An Aging World

The Madrid Plan of Action

The Madrid Plan of Action on Aging is a long-term strategy on aging that addresses issues and recommendations around three priorities:

• Older persons and development;

• Advancing health and well being into old age; and

• Ensuring enabling and supportive environments.

The Plan of Action isn't binding, in that countries who are signatories to the document aren't obliged to implement its recommendations. However, it does represent a moral commitment to take action and should serve to guide governments as they determine priorities for their own policy responses to the reality of an aging society. It also provides context and direction for international cooperation.

Older persons and development

This first priority of the Plan focuses on ensuring the active participation of seniors in society, development and the labour force. Many of these issues link in some way to the problem of poverty. This is not a surprise since, in the developing world, poverty is the main threat to older people: they are consistently and disproportionately among the poorest of the poor. Even in countries like Canada, where seniors' poverty has decreased considerably, a number of seniors still live below the poverty line.

The Plan of Action recommends specifically that governments promote equal access to employment and income generation opportunities and address the obstacles that hinder seniors' participation in an increasingly globalized economy. It also recommends that governments should develop and implement poverty elimination strategies. And since with advancing age, seniors will eventually no longer be able to generate revenue, governments need to develop economic and social programs to protect them.

Advancing health and well-being into old age

This second priority calls on governments to reduce the effects of factors increasing disease and dependence in older age, to develop policies to prevent ill-health and to provide access to food and nutrition. Other recommendations deal with the elimination of social and economic inequalities based on age, gender or other grounds, and developing and strengthening primary, long-term and palliative care. As is the case with so many other issues, this priority area means different things in different parts of the world. In developing countries, a focus on health and well-being often simply means ensuring access to nutritious food, clean water and shelter.

AIDS and AGE • In Thailand, two-thirds of all those affected with HIV-related illness are nursed at home by parents in their 60s and 70s.     • In sub-Saharan Africa, some eight million children orphaned by HIV/AIDS are being cared for by older relatives.

The issue of HIV/AIDS also has particular significance for seniors in the developing world – who have been both "affected and infected" by the disease. They are deeply "affected" in the sense that they (primarily women) have become the caregivers of people infected with the virus as well as the children orphaned by this disease. And as seniors remain sexually active, they can be "infected" and transmit the disease.

Unfortunately, this risk has been amplified by the lack of HIV/AIDS education and support programs targeted at older adults. As a result, they are often unaware of the disease and many go untreated.

The Plan of Action makes a number of recommendations which encourage governments to improve their understanding of the impact of HIV/AIDS on older people, to examine the extent of infection in that age group and to pay closer attention to the needs of older people both as caregivers and as individuals at risk for infection. It recommends that older persons be included as targets for prevention education, treatment, support, etc.