Ageing as a global public health challenge: From complexity reduction to aid effectiveness

Abstract

Since 2002, ageing populations worldwide have received increasing attention by global policy-makers. However, resources committed by inter-governmental donors and US-based private foundations in support of ageing-related policies and interventions in non-Organisation for Economic Co-operation and Development (OECD) countries have remained minimal during this decade and, where mobilised, have rarely responded to actual country-level demographics and institutional capacities. We argue that this lag between issue recognition and effective resource mobilisation, while mirroring known dynamics in global agenda-setting, has also been caused by a depiction of ageing as a uniform trend across the Global South. We develop and apply a comprehensive analytical framework to assess the state of ageing dynamics at the country level and uncover substantial regional and sub-regional variation. In response, we suggest replacing complexity reduction in the interest of issue recognition with targeted support for a more nuanced research agenda and policy debate on country-specific ageing dynamics in order to inform and catalyse effective international assistance.

Keywords:

• ageing
• health policy
• foreign aid
• global governance
• aid effectiveness

Acknowledgements

The authors thank the editors and two anonymous reviewers for their excellent feedback. Susan Shepler, Jeremy Shiffman, Loubna Skalli Hanna, Rachel Sullivan Robinson and Nina Yamanis offered very helpful advice on earlier versions of the manuscript. Rachel Proefke assisted with some of the research while Jed Benjamin Byers, Ramona Daukste and Scott Weathers provided copy-editing support. All remaining errors are entirely the authors’. No conflicts of interest declared.

Notes

1. Cross-national reports on ageing have converged on designating 65 and older as ‘the older population’ since the mid-late 1980s (Kinsella & He, 2009, p. 3), and we, therefore, adopt this definition.

2. It is important to note that these percentages refer to programming and initiatives targeted specifically at ageing populations; programming that may benefit ageing populations as a result of their implementation (for example, community health programmes) are not necessarily accounted for in this data.