During my recent journey to Saint-Petersburg to attend the in situ education program of the International Institute on Ageing of the United Nations, Malta (INIA), I asked one of the main speakers, former Head of the UN Programs on Ageing Dr. Alexandre Sidorenko, to find a few minutes to talk about his work.
After joining the United Nations Secretariat in 1988, Dr. Sidorenko then became the Chief and later the Head of this most important UN initiative on aging. Currently he keeps supporting the development of evidence-based policies on aging worldwide as a Senior Advisor of the European Centre for Social Welfare Policy and Research (Vienna, Austria) and as an expert of the UN Population Fund (UNFRA). Dr. Sidorenko is the author of many interesting articles concerning policymaking in the field of aging, which I recommend you to read.
But before we get to the interview, let me first discuss the main strategic documents on aging that the global community has created by now. As you probably have read in our previous article about INIA activities, aging was first recognized as a global challenge back in 1968, when the Government of Malta brought the demographic changes to the attention of the United Nations. After a period of research and data analysis, the global community decided to organize the first ever World Assembly on Ageing in 1982 in Vienna, Austria.
The most important result of this period is the Vienna International Plan of Action on Ageing, which became the first set of guidelines for different stakeholders to help our society adapt to population aging. The Vienna Plan included many recommendations addressing research, data collection and classification, training for specialists in different fields related to aging, and education. The importance of some sectoral areas was also underlined: health and nutrition, protection of elderly consumers, housing and environment, family, social welfare, income security, employment, and so on. While member states began to introduce new goals in the local policies, the UN kept processing the data and developing a more in-depth vision for the needs of older persons and what measures would help meet these needs.
It led to the creation of the next strategic document: the UN Principles for Older Persons. This list of principles, which the UN encourages member states to include in their local programs on the problems of older people, has several focal points: Independence, Participation, Care, Self-fulfilment and Dignity. The Principles primarily provide a list of goals to promote the well-being of the elderly through social protection measures. However, point 11 of the Care section includes the thesis on the need for a preventive approach to aging:
“11. Older persons should have access to health care to help them to maintain or regain the optimum level of physical, mental and emotional well-being and to prevent or delay the onset of illness.”
From the 1980s to 2000s our population increased significantly (from 4.4 to 6 billion people), and population aging became a strong trend in many countries (primarily the European countries and Japan). The WHO turned its attention to the health problems of the elderly and issued a number of reports and recommendations to help people all over the world extend their healthy period of life. This is exactly when humanity reached the understanding that, while population aging is a challenge with respect to healthcare and the economy, it also is a unique opportunity of growth as a great share of older people are able and willing to support social and economic development – if society is willing to remove some physical and political barriers limiting their activities.
The Second World Assembly on Ageing took place in Madrid, in 2002, with the aim of evaluating the achievements promoted by the Vienna Plan and to set new, more relevant goals. As a result, the Madrid Plan of Action on Ageing was developed under the lead of Dr. Alexandre Sidorenko. This plan offers a bold new agenda for handling the issue of aging in the 21st-century. Its focus is on three priorities: older persons and development; advancing health and well-being into old age; and ensuring enabling and supportive environments. These priorities can be easily merged into one crucial message: inclusion.
While the attention of the Madrid Plan of Action on Ageing is still mostly on social measures to promote well-being of the elderly, it also recognised the importance of more intensive scientific research on age-related diseases and development of new treatments and rehabilitation programs. As an example: “75. Objective 2: Development and strengthening of primary health-care services to meet the needs of older persons and promote their inclusion in the process. … (e) Encourage, at all levels, arrangements and incentives to mobilize commercial enterprises, especially pharmaceutical enterprises, to invest in research aimed at finding remedies that can be provided at affordable prices for diseases that particularly afflict older persons in developing countries and invite the World Health Organization to consider improving partnerships between the public and private sectors in the area of health research.” The Madrid Plan remains the main source for policymakers around the world until now.
However, moving forward we are going to revise and set new priorities many times, in accordance with changing demography and economy. The recent World report on ageing and health (2015) by the World Health Organization, as well as the Global strategy and action plan on ageing and health (2016) and the new set of Sustainable Development Goals (notably, Goal 3, related to health improvement) start introducing the need for innovative medicines to counteract age-related diseases in the international agenda on aging.
Before you watch the interview with Dr. Sidorenko, I’d like to note that changes to priorities do not happen by themselves. The refinement of the global strategy is the result of a common effort by many active people, including representatives of civil society organizations and academia. The more we engage in an open dialogue, the more chances the new action plans will reflect our aspiration to bring biological aging under reasonable medical control, and the sooner regenerative technologies will become available to people all over the world.