WHO, Geneva,
7 April 1999

World Health Day - Active ageing makes the difference

I would like to welcome you to World Health Day 1999 which, as you all know, is devoted to the theme of ageing under the slogan "Active ageing makes the difference".

I trust you have all seen this year's World Health Day poster, which shows the inspiring faces of three older people from different continents, two women and one man. The picture of these people (some of whom may actually be in the audience and we thank them warmly for letting us use their pictures) was taken in the WHO lobby. They were here together for a photo session, but their origins are different and they have different stories to tell. What unites them, regardless of their different geographic and cultural origins, is that they are growing older in good health and by continuing to be active.

How have they done it? How have they achieved ageing in good health? What can we learn from them? Why, in fact, is the very last World Health Day of this century, of this millennium, devoted to ageing? And why active ageing? What exactly is WHO's concern with active ageing?

The most obvious reason why World Health Day 1999 is devoted to ageing is that WHO is part of the UN family and the UN General Assembly designated 1999 as the International Year of Older Persons. Special themes are assigned to international years in recognition of important unfolding changes and processes that affect all of humanity. International years therefore signal the need and offer the opportunity to develop a new consensus around an issue within a global context. This is why we have seen recent UN international years focussing world attention on the status of women, children, the family, the disabled, and indigenous people.

Within the next few decades, we will see an extraordinary increase in the number of older people worldwide. At the end of the century population ageing has become a global process that will increasingly affect everyone of us on this earth. We have experienced increases of 30 years in the average life span in this century. There are currently 580 million people in the world aged 60 years and over, and this figure is expected to rise to over 1 billion within the next 20 years. In addition, fertility rates have fallen significantly in most regions and now even some of the least developed countries are showing declines. Gradually infectious diseases are being replaced by chronic, non-infectious diseases as the major cause of death in most of the developing world. These are indeed profound changes affecting our lives. And they are likely to accelerate in the next century.

Population ageing is the outcome of all of these developments. It is viewed by some with a deep sense of concern for the anticipated costs to society, particularly in the areas of health care, old-age pensions and long-term care. Ours is a different view. Population ageing is first and foremost a success story for public health policies as well as social and economic development. As I have had the opportunity to stress on many occasions, the growing numbers of older persons represent a great resource to society, - and this needs to be better recognized and tapped for the good of all.

We are indeed at an important turning point in the history of humanity. And if we are to overcome the concerns and reaffirm that ageing is a success story, we must recognize that there is still a great deal to be learned about this unprecedented development. The lessons to be learned from research and their implications for the development of effective policies are going to be central for public health in the 21st century.

Active ageing strategies require that we increase our knowledge. Taking the perspective of health promotion throughout the life course, we need to learn how to better motivate people to change their behaviours and lifestyles to achieve active ageing. From a gender perspective, we must recognize gender-based differences and inequalities which affect how well we age as men and women. From a developing country perspective, we must be fully aware that while the developed countries became rich before they became old, the developing countries will become old before they become rich. We must therefore be determined in eliminating the greatest enemy of good health, i.e. poverty, particularly in its most extreme forms. From a resources for health perspective, we must learn how to better ensure an equitable access to and the sustainable provision of health services. And we must train the health service providers how to recognize the needs of an ageing society by taking into consideration the cultural and physical environment in which people live as they grow older.

In summary, we must define and refine strategies that stimulate healthy and active ageing. Active ageing strategies concern everyone, from policymakers to researchers, from practitioners to every individual on this planet. A strategy for active ageing is required to ensure that the greatest number of people stay healthy and active for as long as possible. This takes into account the sum total of all of WHO's activities - from rolling back malaria or tuberculosis to eliminating tobacco or substance abuse, from fighting diseases to eliminating violence, from promoting healthy schools, safe motherhood, good nutrition to promoting mental health and active living - active ageing policies cut across all of these strategies. Active ageing policies help us to focus our attention on what is truly essential: to promote longer and healthier lives. Active ageing policies can truly make a difference as we move into the next century. And clearly, WHO will not stop to promote strategies for active ageing when 1999, the International Year, comes to a close. On the contrary, as we go into the next century active ageing must become a natural and integral part of all of our lives.

And it is in the true spirit of active ageing that we have invited Sir Richard Doll to be with us today as our Guest of Honour. As one of our most eminent epidemiologists, Sir Richard's contribution to public health is truly outstanding.

It has now been exactly 50 years that Sir Richard was finalizing with Bradford Hill the preliminary study that has linked smoking to lung cancer. The resulting paper was published in 1950 and we reprinted it this year in the first issue of our new WHO Bulletin. However, Sir Richard's contribution goes far beyond this extraordinary study. He has spent the last 50 years conducting many outstanding studies, publicizing the results and training generations of epidemiologists at the University of Oxford.

For a young student at Harvard in 1965, Richard Doll was the real guru, as you were to so many others, who are now leaders in public health worldwide.

Sir Richard, a tribute from WHO to your unparalleled achievement has been long overdue - may I therefore ask all of you to give Sir Richard a standing ovation.

Thank you.