In Geneva this week the World Health Organization (WHO) sent a wake-up call to its 194 member governments and its fellow global institutions to open their eyes to what's staring them in the face -- a world that will soon have more old than young; a world where, of all age groups, the 80+ is growing most rapidly; a world where planning for 100-year lives is, for the first time in history, no longer the unimaginable but the norm.
This is massive.
At a cultural level, we are already starting to get it as such Hollywood icons as Robert De Niro in the new film, The Intern, confronts his own aging.
The Intern -- in which the young Anne Hathaway is De Niro's boss -- is a light, grab-your-popcorn sort of movie, but don't let that fool you. We are, globally, at a moment when a century's worth of assumptions about what it means to age have come crashing down, and now we have to ask ourselves hard, uncomfortable questions. When the silver-haired De Niro shuns retirement to take a new job as a "senior intern", he does just that.
And this is precisely why the WHO's new report shatters all our norms: it starts to answer deeply personal questions and provides guidance for practical policy recommendations. It gives public policy voice to Hollywood's cuteness. Those 194 member governments ought to take heed.
Sure, the WHO report is long and exhaustive. But it is also groundbreaking and it must be considered very thoroughly by public and private sector leaders from all corners of the world. Yet, the WHO's profound and serious insight across its hundreds of pages and thousands of footnotes is to frame the 21st century understanding of what "healthy aging is." It also re-defines the course of public health from the 20th century's focus on absence of disease to promoting functional ability among today's population. The WHO has now given us the exact right framework realized through the prism of 21st century longevity.
The successful 100-year life span is about function and ability - contribution and participation in social and economic affairs. It is a way to introduce into the public health agenda the goal of adding good health and quality to the longevity the 20th century has bequeathed. Or, as Dr. Margaret Chan, Director General of the WHO declares, "functional ability has the highest importance. The greatest costs to society are not the expenditures made to foster this functional ability, but the benefits that might be missed if we fail to make the appropriate adaptations and investments". Wow!
At its heart, healthy aging is about the children and our children's children, not just the Baby Boomers and the octogenarians of today. Think of this way: How will our daughters born in the 1990s in New York, London, Beijing, Istanbul or São Paolo live their lives through the three centuries their life spans will touch? And how will they thrive in a world with more old than young? A world where the proportion of society -- the first time in the history of human kind -- has an age structure turned upside down? The age pyramid is on its tip and widens with aging. This is new! And as with any pyramid balancing on its point, it will require enormous global efforts to restructure the social contract for global society.
Yet this new WHO report will prove to be monumental not only for how it redefines healthy aging, but also for how it connects health and aging to questions of personal freedom, fiscal sustainability, and economic growth. Indeed, "functional ability" is not only about crafting a life that is fulfilling in its older years, but also about our collective success when there are two billion of us over 60.
When we start to parse this term "functional ability," we see that it includes a range of building blocks: healthy skin that will literally transform how we consider our aging process and therefore vital to engagement, activity, health, well-being and our emotional state; transform the ability to maintain good vision longer into our older years and the prospects for active aging multiply; reduce the near prefect correlation between today's muscle mass and bone deterioration and our 100-year lives themselves are forever altered.
Of course, the WHO does recognize that the pathways for healthy aging will still need to solve for the growing epidemics of NCDs -- cancer, diabetes, Alzheimer's, cardiovascular disease -- perfectly aligned with our longevity.
The WHO report fully recognizes that the innovations in healthcare, medical science and technology that got us here -- to this longevity -- are at least as essential if we are to realize the quality of healthy lives we all want. Meeting the growing care needs will be immensely advanced if we get the opportunities around the new models of caregiving, especially at home, enabling many more to age in place. Nor does the report miss that such monumental innovations in areas like telehealth and telemedicine will need to gain government policy support if we are to have the incentives to apply them across society and ensure continued innovation.
This WHO report marks a revolution because it forces us to recognize that aging isn't just about the old. It's about all of us. And aging is not just about diseases -- but also health and activity, work and financial planning. It marks health policy as an essential milestone to better lives, individually and for society. No one publicly has ever quite thought this way before.
A century ago, when we were building the policies and institutions that support our lives today -- around health, retirement, education, etc. -- we'd have been lucky to have lived past 47. Now we've got to plan for 100 -- maybe more! The WHO Report on Ageing and Health gives us for the first time the pathway to 21st century healthy aging. Now it's up to us -- governments, partner global institutions across disciplines, and all of us to act!