Secretary for Democracy & Global Affairs,
U.S. Department of State 2007
Author’s name | November 17, 2008
10 | HelpAge International | Presentation title | Author’s name | November 17, 2008
A demographic dividend?
By 2020 the Asian “economic miracle” will still be driven by
demographic change
•
High rates of investment and saving will continue…
•
…highest possible numbers of “working-age” adults in e.g.
India & China
•
…resources which had been used to bring up children will be
free for saving
11 | HelpAge International | Presentation title | Author’s name | November 17, 2008
A demographic dividend
•
By 2030 – will the “Asian demographic
window begin to close” as many in
work-forces in a number of countries
enter their sixties?
•
Countries in East Asia & Latin America
will experience rapidly ageing populations
with changing economic needs, changing
health status
Author’s name | November 17, 2008
An older workforce?
•
Already millions work into old age–
especially in low-income countries.
These numbers are likely to
continue to grow
•
Much of this work is unpaid or
poorly paid & the challenge is to
provide “decent work”
Author’s name | November 17, 2008
Ageing & health
A key priority for older people in low- and middle-income
countries
•
Many poor people enter old age in poor health – lifetimes of
physical labour, poor diet and environments, multiple pregnancies
•
Health services are rarely “age friendly” –
physically inaccessible
health providers have low levels of relevant knowledge
attitudinal barriers especially where resource are scarce
Author’s name | November 17, 2008
Epidemiological transition
• In low-income countries - a shift from infectious diseases, poor nutrition &
hygiene to chronic diseases
• Rapid health gains of 20th Century due to new drugs & technologies have
been difficult to sustain in low-income countries
• More limited progress in clean water supply, sanitation and basic
education
• “Double burden” in many countries - both communicable and noncommunicable disease
Author’s name | November 17, 2008
Health systems & ageing
•In low-income countries health systems,
established in times of high fertility and low
population growth, focussed on mother &
child health
• Focus on reproductive healthcare &
concerns about HIV & AIDS
• Curative services have been prioritised limited services for older people
• MDGs very influential – health targets are
on M&CH & combating HIV & AIDS + other
infectious diseases (TB & Malaria)
Author’s name | November 17, 2008
The rising demand for care
•
Rapid growth in the number of the oldest
old
•
Increase in labour force participation by
women & growing migration
•
Attitudes to care-giving show signs of
changing
•
In 2010 an estimated 35.6 million people
are living with dementia – this is projected
to double every 20 years, reaching 115.4 m
in 2050
Author’s name | November 17, 2008
Why this matters
Long-term chronic illness and the need for long-term care have major
impacts on
individuals and households
psychological stress – for older people and caregivers
economic burden – producers become consumers of care
societies and economies
loss of productivity, lost development
18 | HelpAge International | Presentation title | Author’s name | November 17, 2008
Chheut (68) has been looking after five
grandchildren. Four are the children of his son and
daughter in law, who died about four years ago.
“People said it was AIDS”.
“ In the past my wife would help. But she needed
to work and the only job she could get was near
the Thai border.” He still grows crops on his
remaining land. “and all the children have never
stopped going to school.”
“During Khmer New Year and at spiritual
ceremonies his sons visit, and if they can’t come
they send money. I had thought that I would give
them all my assets – land, oxen and ox carts. But
they say don’t worry about passing on the
assets.”
Chheut, 68, Battambang Province,
Cambodia
(c)Jon Bugge /HelpAge International
19 | HelpAge International | Presentation title | Author’s name | November 17, 2008
Ciprian, (77) a farmer in Peru. “I am
one of the lucky ones. I worked in a
government factory for 28 years.
Now I receive a small pension and
my wife and I also have health
insurance”.
“But even with our pension it is
difficult to make ends meet. Rice has
gone up three-fold just in the last 6
weeks. My wife and I work in our
small field seven or eight hours every
day to grow vegetables to
supplement our diet. The pension
doesn’t cover our living costs like
electricity”.
“My other children have moved to
other parts of Peru & find it hard
enough to survive without supporting
us”.
Author’s name | November 17, 2008
Opportunities in the ageing century
•The world has never been more able to afford
financing solutions
•Health promotion and disease prevention at all ages
•Accessible and appropriate health & social care
•Social protection – the “social floor”
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The global ageing century: Challenges & opportunities