The purpose of this symposium is to highlight some major challenges and solutions in the achievement of health and wellbeing for older people in low and middle-income countries. These will be explored in the context of both key global frameworks which offer pathways to advance older people’s right to health and care free of ageism and of age discrimination; and of empirical experience from low income settings.From the 2030 Agenda for Sustainable Development, Goal 3 of the 17 Sustainable Development Goals aims “to ensure healthy lives and promote wellbeing for all at all ages”. However, an examination of the targets and indicators defining the scope of the goal reveals significant examples of ageism and of age discrimination. The implications of these issues will be analysed as will the role of the proposed Titchfield City Group on ageing and age-disaggregated data in addressing data issues and gaps in international and national statistical systems.The scale and range of the health and care issues arising for older people in a resource poor setting will be represented through the experience of GRAVIS, an NGO working with older people in the Thar region of India. The model of age friendly health and care Gravis has developed will be shared, as will lessons learned for broader health and care policy and practice.The Open-ended Working Group on Ageing (OEWG) has a mandate to consider the possibility of new human rights instruments and is now engaging in substantive debate on older people’s rights to autonomy and independence, palliative care and long-term care. In order to ensure older people’s views on these rights informed the deliberations of the OEWG, HelpAge conducted a consultation with 450 older people in 24 countries. The key findings of the consultation will be shared. There will also be a reflection on the implications of those findings for the normative content of a UN Convention on the rights of older people. Older people are not silent in the face of ageism and discrimination. There will be a presentation from Saidia Wazee Kasulu, an older people’s organisation which has been advocating for the effective implementation of universal health care in Tanzania. Saidia Wazee Kasulu will also offer bottom-up advice from an LMIC perspective to the Global Campaign on Ageism which the World Health Organisation is developing with global partners.

Presenter 1:

Justin Derbyshire – Though Goal 3 of the 17 Sustainable Development Goals incorporated in Agenda 2030 aims “to ensure healthy lives and promote wellbeing for all at all ages”, it could fail older people. An examination of the targets and indicators defining the scope of the goal reveals significant examples of ageism such as the exclusion of older people from the targets for non-communicable diseases and the models of universal health coverage; and of age discrimination such as age caps on major surveys collecting data on population health status. The implications of these issues will be considered as will the role of the proposed Titchfield City Group on ageing and age-disaggregated data in addressing data issues and gaps in international and national statistical systems. The work of the Titchfield City Group will support evidence-based policymaking in relation to ageing; better awareness among policymakers and development practitioners of the importance of the ageing agenda and the pledge to leave no one behind; and greater availability of data tools and guidelines to facilitate understanding and action on ageing.

Presenter 2:

Prakash Tyagi – India is home to second largest population of older people. 70% of its population is rural, which is underserved, impoverished and large number of older people live in villages. Impacted by chronic droughts and severe food, water shortages, Thar is one of least developed regions where older people live with poverty and poor health. GRAVIS, an affiliate of HelpAge International, has been focusing strongly on older people’s health. To identify the challenges, in 2000, a survey covering over 5,000 older people was organized, aiming on gathering information on older people’s health needs. GRAVIS runs a fully-equipped hospital in a remote village with special facilities for older people. The community-based health work of GRAVIS is organized through active participation of Village Older People Associations (VOPAs). Over 300 VOPAs work with GRAVIS reaching out to over 150,000 older people. A network of Village Health Workers (VHWs) has been developed. Currently, 563VHWs are active. They get specialized trainings on geriatric health through a training curriculum. Through its field work and research, GRAVIS has drawn several policy level inputs to contribute to the National Programme for the Health Care for the Elderly (NPHCE).

Presenter 3:

Clotilda Kokupima – Older people in Tanzania experience a number of barriers in accessing health and care services. Health services for older people are inadequate, with medication often not available or health facilities being too far away. The cost of transport is also a challenge for older people who are poor and excluded and need medical attention.

But these are not the only barriers. Ageism is widespread and is generally accepted and unchallenged. Ageism is seen in health contexts when older people are not given the medication they need because their symptoms are considered a natural part of getting older. Or, they are ignored because older people are believed to complain more in older age and are told their symptoms are ‘just old age’. Ms. Clotilda Kokupima is an older woman and advocate, working to empower older men and women in Tanzania. She is a founding member of the Sawata Wazee Kasulu, a local organisation that works to support and care for older people in a district in western Tanzania. She will share her own experiences of ageism and others’ from her community. She will highlight the importance of the WHO Global Campaign on Ageism and why older people must be drivers of the campaign.

Presenter 4:

Jemma Stovell – Older women and men have the same rights as everyone else. Equality does not change in old age. Despite this, older women and men around the world are subject to ageism and age discrimination and are denied their rights on a regular basis. Older people have remained largely invisible within the international human rights system. The 9th OEWG will focus on two areas of rights; autonomy and independence and palliative care and long-term care. HelpAge and its network consulted with older people about what these rights mean to them. The consultation raised questions about the impact ageism has on older people’s ability to make choices and decisions according to their preferences. Independence was also related to good health, and many older people said they started to lose independence when their health deteriorated. These findings add to a growing body of evidence that ageism is a harmful social norm that drives discrimination and prejudice. This session will consider the challenges ageism poses and the role of a new UN convention on the rights of older people.

Bio

Justin Derbyshire

Though Goal 3 of the 17 Sustainable Development Goals incorporated in Agenda 2030 aims “to ensure healthy lives and promote wellbeing for all at all ages”, it could fail older people. An examination of the targets and indicators defining the scope of the goal reveals significant examples of ageism such as the exclusion of older people from the targets for non-communicable diseases and the models of universal health coverage; and of age discrimination such as age caps on major surveys collecting data on population health status. The implications of these issues will be considered as will the role of the proposed Titchfield City Group on ageing and age-disaggregated data in addressing data issues and gaps in international and national statistical systems. The work of the Titchfield City Group will support evidence-based policymaking in relation to ageing; better awareness among policymakers and development practitioners of the importance of the ageing agenda and the pledge to leave no one behind; and greater availability of data tools and guidelines to facilitate understanding and action on ageing.

Dr. Prakash Tyagi

India is home to second largest population of older people. 70% of its population is rural, which is underserved, impoverished and large number of older people live in villages. Impacted by chronic droughts and severe food, water shortages, Thar is one of least developed regions where older people live with poverty and poor health.

GRAVIS, an affiliate of HelpAge International, has been focusing strongly on older people’s health. To identify the challenges, in 2000, a survey covering over 5,000 older people was organized, aiming on gathering information on older people’s health needs. GRAVIS runs a fully-equipped hospital in a remote village with special facilities for older people. The community-based health work of GRAVIS is organized through active participation of Village Older People Associations (VOPAs). Over 300 VOPAs work with GRAVIS reaching out to over 150,000 older people. A network of Village Health Workers (VHWs) has been developed. Currently, 563VHWs are active. They get specialized trainings on geriatric health through a training curriculum. Through its field work and research, GRAVIS has drawn several policy level inputs to contribute to the National Programme for the Health Care for the Elderly (NPHCE).

Clotilda Kokupima

Older people in Tanzania experience a number of barriers in accessing health and care services. Health services for older people are inadequate, with medication often not available or health facilities being too far away. The cost of transport is also a challenge for older people who are poor and excluded and need medical attention.

But these are not the only barriers. Ageism is widespread and is generally accepted and unchallenged. Ageism is seen in health contexts when older people are not given the medication they need because their symptoms are considered a natural part of getting older. Or, they are ignored because older people are believed to complain more in older age and are told their symptoms are ‘just old age’.

Ms. Clotilda Kokupima is an older woman and advocate, working to empower older men and women in Tanzania. She is a founding member of the Sawata Wazee Kasulu, a local organisation that works to support and care for older people in a district in western Tanzania. She will share her own experiences of ageism and others’ from her community. She will highlight the importance of the WHO Global Campaign on Ageism and why older people must be drivers of the campaign.

Jemma Stovell

Older women and men have the same rights as everyone else. Equality does not change in old age. Despite this, older women and men around the world are subject to ageism and age discrimination and are denied their rights on a regular basis. Older people have remained largely invisible within the international human rights system.

The 9th OEWG will focus on two areas of rights; autonomy and independence and palliative care and long-term care. HelpAge and its network consulted with older people about what these rights mean to them. The consultation raised questions about the impact ageism has on older people’s ability to make choices and decisions according to their preferences. Independence was also related to good health, and many older people said they started to lose independence when their health deteriorated.

These findings add to a growing body of evidence that ageism is a harmful social norm that drives discrimination and prejudice. This session will consider the challenges ageism poses and the role of a new UN convention on the rights of older people.