Twenty years ago, the Second World Assembly on Ageing adopted the Madrid International Plan of Action on Ageing (MIPAA). Dr Alexandre Sidorenko, a HelpAge board member and policy expert on ageing who coordinated the Second World Assembly on Ageing, where the MIPAA was drafted, looks back on what progress, if any, has been made.
He ends with personal reflections on the war declared against his home country, Ukraine, and how a society that works for all ages will be forever jeopardised when nationalism and populism prevail.
1982: the First World Assembly on Ageing takes place in Vienna
In truth, international action on ageing began forty years ago, not twenty. It was launched at the first World Assembly on Ageing convened by the United Nations and the Austrian government in July 1982.
The Vienna International Plan of Action on Ageing, the main outcome of the first Assembly, laid the foundation for policy action on ageing for the next twenty years.
It produced mixed results: undeniable progress in meeting the needs and expectations of older people in economically advanced countries which was countered by policy lethargy in less developed countries.
Why the discrepancy? The developing world simply had a far younger demographic and far more immediate challenges to contend with, whether political, health, social or economic. And yet there was growing evidence that it was in developing countries that demographic change and population ageing would occur on unprecedented scale and at exceptional speed.
2002: the Second World Assembly takes place in Madrid
Twenty years later, one of the central tasks of the Second World Assembly in Madrid was to fill the global gaps in action on ageing by addressing the opportunities and challenges of population and individual ageing in countries at various stages of the demographic transition.
Another fundamental task was to propose measures for harmonising demographic ageing and social development. At the same time, the health, independence, security and safety of older citizens also remained key policy priorities.
During the preparations for the Second World Assembly on Ageing – which would go on to agree the MIPAA – the UN secretariat attempted to identify why so little progress had been made following the Vienna Plan of Action. The following obstacles were highlighted:
- lack of resources, both human and financial
- low political priority of issues of ageing
- weak national infrastructure on ageing.
In every review and appraisal of MIPAA since 2002 the same obstacles to action have been identified.
Clearly something is going wrong in the world of international ageing: what’s holding us back?
Progress in the implementation of the MIPAA is assessed every five years; the fourth review and appraisal is currently underway and its findings will be analysed by various regional UN bodies this year and next year at the global level.
The findings of the three previous MIPAA reviews and appraisals are underwhelming, characterised by some progress in some areas and little, if any, in many other areas outlined in the plan.
For those of us who have followed the history of international actions on ageing since the first World Assembly in 1982, this summary looks painfully familiar.
The 2013 UN report on ageing noted that the implementation of the MIPAA in many countries has not promoted ageing as a developmental priority. The discrepancy between legislated policy and its implementation on the ground remains a persistent hurdle, essentially reflecting limited political commitment on ageing, or, again, a lack of political will.
There are also fundamental obstacles at the international level.
Woeful global coordination, chronic underfunding and shifting responsibilities
One such obstacle is the insufficient coordination of the global implementation process, which in turn reflects the low priority given to ageing within the UN system. The global focal point on ageing within the UN secretariat remains ludicrously small, with only three professionals supporting the global (sic!) follow-up process of implementation.
Shortage of professional staff at the UN global focal point has been offset to some extent by shifting the focus of the follow-up of the Second World Assembly on Ageing and implementation of the MIPAA to the regional level, under the oversight of the UN regional commissions.
Proposals to establish within or outside the UN an international organisation for coordinating and supporting evidence informed actions on ageing has never won the support of UN member states or independent sponsors.
The key weaknesses of MIPAA
A choice to act rather than a legal requirement
MIPAA itself has implementation shortcomings: it is not a legally binding document, so governments are not responsible for reporting their national progress towards the implementation of the Plan. Several decades of tireless efforts by non-governmental organisations such as HelpAge International and a few committed governments have not so far resulted in a global consensus on developing a legally binding instrument on ageing such as an international convention or covenant.
Countries are given too little technical support and lack of data drives apathy
Weaknesses of coordination also show up in the very limited technical support to improving national capacity on ageing in less developed countries: these days such support is provided exclusively by the United Nations Fund for Population Activities, UNFPA – one of the UN family organisations.
Another limitation of the UN Secretariat on Ageing is its very limited analytical capacity to ensure evidence informed implementation of the MIPAA. To establish a solid evidence base for international action on ageing, a permanent database of public policies on ageing on the Internet was proposed about twenty years ago. Such a database, linked to the UN programme on ageing, could ensure a continuous international exchange of expertise and experience in designing and implementing policy on ageing. This proposal, which is still valid today, received specific support from the Dutch government, but was abandoned during the preparations for the Second World Assembly on Ageing.
No dedicated fund for ageing
Following the first World Assembly on Ageing, substantive support to technical cooperation activities was provided by the UN Trust Fund for Ageing. The resources of the UN Fund, albeit limited, helped to promote the implementation of the Vienna Plan of Action in developing countries and countries in transition.
Shortly before the Second World Assembly on Ageing the resources of the Fund were depleted and never resurrected owing to rather sluggish fundraising efforts. More recently, COVID-19 has demonstrated that fundraising for ageing is practically inconceivable in a world with declining empathy and flourishing state egotism, framed by populist and highly virulent nationalist ideologies and politics.
Does the future look brighter for action on ageing?
The current pandemic and the future post-pandemic reality require fundamental changes in policy approaches, including policy on ageing. The most difficult choice is between a cosmetic adjustment and a radical revision. But it is necessary to make such a choice, and the anniversary year provides such an opportunity.
A radical review and rethink is needed to harness the potential of mature societies
The content of the MIPAA and its regional implementation strategies require scrupulous review of their objectives and proposed measures: what needs to be added and what should be removed.
Reactive efforts to meet the needs of older people must be complemented by proactive efforts to adapt society to the demographic transition and build a society for all ages, as envisaged by the MIPAA.
Persistent measures to promote the life course and multi-generational cohesion should establish the preventive dimension of policy on ageing. A robust preventive dimension is needed for reducing the negative impact of population ageing and harnessing the potential of mature societies.
The world must be provided with a clear vision and practical tools for adjusting to the demographic transition. In essence, the policy of ageing has to be replaced by the policy of longevity.
And here’s how
The UN global focal point on ageing needs to be transformed into a real coordinating centre with sufficient financial and human resources for providing technical support and policy know-how. Ideally, an international entity on ageing could be established, preferably outside of the UN.
A sound perspective should be given to an international legally binding instrument on ageing, a long-awaited convention.
The COVID-19 pandemic has exposed numerous gaps in international cooperation in various areas of health, social and economic policy, including policy on ageing.
Crisis creates opportunity
A vision that, since John F. Kennedy’s famous statement, has inspired efforts to solve problems and turn them into stimuli for development.
The twentieth anniversary of the MIPAA offers a pretext for thoughtful analysis and revision of actions on ageing.
Will we accept the challenge?
I began writing these notes in early February of this year, when there were signs that the pandemic was on the wane. The light at the end of the tunnel grew brighter and hopes of overcoming the two-year ordeal were strengthened. Plans of adaptating to the new reality began to be designed and implemented. At dawn on February 24, the world plunged into darkness. My country, Ukraine, was attacked by the overwhelming military forces of Russia. I am neither a political expert, nor a military expert, I am unable to predict how and when this war will end. But its course once again demonstrates that populism, disinformation and national egoism are fatal for a civilization if it is unable or afraid to defend itself. So, my country is fighting alone and older Ukrainians are among the main civilian casualties.
Read the Q&A with Alexandre Sidorenko: “Explaining the lack of funds for ageing back in the 90s, the Under-Secretary General whispered “Between you and me, ageing is just not sexy.”