Older Persons
&
the Right to Health
Astrid Stuckelberger, PhD
Institute of Global Health
University of Geneva
The Paradox
 Population Ageing in Europe and the World (N+%)
 GBD and chronic disease = Ageing Population
 4-5 Generations of 2-3 Generations of Older Persons
vs
No Human Rights of Older Persons at UN
No Right to Health of Older Persons at UN
only very few fixed r-marked positions on ageing
No ethical framework
The Right to disease, degeneration, dependency…
The «Neglect Syndrome»
(Prof. Moulias et al., IAGG-ER, 2012)
Complexity of Concept
Right to Health & Older persons
What is the Right to Health in Old Age?
What is an Older Person?
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Administrative
Biological
Socio-Generation
Politically
Economically
Culturally
What is Health at Old Age?
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Active physically
Active mentally
Preventive measures
Healthy lifestyles (25% genes)
Good personalized nutrition
Toxic free environnment
Contribution to Society
Right to Health in Old Age = Availability, Accessibility,
Acceptability, Affordable, Adaptable, and Quality
Right to Health of Older Persons
What is specific?
A long range of specific evidence-based right to health conditions and situations :
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Right to health (UCH) and social security
Right to long life health at work
Right to adequate housing
Right to long life reproductive health
Right to access to health care (preventive, curative, LTC and palliative)
Right to adequate management of mental health and chronic diseases (reversibility)
Right to rehabilitation care (technology)
Right to safe medicine and treatments (ADR)
Right to evidence-based specific screening, food and treatment
Right to professional health care (geriatric medicine)
Right to health literacy and ICT literacy (adequate and correct information)
Right to adequate and non discriminative health and treatments
Etc…
”The right to health is an inclusive right, extending not only to timely and appropriate health care, but also to
the underlying determinants of health, such as access to safe and potable water and adequate sanitation, healthy
occupational and environmental conditions, and access to health-related education and information, including on
sexual and reproductive health.” (OHCHR)
Right to Health of Older Persons
Beside OHCHR and WHO
What UN agencies are concerned?
Linked to ageing conditions
 ILO =Right to long life health at work
 UNFPA, UN Women = Right to long life reproductive health
 UN Habitat, UNDP, UNEP = Right to access to health care, sanitation, developement
 FAO, WFP = Right to evidence-based specific screening, food and treatment
 Right to ITU, UNESCO  Right to health literacy and ICT literacy
Linked to specific situation of older persons
 Older refugees = UNHCR
 Older migrants = IOM
 Older worker = ILO
 Older poor = World Bank
 etc
The Solution: paradigm shift
Multidisciplinary expert teams
From engineering health to treating it
From health promotion and prevention to palliative care
From young age to end of life
The «Prejudice Syndrome»
going from the Right to disease to the right to health
Importance to have scientific evidence and new modelisation of ageing
Reversibilty vs degeneration and unavoidable decline
Deficit screening cured with personalized nutrition and food supplements before disease
NEW MODELS AND SCIENCE OF AGEING
Example: Recommandations made at CSW 2012
Rethinking Right to Health of Older Women with no discrimination
Theoretical - methodology
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New model of ageing – against ageist medicine and health care,
with innovation and echnology for prevention
Older person’s Right to Health modeling based on scientific and medical evidence
Data disaggregation by higher ages and sex
Practical
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Individual empowerment to realize their Right to Health and combat a LL deficit
Family & commmunity empowerment – e.g. training for age specific health care, ToT
Political - Structural
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Putting old age and older women on the agenda (e.g. special rapporteur, item, wording)
Institutional & Policy Section for older women
Evidence-based policy and expert networks, ethical framework in research and end-of-life Q
Role of the Science of Healthy Ageing
Fundamental to the Right to Health of OP
 Evidence vs generalization and prejudice
 Complexity of ageing and cofounding factors
 Non biais evidence and interpretation of data
 Constant reality-check in the face of S&T progress
 Bridge between NGOs and Policy-makers
Filling the gap of the UN Agenda on
Older Persons Rights and Right to Health
OHCHR  more visibility and access to information on older persons’right
All bilateral UN documents and agenda (including HRC agenda)
3 examples of important upcoming events in 2015 :
MDGs review and post-2015
UN Conference on Sustainable Dvt (SDGs), Paris  Health
UN Women Conference  Reinforcing the Beijing Plateform of
Action Older women mentioned once, no life course perspective.
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ICPD 2014: reproductive health and rights at all ages = the most sensitive aspect which clashes with
conservative views of women’s role
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CEDAW: for the first time recommendation on older women