Preparing for population ageing in the Western Pacific Region.

People throughout the Western Pacific Region are now living longer, reflecting decades of health improvements. Longer life expectancies combined with declining fertility rates mean that the proportion of older people is growing faster than any other age group in the Region.

There are more than 700 million people aged 65 and over worldwide and more than 240 million of them live in the Western Pacific Region [1,2]. This number is expected to double by 20501, 2. The Region is also experiencing unprecedented ‘depth’ of the ageing population, with the number of people aged 75 years and above also growing significantly. Currently, there are more than 84 million people 75 years and older in the Region, with this number expected to triple by 2050 [2].

The pace of demographic change is also accelerating. A population is considered to be ageing when more than 7% of people are 65 years or older and aged when more than 14% of people are 65 years or older [3]. The transition from ageing to aged society took about 60 years for Australia and New Zealand and 24 years for Japan (Fig. 1) [2], while younger countries and areas such as Viet Nam and French Polynesia are expected to make this shift in less than 20 years (Fig. 1) [2].

Fig. 1

Speed of ageing for select countries and areas in the Western Pacific Region: time taken to transition from an ageing to aged society

Source: Population Division of the Department of Economic and Social Affairs of the United Nations Secretariat, World Population Prospects: The 2019 Revision.

Population ageing has significant societal implications such as an increased burden of NCDs and chronic conditions [4], as well as a growing population with more diverse health and social needs [5]. However, population ageing can also offer many opportunities for individuals and society as a whole. People are living longer, allowing them to accumulate more knowledge and experiences throughout their lives. But to leverage these opportunities, countries need to invest in the health of older people and recognize the many contributions older people can make to society.

The coronavirus disease 2019 (COVID-19) has further exposed gaps in care for older adults and raised public awareness about the need to better support the ageing population. Older adults have been disproportionately affected both directly in terms of disease threat and indirectly through social and economic consequences [6]. Although all age groups are at risk of contracting COVID-19, older adults are at higher risk of more serious complications and death. Further, public health measures including physical distancing implemented to curb the spread of COVID-19, may actually exacerbate existing social vulnerabilities experienced by some older adults, such as income insecurity, susceptibility to violence and social isolation. These in turn, have significant physical and mental health implications for older adults [7]. The imperative of taking action to prepare for population ageing is now more evident than ever. This presents a unique window of opportunity today for countries to begin taking immediate steps, to build for the future.

With the timeline for the Regional Framework for Action on Ageing and Health in the Western Pacific (2014 – 2019) coming to an end, a high-level panel discussion was held at the Regional Committee in October 2019. Following the meeting, Member States acknowledged that preparing for population ageing is a priority and unanimously called for WHO to develop a regional action plan on healthy ageing. In developing the new regional action plan, WHO has consulted with experts and partners in the Region and globally, as well as worked with countries to better understand population ageing within different contexts. The Regional Action Plan on Healthy Ageing in the Western Pacific [8] was endorsed at the Seventy-first Regional Committee Meeting in October 2020. Its adoption also coincides with the launch of the Decade of Ageing 2020 – 2030 [9], which was endorsed by the World Health Assembly in August 2020.

The Regional Action Plan for Healthy Ageing in the Western Pacific aims to foster older people in the Western Pacific Region, who are healthy, thriving and contributing to their societies. The Plan outlines a series of objectives for realizing the vision of healthy ageing in the Region, including: transforming societies, and transforming health systems including through providing community-based integrated care and fostering innovation. Strengthening monitoring and surveillance and research will also be key.

The Plan recognizes that being healthy at an older age is often a result of a lifetime accumulation of healthy behaviours and environmental exposures. Therefore, a lifelong approach is needed to instil healthy behaviours in individuals, starting at a young age and promoted throughout their lives.  Further, adopting healthy behaviours is often influenced by many social and environmental factors such as income and social support for which differential access can lead to very different ageing trajectories. Therefore, the plan emphasizes a multisectoral approach and an equity lens to foster environments that enable all individuals of all ages to engage in health promoting behaviours. Finally, the Plan recognizes that communities have existing assets that can be leveraged and built upon to respond to and provide tailored services that address each older person's unique needs.

Societal transformation for healthy ageing requires a long-term vision and commitment, but experiences from already aged countries suggest that early investments made towards healthy ageing, can turn challenges into opportunities. Older people are healthier and more knowledgeable than ever before. It is now time to shift the narrative on ageing to one that recognizes the many valuable contributions older people can make to their families, communities and society when they are encouraged and supported to do so.

Declaration of Competing Interest

No conflict of interest.