It should be a no-brainer.
When the UN convened a summit on non-communicable diseases (NCDs) to take place in New York this September, ageing and older people should have been high on the agenda.
No reference to older people
After all, the greatest burden of NCDs worldwide is suffered by over-60s. However, apart from a reference to global ageing as a “key driver” of the growth of NCDs, no reference has been made to older people in the summit preparations.
There even seems to be an effort to steer the debate away from older people, with a strong focus on preventing “premature” death being made a priority.
According to the World Health Organisation, “premature” deaths occur up to the age of 59. They say: “Nine million people die from NCDs every year before they reach their sixtieth birthday. And most of these “premature deaths” occur in low- and lower middle-income countries.”[1]
Where does this leave the over-60s?
Does this mean that the burden of chronic illness and eventual death from NCDs borne by older people is to have a lower priority?
It certainly seems that way, especially given the World Health Organisation’s focus on the impact of NCDs on people at “productive ages”[2].
Focusing attention on younger, “productive” generations could be seen as necessary in order to emphasise high-priority issues for the development agenda, such as the economic impact of NCDs. But this both denies the rights of older people and ignores the fact that many poor people in developing countries continue to work productively well into old age.[3]
Chronic illness a growing burden as people grow older
The fact is that, both in “developed” and “developing” countries, chronic illness is a growing burden as people (especially the poor) grow older. For example, across both rich and poor countries, high blood pressure (often undetected and therefore untreated) is overwhelmingly found in older people, leaving them at severe risk of strokes and heart disease.
Some illnesses, such as Alzheimer’s disease and other dementias, are diseases of old age; two-thirds of all those with Alzheimer’s disease already live in “developing” countries.
Older people often suffer from more than one chronic illness, and are very likely to be the main carers for others (particularly husband or wives) suffering from NCDs.
Action on NCDs must acknowledge importance of ageing
It’s clear that action on NCDs, both at the UN summit and beyond, should acknowledge the central importance of ageing and older people in the NCD epidemic.
How should this happen? We need a whole life-course approach to NCDs, inclusive of all ages, to be adopted for any strategies on detection and diagnosis, as well as for prevention, management and treatment and more effective care.
Just as it is never too early to start prevention and promotion efforts counteracting NCDs, so it is never too late. And the tools to help this happen are already to hand. The World Health Organisation’s “age-friendly” primary health care guidelines provide a practical approach to inclusion, not only of older people, but of all age groups
Civil society needs to work together
It’s important for civil society – NGOs, and also the private sector – to work together. That’s why HelpAge is supporting the great work done by the NCD Alliance both in lobbying for the summit and influencing the outcomes.
We need to convince the governments at the UN summit that it is never too late to act against chronic illness, and this means including older people in their actions both to prevent and manage NCDs.
Read our news story, “Getting ageing and Alzheimer’s included in UN summit on NCDs”
References
[1] World Health Organisation: MDG side-event on NCDs (New York, 20 September 2010) background paper
[2] See for example WHO: Preventing Chronic Diseases, a Vital Investment (2005), p.37 (“It is often assumed that chronic disease deaths are restricted to older people, but this is not the case”).
[3] See HelpAge International: Making a living last longer: Insights into older people’s livelihood strategies