As part of the run-up to the Asia-Pacific Regional Conference on Population Ageing, experts from across the region are sharing their perspectives on one question: What is the one change that would most improve the lives of older people over the next decade?
In this article, Sri Moertiningsih Adioetomo, Professor Emeritus in Population Economics at Universitas Indonesia, argues that the answer lies in building robust long-term care systems. Drawing on decades of research and policy experience, she explores why care must become a public priority if countries across Asia and the Pacific are to respond effectively to rapid population ageing.
Across Asia and the Pacific, populations are ageing faster than ever before. This is a remarkable achievement. People are living longer because of advances in health, nutrition and living standards. Yet longer lives alone are not enough. The real test is whether people can age with dignity, independence and support when they need it.
If I could prioritise one change to improve the lives of older people in Asia and the Pacific over the next decade, it would be the creation of robust long-term care systems.
As populations age, governments can no longer treat care as a family issue alone. It must become a public priority and an essential part of how societies prepare for the future.
Ageing is changing our societies
The centre of global population ageing is increasingly in developing countries. Today, China is home to more than 213 million people aged 65 and over, India to more than 112 million, and Indonesia to 22.5 million. Together with countries such as Bangladesh, Thailand, Pakistan and Vietnam, they account for more than two-thirds of the world’s older population.
Across Asia and the Pacific, countries are experiencing demographic change at a speed never seen before. While some high-income countries had more than a century to adapt to ageing populations, many countries in our region are making that transition within just a few decades. Even more challenging, many countries are ageing before becoming wealthy, with social protection and care systems still struggling to keep pace with growing demand.
This rapid change brings new opportunities, but it also raises urgent questions. How do we ensure that people can remain active, healthy and engaged as they grow older? How do we support those who need assistance with daily life? And how do we do this in societies where family structures, workforce patterns and communities are changing?
The answers to these questions will shape the wellbeing of millions of older people for generations to come.
The growing care challenge
As people live longer, more of us will need support at some stage in later life. This might involve help with mobility, personal care, household tasks or managing long-term health conditions.
Today, most of this support is provided by families. Across the world, unpaid care remains the backbone of care systems, with women carrying most of the responsibility. Family care is invaluable and will always remain important. However, we can no longer assume that families alone can meet the growing demand for care.
Families are becoming smaller. Younger generations are moving for work and education. Women, who have traditionally provided most care, are increasingly participating in the labour force. These are positive changes, but they also mean that the traditional model of family caregiving is under growing pressure.
Without action, many older people risk facing later life without the support they need, while family caregivers face increasing financial, emotional and physical strain.
Why care should be a public priority
Too often, long-term care is seen as a private concern rather than a public responsibility. Yet care affects every part of society.
Good care allows older people to maintain their dignity, independence and quality of life. It supports families, strengthens communities and helps people stay economically active. Investing in care is not just a social policy. It is an investment in healthier and more resilient societies.
Governments regularly invest in roads, schools and hospitals because they are essential public infrastructure. Care systems should be viewed in the same way. They are fundamental to helping societies adapt to demographic change.
Countries that begin planning now will be better prepared for the future. Those that delay may find themselves struggling to meet growing needs as populations continue to age.
What a strong care system looks like
Building a strong care system does not mean replacing families. It means creating support around them.
This includes training and supporting caregivers, expanding community-based services, integrating care into health systems, and ensuring that older people can access assistance when they need it.
It also means recognising caregiving as valuable work. Caregivers, whether paid or unpaid, provide an essential service that benefits individuals, families and society as a whole. Their contribution deserves greater recognition, support and investment.
Most importantly, care systems should be designed with older people at their centre. The goal is not simply to provide services, but to enable people to live fulfilling lives for as long as possible.
From demographic change to social progress
Population ageing is not a crisis. It is one of humanity’s greatest success stories. But success brings responsibility.
Over the next decade, countries across Asia and the Pacific will make important decisions about how they respond to ageing populations.
Among all the priorities competing for attention, the creation of strong, accessible and sustainable long-term care systems stands out as the most urgent and transformative.
If we get this right, millions of people will enjoy longer lives with greater dignity, security and wellbeing. That is the future we should be working towards, and the conversation we need to have more often.
About the author:
Sri Moertiningsih Adioetomo is Professor Emeritus in Population Economics at the Faculty of Economics and Business, Universitas Indonesia. With more than four decades of experience in demography, ageing and social policy, she has played a leading role in shaping understanding of population change and its social and economic impacts in Indonesia and across the region.
Throughout her career, she has advised government ministries, international organisations and development partners on population ageing, social protection and long-term care. Her collaboration with HelpAge International includes research on social protection for older people and country diagnostic studies on long-term care. She currently serves as an Affiliated Expert with the ASEAN Centre for Active Ageing and Innovation (ACAI) and contributes to national discussions on active ageing and inclusive development. Her work continues to focus on ensuring that demographic change translates into greater wellbeing, security and dignity for people throughout later life.
Asia-Pacific Regional Conference on Population Ageing
The Asia-Pacific Regional Conference on Population Ageing brings together governments, civil society, researchers, international organisations, private sector leaders and older people to explore how societies can respond to this transformation.
Hosted by HelpAge International, UNFPA and the China National Committee on Ageing, the conference will take place in Hangzhou, China, from 27–30 October 2026, providing a unique opportunity to exchange ideas, share innovation and learn from experiences across Asia and the Pacific.
