1. Ageing and vulnerability in ASEAN countries Eduardo Klien 5 th ASEAN GO-NGO Forum, 22 November 2010, Brunei Darussalam

2. Demographic Shift Condensed in time Irreversible in nature Comprehensive in scope

3. ASEAN population Source : World Population Prospects: The 2008 Revision Population Database, United Nations Population Division http://esa.un.org/unpp/index.asp?panel=2)http://esa.un.org/unpp/index.asp?panel=2 Compiled by HelpAge 80 60 14

4. ASEAN population Source : World Population Prospects: The 2008 Revision Population Database, United Nations Population Division http://esa.un.org/unpp/index.asp?panel=2)http://esa.un.org/unpp/index.asp?panel=2

5. Growth of the old and older old Source : World Population Prospects: The 2008 Revision Population Database, United Nations Population Division http://esa.un.org/unpp/index.asp?panel=2)http://esa.un.org/unpp/index.asp?panel=2 Compiled by HelpAge

6. Population ageing in ASEAN countries Year 60+80+ maleFemalemaleFemale 199045%55% 39%61% 201544%56% 40%60% 205044%56% 37%63% (%) http://esa.un.org/unpp/p2k0data.asp

7. Reduction of proportion and absolute number of children Increase of people over 60 years Increase of older olds Feminisation of old age

8. Challenges on social and economic policy How to ensure income security How to provide adequate Health services How to enhance Community care and inclusion

9. Dependency ratios (Total, Child, Old-age) 1985 2005 20252050 Total Child Old- age TotalChild Old- age Total Child Old- age TotalChild Old- age Brunei 6863547435413011512823 Cambodia 868056762552448463115 Indonesia72 666 51 438 3013562729 Lao PDR 918477872656497483414 Malaysia 7467656497483513532825 Myanmar 7870850428463313552827 Philippine s 8276665596534310513219 Singapore 42347392712551935782058 Thailand 63567433310482919602832 Viet Nam83 758 55 4510 443014582732 Compiled by HelpAge

10. Dependency ratio in ASEAN Source : World Population Prospects: The 2008 Revision Population Database, United Nations Population Division http://esa.un.org/unpp/index.asp?panel=2)http://esa.un.org/unpp/index.asp?panel=2 Compiled by HelpAge

11. Income security More consumption than income

12. Income security 21% of older people have formal pensions Expansion of contributory pensions: limited option Role of non-contributory pensions

13. Life expectancy after 60 and years of ill health

14. Health Ageing and Non communicable diseases – 75% of the deaths in the region are attributable to NCDs compared to 14% of deaths from communicable diseases – NCDs represent 92% of the burden of disease (DALYs) in high income countries and 63% in middle and low income countries.

15. Main NCDs of older people Adults Aged 60+ RankDiseases 1 2 3 4 5 6 7 8 9 10 Ischaemic heart disease Cerebrovascular disease Chronic obstructive pulmonary disease Lower respiratory infections Trachea, bronchus, lung cancers Diabetes mellitus Hypertensive heart disease Stomach cancer Tuberculosis Colon and rectum cancers Source: WHO, 2006

16. Health Rethink health systems to cover NCDs Self-care approaches Access to health services for older people (2 approaches to achieve universality) – Bismark: social insurance – Beveridge: tax funded free health care

17. Nursing Home Home Care Volunteer& family Difficulties of ADL & IADL of OP Cost of Care Community based care Institutional care Care giving - Continuum of Care Day Care Paid Home Care Short Stay Home for the Aged Source: HelpAge Korea

18. Community care and inclusion Older people in work (family care) Family and community care for older people Inclusion and mainstreaming ageing OPA development

19. Thank you