Reimagining Aging: Prevention Strategies for Health Across the Life Course
By Ada Wong, Sanofi, and Michael Hodin, GCOA
While the age demographic mega-trend is of global consequence — long lives to 100 as a matter of course and more old than young as all societies modernize — it is not at all surprising that this year’s 2021 ASEAN-EU Health Summit focused its opening panel on “Unlocking the ASEAN Longevity Dividend Through Cost-Effective Prevention.” Of all regions globally, there are more societies across the Asia region, including ASEAN, that will have both increased longevity and a higher proportion of old to young, underscoring the profound and overarching need for a healthier and more active aging. This is the only way these societies can continue their impressive economic growth trajectories of the last two to three decades.
The clarity of aging at the very top of the Asia agenda is near axiomatic. Japan holds the status of the world’s super-aging leader, and Singapore and South Korea are among the most rapidly aging countries in the world. In China, the age population frame is literally upside-down, where they will shortly have more people over 80 than the entire American population today. For just one example of the growing policy response, consider the Summit speech by Ong Ye Kung, Singapore’s Minister of Health, in which he discussed the need for measures like greater use of telehealth, pandemic preparedness, secure vaccine supply chains and increased vaccination rates, not just for Covid-19, but for the long-standing, preventable diseases like influenza that still take a significant health and economic toll, especially in an aging society. The minister surely understands the power of health prevention strategies, both for people’s quality of lives and nations’ economic and commercial growth prospects. His keynote also highlighted that even in today’s Covid-19 pandemic and heightened awareness of the importance of immunization, there is still much progress to be made on the pick-up and usage of adult vaccines.
Indeed, what is most impressive about the recent ASEAN-EU Health Summit is its willingness to pose the very tough questions at the heart of public policy change to lay the foundation for healthy and active aging. This is, itself, the essential ingredient to continued economic growth in an era of “aging” and is well received during this first year of the launch of the WHO/UN Decade of Healthy Ageing. The oft-heard undercurrent of resignation and crisis surrounding aging — “oh my, what are we to do with all these old people” — is precisely the opposite of where the Summit has taken the dialogue, which might be summarized with three structural shifts in thinking, behavior, and public policy:
First, let us reimagine and reframe how we age and how we view the lives of older adults, where work, activity, engagement, happiness, dignity, independence, and opportunity are as central for 70-, 80- and 90-year-olds as they are for 20- or 30-year-olds. Of course, these younger adults will also, themselves, be old in a few decades, so forward-looking aging policy is good for all, as several of the “younger” societies, such as Thailand or Vietnam, already recognize. For example, health systems must be transformed to provide incentives for prevention — immunization across the life course, for flu, Covid-19, pneumococcal pneumonia, and shingles — that will enable a healthier and more active aging. This will also bring independence and dignity that holds the possibility of working longer and engaging in economic activity well past the 20th-century idea of retirement. Good health, not least through prevention — immunization across the life course — is at the core of good economics and fiscal sustainability for aging societies.
Second, we must approach how we spend our money, as individuals and as governments, differently. Very differently. Spending on health, including health innovation, should be seen more as an investment than as a cost, which turns upside-down our personal and public budget allocations. If we can prevent flu, manage bone health better and more effectively, and ensure better monitoring and earlier detection of age-related conditions, from vision and hearing loss to cardiovascular disease, oncology, and Alzheimer’s, we will profoundly alter the trajectory of our health as we age. This, in turn, will address the unmanageable spending that our current systems actually encourage. Shifting from the 20th century acute care model to the 21st century “predict and prevent” model is the only basis on which we will enable positive public policy outcomes for our personal lives and our economies and societies.
Third, we must build public-private partnerships to achieve the public policy reforms powerfully reflected in the WHO/UN Decade of Healthy Ageing and its core areas: long-term care, integrated care, age-friendly communities and ageism. This was recognized at the Summit and certainly reflected in this first panel, turning the received wisdom of aging societies on its head. Aging can actually be a force for growth, opportunity and value, but there must be partnerships across society to enable this, from business, civil society, government and all stakeholders. We saw clearly at the Summit that innovation is at the center of healthy aging and scaling across billions of people is a job performed well by the private sector in partnership with all stakeholders.
Three cheers for the themes and ideas that emerged from the Summit. But our work is not done — now is the time for all of us to collaborate and partner to implement. During this moment in 2021, as all of us across the planet continue to struggle with Covid-19, the importance of health to our social, economic, and personal agendas has never been more clear. While a hard lesson, it is valuable to have it revealed precisely when it is so essential in the context of the age-demographic mega-trend. Perhaps this is the silver lining of today’s tragic pandemic: lessons for reforms and change as we are prompted to reimagine and reframe the very character of our 21st century public policy tools.
Ada Wong is Chair of the EU-ASEAN Health Committee and Public Affairs Lead for Sanofi Asia, a member of the Global Coalition on Aging.
Michael Hodin is CEO of the Global Coalition on Aging and Fellow at Harris Manchester College, Oxford University.
