Toolkit

Context: In Austria, nearly 20 percent of the national population is age 65 and older, and by 2050, that proportion is expected to rise to 26.6 percent. Recognizing this demographic shift, Austria has been an early adopter of policies aimed at addressing the well-being of older persons, with the Ageing, Population and Volunteering Policies unit established at the Federal Ministry of Labour, Social Affairs and Consumer Protection in 1997. The Federal Senior Citizens Act, passed in 1998, similarly helped to strengthen the government’s capacity for implementing aging policies by creating the Federal Senior Citizens’ Advisory Council, an umbrella organization made up of non-partisan senior-focused civil society organizations, which raises awareness on senior issues, works with the government to create and implement policy, and holds events and information sessions for seniors. According to data from 2016, over 706,000 senior citizens in Austria were members of the Council’s five sub-organizations.

Plan Development: Austria’s Federal Plan for Senior Citizens was developed in close coordination between the Federal Senior Citizens’ Advisory Council and the Federal Ministry of Labour, Social Affairs and Consumer Protection. Statistics on aging across genders, socio-economic, and immigrant status were provided by the Central Statistical Office to help inform the accuracy and support the effectiveness of the plan. After extensive research and incorporating feedback from members of the Council, the Plan was published in 2012.

Principles & Goals: The Federal Plan for Senior Citizens details 14 action items with the primary concern of improving the quality of life of senior citizens in Austria. These 14 objectives can be broadly grouped into four categories: 1) increasing the ability of older people to work longer; 2) ensuring the social inclusion of older individuals; 3) promoting independence and good health in old age; and 4) creating intergenerational connections among Austrians. These goals align with the 2012 Vienna Ministerial Declaration on Aging from the UN Economic and Social Council, and acknowledge the disproportionate impact of gender, socioeconomic status, and nationality on aging. Specifically, the Plan aims to alleviate the challenges facing older women by increasing their available income, promoting social networks and interest groups for older women, and increasing their participation in society overall. It also recommends an expansion of the Austrian long-term care system and nursing services. Finally, the Plan details awareness campaigns to reduce discrimination against older individuals and promote a diverse representation of Austrian elders in the media.

Execution & Achievements: Each of the Plan’s 14 action items features distinct objectives and recommendations to further that particular goal. The unit on Ageing, Population and Volunteering in the Federal Ministry of Labour, Social Affairs and Consumer Protection is responsible for coordinating implementation across the government. The objectives are meant to be long-lasting and do not have a particular end date assigned to them. According to the country’s 2022 MIPAA report, Austria has built on pre-existing objectives and added new measures to their action plan, noting that “significant progress was made” in all of the target areas.

Current Status & References:. Austria’s MIPAA report from 2022 also provides more information about the country’s latest efforts on Aging. In recent years, the Austrian government has initiated pension reform, undertaken a study to examine the impact of the COVID-19 pandemic on older populations and introduced a national plan on dementia. For more information, visit the Austrian Chancellor’s website to view the national plan.

Context: Bosnia and Herzegovina (BiH) faces acute population aging due to rising life expectancy, low fertility rates, and high rates of migration; by 2050, it is expected to have one of the ten oldest populations in the world, as measured by median age. As of 2022, adults over 65 years of age accounted for 18.3 percent of BiH’s population, but that figure is expected to rise to 24.1 percent by 2030—and to approach 30 percent in 2050. Because women tend to have a longer life expectancy than men, the population over 65 in the country is projected to skew strongly female in 2050, including 54 percent of those over 60, and 63 percent of those over 80. At the same time, women over 65 are the poorest demographic group in BiH. The older population in BiH faces a slew of challenges, including low incomes, increasing cost of living, high rates of disability, poor mental health, and high rates of non-communicable diseases. The national government created the Strategy for Improving the Position of Elderly Persons, 2018–2027, to address the multifaceted problems facing older adults.

Plan Development: The Strategy was initially released in 2017 by the Federal Ministry of Labor and Social Policy (FMRSP), which is the primary government entity responsible for the plan’s implementation. The strategy was developed in accordance with the Guidelines for the Development of Social Policies on Aging, a document developed by the FMRSP in partnership with the UN Population Fund (UNPF) and UN Department for Economic and Social Affairs (UN DESA). These guidelines were informed by a series of workshops and meetings with relevant government entities in the country in 2014 and 2015, which were used to better understand the main challenges facing older adults in BiH. The government pursued public input on an initial version of the strategy in 2017 through public consultations. The FMRSP also cites a number of documents as important for informing the Strategy’s content, including the Madrid International Plan of Action on Aging (2002) and the European Social Charter (2015).

Principles & Goals: The Strategy is based on the overall goal of “improving the quality of life of the elderly,” which it then further breaks down into eight strategic goals. These are (1) reducing poverty, (2) improving health, (3) enhancing access to public institutions and transportation, (4) improving social services, (5) increasing awareness about social services and rights, (6) expanding awareness of the needs of older adults, (7) reducing age-related violence, and (8) expanding social and community participation. These eight goals are then split into 27 constituent measures and further into smaller sub-components. For example, measure 4.3, related to improving the quality of social protection services, includes four subcomponents: improving training, organizing international exchange of best practices, ensuring routine inspection, and standardizing supervision. Each goal also includes a list of the entities relevant for bringing a measure to fruition; for example, for measure 7.1, related to raising awareness about violence against older adults, these entities include social work and protection centers, the police, educational institutions, the Gender Center of the Federation of Bosnia and Herzegovina, medical institutions, and civil society. Altogether, the Strategy emphasizes the fundamental role of human rights, with the “rights” of different groups, such as older adults or those living with disabilities, mentioned 37 times.

Execution & Achievements: The Strategy includes extensive resources related to monitoring and evaluation. Each of the plan’s 27 measures are accompanied by specific indicators as well as a timeline for implementation covering the first two years of the strategy’s timeline (2018 and 2019) on a quarterly basis. This detailed timeline shows how programmatic efforts are organized in successive, complementary stages. For instance, for sub-measure 2.4 “Improving standards for providing palliative care,” the plan projects that an analysis of existing regulations and practices would end by the second quarter of 2019, with the rest of the year devoted to implementing recommendations from that analysis. Another section of the Strategy provides more detailed descriptions of the indicators within each goal, providing definitions and timelines for the evaluation of each stretching out to 2027, with most evaluations set to occur annually or on a four-year cycle. While the strategy explicitly states that the FMRSP will publish annual reports on implementation, these reports could not be located in Bosnian or English through search inquiries or manual searches on the FMRSP website. Some recent achievements are detailed in the latest periodic report on implementation of the MIPAA from 2017 to 2020, published by the Ministry of Human Rights and Refugees. Such accomplishments include reforming the Law on Pension and Disability in 2018 to improve pensions (updated again in 2022), publishing guidelines on conditions in health care institutions, and activation of the Emergency COVID-19 Project, in partnership with the World Bank, to provide social protection assistance to older adults.

Current Status & References: The Strategy is set to be active through 2027 and can be viewed here. A number of other relevant strategies have been pursued by the national government in recent years, including the Social Inclusion Strategy, 2021–2027, the Development Strategy, 2021–2027, and the Strategy for the Improvement of Rights and Position of Persons with Disabilities, 2022–2027. Recent actions by FMRSP can be followed on their website.

Context: The population of Bulgaria is one of the oldest in the world by median age. By 2060, the share of Bulgaria’s population over age 65 years of age is expected to rise to 32.5 percent. As a result, Bulgaria is headed toward a steep decline in its population size, which has already decreased by 11.5 percent between 2011 and 2021. Bulgaria’s aging population, low fertility rates, high mortality rates, and migration patterns are projected to significantly shrink the working-age population at a rate that will outpace every other country in Europe. As a result, Bulgaria developed the National Comprehensive Strategy for Active Ageing in 2016 to meet the potential economic, societal, and health challenges associated with an aging population,

Plan Development: This Strategy was developed based on the results of local roundtables on aging, as well as national, multinational, and European datasets. In particular, the Strategy’s development reflects the indicators and priorities of the Active Ageing Index (AAI), a tool created to measure active and healthy aging across European countries. According to the AAI 2018 results, Bulgaria lags behind a majority of countries in key AAI indicators, including those regarding societal participation and healthy living. 

Principles & Goals: The Strategy centers around the same four priorities as the AAI. These priorities are: 1) promoting active aging in the workforce; 2) promoting active aging through participation in society; 3) promoting active aging through independent living; and 4) building capacity and a favorable environment for active aging at a national and regional level. Principles of the Strategy implicitly support human rights, prioritizing independence, access, participation, and dignity.

Execution & Achievements: There are detailed policies associated with the four priorities of the National Strategy for Active Ageing, which was developed around the 22 metrics established by AAI. To better understand the needs of older adults and progress made by the Strategy, the Ministry of Labour and Social Policy has commissioned a survey to collect up-to-date information on the indicators of the Active Ageing Index. The realization of these measures will be monitored through biannual plans and biannual reports on the Strategy implementation. An evaluation of the Strategy will be conducted every four years during its period of implementation (2019–2030). The first report was released in 2021 and revealed the need for additional integration across the key sectors of employment, health care, education, social security, and social assistance in order to achieve the plan’s goals.

Current Status & References: To date, two Action Plans have been prepared and adopted by the Council of Ministers for implementation of the National Strategy for Active Ageing in Bulgaria, covering the periods 2019–2020 and 2021–2022. The latest Action Plan for 2021–2022 prioritizes measures to contain the spread of COVID-19, improve employment opportunities, and boost civic participation among older adults. For more information, see this website to view the Strategy. 

Context: Finland is among the most rapidly aging societies in the world. The number of adults aged 65 or older is expected to reach 27.6 percent by 2050—rising from 23 percent in 2021, or almost 1.3 million people. The total Finnish population will begin to decline as early as 2031. Both of these factors will cause the Finnish workforce to decrease while also requiring additional government funding to adequately provide care to and support the well-being of the aging population. Another important factor is low rates of employment in older adults as only 30 percent of people over age 61 are currently employed. To address these challenges, Finland released the National Programme on Ageing in 2020. The Programme sets out objectives focused on the retention of older employees in the workforce and improving functional capacity.

Plan Development: The Ministry of Social Affairs and Health published the National Programme on Ageing in 2020 with input from various stakeholders across the Finnish government. It included a working group of experts on aging from the Ministry of Social Affairs and Health, the Ministry of the Environment, the Ministry of Economic Affairs and Employment, the Ministry of Education and Culture, the Ministry of Justice, the Association of Finnish Municipalities, and the Finnish Institute for Health and Welfare. Prime Minister Marin’s government also conducted a survey of relevant specialists, which helped to develop the impact objectives for the program.

Principles & Goals: The National Programme on Ageing articulates several key impact objectives to prepare for these upcoming challenges. These interconnected goals focus on improving functional capacity for older adults, expanding employment options for older persons, promoting volunteering in Finnish society, Age-friendly housing, and home-based care. Another important objective of this Programme seeks to research and utilize new technologies and artificial intelligence to facilitate aging in place and increased independence in old age. This is largely being done through the Well-Being and Health Sector’s Artificial Intelligence and Robotics Programme (known as Hyteairo), which supports aging-in-place priorities. These impact objectives correspond with Finland’s increased challenges, including COVID-19, while also improving the lives of older individuals.

Execution & Achievements: The National Programme details which government agency holds the principal responsibility for each of the impact objectives. Most objectives fall under the jurisdiction of the Ministry of Social Affairs and Health, but other measures will be implemented by the Ministry of Justice, the Ministry of the Environment, and the Ministry of Education and Culture. Each key objective also notes which research and actions for that objective will take place during the 2020–2023 periods and which are regulated for the later 2023–2030 period. Measures for the first implementation period include specific funding and targeted goals, as well as various indexes, plans for further research, and models to support their work. Implementation for the program will be evaluated by a steering group and an implementation group, which will include older individuals and specialists on aging. Finland reserved 5 million EUR per year for 2020–2022 to implement these policies. A more detailed plan for the initiatives from 2023–2030 is expected later in 2023. The Ministry of Social Affairs and Health submitted a report on the implementation of the Programme in 2021, concluding that the National Programme was following UN objectives on aging.

Current Status & References: For more information, visit the website for the Finnish Ministry of Social Affairs and Health. The current plan is active through 2023, with suggestions for future Finnish governments until 2030.

Context: By 2030, France will have more citizens over the age of 65 than younger than the age of 15, with the share of the population over 65 rising from 21 percent in 2021 to a projected 27.8 percent in 2050. Additionally, life expectancy in France is increasing, with projections that 14.6 percent of the French population will be over the age of 75 by 2040. In light of these demographic trends, the government of France developed a plan to mobilize citizens to create a new “society of longevity,” where more French people can age in good health and maintain their autonomy. To develop the best policies to fit France’s changing demographics, the French government has worked to regularly update its efforts relating to aging, resulting in the “Healthy Aging” national plan in 2020.

Plan Development: France began expanding the legal framework for the national plan on aging with the Law of the Adaptation of the Society to Ageing in 2015. In that same year, the French government also created the High Council of Family, Childhood and Age to gather experts in the aging field to help prepare for future challenges related to demographic change. In 2018, France created an Old Age and Autonomy Road Map, with which the priorities of the plan are aligned. Additionally, the French government initiated a public consultation process on aging in 2018, where recommendations were solicited online, through regional forums, and workshops that included representatives from key groups such as seniors, experts on aging, and health care professionals.

Principles & Goals: The 2020 Strategy seeks to comprehensively tackle the challenges related to aging at different stages of life with targeted objectives that focus on measures for French people in their 40s, middle-aged persons, those above the age of 65, and those above the age of 80. The Strategy also seeks to create intergenerational connections between these target groups and French youth. Among older adults, the Strategy seeks to prevent the loss of autonomy, and it tackles this challenge from several angles. The French Ministry of Health and Prevention selected 16 objectives that fall into four categories of action: 1) early prevention starting at age 40; 2) reducing risk factors that increase the loss of autonomy past age 70; 3) embedding prevention strategies into health care frameworks; and 4) improving research and innovation to make France competitive with other European countries. The French government is also concerned with isolation and elder poverty. Some of the 16 objectives listed in the Strategy include a self-evaluation program for early prevention of chronic conditions like Alzheimer’s and other cognitive diseases, the dissemination of the World Health Organization’s ICOPE (Integrated Care for Older People) screening program for identifying frailty, and evaluating the extent to which different cities in France are aging-friendly.

Execution & Achievements: The Strategy outlines goals to be completed by 2020, including the self-evaluation for cognitive diseases and the Age Friendly cities’ label, and others to be completed by 2022, including the dissemination of the ICOPE plan. The plan also budgets funding for objectives, including 175 million Euros over five years for improving dependent care, 15 million Euros per year for expanding prevention measures within retirement communities, and one billion euros for subsidizing home accommodations. In its 2022 MIPAA report, the French government notes that it has appointed a new government position focused on aging, the Minister Delegate for Autonomy, created a new volunteer program to help fight loneliness and ageism, and passed a law that implements a new senior-inclusion contract to extend longevity in the workplace. The French MIPAA report does not detail further progress on the objectives laid out in the plan but relies heavily on work like the 2015 Law of the Adaptation of the Society to Ageing, and the Road Map.

Current Status & References: In its MIPAA report for 2023, the French government notes that this topic requires continuous engagement, and there are plans to pass a future law building on the progress made towards implementation of the 2020 Strategy. Additionally, the report notes that challenges from the COVID-19 pandemic need to be addressed and includes plans for a bill that will incorporate solutions to those challenges. According to France’s 2023 MIPAA report, future projects will also focus on preventing ageism, preserving independence for older individuals, and providing quality and affordable care for older adults. For more information on the plan, visit the website for the French Ministry of Health and Prevention.

Context: By 2051, Ireland’s population of adults over age 65 is projected to double, and its population age over 80 could quadruple. According to the 2011 census, roughly 42 percent of older adults currently live in rural areas, which creates delivery challenges. To plan for an aging Ireland, the Department of Health spearheaded the development of the National Positive Ageing Strategy in 2013.

Plan Development: The Strategy was developed by a Cross-Departmental Group composed of representatives from relevant government agencies with input from government stakeholders, older people, health and service professionals, academics, and nongovernmental organizations (NGOs). This input was solicited through public consultation, as well as through the development of an NGO Liaison Group, which comprised representatives from twelve national-level NGOs that represented the interests of older persons. The consultation process for the Strategy included a public call for written submissions, a series of regional meetings attended by older people and other representatives, and meetings between the Minister for Disability, Equality, Mental Health and Older People, and groups representing older people. The Cross-Departmental Group also visited a roundtable meeting in Louth—the first age-friendly county in Ireland—to understand the county’s Age-Friendly County Initiative. Additionally, the Strategy was informed by a review of strategies on aging from around the world, including healthy aging policies and plans from Australia, New Zealand, and the Netherlands. 

Principles & Goals: The Strategy establishes six national goals to promote and enable positive aging. The first goal seeks to remove barriers to and provide increased opportunities for older adults in cultural, economic, and social life. The second, third, and fourth goals center on health, aging-in-place, and research, respectively. Additionally, the Strategy includes two other goals—combating ageism and improving older people’s access to information—that cut across policy development and service delivery for older people. Each of these goals is underpinned by objectives relevant to the goals’ respective policy areas. These goals were selected with regards to human rights and the World Health Organization’s Active Ageing framework. 

Execution & Achievements: The Positive Ageing Strategy has led to noteworthy achievements in Ireland regarding research, aging-in-place, and age-friendly communities. For example, Sláintecare, a ten-year plan to move toward universal health care, has prioritized the development of programs such as the National Healthy Age-Friendly Homes Programme to ensure as many as 4,500 homes across Ireland have the support necessary to age-in-place. Implementation of the strategy is tracked by 103 indicators. These indicators track progress related to participation, healthy aging, security, and the Strategy’s cross-cutting objectives with additional indicators to track aging among certain marginalized groups, including Irish Travellers and people with intellectual disabilities. Indicators were formulated based on research and data developed from the Irish Longitudinal Study of Ageing, alongside other government census and health statistics.

Current Status & References: The last implementation report was published in 2018. Progress and funding for several report goals have been made since the 2018 report, though, as of April 2022, no further implementation reports have been published. For more information, see this website to view the Strategy. 

Context: Since the State of Israel was established in 1948, the number of adults in that country age 65 or older has increased eighteen-fold. In 2021, 12 percent of the population was age 65 or older, and by 2050, this group is expected to constitute 16.6 percent of Israel’s residents. One unique feature of Israel’s demography is the large proportion of immigrants from as many as 119 different countries, including Holocaust survivors, which presents a diverse range of economic, social, and cultural needs. Israel also has one of the highest life expectancies in the world, at approximately 83 years. At the same time, 20 percent of its population age 65 or older is living in poverty. To navigate these complex challenges, the Israeli government officially recognized aging as a top socioeconomic priority in 2015. It has partnered with the Joint Distribution Committee (JDC) and its Israeli aging research division, JDC-Eshel, to lead the charge on developing national aging strategies for the last 50 years, with an emphasis on members most at risk. JDC-Eshel’s eleventh five-year plan was designed after the onset of the COVID-19 pandemic. The Plan’s implementation is anchored by a national map of indicators for optimal aging, which was adopted by the government of Israel in July 2021.

Plan Development: The development of the 2021–2025 Strategic Plan for Optimal Aging was informed by a public survey of global and local stakeholders. The survey sought to assess risk and resilience factors of Israel’s elderly population following the COVID-19 pandemic. Government partners, who are primarily responsible for implementing the plan’s Large-Scale Initiatives (LSIs), include the Ministry of Health, Ministry of Labor and Social Affairs, Ministry for Social Equality, Ministry of Finance, the Prime Minister’s Office, and the National Insurance Institute.

Principles & Goals: The overarching goal of the Plan is to maximize an older adult’s independence by mitigating health, social, and personal and economic risks for the benefit of both the wider aging population and Israel’s economy. The two cornerstones of the Plan are the map of indicators for optimal aging, formulated and adopted by the government of Israel, and eight Large-Scale Initiatives (LSIs), chosen in accordance with pandemic research findings and tailored to the partner ministries’ strategic directions. Several of the LSIs focus on individual well-being, such as digital literacy skills and quality employment, while others are focused on improving public services, such as affordable housing. These initiatives channel current resources toward elevating preventive care and awareness by investing in platforms such as urban employment centers, hospitals, day centers, and news media.

Execution & Achievements: The six indicators of optimal aging span issues of health, meaning, and economic resilience by measuring: healthy lifespan, functionality, loneliness, quality of life, disposable income, and ability to cope. These indicators aim to direct government ministries’ attention and resources toward gaps in aging policy and serve as a guide for the LSIs. Each LSI is led by one or more government ministry and is overseen by a professional steering committee with members from the public and private sectors. Progress is observed and reviewed every two years and published by the government, with the first round of review anticipated to take place in 2023.

Current Status & References: The Strategic Plan is current through 2025. For more information, see this website to view it.

Context: Between 2020 and 2030, the number of Kazakh adults over 65 is expected to grow by between 4 and 5 percent per year, and the proportion of the population over age 65 is expected to grow 2.5 times from 1.4 million in 2019 to 3.4 million in 2050. This aging trend is leading to pressures on the health care system; for example, in the five years prior to 2019, UNFPA estimates that the number of Kazakh people living with a disability—many of whom are older adults—increased by 7.5 percent, outpacing population growth of roughly 5.5 percent over the same time period. In recognition of this demographic change, the government of Kazakhstan has begun implementing policy specific to the aging population, though national legislation does not provide special status for older adults as it does for children and youth. In 2015, the country adopted standards of geriatric and gerontological care for medical professionals, but medical care remains a priority issue among older adults; in a 2019 survey of adults over 65 conducted by the Ministry of National Economy, just a quarter of respondents found their health to be satisfactory.

Plan Development: To address the growing needs of older adults in Kazakhstan, the Ministry of Labour and Social Protection of the Population developed the National Action Plan for Improving the Senior Citizens’ “Active Longevity” in the Republic of Kazakhstan until 2025. Specifically, the plan is designed to create conditions for the “self-realization and integration” of older adults into Kazakhstan’s society and economy. It builds on the recommendations of the 2002 Madrid International Plan of Action on the Problems of Aging and focuses on concepts such as “active longevity” and the World Health Organization’s definition for “quality of life.” As a part of its foundation, it acknowledges the aging conditions and policies of high-income countries worldwide, particularly OECD countries, examining demographic trends, rights and dignity, pensions, employment, familial relations, health and medical care, social care, and participation in social and political life. The plan is also informed by the results of a number of recent surveys in Kazakhstan to identify the needs of older adults, including a “Generations and Gender” survey and a “Quality of Life” survey conducted by the Ministry of National Economy conducted in 2018 and 2019, respectively.

Principles & Goals: At a broad level, the National Plan identifies three principal elements of the concept of “active longevity” as central for older adults in Kazakhstan: improving health, enhancing participation, and strengthening protection. To accomplish these broad goals, the document defines and enumerates actions and target indicators for nine areas, including (1) increasing life expectancy, (2) reforming pension and retirement practices, (3) harnessing the knowledge of older generations, (4) enabling access to digital services, (5) providing specialized care for older people, (6) enhancing digital literacy, (7) organizing social and cultural activities, (8) ensuring an individualized approach to social care, and (9) standardizing monitoring of costs and needs. Each of the nine areas discusses subcomponent measures to help achieve each goal, such as mandating statistical reporting on older adults, requiring employers to match a certain percentage of employees’ pension contributions, establishing protections for the status of self-employed persons in old age, and expanding medical insurance to long-term care situations. The plan includes particular emphasis on COVID-19 and addresses the unique challenges facing older adults in pandemic or other crisis scenarios, such as addressing social isolation through counseling and psychological support.

Execution & Achievements: The National Plan includes target indicators along with each action area. For example, in the realm of improving health care for older adults, the plan includes indicators to be reached by 2025, such as increasing life expectancy to 75, making major cities friendly to older populations, and creating a modern health registry. A separate “Events Plan” was published alongside the National Plan that defines 67 targets, identifies responsible ministries, and indicates yearly sub-targets to aid and track progress. It does not appear that a systematic monitoring and evaluation process has yet taken place. However, a number of policies and programs introduced both before and after the parliamentary approval of the National Plan suggest that Kazakhstan is implementing efforts to meet the plan’s goals. For instance, the State Program for the Development of Health Care of the Republic of Kazakhstan for 2020–2025 contains provisions focused on non-communicable diseases and facilitating healthy lifestyles across age ranges, while the Ministry of Information and Social Development has introduced a Road Map for the Development of Volunteering for 2021–2023, which includes a focus on “Silver Volunteering” for those over 50 and acknowledges older adults’ wealth of knowledge and experience. Other examples include a 2021 directive by the Minister of Labor and Social Protection which guarantees access to at-home social services for older adults who lack familial support.

Current Status & References: The National Plan is set to remain active through 2025. The plan and some of its supporting documents, including the Events Plan, can be found here. Recent actions by the Ministry of Labor and Social Protection can be followed through the ministry’s website.

Context: Like many other European Union countries, Malta’s population is aging at a rapid rate, leading to population decline. By 2030, one in five people in Malta is projected to be age 60 or over. Given this rapid rate of aging, Malta was among the first countries in the world to adopt a national strategic policy around aging, with a policy in place prior to the Madrid International Plan of Action on Ageing’s publication in 2002. These national policies have helped Malta’s older persons enjoy some of Europe’s longest lifespans spent in good health, with over 90 percent of the average Maltese’s lifespan spent without significant disabilities or illnesses. In 2014, Malta adopted its latest National Strategic Policy for Active Ageing, which was current until 2020. Public consultation is ongoing for a new National Strategic Policy for Active Ageing that will cover the years 2021–2027.

Plan Development: In developing the 2014 Policy, Malta’s government utilized an extended consultation process, led by the National Commission for Active Ageing, which is a commission of 8 experts housed under the Ministry for Senior Citizens and Active Ageing. The consultation took place through informal communications, as well as a Public Consultation Seminar that allowed stakeholders and the general public opportunities to discuss and suggest recommendations and issues surrounding aging in Malta. In addition to the consultation process, the Policy was developed based on the European Commission’s and United Nations Economic Commission for Europe’s 2013 Active Ageing Index (AAI).                

Principles & Goals: Taking inspiration from the AAI, the Policy is organized around three major themes: labor market participation, social participation, and independent living. Within these themes, the Policy details areas where progress is needed, totaling 25 in all. These areas generally target economic empowerment and financial security, adult learning, support for informal careers, long-term care, intergenerational solidarity and volunteerism, age-friendly and dementia-friendly communities and services, and health. To support these themes, the Policy offers a total of 75 policy recommendations. The recommendations detailed in the Policy are intentionally broad, in order to guide the direction of future policies, programs, and activities.

Execution & Achievements: While the recommendations laid out in the National Strategic Policy were not commitments, community services were greatly expanded, according to Malta’s latest National Report on its implementation of the Madrid International Plan of Action on Ageing, published in 2021. A government program, Active Ageing and Community Care, offers several community services including geriatric care, telehealth, mental health services, respite care, dementia intervention teams, handyman services, and age-friendly public bus transportation, called the Silver-T service. The monitoring procedure guiding the National Strategic Policy for Active Ageing aligns itself with three of four key indicators laid out in the Active Aging Index, namely employment, participation in society, and independent living.

Current Status & References: The Policy was current through 2020. Public consultation for a new National Strategic Policy for Active Ageing for the years 2021–2027 is underway. The updated policy will focus particularly on social isolation, as well as equity and diversity. Other action areas will include volunteerism and intergenerational contact, lifelong learning, financial security, age-friendly environments, individual empowerment, and disease prevention. For more information, see this website to view the Policy. 

Context: Portugal has one of the oldest populations in Europe, driven by increased life expectancy and falling fertility rates. By 2030, 27.0 percent of Portuguese citizens will be aged 65 or over. A growing portion of older adults in Portugal are aged 80 or older—a share that more than quadrupled from 1.4 percent of the population in 1971 to 6.6 percent in 2022. One consequence of this population aging is a higher prevalence of non-communicable diseases, such as cardiovascular disease and diabetes; as of 2015, such diseases accounted for 88 percent of years lived with a disability in Portugal. Within Portugal’s health system, the National Strategy is part of a series of National Health Plans, the most recent of which is the National Health Plan 2030. The National Strategy also builds on other initiatives specifically relevant to older adults, such as the National Network for Continued Integrated Care (RNCCI), established in 2006, which created legal guidelines for long-term care for those with disabilities, including rehabilitation, social integration, and ensuring comfort and quality of care.

Plan Development: The National Strategy was developed by the National Interministerial Commission for
Active and Healthy Aging on behalf of Portugal’s Ministry of Health and National Health Service. It builds on the work of the Ministry of Health’s Directorate-General for Health, which developed the 2004 National Program for the Health of Elderly People, a guiding policy document, work that was further carried forward by directives in the National Health Plan for 2012–2016 and its extension for 2016–2020. The strategy further acknowledges the National Health Plan 2016–2020, which, while not specific to older adults, includes actions to improve access to health and social services and reduce the burden of chronic diseases, key challenges facing Portugal’s older adults. Efforts such as the World Health Organization’s “Global strategy and action plan on ageing and health” and the European Union’s “Active ageing and solidarity between generations” help inform the strategy’s objectives and its concept of active and healthy aging. Moreover, the strategy also notes collaboration with a range of government and non-government partners, such as the Association for Friends of the Elderly, the National Confederation of Retirees, the Portuguese Federation of Associations of Families of People with Mental Illness, and the Institute of Mobility and Transport, during the development process.

Principles & Goals: The National Strategy clearly delineates a guiding vision, mission, and set of values to promote “health and well-being, participation, non-discrimination, inclusion, safety, and research” to benefit older adults’ “functional capacity, autonomy, and quality of life.” The plan includes a particular emphasis on equity and diversity, highlighting the principles of human rights, equality, non-discrimination, gender equality, and intergenerational solidarity. To accomplish this goal, the plan identifies four key strategic axes—(1) health, (2) participation, (3) safety, and (4) measurement, monitoring, and research—accompanied by 33 subcomponent areas of action and the relevant government entities responsible for implementation. The health category, for example, includes an effort to encourage non-discriminatory methods of communication among caregivers, and the safety category includes a measure to promote “elderly-friendly” buildings, which aligns with Portugal’s commitment to the WHO’s Global Network of Age-Friendly Cities and Communities. While the plan does not explicitly name programs that will help accomplish its goals, it is possible to identify some relevant government efforts. EUSOUDIGITAL is one such program that seeks to enhance adults’ digital literacy skills, particularly those who have no experience using the internet, through a network of volunteer mentors and dispersed training centers. Another example is the Qualifica Program, which seeks to enhance the employability of individuals through continuing education.

Execution & Achievements: The National Strategy includes a mandate for the National Interministerial Commission for Active and Healthy Aging to carry out monitoring and evaluation based on a list of identified metrics in its appendices. To date, there is no clear evidence of a systematic evaluation of the plan, though this may be in development. However, the United Nations Economic Commission for Europe (UNECE) has published a series of reports analyzing Portugal’s implementation of the Madrid International Plan of Action on Ageing, with the fourth iteration published in 2022. The review identifies areas of progress and challenge over the 2018–2022 period, specifically noting success in areas such as improving labor market participation, education, and training, and difficulties in addressing poverty and digital literacy. There have also been a number of legislative and policy-related measures relevant to healthy and active aging, including a statute adopted in 2019 to regulate the rights of informal caregivers, annual pension improvements from 2017 to 2022, the amendment of the RNCCI to include mental health integrated long-term care, and a 2021 resolution to pursue care-related goals, such as increased communication between primary health care units and those over 65 years of age.

Current Status & References: The National Strategy is set to remain active until 2025 and can be found online in Portuguese here. A number of supporting plans and policies also impact older adults, including the National Health Plan 2030 and the National Strategy for Equality and Non-Discrimination 2018-2030.

Context: According to Slovenia’s Active Aging Index, the national tool developed in accordance with the EU’s Active Ageing Index, Slovenia is experiencing demographic change more accelerated than other parts of the European region. Overall in the EU, there are estimates that 40.6 percent of EU citizens will be over the age of 55 by 2050, which will have vast policy implications in the coming decades. In Slovenia, projections suggest that those over 55 will make up close to 44 percent of the total Slovenian population. The share of Slovenians over the age of 65, currently 21 percent of the population, is projected to rise to 24.8 percent by 2030. Slovenians are also living longer than they did previously, with the average life expectancy over 81 years of age. Additionally, Slovenia has a low percentage of people over 60 in the labor force, with only 25 percent employed in 2020, about half the OECD average. Recognizing these changes, to better support Slovenia’s aging population, and to meet future workforce challenges, the Slovenian government updated the Pension and Disability Act in 2017 and developed the corresponding 2017 Active Aging Strategy. 

Plan Development: The Ministry of Labour, Family, Social Affairs and Equal Opportunities states that it created the Acting Aging Strategy to align with the Madrid International Plan of Action on Aging. Beyond that, the Active Aging Strategy does not provide significant detail on the plan’s development, but Slovenia’s MIPAA report provides detail on the process used by the Ministry of Labour, Family, Social Affairs and Equal Opportunities on other aging-related activities. In 2016, Slovenia’s Institute of Macroeconomic Analysis and Development (IMAD) conducted an economic analysis on demographic change, which revealed that Slovenia was falling behind both EU and OECD averages for population aging. Accordingly, the Ministry of Labour, Family, Social Affairs and Equal Opportunities drafted the Active Aging Strategy in 2017. Non-governmental agencies, such as the Advocate of the Principle of Equality and the Slovenian Federation of Pensioner’s Associations (ZDUS), have collaborated with the Ministry to share stakeholder perspectives on aging policy, helping to inform the 2017 Active Aging Strategy. The Statistical Office and IMAD also provided data to inform and shape the plan further. 

Principles & Goals: Central to Slovenia’s Strategy is the concept of active aging, which seeks to promote activity and creativity in all stages of life, while also emphasizing intergenerational unity. The Slovenian Strategy features four pillars of action across Slovenian society to create this reality for those over the age of 65: 1) adapting employment policies and the labor market; 2) expanding health services for older adults; 3) increasing participation and inclusion in society; and 4) implementing age-friendly housing, transportation, and public spaces. Each pillar includes several secondary goals to further break down transition to the plan’s envisioned future. For the first pillar of adjusting the labor market, this includes efforts like worker training and promoting immigration for foreign workers. The second pillar includes actions like improving health overall, promoting a healthy lifestyle, and reducing inequalities in the health care world. The third pillar focuses on creating community between younger and older Slovenians through volunteering, cultural activities and raising awareness about ageism and to counter age-based discrimination. Finally, the fourth pillar aims to adapt housing, transportation, and education for independent living to better support older adults in Slovenia. 

Execution & Achievements: The Active Aging Strategy lists efforts to increase awareness of Slovenian demographic change and the relevance of the Strategy to the future of Slovenian society generally, including creating a communication strategy for the plan and a formal framework for continued dialogue between stakeholders and citizens. In accordance with the Active Ageing Strategy, the Council for Active Ageing and Cooperation between Generations was established to serve as a permanent consultative body, responsible for coordinating across public and private sectors. In 2021, building on the Active Ageing Strategy and while holding the President of the Council of the EU, Slovenia hosted an international conference on ageing, Human Rights for all Ages: Promoting a Life-Course Perspective and Intergenerational Cooperation to Combat Ageism.

Current Status & References: According to the Slovenian MIPAA report from 2022, the Slovenian government passed the Long-Term Care Act, legislation focused on synchronizing Slovenia’s health and social services, in 2021.

Context: Turkey is facing rapid demographic changes due to falling fertility rates and increasing life expectancy. In 2012, the proportion of the Turkish population over the age of 65 was at 7.5 percent. In 2021, adults aged 65 years or older constituted eight percent of Turkey’s national population, with women aged 65 or older constituting 10 percent of the total female population and men aged 65 or older constituting seven percent of the total male population. Yet older women are underrepresented in the labor force, participating at a rate lower than the OECD. The Turkish government expects the proportion of older adults will increase to 25.6 percent by 2080. Inadequate planning and preparation could lead to the current health system and socioeconomic infrastructure being overwhelmed by this projected growth in the aging population. To prepare the country for the coming demographic shift and to better support older adults, the Turkish Ministry of Health launched the Turkey Healthy Aging Action Plan and Implementation Program 2015–2020, the first of its kind.

Plan Development: The Action Plan was developed by the Ministry of Health, including its Public Health Institution branch and Department of Chronic Diseases, Elderly Health and Disabled People. The Action Plan’s data was gathered by teams, including a technical study group of experts and health officials, in collaboration with the Turkish Public Health Institution, as well as other public institutions, universities, and geriatric care- and health care-focused nongovernmental organizations (NGOs). Turkey aligned its strategy with the 2012–2020 Strategy and Action Plan for Healthy Aging in Europe, developed by the WHO’s Regional Office for Europe, as well as the UN Decade of Healthy Ageing 2020–2030 global platform. The Health Ministry Undersecretary oversees the Turkey Healthy Aging Action Plan and Implementation Program.

Principles and Goals: The Action Plan aims to facilitate accessible and effective health care services to support the aging Turkish population, including support for combatting non-communicable and communicable diseases and chronic conditions to improve health outcomes for older adults, promoting healthier and more active individuals, improving the general health of society, and developing and monitoring policies on healthy aging. The Action Plan defines success through six strategies: 1) arrangement and evaluation of successful policies for senior citizens; 2) implementation of healthy aging strategies through whole-of-society participation; 3) elimination of social health inequalities; 4) gender-focused care for aging men and women; 5) ensuring financial sustainability by strengthening programs in old age and public health practices; and 6) collaboration in health approaches between the public and private sectors and NGOs.

Execution and Achievements: The Turkish policies in aging populations have led to improvements in care and increased national interest on the wellbeing of older adults. In line with the goals of the Action Plan, a 2018 government report notes that Turkey has opened dozens of nursing home facilities nationwide to accommodate thousands of residents. Moreover, the government continues to push for strengthening support to older adults and to expand the number of health care specialists available for geriatric care in particular. In 2015, Akdeniz University established an academic program called “Renewal University,” which targets older adults with a selection of free coursework as a way to support their educational and vocational opportunities. It is also part of the effort to reduce poverty among older adults as well as giving program participants a sense of purpose. This initiative also aims to improve the cognitive health and psychological well-being of older adults, which is key to the Action Plan’s emphasis on healthy aging.

Current Status and References: In 2021, the Turkish Ministry of Health published the Turkey Healthy Aging Action Plan and Implementation Program 2021–2026, which at this time is only available in Turkish.

Context: Adults over 65 accounted for over 18 percent of Ukraine’s population in 2022, making it one of the 30 oldest countries in the world. By 2030, one in five Ukrainians will be aged 65 or older. This demographic trend is in part driven by long-term factors such as low birth rates and high rates of economic emigration in recent decades, but it has also been impacted by Russia’s 2014 annexation of Crimea and full-scale invasion in 2022, which have further contributed to the emigration of young Ukrainians. Chief among the problems older Ukrainians confront is the low quality and intermittent availability of medical care. Ukraine’s older population experiences poverty, with 90 percent unable to afford basic medical needs. These citizens have also suffered disproportionately during wartime, particularly due to their lower levels of mobility and reluctance to leave their homes. Between February 2022 and February 2023, Ukrainians over the age of 60 accounted for 32 percent of all recorded Ukrainian civilian casualties despite accounting for roughly 25 percent of the population.

Plan Development: The most recent iteration of Ukraine’s aging policy, active from 2018 through 2022, was developed by the Ministry of Social Policy, which is charged with managing social services, family and child welfare, human trafficking, women’s rights, and other issues. As its purpose, the strategy targets fulfillment of aging-related UN Sustainable Development Goals, particularly good health and well-being (SDG 3) and the creation of sustainable cities and environments (SDG 11). The plan indicates that it seeks to adapt public institutions to demographic aging and secure equal opportunity for all Ukrainians, though it does not specify the extent to which the development process was inclusive and participatory. While there are some examples of consultative and advisory bodies featuring older adults in Ukraine, such as the City Commission for the Protection of the Legal Interests of Senior Citizens in the city of Mykolaiv, Ukraine’s International Institute for Strategic Studies suggests that such consultative and advisory bodies are not widespread in the country. The national government’s online portal also indicates that the plan was drafted to meet Ukraine’s Association Agreement with the European Union as well as the principles laid out in the Madrid International Plan of Action on Ageing.

Principles & Goals: Ukraine’s aging policy acknowledges a multitude of issue areas impacting the country’s older adults and conceptually groups these issues into four general priority areas: (1) enabling improved aging conditions and seniors’ involvement in social development, (2) fostering health and well-being, (3) creating environments conducive to active lifestyles, and (4) protecting the rights of senior citizens. Subcomponents within each of these areas include several more targeted statements of intention, such as the need to enable education and training throughout the life course or to improve social assistance programs, but there is no mention of specific programs to accomplish these goals. There is particular emphasis on certain themes, such as intergenerational solidarity, including through concepts such as “mutual responsibility of generations” and the transfer of accumulated experience from older generations to younger ones.

Execution & Achievements: While there is limited information about the implementation of the policy over the 2018–2022 period, likely as a result of Russia’s invasion of Ukraine, there is some evidence that regional units of Ukraine were making efforts to enact elements of the plan in their jurisdictions prior to the invasion. Zaporizhia Oblast, for example, which has largely been under Russian occupation since the war began, published an updated state administrative order in 2021 detailing specific efforts to meet the demands of the aging policy. It included several programs focused on older adults, such as an information campaign to explain employment opportunities, projects to improve transportation and communications services, and plans for an intergenerational mentorship program in local communities. Any progress pursuant to the policy has likely been disrupted and undone, and many older adults in Ukraine will have seen their overall situations worsen significantly due to the conflict, including displacement, disruptions to economic activity, and rising costs during wartime. For example, average food and beverage prices increased 34.4 percent between February and December 2022, which is especially concerning for older Ukrainian adults, who commonly experience economic insecurity.

Current Status & References: The 2018–2022 policy can be viewed in Ukrainian here. The Ministry of Social Policy publishes regulatory policy updates here, which contain new policies related to older adults.

Context: Roughly 25 percent of the Welsh population will be age 65 and over by 2038, according to the United Kingdom Office of National Statistics. Already, an estimated 12.5 percent of older people in Wales live in poverty, demanding government intervention to ensure all people can enjoy health and financial security into old age. To address these concerns, the Welsh government has been at the forefront of aging policy, developing its first national strategy around aging, the Strategy for Older People, in 2003. This prioritization of aging policy led to the creation of the world’s first Older People’s Commissioner, as well as numerous achievements around the health and well-being of older people in Wales. The latest strategy, Age-Friendly Wales (2021), seeks to build on these successes and spans multiple policy areas, including financial security.

Plan Development: In addition to demographic and medical research, Age Friendly Wales: Our Strategy for an Ageing Society, published in 2021, was informed by input from those age 50 and over through surveys and forums held in each local authority. This extensive consultation process helped ensure that the strategy was specifically designed around the needs and wants of older people in Wales. 

Principles & Goals: The strategy is underpinned by three “cross-cutting themes,” which include creating an age-friendly environment, prioritizing prevention of chronic disease, and promoting older persons’ rights. It is notable that the Age Friendly Wales Strategy takes an explicit human rights approach to aging, aligning itself with the UN Principles for Older Persons. With these rights in mind, the strategy addresses community planning, civic engagement, employment and financial security, social inclusion, access to health, long-term care, transportation, and housing. It centers around four “aims”: 1) enhancing well-being, 2) improving local services and environments, 3) building and retaining people’s own capability, and 4) tackling age-related poverty. Each “aim” provides examples of actions taken by the government to improve older people’s access and experience in that area, as well as priorities for the future. For example, the strategy seeks to improve access to public bathrooms as a future priority to achieve Aim 2, improving local services and environments. Additionally, the strategy provides relevant examples of how technology is improving services, products, and environments for older persons in Wales. For example, the strategy highlights the Digital Communities Wales: Digital Confidence, Health, and Wellbeing program, which supports the digital inclusion of all people in Wales, including older adults.

Execution & Achievements: The Age Friendly Wales Strategy was only recently published. As such, a delivery plan is still to be released, and specific policies or programs have yet to be enacted. Wales also has yet to publish metrics to track progress toward the Strategy, though an Action Plan and metrics are expected in late 2022. However, the Strategy highlights ongoing projects and programs alongside longer-term priorities. Many of these ongoing projects and programs targeting older Welsh adults were established by the strategy’s predecessor, the 2003 Strategy for Older People. For example, over its three phases, that policy introduced free bus passes for older persons and promoted a maximum weekly out-of-pocket payment limit for home care and social support services (currently £100) for older persons, enabling older people to age in their homes and communities. These successes are, in part, the result of detailed delivery plans that accompanied each phase of the strategy. These delivery plans included timelines for specific actions and metrics by which progress can be measured. 

Current Status & References: For updates on the status of the plan, contact ask@olderpeoplewales.com. For more information, see this website to view the Strategy. 

[1] The term “ageing” is used when the title of a resource uses British spelling, such as the United Nations Decade of Healthy Ageing.

Context: Egypt currently has a particularly young population, with a third of Egyptians under the age of 14, but between 2020 and 2050, the number of older Egyptians—defined as those over 60 years of age—is expected to more than double, from 8.4 million to 22 million. This demographic is protected by Article 68 of the country’s constitution, which commits the state to ensuring a dignified life for older adults, including health, economic, social, cultural, and recreational rights, and Article 79, which states that every citizen has a right to social security to enable a decent life. However, life expectancy in Egypt (70 years) remains below the global average (71 years) and well below the OECD average (79 years). Recognizing this impending demographic shift, the government of Egypt promulgated the National Strategic Plan for Integrated Care for the Elderly 2020–2025 in 2020. The plan specifically notes a number of shortcomings in meeting the needs of older Egyptians, including a lack of sufficient specialized medical care, a lack of support to caregivers, insufficient resources devoted to building suitable environments, and low levels of integration, among others.

Plan Development: In 2017, the Ministry of Social Solidarity (MoSS)—charged with providing for Egypt’s “most vulnerable” citizens—formed the Higher Committee for Elderly Care and tasked it with developing an integrated plan for older adults in Egypt. The Higher Committee is also responsible for developing and reviewing pertinent legislation and programs, facilitating inter-ministerial cooperation, and collecting relevant data. The committee designed the National Strategic Plan for 2020 to 2025, building on Egypt’s predecessor strategy, the National Strategy on Ageing 2015. The new plan heavily emphasizes integrated and cross-disciplinary care, noting that “health, psychological, and social care cannot be separated.” The plan also acknowledges similar strategies in the region, including the aging plans for Saudi Arabia, Bahrain, and Kuwait, while noting the unique characteristics of the Egyptian context.

Principles & Goals: The National Strategic Plan elevates core values, including ensuring justice, respect, and dignity, building suitable and supportive environments, and continually updating and improving services. It includes an emphasis on equity and diversity: one of its guiding principles is to deliver “justice, respect, and dignity for all the elderly without discrimination.” To accomplish these goals, the plan is structured around seven strategic objectives: (1) integrating services related to older adults, (2) expanding health services at all levels, (3) developing better training for medical and care professionals, (4) furthering research into the issues facing older adults, (5) better integrating older adults into society and learning from their experience, (6) guaranteeing social protection, dignity, and cultural and recreational fulfillment, and (7) establishing collaboration in care for older adults with other regional countries. The plan further includes a breakdown of sub-goals within each objective area, identifies the relevant implementing bodies for each, lists general indicators of success, and specifies tentative timelines. For example, in pursuit of expanding health services, the plan identifies six sub-goals, including increasing the number of health facilities working with older adults, standardizing the level of care throughout Egypt’s regions, increasing community awareness, strengthening primary services, standardizing health service criteria, and developing additional homes for older adults. It assigns these goals to the Ministry of Health, the Ministry of Social Solidarity, non-governmental organizations, civil society, and university hospitals, among others.

Execution & Achievements: While the plan includes some indicators of success, these are fairly basic, generally focusing on whether a suggested program or plan has been created rather than on any related statistical metrics, such as the number of older persons living below the poverty line. The plan does not emphasize a specific monitoring and evaluation plan nor identify a relevant body, though this responsibility likely falls to the Higher Committee for Elderly Care. However, there appears to be significant progress pursuant to the National Strategic Plan on a number of issue areas. Most prominently, Egypt passed an Elderly Rights Bill in 2021, which expands social protections, establishes additional care homes, and establishes the right to psychological and rehabilitative care, among other measures. In terms of social protection, the MoSS published Law 371 and Resolution 260 in 2020 and 2021, respectively, which increased pensions for older Egyptians. Additionally, as directed by the Elderly Rights Bill, the government exempted those over 70 years of age from paying fares for public transportation and guaranteed half-price fares for those between 60 and 70 years old.

Current Status & References: The National Strategic Plan is set to run through 2025 and can be read in its entirety here. Laws and resolutions relevant to older Egyptians can be found on the MoSS website here.

Context: Jordan is considered a regional leader in health care provision and devotes 9 percent of its nearly $44 billion GDP to health care, which is high compared to other countries in the region. Before the advent of COVID-19, Jordan received roughly 250,000 annual medical tourists per year, which accounted for a high percentage of tourist revenue. Jordan has a relatively young population, with people over the age of 65 constituting roughly 3.9 percent of the population of 10.2 million. However, old adults are among the most vulnerable in the country, facing a high risk of poverty, disease, and isolation. These trends are, in part, a result of a significant influx of refugees from nearby Syria. To address the vulnerability of older adults and prepare for further population aging, as well as to strengthen its health system, Jordan developed the National Strategy for Senior Citizens in 2018.

Plan Development: The National Council of Family Affairs was established by a Royal decree in 2001 in order to strengthen support for women, children, and the elderly, and has released two National Strategies for Senior Citizens, the first of which was published in 2008. The current National Strategy is an updated version of the previous 2008 Strategy and builds on numerous other pieces of legislation that explicitly protect older persons, including the National Strategy for the Jordanian Family from 2005 and the Jordanian Constitution. The Strategy’s development process incorporated the opinions and needs of people across Jordan, including the elderly, by conducting community focus groups. The National Follow-up Committee on the Implementation of the National Strategy for Senior Citizens then wrote a “baseline study” that analyzed the needs of older persons, based on information derived from the community focus groups and associated research.

Principles & Goals: The National Strategy is based in part on the baseline study, which was released in 2015. The baseline study identified several gaps and themes through a SWOT analysis conducted by the National Follow-up Committee on the Implementation of the National Strategy for Senior Citizens, which the National Strategy later prioritized. The National Strategy aims to improve life for older adults and all Jordanians across three pillars, by 1) engaging the elderly in Jordan’s development process and encouraging them to take part in decision-making across all levels, as well as generally improving living conditions for older persons; 2) providing preventative and curative health services; and 3) providing supportive environments for older persons that include accessible infrastructure, sufficient care homes and social services, and protection from violence and ageism. Each pillar identifies priority areas for actions as well as specific implementation measures and initiatives. The National Strategy also calls for the government to develop a legislative and regulatory enabling environment that considers the needs of the elderly, to help achieve the targets and goals defined in the National Strategy.   

Execution & Achievements: Prior to the National Strategy’s release in 2018, Jordan focused on improving the quality of and access to home health care, through the National Home Healthcare Initiative Project. The project has trained over 300 health care professionals, formalized the country’s home health care system, increased home care visits by 66 percent in one year, and expanded to over 28 medical facilities since its inception in 2017. The National Strategy aims to continue and expand upon these achievements. However, there is little evidence that specific actions have been taken to achieve the goals laid out in the National Strategy, nor is there evidence of significant legislative and regulatory actions to create an enabling environment for older persons in Jordan.

Current Status & References: For more information, see this website to view the National Strategy. Jordan's National Strategy is current through 2022. Additional context for the Strategy can be found here [an article describing the process behind the Strategy’s development, which was published on the National Council for Family Affairs’ website in 2018] and here [a 2020 report by HelpAge International on care and protection of older people in Jordan].

Context: Lebanon is experiencing the fastest population aging among Arab countries, with demographic expectations indicating that about 23 percent of the country’s population will be over the age of 65 by 2050. While Lebanon is fast becoming an aged society, older people are struggling to meet basic needs and often face age discrimination, according to a joint study by the American University of Beirut and the United Nations Economic Commission for Western Asia. In addition, Lebanon, similarly to other countries in the Middle East, has a long history of internal displacement, conflict, and political strife. As a result, Lebanon incorporated these dynamics into its National Strategy for Older Persons (2020–2030).

Plan Development: The National Strategy for Older Persons was drawn from a combination of national reports and surveys, scientific research, and other countries’ aging plans (Jordan, Sudan, Austria, Malta, Singapore, and New Zealand). International and regional frameworks, including the Arab Strategy for Older Persons and the Madrid International Plan of Action on Ageing, also served as inspiration for the Strategy. Developers of the Strategy held consultations with stakeholders and meetings with experts and older people. 

Principles & Goals: The Strategy’s framework centers on six interrelated axes: 1) physical and mental health; 2) economic and social safety; 3) social participation; 4) intergenerational solidarity; 5) age-friendly environments; and 6) protection from violence and conflict. Under each of the axes, strategic objectives and intervention areas are recommended. To support action on each of these axes, the Strategy proposes four mechanisms of intervention to induce change. These mechanisms are policies and legislation, institutional arrangements and governance, capacity building and awareness-raising, and research. The Strategy names human rights, life-course approach, shared responsibility, and positive conceptions of aging as the guiding principles in the development and implementation of its goals. 

Execution & Achievements: The Strategy does not establish a budget or monitoring and evaluation framework, but the government is expected to publish a multi-sectoral action plan. However, as of April 2022, none of these steps have taken place.

Current Status & References: For more information, see this website to view the National Strategy. The National Strategy is current through 2030.

Context: The share of the total population over 60 years of age in Saudi Arabia is expected to grow from 5.9 percent in 2020 to 23.7 percent in 2050, including a more than five-fold increase from 2.0 million to more than 10.5 million adults over 60. This trend is chiefly driven by lower fertility rates and rising life expectancy, which is expected to double between 1950 and 2050, when it is projected to reach 80 years. As in many other places, this demographic group faces challenges including high rates of disability and low rates of financial security. For example, more than 40 percent of Saudis over 60 have some type of disability, while just 33 percent have a pension. Certain aging-correlated non-communicable diseases, such as diabetes, pose a particular challenge to older Saudis: 18 percent of Saudis had diabetes as of 2021—compared to a global average of 10.5 percent—and this number is expected to increase to nearly a quarter of Saudis by 2026, with the highest prevalence group being those over 60. To manage these problems and better enable healthy and active aging, the government of Saudi Arabia published a new National Strategy for Elderly Health in 2017.

Plan Development: The National Strategy was developed by a sub-component of the Ministry of Health, the Assistant Agency for Primary Healthcare, which is specifically charged with providing optimal health care to the country’s older adults. The strategy represents a significant update to its predecessor, the National Strategy for Elderly Health, 2010–2015, and is meant to align with the country’s expansive development plan, Vision 2030. The strategy’s content is informed by a number of international and regional documents, including the Madrid International Action Plan on Aging (2002), Kuwait’s 2007 legislation on the social welfare of older persons, the World Health Organization (WHO)’s Global Strategy and Action Plan on Ageing and Health (2016–2020), and the WHO’s Strategy for Active Aging and Elderly Care 2006-2015 in the Eastern Mediterranean Region. The National Strategy was informed by a workshop involving a range of stakeholders involved in the health of older adults, including regional government health representatives, health care professionals, health planning experts, academics, consultants, and others. While the plan notes the importance of continuous feedback and calibration, it does not specify the degree to which older adults played a participatory role in the plan’s drafting.

Principles & Goals: Through its stated mission, the National Strategy envisions a country where older Saudis have access to comprehensive and integrated health care, enabling environments free of abuse, support during long-term illness, and ultimately a society where their rights are upheld. To accomplish this vision, the strategy includes seven objective areas: (1) building responsive health care, (2) improving the quality of health care, (3) developing supportive environments, (4) establishing long-term care, (5) strengthening partnerships relevant to the health of older adults, (6) promoting healthy aging and social well-being, and (7) building out monitoring and evaluation, measurement, surveillance, and research efforts. The seven objective areas are then split into 22 specific goals with more than 100 component activities and sub-activities. Under the responsive health care objective, such activities include ensuring that health care facilities are accessible to older adults (less than a 30-minute car ride) and are appropriately attuned to the mobility and other needs of older adults. As another example, the seventh objective area includes activities such as building a comprehensive national demographic and medical database for older adults and establishing surveillance programs at senior care facilities to monitor disease- and age-related risk factors. The work in these seven objective areas is informed by societal values and principles that emphasize equity and diversity, highlighting Saudi Arabia’s “unequal distribution of health problems” and the need for inclusivity, especially of the wide range of physical, mental, emotional, and social needs of older adults.

Execution & Achievements: The National Strategy offers extensive general and goal-specific indicators to undergird its monitoring and evaluation. General performance indicators include broad-based metrics such as the number of primary health care centers implementing programs specific to older adults, the number of adults 60 and over who have undergone a comprehensive physical examination, and the percentage of older adults with chronic diseases or risk factors. Each of the strategy’s 22 goals is accompanied by more specific indicators; within the third objective, for example, the mental health goal includes indicators such as the percentage of older adults receiving psychological and social support as well as the general prevalence of disorders such as anxiety and depression. If there has been a systematic evaluation based on such indicators, it does not appear to have been made available to the public. However, there is evidence that Saudi Arabia has been advancing efforts to improve the lives of older adults in recent years. For example, the Ministry of Human Resources and Social Development published Executive Regulations on the System of Rights and Care for the Elderly in February 2023, which focuses on securing the rights of older adults through awareness and education, improved statistics, and enhancing their integration into society, among other measures. Likewise, new guidelines for medical care have also been published, such as on Patient Falls Prevention and Management (2021) and Gerontological Nursing Care (2023).

Current Status & References: The National Strategy is set to run through 2030 and can be seen online here. Recent actions by the Ministry of Health can be followed on its website. Saudi Arabia’s wide range of development efforts, a number of which have relevance to older adults, can be seen on the Vision 2030 website.

Context: Although an official census has never been conducted in Eritrea, the national population is estimated to be 3.7 million. In 2020, Eritrea had an estimated median age of 20.3 years, far below the global average of 29.7 years. The proportion of the total population over 65 is anticipated to grow only modestly from 4 percent in 2022 to 4.2 percent by 2030. This low percentage is partially attributable to the particularly low life expectancy of Eritreans, who live an average of 67.2 years, compared to a global average of 73.4 years. In 2001, African Union member states signed the Abuja Declaration, through which signatories committed to spending 15 percent of general government expenditure on health, yet as of 2022, Eritrea continued to spend less than 3 percent. Furthermore, Eritrea is the only country in the UN Population Fund (UNFPA)’s East and Southern Africa region that has yet to ratify the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). To contend with Eritreans’ health needs and recognizing that older adults face a range of risks and challenges to their well-being, the government has produced the Strategic Plan for the Implementation of Reproductive, Maternal, Newborn, Child and Adolescent Health and Healthy Ageing Programmes in Eritrea, 2022–2026 (RMNCAH & HA Strategic Plan). The plan includes the needs of older adults as one of its focus areas but acknowledges a dearth of knowledge about older Eritreans, noting “significant information gaps on the number of older persons, their health status, living conditions, [and] housing and environmental conditions, among other parameters.”

Plan Development: The Ministry of Health bears responsibility for the Strategic Plan, specifically through the Division of Family and Community Health. The Ministry of Health, in collaboration with the World Health Organization, UNFPA, and UNICEF, conducted a review of the previous iteration of the strategic plan, covering the period 2017 to 2021, and held a workshop in October 2021 to capture lessons learned and identify problem areas. This review involved informational interviews, discussion groups, and evaluation of its findings by a range of stakeholders within and outside government, all of which has served to inform the inclusion of “evidence-based, high-impact interventions” in the new plan. However, it is unclear to what degree older adults themselves were consulted during the process. The new strategic plan specifically references the four targets of the UN Decade of Healthy Ageing: 2021–2030—(1) combating ageism, (2) age-friendly environments, (3) integrated care, and (4) long-term care—as the foundation for its strategic objectives related to aging. The plan also acknowledges pursuit of the UN Sustainable Development Goals as driving its overarching direction.

Principles & Goals: The Strategic Plan’s overarching goals are quite broad, given the wide scope of its focus areas, but they specifically highlight improved health, well-being, productivity, and quality of life for older adults. The plan also provides for a continuum of care across the life-course for all Eritreans, provided in an “equitable and efficient manner.” The plan emphasizes several key principles, including inclusivity and equity, gender responsiveness, attention to human rights, integrated care, a life course approach, and sustainability and accountability, among others. Of the plan’s four strategic objectives, the fourth—focused on a multisectoral response for healthy aging—bears the most relevance to older adults. While the first—resilient health systems and quality care—is not explicitly focused on older adults, it is relevant to the continuum of care for healthy aging. The fourth objective includes six areas of focus: (1) combating ageism, (2) fostering age-friendly environments, (3) providing integrated care and primary health services, (4) strengthening community-based integrated care, (5) fortifying information, monitoring and evaluation, research, and innovation for healthy aging, and (6) strengthening governance and leadership for the country’s healthy aging efforts. Several sub-components of the first objective are also relevant to healthy ageing and the well-being of older adults, such as Strategy 1.4, which relates to adequately training health workers; Strategy 1.7, which relates to ensuring last-mile availability of medicines and health-related equipment; and Strategy 1.9, focused on community engagement.

Execution & Achievements: The execution of the Strategic Plan, to be orchestrated by the Division of Family and Community Health, is further detailed in an implementation plan (Annex I), which breaks down the objectives and their “strategy” areas into 21 specific “sub-strategy” action areas. These action areas are then assigned to specific ministries and designated to specific years over the plan’s five-year period. For example, Strategy 4.2—“foster age-friendly environments”—contains specific directions for the Ministry of Health to collaborate with other stakeholders in identifying social services relevant to older adults and convening multi-sectoral meetings to pursue securing those services, with the anticipated output being an annual working group meeting each year over the time period. The plan also includes a substantial monitoring and evaluation framework that includes specific aging-related indicators, for example, the number of health facilities providing palliative care or the number of patients with non-communicable diseases over the age of 60. Furthermore, the plan devotes several pages to budgetary considerations. It projects that the plan as a whole will cost between ERN 1.6 billion (USD 106.7 million) in a baseline scenario and ERN 3.2 billion (USD 213.3 million) in an “aggressive” scenario. However, spending pursuant to healthy aging accounts for just 5.4 percent of this total under the baseline scenario and does not scale upward in more aggressive spending scenarios.

Current Status & References: The Strategic Plan is set to be active through 2026 and can be viewed online here. It runs parallel to several other guiding health documents, including the Eritrea Health Sector Strategic Development Plan, 2022–2026 and the Eritrea National Health Policy 2020, though the full texts of each do not appear to be available online. Likewise, the Eritrean Ministry of Health currently does not appear to have an active website.

Context: Ethiopia endorsed the African Union’s Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Older Persons in Africa. Demographic trends in Ethiopia show falling birth rates coinciding with growing life expectancy. Though the Ethiopian fertility rate has nearly halved in the past thirty years, it remains at 4.3 children per woman as of 2021. Meanwhile, by 2050, only 10.3 percent of the population is projected to be aged 60 and older, rising from three percent of the population in 2021. Nevertheless, the Ethiopian government is working with international and regional institutions to reduce poverty rates among, and ensure the rights of, older adults. The Ethiopian government has recognized the need to assist older adults, promulgating the National Plan of Actions on Older Persons 1998–2007 in the Ethiopian Calendar (equivalent to 2006–2015 in the Gregorian Calendar).

Plan Development: The Ethiopian National Plan of Action is aligned with the goals outlined in the UN Principles for Older Persons, the Madrid International Plan of Action on Ageing, and the African Union Policy Framework and Plan of Action on Ageing. Moreover, Ethiopia endorsed the African Union’s Protocol to the African Charter on Human and Peoples’ Rights on the Rights of Older Persons in Africa. The Ministry of Labor and Social Affairs and the Regional Bureau of Labor and Social Affairs are responsible for executing the National Plan of Action. Financial and informational support from the Ethiopian Elderly and Pensioners National Association (EEPNA) and the HelpAge International Ethiopia informed the National Plan of Action.

Principles & Goals: Corresponding with the demographic trends developing in Ethiopia and with an eye toward promoting development more broadly, the Ethiopian government has focused on reducing poverty and improving quality of life for older adults in rural regions. The Plan identifies six goals to measure success: 1) expand and strengthen services for older adults through community participation; 2) encourage senior citizens to assist in overall national development, which strengthens their own wealth and well-being; 3) integrate the well-being of older adults into development plans for poverty reduction; 4) identify areas of interest for older adults by listing specific objectives; 5) improve cooperation between government and nongovernmental organizations (NGOs); and 6) encourage foreign support through advocacy for older individuals.

Execution and Achievements: The Ministry of Labor and Social Affairs has tied the National Plan of Action into wider poverty-reduction goals, pushing for a universal pension, older adults’ involvement in national development, and calling for a preventive-focused health care plan. The UN has found that although poverty among older adults has declined in recent decades in Ethiopia, it remains a challenge in rural areas. The government has acknowledged in official documents that older adults are a priority, calling for the expansion of iddirs, a traditional community emergency fund, including for deaths, as well as for the introduction of a universal pension scheme. According to information collected from the Public Servants Social Security Agency (PSSSA) and Private Organizations Employees’ Social Security Administration (POESSA), only 7.3 percent of Ethiopian retirees were covered by pension plans nationwide as of 2019. In March 2022, the government enacted the Private Organization Employees’ Pension Proclamation, which obliges all private-sector workers to join the state-administered pension system. This move is designed to accelerate efforts to reduce poverty among older adults and pensioners.

Current Status and References: In a 2022 report, the UN outlined Ethiopian objectives for older adults, including social security expansion, poverty reduction, and cooperation among NGOs, IGOs, and the government. The Ministry of Health also has made COVID-19 vaccination distribution among older adults part of its preventive care objectives; inoculation remains a priority.

Context: Currently, Ghanaians aged 65 years and above account for approximately 3 percent of the population—or around 1.1 million people—a share projected to rise to 4.2 percent by 2030. This demographic change is taking alongside other developments such as increasing urbanization, changing traditional family structures, and expanding access to digital technologies. For example, the proportion of Ghanaians using the internet jumped from just eight percent to 68 percent between 2010 and 2021. While poverty has declined overall in Ghana, economic hardship, discrimination in employment and medical services, and social isolation are growing concerns among the aging population. To accommodate the needs of a growing population of older adults, the National Ageing Policy: Ageing with Security and Dignity was created in 2010 to provide a unifying framework for “guiding the different sectors and agencies involved in development issues pertaining to older persons.”

Plan Development: Written with input from implementing partners including the Department of Social Welfare, Ministry of Women and Children Affairs, National Population Council, and Ministry of Finance and Economic Planning among others, as well as with non-governmental organizations including the Ghana Employers Association and various older persons’ associations, the 2010 National Ageing Policy highlights the need for a participatory, “bottom-up” approach to ensure that its framework prioritizes the most pressing needs of older persons. The process to update a preexisting 2003 policy and develop the 2010 policy was guided by the United Nations’ Guidelines for Review and Appraisal of the Madrid International Plan of Action on Ageing, and highlights four key areas for review. These areas include identifying all relevant stakeholders, reviewing existing national policies that address ageing, including older persons in the review process, and raising awareness of both age-related issues and possible solutions at the national level. To support the review process, two regional workshops were held to bring together representatives of older persons’ associations and relevant government organizations operating at the local level. Additionally, the NAP outlines plans to develop an “Active Ageing Fund” in order to support the implementation of the NAP’s proposals.  

Principles & Goals: The overarching goal of Ghana’s NAP is to “achieve the overall social, economic and cultural re-integration of older persons into mainstream society, to enable them as far as practicable to participate fully in the national development process.” The NAP identifies eleven broad policy areas to advance this overarching goal and support older persons, including: upholding the fundamental human rights; ensuring active participation in society and development; reducing poverty, improving health, nutrition and well-being; improving housing and living environment; strengthening the family and community; improving income security and enhanced social welfare; providing adequate attention to gender variations in ageing; strengthening research, information gathering, and data management; enhancing capacity for monitoring and evaluation of policies on ageing; and improving financing strategies. These eleven categories were developed from a variety of pre-existing national and international development frameworks, such as the African Union’s Policy Framework and Plan of Action on Ageing and the UN proclamation on Ageing (1992) to more accurately capture the complex issues facing the country’s older persons. Specific goals include creating micro-credit schemes to support older workers in rural areas, establishing a national “databank” of knowledge and skills held by older persons, subsidizing assistive medical devices for older persons, and increasing the accessibility and affordability of public transportation in rural areas. The Policy identifies the Ministry of Employment and Social Welfare as primarily responsible for providing information related to planning, policymaking, and budgeting, and tasks the Ministry of Finance and Economic Planning with ensuring that the budget process allocates adequate resources for support to and older adults and programs on healthy aging.

Execution & Achievements: Before the NAP was published in 2010, a number of policy frameworks identified older persons as a specific demographic whose civil rights are frequently overlooked. The Growth and Poverty Reduction Strategy, for instance, recognizes that a significant number of elderly citizens cannot meaningfully participate in economic activities due to financial vulnerability and social exclusion. Ghana’s National Social Protection Strategy and Persons with Disabilities Act similarly recognized the need for holistic, community-driven responses to address ageing-specific policy issues. Yet, hardly any of the promises made by the NAP have materialized. A 2014 report from the World Health Organization noted that “very little” progress had occurred toward implementation of the NAP’s goals due to a lack of funding and absence of political will. Multiple other reports, for example, journalism and independent research, similarly find that the NAP remains underfunded and overlooked, with its intended vision to better support older adults still to be fulfilled.

Current Status & References: The National Aging Policy can be viewed here. There are no publicly accessible updates from the MESW, which is responsible for conducting a review of the Policy’s implementation every three years and ensuring consistency with its budgetary process.

Context: Kenya, one of the most populous countries in Africa and the largest economy in East Africa, is experiencing a demographic transition. The proportion of people aged 60 and over in the national population is expected to reach 9.2 million people by 2050, increasing significantly from the 2.2 million people over 60 in the country today. To prepare for this transition while maximizing the opportunities of older persons to participate in Kenya’s economic and social development, the National Policy for Older Persons and Ageing was passed by Parliament in 2009. It was updated in 2014 to reflect the tenets of Kenya’s 2010 Constitution, specifically Article 57 of the Bill of Rights, which recognizes as fundamental rights the ability of older persons to “fully participate in the affairs of society” and to receive “reasonable” care from the state. The iteration covered in this database represents the most recent revision of the National Policy, published in 2018.

Plan Development: In 2014, the National Policy on Older Persons and Ageing was updated to better reflect the constitutional rights of older adults through a consultative process that brought together a variety of stakeholders, including representatives from the Ministry of Labour and Social Protection, the Ministry of Health, county-level governments, older persons from across the national population, members of development agencies (including Help Age Kenya and Help Age International), and implementing partners such as the National Cancer Institute and Kenyan Medical Practitioners and Dentists Council. The 2014 version of the National Policy was prepared after initial consultations at the national and regional levels in 2012, and circulated to county governments and additional stakeholders in mid-2013 for their review. The Commission on the Implementation of the Constitution then oversaw the incorporation of these inputs into a final draft, which was created during joint sessions between national- and county-level government representatives before being presented for consideration by the National Assembly in 2014. In addition to stakeholders’ input, the development of 2018 National Policy’s objectives was guided by reviews of Kenya’s previous National Policies on Older Persons and Ageing. The process also considered a number of international frameworks on older persons’ rights, such as the United Nations’ Plan of Action on Ageing, UN Proclamation on Ageing, and African Charter of Human and People’s Rights, and drew on outcomes from global convenings, such as the first and second World Assembly on Ageing held in Vienna in 1982 and Marid in 2002, respectively.

Principles & Goals: The National Policy identifies ten thematic areas to promote and enable a “positive culture” for aging in Kenya. The first area includes the creation of legal measures to recognize older persons as a distinct group of rights holders and to ensure that those rights are protected, promoted, and fulfilled. Priorities two, three, and four pertain to economic, physical, and social health, respectively, while priorities five through nine establish policy objectives related to food security, accessible infrastructure, educational opportunities, income security, and social welfare services for older adults. The tenth thematic area includes cross-cutting issues such as gender, natural disasters, disabilities, and conflicts. Kenya’s constitution and Kenya Vision 2030, a long-term development blueprint designed to improve the country’s quality of living, served as guiding principles for identifying the ten areas and the specific policy objectives they support.

Execution & Achievements: Prior to the release of the current National Policy on Older Persons and Ageing in 2018, Kenya made significant gains in establishing a national policy framework for aging persons by passing the first version of the National Policy on Older Persons and Ageing in 2009, finalizing the National Social Protection Policy of 2011, and creating cash transfer programs for older persons in 2017. The provisions of these policies, the Constitution’s protections for older persons, and related legislation all demonstrate Kenya’s enduring commitment to creating a sustainable, age-friendly environment. However, a lack of both pre-existing and contemporary data on older persons makes progress toward these commitments difficult to gauge. In fact, although the 2018 National Policy provides a broad framework for the development of an effective monitoring and reporting system to address this shortcoming, it does not appear that such a framework has been created to date. Addressing the gap in up-to-date information on older adults in Kenya is key to ensuring effective implementation of the National Policy, but it may be under-prioritized as the government grapples with other competing priorities, such as the development needs of the country’s large youth population.

Current Status & References: The National Policy can be viewed here. Additional information regarding the methodological challenges in implementing Kenya’s older-persons policy agenda can be found here (an article describing data-collection methods on issues relating to older persons, which was published by the UN’s Department of Economic and Social Affairs in 2019), and a summary of legislation related to furthering the rights of older persons can be found here (an article describing previous legislative efforts to address the rights of older persons, published by the Office of the United Nations High Commissioner for Human Rights in 2019).

Context: The population of Malawi is young and growing, with persons over age 65 constituting only 2.6 percent of the total population. While population aging is likely many decades away, significant gains in life expectancy have increased the absolute number of older people. Older people tend to be vulnerable in Malawian society, experiencing high rates of poverty and malnutrition. To address the growing number of vulnerable older persons, the government passed the National Policy for Older Persons in 2016. 

Plan Development: The Policy’s development relied upon reviews and surveys regarding the situation of older persons in Malawi, acknowledging the overall poor quality of life among older Malawians. Additionally, a consultation of stakeholders was reportedly conducted, and, according to a Malawian civil society leader from a group representing older adults, a thorough consultation with older men and women and other stakeholders across the country was held. 

Principles & Goals: The Policy establishes six priority areas for action, which generally align with the UN Sustainable Development Goals and international aging frameworks. These areas are 1) the promotion and protection of older persons’ rights; 2) access to health, water, and sanitation services; 3) food security; 4) income security; 5) housing; 6) research and geriatric training. Each of Malawi’s National Policy priority areas establishes objectives and corresponding strategies that detail specific policy actions. 

Execution & Achievements: The Policy’s implementation plan identifies timelines as well as public and private sector actors’ responsibility for each strategy. It also establishes a monitoring and evaluation plan, which provides outputs for each objective, indicators to track progress, and sources of verification (i.e., reports), with a commitment to publish annual progress reviews. However, according to an expert from a Malawian civil society organization, little progress has been made due to gaps in resourcing and budget.

Current Status & References: For more information, see this website to view the National Policy. The government is reportedly in the process of developing an Older Persons’ Act, according to the Commonwealth Foundation, which is an intergovernmental organization that reports to governments on civil society activities across Commonwealth countries (including Malawi). This legislation is expected to improve the implementation of the National Policy for Older Persons. Key provisions will focus on income security in the form of grants and pensions, the safeguarding of rights, and equal access to services.

Context: With the largest economy and national population in Africa, Nigeria also has the highest number of older adults of any country on the continent.  Nigerians aged 65 years or older comprise 3 percent of the total population. Between 2020 and 2050, the population of Nigerians aged 60 years and above is expected to grow from approximately 9.4 million people to over 25 million, reflecting both a growing population and increasing life expectancies. To address this growth and to prepare for future generations of older persons, Nigeria’s National Senior Citizens Centre (NSCC) Act was passed in 2017. The primary goal in establishing the NSCC was to create an entity in charge of integrating various, pre-existing government programs that address the specific challenges facing older populations. For instance, Nigerians who are living in rural areas or have disabilities face difficulties in accessing the country’s pension fund system, and mental health issues such as social isolation continue to affect many older persons. To address these gaps, the NSCC’s Strategic Roadmap on Ageing, officially launched in 2023, identifies government ministries with overlapping or related mandates regarding older persons, and provides a framework for streamlining the administration of policies in areas such as income security and lifelong educational opportunities.

Plan Development: The NSCC is as an agency of the federal government of Nigeria under the purview of the Federal Ministry of Humanitarian Affairs, Disaster Management, and Social Development. This agency is responsible for initiating, developing, and implementing productive activities and work schemes for older persons in order to provide them with sustainable income and dignity in old age. The NSCC’s Strategic Roadmap on Ageing creates a policy framework to guide political leaders as they work to implement the goals outlined in NSCC’s agenda. The Roadmap was developed during consultations with nine stakeholder groups, including: representatives from multiple federal and state ministries, the Nigerian Union of Pensioners, older persons’ associations, private companies, health experts, academic researchers, religious authorities, development partners, and the media. Consultations were conducted in both northern and southern regions of the country, with Kano hosting nineteen northern states plus residents of the Federal Capital Territory, and Lagos hosting seventeen states representing the southern region. The primary objective of engaging these stakeholder groups was to better understand the challenges that older adults in Nigeria face. Participants repeatedly identified a general lack of awareness among policymakers about age-related issues, such as limited mobility and frequent exclusion from national demographic surveys. The Roadmap makes no mention of attempts to align its development with international policy frameworks on national ageing strategies.

Principles & Goals: The NSCC’s Roadmap is driven by a desire to codify older persons’ rights using a human rights- and economics-centered approach, marking a shift from the country’s former, community-based method of providing care for aging populations. To facilitate this shift, the Roadmap identifies seven priority areas and eleven distinct policy goals to address obstacles in the development of an age-conscious policy environment. These priority areas cover three broad categories, including economic and social wellness, developing an age-conscious society, and strengthening the data-collection and -analysis processes underlying the Roadmap’s policy agenda. Actionable goals include developing a national database of age-focused care professionals and care providers, improving the pension-payment system, distributing identification cards to older persons to formalize their access to specialized services, and raising public awareness of stigmatic issues such as dementia and social isolation.

Execution & Achievements: Officially launched in January 2023, the NSCC’s Strategic Roadmap on Ageing 2022–2032 sets a number of targets for its first year of implementation, including producing advocacy campaigns in all 36 states across Nigeria and the Federal Capital Territory. The Roadmap also prioritizes identifying and mobilizing the resources needed to build the capacity of health workers in geriatric care, and designing a cash transfer program for older persons in collaboration with the National Social Safety-Net Coordinating Office. The NSCC is also seeking to give older persons an active voice in the development of these processes, announcing plans to establish the Continued Engagement Bureau (CEB) in March 2023 as a mechanism for communication and coordination. Once up and running, the CEB will be an online platform designed to engage the knowledge of retired civil service employees and other specialized professionals, giving them the right to participate in the civic process while allowing the federal government to draw on their institutional knowledge.

Current Status & References: A press release outlining the launch of the National Senior Citizen Centre’s Roadmap can be found here, and articles providing context about the CEB and initial public advocacy campaigns can be found here and here, respectively.

Context: Like many sub-Saharan African countries, Rwanda is a relatively young society with a slowly declining fertility rate and a rising life expectancy. Between 2012 and 2032, the number of adults aged 60 and older is projected to increase from 5 percent of the population to 7 percent. As of 2021, three percent of the Rwandan population, or approximately 423,000 people, was 65 years or older. In accordance with international and regional commitments, the Rwandan government positions inclusive development for all, including older adults, as a central tenet of its national programs. Moreover, although poverty and inequality have declined in Rwanda over the last couple of decades, older adults continue to face socioeconomic hardship. Women are an outsized proportion of the older population, in part a legacy of the 1994 genocide, and experience compounding social and economic disadvantages in older age. To better support current population of older adults and in preparation for demographic change, the Rwandan government developed the National Older Persons Policy in 2021. This first-of-its-kind policy addresses elder poverty and bottlenecks in the provision of essential services to older adults.

Plan Development: The National Older Persons Policy was developed by the Ministry of Local Government (MINALOC), in consultation with a Social Protection Sector Working Group comprising various stakeholders from government ministries, agencies, local governments, civil society organizations (CSOs), and faith-based organizations (FBOs). The Policy incorporates many of the key issues identified by stakeholders during these consultations. Poverty due to an insufficient social protection system was a primary concern, as well as expanding pension benefits to informal workers. Social isolation, cultural neglect, and exclusion from the national development agenda were also raised, emphasizing the role of intergenerational dynamics in addressing the needs of the aging population. The Policy was developed with consideration for and building on various international treaties and frameworks such as the Universal Declaration of Human Rights, the Convention on the Elimination of all forms of Discrimination against women (CEDAW), the UN Plan of Action on Aging, and MIPAA.

Principles & Goals: This Policy intends to act as a framework through which all policies affecting older persons can be guided by five key principles: independence, participation, care, self-fulfillment, and dignity. The overarching mission is to secure the integration of older persons in Rwanda’s social, cultural, political, and economic development. It will be achieved through four objectives: 1) create awareness among the community to ensure physical, economic, and psychological preparedness for older persons; 2) improve the health and quality of life of older persons; 3) provide older persons with protection and care through appropriate support services; and 4) promote positive values for intergenerational relationships. The Policy places a strong emphasis on reforming social protection and services, such as pensions and long-term health care, as a national poverty-alleviation measure. However, it recognizes the importance of intergenerational support in achieving these objectives by institutionalizing a culture of volunteerism—the mentoring or coaching of youth by older persons. The Policy will encourage community- and family-based care by developing recreation centers for older adults, where members of the community can gather for celebrations and activities honoring them.

Execution & Achievements: MINALOC is chiefly responsible for the Policy’s oversight, monitoring, and evaluation. The implementation plan spans five years and will be allocated 75,634,899,700 Rwandan Francs (around US $67 million) over a period of four years. To guarantee sustained financing, the government intends to provide fiscal incentives for investment from the private sector, research institutions, and other development partners. These stakeholders are also encouraged to hold ministries accountable by participating in the implementation, monitoring, evaluation, and revision processes. The review process was designed to align with the country’s broader National Strategy for Transformation (NST1) review process, as many of the policy objectives overlap. However, a 2022 UNFPA report highlights the absence of a clear implementation strategy and measurement indicators for tracking progress.

Current Status & References: For more information, see this website to view the National Older Persons Policy. The Policy is current and has no stated expiration.

Context: In recent decades, improvements in the quality of Zimbabwe’s public health services have contributed to increased life expectancies. Currently, the number of people age 65 and older is expected to increase more rapidly than any other age group, and is projected to grow from a currently estimated 6 percent of the population to over 12 percent by 2050. In conjunction with the rising number of older persons, findings from the Zimbabwe Human Rights Commission Baseline Survey (2015) and an assessment of social protection and health services conducted by Help Age International in 2016 confirmed that people in this age group routinely face difficulties in accessing the country’s pension fund and medical services, particularly if they live in rural areas or are disabled. The Ministry of Health and Child Care released the first Zimbabwe National Healthy Ageing Strategic Plan in 2017 to address these and other structural challenges.

Plan Development: Zimbabwe’s Strategic Plan was developed by the Ministry of Health and Child Care through the Department of Epidemiology and Disease Control. The Plan is a country-specific adaptation of the five strategic objectives of the World Health Organization’s (WHO) Global Strategy and Action Plan on Ageing and Health. These include a commitment to action, aligning health systems to the needs of older persons, developing age-conscious policy environments, strengthening long-term care access, and improving monitoring and evaluation efforts. Zimbabwe’s approach was identified through a participatory three-step process, including a situational analysis, developing strategies needed to meet identified policy goals, and a workshop to anticipate and address potential oversights in the Strategic Plan’s implementation. In the situational analysis, focus group discussions were conducted with older persons in four districts to assess their existing needs, and legal instruments at the national level were surveyed to obtain an accurate assessment of the current operating environment for older persons’ health policies. Results of this process were used in conjunction with the WHO framework to identify the policy goals and objectives outlined in Zimbabwe’s Strategic Plan, and results were analyzed by stakeholders to both identify potential barriers to implementation and establish key indicators for monitoring progress.

Principles & Goals: The Strategic Plan was established with two overarching policy goals: fostering an age-friendly environment to strengthen Zimbabwe’s understanding of the needs facing ageing communities, and increasing the ability of older persons to access equitable health service systems. The Plan is supported by five strategic objectives, including a commitment to developing healthy ageing frameworks, addressing the health needs of older persons, developing age-friendly environments, strengthening long-term care, and improving monitoring and research practices. Specific policies proposed in support of these objectives involve establishing a formal budget for older persons’ care at the federal level, developing cross-sector guidelines to govern the provision of services to older persons, and promoting public awareness of older persons’ well-being.

Execution & Achievements: Administration of the Strategic Plan is overseen by the Healthy Ageing Committee, which is chaired by the Ministry of Health and Child Care under the Department of Epidemiology and Disease Control. The Committee is empowered to oversee the implementation, address budgetary concerns, provide ongoing legislative support for strategic adjustments, and gather data measuring the Strategy’s impacts. However, implementation of the Strategic Plan is uneven and lagging, with limited influence on other federal policies and programs. For example, Zimbabwe’s most recent National Health Strategy (2021–2025) does not contain any reference to older adults or ageing populations despite the Healthy Ageing Strategic Plan’s emphasis on the need to better support the health and well-being of older adults. However, in 2020, the Ministry of Labor, Public Service and Social Welfare called for the development of a new National Ageing Policy, which could build on, and be complementary to, the 2017 Strategic Plan.

Current Status & References: More information regarding the National Ageing Policy announced in 2020 can be found here, and the National Health Strategy 2021–2025 can be found here.

Context: The proportion of Australia’s national population aged 65 years and older has been steadily increasing in recent decades, standing at 17 percent as of 2021. In Queensland, Australia’s second-largest and third-most populous state, the number of persons age 65 and over is expected to grow rapidly over the next several decades, nearly doubling from 712,000 people in 2016 to around 1.35 million by 2036. Both public and private health care services have been primarily organized around the needs of a younger demographic of patients. With increasing life spans, however, the state has recognized the need to adapt health systems and to adopt approaches that meet the needs of a growing demographic of older adults. Queensland’s official public health service, Queensland Health, published Healthy ageing – A strategy for older Queenslanders in 2019 to streamline the state’s health care administration processes and to inform investment decisions across public, private, community, and non-government health sectors.

Plan Development: A holistic approach was taken to the Strategy’s development, and a number of health care providers, community services agencies, and local government officials were consulted in order to ensure that the Strategy’s goals and implementation strategy would be realistic, impactful, and cost-effective. Input was sought from a range of constituents, including patients and their families, health service providers, health industry representatives, and others with a focus on understanding how these stakeholders would improve the current health care system to better support healthy ageing practices. Clinical advice was also solicited from hospitals and health service providers throughout Queensland, as well as from the Statewide Older Persons Clinical Network and the Statewide Dementia Clinical Network. The Strategy’s framework is adopted from the World Health Organization’s Age-friendly Cities Framework, which identifies eight policy areas that directly influence the quality of life of older people. The Strategy was also informed by, and aligned with, various state- and national-level policy commitments, including the National Strategic Framework for Chronic Conditions, National Framework for Action on Dementia, National Ageing and Aged Care Strategy for People from Culturally and Linguistically Diverse Backgrounds, and the National Lesbian, Gay, Bisexual, Transgender and Intersex Ageing and Aged Care Strategy, among others.

Principles & Goals: The overall objectives guiding the Strategy are identified as supporting healthy aging and improving the effectiveness of health care for older adults by identifying priorities for service improvement and innovation. In pursuit of these objectives, the Strategy describes itself as being a “point of alignment” for state-level government agencies as they coordinate the development and implementation of new healthy-aging policies. Drawing on input from stakeholders, the Strategy names three “strategic directions,” which are intended to organize and streamline the development of new policies. These include building long-term health and wellness habits, individualizing care for older Queenslanders, and integrating state-provided health care with other locally based support services. Each strategic direction is backed by a summary of benefits, indicators of success, and suggested action items, which range from implementing targeted prevention strategies for middle-aged and older persons to minimizing delays in emergency care services.

Execution & Achievements: The Queensland Department of Health is in charge of aligning the delivery of health care services with the objectives outlined in the Strategy, and is empowered to develop inter-governmental partnerships, fund new research, identify metrics of success, initiate public awareness campaigns, and design and modify physical spaces to better accommodate the mobility of older persons. Currently, the Strategy’s objectives are on the way to being realized as additional aged-care facilities are constructed in rural Queensland, a series of Seniors Expos are hosted throughout the state to raise public awareness of health-related support services, and new initiatives, including public-private partnerships and whole-of-society exchanges, are created to further support the strategic directions identified in the Strategy.

Current Status & References: Healthy ageing – A strategy for older Queenslanders can be viewed here. With a record investment in national health care infrastructure approved by the Australian government in 2022 and an updated Seniors Strategy in development, Queensland is preparing for demographic change and adapting to better support older adults.

 Context: Like many Pacific Island countries, Fiji’s society has been aging rapidly for the last two decades. In February 2023, Fiji’s newly elected government began the process of raising its mandatory public service retirement age to 60 from 55. However, pension coverage and participation rates have been historically low due to a large informal economy and increasing life expectancies, leading poverty among older generations to be a major concern. At the same time, the rise in the aging population has created a “sandwich generation” for working-age adults who become responsible for both childcare and elderly care, without adequate social assistance or health care coverage. Those who are 65 years of age or older comprise 6 percent of Fiji’s total population. Women make up 53 percent of the 60+ group and nearly 60 percent of the 80+ population—a challenge that further motivated this first attempt to develop a policy specifically dedicated to addressing the growing needs of older adults.

Plan Development: This National Policy was developed in collaboration with a number of stakeholders—NGOs, faith-based organizations, government ministries, the private sector, the United Nations Population Fund (UNFPA), and the Fiji Council of Social Services (FCOSS). FCOSS and other agencies held extensive consultations and workshops with the community, including rural villages where elderly populations tend to be more concentrated. This collaborative effort was led by a Cabinet-appointed Inter-Agency Working Committee on the Elderly, and overseen by the Ministry of Social Welfare, Women and Poverty Alleviation.

Principles & Goals: In accordance with MIPAA, Fiji’s Policy takes a rights-based approach to supporting the welfare of the older population and their communities. The Policy seeks to build a more inclusive society that empowers older persons, and it identifies four key goals: 1) recognition of the contribution of older people to the social, cultural, economic, and political sectors of society; 2) strengthened social assistance for older persons; 3) healthy living; and 4) an enabling and supportive environment for the elderly. The Policy recognizes the disproportionate impact of aging on women, widows, and the rural elderly. Strategies to address it focus on re-evaluating the pension system, creating education and self-employment opportunities, bolstering health care capacity, and training more caregivers. To advance these objectives and promote the mainstreaming of aging policy, the Fiji National Council for Older Persons (NCOP) was established in 2012.

Execution & Achievements: A lack of robust data has been a major obstacle for Fiji’s policy development on aging, as so many of the strategies to achieve these goals center around further research, data collection, and awareness. The Department of Social Welfare’s Older Persons Unit was tasked with conducting a baseline study on older persons as part of developing the Policy’s key performance indicators, but that never materialized. This unit, along with the NCOP, was also responsible for the administrative aspects of the Policy’s implementation, but a lack of technical expertise, resources, and political will has stalled any real progress on the action plan. Since the Policy’s expiration, the NCOP has instead focused on coordinating across government agencies and non-governmental partners on aging issues.

Current Status & References: Though the Policy was never updated, Fiji has since implemented a range of national policies that acknowledge the needs and rights of older persons to varying degrees, such as the 2017–2036 National Development Plan. In response to the onset of the COVID-19 pandemic and the growing incidence of NCDs in the region, health systems are increasingly strained, which has led the government to recently revisit the issue. In 2022, Fiji’s Ministry of Health & Medical Services partnered with global research institutions to produce a targeted assessment of their health system, provide recommendations to promote healthy ageing, and advise on potentially integrating care needs into an updated National Policy on Ageing.

Context: By 2034, over a fifth—or around 1.2 million people—of New Zealand’s population will be age 65 or over. In preparation for shifting demographics, New Zealand began developing a national strategy to mainstream aging concerns across government agencies and society at large through the 2001 Positive Ageing Strategy. In 2019, the Office for Seniors released a successor to this plan, the Better Later Life Strategy.

Plan Development: The latest Strategy was developed in 2018 drawing on feedback from nationwide consultations, written submissions, online surveys, social media, and local meetings. Following the drafting process, drafts of the strategy were released for public comment in 2019. In addition to utilizing participatory processes, it was developed using research commissioned as part of the Positive Ageing Strategy. Finally, the Strategy deliberately aligns with the World Health Organization’s Decade of Action on Healthy Ageing.

Principles & Goals: The Better Later Life Strategy seeks to ensure that “older New Zealanders lead valued, connected, and fulfilling lives.” Underpinning the Strategy are a series of guiding principles: dignity, safety, diversity, and collective responsibility. The Strategy takes an explicit whole-of-life approach and also pays specific attention to the island’s indigenous people, the Maori, who experience lower life expectancies than other racial and ethnic groups in New Zealand. The Strategy identifies five key areas for action: financial security and economic participation, health promotion and access to services, housing, social connection and participation, and accessible environments. Within each area, the Strategy outlines more specific targets and the broad steps necessary to achieve them. 

Execution & Achievements: The Strategy identifies ten initial actions within these five key areas to kick off implementation, including achieving financial security and economic participation, promoting healthy aging, and making the built environment accessible for older persons. Each action is assigned to a responsible agency, mainstreaming the issue of aging across the government. Many of these initial actions already had funding allocated from the outset and are ongoing programs. For example, the Residential Tenancies Act 1986 was recently reformed to strengthen renters’ rights in New Zealand against unjustified eviction. This reform was identified as an initial action to support the goal of creating diverse housing choices and options. Another example of success around an initial action is the creation of the Office of Seniors’ Digital Literacy Training program, which began in 2020 with the goal of improving digital literacy among 4,700 older people. This program is directly related to the Strategy’s goal of enhancing opportunities for participation and social connection. The program won an international education award in the 2021 IDC Smart City Asia Pacific Awards.

In addition to budgeting, the Strategy called for the development of indicators to monitor and evaluate outcomes. Initial indicators have already been developed, with many using data from across multiple government agencies. However, certain indicators lacked existing data sources, requiring government agencies to collect additional data to track certain outcomes. Indicators will be updated and expanded every two years when the Office of Seniors publishes a report on progress toward the strategy’s goals. Since 2020, the Office for Seniors has added additional COVID-19 indicators to track the impact of the pandemic on older people.

Current Status & References: For more information, see this website to view the Strategy. In 2021, the Office for Seniors released an Action Plan for 2021–2024, which focuses on an additional 25 actions that will deliver advances in employment, housing, and digital inclusion for older New Zealanders. These additional actions will be implemented alongside the 10 initial actions published in the Strategy. To support the new Action Plan, Parliament allocated another $1.965 million over the next four years to enable the Office for Seniors to continue implementing the Strategy. In 2022, outcome indicators will be updated to reflect the Strategy’s latest priorities as well as track these 25 actions, and an “Outcomes” report will be published in 2023. For more information about the Strategy, see this website.

Context: While Cambodia has a lower proportion of older persons than most other Western Pacific countries, this share is increasing rapidly. According to the 2019 national census, 8.9 percent of the total population is age 60 or over, and this is expected to climb to 30 percent by 2070, similar to the population structure seen now in Japan and Italy. According to the National Ageing Policy, Cambodian culture emphasizes the right of older persons to be taken care of by their adult offspring as they age, which is codified in the Cambodian Constitution. These so-called filial support laws are considered controversial among some human rights organizations.

Plan Development: In light of the country’s changing demographic structure, the Royal Government created the National Ageing Policy: 2017–2030. The Policy builds upon and updates Cambodia’s 2003 National Plan for the Elderly, which is based on principles outlined in the Madrid International Plan of Action on Ageing, as well as several other national policies and plans, including the Rectangular Strategy–Phase III and National Strategic Development Plan, 2014–2018.

Principles & Goals: The Policy takes a life-course approach, in that its vision statement mentions facilitating older persons’ dignity and freedom of choice, as well as assisting younger generations in preparing for healthy aging. The Policy has three main goals: 1) to eliminate any age-based discrimination around older persons’ enjoyment of their rights; 2) to ensure gender equality among older persons, as older women are both more numerous and more vulnerable than older men; and 3) to encourage strong inter-generational relations and family structures. These three focus areas were chosen with the recognition that they would help create enabling environments for older persons and incorporate the needs of older persons into Cambodia’s development process, according to the Policy. The Policy is the only plan in this database to explicitly name gender equality as one of its key goals, although other plans mention viewing aging through a gender lens. The Policy has nine priorities, which include securing safe and accessible living arrangements, supporting intergenerational relationship-building, and encouraging disaster relief management organizations to consider the elder population in their plans.

Execution & Achievements: Thirty-two ministries, government bodies, and non-governmental organizations were named as partners in implementing the Policy, and many of the named organizations collaborated to develop the Three-Year Action Plan 2018–2020, which defines implementation actions. The Action Plan lays out numerous specific, concrete objectives for each of the nine priorities, and defines the annual budget necessary to achieve each objective. One of these objectives, for example, is to support the establishment of further Older People’s Associations across Cambodia and enhance their commitment to and role in promoting healthy aging. The Policy states that Older People’s Associations are critical to the effective implementation of the policy. These objectives can then be used for monitoring and evaluation activities, which are led by the Secretariat for the Cambodia National Committee for Older People, in the Department of Older People Welfare of the Ministry of Social Affairs, Veterans and Youth Rehabilitation.

Current Status & References: For more information, see this website to view the National Ageing Policy, which is current through 2030. The Three-Year Action Plan 2018–2020, which provides information on the implementation process for the Plan, is available here. According to Cambodian news sources, as well as an expert consulted during this database’s development process, the Royal Government and United Nations Development Programme are in the process of finalizing a Memorandum of Understanding to create a second Three-Year Action Plan, which will be current until 2024.  

Context: As of May 2023, India is the world’s most populous country, with a population of over 1.4 billion people. Although India has not formally undertaken a census since 2011, projections from the World Bank suggest there are over 95 million people over the age of 65 in the country, and the older population is predicted to increase to 324 million people by 2050. As life expectancy grows for both men and women, the proportion of the national population over the age of 80 is also expected to increase. With these added challenges, poverty among the aging population has become a major concern for the Indian government. To address challenges faced by older adults and support the aging population, and in accordance with the UN’s Madrid Plan of Action, the Ministry for Social Justice and Empowerment created the National Action Plan for Senior Citizens Umbrella Scheme in 2021. 

Plan Development: A National Policy on Aging has been in progress in India since 1999, when the Indian government published a road map on aging. The same year, the Indian government created the National Council of Senior Citizens, which advises the Indian government on aging-related issues and is housed in the Ministry for Social Justice and Empowerment. The 2011 National Policy for Senior Citizens served as a framework for the latest edition of the National Action Plan. In creating the 2021 National Action Plan, the Indian government consulted representatives from the National Institute of Social Defence, the National Institute of Rural Development, and regional centers. Finally, the government created seven working groups related to aging, including groups focusing on promoting financial security, health care and nutrition, promoting livelihoods and income generating activities, shelter and welfare, skills training for productive aging, awareness and capacity building and promoting the Silver Economy.

Principles & Goals: The Scheme lays out ten objectives across five main areas: 1) financial security and the Silver Economy; 2) health care and nutrition; 3) shelter, welfare, and accessibility; 4) intergenerational awareness and bonding; and 4) research and project management. Within the plan, there are several sub-plans, known as “sub-schemes.” These include the Integrated Programme for Senior Citizens (IPSrC), which focuses on combating elder poverty through expanding access to senior housing. This includes housing specifically for older women and for older adults with Alzheimer’s and dementia. Another sub-scheme, the State Action Plan for Senior Citizens (SAPSrC), targets the responsibilities that Indian states have to provide health care for their aging population and provides grant funding for mobile health care, physiotherapy clinics, and training for nurses. 

Execution & Achievements: Implementation of the Scheme will be undertaken by a steering committee established by the Indian government. The steering committee will include representatives from a wide range of Indian government agencies, including the Ministry of Health and Family Welfare, the Ministry of Rural Development, the Ministry of Home Affairs, the Ministry of Finance, and the Ministry of Labour & Employment among others. It will be led by the Joint Secretary of the Senior Citizens Division of the Ministry of Social Justice and Empowerment. Similarly, there will be a Project Management Committee, composed of representatives from across the Indian government and again led by the Senior Citizen Division. Monitoring methodology includes annual progress reports, live-tracking of projects to increase transparency, and inspections of projects carried out by the Project Management Committee. The plan also designates which objectives will be supported by the Senior Citizen Welfare Fund, which was established after the 2011 National Action Plan. Funding for sub-schemes like “Rashtriya Vayoshri Yojana,” which will provide physical aids such as hearing aids, wheelchairs and other assisted living devices to older Indians, includes grants worth 15,000 rupees per month (around US $182.62) over the five years of the plan. 

Current Status & References: According to the latest annual progress report mandated by the Plan and detailed above, the Indian government intends to set up a National Hotline for Senior Citizens with a budget of 60 crore rupees (around US $7.2 million), plans to fund start-ups focused on elder issues with a budget of 20 crore rupees (around US $2.4 million), and will continue to adapt housing for senior citizens with a budget of 150 crore rupees (around US $18 million) over the 2022–2023 fiscal year. More information about the plan can be found on the website for the Indian Ministry of Social Justice and Empowerment.

Context: While the total share of seniors in Nepal is low, compared to many other countries, Nepal has experienced accelerated population aging since 2000. In 1960, 2.5 percent of Nepal’s population was over 65 years old, which slowly rose to 3.7 percent by 2000 and then shot up to 5.8 percent between 2000 and 2020. Nepal’s population has also  experienced a dramatic rise in life expectancy—in 1960, the average lifespan was 35.5 years, which doubled to 70.8 years by 2020 and may continue to rise to a peak of around 80 years of age throughout the 21st century.

Plan Development: The Senior Citizens’ Act was developed by Nepal’s Parliament in 2006 to promote the social protection of seniors. According to an expert on aging in Nepal consulted while creating this database, Nepal’s government assigned a group of experts from the Law Commission to develop the Senior Citizen’s, 2063. The team members first attended several international conferences on aging to understand how other countries had prepared their policies or laws on aging. Once a draft of the Act was developed, the team then consulted with older persons, professionals who work closely with elderly people (such as those who work in nursing homes), and other relevant experts to finalize the Act. The Senior Citizens’ Act 2063 is based on Nepal’s national calendar, which is 56 years ahead of the Gregorian calendar.

Principles & Goals: The Act details the legal and social protections and special provisions that people over the age of 60 are entitled to in Nepal. It mandates the establishment of several organizations, including senior citizens’ welfare committees, a senior citizen welfare fund, and long-term care and daycare centers. To avoid the risk of having older persons experience poverty—as 85 percent of older adults live in rural, developmentally poor places—the Act also stipulates that families are legally required to fund and care for senior relatives. Filial support laws are considered controversial among some human rights organizations globally, but they can fill gaps in care for older persons, especially in rural areas with limited governmental reach. 

Execution & Achievements: The Act has been amended several times through additional legislation. The Senior Citizens Rules, 2065 (2008) policy, for example, defines and expands the roles of senior citizens welfare committees, which were established by the Senior Citizens Act. The governmental ministry that oversees implementation of the Senior Citizen Act—formerly called the Ministry of Women, Children and Social Welfare—was recently renamed the Ministry of Women, Children and Senior Citizens to signal that its focus had expanded to include the protection of older persons. The government also increased the Old Age Allowance from 3,000NPR (about $25) to 4,000NPR ($33) in 2021. The Old Age Allowance program provides unconditional cash transfers to older persons—in this case classified as persons over the age of 70, except for Dalits (those of the lowest caste) and residents of the underserved Karnali region, who can receive payments starting at age 60. Finally, the government has expanded the policy framework for older persons through policies such as the Geriatric Care Center Implementation Guideline, 2077 (2021).

Current Status & References: For more information, see this website to view the Senior Citizens Act. The Senior Citizens Rules are available here.

Context: Singapore is a rapidly aging society. By 2030, an estimated one in four Singaporeans will be age 65 or older. Given these drastic demographic shifts, Singapore was an early adopter of healthy aging policies, establishing its first national policy on aging in 1999. Its latest national policy, the Action Plan for Successful Ageing, was announced in 2015.

Plan Development: In developing the Action Plan for Successful Ageing, the Ministerial Committee on Ageing engaged with more than 4,000 Singaporeans of various ages to discuss positive aging. Public opinion was explored through focus group discussions and in-person and online consultations that took place between June 2014 and May 2015. The Committee also consulted unions and trade associations, as well as various religious and ethnic groups.

Principles & Goals: The Ministerial Committee on Ageing intended the Action Plan for Successful Ageing to create opportunities for individuals of all ages and foster a supportive community and country for older adults. The Action Plan covers over 70 initiatives in the following 10 areas: employability, health and wellness, senior learning, senior volunteerism, community befriending, intergenerational harmony, aged care, active aging and assisted living, transport infrastructure, and research. 

Execution & Achievements: The Action Plan’s initiatives are specific, often including timelines and measurable outcome targets, such as a target to increase home-based care by 50 percent and community-based care by 100 percent by 2020. In 2017, the Ministerial Committee on Ageing launched the “I Feel Young SG” campaign to promote the Action Plan and facilitate active aging, offering resources for older adults and tracking policy and program developments related to aging. Significant progress has been made towards nearly every target laid out in the plan, with several programs created for implementation. One newly implemented program, the National Seniors’ Health Programme, established in 2015, has already met its goal of reaching 400,000 seniors through health talks and exercise programs by 2020. Other significant programs created at the direction of the Action Plan include Active Ageing Hubs and Senior Activity Centers, which are neighborhood drop-in centers for seniors, and the National Silver Academy, which provides seniors with learning opportunities and has offered more than 1,000 courses since 2018. Additionally, nine Active Ageing Hubs have been built, reaching about 20 percent of older adults in Singapore. These programs, alongside age-friendly housing and transportation infrastructure, have cemented Singapore as one of the world’s most age-friendly environments. While precise targets with timelines have aided implementation, progress as a whole is difficult to track due to the absence of public monitoring and evaluation frameworks for the Action Plan overall.

Current Status & References: For more information, see this website to view the Action Plan. Singapore is expected to launch an updated Action Plan in 2022.

Context: Sri Lanka is one of the fastest-aging countries in the developing world, driven by falling fertility rates and increased life expectancy. The World Bank reported that older adults in Sri Lanka accounted for 11 percent of the national population in 2021. Sri Lanka projects that in 2050, older adults (those age 60 and older) will comprise 29 percent of the total population, and 34 percent by 2080, without an increase in the fertility rate or net gains from migration. There are social, economic, and health implications of this projected change. For example, Sri Lanka has a universal health care system for all citizens, but the current system is not well suited to the impending demographic transition, as it is ill-equipped to meet the needs of a growing proportion of older adults. A report published by the Asian Development Bank (ADB) noted that nursing home care is one such area for improvement, which in 2017 could accommodate 7,100 older adults, only 0.2 percent of the total population of older adults. In recognition of the coming demographic shift and to expand support to the aging population, the government approved the National Elderly Health Policy of Sri Lanka in 2017.

Plan Development: Sri Lanka’s Ministry of Health, Nutrition and Indigenous Medicine developed the National Elderly Health Policy, with the Japan International Cooperation Agency (JICA) and the Rural Health Training Centre (RHTC) providing financial assistance, in 2015 and 2016. The Policy does not specify whether any outside experts, additional Sri Lankan government officials, or representatives of other institutions were involved in its development. The Policy received the endorsement of the sitting cabinet ministers of Sri Lanka at the time of its promulgation.

Principles and Goals: The Policy aims to adopt a whole-of-society approach for improving the infrastructure and public awareness concerning health care services for older adults, involving coordination among the public and private sectors, nongovernmental organizations (NGOs), donor agencies, and the wider health sector. Sri Lanka guarantees all citizens universal health care, but it faces the challenge of adapting this system to its aging population. The Policy has six major objectives for success: 1) ensure that comprehensive health care packages are in place for all older adults; 2) ensure that preventive health services are available for all throughout life to minimize poor health in later life; 3) encourage expansion of older adult care in the private sector and NGOs; 4) ensure efficient health care delivery; 5) expand training of specialists across all sectors of care; and 6) empower a whole-of-society approach in care for older adults that recognizes different needs for men and women and people with disabilities.

Execution and Achievements: The Ministry of Health, Nutrition and Indigenous Medicine has worked with the World Bank, receiving loans for its primary health care restructuring efforts. The World Bank approved a five-year Primary Health Care System Strengthening Project in June 2018, committing US $200 million in loans to Sri Lanka to assist in implementing the National Elderly Health Policy. The World Bank’s Strengthening Project is designed to assist in restructuring Sri Lanka’s national primary health care (PHC) delivery through the prevention of noncommunicable diseases and expanding in-home care for older adults. In an update report from August 2022, the World Bank found that COVID-19 has slowed the deployment of the project, but noted that the it remains committed to completion, scheduled for December 31, 2023. In the same report, the World Bank said that US $98.1 million, or 48 percent of total funding, has been delivered to the Sri Lankan government to date.

Current Status and References: As of March 2023, the Sri Lankan government has provided no updates to the Policy or a timeline for achieving its stated goals. However, the Ministry of Health continues to push for restructuring its care of older adults as laid out in the Policy with assistance of the World Bank.

Context: Thailand has one of the fastest rates of population aging in the developing world and is the second-fastest aging country in the Association of Southeast Asian Nations (ASEAN). In 2000, adults age 65 and older made up about four percent of the total population, a share which rose to 15 percent in 2021. By 2033, older adults are expected to make up at least 28 percent, making Thailand a super-aged society. Traditional family-based care services are at risk of becoming untenable, with the fertility rate steadily declining over the past several decades and a shrinking working-age population. Research shows that historically there has been a higher poverty rate among older adults, compared to the total population. Thailand developed the Second National Plan on the Elderly (NPE) to address and monitor these challenges. The Plan focuses on sustaining a valuable and healthy life for older adults while facilitating access to qualified care and protection by their community and the state.

Plan Development: In 2003, the Act on the Elderly established the National Committee on the Elderly under the Ministry of Social Development and Human Security. The National Committee on the Elderly revised the Second National Plan on Older Persons in collaboration with government and nongovernment stakeholders in 2009. The Office of Welfare, Protection, and Empowerment of Vulnerable Groups partnered with representatives of all levels of government, the aging population, the private sector, and academia to analyze and make recommendations to the national plan. In 2009, the Ministry of Social Development and Human Security received approval from the Cabinet for the revisions to the National Plan. The revised version released in 2009 includes the role of the National Committee on the Elderly, a budget expansion for activities accommodating older adults, modified strategies for long-term care and social protection, and aging education for all ages.

Principles & Goals: The Second National Plan on The Elderly (2002–2021) outlines strategies with the goal of promoting positive attitudes toward aging populations and creating a culture that empowers older adults to be active members of society. The revised Plan is made up of five strategies: 1) preparation for quality aging; 2) promotion and development of the aging population; 3) social security for older persons; 4) development of a national management system; and 5) analysis of knowledge and implementation of the Plan. Reforming the social protection system features prominently throughout the Plan, along with an emphasis on campaigns and education systems focusing on the importance of preparing for aging. Raising awareness of care and social services accessible to families will be especially crucial as family sizes get smaller and there are fewer opportunities for aging populations to depend on their family members in old age. Adjusting public services, homes, transport systems, and all public spaces to accommodate the aging population is also prioritized in the plan to help improve the quality of life for older adults.

Execution & Achievements: At least once every five years, the National Commission on the Elderly is responsible for monitoring the implementation of the Second National Plan on the Elderly. The Plan primarily lists the Ministries of Public Health, Finance, Labor, and Education as the entities responsible for strategic implementation. Each strategy includes target percentages for the next 5, 10, 15, and 20 years. Since 2007, the Plan has been assessed three times by the Chulalongkorn University to analyze implementation of the NPE and determine the most current challenges the aging population faces. To address the need for social protection outlined in the NPE, the Act on the Elderly creates provisions for social, health, and economic protection and access to public services and facilities for persons age 60 or older. There is no budget information published in the Plan.

Current Status & References: To read more about the Second National Plan on the Elderly, visit this website.

Context: Preparing for the economic and social impacts of an ageing population has been a government priority in Vietnam for decades. Adults over the age of 65 represent 9 percent of the total population. The number of Vietnamese aged over 65 is projected to increase from 8.5 million today to over 22 million in 2050. Due in large part to widespread education, declining poverty, and expanded family planning, fertility levels decreased from an average of 6.3 children per woman in the 1960s to 1.9 in 2020. Meanwhile, average life expectancy has increased by almost a full decade to an average of 74 years. As a result of this demographic shift and amidst improved socioeconomic development outcomes, around one in five Vietnamese citizens is expected to be 60 years of age or older by 2035, making it one of the fastest-aging countries in the world. To address this new demographic reality, the government promulgated the National Action Program for Older Persons (NAP) in May 2021.

Plan Development: Prior to receiving approval from the Prime Minister in 2021, a blueprint for Vietnam’s National Action Program for Older persons was developed in 2019 by the Vietnam National Committee on Ageing with support from the United Nations Population Fund. This document, “Towards a Comprehensive National Policy for an Ageing Viet Nam,” provided an “overall situation analysis” on aging in Vietnam and suggested possible ways of preparing the country for an ageing population. The blueprint drew and built upon Vietnam’s previous development plans mentioning older persons, including the Law on the Elderly (2009), National Action Plan on Older People (2012–2020), Vietnam’s Socio Economic Development Strategy (2011–2020), and Population and Reproductive Health Strategy (2011–2020). Additionally, input from the Ministry of Labor, Invalids, and Social Affairs (MOLISA), Ministry of Health (MoH), Ministry of Civil Engineering, and Vietnam Association of the Elderly was solicited during a series of “consultative workshops” to ensure that cross-departmental cohesion was prioritized during the development and implementation of the proposed policies.

Principles & Goals: The NAP identifies 14 wide-ranging “indicators” to identify key goals and measure progress across housing, health care, and social well-being over the next decade. Some examples include requiring all “party committees and authorities at all levels” to publicize new policies targeting older persons as they are released; broadcasting at least two public service announcements per week over television and radio that raise awareness of the issues facing older persons; reducing the proportion of low-income households with older people to less than 3 percent by 2030; and providing 70 percent of older persons with access to “information and communication technology” by 2030. To meet these indicators, the NAP also identifies several specific “tasks,” or policy suggestions, which are organized into nine categories. The first category makes public communication and awareness a priority, and involves organizing “mass media at all levels” to prepare Vietnamese society for an aging population. Categories two, three, and four discuss the physical, health, and social needs of older persons, while categories five, six, and seven provide suggestions for creating a national, cultural mindset that prioritizes the social contributions and happiness of older persons. The eighth category outlines tasks related to developing a national database on the status of older persons throughout the country, with the primary goal of evaluating and providing ongoing adjustments to other policies. Finally, the ninth category stresses the need to support the representatives of associations and boards of older persons, as they will represent the primary stakeholder group as Vietnam begins implementing the above policies. 

Execution & Achievements: The Vietnamese government has taken several steps toward accomplishing the goals outlined above. As of 2022, the country is on track to provide health insurance for 95 percent of senior citizens by 2025, and 9.7 million out of approximately 11.4 million eligible senior citizens have become members of the Vietnam Association of the Elderly. According to the Asian Development Bank (ADB), the NAP also identifies objectives along several areas of focus, from work and culture to health, housing, and rights, and creates a strong framework for long-term care with responsibilities distributed across MOLISA and MoH. However, the ADB notes that the specific mechanisms for creating better coordination between these agencies still need to be clarified if the NAP is to be effectively implemented.

Current Status & References: The National Action Program can be viewed here. Currently, government ministries like MOLISA are working to implement various early stages of the NAP. In 2022, for instance, MOLISA oversaw the creation and execution of a pilot program designed to improve the capabilities of over 1,000 caregivers in the city of Da Nang. At the same time, the Vietnam Association of the Elderly, one of the chief contributors and implementing partners of the NAP, stressed that additional programs will be needed if Vietnam is to meet all of its age-related development goals before the end of the decade.

Context: At the time of Antigua and Barbuda’s independence from the United Kingdom in 1981, the proportion of adults age 65 and older was approximately 5.5 percent of the total population. By 2021, this group had grown to 10 percent, and it is projected to more than double by 2060, reaching an estimated 22.7 percent. This 13.4 percentage point increase is higher than the Caribbean regional average of 10.7 percent. Additionally, the life expectancy at birth of 77.3 years is higher than the regional average of the Americas, which declined from 75.1 years in 2019 to 72.1 years after the onset of the COVID-19 pandemic. To address this trend, the government of Antigua and Barbuda updated its previous 2013–2017 National Policy on Ageing with the new 2017–2027 National Policy on Ageing.

Plan Development: The Policy’s development process was led by the Ministry of Health and Environment, in collaboration with the Ministry of Social Transformation and Human Resource Development. After reviewing and identifying gaps in the 2013–2017 Policy, a situational analysis was conducted to determine the needs of older adults in the country. A technical committee was convened to develop a draft of the policy, which was shared with stakeholders from public, private, and community institutions for their feedback. The consultation process included technical assistance from the Pan American Health Organization and participation by older adults from the national population. The Policy was also informed by existing strategies on aging from jurisdictions such as Ireland, Malta, and Australia.

Principles & Goals: The Policy is organized around the three pillars of the WHO’s 2002 Active Ageing Framework—participation, health, and security—and includes a fourth pillar for general organizational and management policies. Its guiding principles are inspired by the United Nations Principles for Older Persons, which include dignity, independence, participation, safety, self-fulfillment, and recognition. Antigua and Barbuda’s overarching policy goal is to create conditions for healthy and active ageing, while also counteracting the compounding inequalities experienced in old age. One specific objective to this end was to establish a management structure, legal framework, national policy, and National Council on Ageing by 2018, though the Council has yet to be created. The Policy also recognized the need for a skilled workforce to provide services to older persons, age-friendly communities, stronger health systems, and a more expansive social protection system.

Execution & Achievements: The Ministry of Health and the Environment is responsible for monitoring and evaluation, as well as appointing a Monitoring Committee to implement the Policy’s action plan. An Indicator Framework was developed to assess performance on six dimensions: access, equity, quality, effectiveness, efficiency, and sustainability. Indicator data will be collected at facility, district, and national levels, and managed through a database that the Aging Secretariat will use to generate progress reports. Progress reports and reviews by the Monitoring Committee should be conducted every two years, and the Committee is expected to commission specialized studies to inform the Policy’s implementation, such as the Chronic Disease Survey. To date, there is no publicly available documentation to indicate that the Policy’s action plan has been implemented.

Current Status & References:
In the year of the Policy’s release, the island of Barbuda was devastated by Hurricane Irma. Relief and reconstruction efforts took precedent over the government’s other policy goals, which could be a potential explanation for the lack of follow-up to date on the National Policy on Ageing.

Context: Argentina has one of the largest and fastest growing populations of older people in Latin America and the Caribbean. According to the Inter-American Development Bank, as of 2020, 15.7 percent of Argentina’s population of 45.4 million is over the age of 60. The percentage of older persons in Argentina is growing and is expected to reach 22 percent by 2050 and 34 percent by 2100. Argentina is currently experiencing a favorable demographic dividend, in that the working-age population is growing in proportion to dependent populations, such as older persons and children, which potentially allows the country time to plan for an aging population and use money derived from the larger working population to institute a robust care program. With this opportunity in mind, the government of Argentina adopted the National Plan for Older Persons in 2012.

Plan Development:  The National Plan was developed through a collaborative process that engaged national ministries, provincial and municipal councils, academics, specialists in gerontology, and councils that represented senior citizens, among other stakeholders. The Plan’s development process was carried out during 2011 and was spearheaded by the Ministry of Social Development to fulfill the Madrid International Plan of Action on Ageing’s national plans strategy.   

Principles & Goals: Building off previous policies developed since 2003—many of which focused on guaranteeing economic security through pensions and work—the current 2012 National Plan identifies three key areas on which to focus implementation efforts, each of which has several specific targets. The areas are: 1) including older persons in society by providing better access to formal employment, social security, cultural activities, and education; 2) promoting healthy aging through increased access to universal, legally-mandated physical and mental health care; and 3) developing enabling environments, which includes promoting adaptations to the physical environment, as well as increasing legal, social, and governmental support for older persons. Based on each region in the country’s specific needs and gaps, the National Plan specifies several regional targets and goals.

Execution & Achievements: The National Plan stipulates several goals, including training 50,000 home caregivers for the elderly and 750 gerontologists. The Plan also notes a goal of engaging with 100,000 people of all ages through the ​​Promotion of Good Treatment of the Elderly program, in order to dispel negative attitudes toward older persons and aging, and promote intergenerational goodwill. The Plan establishes monitoring and evaluation guidelines and appoints the Federal Council for the Elderly to take the lead in planning two yearly monitoring and evaluation meetings, one of the Federal Council’s Executive Committee and one of the plenary meetings. A major gap, however, is that the National Plan does not include information on budgeting for implementation.

Current Status & References: For more information, see this website to view the National Plan. While the National Plan ended in 2015—and it is unclear if or when a new or updated plan will be released—it serves as the foundation for Argentina’s continued support for older persons. Argentina launched its national efforts toward implementation of the UN’s Decade of Healthy Ageing in 2021, which will likely build on goals laid out in its National Plan, and the country will implement various programs in line with the Decade with Pan American Health Organization’s (PAHO) support between 2021 and 2030.

Context: Barbados places in the top 50 countries worldwide in terms of the percentage of the population over 65 years of age; in 2022, 16.3 percent of Barbadians were 65 or older, compared to 9.8 percent of the global population. A combination of factors, from extended life expectancy to the high rates of emigration that are common across Caribbean countries, are driving this demographic shift, leading to increased demand for services and care for older adults, particularly those living with non-communicable diseases (NCDs) and disabilities. As of 2021, NCDs, including diabetes and cancer, accounted for 83 percent of all deaths in Barbados, and up to a quarter of all Barbadians are anticipated to have a disability by 2050. This has served to highlight gaps in care for older adults in Barbados, over a quarter of whom require some form of long-term care. In 2022, Barbados published the 2023–2028 National Policy on Ageing for Barbados in an effort to integrate the concept of healthy and active aging into all government action related to older adults at the national, institutional, and community levels.

Plan Development: Under the direction of the Ministry of People Empowerment and Elder Affairs, the policy builds on the 2012 National Policy on Ageing in Barbados to update and strengthen the country’s efforts to meet the needs of older adults. The policy was specifically informed by a Situational Assessment Exercise on Essential Care/Services and Older Persons in Barbados conducted in 2021, which included interviews with more than 150 older adults to better understand and map their challenges and concerns. The process also involved extensive desk research and the incorporation of knowledge and best practices from documents such as the United Nations Principles for Older Persons and the UN Decade of Health Aging. The policy likewise notes the responsiveness of certain aging strategies, such as in Canada and Chile, to the hardships of the COVID-19 pandemic and seeks to emulate their focus on building out long-term care focused on older adults.

Principles & Goals: The policy frames its core goals through a rights-based approach and emphasizes that said rights will be “fully recognised, vigorously defended and strongly preserved.” To that end, the policy outlines eight priority areas for action: (1) financial and economic security, (2) social security, (3) health and health systems, (4) the physical and built environment, (5) the social environment, (6) legislation, (7) long-term care, and (8) pandemics, disasters, and emergencies. Each action area is complemented by sub-component objectives and respective strategies to meet those goals, which in some cases include the suggested implementation of new programs. Such proposals include a national program to improve financial literacy among seniors, a collection of efforts to improve geriatric and gerontology courses and training for medical professionals, and, in response to COVID-19, a proposal for a pandemic preparedness and recovery plan for older adults, among others. The policy also provides a set of core values—including dignity, equity and inclusiveness, accessibility, care, self-fulfillment, and freedom from harm—that are intended to undergird a whole-of-society approach to meeting the needs of older adults.

Execution & Achievements: The policy clearly emphasizes long-term efforts to implement, monitor, and evaluate its progress, though as of October 2023 the policy still awaits full implementation as a piece of formal legislation. Specifically, the document anticipates the creation of a National Coordinating and Implementation Committee to oversee its execution, including through further action plans and allocation of resources, continued collaboration with community stakeholders and older adults, and collection and analysis of monitoring and evaluation data. As a part of the monitoring and evaluation process, the policy outlines the need to track implemented programs, identify shortcomings and outstanding gaps, and re-evaluate and realign the policy’s goals, objectives, and strategies over the plan’s five-year time frame. The outlined monitoring and evaluation framework includes activities such as routine progress reports; indicators for program inputs and outputs; and regular meetings, interviews, and surveys to collect primary data.

Current Status & References: The policy, once fully enacted, will be active through 2028 and can be viewed here. As of June 2023, legislation in support of the policy was being prepared by the Ministry of People Empowerment and Elder Affairs, and public comments on the policy’s design were being solicited through March 2023. In April, Minister of People Empowerment and Elder Affairs Kirk Humphrey emphasized ongoing work to improve the lives of older people in Barbados, including establishing access to care facilities for older adults in every parish, and the desire to enable “aging in place” for older adults. Most recently, in August 2023, the government was completing a final town hall meeting to receive input for the proposed 2023–2030 National Policy for Improving the Lives of Persons with Disabilities, which directly impacts seniors.

Context: Québec, Canada’s largest province by area and second most populous, has a higher proportion of adults aged 65 and older than nationally. In Canada, 19 percent national population is 65 years or older compared to 21 percent in Québec’s, and this figure is projected to rise to 25 percent by 2031. Québec’s life expectancy has also increased for both men and women to an average of 82.5 years whereas the birth rate has fallen to 1.59 children per woman. Additionally, women in Québec make up 55 percent of the population over age 65 and tend to have less disposable income than their male counterparts. These developments have brought preparing for aging and supporting older adults to the forefront of the provincial government of Québec’s agenda. Thanks to the province’s previous plan on aging, Age and Live Together: Your home, your community in Québec, the World Health Organization (WHO) considers Québec one of the world’s most advanced societies in terms of developing age-friendly policies and catalyzing innovation on aging. Released in 2018, A Québec for All Ages: An Action Plan for 2018-2023 is the second edition of the provincial government’s aging policy and successor to Age and Live Together.

Plan Development: Québec’s 2018 Action Plan for Québec builds on the aging-focused work the province has led since 2001. That year, the government of Québec published its strategy for Aging and the Loss of Autonomy, which was followed by its strategy for Living in Residential and Long-Term Care Housing, which was published in 2003. In 2012, the government of Québec published their first Action Plan, Age and Live Together. This Plan was active until 2017 and integrated the WHO’s concepts of Active Aging and Age-Friendly Cities. Following that publication, the government led consultations with non-profits, universities, and members of Québec’s population of older adults to create the current Action Plan for Québec published in 2018.

Principles & Goals: The Action Plan lays out 11 objectives across three pillars of action. Within each objective, the Action Plan outlines several targeted goals over the five-year period with a total of 85 goals throughout the entire plan. The three central pillars are: 1) strengthening community engagement across all ages; 2) improving health care focused on aging populations; and 3) creating a healthy, safe, and welcoming environment for Quebecers over age 65. Pillar 1 includes objectives like highlighting and supporting social, cultural, and professional development of older Quebecers through increased cultural offerings, active aging exercise classes, and French language classes aimed at immigrants. Pillar 2 includes objectives like improving the quality of life for older adults through adopting practices to prevent elder suicide, evaluating cognitive diseases and implementing aging-in-place measures. Finally, Pillar 3 includes objectives like facilitating mobility and creating more age-friendly transportation, buildings, and public spaces. The goals within each objective account for different challenges faced by First Nations and Inuit people, rural Quebecers, immigrants, and women, and ways to reduce inequalities among different groups.

Execution & Achievements: Implementation for the Action Plan is jointly housed within the Quebecer Ministry of Health and Social Services and the Ministry of Families, but also details other agencies that will cooperate across the government of Québec, emphasizing the whole-of-government approach to aging. These parties, which include the Ministry of Economy, Innovation and Energy, the Ministry of Education and Higher Education, and the Ministry of Francisation, and Integration of Québec among others, will make up an intergovernmental task force for monitoring implementation. This body is tasked with producing an annual report to review progress. Additionally, the government of Québec will hold biannual regional forums to consult stakeholders and members of the community on their perceptions of the plan. The government will invest CAD $12 billion over five years (about USD $8.8 billion) to achieve the objectives laid out in the Action Plan.

Current Status & References: The current Action Plan is set to expire at the end of 2023. The development of a new action plan for 2024–2029 is currently in progress at the Ministry of Health and Social Services. In March 2023, the Ministry published a call for briefs from researchers and organizations as part of the process of creating a third action plan for Québec. The latest report from the Ministry detailing implementation on the Action Plan thus far was published in September 2022 with data through March 2021 and states that progress had been made on 83 of the 85 goals listed in the plan. The report stated that CAD $5.7 billion had been spent in the first three years of implementation (about USD $5.7 billion). An assessment of the overall Action Plan is expected in 2024.

Context: People over the age of 65 account for 11.9 percent of Chile’s total population, and the share of older adults is expected to double by 2050. Chile has a positive history of focusing on older persons, particularly through the National Service for Older People (SENAMA), which was established in the 1980s under the Ministry of Social Development. While many Chilean older adults are choosing to live independently, a 2021 report from Pan American Health Organization found that most older people in Chile are not considered fully healthy for the final ten years of their lives. There are also some gaps in care for older persons, including a rapid reduction in influenza vaccine coverage among older persons from 98 percent in 2010 to 68 percent in 2019. Chile also lacks geriatrician coverage, with one geriatrician for every 48,000 older persons as of 2018, compared to one for every 15,000 older persons in Brazil and one for every 25,000 older persons in Mexico.  

Plan Development: The National Health Plan builds on three key initiatives—the Comprehensive Positive Aging Policy (2015–2025), the National Health Strategy (2011–2020), and the Older Adult Plan (2018–2022)—that all “focused on achieving a kinder and fairer Chile for older people.” The Comprehensive Positive Aging Policy and the National Health Strategy will be updated with a new proposal for the decade. Another relevant plan that, along with the National Health Plan, will make up the 2020’s framework for addressing aging includes the Strategic Aging Orientation 2021–2030, which was launched in March 2022.

Principles & Goals: The National Health Plan focuses on providing adequate access to and quality of health and social services for older persons, with a particular emphasis on expanding primary health care. The National Health Plan identifies several approaches to elder care, such as life-course, gender-sensitive, and person-centered care approaches, that informed its development. The Plan also highlights the need to provide comprehensive, cohesive health care for older people, including training more geriatricians and expanding the use of the Comprehensive Geriatric Assessment (VCI), which is a multidimensional and standardized patient health survey conducted by geriatricians. The National Health Plan identifies six key strategies: 1) education, promotion, and prevention; 2) service provision; 3) strengthening comprehensive health care for older people; 4) strengthening information systems; 5) regulation and supervision; and 6) sufficient funding. Finally, the Plan identifies a number of implementation initiatives. These include strengthening the National Institute of Geriatrics (INGER), improving access to digital health care for older persons, widely immunizing older people against influenza and COVID-19, and supporting mental health during the pandemic through a Ministry of Health program called SaludableMente.

Execution & Achievements: The National Health Plan was recently released, and a follow-up report about implementation has not yet been published. However, several initiatives are highlighted as having made major progress in recent years, including a 50 percent increase in the number of geriatric physicians nationwide, the building of more Acute Geriatric Units in regional hospitals, and the implementation of the 2019 National Drug Policy through the National Drugs Strategy (2021–2030), which aims to improve access to, and reduce costs of, critical medicines. Additionally, SENAMA recently launched a document, titled the Strategic Aging Orientation 2021–2030, that will identify and attempt to close gaps in Chile’s legal and policy framework around aging.

Current Status & References: The National Health Plan was released in September 2021 and is current through 2030. For more information, see this website to view the Plan. 

Context: The proportion of older adults in Colombia is steadily growing, representing a demographic change with significant implications for the country's workforce and universal health system.  The Colombian Policy on Aging and Old Age is an update of Colombia’s National Aging and Old Age Policy, which was written in 2015 and set to conclude in 2024. In Colombia, 15 million people are projected to be over the age of 65 in less than two decades, rising from 4.5 million people, or nine percent of the total population, in 2021, which makes this update especially timely and pertinent. The preceding Policy lacked a rigorous implementation plan and the ability to withstand shifts in the political and administrative contexts. The updated version of the National Aging and Old Age Policy addresses these gaps and seeks to enhance Colombia’s preparedness for accelerated aging while better supporting older adults, a segment of the national population that disproportionately faces economic and health care inequality. 

Plan Development: The Policy’s development was informed by consultations with the National Council for the Elderly and 67 regional forums held in 2021 by the Ministry of Health and Social Protection. The forums solicited inputs from 1637 participants, including public officials, service provider representatives, the private sector, NGOs, people with disabilities, and members of academia. These recommendations were consolidated and published on the Ministry of Health and Social Protection’s website. The final draft was signed by President Ivan Duque in May 2022.

Principles & Goals: Colombia’s National Policy on Aging and Old Age seeks to secure the right to autonomy, dignity, and longevity throughout the life course, especially for those aged 60 and over, while promoting individual, familial, and societal co-responsibility. A set of ethical imperatives form the framework that guides the objectives and action plan. The Policy consists of six strategic axes: 1) reduce poverty among older persons; 2) promote social engagement and citizen involvement; 3) legal protection from violence for older persons; 4) expand access to comprehensive health care and nursing services; 5) support healthy aging for an independent, autonomous, and productive life in old age; and 6) enable education, training, and research to address the challenges of aging and old age. Each strategy defines specific lines of action and short, medium, and long-term policy goals. Efforts to cultivate a workplace pension culture with awareness campaigns and increased coverage in different sectors are at the forefront of the Policy with an eye toward reducing poverty among older adults. The Policy also emphasizes the importance of making physical spaces (especially in rural areas) more accessible in terms of public transportation, road safety, and community development. Another notable initiative of the latest Policy is strengthening the capacity of local policing systems to help identify and prevent violence in order to better protect older women.

Execution & Achievements: The Policy on Aging and Old Age delegates the National Observatory of Aging and Old Age to monitor progress toward this Policy’s goals. This monitoring tool was officially launched in 2022. Annual progress reports will be housed on the Ministry’s website, through an information management tool called the Colombian Observatory of Human Aging and Old Age. The National Intersectoral Action Plan was also developed under the Policy on Aging and Old Age to adapt all regulations, projects, and strategies to the unique economic, social, cultural, and political-administrative characteristics of each territory’s inhabitants.

Current Status & References: To date, the National Council for the Elderly organized four regional meetings in 2022 to strengthen the knowledge and implementation of the National Public Policy on Aging and Old Age. For more information about Colombia’s Public Policy on Aging and Old Age, view this website.

Context: Over the past forty years, Costa Rica has undergone a noteworthy demographic transition with people aged 65 years or older projected to make up 23.6 percent of the national population 2050, compared to 10.5 percent in 2021. With a strong commitment to social welfare, Costa Rica has developed a proactive approach to aging through the creation of its National Plan on Aging and Old Age. Life expectancy in Costa Rica is among the highest in the world, reaching 79 years in 2020. As life expectancy has increased, issues facing older adults, such as abandonment and lack of access to care services, have become more prominent. As such, the government has sought to improve tools and strategies for better protection of aging populations. However, 23 percent of older adults are still living in poverty or extreme poverty, accelerating the need for accessible housing and better care services.

Plan Development: The National Council for the Elderly (CONAPAM), Pension and Retirement Board (JUPEMA), and the United Nations Population Fund (UNFPA) developed the National Plan on Aging and Old Age. Over 3,000 older adults participated in 16 regional forums around the country in 2009, providing input for the development of the policy. The Plan was also created with the counsel of representatives of organizations supporting older adults from 81 regions of the country. As a society experiencing accelerated aging, the collaboration among members from the public and private sectors, academia, care and service organizations, and NGOs facilitated input and learning via these forums, which were essential to the Plan’s design and development.

Principles & Goals: Costa Rica’s inclusive and considered approach to improving human welfare and addressing aging, and the prioritization of funding for social programs, is outlined in this policy. The Plan has six principles: universality, equity, dignity, intergenerational solidarity, social participation, and social co-responsibility. As the first action plan of its kind, it emphasizes the cooperation of officials from all levels of government in order to devise strategies to meet the needs of each region. The Plan is made up of five strategies: 1) Social protection and poverty prevention; 2) violence and abuse protection of older people; 3) participation and integration; 4) consolidation of rights; and 5) comprehensive health and long-term care. Each strategy outlines specific goals and objectives. The Plan focuses on the need to address high poverty levels in older adults and lack of accessible care services with the expansion of non-contributory pensions and greater funding for social protection and care services. Relatedly, the Plan focuses on non-discriminatory hiring practices as a way to expand opportunities for equal access to work and income-generation activities for older adults. It also recognizes the need for infrastructure development to create accessible public spaces for older adults to support their roles in and contributions to, society.

Execution & Achievements: In 2015, the government increased the funding to support the Plan’s programs by 753 million colones (about US $1.3 million) from the original 14.5 billion colones (about US $27 million) budgeted for the year. In 2015, CONAPAM created a care modality for cases of abandoned and/or homeless older adults to be relocated into government-funded care facilities. Between 2018 and 2022, Costa Rica developed 30 centers that care for aging populations in need of housing. In April 2022 a telephone hotline called the 24/7 Gold Line was launched for filing complaints of abandonment, violence, and needs of assistance. CONAPAM also funded over 85 million colones (about US $150,000) in homes, day centers, and care networks for the older population between 2018 and 2022.

Current Status & References: Read more about the Costa Rica National Plan on Aging and Old Age on this website.

Context: Guatemala is the youngest country in the Western Hemisphere, with an estimated median age of just 23.2 years as of 2020. By 2030, adults over 65 are anticipated to account for 6.1 percent of the population, up from 4.9 percent in 2019. Nonetheless, the needs of this population require increased policy and fiscal resources from the national government. For example, older Guatemalans experience multidimensional poverty—including poor health, illiteracy, and socioeconomic disadvantages. Most economic activity in Guatemala is informal—7 in 10 working adults are employed in the informal sector—and as a result of which, only 12 percent of adults over 65 received a pension as of 2018, compared to an average of 42 percent across Latin America. The state has a range of laws that mandate its responsibility toward older adults. Article 51 of the constitution guarantees protection for the physical, mental, and moral health of older adults, including the right to basic needs such as health, food, education, security, and social services. Pursuant to this goal, the Law for the Protection of the Elderly, Decree No. 80-96, was passed in 1996 to better deliver such rights, as well as access to geriatric and gerontological care and recreation and leisure activities. Other laws, such as the 2005 Law of the Economic Contribution Program for the Elderly, and programs, such as My Golden Years (“Mis Años Dorados”), complement these efforts, but older Guatemalans continue to face a range of challenges.

Plan Development: The National Policy, approved in 2019, was developed by the National Committee for the Protection of the Elderly (CONAPROV), an inter-ministerial body charged with creating, promoting, and maintaining so-called “third-age” policies in Guatemala. Housed within the Secretariat of Social Works of the Spouse of the President of the Republic (SOSEP), CONAPROV features a board of directors that includes representatives from SOSEP, the Guatemalan Social Security Institute, the Ministry of Labor and Social Welfare, the Ministry of Public Health and Social Assistance, and the Attorney General’s Office, among others. The plan specifically references a number of globally relevant aging-related documents, such as the Vienna International Plan of Action on Aging (1982), the Protocol of San Salvador (1988), and the Madrid International Plan of Action on Aging (2002). The plan’s framing includes special emphasis on the feminization of aging—the trend of women living longer than men—among older Guatemalans, the acute challenges facing Indigenous peoples, and the varied characteristics of aging populations between rural and urban settings.

Principles & Goals: The National Policy is centered on five strategic objectives focused on older adults: (1) improving health care, (2) developing education, training, and employment opportunities, (3) expanding social security programs, (4) creating specialized care mechanisms in the justice system, and (5) increasing participation in recreation programs and public institutions. Each objective is then further explained. For example, the first—improving health services—identifies targets such as reducing morbidity and guaranteeing provision of care to 100 percent of the population, and explicitly mentions attending to the needs of people of Mayan, Xinca, and Garifuna descent as well as people of different ages, genders, and sexual orientations. The policy is further grounded along “Strategic Axes” that tie it to the K’atun National Development Plan: Our Guatemala 2032 (PND)—a 20-year development strategy active from 2012 to 2032. Among the PND’s many goals, it cites building, and delivering on, a rights-based approach for Guatemala’s older population, in relation to which the National Policy highlights key issues such as rehabilitation, productive livelihoods, housing assistance, socialization and recreation, and improved health services.

Execution & Achievements: The National Policy ties each of its strategic objectives with specific expected results, as well as actions to help accomplish those goals. The social protection objective, for example, has the aim that 50 percent of older Guatemalans will have access to social assistance programs and universal social security by 2032. In the realm of justice, by 2026, the Policy aims for one-quarter of Guatemalans to have knowledge of the rights of older adults, and identifies creating education and awareness programs as critical to pursuing that goal. CONAPROV, under the control and direction of SOSEP, is charged with monitoring and implementing the plan, and specifically identifies evaluation periods ending in 2020–21, 2026, and 2032. While a 2020–21 evaluation report does not appear to have been made public, CONAPROV and SOSEP publish annual work reports. The CONAPROV 2022 work report details contributions relevant to older adults made by each of its constituent ministries, including the Ministry of Social Development establishing transportation subsidies for older adults and the Ministry of Labor and Social Welfare increasing monthly social security payments to older adults and expanding the scope of the program to reach more individuals. The SOSEP 2022 work report has a broader remit, but it notes continued support to the My Golden Years program, a series of virtual workshops and assistance programs to support the psychological well-being of older adults, and coordination of CONAPROV’s participation in the Fifth Regional Intergovernmental Conference on Aging and the Rights of Older Persons in Latin America and the Caribbean, pursuant to the Madrid International Plan of Action on Aging.

Current Status & References: The National Policy is set to be active until 2032 and can be viewed here. The National Policy is closely interlinked with Guatemala’s national development plan to 2032, which can provide additional context for how programs to support the health of older Guatemalans are part of the government’s broader efforts to improve health care and the social development of the country at large. The latest updates from SOSEP, the parent ministry for CONAPROV, can be seen
here.

Context: The aging population, 60 years and older, is the fastest-growing demographic group in Jamaica. In 2021, 204,000 Jamaicans, or 7 percent of the population, were aged over 65, and this population is projected to grow to 500,000 people by 2030. Life expectancy continues to increase for men and women, and those 60 years and older are facing new challenges. As more citizens are living longer, Jamaican government wants its aging population to lead active and productive lives. Seventy-two percent of the aging population suffers from at least one chronic illness, yet the health care system is under-resourced, with one doctor for every 1,000 citizens. This cohort is more educated than previous decades, and one large priority is to actively involve the aging population in society and community building. To prevent economic and social risks, the government prioritized a comprehensive plan for this cohort in alliance with the Vision 2030 National Development Plan. The Ministry of Labour and Social Security released the National Policy for Senior Citizens in 2021 to support older adults toward reaching their full potential.

Plan Development: In 2021, the National Policy for Senior Citizens (2018) was analyzed and revised by the Ministry of Labour and Social Security and the Planning Institute of Jamaica (PIOJ). A Technical Review Panel made up of the Ministries of Education, Health, Labour and Social Security, Planning Institute of Jamaica (PIOJ), National Council for Senior Citizens, HelpAge International, and members of academia monitored each stage of the revision. Literature review, research, and public consults from older adults and governmental and non-governmental entities made up the initial revision. In 2022, the National Policy for Senior Citizens (2021) was approved and presented to the public.

Principles & Goals: With the input of senior citizens and support organizations, the National Plan is organized in six themes: 1) Social engagement and participation; 2) Social Protection, Income Security and Employment; 3) Health and Wellness; 4) Physical Environments, Protection and Safety; 5) Family Integration and Intergenerational Transfers; and 6) Governance and Capacity-Building. To improve the quality of life for older adults, the Plan outlines a system of support and resource allocation in synchrony with communities, the private sector, and the public sector. Jamaica has outlined the importance of having a personal identity and greatly encourages social engagement and organization involvement for older adults. Income-generating activities and financial-literacy programs in partnership with senior citizen organizations are prioritized, since most older adults rely on their family for income. Educational curriculum across the country will include retirement planning and healthy aging to empower youth and educate them on the needs of older adults. With the majority of the aging population suffering from at least one disease, resource allocation for preventative health care services is also prioritized.

Execution & Achievements: The Ministry of Labor and Social Security (MLSS) is responsible for the development and implementation of the National Policy for Senior Citizens (2021). The National Council for Senior Citizens (NCSC) monitors implementation and progress of government organizations, the private sector, community organizations, and civil society groups. A Monitoring and Evaluation (M&E) Framework created by the NCSC tracks the progress of national strategies and policy. The council will conduct an evaluation of the National Policy for Senior Citizens every five years. The National Council for Senior Citizens is also responsible for establishing specific budgets for implementation of the plan.

Current Status & References: Shortly after the release of the revised policy, Senior Citizens’ Week was observed in the last week of September of 2021. The Social Pension Programme was launched in 2021, providing those aged 75 years and older who don’t have a work pension, disability benefits, or retirement income, access to a social pension in response to the plan. Although the revised plan does not address the implications of COVID-19 for the aging population, the ministry launched a COVID-19 program assisting most affected groups. To learn more about the National Policy for Senior Citizens, visit this website.

Context: The geographic distribution of Panama’s aging population varies significantly: in some rural provinces, adults over 65 account for more than 16 percent of the population, while in most urban provinces they can account for less than 4 percent. In total, 11.3 percent of the population will be over age 65 by 2030, leading to increased demands on government and other services. A growing percentage of the population will experience some type of disability, including 17.8 percent of those over 60, and there will be a cohort of adults over 80, which is expected to expand by 50 percent between 2021 and 2030. Important legal efforts, such as the creation of Law 36 on August 2, 2016—the first comprehensive national protective regulation for adults aged 60 years or older in Panama—form the basis of the government’s renewed focus on senior citizens, which has led to the National Plan for the Elderly, 2022–2025.

Plan Development: The national plan is primarily overseen by Panama’s Ministry of Social Protection (MIDES), which in 2019 established the National Coordination Service for Older Persons (CNAM) to develop and coordinate programs related to older adults in Panama. The plan builds on the strategic guidelines put forward by the Panamanian government in its 2004 National Policy for the Elderly, which was initially developed in light of the 2002 Madrid International Plan of Action on Ageing. It also further highlights the UN Decade of Healthy Ageing report, as well as the WHO’s Age-friendly Cities Framework, as a part of its foundational framework. Recent research also forms the basis for some of the document’s focus areas, such as a 2021 national study which suggested that more than half of older Panamanians suffer from some form of mental illness.

Principles & Goals: The Plan focuses on three central guideline areas—(1) economic security; (2) health and well-being; and (3) conducive and healthy environments—which are then broken down into subcomponent objectives. Economic security objectives include ensuring educational and vocational training for older adults, countering discrimination, and reducing expenses related to health care, housing, and transportation. Health and well-being objectives include establishing a nationwide system for tracking the medical histories of older adults, improving the timeliness of care, addressing the needs of those with disabilities, and providing support to caregivers. To build healthy environments, the plan seeks to prioritize age-friendly infrastructure, improve digital literacy among older adults, and better combat abuse and neglect, among other efforts. While the plan does not specify the extent to which its development process was participatory, it does call for a cross-sectoral, whole-of-society approach to implementation, involving the public and private sectors, civil society, religious institutions, and older adults.

Execution & Achievements: While MIDES is primarily charged with the Plan’s implementation, many of the strategy’s objectives entail collaboration with other government entities, particularly the Ministry of Health (MINSA) and the Panamanian Social Security Fund (CSS). Individual objectives within each of the three central focus areas are assigned to responsible government entities and paired with specific results indicators that can be used to monitor progress. For example, in the case of efforts to offer continuous training to older workers, the plan seeks to track indicators such as the number of training courses offered, the number of adults enrolled in such courses, and the number of older workers who complete specific categories of courses. In the case of the country’s Comprehensive Care Centers for Older Adults (CAIPMs), the Plan seeks to monitor efforts to maintain quality standards for care within all CAIPMs nationwide. At the time of writing, efforts to disseminate the plan as well as some of its components—such as quality standards for CAIPMs and a Comprehensive Care Protocol for Older Adults with Levels of Dependence—were underway but with limited publicly available information on progress made.

Current Status & References: The Plan can be viewed in Spanish here. Updates in Spanish regarding implementation can be found on the MIDES website.

Context: Peru’s population is aging at an accelerating pace against the backdrop of declining fertility rates and increasing life expectancy. The aging population currently represents 12.7 (2020) percent of the national population, and is projected to increase to 16 percent of the population by 2030 . Older adults are adversely affected by gaps in access to education, the labor market, and pension and health systems. In 2019, 16.98 percent of the population over the age of 60 was experiencing poverty or extreme poverty. Subgroups among the population of older adults, such as older women, members of indigenous communities, and ethnic groups, are even more at risk for extreme poverty. Structural conditions can also exacerbate discrimination against older adults, including reports of uneven access to, and coverage in, Peru’s health system as well as an inadequate pension system. To address these gaps in protections for, and challenges facing, the aging population in Peru, the National Multi-Sectoral Policy for Older Adults (PNMPAM) calls for a comprehensive partnership across all levels of government and among families, communities, and civil society. 

Plan Development: A Multisectoral Working Group within the Ministry for Women and Vulnerable Population (MIMP) was formed to update the National Policy for Older Adults. With the input of older adults, the MIMP endorsed the national policy in 2021. Between 2019 and 2021, consultative meetings were held between various support Ministries, including the MIMP, Ministry of Development and Social Inclusion, Ministry of Health, Ministry of Justice and Human Rights, Ministry of Economy and Finance, Ministry of Education, and over 800 representatives of the Comprehensive Care Centers for the Elderly (CIAM) from across the country. The PNMPAM is based on an intercultural approach to honor indigenous cultural groups and designed to be context-specific for each territory to help ensure that each region of Peru is being served according to regional needs.

Principles & Goals: The Policy recognizes the valuable contribution that older adults can have and aims to create a culture that allows them to live a fruitful life without discrimination. As such, dismantling structural discrimination based on age is a top priority throughout the Policy. Moreover, promoting active and healthy aging through social clubs and events in parallel with collaborative care structures and an expansion of public services to older adults and their families are also key goals. The Multi-Sectoral Policy is made up of five objectives: 1) accessible and quality care; 2) promotion of health aging; 3) guarantee of benefits for older adults; 4) access to education at all levels; and 5) engagement and participation. Within the objectives are 22 guidelines and 27 services that seek to encourage participation and engagement in society, improve access to health services, and ensure economic security for older adults. Recognizing that about 76.1 percent of older adults in Peru have a chronic health problem, the Policy seeks to support the creation of a more accessible and inclusive health system. The Peruvian Policy seeks to guarantee that the aging population has the right to care and treatment without discrimination. 

Execution & Achievements: The Ministry of Women and Vulnerable Populations (MIMP) is responsible for the implementation of the Policy, and the PNMPAM will be evaluated annually. All regulation, supervision, and monitoring is to be carried out by the MIMP in coordination with government entities and private-sector facilities. The monitoring and evaluation are regulated in accordance with the guidelines of the National Center for Strategic Planning (CEPLAN). The Policy is financed through the Peruvian government’s Institutional Budget. Each objective within the policy includes target goals and the sector responsible for execution. One of the goals of the policy is to lower the percentage of older adults who report discrimination to 3.9 percent by 2030 through interventions and training of care service institutions, monitored by the MIMP. In order to include all subgroups, the multi-sectoral policy notes that all objectives should be executed based on the diversity of each community and region. 

Current Status & References: In June 2022, a report on the PNMPAM implementation was published. It found that two of the five priority objectives and three of the twelve services exceeded their 2021 goals. One important achievement in the PNMPAM’s services was the distribution of multidisciplinary teams within the Directorate of Older Adults (DPAM) and the approval of a new care strategy proposal. Another achievement was that 38 percent of older adults were affiliated with a pension system by 2021 when the goal was 37.8 percent. However, the report also found that 78 percent of older adults still suffered from a chronic illness when the goal had been for it to drop to 76.7 percent.

Context: The number of Californians over age 60 is expected to double by 2030, reaching 10.8 million and representing a quarter of the state’s entire population. Meeting the needs of these older adults, especially regarding housing, health, and long-term care, will be a massive challenge for California. Although California submits a state plan in compliance with the Older Americans Act of 1965 every four years, the Older Americans Act covers a limited range of subjects, including health, long-term care, and caregiver support. To meet the modern challenges of population aging, in 2019, California’s Governor signed an Executive Order calling for the creation of a “blueprint” for state and local government, the private sector, and philanthropic organizations to prepare for these dramatic demographic changes. This blueprint materialized in 2021 as the Master Plan for Aging.

Plan Development: The Master Plan’s development was informed by extensive engagement with communities and stakeholders through surveys, town hall meetings, pledges, webinars, and community roundtables that California’s Department of Aging held between September 2019 and October 2020. The Executive Order also called for the creation of a Stakeholder Advisory Committee (SAC), which brought together 78 health care providers, health plans, employers, academics, researchers, and community-based organizations to provide policy recommendations and public comment. The SAC notably created an Equity Working Group to ensure that the plan addressed life-long disparities and inequities faced by people of color and LGBTQ+ Californians. Public and stakeholder input was considered by the state government’s Cabinet Working Group, which represented all ten Cabinet departments and other Executive offices in the development of the plan. 

Principles & Goals: The California Master Plan’s development, goals, and implementation are substantive and robust. The Master Plan outlines five goals around housing, health, inclusion, caregiving, and economic security. Each of these goals is further broken down into “strategies,” which include unique aging policy considerations, such as disaster risk reduction and climate change within the plan’s housing goal. The role of these supporting strategies is to provide flexible paths for state and local governments, businesses, nongovernmental organizations, and community-based organizations to achieve goals.

Execution & Achievements: To accelerate progress toward these goals, California developed over 100 Action-Ready Initiatives. These Initiatives have already been adopted by state agencies or local governments and are ready for implementation. Each Initiative identifies the government agencies responsible for leading its execution. To begin implementation, California’s Enacted Budget for Fiscal Year 2021–2022 included 3.8 billion USD to fund new investments to advance the Master Plan for Aging, which is a significant level of funding for a subnational plan, although a relatively small investment for an economy of California’s size ($3.6 trillion USD). In January 2022, California released its first annual report on the plan’s implementation. Leaders have appointed the state’s first Senior Advisor on Aging, Disability, and Alzheimer’s and are investing billions into 132 programs and initiatives to make the state more aging-friendly. Progress toward reaching each goal is monitored on the data dashboard. Reports on the plan’s implementation are published annually—few plans feature similar robust dashboards with accessible data. 

Current Status & References: The Annual Report identified progress on many initiatives outlined in the original plan. For more information, see this website to view the Master Plan. 

Context: Uruguay has one of Latin America’s oldest populations, with almost 20 percent of its population over age 60, and maintains a high standard of care for older persons. Uruguay stands out among Latin American countries for its focus on social protection and human rights. Older persons age 64 and older have the lowest level of poverty among the total population in Uruguay, at 8.8 percent in 2021. The government has implemented a strong institutional framework to improve the lives and health of older persons that includes key institutions such as the National Integrated Care System (SNIC) and the National Institute for Older Persons (INMAYORES). Much of this institutional framework has been developed since 2005, when the Ministry of Social Development was established. Additionally, Uruguay was the first country to ratify the Inter-American Convention on the Protection of the Human Rights of Older Persons and has submitted two national plans to support its commitment, most recently the Second National Plan on Aging and Old Age: 2016–2019.

Plan Development: The National Plan’s development process began with an extensive consultation with civil society groups, especially with the National Network of Organizations for Older Persons (REDAM). This cooperation between the government and civil society actors also created effective channels for monitoring the plan’s progress. Older persons were also consulted about what they hoped to improve in Uruguay’s system of care. Numerous other organizations and government bodies, including academic institutions that specialize in gerontology, Uruguay’s Health Ministry, and the Bank of Social Security, were consulted when developing the National Plan.

Principles & Goals: The key goal of the National Plan is to facilitate older persons’ dignified and full lives and participation in society by promoting healthy lifestyles and physical and mental health. The National Plan takes a rights-based approach and furthers commitments that Uruguay made in ratifying the Inter-American Convention on Protecting the Human Rights of Older Persons. The Plan lays out six key goals, which promote: 1) equality and dignity for all; 2) physical security and autonomy; 3) economic security and development; 4) support for older adults who serve as caregivers; 5) participation and integration of older persons into society; and 6) institutional strengthening. Each of the goals is supported by several specific results and actions that are required for its implementation, along with clear assignments of responsible ministries or institutions. However, the Plan does not include specific accountability mechanisms or budgets for implementation.

Execution & Achievements: In 2018, indicators were developed to monitor implementation toward the targets laid out in the Plan. Experts developing the indicators reached out to relevant ministries and institutions involved in developing the National Plan and wrote a public progress report on implementation actions. Additionally, the progress report highlighted how approaches to supporting aging differ among Uruguay’s institutions and mentioned gaps in protection for older persons. A 2019 report from the office of the Independent Expert on the enjoyment of all human rights by older persons to the Human Rights Council, noted that while Uruguay has made many commitments to protect and care for older persons, a lack of (particularly financial) resources has hindered implementation.

Current Status & References: For more information, see this website to view the Second National Plan. As of April 2022, the government has not updated the Plan or published a Third National Plan. The public progress report on implementation is not currently available online.