Longer Lives, Unequal Care: UN Report Exposes Gaps in Support for Older People Globally

The population aged 60 and over exceeded one billion in 2020 and is projected to reach 2.1 billion by 2050, with the fastest growth expected in low- and middle-income countries.

Living longer should mean having more time to enjoy family, stay involved in community life and make choices independently, but a new United Nations report shows that access to the care and support needed for those extra years remains uneven. Transmitted by the Secretary-General to the 81st session of the UN General Assembly, the mid-term report on the UN Decade of Healthy Ageing (2021–2030) documents national progress and gaps that require attention before 2030. WHO prepared it with the UN Inter-Agency Group on Ageing, drawing on contributions from thirteen UN entities, the World Bank Group and civil society partners.

Longer lives are outpacing access to healthy ageing

The population aged 60 and over exceeded one billion in 2020 and is projected to reach 2.1 billion by 2050, with the fastest growth expected in low- and middle-income countries. Those additional years do not automatically bring good health: the global gap between life expectancy and healthy life expectancy at age 60 widened between 2000 and 2023, and older people accounted for an estimated 71% of excess COVID-19 deaths during 2020–2023. WHO director Dr Pascale Allotey called for expanding and financing support that meets older people's needs and protects their rights.

National policies show measurable improvement, with the share of countries reporting legislation against age discrimination rising from 44.5% in 2018 to 57.7%, and national long-term care policies increasing from 49% in 2023 to 56.7%. Dedicated programmes for age-friendly environments and comprehensive health and social assessments of older people each reach 54.6% of countries. WHO guidance on long-term care and community-based Integrated Care for Older People is helping more countries include these services in universal health care benefit packages, supported by workforce training and digital health tools.

Funding shortages leave everyday support out of reach

For someone who needs hearing aids, spectacles or a rollator, access to an assistive device can make a substantial difference to daily independence, dignity and participation, but only 45.4% of countries have legislation providing access to these essentials. Financing remains the report's central obstacle, with 33.8% of reporting countries having very little or no dedicated resources to develop long-term care and similar shortages affecting other priorities. The report calls for sustained investment through national budgets, country-owned plans, development cooperation and innovative financing mechanisms to close the gaps by 2030.

Weak information systems make it harder to understand whether support meets people's needs, as only 22.7% of countries can track older people's health over time, the largest shortfall among the Decade's core progress indicators. Nationally representative data matters because people of the same age can have very different health conditions, abilities and support requirements. WHO's Dr Ritu Sadana also identified a setback in coordination: the proportion of countries reporting active forums involving multiple stakeholders on ageing fell from 53.1% in 2020 to 43.3%, despite wider gains across regions and income levels.

Older people need a voice in the next five years

The report includes experiences gathered through an International Federation on Ageing multilingual survey reaching more than 1,000 older people across 58 countries, giving their perspectives a place alongside national progress measures. Amal Abou Rafeh of UN DESA stressed the need to expand coordinated UN support, with countries leading legislation, funding and implementation and engaging older people directly. WHO and UN partners urged Member States to accelerate delivery, strengthen data systems and secure financing during the Decade's second half so the benefits of longer lives reach people everywhere.

World Bank ageing and pensions lead Fiona Stewart described healthy ageing as an investment with substantial economic returns, saying early spending on integrated and long-term care can generate savings that outweigh initial costs many times over. Predictable national financing, support for older entrepreneurs and opportunities in the silver economy form part of that case, connecting better care with older people's ability to remain independent and contribute to economic life.