14 November 2017
"Population ageing is occurring rapidly and between 2015 and 2030, the number of people in the world aged 60 years or over is projected to grow by 56%. By 2050, the global population of older people is projected to more than double its size (United Nations, 2015). In Ireland, the old population (i.e. those aged 65 years and over) is projected to increase by between 58 and 63 per cent from 2015 to 2030. The older old population (i.e. those aged 80 years of age and over) is set to rise even more dramatically, by between 85 per cent and 94 per cent in this time period (ESRI 2017). As older people have different healthcare requirements, all healthcare systems need to adapt to meet the demands associated with these demographic changes. Empowering health care professionals with up-to-date knowledge and skills will ensure that when an older person needs health or social care. The care they receive will need to be better planned, better coordinated, easier to access and truly person centred. WHO’s reach, influence and advocacy is needed now more than ever. Within the new reports they issue they must be seen to lead the charge in preparing for an “age accommodating and age attuned” society in the years ahead.
As President of the Irish Gerontological Society, while acknowledging the work the WHO does in advancing the focus and advocacy on the opportunities that the world’s ageing demographic changes are presenting us with, it is regrettable that it is so hard to locate or indeed even see a specific focus on ageing in this new report.
Your omission to highlight this globally-recognised major demographic shift will have significant negative impact consequences for current and future generations worldwide. It also has the potential to undermine any gains you make as a result of the other strategic priorities you have outlined in the report.
We note your objective to “promote health, keep the world safe and serve the vulnerable”. In this context, there is every reason to specifically include older people – a growing and vulnerable group around the world in all countries - as a specific strategic target with specific priorities within each strategic pillar.
In this context we propose that you consider among amendments you plan to make in your revision that you would include in your next draft:
Health coverage – 1 billion more people with health coverage
The addition of ‘ageing and long term care’ to your list of tracer interventions and analysis of health service calculations.
A revised definition of UHC as follows: 'Universal health coverage means that all people and communities can use the promotive, preventive, curative, rehabilitative, palliative and age-attuned health services that are appropriate to their needs and of sufficient quality to be effective, while also ensuring that the use of these services does not expose the user to financial hardship.'
Health priorities – 1 billion lives improved
The target group listed for ‘priority area 1’ is extended to include another vast and vulnerable group as follows: Women, children, adolescent, ‘and older persons’ health. Appropriate specific targets should be added to this listing, for example: Increase the proportion of older adults receiving age-attuned health services by X%; reducing elder-abuse by X% etc.
On behalf of our members and the many communities that we represent, I formally request that you extend the range of your unparalleled leadership and influence to the serious matter of our ageing population. Putting WHO’s considerable weight behind this vital area, through specific inclusion of it in your Programme of Work, will ensure that older people everywhere are not left behind. Indeed we feel it is imperative with your leadership and influence that you lead the charge in preparing for an “age accommodating and age attuned” society in the years ahead.
Thank you for the opportunity to feedback and for considering our submission.
Diarmuid O Shea
Consultant Geriatrician, St Vincents University Hospital, Elm Park
President of the Irish Gerontological Society