The Grey Tsunami

How to Reap a Healthy Longevity Dividend

In January the World Economic Forum at Davos released a major report, “Global Population Ageing: Peril or Promise?”, forecasting an economic and social firestorm - a world growing older at a rapid pace. By 2050 two billion people will be over 60 years of age – one in five compared to one in 10 today. I welcome the WHO decision to dedicate this year’s World Health Day to “Ageing and health,” with the theme "Good health adds life to years." Whilst the ageing trend started in the developed world, it is now accelerating faster in developing countries where income levels are much lower. Developing countries will grow old before they grow rich – putting the health of millions at risk.

To talk only of an ‘ageing problem’ is a grotesque mistake. Longer lives are a triumph. What are needed are solutions that make better use of longer life – reaping the longevity dividend by recognising older people as a resource, not a burden. For instance, the International Labour Organization recently brought together business leaders and workers from the retail sector to look at the impact of ageing on a traditionally young labour supply. The result is that retailers are preparing for adjustments to take advantage of a talented older workforce.

Fostering good health in older age is central to a considered global response to population ageing. Investing in health now will lessen the disease burden, help prevent isolation and has economic benefits for society by maintaining the independence and productivity of older people.

There is no doubt population ageing will result in an increased demand for acute and primary health care, adding to the financial strain of coping with long-term and social care. In the developing world, help with meeting this need is available through the social pension, a policy advocated by the winner of the 2012 Hilton Humanitarian Prize, HelpAge International. Government-funded, regular cash income paid to all older people as their right is both a powerful and cost-effective way of empowering older people and reducing poverty. In many developing countries, up to 40 per cent of the population live in households containing older persons, and these households are often poorer than average. Thus, targeting older people is an effective way to reach poor families, reducing not only their own poverty, but also the overall household.

At present, only 1 in 5 older people worldwide receive a pension. Yet, if the age at which the pension is first paid is chosen to reflect fiscal as well as social realities, the cost of providing coverage to more people is surprisingly small. A universal social pension would cost less than 3 per cent of GDP in most of the countries in Sub Saharan Africa.

The gains from such expenditure are large. Social pensions in OECD countries reduce elderly poverty by between 30 and 60 per cent. In developing countries older people’s pensions and agricultural incomes secure the livelihoods and health of whole family networks, are invested into children’s education and economic independence, and improve access to credit. This is seen in Brazil, where social pensions contributed to a 32 per cent reduction in income inequality and to improvements in children’s nutritional status and schooling. And South Africa’s social pension has improved girls’ nutritional status, with height gains of 3-4 centimetres, and is associated with an 8 per cent increase in school enrolment among the poorest 20 per cent.

Now imagine growing old without a pension, while living with a chronic illness. The main health challenges for older people are heart disease, stroke, visual impairment, hearing loss and dementia. As our world ages, the impact of these conditions is two to three times greater for older people in low- and middle-income countries than for people in high-income countries.

Yet, the health systems in these countries are not designed to meet the chronic care needs that arise from a complex mix of diseases. High blood pressure and consequently, heart disease and stroke, are the biggest causes of years of life lost. Yet, somewhere between only 4 and 14% of older people in low- and middle-income countries are receiving effective treatment. Economic independence would help to ensure that this improves. Health and insurance systems must also adapt to ensure quality care, in and beyond the hospital, but economic independence has to support this change.

Older people must be able to afford and live in good health because they hold up our society. In the developing world, they have a critical role in raising grandchildren, especially where parents have migrated or died from AIDS; their social pension is a form of family support. In Southern Africa alone 60 per cent of orphans are cared for by older people. The great majority of these households live on or under the poverty line, with no defence to a sudden threat such as a chronic health crisis for the older caregiver. The stabilising potential of a regular income for these households is immense.

This coverage gap is rightly seen as a central challenge, but one which can be solved. Social pensions are economically and administratively feasible even in poor countries. Relatively small amounts of money invested in older people also are investments in children, livelihoods and economies, thus sowing the seeds for the longevity dividend. We must learn now that what makes sense economically is also morally the right thing to do.

Follow HelpAge International on Twitter: @helpage

Elderly people dance during an afternoon get-together in Berlin. Credit: Getty

Institute Professor Emeritus at the Massachusetts Institute of Technology and 2010 Nobel laureate in economics.

Getty
Show Hide image

Inside the progressive alliance that beat Zac Goldsmith in Richmond

Frantic phone calls, hundreds of volunteers, and Labour MPs constrained by their party. 

Politics for a progressive has been gloomy for a long time. On Thursday, in Richmond Park of all places, there was a ray of light. Progressive parties (at least some of them) and ordinary voters combined to beat Ukip, the Tories and their "hard Brexit, soft racist" candidate.

It didn’t happen by accident. Let's be clear, the Liberal Democrats do by-elections really well. Their activists flood in, and good luck to them. But Richmond Park was too big a mountain for even their focused efforts. No, the narrow win was also down to the fast growing idea of a progressive alliance. 

The progressive alliance is both a defensive and offensive move. It recognises the tactical weakness of progressives under first past the post – a system the Tories and their press know how to game. With progressive forces spilt between Labour, Liberal Democrats, Greens, the SNP, Plaid Cymru, the Women’s Equality Party and more – there is no choice but to co-operate, bring in proportional representation and then a whole new political world begins.

This move opens up the wider strategy – to end the domination of the City, and right-wing newspapers like the Mail, so Britain can have a real debate and make real choices about what sort of economy and society it wants. A pipedream? Well, maybe. But last night the fuse was lit in Richmond Park. The progressive alliance can work.

Months before the by-election, the pressure group for a progressive alliance that I chair, Compass, the Greens, and some Labour, Liberal Democrat and SNP MPs and activists, began considering this. The alternative after Brexit was staring into the void.

Then the Tory MP Zac Goldsmith stepped down over Heathrow. To be fair, he had pledged to do this, and we should have been better prepared. In the event, urgent behind-the-scenes calls were made between the Greens and the Liberal Democrats. Compass acted as the safe house. The Greens, wonderfully, clung onto democracy – the local party had to decide. And they decided to stand up for a new politics. Andree Frieze would have been the Green candidate, and enjoyed her moment in the autumn sun. She and her party turned it down for a greater good. So did the Women’s Equality Party.

Meanwhile, what about Labour? Last time, they came a distant third. Again the phones were hit and meetings held. There was growing support not to stand. But what would they get back from the Liberal Democrats, and what did the rules say about not standing? It was getting close to the wire. I spent an hour after midnight, in the freezing cold of Aberdeen, on the phone to a sympathetic Labour MP trying to work out what the party rule book said before the selection meeting.

At the meeting, I am told, a move was made from the floor not to select. The London regional official ruled it out of order and said a candidate would be imposed if they didn’t select. Some members walked out at this point. Where was the new kinder, gentler politics? Where was membership democracy? Fast forward to last night, and the Labour candidate got less votes than the party has members.

The idea of a progressive alliance in Richmond was then cemented in a draughty church hall on the first Tuesday of the campaign – the Unitarian Church of course. Within 48 hours notice, 200 local activist of all parties and none had come together to hear the case for a progressive alliance. Both the Greens and Compass produced literature to make the case for voting for the best-placed progressive candidate. The Liberal Democrats wove their by-election magic. And together we won.

It’s a small victory – but it shows what is possible. Labour is going to have to think very hard whether it wants to stay outside of this, when so many MPs and members see it as common sense. The lurch to the right has to be stopped – a progressive alliance, in which Labour is the biggest tent in the campsite, is the only hope.

In the New Year, the Progressive Alliance will be officially launched with a steering committee, website and activists tool-kit. There will also be a trained by-election hit squad, manifestos of ideas and alliances build locally and across civil society.

There are lots of problems that lie ahead - Labour tribalism, the 52 per cent versus the 48 per cent, Scottish independence and the rest. But there were lots of problems in Richmond Park, and we overcame them. And you know, working together felt good – it felt like the future. The Tories, Ukip and Arron Banks want a different future – a regressive alliance. We have to do better than them. On Thursday, we showed we could.

Could the progressive alliance be the start of the new politics we have all hoped for?

Neal Lawson is the Chair of Compass, the pressure group for the progressive alliance.

Neal Lawson is chair of the pressure group Compass, which brings together progressives from all parties and none. His views on internal Labour matters are personal ones.