Responding to older people needs not be philanthropic
By Ms. Carole Agengo, Dr. Ademola Olajide and Dr. Mohamed A. Sheikh
African states have shown varying abilities in preparing and developing COVID-19 response measures introduced to contain the spread of the corona virus, to protect individuals’ health, avoid health systems being overwhelmed as well as measures to mitigate the social and economic impacts that are arising as a result of COVID19 response plans. The continent is challenged by fragile health care systems, limited social protection structures and inadequate laws and policies for people with special needs. These gaps exist within contexts marked by frequent conflict and disasters including floods, locusts, and pandemics.
Africa is often referred to as the ‘world’s youngest continent.’ This is certainly true when one compares the median age of Africans, currently 19 years, to that of other continents. For comparison, Europe’s median age is 43 years and Asia’s 32. Africa’s low median age reflects, among others, the relatively small proportion of older adults – those aged 60 years and over, in the total population
However, a missing piece of the story is the already huge absolute number of older people already alive in the continent: currently some 74 million. This number, moreover, is expected to rise sharply in coming decades: faster than in any other region of the world. By 2050, in just three decades from now, it will have increased three-fold to 216 million.
The onslaught of the COVID-19 pandemic with its disproportionate impact on older persons, as well as the social and economic fall out of the stringent (but necessary) response measures, have heightened the urgency of social protection for the population of older persons.
In Kenya, President Uhuru Kenyatta and the Ministry of Health informed by global statistics were quick to urge Kenyans to limit physical contact to their ageing parents and grandparents for the time being. These measures were implemented in light of figures from WHO which indicated the highest rates of serious illness and mortality for older persons and those with serious underlaying health conditions like heart or lung disease or diabetes.
Social and economic impacts of COVID on older people
The advice to limit contact to aged kin, together with the general COVID-related restrictions on movement have likely led to substantial reductions in the support older persons receive from extended family and traditional community support systems. Older persons, as a result, are likely left more at risk of increased health complications and isolation, while increasing exposure to abuse and violence due to decreased vigilance from family. Physical distancing has also created barriers for older persons to access regular medical appointments, source of livelihoods and social mechanisms.
According to the Centre for Disease Control of the US, 8 out of 10 deaths reported in the U.S. have been in adults 65 years old and older. Ninety five percent of those who have died from COVID-19 in Europe were over 60, and more than half of those were over 80.
In other words, the measures taken to contain the COVID-19 pandemic have aggravated challenges often faced by older people: poverty and insecure incomes, barriers to accessing health and other services, isolation and neglect, abuse and violence. The very fact, meanwhile, that the development of COVID 19 responses, did not explicitly consider the potential impacts on older people, exemplifies the ageism and age-discrimination inherent in much public and humanitarian programming.
A rights-based approach
While the response to mitigate the spread of the pandemic is laudable, the lack of resources to support immediate and long term social and economic impacts of COVID-19 for vulnerable groups remains a challenge. Glaring gaps in the protection of the rights of older persons may reinforce entrenched inequalities and disadvantages they experience in their daily lives.
It is essential that States and other actors protect the rights of older persons on an equal basis with others without exception and in line with international standards during the preparedness and implementation of COVID-19 response (as well as beyond the end of the Pandemic).
Call for Action
To protect the lives, dignity and rights of older people and enable them to continue to play their important role in society, the government and other stakeholders must continue to raise awareness of and tailor information on COVID-19 to all categories of older persons. This includes those living in rural areas, and informal settlements, those who are homeless, refugees or internally displaced and those who live with disability. Communication to reach such groups must employ community structures and local languages to ensure that information about the disease, prevention, protection and treatment measures is fully understood by all.
Governments must now strengthen community services to support health care systems and other social support services to ensure older persons’ dignity and wellbeing. This can best be achieved through substantial involvement of ministries and departments responsible for older persons, older people’s organisations and older persons themselves so that expertise, needs and issues of older persons are reflected in COVID-19 response interventions. In addition, the government must consider a need for adapting physical distancing measures to enable a continuity of social support and intergenerational solidarity
Africa occupies the unique position of being, concurrently, the demographically youngest continent and the world region with the most rapidly growing number of older people. Given this – and the expected steady rise in the percentage of older persons in the total population – there is urgent need than ever for governments and all stakeholders to strengthen all public laws, policies and programmes to promote equality and non-discrimination. States need to scale up social protection mechanism with longer plans to institute universal pension, adapt health services to better respond to the needs of older persons, establish equitable and sustainable long-term care systems, and promote access to decent jobs and microfinance systems. A critical step in this direction, will be for Member states to ratify and implement AU Protocol for the Rights of Older Persons and to support a new convention for the rights of older persons.
Governments’ pursuit of such longer-term responses, in a post-COVID 19 context, must be anchored in a rights-based approach to development, and in the deliberate collection of sufficiently age-, gender and disability- disaggregated data, including data on COVID-19 related trends. The latter will be crucial in building an age-inclusive preparedness for pandemics in the future. It is crucial to understand that older adults are not simply passive recipients of support, but active contributors to families, communities and societies. Older person-focused responses must, therefore, not be seen as philanthropy – but rather as part and parcel of overall national development efforts
The writers are the Africa Regional Director for HelpAge International; UNFPA Representative, Kenya; and Director General for National Council for Population and Development (NCPD)