Director-General's message on World Health Day
Dr Margaret Chan
Director-General of the World Health Organization
Distinguished panellists, colleagues in public health, ladies and gentlemen,
A warm welcome to this World Health Day roundtable discussion about the importance of using good health to add life to years.
We are born ageing, as they say, and we all want to grow older with grace, dignity, and full social engagement. Good health makes this possible.
The trend towards ever-older populations is now universal. It defines what life, and health, mean in the 21st century. And it has some historically unprecedented dimensions.
Worldwide, the proportion of older people in the total population is increasing at more than three times the overall population growth rate.
Populations are ageing fastest in low- and middle-income countries. A transition towards an older society that took more than a century in Europe is now taking place in less than 25 years in countries like Brazil, China, and Thailand. Countries risk being taken by surprise and caught unprepared.
Within the next five years, for the first time in history, the population of people aged 65 and older will outnumber children under the age of five.
In other words, being in the older age group is becoming the “new normal” for the world’s population.
In promoting healthy ageing, WHO follows a life course approach. Doing so lets us discover multiple critical points, throughout life, for preventive intervention. For example, recent evidence demonstrates that undernutrition during gestation and early life increases the risk for noncommunicable diseases later in life.
Most older people experience health problems. These are overwhelmingly caused by noncommunicable diseases, often several experienced together.
In such cases, we need to shift the focus from providing good care for a single disease to providing good health in the face of multiple diseases. The boundaries between primary care and specialist care need to soften.
In my view, we must not let money or lack of access to care decide who stays fit and who gets frail too soon.
Everyone worries about the costs. Sophisticated interventions, like organ transplants and hip replacements, can improve quality of life and foster independence, but they come with a high price tag.
Simple interventions can have a huge impact. For example, hypertension control, using extremely affordable medicines, contributes greatly to increased longevity. Yet only around 10% of older people in the developing world benefit from this treatment.
Regular moderate physical activity has a rejuvenating effect, working to turn back the clock. Ancient Chinese Tai Chi exercises can restore balance in older people and help prevent falls.
Ladies and gentlemen,
We need to change our thinking about people in the over-sixty age group, in radical ways. Longevity has advanced to the point where conditions like old age and frailty can no longer be defined by numerical age.
Past stereotypes developed in past centuries no longer hold. When a 100-year-old man finishes a marathon, as happened last year, we know that conventional conceptions of old age must change.
These days, people who got the right start in life, followed healthy lifestyles, and took good care of their health can expect to remain active during their eighth, ninth, even tenth decade of life.
We need to respect older people as rich sources of wisdom and experience, as assets for society, not burdens, as new models for the “new normal”.
We see a great appetite to move in this direction, apparent in the hundreds of municipalities that have joined the WHO Global Network of Age-friendly Cities. These mayors are committed to creating environments that honour the needs of older people and respect their desire to remain fully engaged shapers of society.