1. 1 Francois Farah Chief, Social Development Division Committee on Social Development New York, February 2008 Population Ageing in the ESCWA Region

2. 2 1. Current Situation and Major findings

3. 3 195020002050 Total Fertility Rate7.04.22.2 Crude death rate per 100024.37.1 Life Expectancy at Birth42.766.576.9 Percentage of the elderly (>65 years) -3.5%6.5% Number of Population (1000)-300 165631 218 Number of elderly (millions)-1040 Demographic changes in the Arab World

4. 4 Percentage of population aged 65 and above in Arab Countries, 2005 >6% 3-5% <3% Source: Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2006 Revision and World Urbanization Prospects: The 2005 Revision, http://esa.un.org/unpp,http://esa.un.org/unpp

5. 5   For the period 2000-2050, the rate of growth of the population aged 65+ has been projected at 4 -5 per cent, with an average annual growth rate of the oldest old (aged 80+) estimated to exceed 5 per cent in 11 Arab countries, including Kuwait and Qatar both at rates of more than 7 per cent.

6. 6 Percentage of population aged 65 & above in Arab Countries 2005 & 2050 >15% 7-15% <7% Source: Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2006 Revision and World Urbanization Prospects: The 2005 Revision, http://esa.un.org/unpp,http://esa.un.org/unpp

7. 7 198020002020 Percentage of population aged between 64-25 32.937.945.0 Elderly dependency ratio 6.46.27.8 Total dependency ratio 90.971.558.4 Demographic changes in the Arab World

8. 8 The MIPAA Review: Typical Characteristic l l The family has been the main source of support for older Arabs. l l The number of institutionalised older adults remains low in most countries. However l l Social changes brought about by modernization, decades of migration in the majority of countries, with the exacerbation of political violence in others, the family role may no longer be taken for granted in the near future.

9. 9 2. Major Achievements

10. 10 Government Measures in the implementation of MIPAA   Setting-up of National Committees   In most cases, these national committees comprise representatives from the private and public sectors, and are usually headed by the minister of social affairs of member countries.

11. 11   Formulation of: national policy, national plans of action, legislation » »Five countries have completed formulation of national policy: Bahrain, Egypt, Jordan, Qatar and Syria. Lebanon is in the process of elaborating an integrated social plan of action. » »In many countries, existing general policies & programmes often cover uncoordinated plans, activities & projects that target old age. In general, providing care for older persons continues to adopt a welfare-based and service-oriented approach rather than a developmental, human rights and/or participatory approach. Government measures in the implementation of MIPAA

12. 12   (1) Programmes and Services » »In many countries, health services have witnessed an increase in the number of specialized centers, day care centers, & mobile clinics, particularly in GCC countries » »Some countries, such as Egypt, Jordan, Lebanon, have included geriatrics in medical faculties, & studies on ageing issues at schools & universities. Government measures in the implementation of MIPAA

13. 13   Programmes & Services (2) » »Some countries have introduced the ‘family welfare programme’, & specialized ‘broadcast channels’ to bridge inter- generational gaps. » »Utilizing the capabilities of older persons in, for example, tutoring students or teaching in eradication of elitracy classes, example: Egypt. » »Implementing initiatives towards productive ageing, including granting of prizes to older persons who sustain being productive, such as in Egypt 7 Qatar. » »Training of concerned personnel, & provision of brochures & manuals for workers in the field of health care. Government measures in the implementation of MIPAA

14. 14   Programmes & Services (3) » »Training ageing persons themselves on handicrafts and productive skills as a mean to raise money & address & cope with problems that are old age-related. » »Commemorating the annual International Day and/or the National Day of Older Persons has become a major national venue for raising awareness regarding ageing issues/ establishing broadcast channels for the elderly/ enhancing publishing of articles & TV programmes. » »Some countries have initiated sports programmes /activities within the elderly clubs. » »In several GCC countries, widowed & divorced elderly are provided with financial help by the government. Government measures in the Implementation of MIPAA

15. 15   National reports and needs assessment studies » »Most countries have started to prepare national reports on the situation of their elderly population. » »Many countries have established relevant database & conducted needs assessment studies. » » Saudi Arabia National Plan of Action includes establishing a registry/database on older persons. Government measures in the implementation of MIPAA

16. 16 3. Challenges

17. 17 The current generation of older persons in most Arab countries exhibits certain social and economic vulnerabilities that have important implications for their health care.   Social Challenges   Economic Challenges   Health Challenges Challenges facing the older population in Arab countries

18. 18 Education indicators » »Low education levels of older people » »Wide disparity among Arab countries regarding level of education, reflecting illiteracy rates at 95% in Yemen, 40% in Jordan Gender Disparity » »Wide disparity between the educational levels of men and women. Social Challenges

19. 19 As a result of modernization and changing life style, family members no longer provide care for their frail elderly, particularly those with special needs. High percentage of widowhood leads to increase in the number of female-headed families. Elderly women living alone amount to 20%. This generates loss of social status and causes vulnerability and many psychological & health problems. Social Challenges

20. 20 Due to the absence or small old-age pensions the majority of older men continue to work after the legal age of retirement (a substantial per cent of men in Yemen continue to work beyond age 80 years – 21%, in Lebanon & Jordan 11-14%) The vast majority of Arab women do not work in the formal sector, their contribution is limited to the informal sector. Consequently older women are dependent upon the benefits of the breadwinner, when available. Economic Challenges

21. 21 » »High levels of chronic diseases, comparable in some countries, such as Kuwait, Jordan & Lebanon to those found in developed countries. In other countries, mainly Arab African countries, communicable & infectious diseases prevail. » »High prevalence of difficulties in activities of daily living being reported in Egypt, Jordan, Lebanon, Tunisia (varying between 25% & 38%). » »Lack of qualified cadre and geriatric specialists » »Inaccessibility or unavailability of specialized home services, and total lack of social or economic support to the family. Health Challenges

22. 22 »Ageing should be considered as a serious challenge. Countries, policy makers, civil society and individuals in the region ought to focus on integrated social policy and address ageing-related issues within the approach of: “A Society for all ages”. »Sharing the responsibility is essential. A multi-sectoral approach, securing the active participation of all partners (individuals/family/civil society/NGOs) should be based on the concept of: “Life-cycle approach” Towards successful ageing

23. 23 4. Future priorities for action in the region

24. 24 Enabling and Supportive Environment Goal A supportive environment promotes social integration and autonomous ageing and contributes to development. Underpinning issues in the Arab countries » »Lack of a clear plan on how to accommodate the specific characteristics and needs of older persons for them to be able to live independently and move around autonomously. » »Compared to older persons in urban areas, those living in rural remote areas in Arab countries are likely to be at a greater disadvantage. » »Shrinking/diminishing financial ability of families to sustain their economic support to their elderly.

25. 25 Active Participation of population ageing in Development Goal Active participation of older people in all aspects of the development process is essential to the policy making process and to successful ageing. It also limits marginalization, promotes empowerment and increases ownership and inclusion in the shaping of practice. “Nothing about us without us” – Help The Aged, UK

26. 26 Active Participation of population ageing in Development Underpinning issues in the Arab countries » »Public participation and legislative representation of older persons appear to be related more to the position of the older persons – often associated with economic and political power, than to institutionalized policy structures and processes. » »Relatives tend to adopt a paternalistic approach and replace older persons in assuming responsibility for several familial decisions, including health-related matters concerning the older persons themselves. » »Prevailing negative stereotypes about ageing and older persons as frail dependent members, coupled with the lack of associations that represent their interests/needs.

27. 27 Two essential points l l Sharing responsibility between: The individual (life style) l l A society for All Ages Integrating ageing-related issues in development plans for all ages (upgrading education, nutrition, healthy life style, job/economic opportunities in younger years would lead to better quality of life during ageing.

28. 28 5. Cooperation by the UN system to assist Member States in implementing the Plan of Action

29. 29 The Way Forward The UN to join efforts to ensure that all sectors and partners undertake their responsibilities in coordination. l l The UN system is called upon to promote an integrated social policy, premised on equity, equal opportunity and intergenerational solidarity and human-rights. l l Policies should aim at: l l Providing adequate social security and health care in old age, l l Enabling older people to remain active and to live independently in their own communities

30. 30 The Way Forward l l The UN should uphold and facilitate the setting of a social support system, formal and informal l l Enhancing the abilities of the family to take care of older persons within the family environment. l l Promoting active participation and mainstreaming aging policies in development l l Generating research and data for the benefit of evidence-based policies/programme.

31. 31 Resources Needs Resources Demographic dynamics & epidemiological change Social & economic characteristics Life-cycle approach Formal sector NGOs Family support system Needs

32. 32 Thank you