Older Persons&

the Right to Health

Astrid Stuckelberger, PhD

Institute of Global HealthUniversity of Geneva

The Paradox Population Ageing in Europe and the World (N+%) GBD and chronic disease = Ageing Population

4-5 Generations of 2-3 Generations of Older Personsvs

No Human Rights of Older Persons at UNNo Right to Health of Older Persons at UN

only very few fixed r-marked positions on ageingNo ethical framework

The Right to disease, degeneration, dependency…

The «Neglect Syndrome» (Prof. Moulias et al., IAGG-ER, 2012)

Complexity of ConceptRight to Health & Older persons

What is an Older Person? What is Health at Old Age?

What is the Right to Health in Old Age?

• Administrative• Biological• Socio-Generation• Politically• Economically• Culturally

• Active physically• Active mentally• Preventive measures• Healthy lifestyles (25% genes)• Good personalized nutrition• Toxic free environnment • Contribution to Society

Right to Health in Old Age = Availability, Accessibility, Acceptability, Affordable, Adaptable, and Quality

Right to Health of Older Persons

What is specific?A long range of specific evidence-based right to health conditions and situations : Right to health (UCH) and social security Right to long life health at work Right to adequate housing Right to long life reproductive health Right to access to health care (preventive, curative, LTC and palliative) Right to adequate management of mental health and chronic diseases (reversibility) Right to rehabilitation care (technology) Right to safe medicine and treatments (ADR) Right to evidence-based specific screening, food and treatment Right to professional health care (geriatric medicine) Right to health literacy and ICT literacy (adequate and correct information) Right to adequate and non discriminative health and treatments Etc…

”The right to health is an inclusive right, extending not only to timely and appropriate health care, but also to the underlying determinants of health, such as access to safe and potable water and adequate sanitation, healthy occupational and environmental conditions, and access to health-related education and information, including on sexual and reproductive health.” (OHCHR)

Right to Health of Older PersonsBeside OHCHR and WHO

What UN agencies are concerned?

Linked to ageing conditions ILO =Right to long life health at work UNFPA, UN Women = Right to long life reproductive health UN Habitat, UNDP, UNEP = Right to access to health care, sanitation, developement FAO, WFP = Right to evidence-based specific screening, food and treatment Right to ITU, UNESCO Right to health literacy and ICT literacy

Linked to specific situation of older persons Older refugees = UNHCR Older migrants = IOM Older worker = ILO Older poor = World Bank etc

The Solution: paradigm shiftMultidisciplinary expert teams

From engineering health to treating itFrom health promotion and prevention to palliative care

From young age to end of life

The «Prejudice Syndrome» going from the Right to disease to the right to

healthImportance to have scientific evidence and new modelisation of ageing

Reversibilty vs degeneration and unavoidable declineDeficit screening cured with personalized nutrition and food supplements before disease

NEW MODELS AND SCIENCE OF AGEING

Example: Recommandations made at CSW 2012Rethinking Right to Health of Older Women with no discrimination

Theoretical - methodology New model of ageing – against ageist medicine and health care,

with innovation and echnology for prevention Older person’s Right to Health modeling based on scientific and medical evidence Data disaggregation by higher ages and sex

Practical Individual empowerment to realize their Right to Health and combat a LL deficit Family & commmunity empowerment – e.g. training for age specific health care, ToT

Political - Structural Putting old age and older women on the agenda (e.g. special rapporteur, item, wording) Institutional & Policy Section for older women Evidence-based policy and expert networks, ethical framework in research and end-of-life Q

Evidence vs generalization and prejudice

Complexity of ageing and cofounding factors

Non biais evidence and interpretation of data

Constant reality-check in the face of S&T progress

Bridge between NGOs and Policy-makers

Role of the Science of Healthy AgeingFundamental to the Right to Health of OP

OHCHR more visibility and access to information on older persons’right

All bilateral UN documents and agenda (including HRC agenda)

3 examples of important upcoming events in 2015 :

MDGs review and post-2015

UN Conference on Sustainable Dvt (SDGs), Paris Health

UN Women Conference Reinforcing the Beijing Plateform of Action Older women mentioned once, no life course perspective.

ICPD 2014: reproductive health and rights at all ages = the most sensitive aspect which clashes with conservative views of women’s role

CEDAW: for the first time recommendation on older women

Filling the gap of the UN Agenda on Older Persons Rights and Right to Health