PRESS BRIEFING BY WORLD HEALTH ORGANIZATION

Press Briefing

PRESS BRIEFING BY WORLD HEALTH ORGANIZATION

The Chief of the World Health Organization's Ageing and Health Programme told correspondents today at a Headquarters press briefing that he was here to put ageing on the development agenda.

Alexandre Kalache said the special session of the General Assembly on the Implementation of the Outcome of the World Summit for Social Development and Further Initiatives (Copenhagen + 5) was fast approaching. In that context, it was imperative to start addressing the pressing issues related to the rapidly ageing population worldwide in the next few decades, especially by the developing world. Moreover, the ageing issue should be seen in the context of poverty. In a nutshell, developed countries first got rich and then they got old. In the next few decades, an unprecedented situation would emerge, as developing countries got older well before they got richer.

In the developed world, the ageing process had spanned a century, he said. In France, for example, the total proportion of the population over age 65 had increased from 7 to 14 per cent in 115 years, from 1865 to 1980. In countries such as Thailand, Malaysia, Brazil and others, that was going to take place over a period of just 20 to 25 years. So, the ageing process itself was being compressed, and it was taking place faster than ever before, given the nature of poverty and unprecedented rapid, social change. Through such trends as migration, urbanization and the participation of women in the workforce, the ethos of the family care and traditional societies was being eroded and the ways in which traditionally vulnerable older people would be looked after by their families and communities were fast disappearing.

Two very important demographic trends were contributing to rapid ageing, he went on. First, more older people were reaching old age. When had been born in Brazil, life expectancy was 42 years. Today, a male boy born in his country could expect to live 70 years and, in a few years, to 75. Also very important to the ageing process were the total fertility rates, or the number of children a woman had by the end of her reproductive life. Throughout the developing world, fewer children were being born, owing to the unprecedented, rapid decline in fertility rates in countries as varied as Latin American and South-East Asian countries, China, and even in sub-Saharan Africa. In 1975 in Brazil, the total fertility rate was 5.8. Today, it was 2.1. If a couple had fewer than two children, the couple would not replace themselves and the population would eventually start to shrink.

He said there were 68 countries worldwide with total fertility rates below replacement level. By 2015, 121 countries, or 80 per cent of the world's population, would have total fertility rates below the replacement level. Thus, in the next few decades the great issue, in demographic and population terms, was not a population explosion, but population ageing at a faster rate than ever before. With more and more older people living in developing countries, often in the context of absolute poverty, it was absolutely essential to develop

WHO Briefing - 2 - 14 February 2000

policies to allow them to be resources to their families and communities, and eventually to the economy. The problem stemmed from their vulnerability and inability to contribute to their societies. Investing in older persons as resources, however, would make them part of the solution.

He noted his plans to brief personnel of United Nations missions and non-governmental organizations later today.

Asked for more details about the countries in which population was diminishing, he reiterated that 68 countries had total fertility rates below replacement level. Following the current bulge, in numeric terms, of the very large number of fertile women, the next generation would be very small and then start shrinking. Some of the fast-shrinking populations, with the lowest fertility rates in the world, were in such unexpected places as Spain, Italy, Hong Kong and Portugal. Those were Roman Catholic countries where the women no longer wanted to have 12 children like their great-grandmothers, or 12 children like their grandmothers, or five like their mothers; they were happy with one or two, if any. That change had taken place over the last 30 years, owing to a combination of social and economic factors and the availability of effective contraception.

To a question about how to turn the ageing populations of the developing world into resources, he highlighted the AIDS epidemic in Africa and noted that it was older people who were looking after their infected children, often in appalling poverty. Further, older persons cared not only for their children, but for their grandchildren, as well. Their contribution was very important, but it had not been recognized or supported. Very little of the billions of dollars poured into Africa to face the challenge of the AIDS epidemic had been diverted to the older persons who, in the vast majority of circumstances, cared for their children and grandchildren. That was one example of how support could be provided to older people who were already, against all odds, contributing to their families and societies. More information about the disease and more material support would, in turn, equip them to be more effective "carers".

Such an initiative would be new, he said to a follow-up question about what new things he wanted accomplished. Older people were already acting as supporters. What would be new would be to implement policies and interventions to allow them to do it more effectively. Income generation was indispensable towards creating new ideas, as was support for non-governmental organizations already working in such countries. A greater exchange of information was also required. The only way to free people trapped in poverty was to provide them with a way of generating their own income and then integrate them into the community.

Replying to a related question, he said the extended family was an illusion. In every country experiencing fast modernization or urbanization, the structures of the extended family would succumb. When he was a child in Brazil, the urban population had comprised less than one third of the total population; it was now approaching 90 per cent. It was a different country, altogether, in which the extended family would not survive. Smaller countries that had invested heavily in education or health care would be better able to face the challenge of ageing, he added.

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