Discussion Paper

Rio+20: The emerging challenge of an ageing world

HelpAge Discussion Paper May 2012

Summary
The United Nations Conference on Sustainable Development (Rio+20), in Rio De Janeiro, Brazil in June 2012, is an important opportunity to shape a post-2015 development framework that has sustainable development at its core. This paper argues that a focus on older people in the outcomes of the conference and the post-2015 goals is critical as older people are affected by environmental change and are key contributors to sustainability. Drawing on HelpAge experience, it discusses some of the emerging challenges to sustainable development as identified in the run up to Rio+20, in the context of an ageing world. This includes migration and displacement, water and food security, natural disasters and climate security, the energy crisis, financial crisis, and health security. The paper highlights that national social protection systems could address these emerging challenges, and provides recommendations for policies that support healthy and resilient ageing populations in the outcomes of the Rio+ 20 summit and the post-2015 framework.

Acknowledgements
Thanks to HelpAge International offices and partners for providing case study information; Mark Gorman, HelpAge International Head of Strategy for content and editorial inputs and special thanks to Portia Reyes for editing support. Cover photo Jeff Williams/HelpAge International

Authors
Clare Harris, Environmental Risk Advisor, [email protected] Bethan Emmett, Social Protection Advisor, [email protected]

ID LON0001

HelpAge Discussion Papers provide background and understanding on ageing issues in development, to stimulate and inform discussion and consultation.

Contents
Introduction ............................................................................................................... 4 Global ageing Older peoples vulnerability and contribution Migration and displacement 4 5 7

Major global challenges and the implications of ageing ............................................. 7 Adjustment and wellbeing the need for age friendly cities .................................. 8 Being left behind in emergency displacement ...................................................... 8 Older people in flight ........................................................................................ 9 Water and food security 10 Securing older peoples access to food and water .............................................. 10 Access to water and sanitation ........................................................................ 11 Ageing farmers a food security issue? ............................................................ 11 Disaster and climate risk reduction and resilience Energy crisis Financial crisis Health security 13 17 18 18 Older peoples vulnerability to shocks and stresses ............................................ 13

Infectious disease .......................................................................................... 18 Non-communicable diseases ........................................................................... 19 A call for national social protection mechanisms to protect the vulnerable and create opportunity ................................................................................................... 21 Recommendations .................................................................................................... 23 References ............................................................................................................... 24

Introduction
On the occasion of the 20th anniversary of the first Earth Summit in Rio de Janeiro in 1992, a high level session will be convened to secure renewed political commitment for sustainable development, assessing the progress to date and the remaining gaps in the implementation of the outcomes of the major summits on sustainable development and addressing new and emerging challenges. General Assembly resolution The United Nations Conference on Sustainable Development (Rio+20), in Rio De Janeiro, Brazil in June 2012, presents a key opportunity to pursue the sustainable development agenda, and influence the post-2015 development goals. Focusing on a green economy in the context of poverty eradication and sustainable development and the institutional framework for sustainable development, discussion at Rio+20 emphasises that the post-2015 development framework needs to have sustainable development as its underpinning narrative. 1 In the run up to the Rio+20 conference, a number of emerging challenges to sustainable development have been identified. This includes migration and displacement, water and food security, natural disasters and climate security, the energy crisis, financial crisis, and health security.2 However, there is a significant gap in the emerging challenges debate that of demographic change and a globally ageing population which has implications for achieving the sustainable development goals, and on both the vulnerability and contributions older people can make in light of these emerging challenges.3 A focus on older people in the outcomes of the Rio+20 Summit and in a post-2015 development framework is absolutely crucial, as older people are both affected by environmental change and are key contributors to sustainability.

Global ageing
We are living through a historic transformation with the world growing older rapidly. The ageing of populations is most rapid in developing countries, and is happening at much lower income levels than it did in richer countries. Developing countries are growing old before they grow rich. Ageing is occurring everywhere, even in the poorest countries. It is evidence of the triumph of development, improved healthcare and of aid that works. Already, those over 60 constitute 11 per cent of the global population and by 2030, there will be more people over 60 than children under 14. By 2050, they will account for 22 per cent of the global population 2 billion people. Currently, 60 per cent of the worlds older people live in developing countries, and this

1 Beyond 2015 input to the UN on Rio+20, 2011, http://www.uncsd2012.org/rio20/content/documents/Beyond%202015%20Rio%20Zero%20Draft%20Final.pdf (01 May 2012) 2 A full list of the Rio+20 emerging challenges include: the financial crisis; food crisis; migration; energy crisis; water scarcity; biodiversity and ecosystem loss; desertification; natural disasters and the ability to prepare for and recover from them; achievement of the MDGs; globalization; health security; climate security; and increased resilience at the national and global level 3 This overarching challenge is recognised by the Royal Society, who in their People and the planet report recommends that Population and the environment should not be considered as two separate issues. Demographic changes, and the influences on them, should be factored into economic and environmental debates and planning at international meetings, such as the Rio+20 Conference on Sustainable Development and subsequent meetings.

The Royal Society, People and the planet report, London, The Royal Society, 2012

proportion is expected to rise to 80 per cent in 2050, with greater numbers in Asia. Africa will see the proportion of its older population rise from 7 per cent today to 30 per cent by 2100. 4 However, very little is known about ageing in developing countries while much data and analysis are available on population ageing, data and information about the lives and situations facing older people are lacking and seldom included in ageing-related publications and in policy discussions. The lack of discussion on ageing and its implications is a striking gap in the sustainable development debate, as demographic ageing has the potential to create major shifts in country vulnerability profiles over the next 40 years.

Older peoples vulnerability and contribution

Rather than viewing ageing as a problem, longer lives must be seen as a triumph. Many older people, however, face specific obstacles that prevent them from enjoying their rights equally to other members of society. Age discrimination and ageism5 are rife and continue to be tolerated across the world and at all levels of society: family, community and institutional. Many older people are discriminated against in employment and access to healthcare, and denied access to services and social security. Older people, especially older women, are often denied their rights to land and property. Many experience violence and abuse because of their age. The discrimination that older men and women experience is often multi-dimensional, based not only on age but also on other factors such as gender, ethnic origin, where they live (urban or rural areas), disability, poverty or literacy levels. As populations age, the number of older people facing age discrimination is likely to increase unless specific measures are taken to prevent such discrimination. Putting in place policies that protect older peoples rights not only enables them to live their lives in dignity, free from poverty, violence and discrimination, but also enables them to continue to play a critical role in their families livelihoods. For example, only one in five older people receive a pension globally but research shows that when the right to social security is realised, pensions to older people, coupled with agricultural incomes improve livelihood security of family networks, are invested in childrens education, provide economic independence for adult children and improve access to credit.6 For instance, South Africas social pension has improved girls nutritional status, with a 3-4 centimetre increase in the height of children in households with grandparents receiving pension, and has led to an 8 per cent increase in school enrolment among the poorest 20 per cent.7 There are similar impacts in Brazil among girls aged 12 to 14.8 In Bolivia, for every $1 transferred to older people, it is estimated that US$2 worth of additional economic activity was generated.9

4 5

UN Department of Economic and Social Affairs, World Population to 2300, New York, United Nations, 2004

Age discrimination is when someone is treated differently, with an unreasonable or disproportionate impact, simply because of their age. Ageism is the stereotyping and prejudice against older people that can lead to age discrimination.
6

See for example, Diamond P, The grey tsunami how to a healthy longevity dividend, World Economic Forum, http://www.weforum.org/content/grey-tsunami-how-reap-healthy-longevity-dividend, (01 May 2012); and SchrderButterfill E, Inter-generational family support provided by older people in Indonesia, Ageing and Society, 24, 4, 2004, pp.497-530
7

Diamond P, op cit.

Girls in households with pensions are 3-4 centimetres taller than their same-age counterparts in non-recipient households. Samson M, van Nierkerk I and Mac Quene K, Designing and implementing social transfer programmes, Cape Town, Economic Policy Research Centre, 2006, p.60 See also Carvalho (2000), Duflo (2003), Edmonds (2004), Studies for Brazil and South Africa associate pension receipt with increased school enrolments and reduced child labour, in Barrientos A, Non-contributory pensions and poverty reduction in Brazil and South Africa", Manchester, IDPM, University of Manchester, 2005
8 9

Samson M, op cit.

Martinez S, "Invertir el Bonosolparaaliviar la pobreza: Retornoseconmicos en los hogaresbeneficiarios", in La InversinPrudente. Impacto del Bonosolsobre la familia, la equidad social y el crecimientoeconmico, Guillermo A,

Research in Indonesia shows the flow of support and resources from older people to younger generations has helped families weather economic crisis.10 Older people play a central role in caring for their grandchildren. In South Africa, 60 per cent of children who have lost both parents to AIDS are cared for by older people, a pattern common in other African countries.11 Social pensions for older people are a potential form of family support, as they often live in households below the poverty line, without any defence from threats such as a health crisis.12 We need to reap the longevity dividend and support older people's role in the family and the economy with policies which recognise older people as a resource, not a burden.

Jemio LC, Laserna R, Martinez S, Molina F, Schulze E and Skinner E (eds.), La Paz, Fundacin Milenio, 2007, pp.109128.
10 Schrder-Butterfill E, Inter-generational family support provided by older people in Indonesia, Ageing and Society, 24, 4, 2004, pp.497-530 11 At least 40-60 per cent of single and double orphans live in older headed households in Kenya, Malawi, Namibia, South Africa, Tanzania, Uganda and Zimbabwe. See Monasch R and Boerma J.T, Orphanhood and childcare patterns in sub-Saharan Africa: an analysis of national surveys from 40 countries, AIDS, 18,l 2, 2004, pp.S55-65. 12

Graham E, In a rapidly ageing world, how can the EU address the age-blindness in its development cooperation?, The Information Daily, http://www.egovmonitor.com/node/49731 (01 May 2012)

Major global challenges and the implications of ageing

Migration and displacement
Due to poor rural investment and increasingly risky livelihoods, such as agriculture, which are subject to a range of shocks and stresses, many working-age adults migrate to urban centres to find work and better services. Many leave behind their children in the care of grandparents. This has a significant impact on older people and their grandchildren and is a trend which is increasing with climate change and economic growth in many developing countries.
Box 1: The impact of migration on older people in Kyrgyzstan After almost two decades of economic and social turmoil throughout Central Asia, Kyrgyzstan is now the second poorest country in the former Soviet Union. The World Bank estimates that up to 12 per cent of the Kyrgyz population (over 600,000 people) is registered formally as migrants in neighbouring Russia and Kazakhstan a figure which does not take into account informal migrants that constitute the majority. One-third of the nations GDP comes from remittances, the fourth highest level in the world. While policy makers assume that remittance flows benefit everyone equally, evidence collected by HelpAge International and organisations such as the ILO indicate that this is not the case. A study of the poorest families in Kyrgyzstan in 2009 showed that remittances made up approximately 1 per cent of income. These families consist overwhelmingly of older people and young children, and can be extremely vulnerable to poverty and social exclusion.13 It is increasingly recognised that labour migration is an important means of economic risk management benefiting individuals, families and communities. Understanding the social and economic impact on the family members staying behind is critical, yet there has been little analysis on the effects of a migrating working-age generation on their parents and their children. Research undertaken by HelpAge14 has revealed that in these situations there was:

1. extreme vulnerability to poverty and exclusion among older people and children left in their care; 2. a steadily increasing number of these multigenerational households (MGHs) headed by older people
across the country;

3. lack of transparency and dialogue between local government and older people, particularly in
relation to budget setting at a local level and the development of service delivery plans; are poorly understood, and therefore missed in the strategies to alleviate poverty and reach the MDGs.

4. the critical links between rural poverty, old age poverty and child poverty

13

HelpAge International, Constant crisis: perceptions of vulnerability and social protection in the Kyrgyz Republic, London, HelpAge International, 2009

14

HelpAge International, Poverty reduction in multigenerational households affected by migration, London, HelpAge International, 2011

Max Ahner/HelpAge International

Older peoples role as the primary carers of grandchildren and contributors to future human development in the country still unrecognised and unsupported by local and national authorities. They receive little financial support state pensions where available are well below subsistence level and are inadequate to provide for the needs of growing grandchildren. Older carers also face emotional, social and physical difficulties as carers. Many feel out of touch with new education systems, need help with parenting skills, or find the generation gap a communication barrier. Critically, older carers typically do not have parental rights, including access to support such as child benefits.

Adjustment and wellbeing the need for age friendly cities Often moving from rural to urban areas later in life can be traumatic for older people. They often become completely dependent on their families for support, and those who have no one to look after them often end up petty trading and begging. The culture shock, loss of community and the loss of status in moving to the cities can impact severely on the wellbeing of older people. When asked about migration in Help Ages Witness to climate change report in 2009,15 almost all older people said they would prefer to stay in environmentally risky rural areas than migrate to urban areas. This has major implications for the safety of older people in a changing climate. Being left behind in emergency displacement There is a growing body of evidence that shows older people are often left behind at the point when the rest of their community is displaced, due to sudden shocks such as conflict or natural disasters. There are several reasons for this. First, older people themselves may not be physically capable of making the journey to safety due to old-age, ill-health or having a disability. An older persons capacity to either keep up with their family, or risk slowing down their progress, potentially puts them in danger, or may result in a decision to stay behind. Older people may feel particularly tied to their home and lands and decide not to leave, no matter what the consequences. Third, the family may decide that it is important for someone to remain behind to secure their assets and this responsibility falls to the older person.
Box 2: Vulnerability of older people during emergencies In Darfur in 2004, when huge numbers of people were forced to flee large distances to urban centres, there were numerous reports of older people being separated from their families during the journey and arriving alone in Internal Displaced Peoples camps, or simply stopping or being abandoned along the route due to physical exhaustion. There were also reports of older people who had stayed behind being terrorised and killed. This situation is not unique. During the Georgian conflict in 2008, data from various assessments, the UN, and from discussions with those who had reached collective centres, indicated that those remaining in their villages during conflict were mostly older people. These older people often hid in the forest at the night for safety, with only their spouse or other older people to offer support and assistance.

As the Darfur case study demonstrates, remaining behind can lead to significant protection risks for older people during conflict and as well as during natural disasters. This situation also has significant implications for the vulnerability of older people in complex political emergency situations and areas of cyclical emergencies such as in the Horn of Africa.

15 HelpAge International, Witness to climate change: learning from older peoples experience, London, HelpAge International, 2009

Ali Issack, in Dadaab camp, Kenya, recounts,"We decided as a group: let us save the children, and let us old people remain. The others went ahead to Dadaab (refugee camp) to register as refugees. After they left, I felt alone and thought I might never see them again. We old people tried to make our way but we were unable to walk. It took many days until we met another man who came from a small town. He put us on another vehicle that brought us to Dadaab. He saved our lives and I still pray for him today."

Older people in flight Older people face significant challenges when displaced, whether in the short-term or during protracted displacement. Factors that seem to support older peoples capacity to cope with displacement include 1) the extent to which older people are valued and are productive within their community and household and 2) whether or not displaced and host communities have the capacity to provide older people with support. Many displacement contexts, in particular protracted displacement, are characterised by the breakdown of family and community support systems and a subsequent loss of respect and dignity for older people. When faced with extreme events, it cannot be assumed that families can or will continue to care for vulnerable older people. The impact of losing their homes and belongings and of the means to provide for their families, can have major psychological consequences for older displaced persons and impact greatly on their self-esteem. In displacement camps, older people are often excluded from food distribution and other services, due to lack of mobility to get to distributions, lack of communication and information that reaches them (because of hearing or sight impairments), neglect and abuse from family members, and the lack of consideration for older peoples needs within the services available. In many cases, a lack of personal documentation such as identity cards, prevents older people from registering, and they often become effectively invisible. As more people migrate to cities or are forcefully displaced, older people will be increasingly vulnerable either through being left behind in precarious environments with care and financial responsibilities for grandchildren, or through lack of facilities, rights and protection in new unfamiliar environments.

Benjamin Schilling/ HelpAge International

Water and food security

Securing older peoples access to food and water Older people are key producers and providers of food, yet millions go hungry. For overwhelming numbers of older women and men, the struggle for regular, nutritious food is constant and debilitating. Older women and men play a vital part in producing, preparing and providing food. Women are usually the main providers of food in the household and this role does not stop in old age. Increasingly, older women are responsible for feeding grandchildren whose parents have migrated or, particularly in areas affected by HIV and AIDS, are sick or have died. Moreover, poor older women and men in developing countries are often unserved in terms of water and sanitation, despite the universal right to water.
Box 3: Horn of Africa drought and food emergency Weather conditions and an unusually strong La Nina event in 2011 interrupted seasonal rains for two consecutive seasons across the Horn of Africa. In 2011, rains failed in Kenya and Ethiopia, and for the previous two years in Somalia. In many areas, rainfall during the rainy season from April to June was less than 30 per cent of the average of 19952011. This led to crop failure and widespread loss of livestock, as high as 4060 per cent in some areas, decreasing milk production and exacerbating a poor harvest.16 As a result, cereal prices rose to record levels while livestock prices and wages fell, reducing purchasing power across the regions. This crisis is compounded by ongoing insecurity and conflict in many areas restricting many peoples options. In many cases, older people were left behind, while their communities left to find food. In some rural Ethiopian communities, the older population now account for 30-50 per cent - a significant rise from the national average of 5 per cent. HelpAge supported older people across east Africa through direct cash transfers, reinstating wells and boreholes, providing livestock feed for their animals and distributing food, water and healthcare to older people and their families, as well as water, animal feed and veterinary care for livestock.17 In 2011, HelpAge International conducted a nutrition survey among refugees aged 60 years and above in the three main camps of Dadaab (Ifo, Dagahaley and Hagadera), north-eastern Kenya.18 The survey found that between about 460 and 840 older people living in the Dadaab camps were in need of nutritional support. This was due to being excluded in the general food distribution, and eating less than three different food items and less than two meals per day, as older people will always be the first to suffer in food shortages, to ensure their family can be fed.

Why do so many older people go hungry and thirsty? There are several reasons, including their living arrangements, reduced mobility, poor access to land, declining capacity to farm, the demands of caring and insufficient income; the design of latrines and the location of water points are often unsuitable for older people. In 2011, global prices of wheat and corn, and staples such as flour, bread and oil, rose again as a result of shortages caused by droughts and stockpiling in 2010. Again, food security has become a political issue, recalling the crisis of 2008. Food price hikes particularly affect older people with low incomes. In Kyrgyzstan, for example, some older people are now spending their entire pension on flour to make bread. As well as lacking regular income, a high proportion of older people live in rural areas that are increasingly affected by water shortages brought on by extreme weather conditions linked to climate change. Many are finding it difficult to grow enough crops to feed themselves and their families. As the need for farmland becomes more acute, older people can be the victims of land-grabbing. Widows, for example, are often denied their right to inherit land. And in areas affected by HIV and AIDS, older people are often left farming plots without the strength or time to work them, or the money to pay someone else to help. In poor households, it is usual

16

OCHA, Eastern Africa: Drought humanitarian snapshot: Eastern Africa, 2011, t Humanitarian Snapshot, 2011, http://www.fews.net/docs/Publications/Horn_of_Africa_Drought_2011_06.pdf (01 May 2012)
17 18

HelpAge situational reports

HelpAge International, Nutrition and baseline survey of older people in three refugee camps in Dadaab, October 2011, London, HelpAge International, 2011

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for older people and young children to live together. In households where food is short, older women and men often bear the brunt of the shortage because they give their share to younger family members. In Sri Lanka, where the price of milk powder almost tripled in February 2009, a study by HelpAge Sri Lanka showed that older people went without, so that children in their care had enough. Access to water and sanitation Water insecurity is a major source of stress and expense for poor older people who due to a combination of factors including distance, cost, design of latrines and unsuitability of water points are often unserved by existing services and facilities. Older people may have difficulty walking long distances every day to fetch water that weighs up to 20 kilogrammes.19 Paying community members or service providers to carry water is unaffordable for older people with no regular income. Evidence shows that where older people need to pay for water, they have to spend a sizeable amount of their income that may come from pensions, cash transfers or from other sources. Women are especially hit by this financial burden as they live longer than men, often work in the informal sector, are less likely to own assets and are discriminated against inheritance.20 In South Africa, for instance, a study of expenditure of pensions showed that older women in a peri-urban area spent the same amount of pension on water as they did on food (20 per cent).21 As water stress increases in many parts of the world due to climate change and pressure from over-exploitation due to increasing populations and economic growth, the potential risk to older people is significant as their access to water could become even more precarious in the future. Today, 800 million people live under a threshold of water stress, and this figure will rise to 3 billion in 2025, especially impacting Asia and Africa.22 The water stress threat in many regions is a major concern for the wellbeing of older people. It increases the risk of marginalisation and could have significant impacts on their livelihoods and health due to dehydration and poor water and sanitation.

Rajo Khan (69) lives in a remote village in the Thar Desert in India, where annual rainfall is well below 200 millimetres. Rajos family, a household of seven, struggles daily for drinking water. The women in the family, including Rajo, walk about 10 kilometres everyday to fetch a pitcher of water. Making sure that there is enough water at home is considered to be a womans duty regardless of age. In the rural Thar Desert, more than 80 per cent of women over 50 years of age are walking 6 to 12 kilometres everyday to fetch water. Rajo now has osteoarthritis in both knees and has difficulty walking. Help Age International and its partner GRAVIS assisted Rajo to construct a rain-water harvesting structure in her household. The tank is a simple construction, but it helps relieve the daily burden of fetching water. This clean water lasts for several months and Rajo is saved from walking in foot under the sun for approximately 3,650 kilometres a year. I have gone through this pain all throughout my life, says Rajo. Finally, there is relief.

19

WaterAid, Problems for the elderly, 2006 http://www.wateraid.org/uk/what_we_do/the_need/208.asp (01 May 2012)
20

Sleap B, Access for all: securing older peoples access to water and sanitation, Paper presented at the 32nd WEDC International Conference, Colombo, Sri Lanka, 2006
21

Mohatle T and Agyarko R, Contributions of older persons to development: The South Africa study, London, HelpAge International, 1999, p.50 United Nations, The global water crisis, http://www.un.org/works/sub2.asp?lang=en&s=19 (01 May 2012)

22

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Ageing farmers a food security issue? The transition towards older-age structures in the agricultural workforce is reinforced by young peoples tendency to seek non-agricultural employment.23 This is due to a variety of reasons such as a lack of rural opportunity and services, an increasingly precarious environment, unreliable rainfall, natural disasters, an image of agriculture being old and tired and a norm that older people encourage younger people to move away. Despite the trend of older farm workforces this is not an issue seen in development debates. However, development thinking may be behind government concerns in this case. Farmers comprise one-third of the worlds population and one-half of its poor. They are primary managers of our ecosystem, and are hence best suited to securing sustainable development.24 Particularly, older farmers have a life time of experience on their land that is a great resource to their communities. The key question persists, however, that if the younger generation move to cities and away from agricultural livelihoods, and once this generation of older adults pass away, who will have the knowledge and skills to grow the food and do it in an environmentally sound and sustainable way? This issue must be addressed at the highest international and governmental levels to ensure national and global food security is ensured. Boosting attention and funding to support older farmers and sustainable farming practice, coupled with rural services, infrastructure investment and economic incentives for farming to attract younger people to agriculture, is urgently needed. Agriculture can no longer be seen as the occupation of the poor and the old, it must be seen as a fundamental life sustaining activity that should be central to every green economy.

23

Bryant J and Gray R, Rural population ageing and farm structure in Thailand, Rome, Food and Agriculture Organization of the United Nations, 2005
24

Farmers major group submission to Rio+20, 2011, http://www.uncsd2012.org/rio20/content/documents/466Farmers%20Major%20Group%20submission%20FINAL.pdf (01 May 2012)

12

Hein du Plessis / HelpAge International

Box 4: An emerging ageing farming population The Indonesian government recently set a target for rice self-sufficiency by 2014 through improving yields and increasing crop areas in east Indonesia. However, the Indonesian Ministry of Agriculture estimates that almost 80 per cent of the nation's 140 million farmers are now aged 45 or older. A Reuters news report, Ageing farmers threaten Indonesias food security, quotes officials of this vast nation [who] are starting to worry that if the trend continues, future food supplies will be affected.25 In Thailand, agriculture also now has the oldest workforce of any economic sector, and further ageing is expected. Some suggest that a sub-population of impoverished rural older people may be emerging. A common assumption is that older farmers are less open to new skills, practises and techniques, which prevent improvements in food production. However, a study of Thai farmers in 2005 showed that there were very little differences in agricultural practices between older and younger farmers. In fact, older farmers tended to have less debt and own their own land, but were less likely to use synthetic fertilisers and pesticides.26

With an ageing farming population due to migration and increasingly risky agricultural environments, global food security and older peoples livelihoods are intrinsically tied. Therefore, there must be a focus on working with older farmers, promoting sustainable and ecologically sound farming practices and utilising older farmers knowledge and skills along with new technologies to facilitate this. Agriculture requires a regeneration to make it an attractive and innovative economic sector to attract younger people and encourage investment.

Disaster and climate risk reduction and resilience

Older peoples vulnerability to shocks and stresses Older people are particularly vulnerable to and face specific threats from man-made and natural disasters. Their needs are very different from those of other groups, such as children. Older age brings reduced mobility and strength, impaired sight and hearing, and greater vulnerability to heat and cold. Minor conditions can quickly become major handicaps that overwhelm a person's ability to cope. Many frail or housebound older people are less able or less willing to flee from potential harm. Older people can struggle to obtain food, travel long distances or endure short periods without shelter. Emergency food distribution programmes are rarely adjusted to include the particular needs of older people and their specific dietary requirements. Older people need micronutrients, protein and food that is easy to digest. Rations can be too heavy to carry, or packaging difficult to open. Many older people report being pushed out of the way by more able-bodied people. After a disaster, the focus is on immediate relief. However, in the medium-term, health services need to respond to the ongoing needs of older people. Walking sticks and frames, hearing aids and eye glasses can make all the difference in reaching distribution points, accessing assistance, preparing food or collecting firewood. Older people also need healthcare for chronic conditions, such as coronary heart disease, diabetes, strokes, respiratory illnesses, rheumatism and dementia. Loss of family members, carers and community ties can also leave older people isolated. Coping with day-to-day life after a disaster can be difficult and some older people report feeling depressed at losing the status they once had. 80 per cent of older people in developing countries have no regular income, less than 5 per cent receive a pension. Older people are

25 Sulthani L, Ageing farmers threaten Indonesias food security, Reuters, http://www.reuters.com/article/2011/06/10/us-indonesia-farmers-idUSTRE7591FD20110610 (01 May 2012) 26

Bryant and Gray, op cit.

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often excluded from "cash for work" or "food for work" recovery programmes as most aid agencies are targeted to younger adults. Micro-credit and other activities that can help older people earn a living are often planned without considering their capabilities. Shelter is also often unsuitable for older people and those who are disabled.
Box 5: Older peoples right to aid is often abused A recent report by HelpAge International analysed the volume of funding allocated to older peoples needs in emergencies through the Consolidated Appeals Process and Flash Appeals. It found that in 2010, US$2.6 million was allocated to projects that included at least one activity targeting older people; this was only 0.04 per cent of all funding. This increased to US$6.7 million 0.13 per cent in 2011. In both years, the proportion spent on older people was below 1 per cent. Most of the increase in 2011 is accounted for by a small number of large projects rather than a more consistent coverage across humanitarian responses. So while older people continue to be a growing population affected by large scale disasters, the emergency resources allocated to their specific needs continue to be extremely low.27 Fatema Begum (89) lives with her daughter in Kalapota, Bangladesh. When asked how she felt after receiving the food and non-food items support, she replied "Please give me a share!" We informed her she had a share in the relief bag, but she said, "My son won't give it to me!". Fatemas son accompanied her to receive the relief. When asked where her daughter was, she replied "She is waiting on the other side, in front of the relief distribution spot". We learned that Fatemas son had told them that he would accompany her, so that he could get the emergency support. We pulled out her share from the bag and put it into her hands, telling her that now no one would take it away from her.

With climate change, use of hazardous land and environmental degradation and conflict, emergencies will likely increase in the future. Coupled with an increasingly ageing population, this will create a major vulnerability nexus that must be urgently addressed. Knowledge and contribution of older people to disaster risk reduction and climate change adaptation Older people are key actors in this for a number of reasons. First, when trying to understand local hazards, environmental change and their impacts, older people have a lifetime of knowledge. Stories, traditions and practices including traditional food and seed varieties adapted to the local environment and its fluctuations these are in danger of being lost due to modern approaches, and with younger generations disregarding older peoples knowledge. Older peoples knowledge of previous disaster events on a local level, are central to developing good disaster risk reduction and climate risk management initiatives.

27

HelpAge International, A study of humanitarian financing for older people, London, HelpAge International, 2010

HelpAge International

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Box 6: Use of ancestral knowledge for climate adaption in the Bolivia Older people can see the longer-term interwoven relationships between people, their livelihoods, wellbeing and the environment. In Bolivia, where increasing flood and drought risks are due in part to the changing climate, HelpAge and partners worked with older people to capture ancestral knowledge of agriculture techniques call Camellones. These pre-Spanish ancient techniques have been handed down generations and held with local older people, but were lost in practice. Camellones are raised island banks which are planted with a variety of vegetables and fruits. It retains water in times of water stress and protects crops from flooding in the lowland areas. The banks ponds are dug in between and populated with fish which diversify the communitys income and make the community more adaptable and resilient to changing conditions.
HelpAge International

Box 7: White Brigades in La Paz Older people can also learn new skills and become a real asset in emergency response. In Bolivia, HelpAge has supported local Brigadas Blancas (self-named White Brigades due to the colour of their hair). The White Brigades are groups of older adults over three districts of the city of La Paz who are being trained in prevention and disaster action planning. This work is being developed under the DIPECHO Action Plan VII, "Building resilience to natural disasters in the municipality of La Paz", which seeks to strengthen capacity in preparation for disaster and emergency response. The White Brigades are responsible for registering and identifying vulnerable older people, recognising threats and risks, building an emergency preparedness plan, acting against a possible emergency and participating in drills. They also work to reduce risks and act during an emergency situation, identifying the needs of other seniors and help facilitate and access humanitarian aid. Nora Aliaga (65), is part of the Community Central Awichas Pampajasi. She has worked on the streets selling soft drinks at the mineral loading mines north of La Paz. "I have worked from a girl, selling drinks and food and going to the mine, I did this to feed and provide education to my children, I was always very active." On 23 February 2011, a landslide caused severe damage to infrastructure and destroyed 1,700 homes in nine districts of La Paz, with approximately 5,000 people affected, many of whom lost all their possessions. "When the landslide occurred we didnt know what to do. It made us nervous because we are told to leave, but some wouldnt. We never thought this could happen so we didnt know what to do, who to call, we didnt know whether it was serious. "We are now training with the White Brigades to know how to prevent anything like this situation from happening again. For example, we learned about the signs, we have to see where in the house is cracked and see if the crack is moving. If so we have to evacuate, we must ask for help from the White Brigades and the police ".

HelpAge International

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Box 8: Harvested rains for more food: India Thar Desert experience In the Thar Desert in India, agriculture is extremely vulnerable due to drought. Yet in absence of other occupations, agriculture remains to be the primary livelihood for most families. Agriculture in the Thar Desert would not be possible without active contributions of older people who use their knowledge on seeds, watering of plants and crop protection methods, as well as using their physical labour on farms. Help Age International and GRAVIS, through projects supported by the EU and BLF, are supporting older people by the construction of farming dykes, called khadins. These dykes retain moisture from limited rainfall and help in a significant yield in the crop. Khadins evolved from an older farmer in the Thar Desert many centuries ago. However, in time and because of the lack of resources, the technology was forgotten. Khadins are now revived, providing great benefits to farmers.

Chanda Khatu (71) is an extremely knowledgeable farmer. She leads her households farming with the traditional knowledge she has accumulated all her life. However, droughts and limited rainfall leave them with limited options. Chanda is a beneficiary of a khadin. A khadin makes sure that not even a single drop of water is wasted. It gives maximum benefit and maximum crops, she says. The new khadin helped her household gain an addition income of about INR 35,000 last year.

Older people are extremely vulnerable to shocks and stresses including climate change but they have invaluable knowledge, experience and skills to contribute to building resilience within their communities. These must be valued and harnessed and not ignored.

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Energy crisis
Fuel poverty is often used to describe a threshold of income that must be spent on fuel for heating, cooking and lighting. Older people are often among the most fuel-poor due to low income, their increased heating needs, especially in colder climates and the long hours they spend at home. In many developing countries, they are also considered energy poor as access to fuel is often an issue. It is estimated that 1.5 billion people are living in energy poverty28. As fuel prices increase due to dwindling resources, the poorest and most marginalised, including older people, will be the hardest hit.
Box 9: Older people, fuel poverty, winterisation and renewable energies in Central Asia In the smaller mountainous countries of Kyrgyzstan and Tajikistan, which lack the oil and gas reserves of their larger neighbours, severe electricity shortages are affecting households. The cost of importing fuel for heating and power generation has risen, and imports often suspended when high demand affects the whole region. In Kyrgyzstan, the price of coal continues to rise, and in many parts of the region, electricity is only supplied for a few hours or cut for several days. Electricity cuts threaten incomes as government requested the closure of restaurants, nonessential factories and shops. Access to safe water is compromised as people are unable to boil water, and water-treatment companies are forced to shut down. Harsh winters and rising food and fuel prices severely impact on the already fragile coping mechanisms of the poorest older people and their families. While most poor families keep livestock, production of crops is not easy in the mountainous terrain that dominates much of Tajikistan and many areas in Kyrgyzstan. Older people usually have at least some means to cook and generate heat using a fuel-burning stove even if that fuel is expensive (bottled gas, coal) or in short supply or damaging to the local environment/agriculture (wood, dried dung). Those who live in apartments, however, have no alternative when the electricity supply is cut and the central heating fails. For example, in a Dushanbe apartment block, residents have resorted to lighting fires in the street to cook communal meals in large cauldrons. When asked how they coped with the cold the previous winter, older people in the region said they stayed in bed wrapped in as many clothes and blankets as they could manage. Cold and isolated, older people in this situation can suffer from malnourishment due to the difficulty in cooking or making hot drinks, and poor hygiene due to the failure of water supplies and the lack of warm water for washing. HelpAge International has worked with fuel and energy poor older people to help insulate their homes and create warm rooms, formed older peoples groups and provided solar energy to help with continuity of power when the main grid goes off. They have also helped older people to access fuel deliveries, and set up greenhouses that help to ensure better food supply during colder periods. While this has addressed the immediate needs and risks to those people who have benefited, a much wider national and regional sustainable and affordable energy strategy is needed.

National and regional sustainable energy strategies are needed which must ensure that vulnerable people such as older people can be lifted out of fuel and energy poverty, ensuring their long-term wellbeing and safety.

28

Robia S, Olshanskayab M, Vrbenskyb R, Morvajb Z, Understanding energy poverty case study: Tajikistan, Paper presented at the World Energy Congress, Montreal, 2010

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HelpAge International

Financial crisis
Investing in older people benefits the economy as older people tend to invest their resources in their families and spend money in the local economy. For this reason, governments in the UK, Thailand and Russia increased spending on social pensions as a response to the financial crisis of 2008. In Thailand, which was severely affected by the 2008 economic crisis, the government boosted social pension as a core part of its economic stimulus package. Three million more older people are now receiving the Thai pension, as the coverage of the social pension increased from 25 per cent to 75 per cent of the older population. The impacts of this were twofold: an improvement in wellbeing, nutrition and empowerment of older people; and increased spending in local economy and businesses. In Russia, pensions benefit level were increased in order to, create growing demand, [and put] more money in people's pockets That will create more jobs in the real sector.29 In the UK, there was a 4.8 per cent increase in real amount of the Pension Credit minimum income guarantee.30 Pension provides a directed financial mechanism, which can act as a stimulus in the poorest of areas and benefit both the older people but also their entire family as older people characteristically share the wealth.

Sopid Chaiso, a food stall vender in Thailand recounts, We have more customers on the day the pension is paid. Our sales are better than on normal days. People buy pork, eggs, vegetables, other basic products and medicine.

Health security
Infectious disease Global health security is an ongoing challenge. As environments change so too will disease patterns and prevalence. The possibility of a major pandemic is also a threat on the horizon. Older people are often more susceptible to infectious disease. In developing countries, older people are vulnerable to infection because of their poverty and malnutrition; they encounter different pathogens that are increased through poor infrastructure and the lack of resources to treat the specific needs of older people. A higher proportion of severe forms (e.g. cerebral complications, more-frequent fatal outcome) have been reported to be associated with malaria among older individuals without immunity, as compared with the younger adult population.31 HIV among older people is often a hidden disease. A large and growing number of older people are living with HIV, but they rarely receive adequate prevention, treatment, care and support. Older people around the world also support and care for loved ones living with HIV and children orphaned as a result of AIDS. This has a huge impact on their economic, health and emotional wellbeing. It is often assumed that older people are no longer sexually active and therefore not at risk of HIV. On the contrary, older people are at risk of infection through the same routes as anyone else but are rarely included in HIV and AIDS awareness education.

29

Prime Minister Vladimir Putin, in a speech to the Eurasec Interstate Council, 9 June, 2009, http://premier.gov.ru/eng/events/news/4323/ (29 May 2012) UK government announcement in response to financial crisis, , 6 April 2009, http://www.davenportenterprises.co.uk/tax-cuts-deliver-extra-help-for-families (29 May 2012)
31 Gavazzi G, Herrmann F and Krause KH, Aging and infectious diseases in the developing world", in Aging and Infectious Diseases, 39, 2004, pp.83-91 30

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Non-communicable diseases An often forgotten but chronic health security issue is the increasing prevalence of noncommunicable diseases (NCDs) such as diabetes, heart disease, cancer, obesity, sensoryorgan disease and dementias. NCDs are no longer a problem affecting only wealthy countries. While commonly thought of as "diseases of affluence", in reality, four-fifths of deaths from NCDs are in low- and middle-income countries, and older people in developing countries are particularly at risk. By 2050, 115 million people will have Alzheimers disease or other dementias. 71 per cent of those with dementia will be living in low- and middle-income countries.32 The reasons for this include a decline in mortality from infectious diseases, childbirth, and malnutrition resulting in an ageing population, and coupled with unhealthy lifestyles that may come with growing affluence. Despite this growing trend, however, NCDs are largely preventable. In September 2011, 130 UN member states met in the first United Nations High-Level Summit on NonCommunicable Diseases to discuss how to tackle NCDs. However, the disproportionate impact that NCDs have on older people was absent from much of the dialogue around the summit. This is despite the fact that global ageing is recognised by the World Health Organization as the first of four drivers of NCD predominance in developing countries. The invisibility of older people in the NCDs debate highlights how ageing populations are marginalised. It has been further highlighted that the changing climate will exacerbate NCD prevalence as well as infectious diseases.33 Evidently, there are merging care challenges in developing countries. Governance and health financing globally need to begin to plan ahead for this shift in needs, to adequately respond to ageing populations. This gap in provision for older peoples health is already growing rapidly, and which HelpAge International aims to address in its programming and highlight to governments and health authorities.

Box 10: Lack of healthcare provision for older people in Moldova To address the inadequate access to healthcare for older people in Moldova, a project to enhance community-based support mechanisms for access to basic healthcare for vulnerable older people was developed. This built on work in two communities of Moldova, Satul in Cimislia and Cazangic in Leova, to strengthen support to multigenerational households. A key problem identified by many households headed by older people is the lack of access to healthcare and support. Health system reform and low salaries in Moldova has resulted in a doctor patient ratio of 1:4250, almost three times the national regulation ratio. Older people are approximately 14 per cent of the population. HelpAge research in 2009 shows that approximately 90 per cent of older people suffer from one NCD and 40 per cent suffer from more than one, with cardio vascular disease affecting 45 per cent of older people.34 The project was therefore designed to pilot a methodology for mobilising communities to reach out to the most vulnerable with health promotion activities to enable older people to better manage their own health and access medical services when necessary.

32 33

Alzheimers Disease International, Annual Report 2010, London, Alzheimers Disease International, 2010, p.15

Friel S, Bowen K, Campbell-Lendrum D, Frumkin H, McMichael AJ and Rasanathan K, Climate change, noncommunicable diseases, and development: The relationships and common policy opportunities. Annual Review of Public Health, 32, 2011, pp.13347
34

HelpAge International, Living Conditions of Older Persons of Moldova 2009, London: HelpAge International, 2009

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Efimia Moisa (89,) lives alone in a village in Moldova. She has five children but they do not visit her often. Her daughter-in-law helps a little but Efimia says she cleans the house and yard herself and has a goodsized vegetable garden that she cultivates. She suffers from high-blood pressure, arthritis and has cataracts; she gets headaches and walks slowly with a stick. Veronica, the volunteer and medical assistant comes to visit her regularly and gives her medicines for her conditions. Since the project began, Veronica comes more regularly to measure her blood pressure and blood sugar level. Efima enjys the visits and says she she does not feel lonely now. She does not go to the doctor but knows that Veronica will be able to call one if needed.

HelpAge International

Governments must take action now to improve healthcare access and provision for older people that is affordable, reliable and will continue to grow with the ageing population.

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A call for national social protection mechanisms to protect the vulnerable and create opportunity
There are a number of good practice examples that can help tackle the emerging challenges to sustainable development. There are also a range of initiatives based on sound ecological and resource management, and modern innovation and technology that if invested in, valued and scaled up, will ensure we achieve the future we want. That future, however, must be reflective and supportive of an ageing world one that does not marginalise, but values older people. One such mechanism that could address these emerging challenges is the better installation, resources and management of social protection mechanisms for the poorest and most vulnerable. Social protection policies such as cash transfers, livelihoods training and social services are seen as some of the most efficient ways of helping the poor achieve better nutrition and education, and more secure incomes and livelihoods.35 Increasingly, social protection is seen as a way of helping people to adapt to climate change. Cash transfers offer particular advantages for long-term adaptive capacity, compared with specific adaptation instruments, as they help people meet nutrition needs, cope with shocks, reduce damaging coping strategies such as selling assets, and support investment in livelihoods.36 They help people to diversify income streams, while providing the capital to manage risk and protect their assets, building resilient communities. For these reasons, social protection mechanisms may be the simplest and most effective way to ensure adaptation finance, such as Green Funds, reaches the poorest.37 However, while international interest on the linkages between social protection, climate change adaptation and wider resilience building is growing, the evidence base is still limited, and research focused predominantly on Africa or on relatively small-scale or short-term cash transfer programmes. The obvious area for further investigation is the impact or potential national-scale cash transfer programmes have for managing shocks and stresses among households in poverty. National-scale cash transfer programmes such as pensions have the following advantages:

They are permanent and operate at a national scale, thus offering widespread and longterm impacts.

They are proven to impact on a variety of vulnerability and resilience indicators,

including education, nutrition, income, livelihood and food security. For example, a variety of cash and food transfers have improved treatment outcomes and provided a social vaccine against HIV/AIDS in Africa,38 and social pensions in South Africa and

35

See for example, DFID Cash Transfers Evidence Paper, April 2011, http://webarchive.nationalarchives.gov.uk/+/http://www.dfid.gov.uk/Documents/publications1/cash-transfersevidence-paper.pdf (01 May 2012)
36

See for example, Godfrey Wood R, Money matters for adaptation, IIED Briefing, London, International Institute for Environment and Development, 2011
37 The Green Climate Fund is intended to raise and disburse $100bn (64bn) a year by 2020 to protect poor nations against climate impacts and assist them with low-carbon development. New research by the World Resources Institute shows that the world's 21 developed countries and the European commission have publicly announced pledges of $28bn in "fast-track" money after a commitment made in Copenhagen in 2009, Guardian, 6 June 2011. 38 See UNICEF, UNAIDS, IDS, Enhancing Social Protection for HIV Prevention, Treatment, Care and Support the state of the evidence, 2010, http://www.unicef.org/aids/files/Social_Protection_Brief_LowresOct2010.pdf (01 May 2012)

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Brazil have been shown to improve nutrition and school attendance of children in recipient households.39

They provide established directed mechanisms, rather than setting up subsequent cash

transfer mechanisms in emergency response, which can be expensive and lengthy. They can be easily extended to respond to specific threats, in the way cash transfer programmes in Thailand, Mexico and Brazil were extended as a response to financial crisis. They could also be employed in natural disasters, migration and displacement contexts as well as respond to seasonal threats such as cold, flood, drought and varying rain fall patterns, along with other financial mechanisms such as micro insurance, providing holistic resilience mechanisms. These funds are being employed both in respect to responding to impact but also proactively in enabling people to prepare and mitigate in the face of increased shocks and stresses.

In many countries, the presence of social protection mechanisms to support vulnerable older people would provide a significant risk reduction measure to many of these emerging challenges. Social pensions have already been shown to have significant development impacts. In Brazil, for example, social pensions contributed to a 32 per cent reduction in the Gini coefficient of inequality, and to improvements in childrens nutritional status and schooling. In Bolivia, it is estimated that every $1 transferred to older people generates $1.5 of additional economic activity. Social pension in South Africa has improved girls nutritional status with girls height gaining 3-4 centimetres; and school enrolment increasing by 8 per cent among the poorest 20 per cent.40 Social pensions in Swaziland, Tanzania, Zambia and Nepal have increased status and respect for older people and their sense of dignity and ability to support their families. In Indonesia, the flow of support and resources from older people to younger generations has helped families to weather economic crisis. For communities affected by migration, a national social pension would ensure a sustainable income as well as provide an established mechanism for funnelling Green Funds related to climate impacts and migration, especially for the most vulnerable. Investment in older people is also an investment in children, livelihoods and economies. Relatively small amounts of money empower older people and their families, strengthen human capital and cope with shocks and stresses. A universal social pension costs around 1 per cent of GDP in most of the countries in Sub Saharan Africa.41 On a local level this investment in older people has been shown to have significant economic multiplier effect.42 Established social protection mechanisms in place before a disaster can be used to direct cash to disaster-affected communities. A reliable income also allows for greater testing and diversification of livelihood and agricultural strategies to increase adaptive capacity of the most vulnerable to changing conditions, including climate change and increasing food and water insecurity. Payments to those who are fuel poor would provide vital seasonal support to older people vulnerable to cold weather. Thus, targeting older people is an effective way to reach poor families, reducing not only older peoples poverty but also household poverty more generally. Social pensions are economically and administratively feasible even in poor countries, and are a powerful instrument for reducing poverty and empowering families and communities to strive for and achieve a sustainable future.

39 40 41

See Carvalho et al., op cit. and Samson M, op cit. Diamond P, op cit.

Knox-Vydmanov C, The price of income security in older age: Cost of a universal pension in 50 low- and middleincome countries London, HelpAge International, 2011
42 A World Bank study found that consumption growth among pension beneficiaries in rural areas in Bolivia is twice the amount of the transfer, a multiplier of two. See Martinez S, op cit, pp.109-128.

Meaning that for every $1 that was transferred to beneficiaries it is estimated that US$2 worth of additional economic activity was generated. In Malawi, for example, it has been estimated that, through multiplier effects, each US$1 of spending from the Dowa Emergency Cash-Transfer stimulates US$2.1 worth of additional economic activity. See Davies S and Davey J, A Regional Multiplier Approach to Estimating the Impact of Cash Transfers on the Market: The Case of Cash Transfers in Rural Malawi, Development Policy Review, 26,1, 2008, pp. 91-111.

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Recommendations
The demographic shift and challenges of global ageing should be a central theme in the sustainable development agenda of which the Rio+20 processes is a key part. Demographic transition, with ageing at its core, is a global trend which is profoundly affecting developing countries, many of which lack the policies and frameworks to address the challenges of their ageing populations. The sustainable development and post-2015 framework must therefore develop and roll out an accountable, rights-based and age-inclusive policy framework that supports people throughout the life course, and across social, economic and environmental domains. Policies supporting the contributions of active, secure, resilient and healthy ageing populations must be reflected in the outcomes of the Rio+ 20 summit and post-2015 framework. HelpAge International is therefore calling for:

Inclusion of a focus on older people in the outcomes of the three priority pillars of the
Rio Summit 2012, recognising that older people are both affected by environmental change and could be key contributors to global sustainability. action on ageing is mainstreamed and outcomes monitored.

An international post-2015 framework for sustainable development which ensures that Inclusion of the voices and experiences of older women and men, particularly their

ecological knowledge and experience, in consultations and planning on environmental sustainability resilience building, disaster risk reduction and climate change adaptation. ageing of farm workforces worldwide and of environmental change.

Action to support older farmers and to address the food security challenges posed by the Action by the humanitarian community to address the invisibility of older people in

humanitarian crises, ensuring that their specific vulnerabilities and needs are met. older people and their assets where migration and displacement leave older people behind, who often care for grandchildren or relocate to new and unfamiliar environments.

Action by the international community to ensure adequate provision and protection of

The mainstreaming of age-inclusive measures into all government and civil society

health programmes to address the associated health risks with an ageing population, environmental hazard and climate change, including integration of action on NCDs across the life course.

Environmentally sound national energy strategies which recognise and address the
energy and fuel poverty of vulnerable groups including older people.

Full implementation of the Social Protection Floor Initiative in the post-2015 framework,
ensuring that mechanisms such as social pensions are fully utilised to address vulnerability and enhance resilience to current and emerging risks.

The use of existing and development of new age-inclusive data sets to measure poverty
and vulnerability to hazard, inequality, capability and wellbeing across the life course at national and international levels.

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References
Alzheimers Disease International, Annual Report 2010, London, Alzheimers Disease International, 2010, p.15 Beyond 2015 input to the UN on Rio+20, 2011, http://www.uncsd2012.org/rio20/content/documents/Beyond%202015%20Rio%20Zero%2 0Draft%20Final.pdf (01 May 2012) Barrientos A, Non-contributory Non-contributory pensions and poverty reduction in Brazil and South Africa", Manchester, IDPM, University of Manchester, 2005. Bryant J and Gray R, Rural population ageing and farm structure in Thailand, Rome, Food and Agriculture Organization of the United Nations, 2005 UK Department for International Development (DFID), Cash Transfers Evidence Paper, 2011, http://webarchive.nationalarchives.gov.uk/+/http://www.dfid.gov.uk/Documents/publicatio ns1/cash-transfers-evidence-paper.pdf (01 May 2012)rough Humanitarian Snapshot, 2011, Godfrey Wood R, Money matters for adaptation, IIED Briefing, London, International Institute for Environment and Development, 2011 Farmers major group submission to Rio+20, 2011, http://www.uncsd2012.org/rio20/content/documents/466Farmers%20Major%20Group%20 submission%20FINAL.pdf (01 May 2012) Friel S, Bowen K, Campbell-Lendrum D, Frumkin H, McMichael AJ and Rasanathan K, Climate change, noncommunicable diseases, and development: The relationships and common policy opportunities. Annual Review of Public Health, 32, 2011, pp.13347 Gavazzi G, Herrmann F and Krause KH, Ageing and infectious diseases in the developing world, in Aging and Infectious Diseases, 39, 2004, pp.83-91 HelpAge International, Living Conditions of Older Persons of Moldova 2009, London: HelpAge International, 2009 HelpAge International, Witness to climate change: learning from older peoples experience, London, HelpAge International, 2009 HelpAge International, Nutrition and baseline survey of older people in three refugee camps in Dadaab, October 2011, London, HelpAge International, 2011 HelpAge International, A study of humanitarian financing for older people, London, HelpAge International, 2010 HelpAge International, Living Conditions of Older Persons of Moldova 2009, London: HelpAge International, 2009 HelpAge International, Constant crisis: perceptions of vulnerability and social protection in the Kyrgyz Republic, London, HelpAge International, 2009 HelpAge International, Poverty reduction in multigenerational households affected by migration, London, HelpAge International, 2011 Knox-Vydmanov C, The price of income security in older age: Cost of a universal pension in 50 low- and middle-income countries London, HelpAge International, 2011 Kreager P, and Schrder-Butterfill E, Indonesia against the trend?Ageing and intergenerational wealth flowsin two Indonesian communities Demographic Research 19, 52, 2008, pp.1781-1810 Martinez, S, "Invertir el Bonosolparaaliviar la pobreza: Retornoseconmicos en los hogaesbeneficiarios", in La InversinPrudente.Impacto del Bonosolsobre la familia, la equidad social y el crecimientoeconmico, Guillermo A, Jemio LC, Laserna R, Martinez S, Molina F, Schulze E and Skinner E (eds.), La Paz, Fundacin Milenio, 2007, pp.109-128. 24

Mohatle T and Agyarko R, Contributions of older persons to development: The South Africa study, London, HelpAge International, 1999, p.50. The Royal Society, People and the planet report, London, The Royal Society, 2012 UN Department of Economic and Social Affairs, World Population to 2300, New York, United Nations, 2004 United Nations, The global water crisis, http://www.un.org/works/sub2.asp?lang=en&s=19 (01 May 2012) Robia S, Olshanskayab M, Vrbenskyb R, Morvajb Z, Understanding energy poverty case study: Tajikistan, Paper presented at the World Energy Congress, Montreal, 2010 Samson M, van Nierkerk I and Mac Quene K, Designing and implementing social transfer programmes, Cape Town, Economic Policy Research Centre, 2006 Schrder-Butterfill, E, Inter-generational family support provided by older people in Indonesia, Ageing and Society, 24, 4, 2004, pp.497-530 WaterAid, Problems for the elderly, 2006 http://www.wateraid.org/uk/what_we_do/the_need/208.asp (01 May 2012) UNICEF, UNAIDS, IDS, Enhancing Social Protection for HIV Prevention, Treatment, Care and Support the state of the evidence, 2010, http://www.unicef.org/aids/files/Social_Protection_Brief_LowresOct2010.pdf

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