ARCHIVED: Appendix 1: Building a Global Framework to Address the Needs and Contributions of Older People in Emergencies – Policy context for active/healthy ageing and emergency management
Policy Context for Active/Healthy Ageing and Emergency Management
Global ageing is one of the most significant trends of this century. The previous century witnessed a significant increase in longevity; globally, the population of older people is growing at a faster rate than any other age group. The declining proportion of young people and the increasing proportion of people over age 60 is changing the population profile of the past and rapidly moving both developing and developed societies into an era of global ageing. This trend has invited governments and civil society alike to change the way they view older people and the ageing process and to adjust the ways that they plan for and manage the needs and the contributions of older people within society.
This new perspective on ageing is reflected in the World Health Organization's concept of active ageing. In 2002, it was defined as "the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age."1 Guided by the United Nations Principles for Older Persons of independence, participation, care, self-fulfilment, and dignity, the WHO active ageing policy framework encourages action on the three basic pillars of health, participation and security. This perspective calls for the promotion of a wider understanding among governments and humanitarian organizations of the environmental, personal, economic and social factors that contribute to the vulnerability and strengths of older people and supports interdisciplinary, cross-sectoral action to build societies for all ages. The WHO framework and complementary national frameworks developed in recent decades, have contributed to a concerted strengthening of international and national capacities to enhance active, healthy ageing.
The International Plan of Action on Ageing adopted at the First World Assembly on Ageing in Vienna in 1982 had recommended action in a variety of areas such as employment and income security, health, education, housing and contributed to global efforts over the latter decades of the 20th century. In 1991, with the development of the United Nations Principles for Older Persons, human rights for seniors were advanced through the promulgation of the five principles mentioned above. Subsequently, the 1999 International Year of Older Persons adopted the theme of "A society for all ages." Follow-up activities promoted an intergenerational approach to enhance healthy ageing and contributed to advancing "awareness, research and policy action worldwide, including efforts to integrate the issue of ageing in all sectors and foster opportunities integral to all phases of life" (United Nations, 2002).
Similarly, Canada's commitment to support the social and economic health and well-being of older people is based on the collective actions of governments, the private sector, and non-government organizations over many decades and has resulted in a vast network of policies, programmes, and services directed at older people.
As a signatory to the 2002 Madrid International Plan of Action on Ageing (MIPAA), Canada is committed to advancing the spirit and intent of the MIPAA and has a number of policy frameworks in place that directly support and advance its three policy directions and the two objectives addressing emergency situations. These policy investments stem from the demographic imperative associated with an ageing population but are also driven by additional factors such as the recognition of the significant contribution of older people to the richness of Canadian life and the economy; the fact that interventions in the later stages of life can be beneficial to improving the quality of life of older people and that healthy ageing can offset the severity of chronic disease and disability; and the growing evidence on the effectiveness of particular interventions for older people that can be used to guide ongoing policy and programme decisions.
In 1994, the federal, provincial, and territorial governments in Canada endorsed a National Framework on Ageing. Its Vision Statement-Canada, a society for all ages-"promotes the well-being and contributions of older people in all aspects of life" and builds on five principles of dignity, independence, participation, fairness, and security to guide policy action (Federal-Provincial-Territorial Ministers Responsible for Seniors (Canada), 1998). More recently, governments have articulated a new vision for healthy ageing in Canada that values and supports the contribution of older people; celebrates diversity, refutes ageism, and reduces inequities; recognizes healthy ageing as a critical pathway to building resiliency and capacity within older people; and provides age-friendly environments and opportunities for older Canadians to make healthy choices that will enhance their independence and quality of life. This new vision builds on the 1994 Framework and pursues action through three mechanisms: self-care; mutual aid; and supportive environments. These mechanisms are supported in turn, by training, building community capacity for healthy ageing, and supporting a research and knowledge development agenda.
A complementary policy initiative in health emergency management in 2001 has also played an important role in strengthening the links between older people and emergency preparedness in Canada. Recognizing the importance of a comprehensive, integrated and coordinated strategic plan for managing health emergencies in Canada, governments at all levels called for the development of a National Framework for Health Emergency Management. The purpose of the Framework is to provide a consistent, inter-operational approach to health emergencies in the country.
The Framework enhances the capacity of local, provincial and national authorities to prepare for and respond to emergencies by fostering operational bridges based on shared principles, guidelines, and operating procedures (Health Canada, 2005). In this capacity, it provides an important policy and programme infrastructure within which to respond better to the needs of all vulnerable people in emergency situations, including older people. In doing so, it addresses the MIPAA policy directions, from improving the quality of life of older people to strengthening the sustainability of social and economic support systems.
Follow-up to the Madrid International Plan of Action on Ageing
At the Second World Assembly on Ageing (April 2002) the Madrid International Plan of Action on Ageing (MIPPA) was unanimously supported by all countries as a critical vehicle for ensuring that people everywhere are able to age with security and dignity, and continue to participate in their societies as citizens with full rights.
The MIPAA is an important milestone in promoting the health and well-being of older people and the realization of a society for all ages. It is the first international agreement urging governments to include ageing in social and economic development priorities. Further, it calls for action on older persons' rights to protection and humanitarian assistance in emergencies; it focuses attention on the effects of marginalization of older people-especially poverty, but inclusive of their heightened vulnerability in disasters; and it promotes a mainstreaming and intergenerational approach to ageing in responding to humanitarian crises.
The July 2006 Report of the UN Secretary-General on Follow-up to the Second World Assembly on Ageing acknowledges the actions undertaken by Member States since 2002 to achieve the objectives of the MIPAA. As well, the report describes the essential elements of capacity development that governments must address in designing, implementing, and monitoring implementation strategies in the context of the MIPAA. The report concludes by identifying a number of strategic measures required to incorporate the challenges and opportunities of ageing and older people into the policies, programmes, and projects of governments and others. These measures include the need to mainstream ageing issues into poverty reduction and national development frameworks, to use inclusive consultations to develop ageing-related policies, to forge stronger multi-sectoral partnerships for capacity building on seniors' issues, and to strengthen research and data collection initiatives on ageing.
Notwithstanding the significant accomplishments achieved since 2002, the MIPAA has been unevenly implemented to date. Conversely, there is considerable opportunity for greater implementation of the Plan within and across Member States. This would appear to be particularly the case in relation to older people and emergency preparedness.
1 The WHO life course approach to active ageing recognizes that older people are not one homogeneous group and that individual diversity in needs and capacities tends to increase with age. Interventions at all times-and especially those related to emergency management-are designed to create supportive environments to maintain independence and prevent disability (World Health Organization, 2002).
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