Africa is ageing — but how prepared is the continent?
THERE is growing recognition of the extent and impact of increasing longevity.
By 2030, there will be more people globally aged older than 60 than children under 10, and 73% of older people will live in developing countries. While an ageing population reflects successes in public health, education and general economic wellbeing, it remains a critical policy issue across the world.
Three major global reports published this year — by the World Health Organisation, the World Economic Forum and the United Nations Population Fund, together with HelpAge International — highlight both a need for more coherent action to ensure the wellbeing of an expanding older population and the importance of such action for societies’ development.
These two messages affirm the central principles enshrined in the UN’s Madrid International Plan of Action on Ageing (MIPAA), the framework set by the international community in 2002 as a blueprint for national responses to ageing.
The MIPAA principles were reinforced at the landmark Africa Ageing conference held in Cape Town in October 2012. Convened by the Africa region of the International Association of Gerontology and Geriatrics (IAGG) and organised locally by the University of Cape Town’s Institute of Ageing in Africa, the conference came on the heels of a step-change in global awareness and debate on population ageing. It brought together 400 researchers, policy makers, practitioners, and civil society and private sector representatives, from 21 countries across Africa and 20 beyond.
Timed to mark 10 years since African governments adopted the MIPAA as well as a parallel African Union framework and plan of action on ageing, the Cape Town conference had three main objectives: to assess progress made in African countries in implementing the two plans; to consolidate knowledge on the realities of old age on the continent; and to set directions for research, policy and practice in coming years.
The discussions brought into focus the demographic projections of ageing in Africa: despite remaining younger than all other continents, Africa will see 13-fold growth in the size of its older population — from 56-million today to 716-million by 2100. This growth will outstrip that of any other world region or any younger age group.
The remarkable spectrum of evidence presented in Cape Town showed that we now have an enhanced understanding of many key dimensions of ageing in Africa. These include:
• the crucial ways in which older people care for younger generations and act as agents of stability and positive change in the contexts of poverty, HIV and migration;
• the living circumstances and family relations of older people, as well as the patterns and causes of ill health, social exclusion, and abuse and poverty in old age in both rural and urban settings;
• types of models that work in providing institutional and community-based long-term care as well as medical treatment for older people, including those with dementia;
• systematic adaptations needed to African health and social protection systems to ensure income security and access to services in old age; and
• frameworks and approaches needed to safeguard older people’s human rights.
There can be no doubt that more than 30 years after it first emerged, the research debate on ageing in Africa has reached a point of inflection. Yet there remains a palpable disconnect between the momentum of the conference and the near-absence of ageing as a feature in mainstream policy and public discussion in the continent.
African media, for example, paid little, if any, attention to either the Cape Town conference or the earlier landmark global reports — contrasting sharply with the extensive coverage of the latter in other parts of the world. Within national governments and regional bodies, desk officers or departments responsible for ageing often face major constraints to their work on the grounds that "older people are not a concern for Africa".
Some of the lack of interest may be explained by two common misconceptions: that the continent’s older population is negligible in both number and proportion, and that older people, in accordance with African custom, are cared for by their families. Both notions have now been amply rebutted.
There is a more fundamental reason for a limited concern with ageing. Issues of older persons are essentially seen as irrelevant to, or even a distraction from, the continent’s core population and development challenges. These challenges are, in particular, to enhance capacity and provide opportunities for Africa’s huge number of youth and unemployed, and to achieve food security — in order to attain stability, equity and sustained economic growth.
Herein lies a key challenge. Researchers must work together to show clearly how, and to what extent, matters of ageing are directly relevant to overarching interests in the region. We already know that such a nexus exists — through older people’s own productivity, through their family roles and the effects they have on the capabilities of younger generations, and through age-based inequities in access to essential services. But only robust evidence on these connections will serve to convince decision makers that population ageing is a key factor for Africa’s development in the 21st century.
Generating such knowledge alone is not enough, however. Too often, critically important research results go unnoticed or are ignored in policy and practice. More African platforms are required to foster dialogue between those producing evidence and those needing to use it at national, regional and international levels. Such exchange, together with basic training on ageing — especially for policy, civil society, practice and private-sector stakeholders — will do much to ensure evidence is translated effectively and where it matters.
There is no more critical need for such efforts than now, as the world ponders what overarching frameworks should succeed the Millennium Development Goals when they expire in 2015 — and as Africa seeks ways of delivering on its promise of sustained progress and growth.
At this juncture, we face a unique chance to ensure the opportunities and challenges of population ageing are harnessed in agendas and strategies for Africa’s future.
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