Older Persons & the Right to Health

1. Older Persons&the Right to Health Astrid Stuckelberger, PhD Institute of Global Health University of Geneva

2. 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 PersonsvsNo Human Rights of Older Persons at UNNo Right to Health of Older Persons at UNonly very few fixed r-marked positions on ageingNo ethical frameworkThe Right to disease, degeneration, dependency…The «Neglect Syndrome» (Prof. Moulias et al., IAGG-ER, 2012)

3. Complexity of ConceptRight to Health & Older persons Whatis the Right to Health in Old Age? Whatis an Older Person? WhatisHealth at 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

5. Right to Health of OlderPersonsWhatisspecific? ”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) 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…

6. Right to Health of Older PersonsBeside OHCHR and WHOWhat 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

7. The Solution: paradigm shiftMultidisciplinary expert teamsFrom engineering health to treating itFrom health promotion and prevention to palliative careFrom young age to end of lifeThe «Prejudice Syndrome» going from the Right to disease to the right to healthImportance to have scientific evidence and new modelisation of ageingReversibilty vs degeneration and unavoidable declineDeficit screening cured with personalized nutrition and food supplements before diseaseNEW MODELS AND SCIENCE OF AGEING

8. Example: Recommandations made at CSW 2012Rethinking Right to Health of Older Women with no discrimination Theoretical - methodology • New model of ageing – againstageistmedicine and health care,with innovation and echnology for prevention • Olderperson’s Right to Health modelingbased on scientific and medicalevidence • Data disaggregation by higherages and sex Practical • Individualempowerment to realizetheir Right to Health and combat a LL deficit • Family & commmunityempowerment – e.g. training for agespecifichealth care, ToT Political - Structural • Putting oldage and older women on the agenda (e.g. special rapporteur, item, wording) • Institutional & Policy Section for older women • Evidence-basedpolicy and expert networks, ethicalframework in research and end-of-life Q

9.  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 HealthyAgeing Fundamental to the Right to Health of OP

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