ENSURING FULL AND RIGHTFUL ROLE OF OLDER PERSONS IN
ILO and WHO Stress Scope for Making Needed Changes in Care Systems
(Received from a UN Information Officer.)
NEW YORK, 9 April (UN Headquarters) -- The rights of older persons and promotion of their full and rightful role in society, sustaining systems for social protection and inter-generational solidarity were among the issues raised during the general exchange of views as the Second World Assembly on Ageing continued its work in Madrid, Spain, this morning.
Felipe Paolillo of Uruguay said that those priorities were among the aims of the draft Plan of Action to be adopted at the closing of the conference. As Chairman of the Main Committee, which is charged with concluding negotiations on the Assembly’s outcome documents, he had seen that many experts negotiating the Plan of Action were young people. He took it as a message of hope for older generations. Older persons could be confident that their future was in good hands, in the hands of young people -- that is, in the hands of future older persons.
Ismail Amat, State Councillor of China, said that all countries should address ageing in line with their national conditions, take full account of the needs of older persons and incorporate ageing into their economic and social development programmes. Proactive measures to protect the rights of older persons and enhance their quality of life constituted an important responsibility of governments and societies worldwide.
Immediate action was required to improve the viability of social protection systems, Germany’s Federal Minister for Family Affairs, Senior Citizens, Women and Youth, Christine Bergmann said. Without fundamental reforms, many countries would find it impossible to ensure the sustainability of their pension systems. New pension legislation in Germany was based on the conviction that viable pension systems required a balanced and fair distribution between generations. Pension contributions should not overburden future generations, while providing an adequate level of income for those in retirement.
"We have more than fulfilled the International Plan of Action adopted in Vienna, ensuring the right of all citizens to a happy, active and secure old age", Cuba’s Minister of Labour and Social Security, Alfredo Morales Cartaya, said. Cuba proved that even with small resources, it was possible to achieve better quality of life for people. His country’s social policies guaranteed employment, education, health care, social security and stability for all. Those advances were only possible under the system of socialism.
Also addressing the Assembly, Gro Harlem Brundtland, Director-General of the World Health Organization (WHO) said that the challenge was to turn the seismic demographic shift into a full benefit for society. Evidence suggested that pessimistic predictions as far as health care was concerned were based on assumptions that health-care structures would simply remain as they are. In truth, there was considerable scope to change them. Among the questions to be addressed in that regard were prevention, changes in lifestyles and promotion of research and knowledge.
Juan Somavia, Director-General of the International Labour Organization (ILO) argued with the position that an ageing population would put additional burdens on social protection systems already struggling to provide health care, food, housing, work and education. While that was an issue that certainly needed to be addressed, it was truly important that for many people, living longer was accompanied by the desire to continue being useful to their communities. Achieving full employment was the best way to ensure reasonable welfare provisions and afford the guarantee of a pension when the time comes for people to leave active employment.
Also speaking this morning were Ministers from Austria, Gambia, Nepal, Barbados, Croatia, The former Yugoslav Republic of Macedonia, Denmark, Mongolia and Mexico, as well as the Deputy Prime Minister of Uzbekistan. The representative of Suriname spoke as well, as did a representative of Switzerland.
Statements were also made by the representatives of two non-governmental organizations, International Longevity Centre and Mensajeros de la Paz.
The Assembly will continue its general exchange of views at 3 p.m. today.
RUTH DREIFUSS, Federal Councillor of Switzerland: One of the achievements of the industrialized countries during the last century was to set up good social security services for old people. In these countries, old age is no longer a synonym for poverty. This does not mean we can sit back and think our work is done. On the contrary, we must improve what still remains to be improved and also cooperate with developing countries to help them set up an adequate system of social security for old people. Priority must be given to the problems of old people in situations of violence, armed conflict and forced migration, who are particularly vulnerable.
Switzerland shares the basic values on which the Plan of Action presented here is founded. It is essential that the basic needs of old people are covered, but it is also necessary that their fundamental rights are respected and that discrimination based on age and sex is eliminated. Bringing together the community and old people themselves to search for solutions affecting them directly is a true choice for society. In a multi-cultural society like Switzerland, where the number of foreigners is high, this means taking into account the specific problems immigrants face in their old age.
In the efforts made to face the challenge of an ageing population, women play an essential role. In most cases, after having brought up their children, they are needed to look after their parents or parents-in-law. They are often called on to look after their grandchildren too. They take on one duty after another, often exhausting themselves and finding it difficult to reconcile all their responsibilities. The role of women merits more appreciation and recognition, notably through setting up a specific old-age pension scheme.
ISMAIL AMAT, State Councillor of China: We have noted with joy that over the past two decades, efforts have been made to facilitate the implementation of the 1982 International Plan of Action on Ageing. With the rapid growth of the world’s older population, the issue of ageing is now looming larger than ever, particularly in developing countries. Under economic and social constraints, the basic needs of many senior citizens have not been met, and the quality of their life in not sufficiently high. The convocation of the Second Assembly is thus of great significance for further mobilizing the entire society.
All countries should understand and address ageing in line with their national conditions, take full account of the needs of older persons and incorporate ageing into their economic and social development programmes. Proactive measures are needed to protect the rights and interests of older persons and enhance their quality of life. This is an important responsibility of governments and societies worldwide. This is also part and parcel of the efforts to protect human rights. Within the framework of economic development and overall progress, the priorities of all countries should include poverty eradication and improvement of health services. Adequate attention should be given to older people’s cultural and spiritual needs. It is also important to promote extensive cooperation on ageing and provide adequate financing for activities on ageing.
As many as 132 million of China’s people are now over 60, accounting for more than 10 per cent of the country’s population. The Chinese Government attaches great importance to the interests of the older population. It has been working hard to implement United Nations resolutions on ageing and the Plan of Action adopted at the First World Assembly on Ageing. Among the measures undertaken in the country are the promulgation of the law on the protection of the older persons’ rights and interests and the five-year plan on the issues of ageing. The Government has been developing its social security system, advocating senior citizens’ participation in public welfare activities and bringing into play the talents of older people with scientific and technological expertise. Vigorous efforts have been made to improve community welfare services, health care, cultural and sports activities for older persons, and to further promote long-standing virtues of respect for older people and providing for them.
DILBAR GULIAMOVA, Deputy Prime Minister of Uzbekistan: Demographic forecasts suggest that in about 10 to 15 years the number of older persons in Uzbekistan will reach eight per cent of the population. This growth is due to improved demographic growth trends, which include a reduced birth rate, lower mortality rate, increased lifespan and improved medical services.
The problems of ageing and of older persons are always at the centre of the Government’s attention in Uzbekistan. The year 2002 was proclaimed the "year to protect the interests of older people" in Uzbekistan, which focuses on promoting the growth of family, social and creative organizations, strengthening social measures for older persons, strengthening care for pensioners and invalids, increasing security for older persons and improving the upbringing and education of youth in caring for parents and the older generation.
As part of that programme, various measures have been adopted to improve health care and prolong life for older persons, including the creation of a special gerontological service to treat older persons. A national gerontological centre has been created, with offices throughout the country. District hospitals are equipped with special geriatric departments, which use modern methods taking into account the particular requirements of treatment for older persons.
The Government has adopted a special programme to strengthen social support for older citizens, particularly food, pension and health security. It also provides older persons with free medicines, hearing aids, dental services and home care, so that they can, as far as possible, participate in an active social life and realize their spiritual potential.
HERBERT HAUPT, Federal Minister for Social Security and Generation of Austria: The revision and further development of the International Plan of Action of 1982 offers indispensable orientations and guidelines to respond to the challenges of the demographic revolution. Only if we can adequately assess the true dimension of future developments can we devise adequate strategies. Today, 20 years on, the revised Plan of Action establishes the important relationship between population ageing and the necessity of sustainable development. It focuses on the promotion of health and well-being over the life cycle, and demographic change is seen in the context of a policy for all ages. We welcome the fact that the revised Plan of Action also stresses the effective implementation of the objectives of ageing policies at all levels of government, in cooperation with non-governmental organizations and the United Nations system.
In Austria, ageing policies are more than just securing pensions or the health system. The Federal Senior Citizen Act of 1998 constitutes a first clear step for strengthening the participation and opportunities of older generations and provides for the funding of the activities of major organizations of older persons. The Federal Senior Citizen Advisory Committee was set up to put forward concrete proposals for the further development of policies for and with older persons. Due to an amendment to the Act, the Austrian Council of Older Persons was authorized to represent Austrian older women and men.
The International Year of Volunteers last year was a highly welcome support to our efforts to highlight the relevance of older persons for the well-being of the community. Voluntary work is indispensable not just for the community, but also offers older people who have retired a possibility to find a new source for self-realization. The demographic changes, with all their challenges for health and social systems, the pensions system, care and family policy, the economy and education, require a clear avowal of an active and positive design of the social framework. Demographic change is not a threat, but enriches our lives. Ageing in good health while leading a self-determined life and being fully integrated in society is a perspective we have to open up for an ever-increasing number of people.
ALFREDO MORALES CARTAYA, Minister of Labour and Social Security of Cuba: The ageing of the world population is a natural phenomenon, which affects everybody. The challenge is to ensure the quality of life for older people. While the countries of the North are getting closer to this goal, hundreds of millions in the South do not have the right to old age, and are suffering from poverty and poor health conditions. Wars do not kill hunger and disease, but they do kill the hungry and the sick. The world is now witnessing the escalation of the Palestinian tragedy, with the complacency of the United States and the silence of others. Cuba reiterates its support for the people of Palestine and demands action on behalf of the international community to halt the genocide.
The tragedy of those who cannot afford to get old is not the fault of the people in developing countries, but rather of those who colonized and plundered their countries and continues to do so. The problems of the ageing population for at least three quarters of humankind living in poor countries are exacerbated by the economic and social problems for which States are responsible. Effective global measures need to be applied to address the problem. It is not enough to gather together in order to adopt plans of action if there is no political will to implement them. We must close the gap between the rich and the poor and eliminate the gap between countries. Social policies should ensure fairness and a good quality of life for older people. It is necessary to cancel debt and create favourable trade conditions in order to allow poor countries to implement such policies.
Cuba, a small third world country, subjected to a criminal blockade, proves that even with small resources, it is possible to achieve better quality of life for people. In 2025, one fourth of the population of the country will be over 60. The social policies implemented in Cuba guarantee employment, education, health care, drinking water and electricity, social security and stability for all. Older adults benefit from the work of physicians and gerontology teams, as well as homes for the elderly and recreation groups. The majority of those living alone receive food and laundry services, as well as home cleaning and maintenance services. The entire population is covered by social services. The living conditions and care for the elderly are among the Government’s priorities. These advances are only possible under the system of socialism. We have more than fulfilled the International Plan of Action adopted in Vienna, ensuring the right of all citizens to a happy, active and secure old age.
YANKUBA KASSAMA, Secretary of State for Health and Social Welfare of the Gambia: In the last census, our population numbered 1 million people, some 68,197 of which were persons 55 years or older. The Gambia has one of the highest annual population growth rates -- some 4.2 per cent -- in sub-Saharan Africa. This is due in particular to high fertility rates, improved mortality rates and high levels of migration during the past few decades. Our health sector has made considerable gains in improving access to health services -- the primary health-care programme has made health services available to many rural communities, or nearly 60 per cent of our total population.
A draft policy on the elderly is being formulated with support from the World Health Organization (WHO). A recently revised health policy specifically and adequately addresses geriatric health-care issues. A national nutrition policy and a joint programme have been launched in order to improve our population’s nutrition and combat the spread of HIV/AIDS. The joint programme gives special emphasis to the needs of the elderly. We are also in the process of finalizing a strategy paper on poverty reduction that will also examine the situation of the elderly.
Such programmes are necessary since most developing countries are facing economic and social crises that will primarily impact the welfare of the poor and elderly. The small consolation for us, however, is that despite widespread poverty in the Gambia, family and community support systems have not completely disintegrated. We recognize that elder persons make innumerable contributions to their families, societies and economies. The notion that the elderly do not or cannot contribute to development is a myth. Support of the older generation is vital for the overall growth of our country, and in turn, they will need our practical assistance in providing moral support and care. The Gambia provides support to the extended family system, but it also encourages families to develop and nurture a culture of reciprocal assistance to enable all age groups to contribute to national development efforts.
SUSHILA SWAR, Minister for Women, Children and Social Welfare of Nepal: We need to understand the multitude of problems stemming from ageing in a given socio-cultural context before we can come up with any measures to cope with them. In Nepal, the problems are partly economic, partly social and partly cultural. Being a Hindu country, inhabited by a largely religious-minded people, Nepal’s problems with ageing may differ from those of many developed and transitional economies.
With a materialistic life style taking over many developing and developed societies, and with spiritual fabrics torn apart, family cohesiveness has been rapidly unraveling. In Nepal, the Vedic tradition still governs family values and older citizens are loved, revered and taken care of. However, with economic pressure increasing, youth are migrating across the border in search of work and the older population is left at home in rural hills. The in-laws consider them inactive, burdensome and passive recipients of support.
We believe we should develop a two-prong strategy to ease the lives of older people. First, we should work towards reviving the old values of family cohesiveness. Next, we need to work out a strategy for those who find living away from home less painful than living in the family. With these objectives in mind, the Government of Nepal came up with some concrete programmes in the so-called Ninth Plan, which aims to develop a family based security system. Under the Plan, the Government has begun distributing monthly allowances to older persons and has also set up separate geriatric words at all zonal hospitals. Recently, the Ministry of Women, Children and Social Welfare has drafted guidelines for implementing a new programme called Senior Citizen Treatment Service, which envisages offering the poor and sick basic health care, free of cost.
HAMILTON LASHLEY, Minister of Social Transformation of Barbados: In Barbados, older persons are seen as an integral part of the population. In its drive to create a society for all ages, the Government intends to move ageing from the periphery to the center of economic and social policies. The Second World Assembly on Ageing provides us with the opportunity to outline measures taken by our society in a comprehensive response to the current ageing process.
Barbados, with an average life expectancy for males of 72 years and 77 years for females, has the highest percentage of persons age 60 and over in the English speaking Caribbean, representing 15.6 per cent of the population. Older persons are a valuable resource, as the repositories of traditions, culture, knowledge and skills, attributes essential in maintaining inter-generational links. As the proportion of older persons increases, the demand for government and private sector programmes to meet their needs increases as well. The Government is already undertaking a programme of pension reform as a first step in response to those challenges. In order to provide equal opportunity and a better quality of life for the elderly, Barbados is developing a National Policy on Ageing, including: creation of a national machinery for older persons’ affairs; legislation to protect older persons against discrimination and abuse; and education and training.
Access to adequate housing is critical for sustaining the quality of life for older persons. Housing, however, must not be restricted to mere physical shelter: it must incorporate the physiological and social dimensions. Barbados will expand the provision of Senior Citizens’ Villages, offering both residential accommodation and recreational programming. There is universal pension coverage. The Committee for Older Persons undertakes a wide range of activities geared to improving the life of older persons. The Government is focusing on the issues confronting our ageing population and pledges its full commitment to creating an enabling environment with strategies and programmes geared to continue to improve the quality of life for elderly persons.
DAVORKO VIDOVIC, Minister of Labour and Social Welfare of Croatia: Croatia is among the countries facing a considerable increase in the number of older persons. The country is going through an economic transition and is facing massive damage caused by war. Older persons in Croatia mostly live in their homes and with their families. Only two per cent of persons over 65 years of age have been placed in institutions. Croatia has 46 homes for older and infirm persons founded by the counties, as well as 34 private homes. Centres for assistance and care are being established within the county offices for labour, health and social welfare. About 2,000 older and infirm persons have been placed in foster families, and the Government is encouraging the provision of services in day-care centres.
The Government is trying to ensure a responsible approach to the issue of ageing on behalf of authorities, families, individuals, associations and all other players, according to their tasks and obligations. The social welfare system functions on the basis of subsidies and community involvement. State assistance comes into play only when all other sources available to the individual and his or her family have already been exhausted. Under the legislation relating to the social welfare system, care for the elderly and infirm rests upon the principles of decentralization and privatization. The process of decentralization is to be concluded by the end of 2004.
To improve the quality of life of older persons, the Government, in cooperation with local communities, is promoting the process of de-institutionalization. Croatia is currently implementing a reform of its pension system and taking measures to improve its health care and medical insurance systems. Among its plans are further development of the non-institutional social welfare sector and care for the elderly by non-governmental organizations, religious communities and associations, as well as promotion of the positive lifestyles and social integration of older persons and their active participation in the society.
BEDREDIN IBRAIMI, Minister of Labour and Social Policy of The former Yugoslav Republic of Macedonia: The changes that occurred in the general population structure of The former Yugoslav Republic of Macedonia as a result of industrialization, urbanization, migration, economic transition and changes in the code of conduct and values have led to an in-depth transformation of the overall social and family climate. All this has negatively affected a number of groups, in particular the elderly, who have found it hard and painful to come to terms with those changes. The accelerated process of ageing is expected to continue and will cause grave problems to future demographic, economic, social and technological development.
The pension system in the country is comprised of three kinds of pension: age pension, disability pension and family pension. The system has established a form of so-called minimum pension, and provides the minimum standard for living. A process to restructure the system has been initiated to include a compulsory pension insurance, a compulsory capital financial pension insurance and a voluntary capital pension insurance. Health insurance is compulsory, and the system covers almost all categories of the elderly. Bearing in mind that the main form of treatment for the elderly should be health care in the home, efforts have been made to establish mobile services, well equipped with human and technical resources. Special training programmes in the areas of gerontology and geriatrics need to be organized.
Social welfare has been regulated in compliance with the Social Welfare Law and its target groups are the old and financially insecure people. Institutional welfare is implemented through four homes for the elderly, owned by the State. Although the Social Welfare Law provides legal opportunities for the development of non-institutional forms of protection for the elderly, protection in the form of the provision of home services is at its nascent phase. Pending reforms in social welfare are directed towards the decentralization and privatization of the current provision of services, coupled with support for the development of private initiative, with the involvement of non-governmental organizations (NGOs) and volunteers.
CHRISTINE BERGMANN, Federal Minister for Family Affairs, Senior Citizens, Women and Youth of Germany: The Vienna Action Plan was an excellent document that was ahead of its time in 1982. Hopefully, the Madrid Assembly will adopt a new action plan that will provide a global framework for a policy response to demographic change -- one of the major challenges for the twenty-first century. In follow-up to Madrid, the United Nations Economic Commission for Europe will hold a ministerial conference in Berlin next September, which is expected to adopt an implementation strategy focusing on regional dimensions and aspects of population ageing.
The magnitude of the demographic change requires attention to all aspects of the problem and calls for integration of the ageing issues into all policies and programmes. Immediate action is required to improve the viability of our social protection systems. We should be aware of the fact that without fundamental reforms, it will be impossible to ensure sustainability of our pension systems in the long run. The new pension legislation in Germany is based on the conviction that viable pension systems require a balanced and fair distribution between generations. Pension contributions should not overburden future generations, while providing an adequate level of income for those in retirement. We need active strategies for ageing in the work place, which would encompass teamwork in mixed-age groups and personnel policies aimed at sustaining inter-generational balance. There is also a growing need to create new employment opportunities for all ages.
We need to promote health and well-being of all people throughout their lives. Being part of a continuum of health care, long-term care insurance in Germany is perceived by the majority of people as a highly successful scheme. Cooperation between all participants is crucial in the planning and management of our health- and care- systems in order to ensure equal access to high quality services while maintaining financial viability of the system. Our ageing societies also require efficient and comprehensive educational system, which should facilitate learning and acquisition of additional qualifications in the course of life. No individual should be denied an opportunity to contribute to social and economic development. Older persons also play crucial roles in families and should remain an important asset within society.
HENRIETTE KJAER, Minister for Social Affairs and Gender Equality of Denmark: The full protection and promotion of fundamental human rights is a priority for all, regardless of age. Men and women must have the same opportunities and enjoy the same quality of life during old age with regard to health promotion, social protection and the right to work and to leisure as they wish. Special regard, however, should be given to older women because of their situation and longer life expectancy. The very old are not a homogeneous group, but a group with different individual needs.
Of major importance is the question of how to organize a policy for older people in which participation and co-determination are cornerstones. Older people should never be regarded automatically as weak just because they are old. They have resources and can contribute to society in a positive and constructive way. In Denmark, older people have a say on their own issues through senior citizens councils established at the local level. This system helps provide a constructive debate, together with older peoples’ organizations, which are quite strong in Denmark.
Activation, co-responsibility and the use of older people’s own resources are key words in ageing policy. The view that older people are automatically regarded as ill or weak shall never dominate. I hope, therefore, that this Assembly will send a clear signal for older people to participate more directly in decision-making procedures.
SHIILEGYN BATBAYAR, Minister for Social Welfare and Labour of Mongolia: Since the first World Assembly on Ageing, the issues of older persons have been taken into serious consideration in Mongolia, and we have achieved some positive results. Notably, we have focused on creating a legal environment for issues about older people. Those issues are reflected in Mongolia’s Constitution, labour code, law on health, law on pensions and benefits from the social insurance fund, law on health insurance for citizens and the law on social welfare.
Mongolia has a tradition of extended families and children taking care of their parents and the elderly. The intensification of internal population migration from rural to urban areas in the past few years, especially the migration of youth, is becoming a challenge for Mongolia. Older people, whose children have moved to urban areas, are usually left behind in the countryside without the support of family members. That issue must draw our attention and measures must be taken to resolve it.
According to population estimates, older people aged 60 or more will be increasing by 50 per cent over the next 25 years. Although Mongolia is considered a country with a young population, changes in age structures have already started. However, efforts by the Government are not sufficient to solve every matter concerning older people. Therefore, it is vital that the Government cooperates with national and international NGOs, the private sector, research institutions, public and international organizations. Thus, one of our significant goals in this era is to obtain world assistance for the development of the country.
ANTONIO SANCHEZ DIAZ DE RIVERA, Vice-Minister, Ministry of Social Development of Mexico: The Second World Assembly on Ageing represents an invaluable opportunity to build bridges to create a society for all ages. Mexico is now experiencing profound changes, consolidating its democracy and seeking to reduce inequality, eliminate extreme poverty and create opportunities and favourable conditions for all of its population.
The Government has implemented a "Contigo" strategy of human development, which is based on the partnership between the State and society. Aimed at the formation of individual resource bases and generation of opportunities for all, it provides for the integration of all aspects of social development and addresses the needs of individuals throughout their lives. It incorporates the social security and protection system and addresses the needs of the disadvantaged groups of population. The need for low-income homes, high rates of illiteracy and poor health services are among the challenges faced by the country. In order to meet them, the country envisions creation of a comprehensive social development system geared, at promoting active ageing.
Ageing means unprecedented challenges all over the world, and Mexico has been working actively for the success of the Assembly. Within the framework of international cooperation on the subject of ageing, Mexico wants to propose a campaign, headed by the United Nations, for the eradication of stereotypes and promotion of a positive image of old age. At the recent conference in Monterrey, President Fox of Mexico affirmed that the twenty-first century should become a century for all. The Declaration and the Plan of Action to be adopted by the Assembly should contain concrete actions and definite mechanisms for reaching international goals in this respect.
FELIPE PAOLILLO, Uruguay: We are witnessing a revolution, global in scope, a silent revolution which will have the greatest impact on the destiny of mankind in the twenty-first century, namely the rate at which the world population is ageing. The phenomenon also poses challenges to which we must respond with intelligence, responsibility, sensitivity and imagination. The changes in population trends since Vienna 1982, as well as the changes foreseen in the structure of population, have compelled us to update the response of 20 years ago. Generations of older persons are living now in a very different world, characterized by globalization, in a world in which we still see the unsustainable coexistence of prosperous and poor societies. A key element is the fact that in developing countries the process of ageing has intensified at a rate unforeseeable 20 years ago.
Uruguay, the country with the oldest population in South America, has been confronting such problems for some time. Persons of 60 years and older comprise 17.4 per cent of the total population. A growing percentage of these persons live alone and most of them are women. In Uruguay, there is a well-developed regulatory framework related to ageing, such as laws providing housing to pensioners, tax exemptions, discounts for transport and cultural events. All that is expensive for the country, representing 17 per cent of its gross domestic product. Uruguay also has a wide network of services for older adults to promote integration in the communities. There is also a broad cooperation with civil society and NGOs.
Our elders represent a bond between the present and the past of all of us. The great challenge ahead is to offer all ageing persons a society in which they can develop their human potential. It is imperative that all countries coordinate their efforts, keep their promises and develop a political will to solve their problems. The Plan of Action is aimed at ensuring the rights of older persons and at developing their rightful role in society, their participation in society, job opportunities, training, inter-generational solidarity, among other things. As Chairman of the Main Committee, I have seen that many experts negotiating the Plan of Action are young people. I take this as a message of hope for older generations. Older persons can be confident that their future is in good hands, in the hands of young people, in the hands of the future older persons.
HEIDI WIRJOSENTONO, Suriname: Our population is multi-ethnic and multi-linguistic. The major groups, living in peace with one another in the urban areas, are from all parts of the world -- a reflection of the United Nations. About half of the population is above 60.
Because of the multi-ethnic nature of our society, the situation of older persons depends on the cultural group to which they belong. They are often part of the family, where they play an important role in the upbringing of the grandchildren. Their opinion is of great importance in family decisions. Research has shown that older persons believe their children must take care of them if they become old. In Suriname, they prefer, however, to function independently as long as possible in their familiar environments. They assume that they will lose their independence in a home for older persons.
At the moment, the Division of Research and Planning in the Ministry of Social Affairs and Housing in Suriname is preparing a national survey on the living conditions of older persons. A survey about the quality and care demand in homes for older persons has already been conducted. The Government will work on strategies for implementing proposals from the annual policy for older persons, such as health care, living conditions, recreation and the financial position of older persons.
JUAN SOMAVIA, Director-General of the International Labour Organization (ILO): The main reason for this World Assembly is to celebrate one of humanity’s great successes: the increase in life expectancy of men and women. This is our new reality, and I believe we can all agree that the gradual ageing of the population marks a radical change in the human fabric of our societies.
There are four crucial issues to address. The first is that because the useful life of individuals has been extended, we are presented with a great opportunity, not an intractable problem. We often hear that an ageing population will put additional burdens on social protection systems already struggling to provide health care, food, housing, work and education. While that is an issue that certainly needs to be addressed, what is truly important is that for many people, living longer is accompanied by the desire to go on being useful to their communities. Older people represent an accumulation of human wealth and vast potential which can obviously contribute to creative solutions to many of the problems facing us today. As repositories of knowledge, values and wisdom, they play a decisive role in passing on cultural heritage from one generation to another. Sadly, we have begun to divorce ourselves from the way the elderly look at the world. Senior citizens are now seen as a "burden" to be shed at the earliest opportunity. This has to change.
The second critical fact is that growing old cannot be considered in isolation. It must be approached through integrated policies that can help people throughout their lives and contribute to strengthening the family. Poverty and exclusion affect older people to a disproportionate degree, and at the centre of a vision to solve that problem lies the family. We must, therefore, promote policies to strengthen families as the fundamental unit of all societies, with special consideration to single-parent families. Thirdly, full employment in decent working conditions is a viable and productive way to meet the challenges of ageing. The ageing of the population presents us with real public policy dilemmas. Countries face serious problems in terms of the viability of pension schemes, public expenditures and health-care systems. I believe, however, that we should put greater emphasis on economic growth and sustainable development, designed to provide a positive response to population ageing and focus on creating enterprises and decent work. The promotion of full employment is the best way to ensure reasonable welfare provisions and afford the guarantee of a pension when the time comes for people to leave active employment.
Fourthly, the chance to prolong one’s working life is a promising alternative for society and deserves to be an option for older persons who wish to do so. Retirement should not be brought forward artificially without taking individual circumstances into account. It is important to ensure that older people have the opportunity to pursue productive activities, whether paid or unpaid, which keep them connected and provide them with a sense of usefulness to society.
GRO HARLEM BRUNDTLAND, Director-General of the World Health Organization (WHO): We are here to celebrate one of humanity’s greatest achievements and face one of its greatest challenges: the increasing ageing of the general population. Our celebration is of an average increase in life expectancy by more than 30 years over the last century. Our challenge is to turn this seismic shift into a full benefit for society. It will demand tremendous changes in the way we organize our workplaces, our living arrangements and our concept of care for those who cannot live on their own.
There is very limited evidence about what effect the growing number of older persons will have on our health systems. This is particularly true for developing countries. In rich countries, the number of people over 65 who will require medical care is expected to increase between 50 and 120 per cent form 1995 to 2050. Not only is the number of aged people rapidly increasing, but health expenditures per person per year will increase correspondingly. People older than 75 accounted for nearly 30 per cent of total health expenditures, despite comprising only 5 per cent of the population. Without changes in the structure and priorities of our health system, it is likely that total health expenditures for the aged will rise rapidly.
In truth, there is considerable scope for change in our health systems. The first and most important is to invest in prevention and early detection. In people over 65, health expenditures are 7 times higher among the chronically disabled. With reduction in tobacco use, improved screening and early treatment of cancer, and development of new genetic risk-detection methods, we may be able to drastically reduce the need for treatment and care for people over 65. We must not only look at lifestyles, but also at the genetic detriments, using our knowledge to predict and counter the likely burden of disease. The frontiers of biological ageing and what we can learn from it in maintaining high levels of health have only just begun to be explored. We must also reorganize the way we provide care and treatment.
Overall, the greatest challenge lies in the developing world. To contribute to the process of change, we have been developing with partners a contribution to this Assembly -- a new policy framework called "Active Ageing". We want to stress that healthy ageing includes more than the mere absence of disease. Our goal is that everybody can enjoy a good quality of life and have a recognized role to play as full and useful members of society. Many of the major determinants of better health lie outside the health system: knowledge, clean environments, access to basic services, equitable societies and fulfilled human rights. For individuals to enjoy health in old age and societies to reduce the burden of caring for those who are chronically ill, we need to adopt a life-course perspective. That means beginning with today’s children, with the young and those just reaching middle age.
ROBERT BUTLER, Chief Executive Officer of the International Longevity Centre: As a physician and gerontologist, I welcome the revolution in longevity. I do not agree with the doomsayers who express grave concerns about the consequences of population ageing. After all, in the twentieth century, we have already provided social protections and medical advances that have reduced disability and advanced the quality of life.
The revised Plan of Action should advance productive, active, healthy ageing and expand research and development to ameliorate or eliminate dementia and age-related diseases. The Plan of Action should enforce the human rights of older persons and work to end inequalities in longevity and health disparities within and among nations. In the era of globalization, healthy, productive citizens of the world are in everyone’s best interest. Further, we simply must meet the needs of the developing world for developmental and humanitarian reforms. We must expand social protections and eliminate poverty. For the sake of our children and future generations, we must transform the character of long life and build a philosophy of longevity that offers meaning and purpose.
Accomplishing these aims requires a new international agency not only supported by governments, but also by industry, civil society and all individuals. Such a public-private partnership dedicated and funded by these partners is necessary to implement the strategy of the United Nations Second World Assembly on Ageing and the revised 1982 Plan of Action. There should also be a Madrid +5 to see what has been accomplished and to make necessary adjustments.
ANGEL GARCIA RODRIGUEZ, President of Mensajeros de la Paz: Those who have families and those who do not live in large cities or rural areas all feel loneliness, but older persons are especially at risk. The percentage of lonely people grows almost geometrically with age.
Our Association has a help line that has received 5 million calls from people suffering from loneliness. Some are desperate calls to escape anxiety, but most are to relieve loneliness. This help line receives calls every day just to say good morning or good afternoon. Older people feel alone because we have left them alone and they feel lost. In losing their capabilities, their dependency increases, but no one cares for them.
Older persons can live with poor pensions or with aches and pains, but not without love. Doctors have a difficult time classifying all the pains of old age, but the good ones know that most die of loneliness. Mother Theresa used to say that AIDS or leprosy is not the worst misery, but that feeling alone is. Loneliness kills, but friendliness and love can help older persons. Since our Association favours birth and opposes abortion, we do not agree with euthanasia. We support the "Group 77" developing countries and China proposal to establish an international body similar to the United Nations Children’s Fund (UNICEF) to help and deal with issues of the older generation.
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