Population Ageingin Africa

Towards

Current Approach to Elderly Care, and Lessons to be Shared Across Continents

A VERBATIM REPORT OF OFFICIAL SIDE EVENT OF TICAD7TOWARDS POPULATION AGEING IN AFRICA: CURRENT APPROACH TO ELDERLY CARE,
AND LESSONS TO BE SHARED ACROSS CONTINENTS
29 AUG 2019, 13:00–14:30 PACIFICO YOKOHAMA EXHIBITION HALL B08

A VERBATIM REPORT OF OFFICIAL SIDE EVENT OF TICAD7

Towards Population Ageing in Africa

Current Approach to Elderly Care, and Lessons to be Shared Across Continents

Vers la vieillissement de la population en Afriquel’approche acutel des soins pour les personnes agées et les leçons à partager
entre les continents
29 AUG 2019, 13:00–14:30 PACIFICO YOKOHAMA EXHIBITION HALL B08

CO-ORGANIZED BY
The KAKENHI Project Team for “Future Population Ageing in East Africa: A Cross-Disciplinary Study of Social Welfare and Elderly Care” (Funded by Japan Society for the
Promotion of Science)

Towards

Population Ageingin Africa
Current Approach to Elderly Care, and Lessons
to be Shared Across Continents

Economic Research Institute for ASEAN and East Asia (ERIA)
Japan Center for International Exchange (JCIE)
Nagasaki University
SUPPORTED BY
National Institute of Population and Social Security Research (IPSS)ア フリカ の 人 口 高 齢 化 を 見 据 え て
高 齢 者 ケ ア の「 今 」と 、大 陸 を 越 え て 共 有 す べ き ケ ア の あり 方共催
「 東 ア フリカ に お け る 未 来 の 人 口 高 齢 化 を 見 据 え た 福 祉 と ケ ア 空 間 の 学 際 的 探 究 」
科 学 研 究 費 助 成 事 業 プ ロジェクトチ ー ム
東 ア ジ ア・A S E A N 経 済 研 究 セ ン タ ー ( E R I A )公 益 財 団 法 人 日 本 国 際 交 流 センタ ー ( J C I E )長崎大学
後援
国 立 社 会 保 障・人 口 問 題 研 究 所

March 2020

OVERVIEW

概要

The world is ageing and Africa is no exception. Although the proportion of older persons is still low compared to

アフリカでは、総人口に占める高齢者の割合はいまだ低いものの、高齢者数は20年間で2倍に、30年間で3 倍に膨れ上がると予想されてother continents, the number of older persons in Africa is expected to double within 20 years and triple within 30
years. Population ageing is a blessing since it means that people are living longer, but it also presents a variety of

new challenges. The double burden of diseases—the combination of persisting infectious diseases and increas- ing

noncommunicable diseases—will inevitably raise the demand for healthcare and long- term care. Disparities inaccess to or quality of healthcare among older persons and between generations can be a cause of social instability
and a barrier to continued development. This side event offers an opportunity for in-depth dialogue among
policymakers, representatives of civil society, and academicians on the present situation and challenges of ageingin Afri- ca, focusing on health and care, social protection, and welfare, and introducing comparative perspectives

います。人口高齢化は、人類が長寿を達成した成果として祝福されるべきであ る一方、それにより生じた新たな課題に人類は直面しています。アフリカの多くの国々は、未だ感染症を克服しないまま非感染性疾患に対峙しており、その延長線上で人口高齢化に付随するヘルスケ
ア・介護への対 応が課題として顕在化することは明白です。更にはヘルスケアへのアクセスや質に関する格差が社会への不 安を招き、持続的な発展の妨げとなります。本サイドイベントでは、アフリカとアジアから専門家を招き、アフリ カにおける人口高齢化の現状と課題について、特に保健、社会保障、介護・福祉に焦点を当て、日本や他の アジア諸国における高齢化対策の経験や見通しを共有しながら、アフリカの人口高齢化の課題と展望を議 論します。

from Asia and Africa.

プログラム

PROGRAMOPENING REMARKS
Akio Okawara, President and CEO, Japan Center for International Exchange (JCIE)SPECIAL REMARKS
Natalia Kanem, Executive Director, United Nations Population Fund (UNFPA)

開会挨拶
公益財団法人 日本国際交流センター理事長

大河原 昭夫特別挨拶
国連人口基金事務局長

ナタリア・カネム
KEYNOTE SPEECH
Awa Marie Coll-Seck, President, CN-ITIE; Former Minister of Health for the Republic of Senegal
Prafulla Mishra, Regional Director-Africa, HelpAge International
Maliki, Director for Population Planning and Social Protection, Ministry of National Development
Planning/National Development Planning Agency, Indonesia
Ken Masuda, Associate Professor, Nagasaki University School of Tropical Medicine and Global
Health

基調講演
セネガルCN-ITIE理事長、元セネガル保健大臣

アワ・マリ・コルセック
プラフラ・ミシュラマリキ
増田 研

ヘルプエイジ・インターナショナルアフリカ地域ディレクター(ケニア)

インドネシア国家開発企画庁 人口計画・社会保障局ディレクター
長崎大学熱帯医学・グローバルヘルス研究科准教授

PANEL DISCUSSION
Reiko Hayashi, Director, Department of International Research and Cooperation, National
Institute of Population and Social Security Research (MODERATOR)
Keynote speakers

パネルディスカッション(モデレーター)

林 玲子

国立社会保障・人口問題研究所国際関係部長

基調講演スピーカー

CLOSING REMARKS
Osuke Komazawa, Special Advisor to the President for Healthcare and Long-Term Care Policy,
Economic Research Institute for ASEAN and East Asia (ERIA)

閉会挨拶
駒澤 大佐

東アジア・ASEAN経済研究センター総長参与

CONTENTS-01APERÇUSLe monde vieillit et l’Afrique ne fait pas exception. Bien que le nombre relatif de per- sonnes âgées en Afrique soit

encore faible par rapport aux autres continents, ce nombre devrait tripler au cours des 30 prochaines années. Le

vieillissement de la population est un résultat positif pour les systèmes de santé, mais il présente également unevariété de nouveaux défis. Les systèmes de santé et de soins de longue durée vont être soumis à une pression
croissante alors qu’ils s’attaquent à une augmentation des maladies non transmissibles tout en luttant contre02

des maladies infectieuses persistantes. En outre, les disparités dans l’accès aux soins de longue durée ou laOpening Remarks by Akio Okawara

du développement. Cet événement se tiendra en marge de la 7ème Conférence interna- tionale de Tokyo sur le04

qualité de ceux-ci repré- sentent une nouvelle cause potentielle d’instabilité sociale et un obstacle à la poursuitedéveloppement de l’Afrique (TICAD7) dans le but de réunir les décideurs, les représentants de la société civile et lesSpecial Remarks by Natalia Kanem

les soins de longue durée, la protection sociale et le bien-être, ainsi que sur le potentiel de partage d’informations

07

chercheurs dans un dialogue sur les défis du vieillissement en Afrique. La discussion portera sur les soins de santé,et de leçons entre l’Asie et l’Afrique.

Population Ageing and Health in Africa
by Awa Marie Coll-Seck (en Français)ORDRE DU JOUR
MOT D’OUVERTURE
Akio Okawara, président et directeur général du Japan Center for International Exchange
REMARQUES SPÉCIALES
Natalia Kanem, directrice exécutive, Fonds des Nations Unies pour la Population (UNFPA)DISCOURS PRINCIPAUX
Awa Marie Coll-Seck, présidente de CN-ITIE, ancienne Ministre de la Santé de la République duSénégalPrafulla Mishra, Directeur régional pour l’Afrique, HelpAge International
Maliki, Directeur de la planification de la population et de la sécurité sociale, Ministère duDéveloppement National et de la Planification, Indonésie
Ken Masuda, professeur agrégé, École de médecine tropicale et de santé mondiale de l’Universitéde Nagasaki

12
Population Ageing and Health in Africa
by Awa Marie Coll-Seck (in English)

17
Experience of the Old in a Continent of Young…and Ageingby Prafulla Mishra

22
National Strategy Towards Independent, Prosperous, and Dignified Ageing Population
From Asia Experiences to African Perspectiveby Maliki

27
Population Aging in Africa: Anthropological perspectiveby Ken Masuda

DISCUSSION
MODÉRATRICE: Reiko Hayashi, directrice, Département de la recherche et de la coopérationinternationale, Institut National de Recherche sur la Population et la Sécurité Sociale(IPSS)
Orateurs des discours principaux
REMARQUES FINALES
Osuke Komazawa, conseiller spécial du président pour la politique en matière de soins de santéet de soins de longue durée, Economic Research Institute for ASEAN and East Asia

34
Discussion
Modrator: Reiko Hayashi

34
Closing Remarks by Osuke Komazawa
Towards Population Ageing in Africa

-02

-03

Opening
Remarks
by Akio OkawaraYour

excellencies,

guests,global health issues playing a catalytic roleis the only forum dealing with the topic ofladies and gentlemen, good afternoon. On

to facilitate international coordination. And

population ageing in Africa. So I believe thisbehalf of the co-organizers, it is my greatin this context, the population ageing issue

is a significant event, introducing us to thepleasure to welcome you all to the TICAD7

has been one of JCIE’s important projectchallenges that Africa will face with respect

officialside

scopes in recent years. In 2017, we launchedto ageing in the very near future. As the sub-Ageingintoa program on Healthy and Active Ageing intitle of this event suggests, the purpose of theElderly Care, and Lessons to be Shared

Asia in cooperation with ERIA, and in closesession is to bring together key experts fromAcross Continents”. Today’s event is jointly

consultation with the Japanese government’s

Asia and Africa to discuss healthcare, socialorganized by the KAKENHI Project Team for

Asia

Initiative,

protection and welfare issues, exploring the“Future Population Ageing in East Africa”,

commonly known as AHWIN. As we all know,

potential for sharing experiences and lessons

the Economic Research Institute for ASEAN

Japan is the most aged country in the world

across continents. With the contribution

and East Asia Area, Nagasaki University,and there are many lessons that could befrom speakers from various sectors including

anddrawn from Japan’s experience in tacklingpolicymakers, civil society representatives,

Exchange JCIE, with tremendous support

aged-related

AHWIN,

and academicians, I am sure that today’sfrom the National Institute of Population

we aim to promote regional cooperation

dialogue will provide new insights andand Social Security Research. At this point,that fosters sustainable and self-reliant

raise awareness that population ageing is

it is my honor to welcome Her Excellency

healthcare systems, and work towards thea challenge that Africa, just like Asia will

Dr. Awa Marie Coll-Seck, former Ministergoal to create vibrant and healthy societies

be facing in the coming years. In closing, I

of Health for the Republic of Senegal, andwhere people can enjoy long and productive

sincerely hope that today’s event will bear

the

event

AfricaJapan

distinguished“Towards-Current

Centerfor

Population

ApproachInternational

HealthandWellbeing

challenges.

Under

Akio Okawara
President and CEO, Japan Center for International Exchange (JCIE)
After graduating from Keio University with a BA in law,
Akio Okawara joined Sumitomo Corporation in 1973.
During the span of his 40-year career with the compa- ny,
he served in the automotive, overseas transport, andother departments. He was seconded in the 1980s to Los
Angeles to serve as assistant to the president of Mazda
Motors America, and in 1991–1997 he was posted as
director of business development in Washington DC. Backin Tokyo, he headed Sumitomo’s Information Analysis
and Research Department. In 2004, he was posted to theSumitomo Shoji Research Institute, and he served as theexecutive director of the institute from 2006 to 2013. In
April 2014, Okawara became President and CEO of JCIE.
He currently serves as a panel member of the US-Japan
Conference on Cultural and Educational Interchange(CULCON) and is a member of the Foundation Council of
the Japanese-German Center Berlin. In the global healthfield, Mr. Okawara serves as director of the Global Healthand Human Security Program Executive Committee anddirector of the Friends of the Global Fund, Japan (FGFJ).
大河原 昭夫 (公財)日本国際交流センター理事長
1973年住友商事株式会社入社、海外運輸部、自動車部等を経て1991年よりワシントン 事務所次席、1997年より情報調査部にて部長代理、部長を歴

Her Excellency Dr. Natalia Kanem, Executive

lives.

fruitful discussion, and provide important

Director of the United Nations Population

Today at TICAD 7, in collaboration with

steps

and

所取締役所長を務めた。2014年4月に 日本国際交流センター(JCIE)理事

Fund, who both of them will be speaking

Dr. Masuda’s KAKENHI project team, we

cooperation between Africa and Asia. Thank

ター評議員を兼務する他、
日英21世紀委員会日本側ディレクター、
日 独フォ

later.

are extending our scope to Africa. Thereyou very much.

ルスと人 間の安全保障プログラム運営委員会幹事、
グローバルファンド 日

JCIE, as a non-profit organization, has been

are over 150 official side events this week,

undertaking programs to address various

during TICAD 7, but as far as I know thistowards

information

sharing

任。2004年より(株)住友 商事総合研究所に勤務、2006~13年まで同研究長に就任。現在、
日米文化教育交流会議(カルコン)委 員、ベルリン日独センーラム委員、
日韓フォーラム幹事委員、国際保健の分野では、
グローバルヘ
本委員会ディレクター等 を務める。慶應義塾大学法学部卒。

Towards Population Ageing in Africa

-04

-05

also says is that part of our mandate is
to make sure that every young person’sSpecialRemarks

potential is fulfilled. That’s part of being
able to contribute to your family, to yourcommunity, to your nation so that by thetime the life cycle brings you to older age
you will have had an investment in you sothat you are prepared for that stage of life.

by Natalia Kanem

Just to close, I would like to say that inthis year UNFPA is celebrating our 50th
anniversary,

so

we

are

on

the

ageingspectrum, and indeed we are celebrating
25

years

since

the

Cairo

International

Conference on Population and Development,
Mr. Akio Okawara, President and CEO of theabout the current youth boom in developing

Japan Center for International Exchange,

nations which will very quickly progress

Ms. Reiko Hayashi, the National Institute ofthrough the cycle of life and indeed in Africa.

Population and Social Security Research, myWe estimate that by the year 2050 arounddear sister Minister Awa Marie Coll-Seck,

80% of people who are aged 60 or older will

Excellencies, Distinguished speakers, Guests

be living in what are now low-or middle-

and Partners, good afternoon. At the outset,

income countries. So the face of the world is

I would like to express our gratitude fromchanging. And ageing is not only driven by

UNFPA to the government of Japan for yourfalling fertility rates, what we have, and thisleadership in bringing us together under theis great news is medical advances, health

TICAD umbrella, and also for highlighting theand nutrition improvements that are leading

very important issue of population ageing.

to longer lifespan, and the outcome of these

There are some brilliant initiatives taking

great achievements has to be part and parcel

place around the world that focus on healthyof a discussion of social and economic

dignified happy ageing, and I would say thatdevelopment so that as we age, the quality

the Asia Health and Wellbeing Initiativeof life also is maintained around the globe.

(AHWIN) is one such brilliant platform.

More and more governments are looking for

It is facilitating regional cooperation inadvice and support from UNFPA on policies

population ageing and I am really happy toand on programmes to address population

learn that an African Health and Well Being

ageing and low fertility. And we are working

Initiative is being spearheaded using somewith partners and demonstrating leadershipof that same blueprint.

by

Population ageing is actually no longer

intelligence and policy advice. Next year,

just a phenomenon in developed countries.

census 2020 a very important year for this.

Planning ahead means that we have to think

Looking across the life cycle what UNFPA

increasing

supportfordemographic

and it was there that all the member states,
179 of them called for action. Action that isvital for a country’s prospect, for prosperity
andtransforming

the

way

we

look

at

population from just looking at numbers andstatistics to seeing the faces of the people
that are represented. And as we convene in
Nairobi on the 12 to the 14th November tocelebrate 25 years since Cairo, we are asking
people to come with commitments, andpopulation ageing is one of the emerging
issues that we will be discussing under theumbrella of demographic diversity. It is been
said that ageing is not lost youth, what it is,
it’s an opportunity to expand creativity andNatalia Kanem
Executive Director, United Nations Population Fund
(UNFPA)
Dr. Natalia Kanem is the UN Under-Secretary-Generaland Executive Director of UNFPA. Dr. Kanem brings to
the position more than 30 years of strategic leadershipexperience in medicine, public and reproductive health,social justice, and philanthro- py. She started her careerin academia with the Johns Hopkins and Columbia
University Schools of Medicine and Public Health. Whileserving as a Ford Foundation Officer from 1992 to 2005,
she helped pioneer work in women’s reproductive healthand sexuality, in particular through her position as therepresentative for West Africa. She then served at theFoundation headquarters, becoming Deputy Vice-President for its worldwide peace and social justice programsin Africa, Asia, Eastern Europe, Latin America, and North
America. From 2014 to 2016, Dr. Kanem served as UNFPA
Representative in the United Republic of Tanzania. In
July 2016, she was named Deputy Executive Director of
UNFPA in charge of programs. Dr. Kanem holds a medical
degree from Columbia University, New York, and an MPH
with specializa- tions in epidemiology and preventive
medicine from the University of Washington.

it’s an opportunity to show our strength as
advocates in this stage of life. So together
let us make a difference, let us project
meaningful responses to population ageing
including some of the pension strategizingthat is happening in Japan at this very

ナタリア・カネム
国連人口基金事務局長
ナタリア・カネムは、
コロンビア大学とジョンズ・ホプキンス大学の医学部と公衆衛生大学 院にて、研究者としてキャリアをスタートした後、30年以上の間、医学、公衆衛生及び性 と生殖に関する健康、社会正義、社会奉仕事業
分野において指導的立場で活躍してきた。1992年から2005年 にかけて、フォード財団に勤務し、同財団の西アフリカ代表とし て女性の性と生殖に関する健康や、
セクシュアリティ分野における先駆者として尽力し、そ の後財団

moment here. Let us learn from each other

本部では、
アフリカ、
アジア、東ヨーロッパ、南北アメリカにおいて世界平和とand let us advance the vision of health andから2016年まで UNFPAのタンザニア代表を務め、2016年7月にプログラhappiness in the golden years of life. Thankyou so much.

社 会正義を促進するプログラムを総括する副代表として活躍した。2014年
ム担当の事務局次長に就任し た。
カネムは、ニューヨークのコロンビア大学
で医学博士号を、
シアトルのワシントン大学 で、疫学、予防医学を専門とした
公衆衛生学修士号を取得。

Towards Population Ageing in Africa

-07

Population Ageing and Healthin Africa

KEYNOTE

by Awa Marie Coll-Seck
Mesdames et Messieurs, chers orateurs, chers
participants à cet évènement important. Je voudrais
parler d’un sujet dont on nous a demandé dedire quelques mots. Et je commencerai par trois
PowerPoints qui nous montrent déjà la position del’Afrique.
La position de l’Afrique qui se trouve être lecontinent où la population a une espérance de vie

SPEECHla plus faible. C’est le continent où vous avez lamoyenne de la population qui varie entre 45 ans et
65 ans. Cela peut être comparé aux pays européens,au pays au Canada per exemple, ou au Japon, ou
à l’Australie, où il y a une population vieillissantebeaucoup plus nombreuse.
Mais on ne s’arrêtera pas là. Il faut dire que dansles années 50, (1950), on avait entre les populations
des pays les plus développés et l’Afrique à peu près
30 ans de différence. Mais tous les pays ont vu
leur espérance de vie augmentée. Et aujourd’hui la
projection sur 2050 nous montre il n’y aura plus
que 15 ans de différences.

C’est dire que le vieillissement de l’Afrique est en

AGE PYRAMIDBY SEX

cours et qu’il faut en tenir comptes dès maintenant.
On regarde de la pyramide de vie. Nous avons parâge une pyramide qui existe toujours dans les pays
en développement, notamment en Afrique, et une
pyramide qui a complètement changé de forme avec
le maximum des personnes entre 25 et 35 ans, alors
qu’en Afrique c’est toujours les jeunes qui sont là.

Cependant, il y a de plus en plus de sujets âgés. Et
comme ailleurs, nous voyons aussi qu’il y a plusde femmes que d’homme âgés. Nous devons donc
anticiper sur cette croissance.

Towards Population Ageing in Africa

-08

C’est pour cela que les personnes qui s’occupent desanté mais également d’action sociale se tournent
régulièrement vers les gouvernements et leurdemandent quoi faire. Et les gouvernements aussi,-09

Assemblé Mondiale sur le vieillissement qui a eu

Mais ces perceptions et ces représentations autours

Passons les stratégies. Elles sont nombreuses aulieu en 2002, mais également les recommandations

de l’âge et de handicap qui va suivre, sont en train

Sénégal, mais nous avons mis en exercice certaines.

de l’OMS en matière de santé. Mais il y a des choses

de changer. Prenons l’exemple de cette vielle

Et nous reviendrons sur notamment le plan Sesame

concrètes qui se font. Aujourd’hui en Afrique dudame, cette femme âgée qui dit qu’en Afrique il y

et un projet spécial qui s’appelle RAMA, qui est

Sud, il y a la création d’une pension pour les sujets

a une réelle solidarité avec les sujets âgés, mais lesun projet au niveau communautaire. Mais sachezâgés, différente de la pension pour les retraités.

traditions sont également en train de se perdre. Et

qu’il y a beaucoup d’exemple de stratégies dont laD’autre pays, comme le Sénégal, ont préféré parler

donc au Sénégal, on a observé, les anthropologues

gratuité et la subvention de certains produits ou

d’accès gratuit au soin. Il y a beaucoup d’expériences

se sont rendu compte que nous avons un déclin

de certains médicaments, comme pour le diabèteen Afrique que nous ne pouvons pas dérouler ici.

desolidarité

insuline. C’est vrai que c’est surtout les enfants

Mais juste pour vous dire que c’est un terrain qui

communautaire, une distance entre les générations,qui utilisent. Mais chez les adultes et chez lesva être exploré et pour lequel il y aura énormément

et les dépendants apparaissent parfois comme étant

sujets âgés, ça peut être aussi utile. La dialyse estd’avancées.

vraiment un problème, particulièrement dans lesgratuite déjà pour tout le monde donc les sujets

villes mais également un défi pour les familles.

âgés en bénéficient. Et les médicaments contre leL’appuis qui est apporté aux personnes âgées est

cancer sont subventionnés au niveau des structures

fragmenté et segmenté en fonction des possibilités

publiques. Voilà donc les choses qui se font. Et lemais également des rôles de chacun. Par exemple,

secteur privé est aussi impliqué de plus en plus avec

un sujet âgé du sexe masculin sera pris en charge

des consultations pour des personnes en fin de vie,dans la toilette et autres, par sa femme surtout

ou bien, des consultations à domicile et prise enquand elle est beaucoup plus jeune, ou par son fil

charge à domicile.

nous attendons tous à ce que les gouvernements
mettent en place des politiques, des stratégies,
des plans d’action, qui permettent de se soutenir
les personnes les plus âgées. Ce qu’il veut dire queles gouvernements auront un double challenge,celui des populations jeunes qui est le challenge
classique, normal - les populations jeunes pourlesquelles qu’il faut une meilleure santé, il faut del’éducation, il faut de l’emploi. Mais en même temps
puisqu’il y a un vieillissement de la population, nous
devons aussi tenir comptes de ce vieillissement-là.

Merci

de

m’inviteràcetévènement,

parce

deviennent une priorité. Et certains pays, commel’Afrique du Sud, le Bénin, le Sénégal, mais également
le Nigeria, ont développé des plans d’action qui sontdesréseauxde

PLAN SESAME

Quand on parle maintenant du Sénégal, presques’agit de la mère, c’est surtout la fille aînée qui s’encomme dans les autres pays africains, on va voir que

occupera. Mais de plus en plus dans les sociétés où

le problème de la prise en charge des sujet âgés est

on a un peu de moyens, on voit qu’on prend des gens

 essential medicines (as part of the Bamako

lié à des mécanismes et à des dynamiques sociales,qu’on paye pour s’occuper des veilles personnes. Il additional basic examinations;qui sont très différents de celles que l’on observey a un changement qui se passe. Mais également

 medical procedures;

dans les pays développés. Traditionnellement

le style de vie est changé. Il y a beaucoup plus de Hospitalizations.

en Afrique et au Sénégal, les sujets âgés sont au

maladie chronique qui se développe et les maladies

centre de la famille. Ce sont des personnes qui sontdonc liées aussi à l’âge. Mais très peu de personne

des gardiennes de l’héritage collective et de nosau Sénégal, qui sont des personnes âgées, moinsancêtres mais également des valeurs religieuses.

de 20% ont accès à des pensions, et souvent sont

Et ce sont des personnes respectées. Et ils ne sontdéconnectées des structures de santé spécialisée.

ELDERLY AND HEALTH STATUTS (2)Free minimum Packadge: consultations;

Initiative);

PLAN SESAME INTO ACTION A study was done to determine the leading cause of

consultation, costs borne by beneficiaries and/or their families.

 A one month comprehensive, cross-sectional, quantitative study

was conducted in one of the Dakar gerontology centre.

 The study population was composed of 203 patients with a mean

age of 68 years, with 59% of women.

normalement jamais discriminés.

un sujet d’actualité en Afrique aujourd’hui. Les

ont toutes dit que progressivement les sujets âgéssolidarité,ainé, ou en tout cas un garçon de la fratrie. Quand ilqu’effectivement parler du vieillissement, c’estautorités, qu’elles soient politiques ou sanitaires,

la

STRATEGIES PUT IN PLACE FOR THE
ELDERLY IN SENEGAL The most common diseases were hypertension (52%), cataract(16%), osteoarthritis (12%)..and Diabetis (8%).

 Retirement insurance Institute of Senegal (IPRES)1958
 Plan Sesame 2006

 Aid

is segmented and fragmented according to thepossibilities and role of each family member

 In

addition, lifestyle changes are accompanied by thedevelopment of chronic diseases and age-related
pathologies resulting in disabilities. .

 Gratuity and subsidies including elders

Diabetis: Insulin,

Quand on parle du plan Sesame au Sénégal, c’est

Dialysis
Anticancer drug Special projects. Ex.: RAMA Project 2018

 Very few older people have access to a pension and areoften disconnected from the few specialized facilities.

Elderly Support Project Private clinics and home care

un plan qui s’adresse aux personnes âgées. Et cheznous on parle de « âgé » dès 60 ans. Dès que vous
avez 60 ans, vous pouvez avoir la consultationen rapport avec les recommandations de la seconde

Towards Population Ageing in Africa

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gratuite, les médicaments essentiels, les examens

disent qu’on a une dette trop importante. C’est pourchoses qui sont prises en considération. Le support

pour les jeunes et pour les femmes, mais pas

paramédicaux, les procédures donc chirurgicales

cela que le président Macky Sall, le président de laavec des consommables, comme des kits d’hygiène,

beaucoup pour les sujets âgés.

et médicales, et les hospitalisations. Mais comment

République, qui a trouvé ce plan Sesame en place, acomme des aides pour ses personnes âgées et desest-il réellement.

décidé de le lier maintenant à la couverture sanitaire

toilettes, même des toilettes. Il y a certaines maisons

On a fait une étude au niveau d’un centre de santéuniverselle qui est financée, ce qui permette d’avoir

où les toilettes ne sont pas adaptées aux sujets âgés.

gériatrique, qui a permis de passer en revue 203

les moyens pour ce plan Sesame.

Et ce projet les aide dans ce sens-là.

patients qui sont venus en consultation avec enl’hommes. Puisqu’il y a 59% de femmes, donc
une notion de genre est à rendre en compte. Les
maladies les plus fréquentes étaient l’hypertension,les cataractes, les arthroses et le diabète.

 Identification of elderly people in situations of socio-healthvulnerability

MANAGEMENT:of Health and Welfare (MSAS) and First Lady
Foundation : Foundation serve Senegal

 Health and nutritional care of the elderly (use of the WHO

 Ministry

OBJECTIVE:
Ø Improving

the well-being of older adults with socio-healthvulnerabilities

validated guide)

PROJECTRAMA
DESIGN Psycho-emotional and social support for seniors
 Improving the living environment of the elderly§§§

Equipment support based on the condition of the elderly person
and their environment
Support in consumables to improve hygiene according to thecondition of the elderly
Construction of toilets and/or rooms or installation of adapted
toilets if the living environment of the elderly person allows

PLAN SESAME INTO ACTION 2
 Although, the Sesame Health Programme is officially free of charge,

most of the drugs used to treat chronic diseases, remained at the
charge of patients and/or their families (estimated to be 55$ permonth).

 Dysfunctions were observed, particularly:§

the difficulty of targeting beneficiaries,§

generic stock shortages,§

absence of generics for the treatment of chronic diseases,§

Delay or no reimbursement to the health structure.

Mais nous avons observé que, on dit que la prise en
charge est gratuite, mais dans les faits, nous ne sontrendu comptes que beaucoup de choses sont encore
payantes. Pourquoi ces choses sont payantes? C’est
parce qu’il y a d’abord une difficulté à cibler lespersonnes bénéficiaires. Nous avons normalement,

Although the proportion of elders is still lower than 5%in
Senegal,. their number is increasing.
We must propose strategies and plan of action adapted
to our socio economic and cultural context but at thesame time learn and be open to experiences ofcountries experimenting already this situation.

PROJET RAMA

moyenne d’âge de 68 ans, et plus de femmes que

CONCLUSION

En conclusion, bien qu’au Sénégal, il y a environ
5% de personnes âgées, si on parle de 65 ans,
mais plus, quand on dit 60 ans comme chez nous.
Et ce nombre est en train d’augmenter. C’est dire

Le projet RAMA est un autre projet du ministère

Je voudrais toute suite, après ça, passer aux

que on doit avoir des stratégies qui sont adapter àde la santé et de la première dame - la fondation

recommandations. C’est vrai que on a beaucoup denos contextes socio-économiques et culturels. En

de la première dame, Servir le Sénégal - et qui veutchose à dire. Mais puisqu’on a que 15 minutes, on

Afrique et au Sénégal en particulier, on a même desaméliorer le bien-être des sujets âgés, notammenta parlé de l’Afrique, on a parlé du Sénégal. Quelles

proverbes qui parlent d’une manière très élogieuse

ce qui sont vulnérable au plan de la sante et social.

sont des recommandations que nous devrions

des sujets âgés. Per exemple, un sujet âgé qui meurt

faire? Il faut d’abord adopter une approche surtout

c’est une bibliothèque qui brûle. Un sujet âgé est lecommunautaire qui renforce les familles, uneciment de la communauté. Il y a donc beaucoup deapproche holistique. Ce n’est pas seulement une

chose encore à faire. Mais surtout apprendre desapproche médicale, mais tous les aspects autres

autres. Apprendre des pays qui sont déjà passer parsociaux, environnementaux sont à rendre compte

là. Il ne faut pas s’enfermer dans ce qu’on croit êtreen considération. Et former des personnes pourle bon, mais essayer aussi de s’ouvrir à d’autres.

une spécialisation un peu en gériatrique. Renforcer

Parce que cela nous permettra d’aller de l’avant

RECOMMANDATIONS Adoption of a community based approach strengthening families
 Holistic approach Provide training for specialized geriatic personnel
 Strengthening health system with decentralized

structures for elders

 Include in the list of essential medicines those for most common

diseases in the elderly; Integrate elderly specificity in all

relevant healh and social natioal
programs ( vaccination, nutrition,communiy health…)

quand on parle de personnes bénéficiaires, nous

les systèmes de sante surtout en une manière

et d’aider les personnes âgées. Je voudrais donc

avons les personnes qui n’ont pas de pension. Les

Identifier ces gens par les relais, comme ces sujets

décentralisée. Inclure dans la liste des médicaments

remercier les organisateurs de nous avoir donnerpersonnes qui sont dans le secteur informel. Mais

âgés par relais communautaire. Les médecins etessentiels les médicaments pour les personnes âgées.

ces opportunités de pouvoir partager avec vous cetteen général, tout le monde vient. C’est ce qui fait que,les infirmières viennent au niveau communautaire

Intégrer le vieillissement dans les programmes

expérience, et vous dire que nous nous sommes à

le nombre qui était prévu et le nombre que nous

après quand ils sont identifiés pour voir lesde santé et autres, comme la vaccination, commevotre disposition. Comme je l’ai dit, être ouvert est

recevons est beaucoup plus important. Il y a souvent

problèmes de santé et les problèmes nutritionnels.

la nutrition, quand on parle de sport. Toutes ces

permettre à nos sujets âgés en Afrique de bénéficier

des ruptures de stock de médicaments génériques,

Une approche aussi psychosociale et émotionnelle

choses vont être prise en considération. Et enfin,d’une prise en charge adéquate, tenant compte del’absence de génériques quand on parle de maladies

est faite. Et on a une amélioration qui se fait au

on ait vraiment un financement approprié. C’est

nos cultures et de nos valeurs. Je vous remercie.

chroniques - très souvent il n’y pas de générique -niveau de l’environnement de sujets âgés. Par

bien beau d’avoir toutes ces stratégies mais il fautet les délais de remboursement pour les structures.

exemple, l’équipement par des supports avec desdes moyens, et cela je lance un appel aussi, non

Puisque l’État doit payer, c’est gratuit mais souvent

chaises roulantes, des béquilles, les choses que ces

seulement aux États, mais également à tous les

il y a des retards. Donc certaines structures

sujets n’ont pas, et cela les bloquent dans la maison

acteurs qui soutiennent nos pays, parce que cela est

n’acceptent pas des sujets âgés, parce qu’elles

et ne leur permet pas d’être mobile. Ce sont les

important. On a plus facilement des financements

Towards Population Ageing in Africa

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-013

many experiences in Africa that we cannot do here.

Population Ageing and Healthin Africa

However, just to tell you that this is a field thatwill be explored and for which there will be a lot ofprogress.

by Awa Marie Coll-Seck
waiting for governments to put in place policies,
Ladiesandgentlemen,dear

speakers,

strategies, action plans that support older people.

dear

What it means is that the governments will haveparticipants in this important event. I would like toa double challenge, that of the young populations

talk about a subject that we were asked to say a few

which is the classic, normal challenge - the young

words about. I will start with three PowerPoints that

populations for whom it is necessary to have a

already show us the position of Africa.

better health, one needs education, it is necessary

The position of Africa, which happens to be theto employment. At the same time, since there is ancontinent where the population has the lowest life

aging population, we must also take account of thisexpectancy. It is the continent where you have theaging.

average of the population which varies between 45

When we speak now of Senegal, almost as in other
African countries, we will see that the problemof the care of the elderly is linked to mechanisms
and social dynamics, which are very different fromthose that we observed in developed countries.
Traditionally in Africa and Senegal, elderly people

years and 65 years. It can be compared to European

are at the center of the family. They are people

countries, to Canada, for example, or to Japan, or

who are guardians of the collective heritage andto Australia, where there is a much larger aging

our ancestors but also religious values. They are

population.

respected people. In addition, they are normally

We will not stop there. It must be said that in thenever discriminated against.

1950s (1950) there was between the populationsof the most developed countries and Africa about

ELDERLY AND HEALTH STATUTS (2)30 years of difference. However, all countries haveThank you for inviting me to this event, because

seen their life expectancy increased. In addition,indeed speaking of the aging, it is a subject oftoday, the projection on 2050 shows us there will be

topicality in Africa today. Authorities, whether

more than 15 years of differences.

political or health, have all said that older people areThis is saying that the aging of Africa is under way

 Aid

is segmented and fragmented according to thepossibilities and role of each family member

 In

addition, lifestyle changes are accompanied by thedevelopment of chronic diseases and age-related
pathologies resulting in disabilities. .

 Very few older people have access to a pension and areoften disconnected from the few specialized facilities.

gradually becoming a priority. Some countries, suchand that it must be taken into account now. We look
AGE PYRAMIDBY SEXat the pyramid of life. We have by age a pyramidthat still exists in developing countries, especially inas South Africa, Benin, Senegal, but also Nigeria,
have developed action plans that are related to therecommendations of the Second World Assembly

Africa, and a pyramid that has completely changed

on Aging that took place in 2002 but also WHO’s

shape with the maximum of people between 25 andstrategies on health. There are concrete things

35, while in Africa it is still young who are there.
However, there are more and more elderly subjects.

anticipate this growth.

that are done. Today in South Africa, there is theMoreover, we also see that there are more womenThis is why people who care for health but also

creation of a pension for the elderly, different fromthan older men as elsewhere. We must therefore

social action regularly turn to governments andthe pension for retirees. Other countries, such as

ask them what to do. Governments, too, we are all

Senegal, preferred free access to care. There are

However, these perceptions and representations
around the age and disability that will follow, arechanging. Take the example of this old lady, thiselderly woman who says that in Africa there is areal solidarity with the elderly, but the traditions
are also being lost. In Senegal, it has been observed,
anthropologists have realized that we have a decline
in solidarity, networks of community solidarity,

Towards Population Ageing in Africa

-014

-015

a distance between generations, and dependents

is free already for everyone so elderly people benefit.

women than men. Since there are 59% of women,

The RAMA project is another project of the Ministry

sometimes appear to be really a problem, especiallyIn addition, cancer drugs are subsidized at the levelso a notion of gender is to be taken into account.

of Health and Welfare and the First Lady Foundationin cities but also a challenge for families.

of public structures. These are then the things that

The most common diseases were hypertension,of the first lady, Serving Senegal - and which aims

are done. Furthermore, the private clinic is also

cataracts, osteoarthritis and diabetes.

to improve the well-being of the elderly, including

The support that is given to the elderly is fragmented

increasingly involved with end-of-life consultations,

In fact, we observed that many things are stillthose who are vulnerable in terms of social-health.

and segmented according to the possibilities but also

home-based consultations and home care.

paying though it is said that the care is free. Why

Identify these people by the relays, as these elderly

are these things paying? This is because there

subjects by community relay. Doctors and nurses

is first a difficulty in targeting the beneficiaries.

come to the community level afterwards when they

Normally, when we talk about beneficiaries, weare identified to see health problems and nutritional

have people who do not have a pension. People who

problems. A psychosocial and emotional approach

are in the informal sector. However, in general,is made. We then have an improvement in thethe roles of each one. For example, an older male

PLAN SESAME

subject will be cared for in the toilet and others, byFree minimum Packadge:

his wife especially when she is much younger, or consultations;by her older son, or at least a boy of the siblings.

 essential medicines (as part of the Bamako

Initiative);

When it comes to the mother, it is mostly the eldest

 additional basic examinations;

daughter who will take care of it. However, more

 medical procedures;

everyone comes. That is why the number that wasenvironment of older people. For example, theand more in societies where we have a little means, Hospitalizations.

planned and the number we receive is much larger.

equipment by means of supports with wheelchairs,

There are often shortages of stocked generic drugs,

crutches, things that these subjects do not have, andwe see that we take people whom we pay to takecare of old people. There is a change happening.

When we talk about the Sesame plan in Senegal, it

the absence of generics when it comes to chronicthat block them in the house and does not allow them

The lifestyle is also changed. There is a lot moreis a plan for seniors and we speak of “aged” from

diseases - very often there is no generic - and delays

to be mobile. These are the things that are taken into

chronic disease that is developing and diseases

60 years. As soon as you are 60, you can have free

in reimbursement for health structures. Since

consideration. The support with consumables, suchtherefore also related to age. However, very few

consultation, essential medications, paramedical

the state has to pay, it is free but often there areas hygiene kits, as aids for the elderly and toilets,

people in Senegal, who are elderly, less than 20%

basic exams, so surgical and medical procedures,

delays. Some health structures then do not accept

even toilets. There are some houses where toilets

have access to pensions, and often are disconnected

and hospitalizations. However, how is it really?

old people, because they say that they have too

are not suitable for elderly people. This projectmuch debt. That is why President Macky Sall, thehelps them in that sense.

from specialized health facilities.
PLAN SESAME INTO ACTIONSTRATEGIES PUT IN PLACE FOR THE
ELDERLY IN SENEGAL Retirement insurance Institute of Senegal (IPRES)1958
 Plan Sesame 2006
 Gratuity and subsidies including elders

Diabetis: Insulin, A study was done to determine the leading cause of

President of the Republic, who found this Sesame

consultation, costs borne by beneficiaries and/or their families.

plan in place, decided to link it now to the universal

 A one month comprehensive, cross-sectional, quantitative study

health coverage that is funded, which allows to have

 The study population was composed of 203 patients with a mean

the means to this Sesame plan.

was conducted in one of the Dakar gerontology centre.

age of 68 years, with 59% of women.

PLAN SESAME INTO ACTION 2
most of the drugs used to treat chronic diseases, remained at the
charge of patients and/or their families (estimated to be 55$ permonth).

of Health and Welfare (MSAS) and First Lady
Foundation : Foundation serve Senegal

OBJECTIVE:
Ø Improving

the well-being of older adults with socio-healthvulnerabilities

come back to the Sesame plan and a special project

the difficulty of targeting beneficiaries,§

generic stock shortages,

called RAMA, which is a project at the community§

absence of generics for the treatment of chronic diseases,§

Delay or no reimbursement to the health structure.

level. Please be aware that there are many examples

 Identification of elderly people in situations of socio-healthsome recommendations we should make? First we Health and nutritional care of the elderly (use of the WHOneed to take a community-based approach thatvalidated guide)

products or drugs, such as diabetes insulin. It is

A study was conducted at a geriatric healthtrue that it is mostly children who use. However, incenter, which reviewed 203 patients who came for
consultation with an average age of 68, and moreto the recommendations. It’s true that we haveSenegal since we only had 15 minutes. What arevulnerabilityof strategies including free and subsidized certain

I would like any continuation, after that, to passa lot to say. However, we talked about Africa and Dysfunctions were observed, particularly:§

adults and in the elderly, it can be as useful. Dialysis

relevant healh and social natioal
programs ( vaccination, nutrition,communiy health…)

 Ministry Although, the Sesame Health Programme is officially free of charge,

Senegal, but we have put into practice some. We will

diseases in the elderly; Integrate elderly specificity in all

MANAGEMENT: Private clinics and home care

Let’s go through the strategies. There are many instructures for elders

 Include in the list of essential medicines those for most common

PROJET RAMA

Anticancer drug
Elderly Support Project Holistic approach Strengthening health system with decentralized(16%), osteoarthritis (12%)..and Diabetis (8%).

 Special projects. Ex.: RAMA Project 2018

 Adoption of a community based approach strengthening families

 Provide training for specialized geriatic personnel

 The most common diseases were hypertension (52%), cataract

Dialysis

RECOMMANDATIONSPROJECTRAMA
DESIGN Psycho-emotional and social support for seniors
 Improving the living environment of the elderly§§§

Equipment support based on the condition of the elderly person
and their environment
Support in consumables to improve hygiene according to thecondition of the elderly
Construction of toilets and/or rooms or installation of adapted
toilets if the living environment of the elderly person allows

strengthens families, a holistic approach. This is
not just a medical approach, but all other social,environmental aspects are to be considered. In
addition, train people for a specialization a little

Towards Population Ageing in Africa

-016

-017

geriatric. Strengthen health systems especially in aseniors in Senegal, if we speak of 65 years, but more,

decentralized way. Include drugs for the elderly inwhen we say 60 years as at home. In addition, thisthe list of essential medicines. Integrate aging into

number is increasing. This means that we must have

health and other programs, such as immunization,

strategies that are adapted to our socio-economic

such as nutrition, when it comes to sport. All ofand cultural contexts. In Africa and Senegal inthese things will be taken into consideration.

particular, there are even proverbs that speak highly

Finally, we really have appropriate funding. It is allof older people. For example, an elderly who dies iswell and good to have all these strategies, but wea burning library. An elderly person is the cement

need means, and I appeal also not only to the States,of the community. Therefore, there is still a lot ofbut also to all the actors who support our countries,

things to do. However, mostly learn from others.

because that is important. There is more funding

Learn from countries that are already going throughfor young people and for women, but not much forthere. We must not lock ourselves in what weolder people.

believe to be the good, but also try to open ourselves

Experience of the Old in aContinent of Young…and Ageingby Prafulla Mishra

to others. This is because it will allow us to move
CONCLUSION
Although the proportion of elders is still lower than 5%in
Senegal,. their number is increasing.
We must propose strategies and plan of action adapted
to our socio economic and cultural context but at thesame time learn and be open to experiences ofcountries experimenting already this situation.

In conclusion, although there are about 5% of

forward and help the elderly.
I would therefore like to thank the organizers
for giving us these opportunities to share thisexperience with you, and to tell you that we are atThank you. Good afternoon, everyone. It is aand Madam Minister from Senegal that Africa

your disposal. As I said, being open is a way for ourreal honor to be standing here and speaking

is expected to see a large population increase

elderly people in Africa to benefit from adequate

to you about population ageing in Africa.

in the next 20 to 30 years. In fact, it willcare, taking into account our cultures and values.

It is a paradoxical situation, which we are

increase by nearly 4 times. It will become

Thank you.

talking about. I am told that in Japan, people

almost 225 million by the year 2050 fromcannot stop talking about population ageing.

around 60 million now. One of the things

Awa Marie Coll-Seck
President of the National Committee of Extractive Industries
Transparency Initiative (CN-ITIE); Former Minister of Health for
the Republic of Senegal

Whereas in Africa, people do not think aboutthat we must keep in mind when we talk

population ageing as an issue, and they do notabout population ageing and what the people

talk about population ageing. It is therefore atry to talk about more is their mobility, their

Dr. Awa Marie Coll-Seck has served as President of CN-ITIE of
Senegal since April 2019. Previously, she served as Minister ofState to the President (2017–2019), Minister of Health and Welfare (2012–2017), and Minister of Health and Prevention (2001–
2003). She was Executive Director of Roll Back Malaria Partnership(2004–2011) and UNAIDS Director of Policy, Strategy and Research, and of Country and Regional Support (1996–2001). With
an MD and PhD in infectious diseases and bacteriology- virology,
she led the infectious diseases department at University Cheickh
Anta Diop of Dakar-Senegal before starting her international career. Dr. Coll-Seck is on the Roll Back Malaria Board of Directors;
Scientific Council of University Cheick Zaid; and the Clinton HealthAccess Initiative’s High Level Steering Group for Every Woman, Every Child. A member of the jury for the ISA Award for Service to
Humanity (Bahrain) and for the 3rd Noguchi Prize Africa, she alsosits on the Lancet Commission on the Future of Health in Africa
and the Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights, and co-chairs the WHO/UNICEF Commission for Realigning Child Health for the SDG Era. Author of over
150 scientific publications, she has been awarded the Knight of theOrder of Merit of Senegal, Burkina Faso and The Gambia; Palmes
Académiques, the French Order of Merit, and Legion of Honor;and “Best Minister of the World” at the 2017 World Summit of theGovernment, among others.

real honor to be speaking about population

challenges.

ageing in Africa. I want to first thank andgive my regards to Dr. Natalia Kanem,
Executive Director for UNFPA, Dr. Okawara
from the Japan Center for International
Exchange,Dr.

Reiko,Madam

Ministerfrom Senegal, Professor Ken Masuda from
Nagasaki University, and distinguished panel
members. In this presentation, I will attempt
to reflect on the issue of population ageing,

I think it is also very important to look at

but specifically talking about social protection

the contribution and the value that older

and health, and the linkage between the two.

people bring to our societies’ families. Thereis one statistics on HIV. When you look at

I think it has already been said by Dr. Natalia,

the orphan and vulnerable children in Africa,

Towards Population Ageing in Africa

-018

-019

a large majority of these orphans are cared

Poverty is one of the biggest inequalities thatsomething that I tried to challenge infor by their older grandparents. That is one

exist in the world today. In the slide, I present

the diagram in the slide. It is based

example. African food security owes largely

the persons living with absolute poverty. Theseon the research done by HelpAge as

to the smallholding farmers. If you look at

are just examples of some countries in Africa. If

well as many other organisations. I

smallholding farmers, the majority of them

you look at Kenya, 57 percent of the older people

work with HelpAge International andare again, older persons. I therefore think as

are living with poverty. Tanzania is 69 percent,other organizations on the impact ofmuch as we are talking about the vulnerability

and so on. When you look at the national poverty

older person pensions on the widerof older persons in Africa, and indeed theyrates in these countries, older people are actuallycommunity.

need support, we must also think of anothersometimes at the same or higher level than the rest

On the left side, if an older person

reality.

of the age groups. However, there is not usually areceives a pension, that person tends toI also think it is very important that we

lot of mention and focus on this population groups

beginning to take a lot of attention. She mentioned

increase her contribution in agriculture,also look at the ‘capacities and values’ older

in national poverty reduction planning across thethe example from Senegal. I have tried to give ahealth seeking behavior, building better houses,

persons continue to bring to our families andcontinent. We cannot achieve SDGs by leaving older

sense of some of the social pension programs thatand so on. Of course, it’s great that you get money

societies. In fact, if you look at the informal

people behind.

go on in the continent over the years in the slide.

and you spend it on yourself and live better. I think

economy, majority of the older persons, up

Some of the key ones if I can speak about is thethat’s obvious thing to summarize.

to 60 to 70 percent, and many of them are

Old Age Pension policy in Zanzibar. The island of

The right side is the family. Especially in many

women, are employed in the informal sector.

Zanzibar (Tanzania) has started a universal old-age

countries where the pensions have happened,

I think those are some of the contributions

pension for all older persons above 70 in the year

or other forms of social pension, the school

they make. Any intervention for older people

2016. Kenya has just started last year a universal

enrollment of girl child has increased significantly

must therefore consider both their capacity as

pension for older persons. Malawi has alreadyin those places. This is because the grandparents

well as vulnerabilities. That will be a more

completed a technical feasibility study for old age

get the pension and give it to their grandchildren,balanced approach in decision making. And

pension and lawmakers are considering the same.

to go to school. In addition, household savingsat the same time ensuring they are supported

Zimbabwe is currently doing a similar feasibility

have increased. Household food dietary diversity

study.

increases and they eat better and different types of

because they have ‘rights’ that they must

Another slide shows sickness faced by older people.

enjoy as any other person.

I think it’s an obvious thing that older people tend

food. I think that’s another indicator. As shown by

to fall sick. This is just the common illnesses. If you

the arrow which goes back, what is also important

take non-communicable diseases, that percentage

is that they do not face the exclusion from theincreases to probably much more. In fact, Kenya, I

family because this person is giving back. They

think probably around 60 percent of older people

come in and the family starts to take care of themwill have a case of non-communicable disease whenall. We can probably easily deduce that it creates

you talk about diabetes, hypertension, arthritis andmore inclusive families.

so on. And yet, the basic public health care systems
are not inclusive of health needs of older people.
Even in countries where health care is supposedly

I have been very fortunate to travel to several

If I move on, you know that we negotiated and‘free’, that is indeed not the case as we will discusscountries in Africa, and meet policymakers andworked on the Sustainable Development Goals. One

later.

government officials to discuss on issue of olderof the key aspects of the Sustainable Development

I think already Madam Minister mentioned about thepeople. One of the usual challenges that I hear is

Goals is to leave no one behind, as we all know.

importance of social pensions, universal pensions.

‘giving money to older people is just putting money

It was already mentioned from this podium.

In Africa, I think I must say that governments arein something that is not very productive’. This isNow, let’s look at health and care. I try to justTowards Population Ageing in Africa

-020

-021

be a very brief slide here. When you look at older

between social pension and access to health care.

free. It will be free if I have the money to takecommon myth that we value our older people. Now,

person’s health and care in Africa, you are looking

When somebody has social protection such astransport and get to a clinic. However, that’s not

valuing older persons should not be only by saying

at the issues of access.

a social pension, there’s better health-seeking

exactly free if the drugs are not there and I havenice words that we value, but also backed up with

When you talk about access, it is social access,behavior, access to health and participation. As I

to go to the market outside. If I have to do somepolicy and programmatic actions.

financial access, physical access and their physicalmentioned to you with the diagram before, persons

diagnostic tests, and the government health facility

Given the experience that Japan has had incapabilities to go to health facilities. That is atend to have a bit more capacity to seek health anddoesn’t have the laboratory, then it’s not exactly

integrating population ageing in your development

significant challenge. I will come to financial

come out of the house though they do not suddenly

free. Thus, it’s not something we’ll be able to talkas we’re talking about here in TICAD, that is a realaccess a bit later.

become healthy. When they feel included, theabout.

opportunity for Africa to learn from Japan. With

Let’s look at the issue of quality. If I’m an older

family also thinks, Let’s less take care of this older

One of the other things that come up is that Africa

TICAD, the collaboration between Japan and theperson in Africa, I might be able to go to a healthperson. That person is valuable to us, and let’s

is a youthful continent. I was listening to anotherContinent will get stronger, and we will be ablefacility. However, more likely than not, I may notalso make sure that person is included. Those arelecture about this Kanagawa prefecture in Japanto address population ageing and learn from each

get the treatments that I need. I may have to wait

some of the things which I wanted to talk about.

this morning. In 1970, the population pyramid ofother a lot more.

there for 3 or 4 hours because the queue is very

Again, we have done research in several countries

Kanagawa was with young people, which means

Before I conclude, I think we have to challenge andlong. Of course, you do not tend to go there as oftenthat proves this. It clearly shows that you cannot

an expansive pyramid. The shape of the pyramid

talk about a very fundamental issue. When we talkas you fall sick.

talk about wellbeing of older people in fragmented

will, however, become constrictive in 2030. Africa

about the older persons, we also need to understandAwareness of our health workers. In fact, what themanner and social pensions and income security forwill also age and unless we have a long timethat we are also dealing with a very deep seatedprofessor said about one recommendation, which I

older persons are a key determinant for achieving

horizon to plan ways in which issues of ageing

behavior, what we call “ageism”. “Ageism” is awant to pick, is the need for geriatric care. You’ll“Health for all” as envisioned in the Sustainable

populations are planned through and integrated

discrimination towards somebody based on their

be very surprised that there is only a handful of

Development Goal 3.

within development processes. In fact, Africa is inage. It is equally pervasive and damning as othergeriatric specialist in sub-Sahara Africa and aa wonderful place now to start planning early andissues such as racism and sexism, and yet, doesn’tmajority of countries don’t even have one! Thatlearning from experiences in Japan and elsewhere.

receive equal attention and condemnation. Thereis not something that we can deal with unless weare people who feel that older persons are lesser

build up that particular base.

human beings. Unless and otherwise we challenge

Regarding data, our formal healthcare systems dothat premise, deep seated behavior, we will not be

not continue to focus on collecting data for older

able to address some of these things.

persons. In fact, data disaggregation as per age, sex

In addition, I hope, in Africa, we will be able toand disabilities are one of the key things that therespect it a lot and backs it up with the action as

Sustainable Development Goals have asked for.

the way of Japanese society. There’s a lot of action
Now I wanted to challenge a bit, again fromalready, and I hope that we will continue the

my discussions and travel through the Africa

trajectory of integrating population ageing in our

region. I have been very lucky to meet with many

Let’s talk about another issue. It is said that wepolicymakers. I just tried to summarize it here.

value our older people in Africa. I think it’s a“Why an African Policy Maker is Unlikely to focus
on Older People.” I think you can read all thoseissues there. I’ll just talk about one or two. Oneof the things which come out often is that many
African governments have declared rightfully that
health is free for all. Now health is free, which
As I have already mentioned, there is a linkmeans basically that the health consultation isdevelopment. Thank you so much.

Prafulla Mishra
Regional Director-Africa, HelpAge International
Prafulla Mishra is Regional Director for HelpAge
International for Africa. In his role for the last
five years with HelpAge, he has led a number oftransformational changes for the organizationin the region, leading to increased engagementwith local partner organizations, generating
and disseminating evidence and learning, andbuilding partnerships with key regional institutions. His professional interests include social
development, gender, humanitarian response
and recovery, resilience, natural resource manTowards Population Ageing in Africa

agement, and governance. With 24 years of professional experience, he has also worked with the
M.S. Swaminathan Research Foundation, Oxfam, International Rescue Committee, and the Norwegian
Refugee Council, and has worked in India, Kenya, Somalia, Ethiopia, Djibouti, Sudan, Chad, Yemen, andother countries in Africa on various developmental,
humanitarian, and post-conflict programs. He takes
keen interest in learning from programs and has
partnered with a number of academic and research
institutions. He holds an MSc in Ecology and PhD in
Life Sciences (Mangrove Ecology).

-022

-023

In(2019,(only(a(few(provinces(have(experienced(ageing

National Strategy Towards
Independent, Prosperous, andDignified Ageing Population

Percentage(of(Population(Aged(60(and(over,(by(Provinces,(2019From Asia Experiences to African Perspective
Sources:(Indonesia(Population(Projection(2015K
2045,(Bappenas and(Statistic(Officeby Maliki
Distinguished guests, ladies and gentlemen. First,

actually to improve the skills of young productive

let me say I want to appreciate for the opportunities

age group and how to open more job opportunities

to share our experiences on developing our policy

for them. We are forgetting that improving

on ageing population.

productivity and preparing old-age welfare is also

Present challenges and opportunities for our

Proportion of Population Aged 15664,:
195062100•

Percentage (%)

70
65

•

60
55

Less(developed
HighKincome

50

South(East(Asia45

Indonesia
Afrika40

Sumber :(UN(Population(Pr ojection(2017(Revision

Productive age population has(been declining in(the advanced

75•

countries (Japan,(European
countries,(and USA).

While,(in(the middle income

countries productive age groupwill reach peak around 2030s.
African countries will faceageing population in(the mid

2050s.(

asThailand,current demographic transition is also a course inIndonesia.
Elderly (60+)(
population
will(be(trippled
in(Indonesia

2045
2015

~)2,1)Billion

To begin with, unlike our neighborhood countries
such

Percentage(of(Population(Aged(60(and(over,(by(Provinces,(2045

one way to optimizing the demographic dividend.

Middle Income
Countries are(experiencing ageing
80

100(Years(of(Independence(will(be(colored(by(ageing(population

Singapore

andMalaysia,

Indonesia is actually in the primary stage ofWorld0,9)Billion

Indonesia

21,67Million

61,47Million

Sources:(Indonesia(Population(Projection(2015K2045,(Bappenas and(Statistic(Office5ageing population. Indonesia is still enjoying the

In terms of percentage, our population with age 60

demographic dividend, which is defined as reaping

and over is not reaching 10 percent yet this year.

the peak of the productive age group. We are going

It will be attained next year. Regarding size-wise,

to have the peak maybe around the next 5 to 10

our aged population will be around 30 million

years from now. At the same time, Indonesia willthough it’s 20 million now. We will have 30 million

also experience ageing population in the next 5

within the next few years. In addition, in our 100

years. We are reaching 10 percent of 60+ population

years of independence, our aged population willapproximately next year. Comparing Indonesia andbe approximately around 60 million. That counts

Africa, that may be relevant at some point, notfor 20 percent of our total population, or around 3

during the periods, but where actually the policy

percent of the total world population. That is whyof demographic dividend is only defined as how

ageing population is not as a trend but it should also

Sources:(Indonesia(Population(Projection(2015K
2045,(Bappenas and(Statistic(Office

be an opportunity for us. Our challenges are notsimilar with other developing countries. While we

only about the size, but also about the diversity.

have life expectancy increasing, where the female

In 2019, as you can see here, only a few provinces

elderly live longer, it doesn’t follow by lengthening

experience ageing society. In some other places, it

the healthy life expectancy. The female elderly willis quite young, and they are still struggling on how

live longer, alone, and more vulnerable.

actually to reach better health access for the children
and also high quality for the human capital.
In 2045, when we celebrate our 100 independence,
most of the provinces will have experienced ageing

Indonesian(will(live(
longer,(the(gap(
between(men(and(women(is(wider

76
72

population. However, cultural and geographicalbackgrounds will also be a real challenge for us in
adopting the same goal. We cannot adopt the same
policy for the whole provinces to achieve a more

Women eldery tend tohave prolong illness.

45
77,3
1971

The7facts7that7women7
lives7longer7 with7more7
financially7and7socially7
vulnerable,7 gives7a7lot7
of7policy7
consequences.

2015

73,7

2045

Sources:(Indonesia(Population(Projection(2015K
2045,(Bappenas and(Statistic(Officedignified elderly society.

Even though the majority of the elderly live with

Our challenge, our population ageing, should betheir children, there is an increasing trend of living

Towards Population Ageing in Africa

-024

alone, especially for female elderly.
Women(elderly
lives(longer(and(alone-025

In addition, the elderly with disability is accelerated,

and formulate national strategy to aim for better andarrangement. Strong coordination, implementation,

especially for female elderly.

productive elderly in the future. The elderly should

and institution are needed, especially in the local

become a role model for the young generation

context. Regulatory framework is also importantand also provide meaningful contribution to thefor legal basis for all the stakeholders to work on

community. There is a lot of evidence that female

the same issues. Third is to protect the elderly as

elderly’s better means for government support toearly as possible. The social protection with cover

improve young generation quality.

of social assistance, and also insurance-based social

Woman(elderly(is(more(
vulnerable

Women
Men

Women
Men

56,4%

60%

56%
AGE

27%

40%

16,2%

12%

20%
0%

With)SpouseWith)Children

5,7%

60+
70+

Alone

Among the elderly itself, poverty is higher as Africa.

80+

Unable(to(walk(and(other(
activities

AGE

Unable(to(remember,(talk,(see,(or(hear

9%

12,9%

60+

13,9%

17,6%

23,3%

29,7%

80+

32,2%

37,9%

12,5%

17,1%

70+

18,5%

Our poor elderly is higher than 12 percent, which isSome of them have national health insurance tohigher than national level. When our poverty rates

cover with, but it is not universal coverage. It isat national level have reached a single digit, thelevel of poverty of the poor people of the elderly isprotection. Pension program and old-age pension

22,9%

is the effort to increase the coverage, especially in
Presidential)Decree)on)
Ageing)Population)
Realizing7prosperous,7 independent,7and dignified elderly by building
strong,7 competitive,7 and7adaptive7

shown that more than 50 percent of the elderly are

human7 capital in7more7integrated
efforts.

already covered by the national health insurance.

2017

2018

13,6%

12,01%

1,677million

1,37million

12,9%

11,6%

1,667million

1,357million

status. It is a very integrated effort that will affect
all aspects. Socialization, education and avocation
have been quite intensive for creating healthy
lifestyles for all generations, which hopefully will
also prepare for the old-age period. Last is how wedeclining very slow.
Being(older(is(vulnerable(to(be(poorthe informal sectors. Fourth is to increase health

Therefore, our ultimate goal is to realize ashould create a better environment for respecting

prosperous, independent and dignified elderly by

the rights of the elderly.

•

Financially,7Indonesian7elderly are7not7ready to retire.7

building strong competitive and adaptive human•

Poverty7rates7among7the7elderly7is7high7and7
persistence7over7time.

capital in more integrated efforts. This will be•

More7over,7women7elderly7are7more7vulnerable.7

implemented by creating more opportunities, and

3"Million"elderly"are"poor"(12,8%"of"the"total"elderly)"– 2017

National)Strategy)for)Building)Independent,)Prosperous,)and)Dignified)Elderly
1

2

3

4

5

Build7people7
awareness

Institutional7
Strengthening

Increase social
protection
coverage

Healthier7
Ageing7
Population

Respect7and7
Fulfill7the7rights7of7the7elderly

better access for elderly.

Yet,"the"figure"hasn’t"changed"one"year"later:
3"Million"elderly"in"2018,"12,3%"BB 2018

Vis ion) and) Mis s ion

VISION
To7realize independent,7 prosperous,7 and

The elderly with disability is also increasing, while

Our Strategy

the coverage of the pension is also not more than 15

Based on this condition, our law on elderly welfare

percent for the elderly. The elderly, both for the richhas been promulgated in as early as 1998. However,• To7strengthen7capacity7of7the7elderly7

and the poor and both in urban and rural, still havethe implementation is still relatively weak and the• To7foster7safe7neighborhood7 for7the7dignified ageing population

MISSION• To7improve7welfare7of7the7elderly
elderly

strategy is not comprehensive. The policy handles

rich people can depend partially from their returnthe elderly as the object of development, not as aon investment, the poor elderly heavily depend on

subject. Therefore, the law is still failed to see theFirst is to strengthen the capacity of the elderly. The

the government’s support.

elderly as potential to contribute to significant

second one is to improve the welfare of the elderly.

economic growth contributions.

The last one, more importantly, is to build a safe

Therefore, since last year, we are trying to improveneighborhood for the elderly itself.

Rich7elderly finance 50)

Making)the)Elderly)

percent of their

Poor elderly,7 in7both

consumption fromrural and urban,7 depend

investment,7mostly

heavily on public

Elderly still WORK.7

properties.

transfers.

Almost 507percent ofMore)Productive)
Active7Ageing7should7be:

their consumption is• Role7model7 for7the7young7
generation

financed by labor
income11• Mentoring the young with theirexpertise• Meaningful7 contribution7 to7the7community

have to be involved, and intervention is best on the
lifecycle efforts. We have to intervene at the rightto work to finance their consumption. While thePension coverage is less than 15%(and family starts to support at 70+

Our strategy is multi-stakeholders effort. All sectors

time and as early as possible.

Then, our national strategy will consist of 5 main

Ageing)Population)
Policy)by)Lifecycle)
Approach
Elderly

Child

Youth

Adult

Neonatal7
and7infant

concerted efforts. First is to build the generationalawareness in the community that ageing process is
a process to be embraced and respected. We needto prepare because everyone will be aged. Second
is to strengthen the institutional and regulation

Towards Population Ageing in Africa

Build awareness on ageing population

Continuing7
education
Healthy7ageing

Healthy lifestylePension and Old7
Age7Savings

Community7
based7LTC
19

-026

-027

a more systematic community elderly care. Our firsteffort is to integrate all programs that have been
implemented by all stakeholders here. In the longterm, we plan to build insurance-based long-termcare system. Japan is one of the best examples as

Population Aging in Africa
Anthropological perspective

benchmark for us.

by Ken Masuda
As part of our national strategy, we acknowledge

When we approach this issue of aging from anthat there is a rapid changing of lifestyles in allanthropological perspective, a number of keywords

generations. Our baby-boomers who were also born

emerge. One is to do proper fieldwork and to write

before ’97 are considered “a sandwich” generation.

a proper ethnography. When we observe a certain

They live with other 2 generations that live in totally

event, we need to understand it within the social

different lifestyles and somehow different norms.
Then, we cannot really depend on the same living
arrangements in the future where children can
provide care for their parents every day. Especiallywith rapid urbanization where children will not beable to live with their parents. They live in separate
cities, and a lot of parents live apart from theirchildren. There is an increasing trend that the living
alone elderly in rural area commits suicide recently
because of feeling lonely.
Therefore,

we

are

keen

to

developmore

comprehensive social protection. That is including
how we build the elderly system and long-caresystem as part of the elderly care system. The elderly
care system is aimed for more productive and active
elderly. We are in the preliminary stage of building

From our experience, what to share with African
fellows is that ageing policy has to come as early as
possible. An ageing policy is a multi-stakeholders’effort. Therefore, we need to integrate, coordinate,
and also harmonize the policy. In addition,
more challenge is how we can be consistent in
implementing in the long term of the policy itself
because the resource will not be in this present time.

context and social dynamics. It is also importantto understand indigenous knowledge, that is, theknowledge that people have built up in their lives,and how they connect to universal knowledge. Thatis, to link local events to global issues. Finally, andchildren, many grandchildren. great-grandchildren,

most importantly, “Learning from local practice.”and even great-great-grandchildren. There are five

Anyway, these are the approaches I intend to take ingenerations of the one family co-existing on thismy research on issues facing the elderly.

earth at the same time, which is probably the firsttime this has happened in the history of humankind.

Lastly, I would like to thank again for inviting me.

These are the kinds of population dynamics that our

We realize that we cannot claim that our experiences

world exists in, with people living long lives andwill be successfully implemented and resulting inhaving many children like this.

the expected outcome. However, one thing we canemphasize here is that ageing population is certain.

Population Ageing in Sub-Saharan Africa

Therefore, our chance is how to convince theMany of our panelists have already talked about

policymakers to prepare this as early as possible.

Africa’s population growth and elderly population

Thank you.

ratio, so I won’t go into too much detail. I’ll justMaliki
Director for Population Planning and Social Protection, Ministry of National Development Planning/National Development Planning Agency(BAPPENAS), Indonesia
Maliki is Director for Population Planning andSocial Protection in the BAPPENAS since 2017.
Before his present position, he previously was
the Director for Labor and Employment Creation from 2014 to 2017. He earned his bachelor’s degree in biochemi- cal engineering from
Bandung Institute of Technology in 1994, fol-

lowed by a master’s degree in engineering economics from Purdue University (USA). He holds a PhD in
economics from the University of Hawaii at Manoa.
Maliki is one of the global experts of the National
Transfers Account (NTA). In addition, his portfolio
includes social protection, ageing, labor economics,
and civil registration, and vital statistics.

I am going to raise several topics today, but one thatsay that the population will keep growing and theI think is particularly important is the question ofelderly population ratio will be high by the end of

how we link or build a bridge between macro events

this century.

and micro events. One example is this lady. ThisIn 1950, the elderly population ratio in Sub-

video was shown on the BBC in 2017, and it is about

Saharan Africa was 5%. That has not changed very

the celebration for her 117th birthday. Her ID cardmuch today – it is still 5%. This is the ratio of thestates that she was born in 1900.

population aged 60 years and over, but at the end

What is interesting is this lady’s family. She was oneof this century, even raising the baseline to 65 yearsof six wives of a Kikuyu chief in Kenya. She has sevenand over, the Old Dependency Ratio will be 13.3%.

Towards Population Ageing in Africa

-028

-029

for a baby. However, we don’t know who the baby’s

as well, but he still sits outside the shop’s entrance,

mother is. Apparently, a young woman entrusted

sewing sandals. He is quite active and also a famousthe baby to this woman and she has continued tofor his knowledge of local history.

care for it. Because it is a slum, the area is very poor,and the people living there support each other, so
the elderlies are.

streets. There is an NGO that rescues these homelesselderlies, gives them a place to stay, cleans them up,
checks their health, and, if they can find out who
they are, sends them back to their families.

Even though he has stepped away from the businessof the shop, he still looks like he is having a wonderfultime. The best thing about him is that he is very wellrespected by the people in the neighborhood andAddis Ababa

he is recognized as an important muzée. This is aOlder persons do not live in the one place the whole

Swahili word for “elder”, that is, he has a recognized

time, instead they move around for various reasons.

position in society.

This picture is from the Ethiopian capital city ofAddis Ababa. These people are like my family.

Elderlies in Rural Villages in Coast Kenya

She had lived in a town in southern Ethiopia for

These photos were taken in a place called Kwale inseveral decades, but after her husband died, she

Kenya. This is the area where we are about to startThis gentleman is one of the elderly staying in theintensive research. Kwale has an elderly population

NGO’s shelter. Unfortunately, even though I speak

ratio of about 5%. Many of the elderly here are

Amharic, one of the Ethiopian official language, I

supported by their families, but some are what

was unable to have a conversation with him, but hewe call “skipped-generation households,” that is,

Elderlies on the Movecertainly looks like he enjoys living in this shelter,households in which the elderly are caring for their

I would like to introduce you to several elderly people

like spending everyday playing the traditional music

grandchildren.

I have met in Africa. The situation surrounding the

instrument.

has since moved to the capital. Now she lives withher daughter’s family, spending her old age, looking
after her grandchildren.

elderly in Africa is by no means stable. Please keep
in mind that it is constantly in flux.

A Retired Sandal Shop Owner in Zanzibar
Moving to a different location, to an island called

A 59-year-old Lady living with someone’s

Zanzibar, in Tanzania, this old man is a retired

child in Kibera

sandal shop owner, who is one of my best friends

Kibera is the largest slum area in Nairobi. It has aon Zanzibar.

population of over 1 million. This woman, whom wemet last year, is 59 years old, so is not strictly in theelderly category. She lives alone, and she is caring

Also in Addis Ababa, in recent years, there is a
growing number of homeless elderly living on the

He used to be a police officer. After he retired, heran a sandal shop, and he has since retired from that

Towards Population Ageing in Africa

-030

-031

of them are originally from Southern Ethiopia. Dad

micro, we think of global aging as a global issue, butthere is tremendous cultural diversity in the Africancame from the north to hunt elephants, and ended

at the same time, we need to do fieldwork to gain anations. Therefore, there is potential for a gap toup staying. Mom came to the South to marry Dad,

proper understanding of what is happening within

form between the policies being established by theand they have both lived here ever since, over a half

the local context.

state and the indigenous care that is actually beingof century.

carried out in local communities. Well, there is thatgap.

Macro and MicroThis old man passed away about 15 years ago, but I

I have learned a great deal about the care that

remember what he told me. This was in a tent village

people like these receive in their lives. In fact, asof the Banna ethnic group in Southern Ethiopia,

I show here, there is a care system for the elderly,

where I lived for a long time. This old man said

I have met the retired farmer twice so far. When I

I guess you could call it, a mechanism or overall

to me, ‘There is only one model for life as Banna.

first met him four years ago, he was living in a large

arrangement that consists of multiple layers of care.

You plow the fields, care for the cows, undergo thecompound that his family had built in a farmingThis is the same in Japan. In the closest layer, wevarious rites and rituals, marry and have children,

region, with his eldest, third, and fourth sons andhave self-care, that is, the elderly do what they cangrow old, and die. That is the only way.’ He also

their families. However, the old man was living

to look after themselves. They are also cared for byinsisted that there was no need for schools. It is

in a crude hut, and he was actually living with thetheir families, or they receive support from theirDiversity of Care-Culture

difficult for people living in this model to fit into thechickens, otherwise, the chickens were living withneighbors. Further up, there is care from the public

Finally, I would like to conclude my talk with one

national welfare policy.

him. After three years, when I met him again last

sector. For example, there is LTC, or long-term care,more example. What kind of gap is there between

He (Mr. AG) was a ritual leader of the Banna, or

year (2018), his second son had taken him in. This isin which the elderly receive public, or government,

national policy, which is formed by the state, andchief. You could probably call him a king. He had

another indication of how the elderly, even in rural

support over the long term to support their lives.

local culture, in which people live their daily lives?

six wives, and, in his final years, he divided his time

As for why I came to pose this question, it is because

between the houses of his first and sixth wives. He

villages, do not live in the same place the wholetime.

Husband and Wife in a Rural Town inSouthern Ethiopia
These are my “Ethiopian parents”. Anthropologists
live in the field for a long time, so we forge family-like
connections with the local people. My “father” is in
his early 90s, and my “mother” is in her 70s. Neither

Just to go a bit further, as shown here, pensions,for example. The lives of the elderly are positioned
within various support networks. If those networks
exists, then that’s great, but if they don’t exist, thenthey have to do what they can with what they have.
This is where we need to do fieldwork to look at whatlevel the elderly are living within this framework,
what the reality is.
In terms of this bridge between the macro and the

Towards Population Ageing in Africa

-032

Ritual Leader: Mr.AG
1

2

3

4

5

6

AG

1
KA

2
BA

3

4

↘ ↘

?

?

?

AG (1930s-2017)■ A Typical “African Elder”. Mr. AG wasrespected as ritual chief of the Bannawith strong spiritual power. He married 6
wives and 15 children. Late in life, helived in houses of his 1st and 6th wives.

-033

already passed away before I came to this area. He

at the end. 20 years after taking this picture, all of

had three wives and many children. I saw his second

these elderly men are no longer with us.

wife (D) up close on several occasions, and when her

When I asked them what they thought abouthusband passed away, when it came to where she

growing old, I received a variety of replies. The

would live, she had the options of living with hermost common expression is “inta gecchi di ni” inco-wife...the first wife’s children, or with her own

Banna, which means “I got old.” There are various

children. She would live here for a time, then live

expressions, such as, for example, “gecchamo no sia

here for a time, then another house for a while...So,ne”, “Getting older is bad.” But one man said, with

her living arrangements were not very stable, butpassed away two years ago, and I learned of hiswherever she went, she would always do some kind

death on Facebook. He was the first Banna to haveof work, like seen in the picture showing her tanning

his death announced on Facebook.

the skin of a sheep that we had just eaten.

One more, G.A. I have never met this man. He had

What does it mean for people to get old? Is it seen

as a good thing or a bad thing? That interpretationdiffers from culture to culture. In this Banna village,
when the males eat meat, they do not sit around atable. They sit beside each other in one long row.
The men sitting at the far right of the row are theelders, and they go down the line in order fromoldest to youngest. Here, the children are sitting

such a happy expression on his face, “gecchamo no
paia ne” “Getting older is nice.” In other words,
even within a single culture, there exist a variety ofreactions to growing old. These people are trying tobuild up a culture that sees it as a good thing, sowhat can be learned from this kind of local practice?
How can we incorporate what we have learned
into national or government polices? These are
the kinds of questions that I am conscious of as ananthropologist.

Ken Masuda
Associate Professor, Nagasaki University School of Tropical Medicine
and Global Health
Ken Masuda is an Associate Professor of the School of Tropical Medicine and Global Health, and the School of Global Humanities and Social Sciences, Nagasaki University. Since 1993, he has conducted ethnographic research among the Bannai people, an agro-pastoral groupin southern Ethiopia. He obtained a PhD in social anthropology from
Tokyo Metropolitan University in 2003. Masuda joined Nagasaki University in 2004 and has been a lecturer for medical anthropology andethnographic methods at the School of International Health Development (2008–2015) and the School of Tropical Medicine and Global
Health (2015–present). He has organized a multi- disciplinary, collaborative research project (“Towards a Multi-Disciplinary Approach forDeveloping and Harmonizing Field Methods in Anthropology and Development Studies”) at Tokyo University of Foreign Studies, and has
been conducting a study of elderly life and care in East Africa (“Future
Population Ageing in East Africa: A Cross-Disciplinary Study of Social
Welfare and Elderly Care”) as a JSPS KAKENHI project since 2013. The
research projects draw members from such fields as anthropol- ogy,
ethnography, public health, demography, health economy, geography, and gerontology.

Towards Population Ageing in Africa

-034

-035

people in Indonesia, before coming to the long-termfrom family to the social sphere. Is this thing cancare system itself.

be the parallel thing in Africa or not? Then, what is
the family role, and how is the family considered to

Discussion
MODERATOR: REIKO HAYASHIIn addition, also for the long-term care, this may

offer the care, especially in consideration of gender

be the part which is less developed in Africa.

issues.

However, as Professor Awa has mentioned slightly,
I would like to ask what kind of long-term-care-

These are the questions that I now address to thegiving setting which is already existing in Senegal?

4 speakers. I will pass the microphone to get the

Furthermore, is it on the way to be developed or

answers. After that, I want to open the floor to havenot? In addition, Dr. Prafulla might be able to sharesome questions and comments from you. If you havewith us the situation of long-term care such as forsome questions and comments, please be prepared.

the bedridden elderly.
Prafulla Mishra: Thank you so much, Dr. Reiko.
Moreover, when we talk about the development

You have asked me a question to reflect on long-of long-term care system, we cannot escape fromterm care in Africa. Long-term care as a concept

family issues. That is what Professor Masuda has

is not well understood in the continent. There is atalked about such as the family structure. Also there

favorite, or a common expression you’ll hear, “Oh,is the value issue. Professor Awa has talked that

we take care of our older people, and they’re in theirelderly in Africa is like the cement of the family, andfamilies.” However, that is not the truth because

when older people die, it is like burning one library.

there are a lot of challenges that they face. When

This value is also changing. In addition, it might

you try to look at national-level data on how manybe in the case of Indonesia, there are an increasing

people out of the old who require long-term care,number of elderly living alone. Is this the case forthe data simply does not exist for most countries.

Africa? P Professor Masuda mentioned there is

If I give an example of Ghana. In Ghana, if you lookhomeless elderly in Africa which shows the changing

at persons requiring some sort of assistance in daily

Reiko Hayashi: Hello, everybody. My name ismore, in 30 years, it will be 3 times more older

value of family. For example, in the case of Japan,

life, among people of 65 to 75 age group, 50 percent

Reiko Hayashi. I’m the moderator of this panel

people living in Africa because the population itself

we are the most aged society in the world and haveof them require that kind of assistance. That number

session. I’m from National Institute of Population

is increasing.

had the long-term care insurance since 2000. Whenis 65 percent above the age of 75. A large number of

we introduced the long-term care insurance, there

older people in Africa are thus requiring assistanceand Social Security Research. For the speakers’ talk,we asked each to use different language to have theIf there are more older people, then there are more

was this harsh discussion, whether we should pay

in managing daily life. Just to give you a reference,“diversity,” and now for the discussion we decided

needs for medical care and long term care. This is one

for the family. Especially, it is the first son’s wife,

let’s look at Switzerland where is a great place to be

to do it in English.

topic which we have been hearing from 4 speakers.

who was in charge of taking care of her parents-

old in as well as Japan. In Switzerland, around 5 to

About medical care, as Professor Awa Marie Coll-in-law. However, we decided not to introduce the20 percent of older people above the age of 70 are

Many of you might have thought that why we are

Seck has mentioned, healthcare is now expanding,family allowance for the long-term care, because if

requiring some sort of assistance.

talking about ageing in this TICAD, for African

but there is still a lot of lack in providing healthcare

we pay cash to the woman in the family, then we

context? As already the speakers have talked about,for older people. As Dr. Prafulla has mentioned,

might give the pressure implicitly to this woman to

Now the other reflection I would say is that it becomes

it is becoming an emerging issue. Although theyou have more diseases when you get older. I would

stay at home and care for the elderly. That is how wea burden when we say that it is the responsibility of

proportion of old people is small yet, the number oflike to ask the Indonesian situation, how you dealt

have introduced the long-term care insurance. Thatthe family to take care of the older persons. It is aelderly is increasing. In 20 years, it will be 2 times

with increasing morbidity and diseases for the older

is how we have tried to move the long-term carehuge burden because most of the time, the family

Towards Population Ageing in Africa

-036

-037

international conference of gerontology, study

completely. When I hear everybody, it seems to

new to us. We have some projects. We have someof elderly people, 3 years ago in Nairobi. A lot ofme that the situation we have in Senegal is the one

strategies. However, the plan of action is not very

policymakers came and got together from all over

we have in Ethiopia, Kenya, and Indonesia. We

clear. We realize that we need to learn from others.

Africa. Some are from the Ministry of Health, some

all would like the family to take care of. However,That is why I think all the questions you raised areare from the Ministry of Labor. Some countries

the family will not be able to do that if the family

important. Because we need to learn. And I would

already started making the new policy, yet most of

is not supported. In addition, how to do that is

like to ask for all the PowerPoint presentation, if

the policymakers are also expecting informal care.

really where the realistic approach is importantpossible. I’m sure that we will be listening people,

Family care is therefore so important. Still now,

because we cannot consider that we help them only

but we have also all these PowerPoint existing formany people are expecting the family care evenon medical issues. It is sure that they have more

us. Thank you.

itself, the well-being is a key question. We have done

though the policymakers are trying to make a new

problems of health, but they have also problems

a lot of studies in many countries where there is aplan. This is the Africa now.

with consideration. How the people are taking careof them. How people are behaving. Sometimes, we

lot of violation of rights of older people happening
at the family level because they just think that

How to integrate or include the peripheral andcan be in a family and we are not involved a lot in

it’s a burden that they’re dealing with. As I am anvulnerable people living in the rural areas in Africa?

the town because of the specialty, We have some

optimist by nature. Then, I want to talk a bit about

That depends on, for example, the rapid growthelders who are in a family, and nobody knows thatthe positive thing. It is beginning to be recognizedof economic status, and also educational status.

they are there. I have my own experience where I am

as an issue. In fact, the African Union has, lastThis is not just a medical issue or a welfare issue.

living. I knew some people who were sick and older

year, developed an African Common Position on

It becomes a holistic matter. As Prof.Coll-Seck told

people were never in structures. Then, we decided

Long-Term Care. A document, which intends tous, it needs a holistic approach with a wide scope

to organize an NGO where we are going to look atbring integration between family, nation states andto cover these matters. A lot of things must be paid

old people in their family. There is a lot. We had

individuals, as Professor Masuda mentioned, has

attention to.

never seen them because we were thinking that they

Reiko Hayashi: Thank you. Dr. Maliki?

just come out. How do we bring it together? I think

don’t exist. This is also a way to show that the issue

Maliki: Thank you for the opportunity. In terms

that’s something positive. We hope it will be rolledof discrimination exists now in Africa.

of the national level, long-term care itself has been
officially built. We are trying to design this as wellout ahead. Thank you.
The second point, I was very happy to hear the issue

as how we can also have the opportunity to have

Reiko Hayashi: Thank you. Then, Professorof cash transfer because in Senegal we are doing

community-based, as well as the insurance-based

Masuda, would you please start?

cash transfer for women but not for old people.

long-term care itself. However, in a few years,

This issue maybe look at. Because when they haveand also in the future, some local initiatives have

Ken Masuda: Thank you very much. Why I am

some money, they have more power. The families

already existed. Some of the local governmentsinterested in the elderly issue in Africa? I’m teaching

are sometimes tired to do everything for them at thethat are already aware that there’s a lot of elderly

end because they are completely dependent. If theypeople in the community that is not having enoughhave some money that they can have themselves, it

attention from government support. Therefore, theyat Tropical Medicine and Global Health School at

Reiko Hayashi: Thank you. Next is Professor Awa.

Nagasaki University. Most of my students used tofocus on infectious diseases like Malaria, HIV, AIDS,

Awa Marie Coll-Seck: Thank you. I’m sure that

seems to be that this will give them again the placealso create some programs that related to the careetc. However, as a result of rapid health improvement

we are all in agreement that we don’t have one

where they deserve. For the long term care also, itof the elderly itself. This is more integrated effort

in Africa, the life expectancy is growing. Then, westory in Africa. It’s several stories, but we have ais difficult if you don’t have social services or NGOs

between the sectors. At least there are 3 sectors thatare expecting the future population ageing in Africa.

common ground, which is an issue of how family

at the community level supporting countries withwork on this local initiative. There are health sectors

That’s why I’m interested in this area.

is really taking care. All the traditional way, saying

older people. This is because they need some home

and the social sectors. The last, the more importantthat family is taking care completely of elders is notcare and all these things need to be organized if they

one, is the family planning initiatives. The family

something which we need to say that it is existingneed long term care. I want to say that this is veryplanning itself has very important roles because

Now focusing on LTC, I participated in the

Towards Population Ageing in Africa

-038

they have programs on how family members is

we have many challenged to do. I want to open thestrengthened. The capacity of the family members

floor though the time is limited.. Is there anybody

to taking care of the elderly itself. I think these 3

who have some question and comments?

-039

major sectors are working well together in some of
the local governments, especially which have more

Hideki Yamamoto: My name is Yamamoto andliberty on financial capability like some provinces

I am from Teikyo University. I am working on

in Java Islands and Bali. They have quite well fiscal

joint research at KAKEN together with Professor

capabilities. Then, they can give more attention to

Masuda and Professor Hayashi. Professor Masuda

elderly care.

talked about the examples of elderly who have been

Closing
Remarks

supported within the traditional family system, but
In terms of what our national level is trying to do,

the current theme of TICAD is growth in Africa,

is how we can actually define more acceptable long-that is, population growth, economic growth.

term care system itself. This is because some our

The problem is that there are concerns about the

stakeholders, some of the academicians, also all theurbanization of the population, and about theexperts, and some of the line ministers also haveelderly living in those urban populations. Professor

not yet agreed on what is actually the long-term

Masuda gave the example earlier of a slum incare system defined at the national level. This is our

Kenya, and I feel strongly that there is a particularcondition in Indonesia.

need for support from community to care for theseelderly living in the urban areas. We have integrated

Reiko Hayashi: Thank you very much. Thus,

community care system in Japan, and I think that

there are issues raised such as we need data andthere is a need for something similar. I just wanted

long-term care is something very new in Africa. In

to make this comment.

addition, along with assisting the family who cares,

Reiko Hayashi
Director, Dept. of International Research and Cooperation, National
Institute of Population and Social Security Research (IPSS), Japan
Dr. Reiko Hayashi obtained a PhD in policy studies from the National Graduate Institute for Policy Studies (GRIPS), Japan, a Master of
Health Sciences and Bachelor of Technology (Architecture) from the
University of Tokyo, and a DESS from Université de Paris I. Prior tojoining IPSS in 2012, her career included Technical Advisor to the
Minister of Health, Republic of Senegal (JICA expert) and Project
Assistant Professor of Center for Sustainable Urban Regeneration,
the University of Tokyo. Her recent researches are on the topics
such as global ageing, internal and international migration, population and development, measurement of health, mor- bidity andmortality, and so on. She is the member of ICF and ICD committeesof Social Security Council Statistical Working Group of Ministry of
Health, Labour and Welfare of Japan, the Japanese Delegation ofUnited Nations Commission on Population and Development, andthe Board of Population Association of Japan.

by Osuke Komazawa
Excellencies, distinguished guests, ladies

rural Kenya. I stayed in a very remote fisheryand gentlemen, good afternoon. I don’t havevillage in Lake Victoria. According to ourto make closing remarks here because Dr.

database, the population of that island was

Reiko already wrapped up. However, I am

1,000. However, the population of 60+ people

supposed to make very brief closing remarks

was only about 10. It’s 1 percent. I thinknow.

at that time, I never discussed population

On behalf of the co-organizers, I would likeageing in the project. In addition, I had

to appreciate your participation and interest

activities in Vietnam, and I stayed in ethnic

in this event. I think we succeeded to provide

minority village in the mountainous Vietnama very good, one of the very few opportunities

region. I participated in the Malaria control

to have a dialogue between Asia and Africa

project. If you had been engaged in someon population ageing. Actually, myself has

health development projects, you know thatbeen involved in, both with Asia and Africa,

the target of Malaria control project is child.

so it’s a very impressive event for me.

We almost ignored the older people in thatI’m from ERIA. That is the Economic Research

project. Therefore, it is a very impressive

Institute for ASEAN and East Asia. We are

event for me that Asia and Africa have a

based in Jakarta, and our mission is policy

dialogue on population ageing.

recommendation to ASEAN secretariat. You

Now you are in Japan. As you know, Japan

must be wondering why ERIA is one of theis the most aged country in terms ofco-organizers of this event. Let me talk about

population structure. The proportion of 65+

my own experiences to explain, to answer

is over 25 percent. It will reach 30 percent

this question. Actually, I had activities insoon. So I believe even in Japan, the older

Africa. When I was a Ph.D. candidate ofpeople are respected because they have very

Nagasaki University, which is also one of therich experiences and knowledge, and theyco-organizers, we had a project to establish

developed a well refined skills, and they

the demographic surveillance system inhave very good insights on the societies andTowards Population Ageing in Africa

-041

everything. Then, even in Japan, I believe

contribution of the panel members with athey are all respected. However, you can findbig applause. In addition, the dedicated worksome communities if you look around Japan,of Japan Center for International Exchange

for example all of the community members

must be applauded strongly. Furthermore,are 65+, and inside the societies, it is very

thank you very much, distinguished guests,common an older person is taken care of by

excellencies, ladies and gentlemen for youran older person. It resulted in tragedy andparticipation in this event. I hope to see you

even abused, as Professor Prafulla said.

again in the near future. Thank you very

It is taking place in Africa. Abuse of older

much. I’d like to close this event. Thank you

people is not so rare in Japan. You may thinkvery much.

that is an extreme example of the most aged
country in the world. However, I think theworld population is ageing, because it’s anatural consequence of human development.
If

the

2030

Agendafor

Sustainable

Development is achieved in the future, theworld would certainly have a society withpopulation ageing. I think therefore thiskind of dialogue is very important, because
the solution for population ageing is not
only one. There are very many strategies tocope with population ageing. Therefore, wehave to find and create new opportunities for

Osuke Komazawa
Special Advisor on Healthcare & Long Term Care Policy, Economic
Research Institute for ASEAN and East Asia (ERIA)

in the near future as a spearhead of such

Osuke Komazawa belongs to the Healthcare Unit of ERIA, which
was established in 2017 to promote research and policy recommendations on population ageing and long-term care. Since his
appointment to ERIA, he has launched several research projects,
such as a longitudinal survey of older people in the Philippines
and Viet Nam, and work on the development of career paths forlong-term care personnel who return from working abroad. His
background is as an ENT surgeon. Dr. Komazawa graduated from
the Medical School of Tohoku University in 2000 and obtained
his PhD in medical science in 2013 from Nagasaki University. His
dissertation examined the community effect of long-lasting insecticide-treated bed nets based on data collected through a healthand demographic surveillance system established by Nagasaki
University and the Kenya Medical Research Institute in western
Kenya, covering about 50,000 people in the area along Lake Victoria. During his dissertation fieldwork, he stayed at a local fishingvillage several months on an island off the coast of Lake Victoria.
He began working for Ministry of Health, Labour and Welfare ofJapan in 2015 and was posted to ERIA in 2017.

a movement to discuss on how humanity

駒澤 大佐

population ageing, rather than considering
it burdensome.
Ladies and gentlemen, distinguished guests,
your excellencies, population ageing is the
success of humanity. If we want to enjoy theachievement of 2030 Agenda for Sustainable
Development, now we have to prepare forthe era which will certainly have population
ageing. I hope this event will be consideredcopes with population ageing, and how

東アジア・アセアン経済研究センター総長参与

we can enjoy the benefits of extra lives of

昭和51年奈良県生まれ。平成12年東北大学医学部卒業、同年医師免許。東北大学

years we will acquire as a result of human

形市 立病院済生館勤務。平成17年日本耳鼻咽喉科学会認定専門医(現在休止中)。

development.
Finally, I’d like to appreciate the great

医 学部附属病院(現東北大学病院)、公立気仙沼総合病院(現気仙沼市立病院)、山同年長 崎大学大学院医師薬学総合研究科博士課程入学、平成25年長崎大学博士

基調講演・モデレーター-040

アワ・マリ・コルセック

採取産業透明性イニシアティブ国家委員会理事長、元セネガル保健大臣
ナタリア・カネムは、
コロンビア大学とジョンズ・ホプキンス大学の医学部と公衆衛生大学 院にて、研究者としてキャリアをスタートした後、30年以上の間、医学、公衆衛生及び性 と生殖に関する健康、社会正義、社会奉仕事業分野において指導的立場で活躍してきた。1992年から2005年 にかけて、
フォード財団に勤務し、同財団の西アフリカ代表とし て女性の性と生殖に関する健康や、セ
クシュアリティ分野における先駆者として尽力し、そ の後財団本部では、アフリカ、アジア、東ヨーロッパ、南北アメリカにおいて世界
平和と社 会正義を促進するプログラムを総括する副代表として活躍した。2014年から2016年まで UNFPAのタンザニア代表を務め、2016年7月にプログラム担当の事務局次長に就任し た。
カネムは、ニューヨークのコロンビア大学で医学博士号を、
シアトルのワシントン大学 で、疫学、予防医学を専門とした公衆衛生学修士号を取得。

プラフラ・ミシュラ

ヘルプエイジ・インターナショナル アフリカ地域ディレクター
国際NGOヘルプエイジ・インターナショナルのアフリカ地域ディレクターとして、過去5年 間、アフリカ地域内のローカルパートナーとの連携やエビデンスの創出・普及、専門機関と のパートナーシップ構築を進めるなど、
アフリカにおけるヘルプエイジの組織変革に貢献した。社会開発、
ジェンダー、人道的援助と復興、強靭性、天然資源管理とガバナンスの分 野に関心をもち、24年の経歴をもつ。
これまでM.Sスワミナザン研究財団、
オックスファム、国際救済委員会(IRC)、
ノルウェー難民問題評議会に所属し、
インド、
ケ
ニア、
ソマリア、
エ チオピア、
ジブチ、
スーダン、
チャド、
イエメンなどアフリカ各国にて数多くの開発・人道支援と紛争復興プログラムに従事。生態学の修士号とライフサイエンス(マングローブ生態学) の博士号をもつ。

マリキ

インドネシア国家開発企画庁 人口計画・社会保障局ディレクター
インドネシア国家開発企画庁(BAPPENAS)にて2014年から2017年まで労働・雇用創 出局のディレクターを歴任し、2017年より現職。1994年にバンドン工科大学生物化学工 学学士卒業後、米国パデュー大学にて経済工学で修士号を取得。その後、ハワイ大学マ ノア校にて経済学博士号取得。国民移転勘定(National Transfer Accounts: NTA)の 国際的な専門家の一人であり、
その他にも社会保障、高齢化、労働経済学、人口動態統計(出生・死亡登録)の分野においても見識をもつ。

増田 研

長崎大学熱帯医学・グローバルヘルス研究科准教授
長崎大学熱帯医学・グローバルヘルス研究科、および多文化社会学部准教授。1993年 にエチオピア南部の農牧社会バンナにおいて民族誌的研究を開始し、2003年に東京都 立大学より博士論文『アイデンティティとしての「周辺」:エチオピア南部における近代の物 語』
により社会人類学の博士号を授与された。2004年に長崎大学に着任し、2008年から は大学院国際健康開発研究科(2015年からは熱帯医学・グローバルヘルス研究科)にお いて，
医療人類学と民族誌的方法の教育にあたっている。2010年以降、分野横断型研究 手法の開発に取り組みはじめ、東京外国語大学アジア・アフリカ言語文化研究所におい て共同研究「社会開発分野におけるフィールドワークの技術的融合を目指して」を3年間 にわたって組織した。2013年からは科学研究費助成金による東アフリカの高齢者に関す る生活、健康、福祉をめぐる共同研究を組織し、人類学、民族誌、公衆衛生、医療経済学、人口学、地理学、老年学といった関連分野を統合したフィールドワークの方法を模索して いる。

林 玲子

国立社会保障・人口問題研究所国際関係部長
東京大学保健学修士、東京大学工学士(建築)、パリ大学修士、政策研究大学院大学博 士(政策研究)。セネガル保健省大臣官房技術顧問、東京大学GCOE「都市空間の持続 再生学の展開」特任講師などを経て2012年より現職。世界的な高齢化、人口移
動、人口と開発、健康度・死亡率分析等の研究を行っている。厚生労働省社会保障審議会統計分 科会疾病、障害及び死因分類部会員、生活機能分類専門委員会委員、国連人口開発委 員会政府代表団員、
日本人口学会理事などを務める。

(医学)。博 士課程在籍時、長崎大学がケニアで展開していた人口静態・動態調査シス
テム構築プロ ジェクトに参画。自身は、ビクトリア湖の離島に滞在して現地調査。学位
論文は「長期残効 型殺虫剤浸漬蚊帳の地域効果に関する検討」。長崎大学病院勤
務後、平成27年厚生労 働省保健局。同28年厚生労働省政策統括官(統計・情報政策担当)付参事官付人口動 態・保健社会統計室。同29年東北厚生局勤務後、同年8月より厚生労働省からの派遣 により現職。

Towards Population Ageing in Africa

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We would sincerely like to give special thanks to
Ms. Momoko Abe,Ms. Tomomi Igari,
Ms. Mami Hitachi and
Mr. Ryuji Yoshino
for their support, coordination, and dedication to orgnizing
the official side-event.

Editor: Ken Masuda
Published Online at

Global Ageing Study Group
http://global-ageing.org/

Towards Population Ageing in Africa