The Response of the International Community: Madrid International Plan of Action on Ageing (MIPAA) Presentation by Asghar Zaidi European Centre Vienna Also on behalf of Alexandre Sidorenko, UN Programme on Ageing UN PROGRAMME ON AGEING AS 2007 European Centre for Social Welfare Policy and Research

Outline of my two-part presentation: The Madrid International Plan of Action on Ageing (15 mins) What is MIPAA? Implementation strategy of MIPAA Implementation efforts Review & appraisal: what modalities and procedures MIPAA and the Improvement of the Quality of Life (5 mins) UN PROGRAMME ON AGEING AS 2007 European Centre for Social Welfare Policy and Research

What is MIPAA? Madrid, April 2002: The 2nd World Assembly on Ageing adopted the Madrid International Plan of Action on Ageing (MIPAA) – a major international coordination initiative; Mandate to the UN Regional Commissions to translate the Plan into regional action plans and to assist national institutions in implementation and monitoring of their actions on ageing (MIPAA, para 128); 2007/08 is the 5th anniversary of MIPAA – thus, a review and appraisal of the activities undertaken under the MIPAA.

COMMITMENTS OF GOVERNMENTS IN THE POLITICAL DECLARATION: and Madrid International Plan of Action on Ageing Second World Assembly on Ageing, Madrid, Spain 8-12 April 2002 COMMITMENTS OF GOVERNMENTS IN THE POLITICAL DECLARATION: Incorporate ageing within social and economic strategies… Eliminate age discrimination… Protect older persons in armed conflict and foreign occupation… Provide older persons with universal and equal excess to health care and services… UN PROGRAMME ON AGEING

Reaching a society for all ages Political Declaration and Madrid International Plan of Action on Ageing Second World Assembly on Ageing, Madrid, Spain 8-12 April 2002 Overall GOAL: Reaching a society for all ages CONTENT: Adjustment to an ageing world UN PROGRAMME ON AGEING

I. Older Persons and Development Priority Directions for Policy Actions I. Older Persons and Development II. Advancing Health and Wellbeing into Old Age III. Ensuring Enabling and Supportive Environments UN PROGRAMME ON AGEING

I. Older Persons and Development Adjustment to an ageing world is measured in terms of: I. Older Persons and Development Social development II. Advancing Health and Wellbeing into Old Age Improving ‘QOL’ of older persons Sustainability of support systems III. Ensuring Enabling and Supportive Environments

“TARGETED” MAINSTREAMING Region Overall (social/economic) priority Ageing mainstreaming component (focus) Africa Poverty HIV/AIDS, incl. orphan children Older persons as caregivers and household leaders Latin America (Out)migration Older persons left behind in rural areas. Older persons adjusting to urban environment Asia Adjustment to fast societal change Transition from informal (family, e.g. filial piety, etc.) to mix (formal + informal) support systems Eurasian countries Transition from all-inclusive social welfare to market based schemes Older persons as active members of transitional society UNECE countries Reform of social security and health care systems; Labour force participation Older persons as beneficiary of social security system and contributors to development UN PROGRAMME ON AGEING

Implementation of the Madrid Plan Political Declaration and Madrid International Plan of Action on Ageing Second World Assembly on Ageing, Madrid, Spain 8-12 April 2002 Implementation of the Madrid Plan

The essential element of its implementation is to help extend national capacity on ageing institutional framework human resources (governmental/ non-govt) mobilization of financial resources research, data collection and analysis policy processes, including the use of mainstreaming

Example on national capacity on ageing: research, data collection and analysis UN EUROPEAN REGION: The European Centre for Social Welfare Policy and Research (Vienna) assists governments in monitoring the regional implementation strategy for the MIPAA in the UNECE region. The European Research Area in Ageing (ERA-AGE): a four year project funded by the European Commission, to promote the development of a European strategy for research on ageing.

Political Declaration and Madrid International Plan of Action on Ageing Second World Assembly on Ageing, Madrid, Spain 8-12 April 2002 3. First cycle of the review and appraisal of the Madrid Plan of Action

Key Modalities of National Review & Appraisal: Review and appraisal will be undertaken every five years; Each review and appraisal cycle will focus on the theme based on the priority directions of MIPAA; Review and appraisal will include two dimensions: ageing-specific policies and ageing-mainstreaming efforts; and Bottom-up and flexible approach will be the major format of the review and appraisal exercise.

The first global cycle of the review and appraisal of the Madrid Plan of Action - Started in 2007 at the 45th session of the Commission for Social Development and will conclude it in 2008 at its 46th session. Global theme: “Addressing the challenges and opportunities of ageing”. Format of the concluding event (in 2008): plenary debate + a series of panel discussions and events related to the theme of the first review and appraisal cycle.

Part II: Quality of Life What does it generally mean? multi-dimensional and complex concept Health often used as a proxy Major focus of scientific research in Europe and North America, BUT with limited benefits to policymaking and to actual people quality of life It is important driver of policy (in EU, in UN and also in MIPAA) MIPAA: It is not clear what exactly is meant by such terms as “enhancing of quality of life”, “maintaining quality of life”, “contributing to quality of life”, etc, but it is regarded one of the central goals of ageing policies.

References to Quality of Life in MIPAA “medical conditions due to environmental pollution affects quality of life of persons as they age” “mental health problems are a leading cause of disability and of reduced quality of life” “health promotion and disease prevention activities [that] can improve the functioning and quality of life of older persons who already have disabilities” The Action Plan refers to quality of life within the context of health! Is this what it is?

MULTI-DIMENSIONAL NATURE OF QoL Psychological Physical Spatial Social/Economic Source: Walker (2007)

MODELS OF QUALITY OF LIFE Objective social indicators Satisfaction of human needs Subjective social indicators Health and functioning

Older People’s own perspectives on QoL FOUNDATIONS OF A GOOD QoL IN OLD AGE Having good social relationships with family, friends and neighbours Having good health and functional ability Living in a good home and neighbourhood Having a positive outlook and psychological well-being Having adequate income Maintaining independence and control over one's life Source: Bowling et al (2002)

Challenges and Opportunities Challenges: they vary between regions and countries; UN regional commissions and national stakeholders have an important role; MIPAA to ensure effective intergovernmental cooperation. Opportunity: A comprehensive strategy is adopted by national authorities (necessary to understand the sources of and promotion of quality of life): by combining preventative and remedial actions by adopting a ‘Society for All Ages’ approach by integrating economic and social policies by joining up all of relevant actors by ingraining the principle of participation under conditions which enhance older people’s well-being