WHO Warns Millions of Older People Risk Being Left Behind Despite Longer Lives

The WHO has warned that millions of older people face poverty, poor healthcare and inadequate support despite longer life expectancy. In Nigeria, many elderly people lack pensions and continue working to survive. The organisation is urging governments to improve healthcare, strengthen social protection and invest in long term care to ensure healthier and more dignified ageing.

LONGER LIVES DO NOT ALWAYS MEAN HEALTHIER AGEING

Millions of older people across the world continue to face poverty, poor health and inadequate social support despite improvements in life expectancy, according to a new report by the World Health Organisation (WHO).
The report, released at the midpoint of the United Nations Decade of Healthy Ageing (2021–2030), highlights progress in protecting older people while warning that many countries still lack the funding, healthcare services and social protection needed to help them live healthier and more dignified lives.
In rural Nigeria, for example, a 68-year-old woman continues to cultivate cassava to support herself because she has no pension. Having never worked in the formal sector, she has no regular retirement income, while her children have moved to Lagos in search of better economic opportunities.
Despite years of physically demanding work, she cannot afford medical treatment for the joint pains she experiences at night.
A similar concern has emerged in Kenya, where a government official described his son's indifferent response after being told that his grandmother was sick. The young man simply asked that his apologies be passed on to her, reflecting concerns about weakening family connections and the challenges older people face in receiving emotional and practical support.
Although the two situations occurred in different countries, they illustrate a shared problem across many African communities: people are living longer, but not everyone is enjoying good health, financial security or adequate care in old age.

GLOBAL POPULATION OF OLDER PEOPLE CONTINUES TO GROW

The WHO report states that the global population aged 60 and above exceeded one billion in 2020 and is projected to reach 2.1 billion by 2050.
The fastest growth is expected in low and middle-income countries, where healthcare systems and social protection programmes may struggle to meet the increasing needs of ageing populations.
Living longer is generally considered an important achievement, but longer life expectancy does not automatically translate into more years of good health.
Between 2000 and 2023, the gap between life expectancy and healthy life expectancy at age 60 widened. This means that people may spend a greater portion of their later years living with illnesses, disabilities or other conditions that affect their independence and quality of life.
Healthy ageing involves more than preventing disease. It also includes maintaining the ability to move around, perform everyday activities, participate in society and enjoy supportive relationships.
For older people who lack money, healthcare and family assistance, even manageable health conditions can become serious obstacles to independent living.

COVID-19 HIT OLDER PEOPLE PARTICULARLY HARD

The COVID-19 pandemic exposed the vulnerability of older people, who faced a greater risk of severe illness and death than many younger age groups.
According to the WHO report, an estimated 71 per cent of excess deaths globally associated with COVID-19 between 2020 and 2023 occurred among people aged 60 and above.
In Nigeria, the Nigeria Centre for Disease Control and Prevention reported thousands of confirmed COVID-19 deaths, with older people and individuals with underlying health conditions facing an increased risk of severe outcomes.
Kenya also recorded thousands of deaths during the pandemic, with older adults among those particularly vulnerable to severe illness and death.
The pandemic demonstrated why older people need accessible healthcare, timely medical attention and reliable support during public health emergencies.
It also highlighted the consequences of inadequate health systems, especially where older people must pay out of pocket for treatment or struggle to reach medical facilities.
The experience has strengthened calls for governments to develop healthcare systems that respond to the needs of people throughout their lives, including during old age.

COUNTRIES MAKE PROGRESS IN PROTECTING OLDER PEOPLE

Despite these challenges, the WHO report identifies several areas where countries have made progress since the UN Decade of Healthy Ageing began in 2021.
The proportion of countries reporting legislation against age-based discrimination increased from 44.5 per cent in 2018 to 57.7 per cent in the latest assessment.
More than half of reporting countries also have national policies on long-term care, programmes designed to make communities more age-friendly and systems for assessing the health and social needs of older people.
Age discrimination, commonly known as ageism, occurs when people are treated unfairly or stereotyped because of their age. It can prevent older adults from accessing employment, healthcare, social services and opportunities to participate in community life.
The report emphasises that legal protection and public policies are important steps towards ensuring that older people are treated with respect and have access to the services they need.
Dr Pascale Allotey, Director of the WHO department responsible for sexual, reproductive, maternal, child and adolescent health and ageing, said longer lives represented a major human achievement, but warned that millions of older people continued to lack adequate health and social support.
She called on governments to expand and finance existing programmes during the second half of the decade.

FUNDING SHORTAGES REMAIN A MAJOR OBSTACLE

Although countries have introduced more policies to support healthy ageing, the WHO report warns that implementation remains uneven.
One of the biggest problems is insufficient funding for long-term care, which includes assistance for older people who need help with daily activities, managing health conditions or maintaining their independence.
The report found that 33.8 per cent of reporting countries had very limited or no dedicated resources for developing long-term care services.
Access to assistive devices is another concern. These include hearing aids, spectacles, walking frames and other equipment that can help older people remain mobile, communicate effectively and carry out daily activities.
Only 45.4 per cent of countries reported having legislation that provides access to assistive devices.
The report also found that just 22.7 per cent of countries could track the health of older people over time. Without reliable information, governments may struggle to identify unmet needs, monitor progress or direct resources towards the people who need them most.
Dr Ritu Sadana, head of the WHO Secretariat for the UN Decade of Healthy Ageing, said more countries were strengthening healthcare and long-term care systems, but progress was not consistent.
She also highlighted a decline in the proportion of countries reporting active forums that bring different stakeholders together to discuss ageing. The figure fell from 53.1 per cent in 2020 to 43.3 per cent in the latest assessment.
Such forums can help governments, healthcare providers, civil society organisations and older people themselves coordinate policies and address common problems.

NIGERIA'S OLDER POPULATION FACES FINANCIAL INSECURITY

The challenges identified by the WHO are particularly relevant to Nigeria, where many older people work in the informal economy and have little or no access to formal retirement benefits.
Pension arrangements generally cover people who have worked in eligible formal employment or made contributions under applicable pension schemes. Farmers, petty traders and other informal workers may reach old age without a dependable source of retirement income.
The report's accompanying account estimates that Nigeria's pension system covers only about three per cent of older adults, while roughly 70 per cent of older Nigerians are classified as poor or economically vulnerable.
These figures point to the difficulties many older people face in meeting basic needs, including food, housing, transportation and healthcare.
For elderly farmers and traders, stopping work may mean losing their only source of income. Consequently, many continue performing physically demanding tasks long after their bodies have become less able to withstand the strain.
Family support, traditionally an important source of assistance for older Nigerians, is also facing pressure. Younger people increasingly move to major cities or other countries in search of employment, education and better living conditions.
Migration does not necessarily mean that families abandon their elderly relatives. However, distance and financial pressures can make it harder for younger family members to provide regular personal care, visit frequently or respond quickly when an older relative becomes ill.
Without reliable pensions, affordable healthcare and community support services, older people can become increasingly vulnerable to poverty, loneliness and preventable health complications.

WORLD BANK SAYS INVESTING IN HEALTHY AGEING CAN BRING ECONOMIC BENEFITS

The WHO report also highlights the economic importance of investing in the health and wellbeing of older people.
Fiona Stewart, Global Lead for Ageing and Pensions at the World Bank Group, argued that investment in healthy ageing should not be viewed simply as a government expense.
According to Stewart, countries that invest early in integrated healthcare and long-term care can achieve savings that outweigh the initial costs.
Preventive healthcare, early diagnosis and appropriate support can help older people maintain their independence for longer, potentially reducing avoidable hospital admissions and the need for more intensive care.
Supporting older entrepreneurs can also allow those who wish to continue working to contribute to their communities and local economies.
For countries such as Nigeria, improving access to healthcare and expanding social protection could help reduce the pressure on families who currently shoulder much of the responsibility for caring for older relatives.
Such investment would also recognise that older people remain valuable members of society, with knowledge, experience and skills that can benefit younger generations.

COMMUNITIES DEVELOP NEW WAYS TO SUPPORT OLDER PEOPLE

Despite the difficulties, communities across Africa are developing approaches to strengthen relationships between generations and improve the lives of older residents.
In Kenya's Kibera settlement, intergenerational self-help groups bring younger and older people together to advocate for better services and address shared community concerns.
These initiatives recognise that ageing is a process everyone experiences and that today's younger population will eventually face many of the same challenges.
In Narok, Maasai elders are involved in sustainable agricultural initiatives that promote food security while helping older people remain productive and connected to their communities.
Such programmes demonstrate how local action can complement government policies by creating opportunities for older people to participate in community life, share their experience and maintain social relationships.
However, community initiatives cannot replace the need for properly funded healthcare, pensions, long-term care services and effective legal protection.
Governments still have a central role in ensuring that essential support is available to older people regardless of their income, location or family circumstances.

THE NEXT FIVE YEARS WILL TEST GOVERNMENTS' COMMITMENT

As the UN Decade of Healthy Ageing enters its second half, the WHO and its United Nations partners are calling on governments to accelerate implementation of existing commitments, improve data collection and provide predictable funding for programmes that support older people.
The goal is to ensure that people can enjoy longer lives with better health, greater independence and access to the assistance they need.
For countries such as Nigeria, this will require stronger social protection for people who have spent their working lives outside formal employment, more affordable healthcare and practical support for families caring for elderly relatives.
It will also require efforts to combat age discrimination, improve access to assistive devices and ensure that older people have a voice in decisions affecting their lives.
The experiences of the Nigerian cassava farmer and the Kenyan grandmother illustrate why these changes matter. Living longer should not mean spending old age in poverty, enduring untreated pain or facing illness without reliable support.
The remaining years of the UN decade will be an important test of whether governments can turn policy commitments into meaningful improvements in the daily lives of older people.