On 1 October 2007, International Day of Older Persons, delegations of older people in 26 countries met with government representatives to review progress in implementing the 2002 Madrid International Plan of Action on Ageing (MIPAA), present their issues and demand action.
Older people said that regular income, alongside affordable healthcare, were essential to securing MIPAA's vision of a society for all ages. They called for priority to be given to economic security, health provision, inclusion, and an end to age discrimination. Their governments responded by providing firm commitments to increased pensions, improved healthcare and better access to basic services such as food, water and credit.
This first-ever coordinated global action by older people to bring about change – the Age Demands Action campaign coordinated by HelpAge International – showed that older people have clear aspirations, and that they want their voices to be heard by policy makers. They want MIPAA to be implemented in a way that is relevant to them – and to avoid falling into the trap highlighted at the 2002 Assembly, when an older woman from Zimbabwe said: "They say this is the second plan – what happened to the first?"
Promoting participation
In keeping with MIPAA's central aim of promoting older people's participation in society, the UN Commission for Social Development (CSD) endorsed a bottom-up approach to review and appraisal of MIPAA. It undertook to carry out a global review every five years.
The CSD mandated UN regional commissions to organise regional conferences to present the outcomes of "an open-ended, participatory process that seeks to incorporate and link local and national activities to UN regional intergovernmental bodies and up to global level of the review and appraisal" of MIPAA.
This approach marked an unprecedented and welcome shift away from the conventional review process, in which governments report on their own actions, towards sharing this responsibility with a wider group of stakeholders, including older people.
Patchy commitment
UN regional review meetings were held in Macau in October 2007 (ESCAP), León in November (ECE), Amman in November (ESCWA), Addis Ababa in November (ECA) and Brasilia in December (ECLAC). In the event, country reports presented at these meetings reveal a patchy commitment to reviewing MIPAA, and a disappointingly low adoption of a participatory approach. Despite UN member states' declarations to the contrary, the views of poor older women and men have not been systematically reflected in the official reports. For example, in Europe and North America, only 31 of the 56 member states submitted country reports on progress of the UNECE regional implementation strategy. Of these, just 12 had established a bottomup monitoring process and a close working relationship between governments and citizen groups.
The Africa regional report details progress on policy formulation and adoption in a range of countries. But it is often not clear what the provisions of the policies are, or whether older people have engaged in their formulation. Reports from Asia and the Pacific indicate some inclusive approaches to policy-making. An ESCAP survey, launched in 2005 and covering more than 20 countries, shows that about half these countries used participatory tools, such as client satisfaction surveys and focus group discussions to collect information for reviewing MIPAA.
According to the report of the ESCAP regional review, most countries in the region have developed policies and are implementing interventions to address the needs of older people. Coordinating mechanisms on ageing at presidential and ministerial level have been established in some countries, while others have designated national focal points on ageing. The report recognises that low levels of education have been an impediment to the promotion of active ageing. Better resourced governments, such as Hong Kong, China, Japan and Singapore have prioritised the promotion and provision of opportunities for continuing education and retaining mature workers beyond the compulsory retirement age.
In Western Asia, achievements include the establishment of national committees on ageing in seven countries, the building up of specialist geriatric care skills in medical professions, the introduction of mobile clinics in Bahrain, Oman and Saudi Arabia and the gradual decline of older people's illiteracy in the region (although very high levels remain – up to 40 per cent of over-60s in Jordan).
However, there has been little progress in formulating national policies for older people, with only four countries – Bahrain, Jordan, Qatar and Syrian Arab Republic – drawing up guidelines for doing this. According to the ESCWA representative who gave the keynote address at the regional review meeting, "charitable acts" on ageing, rather than "systematic policies", dominate the region. A strong social model could reduce inequalities and tension between communities. The Latin America and Caribbean regional meeting reflected most closely the priorities identified by older people who took part in the Age Demands Action campaign. The report highlights the importance of economic security for older people, and the need for action at governmental and UN level to curb abuses of rights perpetrated against older people.
Its recommendations include greater provision of social security in old age, and the appointment of a special human rights rapporteur for older people. Governments of the Caribbean, in their sub-regional meeting, stated their commitment to an ageing population. They reported advances in the formulation and adoption of national policies and supportive legislation to provide for and protect older people. Their reports detail the extension of existing social security coverage by increasing pensions; establishing and strengthening non-contributory pension schemes; and taking measures to address isolation and loneliness of older persons through social, recreational and cultural activities.
Transparent monitoring
The fact that a number of the reports and recommendations reflect older people's demands for income, health provision and the end to abuse is to be welcomed. Older people are disproportionately poor across the world. Regular income to older people, especially those in the informal sector, and the provision of affordable healthcare, are acknowledged as key to reducing old-age poverty and supporting intergenerational interdependence. But the reports contain no concrete plans to implement the proposed policies or to provide any dedicated resources to pay for them.
The fact that small delegations of older people met with government ministers and heads of state in 26 countries to discuss key concerns and develop partnerships shows that older people are ready and willing to engage in policy processes. Yet very few formal government responses were developed in conjunction with older people. Despite being experts in the realities of ageing, older people were not invited to participate in the expert meetings.
It is possible to make change. For the next five-year review cycle, NGOs and citizen groups are suggesting a monitoring process that is transparent and participatory. It should contain contributions from NGOs and older people, and be based on meaningful indicators, agreed upon with civil society. There must be renewed support for older people and their governments to engage in a bottom-up approach. At the same time, all countries should commit resources to data-gathering disaggregated by age and sex, relevant research on ageing, cross-disciplinary collaboration, and promoting best practice. This is necessary to ensure that policies on ageing are responsive to older people's needs and rights, and that they receive the political and financial backing they require.
