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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According to population estimates, older people aged 60 or more will be increasing by 50 per cent over the next 25 years. Although Mongolia is considered a country with a young population, changes in age structures have already started. However, efforts by the Government are not sufficient to solve every matter concerning older people. Therefore, it is vital that the Government cooperates with national and international NGOs, the private sector, research institutions, public and international organizations. Thus, one of our significant goals in this era is to obtain world assistance for the development of the country.

ANTONIO SANCHEZ DIAZ DE RIVERA, Vice-Minister, Ministry of Social Development of Mexico: The Second World Assembly on Ageing represents an invaluable opportunity to build bridges to create a society for all ages. Mexico is now experiencing profound changes, consolidating its democracy and seeking to reduce inequality, eliminate extreme poverty and create opportunities and favourable conditions for all of its population.

The Government has implemented a "Contigo" strategy of human development, which is based on the partnership between the State and society. Aimed at the formation of individual resource bases and generation of opportunities for all, it provides for the integration of all aspects of social development and addresses the needs of individuals throughout their lives. It incorporates the social security and protection system and addresses the needs of the disadvantaged groups of population. The need for low-income homes, high rates of illiteracy and poor health services are among the challenges faced by the country. In order to meet them, the country envisions creation of a comprehensive social development system geared, at promoting active ageing.

Ageing means unprecedented challenges all over the world, and Mexico has been working actively for the success of the Assembly. Within the framework of international cooperation on the subject of ageing, Mexico wants to propose a campaign, headed by the United Nations, for the eradication of stereotypes and promotion of a positive image of old age. At the recent conference in Monterrey, President Fox of Mexico affirmed that the twenty-first century should become a century for all. The Declaration and the Plan of Action to be adopted by the Assembly should contain concrete actions and definite mechanisms for reaching international goals in this respect.

FELIPE PAOLILLO, Uruguay: We are witnessing a revolution, global in scope, a silent revolution which will have the greatest impact on the destiny of mankind in the twenty-first century, namely the rate at which the world population is ageing. The phenomenon also poses challenges to which we must respond with intelligence, responsibility, sensitivity and imagination. The changes in population trends since Vienna 1982, as well as the changes foreseen in the structure of population, have compelled us to update the response of 20 years ago. Generations of older persons are living now in a very different world, characterized by globalization, in a world in which we still see the unsustainable coexistence of prosperous and poor societies. A key element is the fact that in developing countries the process of ageing has intensified at a rate unforeseeable 20 years ago.

Uruguay, the country with the oldest population in South America, has been confronting such problems for some time. Persons of 60 years and older comprise 17.4 per cent of the total population. A growing percentage of these persons live alone and most of them are women. In Uruguay, there is a well-developed regulatory framework related to ageing, such as laws providing housing to pensioners, tax exemptions, discounts for transport and cultural events. All that is expensive for the country, representing 17 per cent of its gross domestic product. Uruguay also has a wide network of services for older adults to promote integration in the communities. There is also a broad cooperation with civil society and NGOs.

Our elders represent a bond between the present and the past of all of us. The great challenge ahead is to offer all ageing persons a society in which they can develop their human potential. It is imperative that all countries coordinate their efforts, keep their promises and develop a political will to solve their problems. The Plan of Action is aimed at ensuring the rights of older persons and at developing their rightful role in society, their participation in society, job opportunities, training, inter-generational solidarity, among other things. As Chairman of the Main Committee, I have seen that many experts negotiating the Plan of Action are young people. I take this as a message of hope for older generations. Older persons can be confident that their future is in good hands, in the hands of young people, in the hands of the future older persons.

HEIDI WIRJOSENTONO, Suriname: Our population is multi-ethnic and multi-linguistic. The major groups, living in peace with one another in the urban areas, are from all parts of the world -- a reflection of the United Nations. About half of the population is above 60.

Because of the multi-ethnic nature of our society, the situation of older persons depends on the cultural group to which they belong. They are often part of the family, where they play an important role in the upbringing of the grandchildren. Their opinion is of great importance in family decisions. Research has shown that older persons believe their children must take care of them if they become old. In Suriname, they prefer, however, to function independently as long as possible in their familiar environments. They assume that they will lose their independence in a home for older persons.

At the moment, the Division of Research and Planning in the Ministry of Social Affairs and Housing in Suriname is preparing a national survey on the living conditions of older persons. A survey about the quality and care demand in homes for older persons has already been conducted. The Government will work on strategies for implementing proposals from the annual policy for older persons, such as health care, living conditions, recreation and the financial position of older persons.

JUAN SOMAVIA, Director-General of the International Labour Organization (ILO): The main reason for this World Assembly is to celebrate one of humanity's great successes: the increase in life expectancy of men and women. This is our new reality, and I believe we can all agree that the gradual ageing of the population marks a radical change in the human fabric of our societies.

There are four crucial issues to address. The first is that because the useful life of individuals has been extended, we are presented with a great opportunity, not an intractable problem. We often hear that an ageing population will put additional burdens on social protection systems already struggling to provide health care, food, housing, work and education. While that is an issue that certainly needs to be addressed, what is truly important is that for many people, living longer is accompanied by the desire to go on being useful to their communities. Older people represent an accumulation of human wealth and vast potential which can obviously contribute to creative solutions to many of the problems facing us today. As repositories of knowledge, values and wisdom, they play a decisive role in passing on cultural heritage from one generation to another. Sadly, we have begun to divorce ourselves from the way the elderly look at the world. Senior citizens are now seen as a "burden" to be shed at the earliest opportunity. This has to change.

The second critical fact is that growing old cannot be considered in isolation. It must be approached through integrated policies that can help people throughout their lives and contribute to strengthening the family. Poverty and exclusion affect older people to a disproportionate degree, and at the centre of a vision to solve that problem lies the family. We must, therefore, promote policies to strengthen families as the fundamental unit of all societies, with special consideration to single-parent families. Thirdly, full employment in decent working conditions is a viable and productive way to meet the challenges of ageing. The ageing of the population presents us with real public policy dilemmas. Countries face serious problems in terms of the viability of pension schemes, public expenditures and health-care systems. I believe, however, that we should put greater emphasis on economic growth and sustainable development, designed to provide a positive response to population ageing and focus on creating enterprises and decent work. The promotion of full employment is the best way to ensure reasonable welfare provisions and afford the guarantee of a pension when the time comes for people to leave active employment.

Fourthly, the chance to prolong one's working life is a promising alternative for society and deserves to be an option for older persons who wish to do so. Retirement should not be brought forward artificially without taking individual circumstances into account. It is important to ensure that older people have the opportunity to pursue productive activities, whether paid or unpaid, which keep them connected and provide them with a sense of usefulness to society.

GRO HARLEM BRUNDTLAND, Director-General of the World Health Organization (WHO): We are here to celebrate one of humanity's greatest achievements and face one of its greatest challenges: the increasing ageing of the general population. Our celebration is of an average increase in life expectancy by more than 30 years over the last century. Our challenge is to turn this seismic shift into a full benefit for society. It will demand tremendous changes in the way we organize our workplaces, our living arrangements and our concept of care for those who cannot live on their own.

There is very limited evidence about what effect the growing number of older persons will have on our health systems. This is particularly true for developing countries. In rich countries, the number of people over 65 who will require medical care is expected to increase between 50 and 120 per cent form 1995 to 2050. Not only is the number of aged people rapidly increasing, but health expenditures per person per year will increase correspondingly. People older than 75 accounted for nearly 30 per cent of total health expenditures, despite comprising only 5 per cent of the population. Without changes in the structure and priorities of our health system, it is likely that total health expenditures for the aged will rise rapidly.

In truth, there is considerable scope for change in our health systems. The first and most important is to invest in prevention and early detection. In people over 65, health expenditures are 7 times higher among the chronically disabled. With reduction in tobacco use, improved screening and early treatment of cancer, and development of new genetic risk-detection methods, we may be able to drastically reduce the need for treatment and care for people over 65. We must not only look at lifestyles, but also at the genetic detriments, using our knowledge to predict and counter the likely burden of disease. The frontiers of biological ageing and what we can learn from it in maintaining high levels of health have only just begun to be explored. We must also reorganize the way we provide care and treatment.

Overall, the greatest challenge lies in the developing world. To contribute to the process of change, we have been developing with partners a contribution to this Assembly -- a new policy framework called "Active Ageing". We want to stress that healthy ageing includes more than the mere absence of disease. Our goal is that everybody can enjoy a good quality of life and have a recognized role to play as full and useful members of society. Many of the major determinants of better health lie outside the health system: knowledge, clean environments, access to basic services, equitable societies and fulfilled human rights. For individuals to enjoy health in old age and societies to reduce the burden of caring for those who are chronically ill, we need to adopt a life-course perspective. That means beginning with today's children, with the young and those just reaching middle age.

ROBERT BUTLER, Chief Executive Officer of the International Longevity Centre: As a physician and gerontologist, I welcome the revolution in longevity. I do not agree with the doomsayers who express grave concerns about the consequences of population ageing. After all, in the twentieth century, we have already provided social protections and medical advances that have reduced disability and advanced the quality of life.

The revised Plan of Action should advance productive, active, healthy ageing and expand research and development to ameliorate or eliminate dementia and age-related diseases. The Plan of Action should enforce the human rights of older persons and work to end inequalities in longevity and health disparities within and among nations. In the era of globalization, healthy, productive citizens of the world are in everyone's best interest. Further, we simply must meet the needs of the developing world for developmental and humanitarian reforms. We must expand social protections and eliminate poverty. For the sake of our children and future generations, we must transform the character of long life and build a philosophy of longevity that offers meaning and purpose.

Accomplishing these aims requires a new international agency not only supported by governments, but also by industry, civil society and all individuals. Such a public-private partnership dedicated and funded by these partners is necessary to implement the strategy of the United Nations Second World Assembly on Ageing and the revised 1982 Plan of Action. There should also be a Madrid +5 to see what has been accomplished and to make necessary adjustments.

ANGEL GARCIA RODRIGUEZ, President of Mensajeros de la Paz: Those who have families and those who do not live in large cities or rural areas all feel loneliness, but older persons are especially at risk. The percentage of lonely people grows almost geometrically with age.

Our Association has a help line that has received 5 million calls from people suffering from loneliness. Some are desperate calls to escape anxiety, but most are to relieve loneliness. This help line receives calls every day just to say good morning or good afternoon. Older people feel alone because we have left them alone and they feel lost. In losing their capabilities, their dependency increases, but no one cares for them.

Older persons can live with poor pensions or with aches and pains, but not without love. Doctors have a difficult time classifying all the pains of old age, but the good ones know that most die of loneliness. Mother Theresa used to say that AIDS or leprosy is not the worst misery, but that feeling alone is. Loneliness kills, but friendliness and love can help older persons. Since our Association favours birth and opposes abortion, we do not agree with euthanasia. We support the "Group 77" developing countries and China proposal to establish an international body similar to the United Nations Children's Fund (UNICEF) to help and deal with issues of the older generation.

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