Honourable ministers, colleagues in the UN system, distinguished guests, ladies and gentlemen, demographic ageing is now a universal trend, affecting countries at all levels of development in every region of the world. By the middle of this century, the population of people aged 65 and older will outnumber children under the age of five for the first time in history.
Populations are ageing fastest in low- and middle-income countries. A transition towards an older society that took more than a century in Europe is now taking place in less than 25 years in countries like Brazil, China, and Thailand. This is a demographic revolution, and it is already in full swing.
Demographic ageing is accompanied by two other powerful and universal trends: rapid urbanization and an epidemiological transition in which chronic diseases have overtaken infectious diseases as the world’s biggest killers.
The consequences for health and economies are huge, especially when the demands of a disease like dementia are factored in. Some experts predict an apocalyptic future of disease, despair, unsustainable health care costs, and household debts as families are forced to sell assets in order to pay for elderly care.
WHO, with its emphasis on active ageing, has a different narrative that views older people as a massive human asset that needs to be tapped. Everyone wants older people to live, comfortably and safely, in their homes for as long as possible. Everyone wants to see older people, with their wisdom and experience, continue their contributions to society for as long as possible.
The best way to support this vision is to follow a life-course approach to prevention. Health services organized around universal health coverage provide the best platform for doing so.
Even with excellent preventive care, most older people will eventually experience health problems. These are overwhelmingly caused by noncommunicable diseases, often several experienced together.
Again, these needs are best, and most affordably, met by UHC, with its emphasis on people’s overall health needs instead of individual diseases.
Substantial research shows that older people do best when they participate in local life and have opportunities for social interaction. Very often, it is the built environment that is disabling, and not a disease.
Older people stay home, in self-imposed house arrest, because pedestrian lights do not give them enough time to cross the street, the bus driver takes off before they can sit down, or uneven pavement and high curbs increase the risk of falls.
In 2006, WHO launched its Age-Friendly Cities initiative to show how changes, often small, in the physical and social environment can help people age actively. That initiative has now become a movement, embracing more than 300 cities and communities that together cover nearly 120 million people.
Looking ahead, the challenge will be greatest in societies where care for the elderly has traditionally been provided by the extended family network. As societies have modernized, these traditional networks have been disrupted when children in rural areas migrate to cities, leaving their parents behind.
Thank you.