Ensuring Full and Rightful Role of Older Persons in Society, Sustaining Social Protection Systems Stressed on Second Day of Ageing Assembly, Madrid

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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 2 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.

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