Older Persons & the Right to Health Astrid Stuckelberger, PhD Institute of Global Health University of Geneva

The Paradox  Population Ageing in Europe and the World (N+%)  GBD and chronic disease = Ageing Population  4-5 Generations of 2-3 Generations of Older Persons vs No Human Rights of Older Persons at UN No Right to Health of Older Persons at UN only very few fixed r-marked positions on ageing No ethical framework The Right to disease, degeneration, dependency… The «Neglect Syndrome» (Prof. Moulias et al., IAGG-ER, 2012)

Complexity of Concept Right to Health & Older persons What is an Older Person? What is Health at Old Age? What is the Right to Health in Old Age? Administrative Biological Socio-Generation Politically Economically Culturally Active physically Active mentally Preventive measures Healthy lifestyles (25% genes) Good personalized nutrition Toxic free environnment Contribution to Society Right to Health in Old Age = Availability, Accessibility, Acceptability, Affordable, Adaptable, and Quality

Right to Health of Older Persons What is specific? A long range of specific evidence-based right to health conditions and situations :   Right to health (UCH) and social security   Right to long life health at work   Right to adequate housing   Right to long life reproductive health   Right to access to health care (preventive, curative, LTC and palliative)   Right to adequate management of mental health and chronic diseases (reversibility)   Right to rehabilitation care (technology)   Right to safe medicine and treatments (ADR)   Right to evidence-based specific screening, food and treatment   Right to professional health care (geriatric medicine)   Right to health literacy and ICT literacy (adequate and correct information)   Right to adequate and non discriminative health and treatments   Etc… ”The right to health is an inclusive right, extending not only to timely and appropriate health care, but also to the underlying determinants of health, such as access to safe and potable water and adequate sanitation, healthy occupational and environmental conditions, and access to health-related education and information, including on sexual and reproductive health.” (OHCHR)

Right to Health of Older Persons Beside OHCHR and WHO What UN agencies are concerned? Linked to ageing conditions   ILO =Right to long life health at work   UNFPA, UN Women = Right to long life reproductive health   UN Habitat, UNDP, UNEP = Right to access to health care, sanitation, developement   FAO, WFP = Right to evidence-based specific screening, food and treatment   Right to ITU, UNESCO  Right to health literacy and ICT literacy Linked to specific situation of older persons   Older refugees = UNHCR   Older migrants = IOM   Older worker = ILO   Older poor = World Bank   etc

The Solution: paradigm shift Multidisciplinary expert teams From engineering health to treating it From health promotion and prevention to palliative care From young age to end of life The «Prejudice Syndrome» going from the Right to disease to the right to health Importance to have scientific evidence and new modelisation of ageing Reversibilty vs degeneration and unavoidable decline Deficit screening cured with personalized nutrition and food supplements before disease NEW MODELS AND SCIENCE OF AGEING

Example: Recommandations made at CSW 2012 Example: Recommandations made at CSW 2012 Rethinking Right to Health of Older Women with no discrimination Theoretical - methodology   New model of ageing – against ageist medicine and health care, with innovation and echnology for prevention   Older person’s Right to Health modeling based on scientific and medical evidence   Data disaggregation by higher ages and sexPractical   Individual empowerment to realize their Right to Health and combat a LL deficit   Family & commmunity empowerment – e.g. training for age specific health care, ToT Political - Structural   Putting old age and older women on the agenda (e.g. special rapporteur, item, wording)   Institutional & Policy Section for older women   Evidence-based policy and expert networks, ethical framework in research and end-of-life Q

 Evidence vs generalization and prejudice  Complexity of ageing and cofounding factors  Non biais evidence and interpretation of data  Constant reality-check in the face of S&T progress  Bridge between NGOs and Policy-makers Role of the Science of Healthy Ageing Fundamental to the Right to Health of OP

OHCHR  more visibility and access to information on older persons’right All bilateral UN documents and agenda (including HRC agenda) 3 examples of important upcoming events in 2015 : MDGs review and post-2015 UN Conference on Sustainable Dvt (SDGs), Paris  Health UN Women Conference  Reinforcing the Beijing Plateform of Action Older women mentioned once, no life course perspective. ICPD 2014: reproductive health and rights at all ages = the most sensitive aspect which clashes with conservative views of women’s role CEDAW: f or the first time recommendation on older women Filling the gap of the UN Agenda on Older Persons Rights and Right to Health