High-level panel discussion on the Third Review and Appraisal of the MIPAA

The Commission for Social Development in its 56th session, held a high-level panel discussion on the third review and appraisal of the Madrid International Plan of Action on Ageing (MIPAA) on 31 January 2018. The panel comprised of five panelists nominated by the United Nations Regional Commissions, and aimed to identify opportunities and challenges for further implementation of the MIPAA; explore how laws and policies aimed at enshrining and respecting the human rights of older persons can advance implementation of the MIPAA, including through the exchange of good practices and lessons learned; and explore how the Member States and the Commission can create synergies between the MIPAA and the SDGs to enhance the well‐being and the rights of older persons as well their role in advancing sustainable development for all.

The panel included: His Excellency Mr. Héctor Cárdenas, Social Action Minister of Paraguay; His Excellency Mr. Jose Antonio Viera da Silva, Minister of Solidarity, Employment and Social Security of Portugal; Her Excellency Ms. Shirin Sharmin Chaudhary, Honorable Speaker of Parliament of Bangladesh; His Excellency Mr. Lazarous Kapambwe, Permanent Representative of Zambia to the United Nations; and Ms. Abla Sibai, Professor at the American University of Beirut and Co-founder and President of the Center for Studies on Ageing in Lebanon. The panel was moderated by Ms. Sylvia Beales, Consultant on Global Ageing.

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His Excellency Mr. Héctor Cárdenas, Social Action Minister of Paraguay highlighted that Latin America and the Caribbean was the first region in the world to hold a review and appraisal meeting of MIPAA, through the Fourth Regional Intergovernmental Conference of Latin America and the Caribbean on Ageing and Rights of Older Persons. This Fourth Conference was held by the Economic Commission for Latin America and the Caribbean (ECLAC), together with the Government of Paraguay, in Asunción, from June 27 to 30, 2017. During the Regional Conference, delegations highlighted the main activities carried out to extend the protection of the rights of older persons, the advances achieved in the policies targeting older persons, as well as existing challenges and gaps in the implementation of the San José Charter. The debate allowed sharing experiences and best practices in countries of the region, whose population is rapidly ageing.

In the Latin American and Caribbean region there is a high percentage of employment in the informal sector, social inequalities, a low level of institutional development and incomplete social security coverage. However, great progress has been made in the last five years, including the adoption of specific laws on older persons, the preparation of national plans, the institutional strengthening of local governments in relation to ageing issues, the prevention and sanctioning of violence against older persons, the access to justice, care for mental illnesses including Alzheimer's disease, and the promotion of long-term care. Reference was made to the Inter-American Convention on the Protection of the Human Rights of Older Persons, which is the first regional specific legal instrument on the human rights of older persons to promote, protect and ensure the recognition and full enjoyment, under conditions of equality, of all their human rights and fundamental freedoms. To date, Argentina, Bolivia, Chile, Costa Rica and Uruguay have ratified the Convention, and at the Regional Conference, several other countries highlighted the steps taken to move forward in this regard.

The Declaration of Asunción on Building Inclusive Societies: Ageing with Dignity and Rights, was adopted during the Fourth Regional Conference. In the Declaration, Governments reaffirmed their commitment to promote, protect and respect the human rights, dignity and fundamental freedoms of all older persons, without discrimination of any kind, and emphasized the importance of the San José Charter as regional framework for the development of public policies on ageing, which also complements the work of other existing regional and international mechanisms, such as MIPAA. The Declaration, highlighted the following: (a) a call for Governments to mainstream ageing issues in policies and development plans and to implement specific policies that recognize gender inequalities and promote autonomy and independence; (b) the need to consider the situation and interests of older persons in the implementation and follow-up of the 2030 Agenda for Sustainable Development and the Sustainable Development Goals; (c) the eradication of age-based discrimination, neglect and violence; (d) the importance of strengthening the capacity of leading national institutions in the area of ​​ageing; (c) the importance of collecting data and preparing statistics disaggregated by relevant factors in national contexts; (d) specific assistance to older persons in risk assessment, preparedness, prevention and response in cases of disaster and emergencies; and (e) the development of long-term care policies and programmes. A specific reference was also made to preventive and care programmes for Alzheimer's disease and other forms of dementia; as well as the expansion of palliative care services.

The Latin American and Caribbean States reaffirmed their commitment to the work of the General Assembly’s Open-Ended Working Group on Ageing and asserted the need to initiate the drafting of a specific multilateral legal instrument, based on a comprehensive and binding approach, to promote and protect the rights and dignity of older persons. The region also welcomed the work of the Independent Expert on the enjoyment of all human rights by older persons.

His Excellency Mr. Jose Antonio Viera da Silva, Minister of Solidarity, Employment and Social Security of Portugal highlighted the Declaration of Lisbon adopted at the Ministerial Conference on Ageing, which was held in Lisbon on 21 and 22 September 2017, entitled “A sustainable society for all ages: realizing the potential of living longer”. The Declaration aimed to recognize the potential of older persons; to encourage longer working lives and ability to work; and to ensure ageing with dignity. Over the past five years, the region has succeeded in increasing attention on issues of population and individual ageing; in developing and/or revising national strategies on ageing, with a focus on active ageing; in adapting national social protection systems to demographic changes; in enhancing the involvement of civil society organizations; and in the utilization of innovative approaches in the provision of services for older persons.

The implementation of MIPAA, during the third review and appraisal cycle, and against a background of economic crises in Europe, faced socio-demographic framework challenges; low fertility rates and transformation resulting from globalization and technological revolution; and a rapidly changing economy and new emerging risks. This called for new responses including changing the mindset to view older persons as a potential and not a burden, and recognizing that ageing is a common challenge for all societies. The region is working towards achieving the following main proprieties by 2022: (a) empower older persons; (b) realize the potential of longevity; (c) eradicate competitive disadvantages older persons face in the labour market; (d) make early retirement less attractive; (e) combat all forms of discrimination; (f) promote the dignity of older persons and recognize their contributions; (f) better integrate and coordinate quality health and social care systems; (g) develop age-friendly community programmes and better support informal and family care providers; and (h) address challenges as dementia, social isolation and loneliness.

His Excellency da Silva concluded by reiterating that the challenges ahead are huge, and noted that MIPAA is able to respond to these challenges. It is therefore important to strengthen the implementation of the Plan and to also anchor it within efforts to implement the 2030 Agenda for Sustainable Development and the Sustainable Development Goals Efforts, including through enhancing opportunities for the contributions of older persons in that regard.

Her Excellency Ms. Shirin Sharmin Chaudhary, Honorable Speaker of Parliament of Bangladesh drew upon the outcome of the Asia-Pacific Intergovernmental Meeting on the Third Review and Appraisal of MIPAA, convened in Bangkok from 12-14 September 2017. To turn population ageing into an opportunity, countries of the region have developed and adopted policies that ensure that older persons are not being left behind but are empowered to play their due role in promoting sustainable development. The UNESCAP report entitled “Addressing the Challenges of Population Ageing in Asia and the Pacific”, prepared as a part of the regional review, noted that to-date, most countries of the region have a national policy or action plan on ageing and about two-thirds of the countries have an overarching legislation on ageing or on older persons. Since the second regional review of MIPAA, several countries adopted new polices or revised existing policies and action plans.

Governments have taken positive steps to promote decent work and income-generating opportunities for older persons through measures such as training, labour market information and job search support, or tax incentives for companies that employ older persons. Providing or improving income security for older persons was at the center of many policies. Countries increased coverage of and access to contributory and non-contributory pension schemes and have taken steps to ensure the sustainability or existing pension systems. While noting the importance of universal health coverage for all, many countries implemented policies to increase access to healthcare for older persons. Often, healthcare services are provided free of charge to older persons. Others expanded access to health insurance to older persons. Long-term care systems for older persons were further developed with public, private, and community providers as well as with families to provide integrated care for older persons. Specifically, some countries had taken steps to develop existing systems into systems of integrated care focusing on community-care services.

Despite improvements, there were still gaps in providing income security for older persons. Limited access to income security can raise concerns over rising poverty among older persons and rising income inequality in ageing societies. The lack of income security is particularly a concern for older women, whose life expectancy is typically higher. There is a further need to support the creation of enabling environments for older persons, including through supporting ageing in place, encouraging lifelong learning opportunities, addressing violence against and neglect and abuse of older persons; promoting positive images of ageing; and preventing ageism and age-related discrimination in the workplace. In tune with the 2030 Agenda, providing access of older persons to new technologies should become a future priority. The regional review also emphasized the importance of age-disaggregated statistics as key elements in formulating evidence-based policies.

His Excellency Mr. Lazarous Kapambwe, Permanent Representative of Zambia to the United Nations noted the work of the United Nations Economic Commission for Africa on the third review and appraisal of MIPAA, and provided the context of ageing in Africa, which is often described as a youthful continent, yet is undergoing a dramatic change in its demographic structure due to declining fertility and mortality levels. Since 2012, Africa has made some progress on the implementation of the three priority areas of MIPAA. Most African countries have national policies on older persons, with others undertaking efforts to develop such frameworks. However, all countries continue to face a wide range of challenges that hinder the implementation of policies on ageing. Several countries reported major human rights challenges experienced by older persons, including: lack of awareness of older persons’ rights, age-based discrimination and marginalization, gaps in social security provisions, as well as violations, abuse, neglect and lack of legal protection in that regard. Most governments also reported limited human resources dedicated to ageing, limited support from international agencies and limited budgetary resources to implement activities for older persons.

Results from the third review and appraisal in Africa shows that data on various indicators disaggregated by age and sex are limited and available only in a few countries in the region.  Involvement in later-life research by Government agencies, universities and independent researchers is very low. Overall, few countries have data pertaining to social, economic, demographic and health characteristics of older persons. Only a few countries provide an accessible repository where data and evidence on population ageing dynamics is available to concerned stakeholders, therefore limiting in-depth understanding and robust analysis of older persons’ issues in the region. Most of the countries noted the lack of availability of continued education programmes, including programmes that target the use of communication technology among older persons. Similarly, older persons’ inclusiveness in other areas such as non-contributory pension and emergency preparedness is strikingly limited. The results of the third review and appraisal also show that not many African countries have measures to advance health and wellbeing of older persons into old age. While most governments have policies and programmes to promote health and wellbeing, the implementation and sustainability of relevant measures is a challenge. There is a lack of policies and programmes to ensure universal and equal access to healthcare for older persons in most African countries. Educational opportunities for training healthcare providers, health professionals and informal care givers are inadequate. Many African governments do not have measures to support older persons with disabilities.

In the context of ensuring enabling and supportive environments, only a small number of countries have put in place programmes that promote ageing in the home environment, mobility outside home environment as well as care for older persons. Similarly, there are limited measures for mitigating neglect, abuse and violence against older persons and encouragement of positive images of the older persons. His Excellency concluded by indicating that although progress has been made since 2012, African countries need to do more to address the challenges which militate against implementation of national plans and policies. There is need to address key reported barriers to implementation namely: insufficient financial resources, lack of political will, inadequate cooperation between ministries, shortage of information on population ageing; and insufficient human resources capacity.

Ms. Abla Sibai, Professor at the American University of Beirut and Co-founder and President of the Center for Studies on Ageing in Lebanon presented findings from the ESCWA region, comprising 18 countries in the Middle East and North Africa region. As the pace of population ageing in the region quickens, most of the countries in the region are on the cusp of demographic changes with far-reaching social and economic implications. This transition comes with many challenges including a decline in extended family structures and a rise in the burden of chronic degenerative diseases. The region is additionally challenged by protracted wars, conflict and political instability, including the Syrian crisis, resulting in several waves of youth outmigration seeking better opportunities elsewhere, and leaving behind older refugees to fend for themselves.

Institutional response on ageing have mostly been inspired and encouraged by MIPAA with governments creating various modalities of arrangements. Policies tend to be focused around the mandate of the Ministry where the department of ageing or the National Commission is housed (e.g. health, social or family affairs). Despite variations across the region, the current generation of older adults share baseline vulnerabilities that have important implications for their care. These include low levels of educational attainment, with illiteracy rates reaching up to 80 per cent for women in certain localities, dwindling economic safety nets, and continued workforce participation into the latter years of life due to insufficient or inadequate social protection. Social Protection schemes vary but are mostly characterized by inequity in coverage across sectors of employment and by gender. In contrast to civil servants and those in the public sector, the self-employed and those in the informal sector are less likely to qualify for old-age pension plans, thus adversely affecting women who fall sharply out of the social security umbrella. As a result, prolonged participation in the labor force beyond retirement age is a common phenomenon in the region.

Data on health and wellbeing in old age is scarce in the region, where healthcare delivery is built around cure rather than prevention. The family remains the main pillar of ageing policies, with legislations being founded on the vital role of informal and unpaid family care. However, socioeconomic realities and political conflicts across the region have triggered neglect and various forms of alienation from the traditional multigenerational family configuration, resulting in increasing solitary living among older persons. Arab societies consider social obligations to be sufficient for the protection of older persons against maltreatment. Maltreatment is often cloaked by family secrecy, which is why it remains vastly under-researched, and figures likely to be underestimated. Despite growing conflicts in the region, there is a distinct lack of consideration for the specific needs of older people in emergencies. Ms. Sibai concluded by noting that challenges in the region include deficiency of financial and human resources, weak ministerial coordination and lack of disaggregated data for evidence-based making.

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