The world is ageing at a pace humanity has never experienced before. By the end of this century, the population of people aged 65 and over is projected to reach 2.4 billion. Those aged 80 and older will grow even faster, reshaping health systems, national budgets and social expectations. The 2025 International Day of Older Persons, marked on 1 October, has brought that reality into sharper focus with a renewed call from Dr Sarah Barber, Director of the WHO Centre for Health Development in Kobe, for countries to adopt inclusive and sustainable approaches to ageing.
This year’s theme—healthy and inclusive ageing—signals a decisive shift away from viewing older adults through a lens of dependency. Instead, it underscores their rights to dignity, independence and meaningful participation. Dr Barber’s message also reflects growing recognition that ageing must be fully integrated into universal health coverage strategies rather than treated as a niche concern.
As governments grapple with demographic shifts that will touch every region, the scale of the challenge is becoming clearer. Today, one in six people worldwide is expected to be aged 60 or older by 2030. By 2050, that share will double in many low- and middle-income countries. Without serious investment in health and long-term care systems, millions risk being excluded from services they need at the most vulnerable stage of life.
New Research Reveals Unmet Needs Across Regions
Over the past year, the WHO Kobe Centre led pioneering research across five WHO regions to understand exactly where older people are being left behind. For the first time, policymakers now have region-specific data on unmet health and social care needs among adults aged 60 and above. The findings point to gaps in access, coordination and quality of services—including in areas as fundamental as primary care, rehabilitation and assistive technologies.
These studies have surfaced five consistent challenges: limited coverage of essential services, high out-of-pocket costs, fragmented care pathways, insufficient data for planning and a shortage of trained health workers. The consequences can be severe. When health and social needs go unanswered, older people are more likely to be hospitalised, pushed into poverty or forced to rely on informal caregivers without support.
Accessible health information systems are one of the biggest deficits highlighted. Many countries do not collect sufficient age-specific data to plan services or monitor outcomes. Without reliable numbers, budgets are poorly aligned with demand, and reforms often stall before they start.
Dr Barber emphasised that the new evidence gives decision-makers a baseline to act. It also reveals opportunities: strengthening primary care teams, updating benefit packages to cover long-term care, and integrating health and social services at the local level. These shifts are not simple, but they are increasingly unavoidable.
Long-Term Care Financing Emerges as a Defining Test
How countries will pay for health and long-term care has become a defining policy question. Older adults often need services that are continuous rather than acute—help with daily living, cognitive support, rehabilitation and community-based nursing. These services are either underfunded or inaccessible in most countries, leaving families to shoulder the burden.
To address that, the Kobe Centre has published a series of 11 research briefs on financing long-term care in low- and middle-income settings. These briefs identify practical options governments can adapt to their context. Topics range from cost-effective use of digital tools to the economic value of supporting informal carers.
One striking finding is that investment in long-term care is not a financial drain, as commonly assumed. When properly funded and regulated, these systems create jobs, reduce hospital admissions and support labour force participation among family carers—producing returns that benefit economies and communities. The evidence challenges the belief that long-term care is a luxury only wealthy nations can afford.
In partnership with the European Observatory on Health Systems and Policies, WHO Kobe also released a full-length analysis on the economic and social returns of public investment in long-term care. The research reinforces an essential point: financing models built solely on private spending or unpaid labour are not sustainable. Public investment protects households from catastrophic costs and strengthens system resilience.
Digital Tools and Caregiver Support Are Critical Levers
Technology is not a cure-all, but it is becoming central to healthy ageing strategies. The research briefs highlight how digital platforms can connect remote communities to clinicians, monitor chronic conditions, and streamline care coordination. Yet digital tools only work when paired with human support—particularly for older adults less familiar with technology.
Supporting informal caregivers is another pillar of effective systems. Families, especially women, provide the bulk of unpaid care worldwide. Without respite services, financial assistance or training, caregivers burn out and often exit the workforce. Countries that invest in caregiver support see better health outcomes and lower long-term costs.
Several governments are now piloting stipend programmes, flexible employment policies and community-based respite care. These offer practical templates others can adopt. Evidence from countries like Japan, Uruguay and South Korea shows that combining public financing with community services can expand access even in resource-constrained settings.
Data Systems Must Catch Up With Ageing Realities
Most countries still lack robust data on service use, costs, and care needs among older adults. That gap makes planning almost impossible. Dr Barber pointed to health information systems as an essential upgrade—not a luxury. Without accurate numbers, reforms risk going in the wrong direction or failing to reach those most in need.
Improving data involves more than new software. It requires standardised metrics, cross-sector collaboration and political will. Surveys, electronic records and national ageing registries are helping some regions build a clearer picture. Still, many systems ignore the social determinants of health: housing, nutrition, mobility and social connection.
Demographic projections show the urgency. By 2050, the proportion of older adults in sub-Saharan Africa will double. Latin America and Asia will see the steepest rises in long-term care demand. Unless health financing, data systems and labour planning adapt in time, inequalities will deepen and social protection systems could fracture.
Universal Health Coverage Must Include Ageing
A core message of this year’s International Day is that universal health coverage cannot succeed if it leaves older persons out. UHC commitments often focus on maternal and child health, reproductive services and communicable disease control. While those remain essential, ageing populations demand a broader lens.
That means primary care equipped to manage multiple chronic conditions. It means long-term care services available in the community, not only in institutions. And it means fair financing that protects older adults from impoverishment. Countries are increasingly being judged by how well they prepare for these shifts, not by crisis response alone.
Dr Barber stressed that inclusion is not only about access. It is also about autonomy and respect. When older adults contribute to society—economically, socially or culturally—everyone benefits. Policy reform should make that possible by removing barriers, not reinforcing stereotypes of decline or dependence.
Economic and Social Returns Are Clear
Healthy and inclusive ageing is not just a moral imperative. It is a strategic investment. Workforce shortages, pension sustainability and rising health expenditures are real issues, but they are compounded—not caused—by ageing. With the right policies, older people can remain active for longer, contribute to caregiving networks and mentor younger generations.
Financial protection mechanisms such as pooled insurance, public subsidies and targeted tax measures can make long-term care viable. Countries that delay reform often end up spending more on emergency care, institutionalisation and income support. Prevention and early support cost less and improve quality of life.
Some governments are already moving. Thailand has expanded its universal coverage scheme to include community nurse visits for older adults. Chile is testing municipal care networks. Germany uses mandatory long-term care insurance to guarantee benefits across income levels. These examples show that systems can evolve without collapsing under cost.
Practical Actions Governments Can Take Now
Countries do not need to reinvent their health systems to prepare for ageing. Experts identify several practical steps that align with existing UHC and social development plans:
- Integrate long-term care into national health benefit packages.
- Train multidisciplinary teams in geriatrics, rehabilitation and social care.
- Finance home and community-based services alongside hospital care.
- Support informal caregivers with leave policies, training and financial aid.
- Build interoperable data systems to track ageing trends and outcomes.
- Use digital platforms to reach rural and underserved populations.
- Encourage public-private collaboration where regulation protects access and quality.
- Involve older persons in policy and service design.
These options are scalable and adaptable. They also require political will more than new inventions. Aligning ageing policy with economic planning, labour strategies and social protection frameworks increases impact and reduces duplication.
The Stakes Are High, but the Momentum Is Growing
The Kobe Centre’s work reflects a wider shift in global policy discourse. Ageing is no longer a postscript in development planning—it is a defining force for this century. As populations live longer, the measure of progress will be how well societies protect rights, maintain independence and ensure equitable access to care.
International cooperation will matter. Countries at different stages of demographic transition can learn from each other’s successes and missteps. The evidence gathered by WHO and its partners offers a shared reference point, but implementation will depend on national context and local innovation.
Dr Barber’s message closes with a reminder that older persons deserve more than ceremonial acknowledgement. They deserve systems that adapt to their needs with foresight, not crisis management. The evidence now exists. The next step is acting on it with urgency and care.
The International Day of Older Persons is not just a celebration—it is a signal that the future of health systems, labour markets and communities depends on decisions made today. Those decisions will determine whether ageing becomes a burden to manage or an achievement to embrace.
