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10/1/2020

International Day of Older Persons Responding to COVID-19: Building a Better Future

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​As we mark the  75th anniversary of the United Nations, our last two  blogs focused on the challenges to multilateralism. At the same time, debates at the United Nations General Assembly   revolved  around the Sustainable Development Goals, Climate Change, Financing  for Development, Gender Equality  and COVID-19.  As we write this week’s blog,  it is important to highlight that October 1  marks the 30th anniversary of the International Day of the Older Person. The United Nations General Assembly has taken the opportunity to promote the Decade of Healthy Aging (2020-2030) which highlights the process of developing and maintaining  the functional requirements that enable wellbeing in older age. The realities of living in the era of COVID-19 have  brought the reality of ageing to the forefront of the national and international agendas. 
 
The Demography of Ageing 
 
A paper prepared for the 146th WHO Executive Board in February 2020,  revealed some interesting statistics. It  showed that populations around the world are ageing at a faster pace than in the past and that this demographic transition will have an impact on almost all aspects of society. It illustrated more specifically  that between 1950 and 2010, life expectancy worldwide rose from 46 to 68 years; that there were 703 million persons aged 65 or over in 2019; that  Eastern and South-Eastern Asia was home to the largest number of older persons (261 million), followed by Europe and Northern America (over 200 million). It is also projected that over the next three decades, the number of older persons worldwide will  more than double, reaching over 1.5 billion persons in 2050. It is to be noted that all regions are estimated to  see an increase in the size of the older population between 2019 and 2050. The fastest increase in the number of older persons is expected in Northern Africa and Western Asia, rising from 29 million in 2019 to 96 million in 2050 (an increase of 226 per cent). The second fastest increase is projected for Sub-Saharan Africa, where the population aged 65 or over could grow from 32 million in 2019 to 101 million in 2050 (218 per cent).  ECLAC projected  for the Caribbean that between 2015-2035 persons aged 60 and over will increase by 1.1 million (13 percent of the population)  to 2 million (22 percent). At the same time, low and falling fertility rates will continue to reduce the number of young people.
 
The COVID 19 Intervention 
 
COVID-19 threatens to reverse the progress of the Sustainable Development Goal (SDG) 3, which aims to ensure healthy lives and wellbeing for all. According to  the  UN Report on COVID -19 (September 2020),  70 countries halted childhood vaccination programmes, and in many places, health services for cancer screening, family planning, and other non-COVID-19 infectious diseases have been interrupted or are being neglected. The report warns that health service disruptions could reverse decades of improvement.  Allowing people to slip through these service gaps could affect population health for years to come. 
 
 
COVID-19 has laid bare  the urgency for addressing  the human rights of older persons.  The figures from AARP Foundation Report (September 2020) show that worldwide   8 out of 10 older persons with coronavirus risk dying; 94% of deaths from COVID-19 were older adults of which 40% were in long term care. With respect to long term care, the risks are essentially associated with under-staffing, lack of training of staff,  lack of PPEs, and control protocols;  and within hospitals and medical facilities,  by the challenges of triaging ventilators in short supply. These structural inadequacies are compounded by greater risk of  isolation of older adults with traumatic mental and psychological consequences. They are also faced with discrimination based on lack of security and protection from abuse.  An overall human rights concern  is reflected in age based restrictions on   the movement of older people,  whether mandatory as in Columbia  for those over 70 years or perfunctory as in Jamaica for everyone over 65 years.     ILO adds yet another dimension to the human rights. agenda  by illustrating the intersection between ageing and gender with women being in the majority of the ageing adults  without jobs, and 63% without pensions are women.  What is often neglected  is the contribution made by  the older adults as frontline workers whether as medical personnel including retired doctors or generational self-help like food preparation and distribution.  
 
Conclusion: Build the Future Better to include Older people 
 
During the UN General Assembly  this week,  a new slogan -- Build the Future Better-- emerged as a clarion call. It is premised on strengthening multilateralism by placing global alliances ahead of  nationalism to tackle the many challenges associated with the Sustainable Development Goals (SDGs).  Jamaican Prime Minister, Andrew Holness who  with Canadian Prime Minister, Justin Trudeau, was joint chair of the UN Panel called  for a Marshall Plan in response  to the immediate crisis caused by COVID-19 and  securing a global recovery that is based on strengthened resilience, and transitioning over the long-term to green, inclusive and sustainable development.  As part of this overarching approach to multinationalism  HelpAge International is promoting   the UN Convention to Protect the Rights of Older People.   
 
In the buildup to the Convention it is important to recall the “Year of the Nurse and Midwife” celebrated  earlier this year,  as we highlight the role  that health care workforce must play in contributing to the health of older persons.  And in so doing, special recognition is given to  the nursing profession, and a primary focus on the role of women - who are relatively undervalued and in most cases inadequately compensated. We recognize too, that older people must be involved in shaping the framework and implementing the elements of the Convention.  In this way,  a charter on the human rights of older people will indeed contribute to Building  the Future Better.  
 
 
Eddie Greene 
 
 

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4 Comments
Damian E. Greaves
10/2/2020 05:59:49 am

This is certainly a very serious situation given that in our region, the Caribbean, our health and social systems are seemingly unprepared to handle the tsunamic effect of the situation that you have most elegantly described above. This suggests that there must be an urgent attempt to manage our health systems better, both in this current period and in the future. I think that there is also an urgent need to redouble our efforts to ensure greater integration of our health and social services given the likely prospect of the multiple morbidities that will be experienced by our elderly population and the absence of a human rights approach to their care.

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Leith Dunn
10/2/2020 09:45:52 am

Many thanks Eddie. This is an excellent resource; very informative and timely. I've shared it with academics, postgraduate students, policy makers and advocates for the rights of older persons. Very valuable for SDG5.4 on valuing unpaid care work. Keep up the good work!

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Patricia Mohammed
10/2/2020 11:37:12 am

This is both a welcome and timely initiative -the COVID pandemic has heightened what was already a problem that has increasingly surfaced in countries such as those in the Caribbean who have depended largely on female family care for the elderly and infirmed. Without associating ageing only as a deficit associated with ill health, there are obvious institutional responses that need to be made to both promote healthy ageing as well as facilitate those who need continuous healthcare.

The recently published book Connecting the Dots: Work Life Balance Ageing, (Editors Patricia Mohammed and Cheryl Ann Boodram, Ian Randle Publishers, Kingston, 2020) though based on research carried out from 2015 anticipated many of the issues that the pandemic foregrounded globally.

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Sunanda Ray
10/4/2020 11:52:52 pm

"The second fastest increase is projected for Sub-Saharan Africa, where the population aged 65 or over could grow from 32 million in 2019 to 101 million in 2050 (218 per cent)." Although this rise can be attributed to an increase in total numbers, also reflecting higher birth rates from past decades, people over 65 years still form around 5% of the total population of SSA. Roughly half the population is under 19 (median age). What we have to remember is that small percentage of people are often maintaining extended family homes in rural areas, are the main care-givers for younger children, and are the ones who keep the stories and narratives of communities alive. They enable young parents to continue to be economically productive, and should be valued as such.

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    Edward and Auriol Greene Directors, GOFAD.

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