The World Health Organization (WHO) is not a group to be looking towards for leadership in the matter of treating aging as a medical condition. This is unfortunate, as the WHO propagates the International Classification of Diseases (ICD) that medical regulators use as a list of conditions for which treatments are permitted, and further has a fair degree of influence over government policy. If there is to be a summary of the WHO position on aging, it is that people should be wealthier, exercise more, and smoke less. Also more should be spent on compensating for the harms done by aging. There is no mention of treating aging as a medical condition, or even of research and development in medical science.
Thus enormously expensive government-funded advocacy for lifestyle change is about the sum of the ambition on display at the WHO, despite the fair number of groups attempting to improve WHO programs through open comment and feedback processes. And this in an era of radical progress in biotechnology, and the advent of the first working rejuvenation therapies that clear senescent cells from old tissues! That efforts such as those of the International Longevity Alliance and others to influence the WHO, with the aim of getting the organization to pay more attention to medical research, inevitably produce very little movement is one of the reasons why I think it pointless to attempt to steer bureaucracies.
To my mind it is far better to build the first rejuvenation therapies, achieve success, and let the lumbering giants of human society then catch up to the reality on the ground. If you want the best possible chance to create meaningful change in the world, then work on building new technologies. If you want to waste most of your life, then try to change institutions from the inside.
The Decade of Healthy Ageing (2020-2030) is an opportunity to bring together governments, civil society, international agencies, professionals, academia, the media, and the private sector for ten years of concerted, catalytic and collaborative action to improve the lives of older people, their families, and the communities in which they live. Healthy ageing is the process of developing and maintaining the functional ability that enables wellbeing in older age. Functional ability is about having the capabilities that enable all people to be and do what they have reason to value.
Populations around the world are ageing at a faster pace than in the past and this demographic transition will have an impact on almost all aspects of society. The world has united around the 2030 Agenda for Sustainable Development: all countries and all stakeholders pledged that no one will be left behind and determined to ensure that every human being can fulfill their potential in dignity and equality and in a healthy environment. A decade of concerted global action on healthy ageing is urgently needed. Already, there are more than 1 billion people aged 60 years or older, with most living in low- and middle-income countries. Many do not have access to even the basic resources necessary for a life of meaning and of dignity. Many others confront multiple barriers that prevent their full participation in society.
The extent of the beneficial opportunities that arise from increasing longevity will depend heavily on one key factor: health. If people are experiencing these extra years of life in good health, their ability to do the things they value will be little different from that of a younger person. If these added years are dominated by poor health, the implications for older people and for society are much more negative.
Poor health does not need to dominate older age. Most health problems confronting older people are associated with chronic conditions, particularly noncommunicable diseases. Many can be prevented or delayed by engaging in healthy behaviours such as not smoking and drinking, eating well and undertaking regular physical activity. Even for people with declines in capacity, supportive environments can ensure that they live lives of dignity and continued personal growth. Healthy ageing can be a reality for all.
We certainly welcome WHO's vision of the world in which all people can live longer and healthier lives. However, the Zero draft does not address sufficiently "Strategic objective 5: Improving measurement, monitoring and research on Healthy Ageing" of the WHO's Global strategy and action plan on ageing and health. Regarding the Zero draft of the proposal for the Decade of Healthy Ageing from June 12, 2019, its section 4.4 "Fostering research and innovation" should be significantly strengthened with biomedical and clinical research agenda. In fact, a separate section should be developed on biomedical research and innovation on ageing.
Research and development in the areas of biological ageing and ageing-related disease is the major long-term strategy to improve health and the quality of life in older ages. Therefore, the work and cooperation in the area of biomedical and clinical research in ageing and ageing-related diseases by the WHO, the WHO parties, and non-governmental stakeholders' should be explicitly stated as an agenda item for the Decade of Healthy Ageing. There is a growing body of consensus about the need to include research and development for healthy longevity as a part of the global WHO agenda. Aging health and R&D for healthy longevity must be included into the WHO Work Program.