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SUMMARY                       The 2002 regional survey on ageing has been conducted to review the current situation of older persons in the Asian and Pacific region and analyse future directions to derive a regional strategy for the implementation of international, regional and national commitments on ageing.  A questionnaire was sent out in June 2002 to 56 members and associate members of ESCAP that are situated in Asia and the Pacific.  The findings and analysis contained in the report are based on information available from 29 countries and areas. The sources of data being used for this survey analysis include responses to the survey questionnaire, data from national studies, reports and governmental statements at the Second World Assembly on Ageing (Madrid, April 2002).                 Responses from the countries and areas reveal the priorities attached and actions undertaken by governments to meet the challenges of ageing, improve the quality of life of older persons and ensure their continued participation and development in society.  These include the emphasis on building positive images of ageing, promoting active ageing and life-long preparation for ageing, strengthening traditional support systems for the elderly, providing assistance to older persons who are vulnerable and without family support, review of social security systems, establishing standards of care, developing integrated health and social services, providing quality long-term care and community services.                 In accordance with specific national circumstances, Governments in the region have undertaken measures and set up mechanisms, to implement their commitments under the 1999 Macao Plan of Action in Ageing for Asia and the Pacific and the 2002 Madrid International Plan of Action on Ageing.  In view of the difficulties encountered during the implementation process, such as lack of funds, knowledge, and training, continued regional and international cooperation is essential to facilitate the exchange of experiences and expertise among countries and areas.                 The report concludes by discussing future priorities in the coming decades.  These include old age pension and social security systems, health care coverage and public care concerns, formal/informal care provision and protection of the rights of older persons.

 

I.  Background

Population ageing has been a global issue since the early 1980’s.  While the majority of the world’s elderly population resides in the developing countries, the Asian and Pacific region is home to the largest number of older persons.  Worldwide, the number of people aged 60 and over will increase from about 600 million in 2000 to almost 2000 million in 2050, of whom about half will reside in Asia.   

The Asian and Pacific region is a heterogeneous group with vast differences in size, population, wealth, development levels and cultural diversity. The region is ageing rapidly.  In order to capture the commonality as well as diversity, a regional survey was carried out by the United Nations Economic and Social Commission for Asia and the Pacific( UNESCAP) in June 2002 to gather information on the situation of older persons, areas of concern and priorities in national policies and programmes on ageing in the region. The findings also reveal future directions to derive a regional strategy for the implementation of the international, regional and national commitments on ageing.

The report discusses the results of survey using data collected from 29 respondent countries and areas (52 per cent) which are members and associate members of UNESCAP. Out of the 56 regional members/associate members of ESCAP to whom a questionnaire was sent, 25 countries and areas (45 per cent) responded to the questionnaire.  Among them, 6 countries and areas (China; Hong Kong, China; Japan; Macao, China; Mongolia; and  Republic of Korea) are from East Asia, 8 countries (Cambodia, Indonesia, Lao People’s Democratic Republic, Malaysia, Myanmar, Philippines, Thailand, and Viet Nam) from Southeast Asia, 5 countries (Bangladesh, Maldives, Nepal, Pakistan, Sri Lanka) from South Asia, 3 countries (Azerbaijan, Tajikistan, and Uzbekistan) from Central Asia and 3 countries (Australia, New Zealand, Papua New Guinea) from the Pacific. Data on 4 countries (India, Islamic Republic of Iran, Singapore, and Turkey) were also available from national reports on ageing and governmental statements delivered at the Second World Assembly  on Ageing (Madrid, April 2002). The analysis of the present report is based on both responses to the questionnaire, and national studies, reports, national plans of action and governmental statements at the Second World Assembly on Ageing. The responses from 4 countries (Australia, Japan, Tajikistan, and  Uzbekistan) were received after the cut-off analysis and date for data collection and therefore could not be included in the present analysis. However, as appropriate, references are made to specific policies and activities on ageing in these countries to illustrate relevant points of discussion.

II.  Population Ageing in the Asia-Pacific Region

The Asia-Pacific region is most diverse in its population composition.  The region houses probably the second oldest country in the world – Japan, with an elderly population of 23.2 per cent in 2000, and the biggest elderly population in absolute numbers – China, with nearly 130 million older persons in the same year.  The other more developed countries and areas in the region such as Australia; Hong Kong, China; New Zealand; Republic of Koreal; and Singapore, also have high percentages of the population aged 60+, ranging from 10 to 20 per cent.  Developing countries like Sri Lanka, Malaysia and Azerbaijan have the percentage of elderly people as high as 10 or slightly over 10.  In comparison, some South-east and South Asian countries, such as Cambodia, Lao Peole’s Democratic Republic, Maldives, Nepal, Pakistan, Papua New Guinea, are still youthful with lower proportions of older persons, around 5 to 7 per cent.  Despite this fact, most countries in the region will experience considerable growth in their elderly populations in the next few decades when the proportion of people aged 60+ will triple or quadruple to over 20 or 30 per cent.  Table 1 shows the current and projected percentage of the elderly population of selected countries and areas in the region.     

Another important feature of the region’s demography is that, with the exception of

Japan, there is probably no 'demographic time-bomb' set to explode, creating serious short-term problems. However, many countries in the region will take a shorter span for their ageing populations to double or triple in percentages.  While it took developed countries (such as France, Germany, United Kingdom, United States of America, and Sweden) 80 to 150 years to double their elderly population from 7 per cent to 14 per cent or from 10 to 20 per cent, most countries in Asia and the Pacific will experience that process in less 50 years time.  In China, it is projected that it will take only 27 years, from 2000 to 2027 for the proportion of the population aged 60 and over to double from 10 to 20 per cent. The relatively short span of time has therefore exerted certain urgency on many countries who have to face and prepare for the challenge of simultaneous development and population ageing.

Two other significant characteristics observed in the region are the ageing of the elderly and the feminization of ageing.  The proportion of the old-olds among the elderly population is increasing. The percentage of people aged 75+ will increase from 23 per cent in 2000 to 38 per cent in 2050.  By 2020, 48 per cent of the world’s people aged 80+ will reside in Asia, compared to the present 39 per cent. Many of these older persons in the region are often without substantial personal resources.  Few of them have participated in any pension schemes and a considerable proportion are living in the rural areas where social and welfare services are relatively underdeveloped, so they may well suffer if state and family resources are not available. 

Table 1.  Demographic Profile of Selected Countries and Areas in the Asia-Pacific Region*

Source:  World Population Ageing 1950 – 2050, Population Division, DESA, United Nations, 2002.

Moreover, there is a continuing gender gap in life expectancy in the region, with females consistently outliving males, meaning many of the old-olds would be women. Poverty amongst older women is potentially a great problem, for they are often widowed and probably without adequate means of support, less educated, have poorer health and worse financial situation as compared to men.  This implies that many older women will have to live alone and in poverty in the last stages of their lives.

Looking at the brighter side, most of the elderly people are going to be healthy in their early retirement years and will be able to participate in community activities, including work. The idea is to keep these people as active and as healthy as possible, and to ‘compress’ morbidity till later years.

These characteristics of the population ageing process in Asia and the Pacific call for a necessity for national or regional strategies to address the challenges. The unprecedented growth of ageing populations in the region has brought about not only changes in the social and economic structures and relationships in societies, equity across generations, but also has impacts on fundamental changes in the attitude and perception towards not merely the older generation, but the ageing process as well.

III.   National Policies and Programmes on Ageing

A.        National Mechanisms on Ageing

The regional survey on ageing shows that among the 29 respondent countries and areas, nearly 80 per cent of them have set up either a focal agency or a coordinating body to oversee issues relating to ageing or older persons.  The nature and structure of these agencies or bodies are varied, ranging from more permanent government structure at the ministerial level to a single-agency or inter-agency/committee on ageing, or a branch/function of the social welfare department/ministry.  While the differences in the structure and functions of these coordinating bodies may reflect the different strategies adopted to address ageing-related issues, they also signify the importance and coordinated efforts devoted to the issues of ageing by the countries and areas concerned.  Table 2 summarizes the four main types of agency/body established by selected countries and areas.    

Table 2.           Types of National Focal Agency / Coordinating Body on Ageing

Sources: Regional Survey on Ageing, ESCAP, 2002.

Developed countries in the Asia-Pacific region, such as Australia, Japan and New Zealand, who have been grappling with their ageing population for a longer period of time have directed their efforts in establishing a high-level government agency, usually at the ministerial level, to focus and coordinate manpower and resources in dealing with ageing issues. Their national policies and plans of action are also more elaborate in content. Countries and areas such as China; Hong Kong, China; Republic of Korea; Cambodia; Malaysia; Nepal; Pakistan; Papua New Guinea; Sri Lanka and Thailand are also taking serious steps to tackle the of ageing by establishing national committees on ageing.  Many of which are newly formed or strengthened as institutional follow-up structure or coordinating mechanisms that oversee the implementation of national, regional and international commitments on ageing. The composition of these committees is varied.  Most consist of officials from different government agencies/departments (as in the case of Philippines and Singapore), representatives from NGOs and the private sector. In some cases, individuals who have interests and recognized expertise in ageing issues are also invited to join the committees.

In countries where there are no specialized agency/body dealing with ageing issues, the welfare of the elderly population is usually taken care of by the Ministry/Department of Social Welfare or Social Development which is responsible for welfare policy development and service provisions for older persons.  Only a few among the respondent countries and areas report the absence of a focal agency or national policy/plan of action on ageing, which is probably due to the relative low percentage of the elderly in the population as in the case of the Maldives and Cambodia or other conditions as in the case of Azerbaijan and Uzbekistan. 

Apart from that, it is common among the surveyed countries (80 per cent) to have a national policy or plan of action on ageing and/or legislation concerning older persons.

Table 3: National Policies/Plans of Action on Ageing

Surveys on ageing have revealed a considerable portion of issues at the national and/or local levels.  All these reflect the recognition by countries of the importance of coordinating efforts and forging partnership between all levels of government and society, so as to facilitate the translation of national polices and plans of action into practice.

B.  Areas of Concern and Priorities

In response to the global trend and challenges of population ageing, the Second World Assembly on Ageing (April 2002) adopted the Political Declaration and Madrid International Plan of Action on Ageing (MIPAA).  The Plan provides policy guidance and a practical tool in assisting policy makers to focus on the key priorities which in turn guide policy formulations and implementation towards the goal of successful adjustment to an ageing world.  There are three priority areas: (1) older persons and development; (2) advancing health and well-being into old age; and (3) ensuring enabling and supportive environments. The Macao Plan of Action on Ageing for Asia and the Pacific (1999) identified seven major areas of concern for the region, ranging from income security, health and nutrition to social services and older persons and the family. There are many commonalties and convergence in terms of priorities and areas of concerns identified in the Macao and Madrid Plans of Action. Notwithstanding the great diversity of circumstances in each country, the following attempts to identify some general trends within the region as reflected in the measures taken or programmes initiated by governments in each area of concern and priority.

1.      Older Persons and Development

The priority direction of ‘older persons and development’ emphasizes the continuing participation and empowerment of older persons in the development process and their fair share of the benefits of development as well.  participation can be at various levels and in different arenas, including in society, at work, in the family, the market and the community. This priority direction also covers such areas as social protection and security and elimination of poverty in old age, among others.

Active Participation in Society and Development

Most of the surveyed countries in the region have assigned greater importance to the promotion of positive images of ageing (mean score = 3.83 on a scale of 1 to 5 points) in this aspect.  A large majority (90 per cent) claim that they have undertaken such promotion through public educational activities/programmes.  As one of the notable examples in the region, New Zealand has explicitly adopted a ‘Positive Ageing Strategy’ (2001) as the central point from which all national policies and action plans for older persons evolved.  Others like Hong Kong, China and India have also laid emphasis on the concept of ‘healthy ageing’ or ‘productive ageing’ in their policies and plans, but in a more discrete way, such as launching campaigns on healthy ageing.

Other measures undertaken by countries and areas in the region that aim to enhance older persons’ participation include publicizing the UN principles for older persons (85 per cent), involving older persons in decision-making processes at all levels (85 per cent), and recognizing the contribution of older persons through mass media campaigns (81 per cent). The priority (mean score = 3.4 on a scale of 5) given to these measures as well as the promotion of positive ageing, reflects an increasing recognition by the countries of the importanc of inducing and effecting an attitude change or ‘paradigm shift’ in which ageing is seen not as a welfare concern and a social problem, but rather as an opportunity for development and contribution.  (See Table 4)    

Table 4.           Active Participation of Older Persons in Society and Development

                                                                                                                                                                                                                                                n = 21

Productive Ageing

Regarding the concern on productive ageing and increasing employment opportunities for older persons, the picture is less encouraging.  Only about half of the surveyed governments report that they have taken measures to increase older persons’ employment in the labour market and remove disincentives to working beyond retirement age.  The measures include seeking employment for retirees as in (as in Malaysia where its Ministry of Human Resources matches retirees who wish to work with potential employers). The successful rate is about 10 per cent in a two-year period.  Elsewhere, such as Indonesia and Hong Kong, China, an officer or job counter is specially assigned at the district level to assist older workers in administration, guidance and job placement in the formal or informal sector.  In New Zealand, not only employment services are provided for mature and older job seekers, government initiatives are also developed to change employer attitudes to recruiting mature workers. 

Over 70 per cent of the respondent countries and areas (15 countries/areas) have worked toward promoting lifelong preparation for old age and continuing education, while about 80 per cent of them (17 countries/areas) have undertaken measures aimed at maintaining older persons’ engagement in social, economic and community activities.  The results are in line with the priority ranked by the governments to the various areas of concern.  Less importance is given to encouraging employment at old age and extending retirement age (mean score = 3.17 and 2.55 respectively out of 5), while greater importance to early preparation for old age (mean score = 3.64 out of 5).  (See Table 5)

Table 5.           Productive Ageing

                                                                                                                                                                                                                                                n = 21

Older Persons and the Family

Regarding persons and the family, the strengthening of traditional support systems (mean score = 3.94 on a scale of 5) and provision of assistance to older persons without family support (mean score = 3.83) are rated as prime concerns by most governments in the region, reflecting the continual reliance on the family as the main source of care and support for the elderly.  Despite the withering of extended family systems and its care-giving capability in modern times, many countries and areas in the region still pride on their traditions in which the older persons live with, and are cared for and respected by the younger generation.  Only to those without family support would assistance be rendered.  This is still true in most of the South-east Asian countries, a large part of South Asia, Mongolia, and to a lesser extent, the Republic of Korea; Hong Kong, China; and Macao, China.

About 85 per cent of the respondents (18 countries/areas) have taken initiatives to strengthen supporting system for older persons, including direct assistance to older persons without family support, provision to help families with older members and enhancement of multi-generational relationships.  In comparison, training family members on home care of older persons, and launching special programmes to support the elderly in rural areas are less of a priority concern.  Less than two-third of the respondents have devoted resources to this aspect.  (See Table 6)

Table 6.           Older Persons and the Family

                                                                                                                                                                                                                                                n = 21

Older Persons and the Market

Compared with other areas of concern, the role of the elderly as consumers and their consumer rights have received less attention from the surveyed countries and areas. Only 11 countries and areas have undertaken activities/programmes to promote consumer awareness and consumer education among the older persons, and even less have done anything to promote consumer groups that include older persons or taken measures to protect elderly consumers.  In countries where older consumers account for nearly 45 per cent of the total growth in retail spending, such as in Australia, elderly people constitute a group that is economically better off, has higher consumption rate and whose specific lifestyles and needs will alter the range of goods and services provided on the market.  

Income Security and Poverty Alleviation

In comparative terms, greater concern has been attached to the issues of income security and social assistance to older persons among the surveyed countries and areas.  The highest priority is placed on reviewing the adequacy of benefits to ensure a reasonable standard of living, which includes improving insurance coverage and the levels of benefits (mean score = 4.07 on a scale of 5) (See Table 7).

Table 7.           Social Protection and Security

                                                                                                                                                                                                                                                n = 21

    Other measures that are given great importance include provision to help older persons who are especially vulnerable or in emergency situations (mean score = 3.78), targeting local poverty alleviation programmes for older persons (mean score = 3.75), and encouraging savings by employees and workers (mean score = 3.71).  (See Table 8)  While measures aiming at  providing social security coverage to informal sector older workers recieve a relatively higher ranking, conducting surveys on poverty in older persons, and facilitating income generation schemes for the elderly are assigned lower priorities.  Only 41 per cent of the surveyed countries and areas have taken action in these areas.

Table 8.           Poverty and Old Age                                                                                                 

        n = 21

While financial security in old age has become a major issue for the ageing populations in the region, the above results show that most governments tend to give higher priority to measures that require lesser involvement from the government in terms of financial burdens and long term preventive measures that emphasize savings at young of age and individual responsibility, as well as help rendered to the most vulnerable and needy group of older persons.  Table 9 illustrates the types of pension schemes and social security measures adopted by selected countries and areas in the region.

Table 9.           Pension Schemes and Social Security Measures

Sources: Regional Survey on Ageing, ESCAP, 2002;

                    Policy papers and national plans from selected countries and areas

In East Asian countries, Pakistan and Myanmar, state or public pension for government employees is common. However, with the exception of China and Japan, almost all government pension schemes cover only a small portion of the elderly population.  The rest of the older population has to rely either on self-contributory schemes or old age allowance from the government which is usually small in amount.  The latter is meant to provide a safety net for the most vulnerable group in the society. 

In developed countries, such as Australia and New Zealand, where old age pension systems have a longer history, emphasis is on increasing the amount of premium through a variety of means, including private investments and superannuation.  Even in China and Japan where pension systems are more comprehensive in coverage, the governments are feeling the growing burden as a result of the rapid increase in the older population.  The trend is thus shifting to developing a more contributory type of pension system in which the employer and employee take up more responsibility of the preparation for old age. 

Meanwhile, a large portion of developing countries in the region, such as Azerbaijan, Cambodia, Lao People's Democretic Republic and Uzbekistan, are still trying to develop adequate and sustainable pension systems for their older population, whereas the rest are in the process of developing appropriate schemes and measures to prepare for the onset of population ageing in their countries.  Indonesia, Islamic Republic of Iran, Malaysia, Papua New Guinea, Philippines and Sri Lanka are making plans to install their national pension systems; among them the first two countries have also at present some measures to provide minimum income to the most needy elderly group.

Social Services and the Community

In order to recognize the importance of meeting the needs for social services of older persons, much effort in the region has been directed to strengthen the provision of basic social services for older persons and to encourage the formation of elderly clubs and associations.  Different types of social service centres for older persons, community service centres for the elderly, senior citizen clubs,  and resident committees are set up in countries and areas such as Thailand, China, Philippines and Hong Kong, China.  These centres and clubs provide day-care, rehabilitation services, recreation activities, health promoting programmes and social activities for the older persons. 

The majority of the surveyed countries (18 countries and areas) have all undertaken measures to provide basic social services to older people at concessionary rates or free of charge, improve their access to those services, encourage the participation and contribution by older persons in community activities as well as the associations of older persons.  Even though fewer countries (60 per cent, 13 countries), such as most of the Southeast Asian countries; China; Hong Kong, China; New Zealand; Pakistan and Sri Lanka, have taken steps to monitor the standards and quality of services specially targeted for older persons, the countries in general have assigned equal importance to this aspect as the other aspect of social services (mean score = 3.75).  (See Table 10) 

Table 10.         Social Services and the Community

                                                                                                                                                                                                                                                n = 21

2.         Advancing Health and Well-being into Old Age

Health and Education and Universal Access to Health Care

Promotion of integrated health and social services in community programmes and provision of health care free or at concessionary rates for older persons are the two areas of concern that are rated with higher priority (mean score = 3.94 on a scale of 5) by the surveyed countries and areas.  Other important concerns include education on health risks from unhealthy behaviours (diets, smoking, substance abuse) (mean score = 3.78 on a scale of 5) and public education on active ageing (mean score = 3.71 on a scale of 5).  (See Table 11.)  

Table 11.                     Health and Nutrition

                                                                                                                                                                                                                                                n = 21

Regarding the training aspects, such as development of geriatric training, provide training/incentives for health and social care professionals on counseling older persons on healthy lifestyles and self-care, and training of caregivers/health workers about specific nutritional needs of older persons, the priority assigned to them are relatively lower (mean score between 2.44 – 3.0 out of 5), reflecting the countries’ greater concern on the aspects of direct health care delivery and general health education.

Older Persons and HIV/AIDS

This is an area where less concern is rendered by most of the respondents.  Less than 40 per cent of the governments in the region have taken active measures to collect data on the extent of HIV/AIDS infection affecting older persons; recognize and support the needs of infected older persons; train older caregivers in HIV/AIDS care; and improve assessment of its impact on older persons.  The priorities given in the above areas are also relatively low compared to other health care issues in the region (mean scores range from 1.83 – to 3.0 out of 5).

Disability and Mental Health Needs of Older Persons

This is also not a major concern among the surveyed countries and areas, as only slightly more than half of them (11 countries) have undertaken measures to develop programmes to help persons with Alzheimer’s disease and other sources of dementia, include in relevant national agendas issues concerning older persons with disabilities, and provide physical and mental rehabilitation services for older persons with disabilities.  The priorities assigned to these items by the respondent countries are not impressively high either (mean score = 2.73 – 3.77 out of 5). 

3.         Ensuring Enabling and Supportive Environments

Enabling and supportive environments imply a safe, comfortable and caring environment free of abuse and violence against older persons.  In developed countries such as Japan and Singapore, there are already plans to promote urban planning under the concept of ‘universal design’ in which a continuous barrier-free environment extending from home, to public transport and central city areas is created.  In other countries where urban housing is still scarce, the emphasis is on equitable allocation of affordable housing to older persons.

Housing and Living Environment

About 50 per cent of the respondents  (10 countries and areas) have taken initiatives in each of the following activities or programmes: To promote equitable allocation of public housing for older persons; promote “ageing in place” with due regard to individual preferences and affordable housing options, ensure that new urban spaces are free from barriers to access/mobility, encourage age-friendly and accessible housing design, and design safe roads and develop new kinds of vehicles catering for the needs of older persons and persons with disabilities.  The first two of the above measures are given higher priority by the respondent countries and areas, with mean scores of 3.9 and 3.7 out of 5 respectively.

Care and Support for Care-givers

As more and more societies, especially among the developed ones, in the region have recognized the importance of enabling older persons to ‘age in place’ or remain living in the community for as long as they wish, the emphasis has been shifted to delivering enhanced home and community care as well as providing high quality residential care services.  In areas like Hong Kong, China, home help teams provide meals and home care services for older persons who are unable to take care of themselves and these teams are strengthened and restructured into enhanced home care programmes.  These programmes often come in the form of individually tailored packages for frail elders that consisted of a range of services rendered in the elders’ own homes.  Moreover, day and residential respite services for elders are also provided to lessen the care burden of careers, there are career support centres, providing careers with information, training and emotional support as well.

Regarding care and support for care-givers, the areas that received high priority ranking from the respondent countries and areas are:

a)            Establish standards to ensure quality care in formal care settings (mean score = 4 on a scale of 5);

b)            Improve access to and quality of long-term care for older persons (mean score = 3.9);

c)            Develop social support systems to enhance the ability of families to take care of older persons within the family (mean score = 3.83);

d)            Support community-based care and family care (mean score = 3.79). 

It is also notable that only about 50 per cent of the respondents (11 countries/areas) have undertaken actions to implement the first two items which they see as more important than the rest.  This reflects the gaps in the demand for provision and monitoring of long-term care services.  (See Table 12)

Table 12.                     Care and Support for Care-givers

                                                                                                                                                                                                                                                n = 21

Neglect, Abuse and Violence against Older Persons

      The number of countries/ areas that have taken measures to enact legislation to eliminate elder abuse is also comparatively low (10 countries and areas) despite the fact that it is a priority area that ranks high (mean score = 3.7 out of 5).  About 70 per cent (15 countries and areas of the respondents) have undertaken activities to sensitize the public and professionals on neglect, violence against and abuse of older persons and 60 per cent have established services for victims of abuse, including rehabilitation.

C.      Implementation Structures and Processes

Regarding the implementation of the Madrid International Plan of Action on Ageing (2002) and the Macao Plan of Action on Ageing for Asia and the Pacific (1999), countries in the region are undergoing different stages of development, and therefore would be having disparities in their expertise and resources for mobilization.  About 7 countries have indicated that they allocate less than 2 per cent of the government budget for the implementation of policies and programmes on ageing. Australia allocates between 2 and 4 per cent, and 4 other countries and areas allocate more than 4 per cent of the government budget for the same purpose. No information concerning the budget spent on ageing is available from the rest of the respondent countries and areas (See Table 13).  New Zealand and Hong Kong, China are among those who spent more than 4 per cent of their budget on programmes for older persons.  Together with Japan, Philippines and Thailand, they have all developed relatively concrete and elaborate plans to take care of the elderly in their societies.  The plans contain strategies and target goals with clear outcome indicators to monitor the progress of implementation.  The governments of Australia, China, Indonesia, Malaysia, Papua New Guinea, the Republic of Korea, Singapore, Sri Lanka, and Viet Nam have also taken up various programmes and activities for implementing the broad recommendations of the Madrid International Plan of Action (2002) and the Macao Plan of Action on ageing for Asia and the Pacific. 

Table 13.                     Implementation: Resources and Structures

                                                                                                                                                                                                                     n = 21

Nevertheless, it must be noted that despite the growing awareness of ageing issues and the formulation of national plans of action, there are still obstacles to mainstreaming ageing and the concerns of older persons into national development frameworks and poverty alleviation strategies.  In some countries and areas, such as Thailand and Indonesia, Lao People's Democratic Republic, Mongolia, Islamic Republic of Iran, Pakistan, and Azerbaijan, the preoccupation with more immediate economic problems or political instability has been a major reason that keeps the governments from formulating appropriate action plans and the required infrastructure.  Table 14 summarizes the plans of governments to mobilize resources and new structures or mechanisms set up for the implementation of national, regional and international commitments on ageing.  It reveals the extent to which ageing issues are mainstreamed into national development projects or poverty alleviation strategies, and the involvement of NGO and private sectors in major projects and programmes benefiting older persons.  

Table 14.                     Implementation Structures and Processes

Slightly more than half of the respondents  (12 countries and areas) have devised plans, usually in the form of a national plan of action or five-year plan for the implementation of the Plan of Action on ageing. Four countries and areas report that they have no corresponding plan of action.  Some countries and areas like Macao, China; Sri Lanka; and Uzbekistan report general measures being taken, such as increasing budget and expenditures on ageing-related matters or organizing relevant workshops in this regard. 

Involvement of NGOs and the Private Sector

NGOs have actively involved in the implementation of national plans of action in over 80 per cent of the respondent countries and areas including Indonesia; Philippines; the Republic of Korea; Thailand; Hong Kong, China; and countries in the Pacific. They play an active role in providing social services and relief, such as elderly homes, elderly centres, nursing homes and home help services to older persons in the region.  As a matter of fact, NGOs in certain countries and areas such as Singapore; Hong Kong, China; and Philippines have extended a predominant role in the provision of elderly care and services.  The private sector in the above countries is also keen to provide material aids or involve in community projects such as the provision of senior citizen card in Macao, China.  However, the involvement of private enterprises, especially those of international corporations, in elderly welfare have sometimes been looked at with suspicions from various perspectives: as creating dependency (hence exclusive sales of certain products) on aids, or as simply image promotion (e.g. tobacco companies).

Research on Ageing

Research activities on ageing are an important item on the agenda of the Madrid International Plan of Action and Macao Plan of Action on Ageing in Asia and the Pacific.  Fourteen respondents report that they have conducted or sponsored research to collect national on age-specific data for policy planning, monitoring and evaluation.  In countries like the Philippines, surveys have been conducted at the national level in the areas of social security, education, mass media, nutrition and elderly statistics.  Moreover, researches are also carried out on the themes of law implementation, inter-generational support and family problems experienced by older persons, and causes of morbidity and mortality among older persons.

Although more governments have now recognized the importance of research activities in assisting policy formulation, it usually takes relatively long years and efforts to collect data and build up and the evidence base for analysis before they can be used for drafting long-term policies and plans on ageing.  Thailand’s Second National Long-term Plan for Older Persons (2002 – 2021) is a case in point.

D.      Regional Cooperation

As recommended by the Macao Plan of Action on Ageing for Asia and the Pacific and the Madrid International Plan of Action on Ageing, regional and international cooperation is essential to complement national efforts on ageing-related issues and enhance implementation of commitments on ageing. The Madrid International Plan of Action emphasizes that enhanced and focused international cooperation and an effective commitment by developed countries and international development agencies will enhance and enable the implementation of the Plan. Other priorities for international cooperation on ageing should include exchange of experiences and best practices, researchers and research findings and data collection to support policy and programme development as appropriate; establishment of income generating projects; and information dissemination.

The results of the survey reveal that participation in regional and international cooperation is not particularly high among the surveyed countries and areas.  While 70 per cent of the respondents have participated in sub-regional or regional activities relating to ageing, and inter-country exchanges of information and experience, only 11 countries and areas (52.4 per cent) have requested for technical assistance from ESCAP or other international agencies; 7 countries (33.3 per cent) have participated in inter-country joint research and training activities, initiated resource mobilization from multi-lateral institutions, or provided technical assistance and advisory services on ageing to other countries.

Moreover, it is believed that developing countries and countries with economies in transition face special difficulties in responding to the challenges and opportunities posed by an ageing population.  Table 15 reveals the difficulties perceived by the surveyed countries in making progress in the implementation of their regional and international commitments on ageing.

Table 15.   Difficulties encountered in implementing regional and international

plans of action on ageing                                    

n = 21

The lacks of funds and of training for implementation turn out to be the two most common and serious problems faced by most of the surveyed countries.  Over 80 per cent (18 respondents) perceive them as a hindrance in the implementation process.  This is significant given the recent economic downturn and crisis in the region.  It also signifies the importance for countries to mobilize international expertise and seeking financial assistance in the implementation of plans.  Other unfavourable factors include a lack of inter-departmental cooperation (means score = 3.5 on a scale of 5) and shortage of government staff (mean score = 3.29).  Nearly half of the respondent countries and areas believe that low priority given to ageing issues and the lack of policymaking knowledge are also obstacles to progress.  

IV.     Future Priorities

Table 16 shows the priorities of countries and areas in the coming decades regarding policies and programmes on ageing and the level of importance likely attached to them.  The priorities shown are very much similar to the concerns highlighted in the present survey.  Financial security, health and social services, and protection of older persons’ rights are the main areas that are rendered greater priority. They represent the more urgent aspects which bear direct implications on the well-being of older persons, as well as far-reaching effects on the socio-economic development of the region as a whole.  They are what the governments have to deal with to prepare for the onset of an ageing population in their countries. 

Table 16.                     Future Priorities of Selected Countries and Areas in the Region  

  n = 21

V.               Conclusion

The findings and analysis in the report are based on information from 29 countries and areas out of 56 regional members and associates members of UNESCAP. The response rate to the regional survey was over 50 per cent.

A number of common themes and issues are clear from the data. In particular, ageing is now viewed as a priority issue in much of the region and the majority of the 29 countries/areas have a national policy, legislation, plans or ministerial directives on the subject. Importantly, a majority of countries/areas are concerned and undertake programmes to promote positive images of ageing and many involve older persons in the decision making process at all levels. It is clear that old age is no longer simply viewed as a welfare concern by most respondents. Ageing must be viewed from a developmental perspective, such that both needy and able older persons are considered and the quality of life (including material, physical and mental well-being) of the elderly population can be secured and improved.  Nevertheless, the changing roles and abilities of families to care for their elderly members, the lack of inter-disciplinary and inter-sectoral collaboration among actors in societies, and the absence of or immaturity of welfare and social protection schemes in many countries of the region, have singly and in combination created new challenges to governments in their endeavor to meet the challenges of an era of population ageing.

In facing all these challenges, apart from understanding the issues and implications of population ageing and making preparations for an ageing process that is productive and fulfilling, national or international inititives will have to take a number of key trends into account. These include the numbers and percentages of older persons will increase in most countries over the next three to five decade; smaller family size, greater longevity, probably healthier old age and continued but not perhaps as marked feminization of population ageing. To adequately address the concerns and priorities noted above, changes in public attitudes towards ageing are an important component and one to which many countries are turning attention. In the immediate future, priorities are revolving around the practicalities of old age financial security and pension schemes, health care coverage, social security and care giving. It is encouraging that intergenerational solidairity and the protection of the rights of older persons are ranked highly as future priorities by a majority of respondent countries. Similarly, research on ageing is a priority and this will inform and underpin policy formulation, implementation and evaluation.

Nevertheless, respondent countries/areas recognize that there remain a number of

obstacles to their implementation of regional and international plans and policies on ageing.

Continued low priority of the topic and lack of funds rank the highest, followed by a lack of

policymaking knowledge and shortage of staff and training for implementation. Lack of inter-

departmental cooperation and coordination are also noted in many responses. However, most

of these difficulties can be addressed by reallocation of resources and reorientation of staffing

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