Rohit Prasad, CEO, HelpAge India highlights that in the vision of ‘One Earth, One Family, One Future’, senior citizens deserve to be celebrated for their contributions and recognised for their potential
The G20 Summit meeting in September, under India’s Presidency, holds great significance as discussions culminate on important global issues including health, sustainability, climate change and financial inclusion. Population ageing is an underlying mega-trend impacting almost all the G20 countries. From an economic perspective, ageing has major implications on healthcare costs, workforce, social security and financial services. Alongside these, longevity offers tremendous opportunities if a good quality of life is ensured in later years. While the 60 plus population for the world is at a 10 per cent average, most countries in G20 already have a high percentage of aged population (Japan 38 per cent, UK 24 per cent, and USA 23 per cent). Few countries such as India, China, Brazil and Saudi Arabia are relatively early on the curve, but facing rapid demographic changes linked to their development trajectory. In the vision of ‘One Earth, One Family, One Future’, senior citizens deserve to be celebrated for their contributions and recognised for their potential.
G20 affords an opportunity to learn from the experience of member countries for collective action for a world better prepared to deal with all the common challenges and lay the foundation for a sustainable and inclusive future. Under India’s Presidency we hope to achieve this unparalleled and futuristic vision. Therefore, the inclusion of the needs and demands of the fastest growing segment of the population of most of the countries of the group is imperative. India has already made the beginning and can lead the way.
Senior citizens in ‘Viksit Bharat’ 2047 vision
A couple of aspects are noteworthy for India. Firstly, its population of senior citizens will witness a rapid rise from 10 per cent to 20 per cent in 2050 (i.e. from 1 in 10 to 1 in 5) over a much shorter period of 30 years than what others did over 50-80 years on an average. Along with overall growth, feminisation of ageing and the growing share of 80 plus (as longevity extends more) will require special focus. Secondly, while most other countries became old after becoming rich, India will do this in parallel. These challenges apart, India is uniquely placed to not only ride on its ‘demographic dividend’ (its large young population), but also take advantage of its ‘demographic bonus’ (growing elderly population).
India set out its National Policy on Older Persons (NPOP) in 1999, and subsequently had several initiatives including the landmark Maintenance of Parents & Senior Citizens Act (MWPSC, 2007). The National Action Plan for Senior Citizens (NAPSrC, 2020), implemented by the Ministry of Social Justice & Empowerment, outlines the commitment to the well-being and empowerment of senior citizens in India. The G20 meetings under different tracks have been touching upon issues of older persons. For instance, ‘Integrated Holistic Health: Mind, Body, and Environment’ included a sub-group on ‘Elderly Health and End of Life Care’. In its 2047 aspiration of ‘Viksit Bharat’ (Developed India), age preparedness and the creation of an age friendly society will be a critical success factor, aligned with its vision and tradition of a caring society. Some key aspects would merit the attention of all stakeholders.
Healthy ageing and long-term care
UN-WHO has declared 2020-30 as the ‘Decade of Healthy Ageing’, recognising the ageing trend and health imperative. Ageing itself is a primary risk factor for several chronic conditions and disability and health systems need special orientation towards elderly. The Longitudinal Ageing Study in India (LASI) indicates over 50 per cent of people aged 60 plus have one or more chronic diseases, 40 per cent face functional disabilities and about 20 per cent are suffering from mental health issues. The transition towards universal health coverage should be accelerated with prioritised coverage for the elderly, embedding geriatric care in health systems and preventive care for the current 40-60 age group cohort. The Government’s programme Ayushman Bharat-Health and Wellness Centre (AB-HWC) has rightly included a comprehensive package of agecare services. The ‘National Programme for Health Care of the Elderly’ (NPHCE) makes provisions for dedicated geriatric healthcare facilities for senior citizens across primary, secondary and tertiary levels. The accelerated implementation of such programmes in mission mode would immensely benefit the elderly.
Besides clinical care, the long-term care (or social care) in India is where much greater attention is needed and the G20 experience and lessons can be valuable. With the objective of ensuring ‘ageing at home’ care (a family and community-centred ethos, rather than institution-based) for independent living and well-being, services for delivering care at home or near home will need to be scaled up significantly. Financing of long-term care needs to be planned as a societal responsibility and not just left for the family to bear. For instance, Japan’s Long-term Care Insurance System aims for the society as a whole to support the long-term care of the elderly. An innovative financing and insurance mechanism needs to be developed, particularly for the lower-middle class elderly who lack the ability to pay and are also out of welfare schemes. More tax benefits for senior citizens and family caregivers will be helpful. It is a paradox that when the elderly most need health and care insurance, there is either no option or it is prohibitively expensive.
Social protection & financial security
The COVID-19 phase starkly exposed the social protection gaps for the most vulnerable and marginalised, from a health-income-livelihoods-isolation perspective. Social protection coverage must not get lost in an intergenerational resource trade off (young versus old) but adopt an inclusive approach. The current level of old age pension for the poor is around Rs 500 (average across the states) which is grossly inadequate. Promoting livelihoods and workforce participation for senior citizens will improve financial security. For the rural poor, Elder-Self-Help-Groups (ESHGs), pioneered by HelpAge India, create community platforms that combine social-financial-health-digital inclusion. Already adopted by the National Rural Livelihood Mission of the Government of India, the ESHGs offer immense potential for scale-up. Elders also face disproportionate impact from climate change related disasters and investments in community-based approaches can provide a protective shield.
Technology & digital empowerment
Building and leveraging digital prowess has been a key theme under India’s G20 Presidency. Under Prime Minister Narendra Modi, India has led the way in transformational digital adoption at scale reaching the remotest and harnessing the benefits for all. While older persons stand to gain immensely, they risk getting left out due to lack of knowledge about access and the ability to navigate these safely (they are highest at risk of falling prey to cybercrimes). It would not be fair to expect elders to just ‘catch up’, instead it is obligatory on all of us to advance digital literacy for senior citizens. A policy change to include the elderly under Government’s PMGDISHA (Pradhan Mantri Gramin Digital Saksharta Abhiyan) would be helpful. Intergenerational technology/knowledge transfer within families, where grandchildren (mostly digitally native) teach grandparents (many digitally naive) holds a lot of hope and promise, and many schools and children are joining this social change. More broadly, age-tech or technology for elders holds immense potential to transform lives through reducing social isolation, improving health access and developing assistive technologies. Much more funding, including from the private sector, is needed in age-tech as well as for developing intermediary platforms (such as the Government’s Common Service Centres network) to enable adoption at the last mile.
Putting planning mechanism and structures
It is clear that the next 30 years projected demographic ageing journey has major implications for economy and society. A multi-sectoral response is a necessary step. In building a supportive system for the elderly, the government can incentivise the private sector’s role to realise the potential of India’s ‘silver economy’. Other enablers such as age-disaggregated data would be at the heart of research and planning for the future. Recent news about NITI Aayog preparing a longer term plan on elderly care is very welcome. The lessons and experiences of G20 countries would be very relevant, even as India charts out its own path to a brighter future for the country and its senior citizens.
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