The World Health Organization has long been a leader in matters of public health, from its successes against such dreaded diseases as smallpox to its campaign to control tobacco. Its new Health and Ageing Strategy, passed recently in Geneva at the 69th World Health Assembly, follows in this admirable tradition.
But this effort goes beyond a current and easily observable health crisis, built instead from a huge insight on one of the mega-trends of our time -- 21st century longevity. The WHO has in its sights a unique approach to public health that fosters the goal of healthier and more active aging by enabling "functional ability" in our later decades. More than absence of disease is a huge shift, but has in its sights the essential need for wellness and prevention in an era of 100 year lives.
Wow. A global institution with a strategy that offers the preconditions for healthier and more active aging today, even as it creates the solid foundations to aid our grandchildren's longer lives? A rare, much-welcome development.
Moreover, the strategy includes an execution plan for the 194 Health Ministers in the Geneva Assembly Hall to take home. They will report their progress over the next five years and then gather in 2020 to launch the decade of Healthy Ageing.
The newly minted strategy impressively builds on a year of work by the WHO's Ageing and Life Course Unit, headed by Dr. John Beard, and ably supported by Dr. Alana Officer. Last October, they issued the report that informed the strategy that WHO Director General, Dr. Margaret Chan, just got approved. Both the Report and the Strategy are well supported by the medical, health and scientific leaders seen in the Gerontologist Supplement on Healthy Ageing that accompanies the Report.
While it's understandable that emergencies like Ebola or Zika will continue to grab the public health headlines, don't for a second underestimate the importance and impact of what just happened in Geneva, which is laid out by the WHO itself.
• commitment to action on Healthy Ageing in every country;
• developing age-friendly environments;
• aligning health systems to the needs of older populations;
• developing sustainable and equitable systems for providing long-term care (home, communities, institutions); and
• improving measurement, monitoring and research on Healthy Ageing
The broad takeaways:
Culture Shift: As with any social or economic revolution, those living through it often miss the really big idea. Drs. Chan, Beard and their team got it exactly right by identifying the subtle shift necessary for the health of our 21st century global society. This is a world that will soon have more old than young; where 80+ is the fastest growing demographic; where planning for 100 years of life is, for the first time in history, the norm. It is essential to stop treating our 60+ population -- reaching 2 billion by mid-century -- as an afterthought to public health needs. But in a culture that counts an old person's health needs as, well, "they're just old" you get a kind of subtle but powerful and automatic lowering of priority. Yet, in today's "older world," how could we not consider an "adult immunization campaign" parallel to the childhood immunization program we have so brilliantly embedded in every aspect of public health thinking, everywhere? Or, dedicate the funds required to better manage and ultimately cure Alzheimer's? This new strategy will, by its very existence, re-imagine and re-shape public health to align with 21st century longevity. And it will be good for all of society.
Longevity wellness and functional ability: Perhaps the greatest insight of the new strategy is its shift towards the metric of functional ability. You see, with 20 percent, 30 percent and 40 percent of national populations being old, helping adults be active and healthy will be essential for economic growth and prosperity. Done right, we can add quality of life to all of our years, while also substantially reducing the expected cost burdens on health systems. To this end, the new strategy targets areas virtually ignored today, such as skin, oral and nutritional health. Longevity makes these aspects critically important. For example, a lifetime of skin damage will now also impact your mental health, make you susceptible to infections and wounds, and increase your risk for melanoma. To combat these kinds of challenges that otherwise impede functional ability, we need prevention and wellness strategies across the life course to keep us healthier and more active as we age.
Caring differently: It was fine for public health to arrange long-term care for 20th century aging. But today, in the 21st century, the ways we care for our aging population assume brand new paradigms and possibilities. Aging at home; effective and efficient uses of innovative technology; care aligned with wellness and functional ability; and employer support for caregivers all represent parts of the sea-change the new strategy envisions.
To achieve changes in long-term care and many other areas, the WHO calls for widespread action: "Multiple actors and agents will need to align, collaborate and coproduce Healthy Ageing ... formal tiers of government, individuals in communities and as patients and caregivers, and a wide spectrum of networks, associations, businesses and organizations in diverse sectors." This, too, in today's global and diverse society is necessary for collaboration and partnership. One or the other segment of society just cannot do it alone.
Congratulations, WHO. Now, for the 194 Health Ministers to go home and start working with the rest of us for all our healthier and more active aging.