70 is the new 50: World Bank raises complexities of tackling aging

When experts declare that the “70s are the new 50s,” it’s more than just a catchy phrase. Data from 41 countries released by the International Monetary Fund in time for this week’s World Bank/IMF Spring Meetings found that, on average, a person aged 70 in 2022 had the same cognitive abilities as someone who was 53 years old in the year 2000, meaning the world is aging better. But while it’s worth celebrating, aging and longevity also unveil complex challenges that countries and development institutions such as the World Bank need to navigate. The challenges cover health, but also social protection, jobs, and financing. During a World Bank session on Super Aging, Loli Arribas-Banos, practice manager for the Social Protection and Jobs Global Unit at the World Bank, described how countries are in different demographic transitions at the moment. She said there are countries where aging is already seen as a crisis, not just because of the high number of older people, but because of the length of their dependence on pensions and care. She gave the example of her father, who retired at 65 years old. Now at 98, he has been receiving a pension for 33 years and care for the last 15 years. “Countries that are facing this challenge [...] are already facing fiscal deficits in pension systems because the population pyramid is already inverted,” Arribas-Banos said. “They are experiencing higher health and hospital costs, and they have labor shortages in different sectors, particularly in the elderly care sector.” Some countries, such as Vietnam, are also experiencing rapid aging. The problem is “they’re getting old before they are getting rich”, she said, making it more challenging for them to prepare for the upcoming challenges of an aging population that higher-income nations are struggling to deal with. And while most countries in Africa are still considered young economies, their elderly numbers are expected to triple by 2050, reaching the same levels as Europe. The challenge is that lots of people are employed in the informal sector, which means they likely won’t have access to a pension system when they reach old age. It’s also important to support healthy aging. At the moment, the rise of noncommunicable diseases is shaping the burden of disease in many countries, but also putting stress on countries’ health finances. Over 1 billion people are currently living with hypertension globally. Juan Pablo Uribe, the bank’s global director for health, nutrition, and population, said ministers, particularly those in low-income countries with weak health systems, are struggling to deal with noncommunicable diseases. “They are all recognizing the importance of being more effective in tackling NCDs, which are a huge obstacle for the proper development of their systems. But it’s a very tough political choice, because even though they know very well the origins of NCDs, the risk factors behind them, the interventions are very difficult,” he said. Recognizing the complexities, the World Bank, from a social protection lens, is applying different approaches to help countries, including ensuring the poor and vulnerable have access to quality and affordable care as well as social pensions and savings schemes for those working in the informal sector. And for those living longer, Arribas-Banos said one focus is on upgrading their skills to ensure they remain employable. Meanwhile, Sir George Alleyne, director emeritus at the Pan American Health Organization, or PAHO, said one important step that countries can take is to raise cigarette taxes. He said 80% of the world’s 1 billion smokers now live in countries where cigarettes are the same price or cheaper than they were 10-15 years ago, but not enough is being done to articulate the dangers of smoking. Smoking tobacco is a major risk factor for many NCDs, including cardiovascular diseases, chronic respiratory diseases, cancer, and diabetes, according to the NCD Alliance. “I think it is a collective failure of society that there’s still cigarette smoking on Earth,” Alleyne said.