Ageing
In 2015, the number of people aged 60 years and over (‘older persons’) worldwide was estimated to be about 900 million. The size of this age group is expected to grow to 2 billion by 2050. Furthermore, the current estimated number of people aged over 80 years is about 125 million. And this specific age group is estimated to grow to about 434 million by 2050, with about 120 million people living in China alone. Importantly, by 2050, 80% of all people aged 60 and over (about 1.6 billion) will be living in low- and middle-income countries.
Background
Coupled with the growth in the size of the age group of older persons, many of the low- and middle-income countries are also experiencing a faster pace at which their populations are ageing than what happened in high-income countries. That is, while some high-income countries took one hundred or more years to double the size of their older population, some low- and middle-income countries will do the same within the next 20 to 30 years.
The increasing number of older persons nationally and globally, as well as the pace at which the size of the group is growing has been described as ‘population ageing’. Underlying these major demographic shifts is the fundamental and extraordinary human achievement of extending our own life spans. These extra or more years of life, however, are unevenly distributed within and across countries. And the demographic shifts have profound implications for each of us, for the societies we live in, as well as global institutions, processes, and international relations.
Living longer is generally a valuable aim for most people. Yet population ageing raises many issues about the right or just social and global responses. So far, social policies and national debates related to population ageing have focused largely on healthcare and economic policies. Ageing-related health problems such as dementia, physical and mental abuse, long term care, and intensive use of healthcare at end of life are some issues identified as needing better social policies. Some economic issues being debated include mandatory retirement age and working conditions for older persons, sustainability of pensions, inheritance taxes, and old-age poverty. But individual and population ageing should not be synonymous with ill-health, nor loss of productivity or lack of contribution to society.
Throughout the world, older persons lead active lives and contribute to society in many ways –within their family, to their local community, and to society more broadly. In addition, much of the published academic and policy literature on ageing, and particularly on the social ethics related to ageing, have largely reflected the views and experiences in high-income countries. And, their relevance to low- and middle-income countries have remained unexplored.
2015 World Report on Ageing and Health
In 2015, the WHO produced a World Report on Ageing and Health in which it conceptualized healthy ageing as the process of developing and maintaining the functional ability that enables wellbeing in older age. Functional ability is made up of a person’s intrinsic capacity combined with external conditions and the interactions between the two. The functional ability concept is informed by a variety of health and social science disciplines as well as a philosophical and ethical theory of human wellbeing called the Capability Approach. Initially developed by Nobel Laureate Amartya Sen, and further extended by eminent philosopher Martha Nussbaum, the Capability Approach argues that a person’s wellbeing and quality of life should be evaluated according what they are practically able to be and do thing they value, in their contexts of daily living. Moreover, Sen argues that the capability concept should be understood as a kind of human freedom, and that a good society is one that protects and expands such freedoms.
WHO's work on Ageing Ethics
The WHO Global Health Ethics team aims to help advance this key area of ageing health policy through providing the philosophical and ethical framework for WHO’s healthy ageing model, policy guidance, and measurement and monitoring. The first step was a scoping meeting which included global ageing experts, and leading philosophers of health, wellbeing and ageing. It focused on clinical care, nutrition, care dependence, long term care and social support, advanced directives, health promotion, cost-effectiveness/economic evaluation, human rights, and sociology and psychology. This WHO meeting was held at the University of Tübingen, Germany on 18 March 2017. A short report titled, Developing An Ethical Framework for Healthy Ageing, was produced.
The next phase of the Healthy Ageing Ethics work involves working closely with colleagues in the Ageing and Life Course Department in order to conduct a full and inter-disciplinary literature review on ethical aspects of global ageing, interviews of experts worldwide, a global public consultation on ethical issues related to global ageing, and organize an expert consultation that develops ethical guidance for healthy ageing policies within and across countries.
The timeline for publishing the guidance document is late 2019 in order for the resource to be available at the launch of the United Nations Decade of Healthy Ageing 2020-2030.
After such guidance is developed, the subsequent work on the ethics of healthy ageing and wellbeing of older persons, work will focus on specific and pressing ethical issues that have been identified in the public consultations or become prominent as Member States begin to implement healthy ageing policies.
Publications
According to the WHO World report on ageing and health , the number of people over the age of 60 is expected to double by 2050. This will result...
Women, ageing and health: A framework for action
This framework for action addresses the health status and factors that influence women's health at midlife and older ages with a focus on gender. It provides...
The primary goal of this report is to identify some of the issues that need to be considered as those systems are designed. It reflects a consultation...