CONNECTION SERIES: 2

The 2030 Agenda
for Sustainable
Development andthe UN Decadeof Healthy Ageing2021-2030

1

September 1, 2021 (version 1)

In periodic, themed advocacy papers, this Decade Connection Series is intended tostrengthen understanding of the links between the Decade of Healthy Ageing and crosscutting global issues.
On 16 December 2020, the Member States of the United Nations (UN) system proclaimed
2021–2030 as the UN Decade of Healthy Ageing (General Assembly Resolution 75/131),
following endorsement of a proposal by the Seventy-third World Health Assembly on
3 August 2020. The UN Decade of Healthy Ageing is aligned with the 2030 Agenda
for Sustainable Development and its call to leave no one behind. It builds on andcomplements the Madrid International Plan of Action on Ageing (MIPAA) of 2002.
A plan for the Decade of Healthy Ageing includes a voluntary work programme for use
by governments and other stakeholders, as appropriate, and is intended to be a living
document.
The vision of the Decade of Healthy Ageing is a world in which all people live longer,
healthier lives. It is intended to be a global collaboration, bringing together diverse
sectors and stakeholders in governments, civil society, international organizations,professionals, academia, media and the private sector.
The Decade’s four interconnected action areas are:••••changing how we think, feel and act towards age and ageing;developing communities in ways that foster the abilities of older people;
delivering person-centred, integrated care and primary health services that are
responsive to older people; andproviding older people access to long-term care if they need it.

The target readership for the advocacy briefs in the Decade Connection Series includes
leaders and influencers in Member States, the UN system (particularly UN country teams),
international organizations and civil society networks.
In our fast-changing, complex world, the Decade must remain relevant, agile, countryfocused and person-centred. We hope that the briefs in the Series will help stakeholders
to reflect on current and emerging global cross-cutting issues and their implications forageing. Readers are encouraged to find out more by exploring the Decade platform and
WHO Decade’s baseline report (2020).

WHO defines “healthy ageing” as “the processof developing and maintaining the functional
ability that enables well-being in older age”.
“Functional ability” consists of the capabilities thatenable all people to be and do what they have reason
to value. It refers to people’s ability to: meet their basic
needs; learn, grow and make decisions; be mobile; build
and maintain relationships; and contribute to society.
Functional ability is the intrinsic capacity of the individual
to interact with relevant environmental characteristics.

Please send any feedback on this advocacy brief to:hello@decadeofhealthyageing.org
For more information on the Decade, please visit:https://www.decadeofhealthyageing.org andhttps://www.who.int/initiatives/decade-of-healthy-ageing
2Agenda 2030
and the UN Decadeof Healthy Ageing
The 2030 Agenda for Sustainable Development (A/RES/70/1) (1), adopted by all Member
States at the United Nations (UN) General Assembly in 2015, is a shared blueprint for our future as
humans and the future of our home, planet Earth. It sets out a universal plan of action for achieving
sustainable development in a balanced manner. The central concept is leaving no one behind,ensuring that people of all ages in all segments of society can reach their potential and lead a life ofdignity in fulfilment of their human rights. The concept focuses on the most vulnerable (2).
Agenda 2030 is best known for the Sustainable Development Goals (SDGs), an
ambitious set of 17 goals and 169 targets defined during an unprecedented dialogue among
UN Member States, local authorities, civil society, the private sector and other stakeholders.
They recognize that ending poverty and other types of deprivation must go hand-in-handwith strategies to improve health and education, reduce inequalities and spur economic
growth, while tackling climate change, preserving oceans and forests and restoring biodiverse
ecosystems for all life on our planet to thrive and not just survive. They consist of an “indivisible
intertwined tapestry of thinking and action, relevant for every human being everywhere” (David
Nabarro, Under-Secretary-General, Special Advisor on 2030 Agenda) (3).
Underpinning the SDGs are the “5 Ps”, basic values laid out in the preamble toAgenda 2030. The five values are: people – a thriving society; prosperity – a prosperous
economy; the planet - healthy ecosystems and environments; peace – ethics and justice; andpartnership – collaboration and collective action (Fig. 1). As the core of humanity’s journey
towards genuine sustainability (4), these values must be applied to all global and national
commitments, including for Healthy Ageing and the UN Decade of Healthy Ageing (5). The
preamble also highlights “a spirit of strengthened global solidarity, focused in particular on theneeds of the poorest and most vulnerable and with the participation of all” (6, 7).
Based on the 5 P values, this advocacy brief highlights connections among the four
action areas of the UN Decade of Healthy Ageing and Agenda 2030. This approach isdriven by values rather than technical or sectoral considerations. It is particularly relevant in
the context of the COVID-19 pandemic, with emerging declarations and ambitions to “build
back fairer” (8). The 5 Ps apply to all the goals, directing attention to transformative intersectoral
approaches for local contexts. During the Decade, every sector and stakeholder group cancontribute simultaneously from their perspectives (9) while potentially influencing others, as theaction areas are interconnected.
Connections to be made between the Decade and the 5 P values of Agenda 2030
•
•
•

•
•

The Decade is centred on people in the second half of their lives. It proposes actions
that will improve both the lives of older people and the situation for future generations.
Many systemic inequities limit prosperity and intersecting discrimination, including
according to age.
Without a healthy planet, healthy ageing will be difficult to achieve for people in thesecond half of their lives and for the generations that follow. Climate change is alreadywidening existing wealth- and age-related divides (10).
Partnerships that go beyond the usual coalitions and strengthen global solidarity (11)are essential for attaining the SDGs.
Actions to foster healthy ageing will contribute to building more inclusive, just,peaceful societies.

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The 2002 Madrid International Plan of Action on Ageing (MIPAA) (12) is the main
guiding document for building societies for all ages. The political declaration is a commitment
by governments to take a rights-based, development-centred approach to population ageing,
focusing on three priorities: (1) older people and development; (2) advancing health and wellbeing into old age; and (3) ensuring enabling, supportive environments. The MIPAA is reviewed
and appraised regularly at national, regional and global levels, as mandated by the UN General
Assembly and the UN Economic and Social Council, with clear reference to the SDGs andrelated indicators. The links between the MIPAA and the UN Decade of Healthy Ageing will be
described in a future brief in this Connection series.
This advocacy brief was developed in partnership with the WHO secretariat and 20
members of the Inter-Agency Group on Ageing (13) in the spirit of the 2018 UN reform (14).
The brief complements the (forthcoming) Titchfield City Group Report on making older people
visible in the SDG indicators, which illustrates how national statistical offices around the world
report and use information. With the SDG Index and Dashboards reports (15), which describe
country performance in achieving Agenda 2030 and the SDGs, the brief will provide guidance
to UN agencies and country teams in developing, implementing and monitoring common
country assessments and UN sustainable development cooperation frameworks.
Spurred by the challenges emerging during the COVID-19 pandemic, the UN system (16) will
mobilize more worldwide action and solidarity for positive change by strengthening UN country
teams, agency country offices, regional mechanisms and the framework of the UN Decade of
Action (17) on the SDGs. This must include support for adapting and implementing guidance toaddress the needs, preferences and rights of the world’s diverse older people now and for agefriendly, inclusive systems that will serve older generations in the future.

Figure 1: The 5 Ps of Agenda 2030

PEOPLE
End poverty and hunger
in all forms and ensuredignity and equality

PLANET
Protect ourplanet’s natural
resources
and climate
for future
generations

Sustainable
Development

PARTNERSHIP
Implement theagenda througha solid global
partnership

PEACE
Foster peaceful,just and inclusive
lives

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PROSPERITY
Ensureprosperous andfulfilling lives inharmony withnatureAction area 1. Changing how we think, feel and act towards age
and ageing
What this means 1

Ageism refers to stereotypes (how we think), prejudice (how we feel) anddiscrimination (how we act) towards others or ourselves according to age.
Ageism affects people of all ages but has particularly deleterious effects onolder people (18).

PEOPLE
Thriving
society
Relevance:

A thriving society and the promise of the UN Decade of Healthy Ageing can be fully
realized only if ageism is recognized as a social determinant of health and addressed
accordingly (19). As many older people actively contribute to their societies andeconomies through paid work, unpaid care work and volunteering, improving theiraccess to education and lifelong learning, good health and nutrition, food security andgender equality are all crucial. Ageism can impede progress. For example, some older
people can fall into poverty because of ageism; ageism can negatively affect equal
access to drugs and services and clinical research on prospective therapies; and, in
the area of statistics, use of a single age group of 60 or ≥ 65 years disguises the wide
diversity of older people, and the concept of “dependence” 2 in old age can mislead andstigmatize.

Examples ofwhat can bedone:

Ageism should be combatted in all policies, institutions, data and programmes in
multiple sectors. The Global Report on Ageism (18) recommends implementation of
three strategies to address ageism: (1) policies and laws with relevant enforcement
measures, such as anti-age discrimination in labour markets and programmes toencourage the employment of older people, as stipulated in the MIPAA; ensuring thatageism is not reinforced in the ways that services are delivered, such as basing accessto services on chronological age; (2) educational activities to foster empathy anddispel misconceptions about age and ageing at all levels and in all types of education;and (3) interventions that bring older and younger people together. The intersections
between age and other social categories and the drivers of stereotypes, prejudice
and discrimination, particularly gender, should also be considered (17). For example,
older women may be vulnerable to food insecurity, malnutrition and lack of care in
humanitarian emergencies if younger people are prioritized.

PROSPERITY
Prosperous
economyRelevance:

Population ageing presents many opportunities for social and economic development
if the full potential of older people is harnessed. Ageism can negatively affect people’s
access to and options for employment, career advancement and appraisal. Older
peoples’ access to decent work (20), social protection and assistance, including old
age pensions, are all relevant to economic growth, prosperity and equality.

1

The introductory sections “What this means” for all four action areas are based on the Decade of Healthy Ageing (5).

2The old-age dependence ratio is the number of older people (aged ≥ 60 or ≥ 65) in relation to the number of working-age
adults (aged ≥ 15 or 25).

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Examples ofwhat can bedone:

The prosperity of older people and their families can be supported by: robust systems
to create employment opportunities for older people; elimination of age-related barriers
to decent employment and financial instruments (including flexible work contracts andretirement policies, 3 credit and loan schemes, insurance, e-commerce and e-banking(21)); and addressing individual and institutional ageism by creating age-inclusive work
environments by workforce mix and training and raising the awareness of employers
about ageism. Age-friendly technologies, including accessible digital and information andcommunication technology (ICT) (22), contribute to age-inclusive work environments
and reduce the intergenerational digital divide. Reduction of inequality should focus
on the intersection between ageism and sexism and other types of discrimination.
Although many older women contribute substantially to national economies, their limited
participation in the paid workforce has cumulative negative consequences, including
greater risks of poverty due to limited access to or low pensions (23).

PLANET
Healthy
ecosystems andenvironments
Relevance:

All people everywhere, without discrimination, including that based on age, needaccess to clean water and sanitation and to live in a sustainable biosphere (life onland, below water and in the oceans) characterized by responsible consumption andproduction. All older people continue to consume goods and services, and many are
involved in production well into later life. Many are also visible in climate action.

Examples of what
can be done:

Older people must be heard, seen and included in developing, implementing andmonitoring policies, programmes and research for the planet-related SDGs. Any
exclusion of people from involvement in such work due to age should be challenged
and countered (24).

PEACE
Ethics and justice
Relevance:

Progress in achieving all SDGs will require ending all forms of discrimination, includingthat based on age, as discrimination is incompatible with equity and human rights.
Pervasive stereotypes of older people as uniformly frail, burdensome and dependent
limit society’s ability to appreciate and release their potential human and social
resources. This undermines intergenerational solidarity and dialogue and threatens
inclusive, just societies, to the detriment of all

Examples of what
can be done:

In all settings, social exclusion and isolation of older people must be acknowledged
and reduced to eliminate negative stereotypes, prejudice and discrimination due to age
and reduce neglect, abuse and violence against older people, including during war,
conflict and humanitarian emergencies.

PARTNERSHIP
Collaboration andcollective action

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Relevance:

Ageism is widespread, including in institutions and governance mechanisms and insystems for service and benefit provision in all sectors, including the workplace.

Examples of what
can be done:

Partnerships among intersectoral stakeholders (government and nongovernment) at alllevels should be strengthened or initiated to build anti-ageist societies through concerted,
collaborative policies, programmes and practices. Partnerships with the media and theentertainment industry are also important to ensure a balanced view of ageing. The
Global Campaign to Combat Ageism (25) is an opportunity to leverage partnerships tocombat ageism, as are the MIPAA periodic reviews. New partnerships should be fostered
to make institutions and systems inclusive, to combat ageism and to empower older
people to achievements that previous generations could not have imagined.

Combined with legal entitlements to adequate old-age pensions, provided social insurance and tax-funded minimumsocial pensions are effective in securing income security for older people and their households, reducing the risk ofpoverty for older people and their families (SDG target 1.3.1)

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Action area 2. Developing communities in ways that foster theabilities of older people
What this means

Age-friendly cities and communities are physical, social and economic urban
and rural environments that enable older people with different capacities to: age
safely in a suitable place, be included and participate, have access to affordable,
accessible services, develop personally and professionally and contribute totheir communities while retaining their autonomy, dignity, health and well-being.

PEOPLE
Thriving
society
Relevance:Age-friendly settlements and living conditions are key to enabling people to live long,
healthy lives by maximizing their intrinsic capacity and functional ability throughout thelife-course and influencing personal choices that affect their health and well-being.
Poverty, characterized by income insecurity, educational deficits, malnutrition andgender inequality, is a major threat to older people’s health and well-being. It affects
their independence, opportunities to participate in social and economic life and the costand burden of health and social care to the family and limits the possibility of ageing
at home.

Examples ofwhat can bedone:

Age-friendly policies, systems, services, information, products and technologies
remove barriers for older people to continue to do what they value as they age andimprove the fit between their needs and lived environments. A national social protection
scheme that guarantees that every older person has a secured income, from social
insurance or a tax-funded minimum social pension, will prevent them from falling intopoverty, alleviate their financial dependence on family members (and thus the risk ofwider poverty) and ensure their financial autonomy and dignity (24). Life-long learning
opportunities and affordable, accessible in “smart” digital cities and rural and remotecommunities will help to ensure that the needs and abilities of older people and thosewith disabilities (26) are included and addressed. Healthy behaviour (not smoking or
drinking alcohol to excess, eating a healthy diet, being physically active) should bepromoted in order to postpone dependence and decreased intrinsic capacity.

PROSPERITY
Prosperous
economyRelevance:

Clean energy, decent work in a safe environment, adequate transport and infrastructure,less inequality and sustainable cities and communities promote economic growthand healthy ageing everywhere. These attributes shape older people’s mobility, theiropportunities to contribute to local social life and economic activities and their accessto services, adequate housing, support, ICT and safety. Older people in poor healthwork less, earn less and retire earlier than those in good health.

Examples ofwhat can be
done:

Flexible retirement policies and access to vocational training and re-training, including
in digital skills (27), will be necessary for older people to remain in the workforce ifthey wish. An enabling legal framework should ensure a smooth transition between
employment and retirement with an adequate pension at the pace desired by eacholder person, without material or structural barriers to their participation. Barriers
to healthy behaviour and choices (such as high crime rates or dangerous traffic)
should also be addressed. Affordable housing, accessible workplaces and safe,
accessible transport, roads and pavements will all be necessary, as will appropriate,
accessible assistive ICT (28) and digital innovations for healthy, independent ageing
and management of health conditions (29). The intersection of older people’s
lived experiences with disability, gender and ethnicity should be acknowledged
and addressed.

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PLANET
Healthy
ecosystems andenvironments
Relevance:

Health is strongly associated with access to clean water and sanitation, healthy oceans
and biodiverse habitats for livelihoods (30) and recreation, and sustainable production
and consumption. Because of decreased mobility, changes in physiology and limited
adaptive capacities, many older people are disproportionately affected by extreme
weather events (heat (31), cold, floods). Many are at greater risk of adverse health effects
from exposure to air pollution (causing or exacerbating respiratory conditions) (32).
Climate-related migration and displacements are likely to leave many older people
behind (24).

Examples of what
can be done:

Protecting and preserving the source of human health – nature (33) – will be key tohealthy ageing everywhere. Intersectoral and interdisciplinary approaches should
focus on the convergence of the health of humans, animals and ecosystems. Many
older people, particularly in indigenous communities, actively contribute to protecting
and preserving biodiverse ecosystems and have essential traditional knowledge (34).
Investment in clean water and sanitation services, green energy and more accessible,
safe green spaces are necessary to ensure more liveable cities with less air pollution
and fewer road traffic injuries. Advocates of healthy ageing of all ages can make more
explicit links with climate change, pollution, ecosystem degradation and environmental
change (35).

PEACE
Ethics and justice
Relevance:Age-friendly environments help to shape and sustain inclusive societies by providing
the contexts necessary for healthy ageing and well-being.

Examples of what
can be done:

Institutions in cities and communities should increase understanding of healthy ageing
among stakeholders. Legislation and policies for meaningful engagement of older
people in all aspects of city and community life should be encouraged. In all settings,
barriers to participation should be reduced, intergenerational solidarity strengthened,ageism combatted and neglect, abuse and violence against older people eliminated.

PARTNERSHIP
Collaboration andcollective action
Relevance:

Government sectors, businesses and civil society that address food, health, care,transport, housing, labour, energy, social protection and ICT all contribute to thecollaboration in cities and communities that is necessary for healthy ageing.

Examples of what
can be done:

Collective action by many stakeholders is necessary. These include older people andtheir organizations, mayors and other elected municipal leaders, indigenous leaders,
young people’s and women’s associations and community development groups andnetworks. Such collaboration can result in appropriate infrastructure, identification of
barriers and solutions for healthy ageing, including during crises. Existing partnerships
include the WHO Global Network for Age-friendly Cities and Communities (36), theGlobal Health Observatory’s dementia-friendly initiative (37), the Healthy Ageing Centresof the UN Population Fund in eastern Europe and Central Asia (38) and the Global
Partnership for Universal Social Protection (39).

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Action area 3: Delivering person-centred, integrated care andprimary health services responsive to older people
What this means

Primary health care 4 is the most effective, efficient approach for improving thephysical and mental capacity and well-being of individuals of all ages (40).
Person-centred primary health care, with community partners, should be
integrated in all settings at all levels, including for clinical management, andlinked to long-term and specialized care.

PEOPLE
Thriving society
Relevance:

Despite strong commitments by Member States to universal health coverage (UHC),
access to adequate, affordable health and social care is not yet a reality for half of theworld’s population. This particularly affects people with greater needs and vulnerability,
including older people in poor health. Opportunities for healthy ageing and access tothe necessary services, support and ICT (27) in homes and communities are strongly
influenced by poverty, hunger and food insecurity, co-morbidity, lack of access to social
protection (41), 5 little formal education or lifelong learning, gender inequality and otherintersectional drivers of inequality such as ethnicity.

Examples ofwhat can be
done:

Health and social systems and service delivery must be transformed for healthy ageing,
maintaining independence, avoiding hospitalization and improving the quality of life,
without creating a financial burden that can push older people and their households
into poverty. Transformation is necessary from a focus on diseases to provision of
integrated, affordable, person-centred care, with community support for complex andchronic health needs (including dementia (36, 42), stroke, chronic obstructive pulmonary
disease, visual impairment and reduced mobility and hearing). Primary health care forolder people should integrate prevention, health promotion and disease managementwith effective coordination of both multidisciplinary health and care (horizontal) and ofprimary, secondary and tertiary health and care (vertical). This will require investment inhealth and social systems, essential medicines, vaccines, diagnostics, digital assistive
technologies and ICT (27) (e-health and telemedicine). A competent health and care
workforce with appropriate skills to deliver essential services to older people in bothurban and rural settings should be supported by relevant training and decent working
conditions. To identify and address inequalities and promote health equity, data on
intrinsic capacity and functional ability should be collected, analysed and reported,disaggregated by age, sex and other intersectional variables.

PROSPERITY
Prosperous
economyRelevance:

Adequate pay and decent working conditions are important for older people who needor want jobs (including in health and social care) and contribute to broader economic
growth. With social protection, jobs will influence the share of household expenditure
or income spent on health and social care and/or family care-giving, especially by
women, without imposing a financial burden, which is the cornerstone of both UHC anduniversal social protection (39).

4Primary health care is non-discriminatory access to good-quality essential health services that include prevention,
promotion, curative, rehabilitative and palliative care, end-of-life care and safe, affordable, effective, good-quality essential
medicines, vaccines and health technologies, without imposing undue financial hardship. It is the cornerstone of universal
health coverage.

5

ILO’s Recommendation No. 202 on national floors of social protection (2012) provides a practical, effective framework
within which most countries may review and strengthen, specifically, their pension systems, but within the broader
objective of adequate social protection throughout the life-cycle.

9

Examples ofwhat can bedone:

For healthy ageing, policies and evidence-based actions are necessary to reducethe inequity faced by older people in all sectors. Data should be collected anddisaggregated, and existing data analysed by age, sex and other social characteristics(such as income, ethnicity, indigenous status, disability) to identify patterns of social
differences and to monitor inequality and social gradients for older people. ICT can play
an important role in data collection, monitoring and evaluation (43). Attention shouldbe paid to those at greatest risk of being left behind, with effective financial protection
for older people in lower socio-economic quintiles. Policies will be required to increase
investment in and innovations and incentives for clean energy in health and caresettings and in other occupational settings

PLANET
Healthy
ecosystems andenvironments
Relevance:

As outlined in action area 2, many older people are at greatest risk of the effects ofclimate change. This will increase the demand for responses in all health and social caresystems.

Examples of what
can be done:

All stakeholders involved in healthy ageing should highlight the importance of climatechange, its impacts on older people and the implications for their access to health andsocial care. Evidence-based actions for responsible consumption and production,
climate change and One Health should be emphasized. Health and care workers shouldhave access to capacity-building to understand the susceptibility of older people toclimate change and to prevent and manage the effects. Health-care institutions should
ensure adequate clean water and sanitation on their premises.

PEACE
Ethics and justice
Relevance:

Ensuring the dignity and non-discrimination of people of all ages in inclusive healthsettings is consistent with a human rights-based approach to health and will contributeto the strong, just institutions necessary to foster peace.

Examples of what
can be done:

Organizational arrangements and practices should involve all age and populationgroups and the civil society organizations that advocate for them. Age-friendly societies
and systems should be created, with fair, inclusive, participatory, intergenerational
decision-making.

PARTNERSHIP
Collaboration andcollective action
Relevance:

Partnerships to deliver person-centred, integrated primary health care that is
responsive to older people as a component of UHC can build a healthier world (44).

Examples of what
can be done:Countries could use existing and new partnerships to advance healthy ageing. One
example is the “Global Action Plan for Healthy Lives and Well-being for All” (45),a partnership of 13 multilateral health, development and humanitarian agencies that
supports countries in achieving the health-related SDGs. Partnerships of diverse
groups of older people, their communities and non-health sectors will be key forstronger person-centred, integrated care and primary health services responsive toolder people.

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Action area 4: Providing older people with access to long-termcare when they need it
What this means

Some people reach a time in their lives when they need care and support to live
independently. When people experience significantly decreased physical andmental capacity, access to good-quality long-term care, including palliative care,is essential to maintain their functional ability, consistent with their basic humanrights, freedom and human dignity. Long-term care must be part of health andsocial care systems and respond accordingly.

PEOPLE
Thriving society
Relevance:

Healthy ageing is fundamental to progressive achievement of UHC and includes
long-term care. Many older people are at increased risk of severe illness and deathfrom underlying conditions. Even before COVID-19, social and health services poorly
integrated long-term care systems, which were fragmented, under-resourced andneglected. Many older people have unequal access to services and support in theirhomes and communities, often because of their gender, ethnicity, level of education or
disability or economic status. In many countries, even when such services are available,
they are not financially accessible to many older people and their families.

Examples ofwhat can be
done:

Health and social care services must be better integrated to ensure a continuum of
long-term care. A broad range of services (including assistive care, day care and respitecare) should be provided within the continuum of promotion, prevention, treatment,
rehabilitation and palliation. Long-term care should include affordable access to theInternet, assistive digital technologies and inclusive environments to improve thefunctional ability and well-being of those who require care. Long-term care systems
and solutions should support caregivers, carers and care workers, ensuring genderequality and equity. Models of home and community care should be promoted, as
long-term care does not have to be institutionalized. Securing legal entitlement andeffective access to adequate long-term care without hardship is crucial and should becoordinated with work to secure adequate pensions (46).

PROSPERITY
Prosperous
economyRelevance:

Current approaches to long-term care rely heavily on the provision of informal care,predominantly by families and notably by women (47), although their contributions tosociety and the economy are not recognized in the same way as paid work. Informal
carers often lack the necessary financial support and social protection, making
them vulnerable to poverty, stress and long working hours without respite, whichjeopardize their own access to an adequate pension in old age, affect their physicaland mental health and adversely affect the quality of the long-term care they give toolder people. This inequitable care model is unsustainable, given the rapidly ageing
demography worldwide.

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Examples ofwhat can be
done:

A comprehensive approach to long-term care systems should take into consideration
the different conditions and vulnerability of older people and integrate approaches foraddressing complex multi-morbidity. Financing for long-term care will be crucial andmight include adding long-term care to social insurance. Decent working conditions
should be ensured in all services, with the necessary resources and recognizing
and adequately paying for the contributions of informal care workers and unpaid
caregivers. The long-term care workforce should be healthy, feel valued, receive thenecessary training and support (including for addressing ageism and elder abuse incare provision), opportunities for respite, information and flexible working arrangements.
Cities and communities should be designed to include digital accessibility andstandards to ensure that their long-term care services and facilities know about andadhere to health-promoting standards and governance of accommodation (48). Dataon long-term care facilities and on those who receive long-term care at home should
be better disaggregated, with information on their legal entitlements. Older women,
indigenous older people, older people with disabilities and older refugees and migrants
should be included in work to reduce inequalities in long-term care provision. As we live
increasingly in digital environments, requirements for access to ICT are important toensure the inclusion of communities.

PLANET
Healthy
ecosystems andenvironments
Relevance:

Older people in long-term care may have limited mobility and changed physiology,
cognition and psychology, making them vulnerable and less adaptable to climate
extremes and other environmental stresses, such as air pollution.

Examples of what
can be done:Age- and environment-friendly environments for long-term care and services will benecessary, including digital access and adequate clean water and sanitation. Resources
will be necessary for various systems.

PEACE
Ethics and justice
Relevance:

Access to good-quality long-term care is not only essential to maintain functional
ability but also enables older people to enjoy their basic human rights and live with
dignity, which are prerequisites for just, peaceful societies, including communities
and institutions.

Examples of what
can be done:

Organizational arrangements and practices should ensure inclusive processes, withparticipatory, intergenerational, interdisciplinary decision-making.

PARTNERSHIP
Collaboration andcollective action
Relevance:

Delivering long-term care that is responsive to older people requires partnerships
among health and social sectors and others. As long-term care is a fundamental service
for the health and well-being of older people, it should be provided as a part of UHC bymultiple stakeholders (44).

Examples of what
can be done:

Through opportunities such as the SDG3 Global Action Plan (see action area 3),
countries can ensure advocacy, investment, capacity-building and actions for longterm care with more human and financial resources. Collaboration and collective
action among leaders and policy-makers for older people, their caregivers and families,
nongovernmental organizations, volunteers, community networks and the private
sector should be encouraged and supported in the design, evaluation and monitoringof long-term care policies, programmes and research.

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These four action areas of the Decade will be implemented through four “enablers”.

1
Listen to diverse
voices and ensure
meaningful
engagement of older
people and theirfamily members,
caregivers andcommunities:
The voices,
engagement andempowerment of older
people in all 5 P valuesof Agenda 2030
should be supported.
This “bottom-up”
approach is alsoemphasized in regularnational and regional
reviews of the MIPAA.

2

3

Nurture leadershipand build capacity
at all levels totake appropriate,
integrated action
among sectors:

Connect diverse
stakeholders aroundthe world so thatthey can share andlearn from eachother’s experience:

The Decade’s platform(49) will contribute toaddressing the gaps
through, for example,
raising awareness,
providing guidelines
to policy-makers andother stakeholders,developing capacitybuilding resources andpromoting learning
to encourage peer
support networks andstrengthen partnershipamong all sectors toaddress all 5 P values.

Strengthened
collaboration, including
in “knowledge
development”
workshops and events
for sharing challenges,
experiences andgood practices
between stakeholders
in different sectors,
settings and levels will
support all 5 P valuesof Agenda 2030. Close
collaboration with other
UN entities, especiallythose involved infollow-up and reviewof the 2030 Agenda
and the MIPAA at
national, regional andglobal levels, will avoid
duplication of work andensure synergy.

4Strengthendata, researchand innovationto accelerate
implementation:Older people should
be made more visible
by disaggregationof all relevant dataaccording to age andother intersectional
categories in all 5
P values of Agenda
2030.

The global, multisectoral and multi-stakeholder framework of this advocacy brief is based on
the 5 P values of Agenda 2030, through which the UN Decade of Healthy Ageing can advancethe advocacy, actions, investment and capacity necessary to foster healthy ageing.
The UN Decade of Healthy Ageing gives the world a timely opportunity to develop interlinked
trajectories to ensure gains in the 5 Ps for transformative, inclusive, sustainable development.
The world is facing increasingly complex, intertwined challenges, exacerbated by the
COVID-19 pandemic.
More collective, connected action and leadership are required from all quarters —citizens and governments at every level, the public and private sectors, nongovernmentalorganizations, academia and philanthropy. Through its prioritized action areas and enablers,
the UN Decade of Healthy Ageing, in the context of the 2030 Agenda and the MIPAA, cancontribute to the sustainable development of current and future generations in the countdown
to 2030.

13

References
1

A/RES/70/1 – Transforming our world: the 2030 Agenda for Sustainable Development. New
York City (NY): United Nations; 2015 (https://www.un.org/en/development/desa/population/
migration/generalassembly/docs/globalcompact/A _RES_70_1_E.pdf).

2

Ageing, older persons and the 2030 Agenda for Sustainable Development. New York City (NY):
United Nations; 2017 (https://www.un.org/development/desa/ageing/wp-content/uploads/
sites/24/2017/07/UNDP_ AARP_HelpAge_International_ AgeingOlderpersons-and-2030Agenda-2.pdf).

3

FAQs. What are the Sustainable Development Goals (SDGs)? New Delhi: United Nations
Economic and Social Commission for Asia and the Pacific; 2020 (http://sdghelpdesk.unescap.
org/faqs).

4

The 2030 Agenda for Sustainable Development. Bonn: United Nations System Staff College;
undated (https://www.unssc.org/sites/unssc.org/files/2030_agenda_for_sustainable_
development_kcsd_primer_en.pdf).

5

The Decade of Healthy Ageing: a new UN-wide initiative. 14 December 2020. Geneva: World
Health Organization; 2020 (https://www.who.int/news/item/14-12-2020-decade-of-healthyageing-a-new-un-wide-initiative).

6

Stakeholder engagement. New York City (NY): United Nations; undated (https://sdgs.un.org/
stakeholders).

7

UNDP, UN Habitat, Global Taskforce of Local and Regional Governments, United Cities
and Local Government and Diputació Barcelona. Learning Module 1: Localizing the SDGs/
Introduction. The trainer’s guide. New York City (NY): United Nations Development Programme;
2017 (https://www.local2030.org/library/348/Trainers-guide-for-Localizing-the-SDGsLearning-Module-1.pdf).

8

Marmot M, Allen J, Goldblatt P, Herd E, Morrison J. Build back fairer. The COVID-19 Marmot
review. The pandemic, socioeconomic health inequalities in England. London: The UCL
Institute of Health Equity; 2020 (https://www.instituteofhealthequity.org/resources-reports/build-back-fairer-the-covid-19-marmot-review).

9

Brown K, Rasmussen K. The Sustainable Development Goals in 2019: People, planet, prosperity
in focus. Washington DC: United Nations Foundation; 2019 (https://unfoundation.org/blog/
post/the-sustainable-development-goals-in-2019-people-planet-prosperity-in-focus/).

10

Agenda 2030. The Sustainable Development Goals and global ageing. London: HelpAge
International; 2017 (https://www.helpage.org/silo/files/agenda-2030-the-sustainabledevelopment-goals-and-global-ageing.pdf).

11

Stibbe D, Prescott D. The SDG partnership guidebook: a practical guide to building highimpact multi-stakeholder partnerships for the Sustainable Development Goals. Pre-releaseworking draft 0.95. Oxford: The Partnering Initiative; New York City (NY): United Nations;2020 (https://sustainabledevelopment.un.org/content/documents/26627SDG_Partnership_
Guidebook_0.95_web.pdf).

12

Second World Assembly on Ageing. Political plan of action and Madrid International Plan of
Action on Ageing. New York City (NY): United Nations; 2002 (https://www.un.org/development/
desa/ageing/madrid-plan-of-action-and-its-implementation.html).

13

UN Inter-Agency Group on Ageing (IAGA). Strengthening the inclusion of older persons in
the work of the United Nations.New York City (NY): United Nations; 2021 (https://www.un.org/
development/desa/ageing/iaga.html).

14

United to reform. New York City (NY): United Nations; 2021 (https://reform.un.org/).

15

Sachs J, Kroll C, Lafortune G, Fuller G, Woelm F. Sustainable development report 2021. The
decade of action for the Sustainable Development Goals. Cambridge: Cambridge University
press; 2021 (https://www.sdgindex.org/).

16

Shared responsibility, global solidarity: responding to the socio-economic impacts of
COVID-19. New York City (NY): United Nations Sustainable Development Group; 2020 (https://www.un.org/sites/un2.un.org/files/sg_report_socio-economic_impact_of_covid19.pdf).

17

Decade of action. New York City (NY): United Nations; 2020 (https://unsdg.un.org/2030agenda/decade-action).

14

18

Global report on ageism. Geneva: World Health Organization; 2021 (https://www.who.int/
publications/i/item/global-report-on-ageism).

19

Mikton C, de la Fuente Núñez V, Officer A, Krug E. Ageism: a social determinant of health thathas come of age. Lancet. 2021;397(10282):1333–4 (https://www.thelancet.com/journals/
lancet/article/PIIS0140-6736(21)00524-9/fulltext).

20

Decent work. Geneva: International Labour Organization; 2021 (https://www.ilo.org/global/
topics/decent-work/lang--en/index.htm).

21

Resolution concerning employment and social protection in the new demographic context.
Geneva: International Labour Organization; 2013 (https://www.ilo.org/ilc/ILCSessions/previous-sessions/102/texts-adopted/WCMS_223784/lang--en/index.htm).

22

Ageing in a digital world – from vulnerable to valuable. Geneva: International
Telecommunication Union; 2021 (https://www.itu.int/en/ITU-D/Digital-Inclusion/Pages/
ageing-in-a-digital-world/default.aspx).

23

Social protection for older persons: Policy trends and statistics 2017–19 (Social Protection
Policy papers, 17). Geneva: International Labour Organization; 2018 (https://www.socialprotection.org/gimi/RessourcePDF.action?id=55212).

24

Editorial. No healthy longevity without a healthy planet. Lancet Healthy Longevity. 2021;2:e1.

25Campaigning to tackle ageism: current practices and suggestions for moving forward. Geneva:
World Health organization; 2020 (https://www.who.int/publications/m/item/campaigning-totackle-ageism).

26“Towards building inclusive digital communities”: ITU toolkit and self-assessment for ICT
accessibility implementation. Geneva: International Telecommunication Union; 2021 (https://www.itu.int/pub/D-PHCB-TOOLKIT.01-2021).

27

Digital skills insights. Geneva: International Telecommunication Union; 2020 (https://academy.
itu.int/index.php/main-activities/research-publications/digital-skills-insights/digital-skillsinsights-2020).

28

ICT/ digital accessibility. Geneva: International Telecommunication Union; 2021 (https://www.itu.
int/en/ITU-D/Digital-Inclusion/Persons-with-Disabilities/Pages/Persons-with-Disabilities.aspx).

29

Digital health strategies. Geneva: International Telecommunication Union; 2021 (https://www.
itu.int/en/ITU-D/ICT-Applications/Pages/e-health-strategies.aspx).

30

Connecting global priorities: biodiversity and human health. Geneva: World HealthOrganization; 2015 (https://www.who.int/publications/i/item/connecting-global-prioritiesbiodiversity-and-human-health).

31

Climate change and health. Geneva: World Health Organization; 2018 (https://www.who.int/
news-room/fact-sheets/detail/climate-change-heat-and-health).

32

HelpAge International, Climate change in an ageing world, 2015. (https://www.helpage.org/
newsroom/latest-news/cop21-helpage-releases-position-paper-on-adapting-to-climatechange-in-an-ageing-world/).

33

WHO manifesto for a healthy recovery from COVID-19. Prescriptions for a healthy and green
recovery from COVID-19. Geneva: World Health Organization; 2020 (https://www.who.int/
news-room/feature-stories/detail/who-manifesto-for-a-healthy-recovery-from-covid-19).

34

United Nations High Commissioner for Human Rights, 2021. Analytical study on the promotion
and protection of the rights of older persons in the context of climate change. Human Rights
Council Forty-seventh session 21 June–9 July 2021 Agenda items 2 and 3 Annual report of
the United Nations High Commissioner for Human Rights and reports of the Office of the HighCommissioner and the Secretary-General. https://undocs.org/A/HRC/47/46

35

Mavrodaris A, Mattocks C, Bryne C. Healthy ageing for a healthy planet: do sustainable
solutions exist? Lancet Healthy Longevity. 2021;2(1):e10–1 (https://www.thelancet.com/
journals/lanhl/article/PIIS2666-7568(20)30067-2/fulltext).

36

WHO global network for age-friendly cities and communities. Geneva: World HealthOrganization; 2021 (https://www.who.int/ageing/projects/age_friendly_cities_network/en/).

37

Dementia-friendly initiatives. Global dementia observatory. Geneva: World Health Organization;
2021 (https://www.who.int/data/gho/data/themes/topics/topic-details/GHO/dementiafriendly-initiatives).

38

Healthy Ageing Centres are important for older people in Bosnia and Herzegovina, United
Nations Population Fund; 1 October 2021. New York City (NY). (https://ba.unfpa.org/en/news/
healthy-ageing-centres-are-important-older-people-bosnia-and-herzegovina).

15

39

Global partnership for universal social protection to achieve the Sustainable Development
Goals. Geneva: USP2030; 2021 (https://www.usp2030.org/gimi/USP2030.action).

40

Declaration of Astana. Global conference on primary health care. Astana, Kazakhstan, 25–26
October 2018. Geneva: World Health Organization; United Nations Children’s Fund; 2018(https://www.who.int/docs/default-source/primary-health/declaration/gcphc-declaration.pdf).

41

R202 – Social Protection Recommendation 2012. Geneva: International Labour Organization;2012 (https://www.ilo.org/dyn/normlex/en/f?p=NORMLEXPUB:12100:0::NO::P12100_
INSTRUMENT_ID:3065524).

42

Global action plan on the public health response to dementia. Geneva: World HealthOrganization; 2017 (https://www.who.int/mental_health/neurology/dementia/action_
plan_2017_2025/en/).

43

Digital identity. Geneva: International Telecommunication Union; 2021 (https://www.itu.int/en/
ITU-D/ICT-Applications/Pages/digital-identity.aspx).

44

Moving together to build a healthier world. UN high-level meeting on universal health coverage,
23 September 2019 New York City (NY): United Nations; 2019 (https://www.un.org/pga/73/
event/universal-health-coverage/).

45

Stronger collaboration, better health. Global action plan for healthy lives and well-being for all.
Geneva: World Health Organization; 2021 (https://www.who.int/initiatives/sdg3-global-actionplan).

46

Scheil-Adlung X. Long-term care protection for older persons. A review of coverage deficits in
46 countries (ESS – Working Paper No. 50). Geneva: International Labour Organization; 2015(https://www.social-protection.org/gimi/RessourcePDF.action?id=53175).

47

World report on ageing and health. Geneva: World Health Organization; 2015 (https://www.
who.int/ageing/events/world-report-2015-launch/en/).

48

Monitoring and evaluation framework. COVID-19 strategic preparedness and response.
Geneva: World Health Organization; 2020 (https://www.who.int/publications/i/item/
monitoring-and-evaluation-framework).

49

The platform. Decade of healthy ageing. New York City (NY): United Nations; 2021 (https://www.
decadeofhealthyageing.org/).

Acknowledgements
This brief was produced by the Demographic
Change and Healthy Ageing Unit and the Ageing and
Health Unit at the World Health Organization (WHO)headquarters, and focal points for ageing in the Pan
American Health Organization and the WHO Regional
Office for Europe. Contributions were also received
from members of the United Nations Inter-Agency
Group on Ageing (IAGA), specifically the International
Labour Organization (ILO), the International
Telecommunication Union (ITU), the United Nations
Department of Economic and Social Affairs (UNDESA),the United Nations Economic and Social Commission
for Asia and the Pacific (ESCAP), and the United
Nations Population Fund (UNFPA).

16