Ladies and Gentlemen,
It is my pleasure to be here today to join the discussion of the Special Rapporteur’s thematic study on the right to health of older persons. In recent months, the international community has increased its attention to the human rights of older persons. I welcome this development and commend the establishment by the General Assembly of an open-ended working group last December to focus on strengthening the protection of the human rights of older persons.
The composition of the world population is changing dramatically. Almost 700 million people are now over the age of 60. By 2050, 2 billion people-over 20% of the world’s population- will be 60 or older. Women already outnumber men among those aged 60 years or over: among those aged 80 years or over, women are twice as numerous, and among centenarians women are between four and five times as numerous as men.
Against this backdrop, it is clear that the situation of older persons should rank among the most pressing policy issues for governments, public institutions and societies at large.
This year’s Secretary-General Report on Ageing to the General Assembly focuses entirely on the human rights situation of older persons. I would like to outline two of the report’s themes that are especially relevant to the discussion on health and human rights: (1) age discrimination, and (2) lack of special measures, mechanisms and services.
Allow me to start with age discrimination. Formal and substantive discrimination, discrimination in law and in practice, are essential entry points for human rights analysis. Indeed, the prohibition of discrimination is one of the pillars of international human rights law.
Although “age” is not explicitly listed as a prohibited ground of discrimination in most international human rights treaties, these lists are intended to be illustrative and non-exhaustive. They include an open-ended category (for example “other status”), under which treaty monitoring bodies have considered age-related discrimination, in particular the Committee on Economic, Social and Cultural Rights and the Committee on the Elimination of Discrimination Against Women.
Regrettably, prejudice against and stigmatization of older persons (known as “ageism”) are consistently reported everywhere in the world. Discrimination based on age is present in areas as vital as social protection policies, employment laws, and access to public services. And, of course, age discrimination is compounded by other forms of discrimination and prejudice.
Discrimination affects a broad range of rights of older persons, however its intimate link with the right to health has particular relevance. Health lies at the heart of all human rights issues when we age. Research shows that health tops older persons’ issues of concern. Problems such as lack of adequate diagnosis or treatment, lack of trained staff or home-based services, or difficulties to access reliable health information are often cited.
Equally significant for older persons is maintaining good physical and mental conditions—and thereby independence— as well as obtaining access to good quality health services. All these factors help to preserve dignity in all phases of life.
Yet, age-related discrimination in health care is common in all regions of the world. Many submissions to the Secretary-General’s report highlighted the fact that age often defines whether someone is allowed to access medicines, treatment, devices or long-term care. Older persons claim that their age alone is handled as a disease: oftentimes they are dismissed without proper diagnosis.
Similarly, as the Special Rapporteur has pointed out in his thematic study, older persons are perceived as less able to provide informed consent. Paradoxically, older persons face more frequently situations in which informed consent for treatment, diagnosis and care is indispensable. These situations increase their vulnerability to violations of their rights.
Let me discuss now the second important challenge, namely a lack of adequate services, facilities and care, or their prohibitive costs. Estimates show that only one in 5 persons aged 60 or more has a pension. Without a pension, older men and especially older women may well be confronted with poverty. Stress about affordability of health services leads to or is compounded by unattended chronic diseases, malnutrition and lower standards of living.
Even if a pension is available, older persons often have to spend it entirely on medicines rather than adequate food, transportation or rent. In this context, a social protection system is crucial, and States are required to allocate sufficient resources and facilities to cope with these demands now and to prepare for the future.
The unique requirements of older persons must be incorporated in national health systems, especially in low and middle income countries. However, such countries often lack specialized services such as residential centers, home care programmes or geriatric services. Age-friendly primary health care remains rare and the lack of medical and nursing personnel adequately trained is set to worsen.
Most states still require comprehensive health policies, which take into account prevention, rehabilitation and care of the terminally ill. Older persons face a disproportionately large burden of chronic and sometimes incurable illnesses and health conditions, which often dramatically reduce their quality of life. Adequate access to palliative care is essential to ensure that these people can live and—ultimately—die with dignity.
Before concluding, let me say a few words about the General Assembly resolution 65/182 of December 2010. It created an open-ended working group with the purpose of strengthening the human rights situation of older persons. This initiative has offered Member States a much needed springboard to discuss the situation of older persons from a human rights perspective.
Chaired by Ambassador Argüello from Argentina, the open- ended working group has held two sessions in New York, in April and August. During the April session, the working group considered the existing international and regional human rights framework and mechanisms, and reflected on a number of normative, information and implementation gaps in the protection system. The August session focused on some of the most pressing thematic issues, namely, discrimination, violence and abuse, the right to health, the right to social security, and age and social exclusion of older persons.
As noted by the Chair’s summaries of both sessions, Member States have agreed that gaps exist in the international protection regime. Even if diverging views about the nature of these gaps are present among member States, it is clear that we need to do more and do it better. Member states acknowledge fragmentation and uneven or insufficient focus at the international level on the human rights of older persons. Despite provisions already applicable to older persons in the existing human rights instruments, panelists and experts lamented an absence of specific standards on the rights of older person who, consequently, have remained largely neglected by human rights advocacy.
Exploring existing gaps in the international protection regime is an essential dimension of the work of the open-ended working group. It should continue and deepen its analysis with a view to identifying measures and concerted actions at the international level.
Ladies and Gentlemen,
Let me conclude by reiterating that the international protection regime must be enhanced to ensure the respect and protection of all human rights regardless of age. All measures must be considered, including the feasibility of new instruments and mechanisms with a dedicated and explicit focus on older persons. An international protection regime must aim at accommodating the uniqueness of every person regardless of age and at guaranteeing them the opportunity to age in dignity. I encourage Member States to continue taking steps to consider all options, without hesitation, to ensure the fullest protection of the rights of older persons.