Aging population challenges in africa distribution

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Aging population challenges in africa distribution

  1. 1. Vol. 1, Issue 1 AfDB Aging Population Challenges in Africa Alice Nabalambaa and Mulle ChikokobNovember 2011 Chief Economist Complex Content Abstract Abstract leading to even greater vulner- ability to poverty. Aging, how- 1. Background This brief describes trends in ever, is not visible in most poli- population aging in Africa rela- cy dialogue, and so tends to be 2. Africa: demographic tive to those in economically deprioritized in terms of budg- trends advanced countries. It high- etary allocations, thereby in- lights the key drivers of the creasing the vulnerability and 3. Country-specific demo- phenomenon, both globally and marginalization of older Afri- graphic trends in the African context more cans. Unlike children, youth, specifically. The brief also ana- and women who are given a 4. The drivers of population lyzes country-specific trends high profile in the MDGs agen- aging in Africa and demonstrates the reasons da, for example the elderly tend why the proportion of popula- not to be targeted as a specific 5. Why we should be con- tion 65 years and older is grow- group in terms of poverty re- cerned about an aging ing in many countries across duction policies. However, cor- population in Africa the continent. Aging is highly rectly managed and with the correlated with long-term phys- appropriate level of healthcare 6. Conclusions and policy ical and mental disability, and provision and social protection implications a number of long term chronic programs population aging can conditions and will likely in- present an unprecedented op- crease personal care require- portunity for older citizens to ments. Furthermore, most soci- enjoy a full and active life, far oeconomic indicators for the beyond the expectations of pre- elderly in Africa are low, and in vious generations. Policymak- many countries poverty rates ers will need to take full ac- Mthuli Ncube among the elderly are signifi- count of the phenomenon, to m.ncube@afdb.org cantly higher than the national safe-guard family and commu- +216 7110 2062 average. In countries with a nity resources and to put in high prevalence of HIV/AIDS, place robust public pension, Charles Leyeka Lufumpa many households are increas- insurance and healthcare sys- c.lufumpa@afdb.org ingly headed by the elderly +216 7110 2175 tems. Désiré Vencatachellum d.vencatachellum@afdb.org +216 7110 2205 a Alice Nabalamba, Principal Statistician, Statistics Department (ESTA), a.nabalamba@afdb.org Victor Murinde b Mulle Chikoko, Principal Social Protection Officer, Human Development Department (OSHD), v.murinde@afdb.org m.chikoko@afdb.org +216 7110 2072 Reviewers: Barbara Barungi, Lead Economist OSFU; Peter Ondiege, Chief Research Economist, EDRE; Ruth Karimi Charo, Social Development Specialist, KEFO; Barfour Osei, Chief Research Econ- omist, EDRE; Tavengwa Nhongo, Africa Platform for Social Protection, Nairobi, Kenya. The findings of this brief reflect opinions of the authors and not those of the African Development Bank, its Board of Directors or the countries they represent. African Development Bank
  2. 2. AfDB [AGING POPULATION CHALLENGES IN AFRICA]1. Background youth population (0 to 15 safety nets, increased prev- years) and senior popula- alence of poverty, particu-As of 2010, 36 million tion (65 or older) to the larly among elderly headedelderly people working-age population households, and a shrink-aged 65 years and over (16 to 64 years). It is ex- ing cohort of caregivers inaccounted for 3.6% of Af- pressed as the number of countries ravaged by therica’s population, up from “dependents” for every 100 HIV/AIDS epidemic.3.3% ten years earlier. In “workers.” The senior de- Linked to the HIV/AIDS1980, 3.1% of the popula- mographic dependency epidemic are the changingtion was elderly aged 65 ratio is the ratio of seniors family structures whereand above, and there has to the working-age popu- older parents are increas-been a steady increase dur- lation.2 ingly caring for grandchil-ing the last forty years. dren left behind by victimsPopulation aging1 in Africa Africa’s population is ag- of HIV/AIDS. More thanis expected to accelerate ing simultaneously with its 50 percent of the orphansbetween 2010 and 2030, as unprecedented growth of in Africa currently livemore people reach age 65. the youth population and with their grandparentsProjections show that the its related challenges. The with limited resources andelderly could account for aging population in Africa unstable incomes to sup-4.5% of the population by faces a different set of port their households2030 and nearly 10% of challenges. Aging is highly (UNICEF, 2003).the population by 2050 linked with long-term(UN DESA, 2011.) In physical and mental disa- Global Aging Trends:many countries in Africa, bility and a number ofthe proportion of older long-term chronic condi- In many developed coun-persons will be close to tions and will likely in- tries, the aging demo-that of industrialized coun- crease personal care needs. graphic transition is al-tries by 2030 and 2050. Yet, much of Africa faces ready taking shape as the weak health care systems average age of populationsOne important conse- to adequately address these continues to rise, as a di-quence of an aging popu- emerging health problems rect consequence of thelation is the shift in the among the elderly. As well, postwar II “baby boom”demographic dependency much of the region is faced (Anderson and Hussey,ratio. The total demo- with a lack of viable social 2000). Fertility rates havegraphic dependency ratio is declined below the re-the ratio of the combined 2 placement rate of 2.1 in The demographic dependency many industrialized coun- ratio is based on age rather than employment status. It does not tries. Similarly, the average1 life expectancy at birth Population aging is described account for young people oras the rise in the median age of a seniors who are working, nor for continues to rise. In OECDpopulation resulting in a shift in working-age people who are countries, for example, thethe age structure of that popula- unemployed or not in the labor average life expectancy intion. It is the consequence of a force. It merely reflects popula-number of factors, including tion age structure and is not 2007 was 79.1 years, up bydeclining fertility rates, de- meant to diminish the contribu- 10.6 years since 1960creased premature deaths, and tions made by people classified (OECD 2010).prolonged life expectancies. as “dependents.” 2 African Development Bank
  3. 3. AfDB [AGING POPULATION CHALLENGES IN AFRICA]The UN medium-scenario lights gender differences in years for men. By 2010,projections indicate that the changing population this had risen to 57.1 yearsfertility rates will remain structure. Section four ad- for women and to 54.8below the replacement rate dresses the drivers of pop- years for men (Figure 1).through to 2020 for most ulation aging in Africa.of the industrialized coun- Section five demonstrates Healthy life expectancy –tries. At the same time, the why we should be con- defined as life expectancyproportion of persons aged cerned about an aging pop- weighted at each age to65 years and older will ulation in Africa, high- account for levels of healthincrease rapidly over the lighting many health and status over the life course –next few decades, to reach socio-economic challenges although lower at 39.5upwards of a quarter of the faced by Africa’s older years for Africa as a wholepopulation in most coun- population. The brief con- in 2000, had increased totries. By comparison, only cludes with some broad 42.7 years by 2002 and to10–14% of the population policy implications to 48.9 years by 2007.was 65 years or older at the guide policy makers andturn of the century in most development partners in Similar to developed coun-industrialized countries general, on how to address tries, the life expectancy(UN DESA, 2011). emerging challenges re- figures indicate that Africa lated to population aging. is also witnessing a shift inThe purpose of this brief is the population structure. Into (a) highlight the chang- 1980, 3.1% of Africa’sing demographics on the 2. Africa: demo- population was aged 65African continent; and (b) graphic trends and older, but this had ris-to demonstrate the chal- en slightly to 3.5% bylenges of an aging popula- In contrast to industrialized 2010. Women aged 65tion and the major issues countries, in developing years and older representedthat need to be addressed. countries, particularly 3.4–3.9% of the total fe- those in Africa, life ex- male population betweenThe brief is organized in pectancy at birth has re- 1980 and 2010. Men in thissix sections. The first sec- mained relatively low for age group represented 2.8–tion introduces trends of both men and women. In 3.2% of the male totalpopulation aging in Africa 1990, Africa’s average life population during the samerelative to those in eco- expectancy at birth was period (Figure 2).nomically advanced coun- 52.7 years, although it in-tries. Section two analyzes creased steadily to 56.0Africa specific demo- years until 2010 (AfDB’sgraphic trends and demon- Data Portal, 2011)3. Instrates the reasons why the 1990, women’s life expec-proportion of population tancy at birth was 54.365 years and older is grow- years compared to 51.1ing in many countriesacross the continent. In the 3 Statistics presented in this briefthird section, the brief fo- have been sourced from ESTA’scuses on country-specific Social and Economic Statisticstrends over time and high- database, unless otherwise attributed. 3 African Development Bank
  4. 4. AfDB [AGING POPULATION CHALLENGES IN AFRICA]Figure 1: Life expectancy at birth in Africa, 1990–2010 Life expectancy at birth in years 60 57 57 56 54 55 54 53 51 51 48 45 1990 1994 1998 2002 2006 2010 Male Female TotalSource: AfDB, Social and Economic Statistics Database (2011).Figure 2: Proportion of men and women aged 65 and above in Africa, 1980–2010 % population aged 65+ 5 3.9 4 3.4 3.2 2.8 3 2 1 0 1980 1990 2000 2010 Male Female TotalSources: UN DESA (2011); AfDB, Social and Economic Statistics Databases (2011). 4 African Development Bank
  5. 5. AfDB [AGING POPULATION CHALLENGES IN AFRICA]3. Country-spe- Tunisia (4.6%). By 2010, years and older declined in Tunisia had surpassed all Gabon, São Tomé andcific demographic other countries as the coun- Príncipe, and Equatorialtrends try with the highest propor- Guinea, while it remained tion of elderly population unchanged in the CentralAn examination of the de- (7.3%), followed closely African Republic over themographic trends at the by Mauritius at 6.9%. The 20-year period. The rea-country level reveals some elderly population of these sons for the decline in theinteresting patterns (Figure two countries nearly dou- former three countries are3). Between 1990 and bled over the 20-year peri- not very clear. Paradoxi-2010, nearly one-third of od. Other countries such as cally, these three countriesthe countries (16 out of a Libya, Botswana, and are among those with thetotal of 53) recorded that at South Africa witnessed a highest GDP per capita inleast 4% of their popula- similar phenomenon. Africa, so one might havetions was aged 65 or expected the improvedabove. In 1990, Gabon had There are marked varia- living standards to lead tothe largest elderly popula- tions among African coun- an increase in life expec-tion (5.6%), followed by tries though. The propor- tancy.Cape Verde (4.8%) and tion of population aged 65Figure 3: African countries with over 4% of their population aged 65 years and over, 1990–2010 % 8 7 6 5.6 5 4.4 4.5 4.3 3.9 4 2.9 3 2 1 0 Libya Morocco South Africa Lesotho Algeria Zimbabwe Congo Republic Tunisia Mauritius Cape Verde Botswana Egypt Gabon Equatorial Guinea Central African Sao Tome & Principe Republic 1990 2010Sources: UN DESA (2011); AfDB, Social and Economic Statistics Databases (2011). 5 African Development Bank
  6. 6. AfDB [AGING POPULATION CHALLENGES IN AFRICA]The gender dimension 4% of their total population elevated female mortality (Figure 5) than there were in low-income countries.While the ratio of males to in 1990. The growth in the This is largely attributablefemales is about 50:50 up elderly female population to high rates of maternaluntil the age of 64, it over this time frame ranged mortality, especially inquickly changes after this from 1.2% in Algeria to Sub-Saharan Africa. Thisage, with women outliving 3% in Tunisia. This repre- is exacerbated by inade-men (Figure 4). Among sents an increase of quate access to healthcarethose aged 65 and older, 404,000 and 207,000 fe- in many countries in Sub-there were 25% more males aged 65 or older in Saharan Africa, and to lowwomen than men in 2010. Algeria and Tunisia re- investments in the healthThis pattern is consistent spectively. However, Ga- sector. These weaknesseswith demographic changes bon, São Tomé and Prín- in the system mean thatelsewhere in the world. cipe, and Congo Republic fewer women live to reach experienced a decline over the age of 65 than mightIn 2010 there were 17 the 20-year period. Evi- otherwise be the casemore African countries dence emerging from re- (World Bank, 2011).with an elderly female cent gender equality stud-population that exceeded ies points to a persistentlyFigure 4: Africa’s population of men and women by age group, 2010 (millions) 65+ million 16 20 million 60-64 9 10 55-59 12 13 50-54 15 16 45-49 18 19 40-44 22 22 35-39 28 27 30-34 34 34 25-29 42 41 20-24 48 48 15-19 54 53 10-14 60 59 5-9 68 67 0-4 78 76 150 100 50 0 50 100 150 Male FemaleSources: UN DESA (2011); AfDB, Social and Economic Statistics Databases (2011). 6 African Development Bank
  7. 7. AfDB [AGING POPULATION CHALLENGES IN AFRICA]Figure 5: African countries with at least 4% elderly (65 and older) female population, 1990 and 2010 % 12 10 8 6 4 2 0 Algeria Morocco Tunisia South Africa Lesotho Congo Republic Ghana Mauritius Cape Verde Botswana Zimbabwe Gabon Namibia Egypt Central African Republic Sao Tome and Principe Libyan 1990 2010Source: AfDB, Social and Economic Statistics Databases.Figure 6 shows that far (4.1%). By 2000, the num- Gabon also witnessed afewer countries have a ber had nearly doubled decrease in its male elderlymale elderly population with the addition of Mau- population from 5.1% inexceeding 4% of their total ritius, Morocco, and Egypt 1990 to 4.0% in 2010. Tu-populations, compared to and this increased to a total nisia, Mauritius, and Mo-their elderly female popu- of nine countries by 2010. rocco recorded the highestlations. By 1990, only four The new additions were increases in the proportioncountries had a male el- Libya, Algeria, and Côte of elderly male populationderly population of 4% or d’Ivoire. However, São between 1990 and 2010,greater, namely Gabon Tomé and Príncipe’s male while Côte d’Ivoire and(5.1%), Tunisia (4.8%), elderly population dropped Libya also made good pro-Cape Verde (4.4%), and from 4.1% in 1990 and gress over the 20-year pe-São Tomé and Príncipe 2000, to 3.4% by 2010. riod. 7 African Development Bank
  8. 8. AfDB [AGING POPULATION CHALLENGES IN AFRICA]Figure 6: African countries with at least 4% elderly (aged 65 years and over) male population, 1990–2010 % 7 6 5 4 3 2 1 0 Cape Verde Libya Mauritius Algeria Egypt Morocco Africa Côte dIvoire Tunisia Gabon Sao Tome & Principe 1990 2000 2010 Source: AfDB, Social and Economic Statistics Databases.4. The drivers of The rise in the elderly pop- proportion of the national ulation in many of these population can be at-population aging in countries corresponds to a tributed to a shrinkingAfrica sharp decline in the fertility adult age cohort due to a rates compared to the rest high prevalence of HIV-Overall, it has been the of Africa over a 40-year AIDS, linked to the factmiddle-income countries – period (Table 1). Likewise, that HIV-AIDS is concen-such as Mauritius, Tunisia, many of these countries trated in the younger pop-Morocco, Algeria, Egypt, have made remarkable ulation. In fact while fer-and South Africa – which strides in improving health tility rates have droppedhave witnessed the greatest care delivery systems, re- substantially, the life ex-increase in population ag- ducing child mortality and pectancy of all five coun-ing. These countries’ pop- as a result are experiencing tries has declined over theulations aged 65 years and improved life expectancy 20 year period (Tables 1older range between 4.5% at birth and healthy life and 2). Similarly, the adultand 7.3% of the total pop- expectancy (Table 2). age cohort has either expe-ulation. Other countries However, for countries rienced stagnant or nega-such as Libya, Botswana, such as South Africa, Bot- tive growth (Figure A3)Zimbabwe, and Djibouti swana, Lesotho, Zimbabwe when compared to coun-have also witnessed a sig- and Swaziland, the in- tries such as Mauritius andnificant increase in their crease in the size of the Tunisia where theelderly population. elderly population as a 8 African Development Bank
  9. 9. AfDB [AGING POPULATION CHALLENGES IN AFRICA]same age cohort has grown from 20-32% and 10-24% among 25-44 and 45-64 year olds respec-tively (Figure A4).Table 1: Fertility rates for selected African countries, 1980–2010 1980 1990 2010 AFRICA, average - 5.30 4.40 Mauritius 2.76 2.23 1.80 Tunisia 5.33 3.63 1.83 Morocco 5.65 4.03 2.31 Cape Verde 6.44 5.31 2.61 Lesotho 5.59 4.92 3.20 Algeria 6.91 4.71 2.32 Egypt 5.61 4.56 2.77 Gabon 5.17 5.18 3.17 South Africa 4.79 3.66 2.48 Libya 7.38 4.81 2.59 Botswana 6.22 4.70 2.78 Zimbabwe 7.10 5.19 3.29 Seychelles nd nd 2.30*Source: AfDB, Social and Economic Databases.Notes: *Estimate is for 2008. nd: Data not availableTable 2: Life expectancy at birth, total and disaggregated by gender, for selected African coun-tries, 1980 and 2010 Life Expectancy at Birth Total Men Women 1980 2010 1980 2010 1980 2010 AFRICA, average 50.1 55.7 51.1 54.5 48.5 56.8 Libya 67.8 74.3 65.8 72.0 70.5 77.2 Tunisia 68.6 74.2 66.9 72.1 70.6 76.3 Algeria 67.0 72.7 65.9 71.2 68.3 74.1 Mauritius 69.2 72.1 65.5 68.5 72.9 75.8 Morocco 64.1 71.6 62.3 69.4 66.1 73.9 Egypt 62.9 70.3 61.6 68.6 64.3 72.2 Botswana 64.2 55.1 61.9 55.1 66.4 54.8 South Africa 61.4 51.7 57.8 50.3 65.2 53.1 Lesotho 59.3 45.6 57.4 45.0 61.0 45.7 Swaziland 60.5 46.4 58.3 47.1 62.6 45.5 Zimbabwe 60.8 45.7 57.5 45.3 64.3 45.6 Source: AfDB, Social and Economic Databases (2011). 9 African Development Bank
  10. 10. AfDB [AGING POPULATION CHALLENGES IN AFRICA]5. Why we cent show that the preva- implications, principally lence of chronic conditions that the burden of care isshould be concerned such as angina, osteo-ar- increasingly being shiftedabout an aging pop- thritis and diabetes is not to those least able to affordulation in Africa only on the rise, but more it. A study of 15 countries than twice as high among in Africa showed that largePopulation aging is highly elderly population aged 60 proportions of the lower-correlated with physical and above compared to income populations resortand mental disability and those under 60 years (Fig- to borrowing and sellingan increase in the preva- ure A5). assets to cope with highlence of a number of long- healthcare expendituresterm chronic conditions. In The management of long- (Leive and Xu, 2008). This2006, the World Health term chronic conditions practice drives many fami-Organization (WHO) pro- and related disabilities re- lies into even deeper pov-jected that diseases associ- quires a considerable erty and poorer health.ated with aging such as amount of resources – bothParkinson’s disease, Alz- human and financial – An even bigger challengeheimer’s and other forms from governments, com- for Africa is the decline ofof dementia, accounted for munities, and families. Yet informal systems of social6.3% of disability-adjusted in much of Africa, gov- protection in the form oflife years. This is signifi- ernments still spend far cash and support from bothcantly higher than the con- less per capita on extended family and com-tribution to disability-ad- healthcare in general, let munity sources. An addi-justed life years globally of alone social protection, tional challenge is theHIV/AIDS (5.5%), all can- than is the case in most change in family structurescers (5.3%), heart disease developed countries. Few and shrinking social sup-(4.2%) and respiratory dis- African countries have port networks. Tradition-eases (4.0%). Alzheimer’s public pension programs or ally, the informal socialand other forms of demen- formal systems for caring protection has been effec-tia alone account for 12% for older persons; indeed, tive for generations inof the burden of neurologi- most rely on traditional providing a major share ofcal disorders. More recent family structures. For ex- support to the elderly par-studies suggest that these ample, in 2005, govern- ents and the most vulnera-conditions are on the rise ments in 48 of the 53 Afri- ble. With increasing ur-due to an aging population. can countries spent US$ banization, and the ravagesMore alarming is the evi- 25.7 per capita on health of HIV/AIDS, this supportdence suggesting that these on households, while pri- network is increasinglyconditions will increase vate households spent being dismantled. In fact inmore rapidly in developing more than twice that some societies, particularlycountries than in developed amount (US$ 58.2) per those experiencing thecountries. capita (ICP-Africa data, HIV/AIDS epidemic, the 2005). Such a high dispar- roles have been reversed.Data from six countries ity in healthcare expendi- On the one hand, olderwith an elderly population ture between governments parents are increasinglyequal or exceeding 4 per- and households has several caring for grandchildren 10 African Development Bank
  11. 11. AfDB [AGING POPULATION CHALLENGES IN AFRICA]left behind by victims of such as: (i) rapid popula- security of formal sector,HIV/AIDS. For example, tion growth, evidencing in wage-dependent markets.more than 60% of orphans high youth populations andin South Africa, Zimba- high unemployment; (ii) Economic indicators forbwe, and Namibia – and high infant and child mor- the elderly show that50% in Botswana, Malawi tality rates, (iii) excessive households headed by old-and Tanzania – live with urban expansion; and (iv) er persons are among thetheir grandparents high maternal mortality poorest. For example, in(UNICEF, 2003). On the rates, etc. This has resulted Kenya and Tanzania,other hand, the rise in in governments and socie- households headed by old-HIV/AIDS death rates has ties de-prioritizing older er people have a povertyled to a rapidly increasing people in favor of other, rate that is over 20% high-new category of neglected often more vocal age er than the national aver-elderly individuals or older groups. Governments’ de- age. In Sierra Leone andadults living alone, without velopment priorities are Uganda, the poverty rate ofthe benefit of any caregiv- tending to favor expendi- these households is 8% anders. tures that invest in the 5% higher than the national long-term productive po- average (Kakwani & Sub-Despite these serious de- tential of the young. In barao, 2005; HelpAge,mographic shifts, aging is recent years, we have seen 2011). Poverty in old agenot visible in most policy governments focusing on often reflects poorer eco-dialogue. The invisibility the youth because of high nomic status earlier in lifeof vulnerable older people levels of unemployment and has the potential to bein major policy documents among this age group and transmitted to the nextis reinforced by their in- their potential to create generations if effectivevisibility in most national social and political unrest interventions are not ap-development plans. While if their demands and life plied.the MDGs provide specific chances are not fulfilled.targets for children, youth Thus countries accord low 6. Conclusionsand women, they do not priority in their nationalrefer to older people as a development policies and and policy implica-specific group. As a result, programs to the aging pop- tionsolder people are less likely ulations.to benefit from targeted This brief has discussed thedevelopment support. Lack The continent is not well problems of an aging pop-of recognition of aging prepared for a major in- ulation and the major is-even in the MDG agenda, crease in its aging popula- sues that need to be ad-which is the overarching tion. For example, contrib- dressed. There is a need forframework for interna- utory pension schemes governments, developmenttional development priori- cover very few people due partners, communities, andties, contributes to this lack to the informality of most families themselves to beof attention. livelihood activities and aware of the problem and employment. Most socie- to collaboratively work outThe African continent has ties are predominantly ru- a way of tackling the needsother urgent and pressing ral and much of the popu- of this growing segment ofdemographic problems lation operates outside the the population. Some broad 11 African Development Bank
  12. 12. AfDB [AGING POPULATION CHALLENGES IN AFRICA]proposals for governments social protection that cater free and subsidized healthand health services in par- to the specific needs of services, medication andticular are outlined below older people. However, longer-term healthcareto be included in policy South Africa, Mauritius, facilities for the elderly.discussions. Development Lesotho, Botswana, Capepartners can also assist Verde, and Namibia have Community and familythrough research and tar- introduced non-contribu- care.geted support. tory social pension pro- Family and community grams for the elderly. will remain the basic re-Budgetary provisions. source for the older per-Governments should pay National old-age pension sons in the absence of pub-greater attention to issues schemes will need to ex- licly funded social securityof aging. There is an urgent tend coverage and also schemes. There is need toneed to develop and im- consider contributory pen- support and promote com-plement coordinated na- sion plans for those who munity-based care in ordertional policies for this age are working now, in a bid to ensure that better ser-cohort and to mainstream to alleviate old age pov- vices are provided to theaging issues in national erty, guarantee a minimum aging population. The in-development frameworks income for older people, formal systems of socialand poverty reduction and prevent the intergener- protection through extend-strategies. This is in order ational transmission of ed family and communityto address the socioeco- poverty. The majority of support will continue to benomic needs and rights of Africa’s population is self- a viable option for short toolder people and improve employed and works in the medium term. Thereforetheir well-being. One re- informal and agriculture improved employmentquirement is to make ade- sectors. This sector does opportunities to inducequate provision in national not offer much in terms of younger people to remainbudgets for the provision social security and protec- in rural homes could bene-of social services for the tion, including for old age. fit the elderly both eco-elderly. The focus should Therefore, public–private nomically and socially andbe on the provision of shel- partnerships (PPPs) should would facilitate adequateter, healthcare, food securi- be explored as a way of support and care for thety, nutrition, and social promoting and expanding elderly. Strengthening thesecurity schemes, among contributory pension resources of women, whoothers. schemes. are the traditional caregiv- ers, would benefit all fami-Scaling up social protec- Targeted healthcare. ly members, including thetion schemes. Healthcare systems will elderly. This would expandMost African countries need to be responsive to the impact of existing self-will need to develop and the needs and demands of help and mutual aidimprove the coverage of an aging population, in- groups. Therefore policiescomprehensive social pro- cluding the greater access should also aim at im-tection systems for their to specialist services and proving the situation ofsenior citizens. The major- treatments. In particular, rural communities, andity of African countries do governments need to con- specifically target womennot have formal systems of sider introducing access to 12 African Development Bank
  13. 13. AfDB [AGING POPULATION CHALLENGES IN AFRICA]who make up the majority tion of statistics pertaining World Bank, Washington,of the elderly population. to aging trends to better DC. inform policy decisions;The role of statistics: scal-  Provide leadership Kalasa, B. (2001). “Popu-ing-up the availability of in the analysis of emerg- lation and aging in Africa: aage-disaggregated data. policy dilemma?” Paper ing issues around popula- presented at the Interna- tion aging; tional Scientific Study ofGovernments need to  Enhance policy ad- Population’s XXIV Generalstrengthen their national vice and support for coor- Population Conference, heldstatistical systems and to dinated long term solu- in August 2001 in Brazil.collect age-disaggregated tions to promote socialdata for all relevant sec- protection programs that Kidd, S. and E. Whitehousetors. This will allow gov- include the critical needs (2009). “Pensions and oldernments to monitor pro- of the elderly. age poverty,” in R.gress, for example, in re- Holzmann, D. Robalino, andducing old-age poverty and References: N. Takayama (eds.), Closingin tracking how health the Gender Gap: The Role offunds are being expended Social Pensions. Washing- African Development Bankfor this age group. Such ton, DC: World Bank. Group, Data Portal (ac-data should be made read- cessed May 2011).ily available to policymak- Leive, A. and K. Xu (2008). “Coping with out-of-pocketers and other data users, Anderson, G.F. and P.S. Hus- health payments: empiricalincluding development sey (2000). “Population evidence from 15 Africanpartners. Further research Aging: A comparison among countries. Bulletin of theis needed to build the evi- industrialized countries.” World Health Organization,dence base on aging to Health Affairs, vol. 19, no. 3, 86 (11).inform policy-making and pp. 191–203.programming within a spe- OECD (2010). OECD Cordaid/HelpAge Inter-cific country context. Factbook: Economic, En- national. (2011). A Study ofCountries should examine vironmental and Social Sta- Older People’s Livelihoods inthe economic and social tistics. OECD Publishing. Ethiopia. London and Theimplications of population Accessed online October 14, Hague: HelpAge and Cor-and demographic changes 2011. daid. Report availableand how these relate to online at: Salomon, J.A. and C.J.L. Mur-development concerns. www.helpage.org/downloa ray (2000). “The epi- d/4d9aeec5f28b8 demiological transitionDevelopment partners such revisited: new composi-as the AfDB can play a HelpAge International. tional models for causes ofsupportive role in several (2011). Aging in Africa, vol. death by age and sex”. Partrespects: 36. of the working paper series: The Global Burden of Dis- Kawani Narak and Kala- Help to build the ease 2000 in Aging Popula- nidhi Subbarao (2005),statistical capacity of re- tions. Research Paper No. Aging and Poverty in Africagional member countries 01.17. Harvard Burden of and the Role of Social Pen-(RMCs) to undertake the Disease Unit. Cambridge, sions, Social Protection Dis-collection and dissemina- MA: Harvard Center for cussion Paper Series. The 13 African Development Bank
  14. 14. AfDB [AGING POPULATION CHALLENGES IN AFRICA]Population and Develop- nomic and Social Affairs,ment Studies. Population Division. World Bank (2011). World Development Report: GenderUN DESA(2011). World UNICEF (2003), Africa’s Equality and Development.Population Prospects: The Orphaned Generations. New Washington, DC: World2010 Revision, CD-ROM Edi- York, NY. Bank.tion. New York: United Na- www.unicef.org/sow06/pdftions, Department of Eco- s/africas_orphans.pdf 14 African Development Bank
  15. 15. AfDB [AGING POPULATION CHALLENGES IN AFRICA]Annex 1.Figure A1: Estimated proportion of elderly population, 65 years and above, in Africa, 1950–2010 % 5 4 3.5 3.3 3.3 3.1 3.1 3.1 3.1 3 2 1 0 1950 1960 1970 1980 1990 2000 2010 Male Female TotalSources: UN DESA (2011); AfDB, Social and Economic Statistics Databases (2011).Figure A2: Projection of elderly population, 65 years and above, in Africa, 2020–2050 % 8 7 6.6 6 5.3 5 4.5 3.9 4 3 2 1 0 2020 2030 2040 2050 Male Female TotalSources: UN DESA (2011); AfDB, Social and Economic Statistics Databases (2011). 15 African Development Bank
  16. 16. AfDB [AGING POPULATION CHALLENGES IN AFRICA]Figure A3. Southern Africa: The Effect of HIV/AIDS on the Adult Age Cohort % Zimbabwe 60 48 46 50 39 40 30 25 21 22 23 18 20 20 10 9 9 10 3 3 4 0 0-14 15-24 25-44 45-64 65+ 1970 1990 2010 % Botswana 60 48 50 45 40 33 28 30 24 22 21 19 20 20 13 9 9 10 3 3 4 0 0-14 15-24 25-44 45-64 65+ 1970 1990 2010 % Lesotho 60 50 44 44 40 37 30 23 25 20 20 20 21 20 12 11 10 10 4 4 4 0 0-14 15-24 25-44 45-64 65+ 1970 1990 2010 16 African Development Bank
  17. 17. AfDB [AGING POPULATION CHALLENGES IN AFRICA] % South Africa 60 50 42 39 40 30 29 30 24 26 19 20 20 20 16 12 12 10 3 3 5 0 0-14 15-24 25-44 45-64 65+ 1970 1990 2010 % Swaziland 60 50 47 48 38 40 30 25 23 19 20 20 20 20 11 9 10 10 3 3 3 0 0-14 15-24 25-44 45-64 65+ 1970 1990 2010Sources: UN DESA (2011); AfDB, Social and Economic Statistics Databases (2011). 17 African Development Bank
  18. 18. AfDB [AGING POPULATION CHALLENGES IN AFRICA]Figure A4. The Effect of HIV/AIDS on the Adult Age Cohort: Selected Comparison Countries % Mauritius 60 50 44 40 30 31 31 30 24 22 23 20 21 20 17 14 10 10 7 3 5 0 0-14 15-24 25-44 45-64 65+ 1970 1990 2010 % Tunisia 60 50 46 38 40 32 30 25 23 18 20 19 20 18 20 12 12 10 7 4 5 0 0-14 15-24 25-44 45-64 65+ 1970 1990 2010Sources: UN DESA (2011); AfDB, Social and Economic Statistics Databases (2011). 18 African Development Bank
  19. 19. AfDB [AGING POPULATION CHALLENGES IN AFRICA]Figure A5: Prevalence of Selected Chronic Conditions by Age, Africa % Prevalence of selected chronic conditions by age, Africa 70 60 50 40 30 20 10 0 Osteo-Arthritis Osteo-Arthritis Osteo-Arthritis Osteo-Arthritis Osteo-Arthritis Diabetes Osteo-Arthritis Diabetes Diabetes Diabetes Diabetes Diabetes Angina Angina Angina Angina Angina Angina Mauritius Tunisia South Africa Morocco Congo Zimbabwe Under 60 yr 60+ yrSources: WHO (2002); World Health Survey: Results from Mauritius, Tunisia, South Africa,Morocco, Congo and Zimbabwe. 19 African Development Bank

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