Ageing, disability and development

Disability Mainstreaming Forum

DFID 3rd March 2009

Sylvia Beales

HelpAge International

sbeales@helpage.org

Context and Definitions • Life expectancy is extending worldwide, fertility rates

are falling, and demographic ageing is accelerating – fastest in the developing world

• Disabilities is an umbrella term, covering impairments, activity limitations, and participation restrictions. An impairment is a problem in body function or structure; an activity limitation is a difficulty encountered by an individual in executing a task or action; while a participation restriction is a problem experienced by an individual in involvement in life situations.

• Thus disability is a complex phenomenon, reflecting an interaction between features of a person’s body and features of the society in which he or she lives.

(World Health Organisation 2009)

Reality check ; who – and where - are the poor?

Ultra poor: 162 million

12%

7%

76%

5%

East Asia & Pacific

South Asia

Sub-Saharan AfricaLatin America & Caribbean

0 10 20 30 40 50 60

AVERAGE

Zambia

Uganda

Nigeria

Mozambique

Malaw i

Madagascar

Kenya

Guinea

Ghana

Gambia

Ethiopia

Cote d'voire

Cameroon

Burundi

Burkina Faso

depth of poverty (poverty gap %)

Elderly and children

Elderly persons

No elderly persons

Life expectancy trends

Poverty in older ageHelpAge International

Ageing and disability • Hearing loss, vision problems and mental disorders are the

most common causes of disability and loss of livelihood – 82 % of blind persons are over 50

• Depression and Alzheimer's are among the 20 leading causes of disability worldwide. Alzheimer's affects 1 in 20 over the age of 65 and in in 5 over the age of 80

• Fewer than 25% of those affected have access to adequate treatment and health care

• Chronic limiting disorders are treatable at low cost (e.g. hearing loss; cataracts; stress; WHO wants extra mental health spend of US$ 2 per person per year in low-income countries

• High overall rates underline the need for focus on these conditions and wider access to interventions that help people live productively

Non communicable diseases (WHO 2008)

Death by Non Communicable Disease WHO projections

2005 2006-2015 (cumulative)

Geographical regions (WHO classification)

Total deaths

(millions)

NCD deaths (millions)

NCD deaths

(millions)

Trend: Death from infectious disease

Trend: Death from NCD

Africa10.8 2.5 28 +6% +27%

Americas6.2 4.8 53 -8% +17%

Eastern Mediterranean

4.3 2.2 25 -10% +25%

Europe9.8 8.5 88 +7% +4%

South-East Asia14.7 8.0 89 -16% +21%

Western Pacific12.4 9.7 105 +1 +20%

Total 58.2 35.7 388 -3% +17%

Age helps

• Older people make critical contributions to the welfare of their families and thus to the development of their communities and societies

• Older people are caregivers, breadwinners

• Older people are carers even when disabled and struggling to access health and other basic services

• In the context of the HIV/AIDS, older women frequently act as the sole carers of their children dying of the disease and their grandchildren left orphaned…

• Older people have the same rights as other age groups

Approaches to work to support older people • Grassroots work that directly supports older people and their

families

• Supporting and strengthening organisations that are working in practical ways to improve the lives of older people and their dependents

• Demonstrating contributions and building connections and coalitions across generations and across sectors

• Supporting older people to be influencers on ageing, to gain access to services, to social protection and development benefits

• Strengthening the capacity and reach of organisations working with older people

• Connecting grassroots experience with government thinking and policymaking

Way forward for partnerships• Recognise and act on impact of chronic limiting illness for older people

and their dependents

• Ensure age desegregation in MDG, poverty, hunger and disability data

• Acknowledge intergenerational interdependence

• Ensure age friendly health access and delivery – focus on accessibility, non communicable diseases and cost effective responses

• Social Protection; universal basic income and equitable access to health – ‘minimum package’

• Rights promotion – equal treatment equal rights

• Awareness of and prevention of discrimination and abuse

• HIV/Aids programmes that support older carers and access to treatment for all

• Empowerment; voice, dignity and participation in old age

• Inclusion of older people in humanitarian programmes

• Age and disability awareness training, linked to service assessment, access monitoring and recorded age and disability outputs