By: Dr. Sultan Ahmad (Author is former Professor, Chittagong University and East West University, Bangladesh)
Declining fertility along with increase in life expectancy has reshaped the age structure of the population from young to old. Current total fertility rate is below replacement level in all industrialized countries and life expectancy ranging from 71 years in Latvia to 82 years in Japan, had rapidly turned to an aged population in these countries. The complex situation arising out of this ageing of population and what it means to the world, at large, and the developing countries in particular , needs to be addressed properly. Otherwise, we will be heading towards a human disaster in the near future.
In the more developed regions of the world, the proportion of older persons already exceeded that of children. Over the last 50 years, the ratio of people aged 60+ to children younger than <15 years (called ageing index) has increased by about half, from 24 per hundred in 1950 to 33 in 2000. The dependency ration defined as the ratio of all persons <15 and 65+ to the working age population 15to 64 has also increased. As a consequence, working age population will, in general, have to sustain those who are dependent on them. As a result, it is increasingly becoming more difficult to accelerate the standard of living because of increase in cost of dependant old people.
The main problem of this ageing process is budgetary constraint in allocating resources between development vis a vis allocating funds for food, shelter and above all the health of the aged population. This problem will be more acute, in the very near future, in the underdeveloped and developing countries as the fertility in these countries is approaching the replacement level (2.2 child per woman in an average), and the life expectancy will continue to increase. Increase in life expectancy in the now developed countries had increased at slow pace, but in underdeveloped and developing countries, the increase in life expectancy will not take long time to reach that in the developed countries as a result of advancement in health care and nutrition that took a long time in the developed countries. We, in the developing countries, are ripping the fruit of advancement in health technology that took a long time to develop by the now developed countries.
Now the question remains, do we consider aged people as a burden? No. Because they contributed a lot to the development and economy of the country during their working age. So it is the responsibility of all the countries to share this burden by deploying proper policy measures to redress their sufferings at old age. Most of the underdeveloped and developing countries still lack a basic social protection package that provides financial, basic health care and housing for the senior citizens.
The table above shows few age related indices in the SAARC region. It is apparent that the population of India in 2012 is almost 3 times the population of the other SAARC countries taken together. In 2050, the population of India will be more than twice the population of the other SAARC countries taken together. The population 60 and over in India in 2012 is 3.6 times more than the combined population 60 and over of the other countries taken together. And in 2050, the population of India aged 60 and over will be more than double of the share of the other countries taken together. The percentage of population 60 and over in 2012 is the highest in Sri Lanka and lowest in Afghanistan. While Maldives will take the lead in 2050, but Afghanistan will have the lowest position as usual.
As the percentages do not reflect the real magnitude of the problem to be faced by the countries in 1950, Bangladesh will have to share the burden of 59.4 million aged 60 and over in 1950; India, on the other hand, will have the burden of 300.3 millions. While in Maldives, one 1 in 3 of the population will be 60 and over, it will be almost 1 in 5 in India and more than 1 in 4 in Sri Lanka and about 1 in 4 in Bhutan and more than 1 in 5 in Bangladesh in the year 2050.
Evidence shows that an ageing population in these countries is a population that is still economically active in non-formal sector just for survival. People in these countries keep working no matter how old you are- no one is rich enough to stop. Health care system although free in all countries , it provides little treatment and hardly any medicine. The system is either corrupt or is not yet ready to handle the growing demand.
The table above shows that the life expectancy at birth is highest (78) in Maldives, followed by Sri Lanka (75) and lowest (60) in Afghanistan. other countries are either70 or very close to 70. All countries have a pension system only for those in government. Countries still lack a basic social protection floor that provides income, health care and housing for their senior citizens. Moreover, the disease pattern has changed from parasitic and communicable diseases to deadly cancer, heart diseases; which these countries are not yet equipped with meeting the growing demand to handle these modern pattern of diseases and the health care system has not yet been updated or necessary funds are not been provided to prepare the health care system for the alarming situation.
Non-contributory cash transfers to older people are provided by government in Bangladesh ($3.66), India ($3.18) , Maldives ($131.5), Nepal ($5.95) (means tested, source: www.pension-watch.net). The remaining countries has not yet providing any such support except the government employees pension scheme..
The pension Watch organization calculated the monthly allowance for population aged 60 and over, and the allocation as percent of GDP. The results are shown in the table under reference. The table shows that if all people aged 60 and over is paid $0.78/person, Maldives will be spending only 0.01 percent of its GDP; while if other countries in the region spend $0.02 to 0.21, the percent of GDP to be allocated are 0.1 to 0.21 percent only.
It is clear that if government allocations in the budget increases to 0.5% for the senior citizens (aged 60 and over), the senior citizens could have a better life style. Moreover, the allocation for the health sector will have to be substantially increased in the budget allocations to serve the grater needs of the senior citizens. Corruption and misappropriation must be strictly stopped, and proper utilization of the budgeted allocation must be ascertained and monitored.
Progressive social welfare policy must be adopted that will provide income security and health essentials. The sooner our governments realize the gravity of the problem and act judiciously, the better will the problem of the senior citizens will be in better position morally, physically and psychologically.