Ageing 'is an international problem'

The ageing population is growing across the world

A massive increase in the world's elderly population will pose huge challenges to the international community, the United Nations Secretary General has said.

Kofi Annan was speaking at the opening of the UN World Assembly on Ageing in Madrid on Monday.

Just because health services are under pressure doesn't mean the elderly should lose out

Mark Gorman, HelpAge International

The meeting will hear that the approach to health care for the elderly needs a fundamental overhaul.

While developed countries have improved their health and care services to deal with increased demand, developing countries have been unable to make the same progress.

Mr Annan said that by 2050 the number of people over 60 will hit two billion - more than the number of under 15s in the world.

Life expectancy

In 1950, the average life expectancy world-wide was 44, but by 2050 it is expected to rise to 77.

The Secretary General called for elderly people to be given a greater role in the community, and for society to promote solidarity between the different generations.

Delegates will look issues such as health, poverty, violence and discrimination.

It is hoped by the end of the week they will formulate a document to shape national policy on ageing across the globe.

The charity HelpAge International will use the assembly to launch a report entitled State of the world's older people 2002.

The issues highlighted in the report include findings that:

most older people in the developing world live in chronic poverty - more than 250 million older people are living on less than £1.20 a day

public services such as health care, HIV/Aids programmes and social security discriminate against older people

at national and international level, governments and aid donors ignore older people's contributions and fail to provide adequate resources to meet their needs

In developing countries, lifetime exposure to health problems means many people enter old age already in poor health, the report suggests.

Barriers to good health include lack of access to health care and its cost.

Treatment is often unaffordable for older people even when it is nominally free.

This is because hospitals are concentrated in towns, far from the rural areas where the majority of older people live and public transport is unaffordable.

The negative attitudes of health staff towards older people discourage them from seeking treatment.

The report says this is evident both in routine care and in the neglect of older people's medical and nutritional needs in humanitarian emergencies.

'Positive discrimination'

HelpAge International's head of policy Mark Gorman said: "The political will is fundamental, and whether international agencies and governments are interested in maintaining health services.

"Even where there is private provision, it should be underpinned by a decent public health service.

Elderly look after grandchildren orphaned by Aids

"Health services should not be age exclusive. Everyone has a right to good health and that should be carried through to older people.

"Maybe there should be some positive discrimination. Just because health services are under pressure doesn't mean the elderly should lose out."

The HelpAge International report found that people across the world are living much longer.

Global life expectancy in 1945 was 45; now it is 65 and by 2045 it is estimated it will be 76.

Older women outnumber older men. In developing countries there are now 91 men for every 100 women over 60 and that will rise to 86 men to every 100 women by 2030.

Older people continue to support their families and in sub-Saharan Africa, 8 million children orphaned by HIV/Aids are being cared for by older relatives.

Dr Muang Tong Khennani, from the Foundation for Older Person's Development in Thailand, said governments need to change their approach to health care for the elderly.

He said: "The issue in developing countries is that they don't get proper access to health services and if they do, they are treated as second-class citizens.

"Poor, older people and underprivileged people do not have the voice or the power and it is regarded as a burden to society to take care of them.

"I would like to see the governments, especially of developed countries, giving more recognition of older people's needs when formulating policies of health care."