Will the SDGs and the UN Decade of Healthy Ageing Leave Older People Behind?

Since the 1950s, multinational institutions have taken a number of positions towards population ageing and later life. In 1994, the World Bank (WB) saw population ageing as a crisis that needed ‘averting’. The United Nations (UN) approach evolved from the individualized, compassionate ageism of 1981 to a developmental, ‘society for all ages’, perspective in 2002. Yet the UN made comparatively little headway. In 2021 the UN launched its Decade of Healthy Ageing to support the 2030 Sustainable Development Agenda’s ‘leave no one behind’ goal. The UN rightly sees ageing as a lifelong, societal and developmental process and strongly supported the evidence that unequal resource distribution is the main contributor to health inequalities across the lifespan. Despite this evidence, the focus is now on a biomedical framing of impaired health and on a multi-stakeholder approach that emphasizes the Silver Economy’s economic potential. The first two years of the decade saw significant efforts to generate private-sector support. While the Decade of Healthy Ageing is still young, there is much good, harm and missed opportunity that can happen in a decade, justifying early consideration of what the Silver Economy’s biomedical approach will do for older people in low and middle income countries (LMICs).