36th UN International Day of Older Persons Celebration

Ladies and gentlemen, if you could take your seats, we will start momentarily. Thank you.

Good morning. My name is Dr. William Smith, and it's great to wish you a good morning and all those online a good day as we celebrate the commemoration of the 36th National/International Day of Older Persons. I am the chair of the NGO Committee on Aging here in New York, which in collaboration with the UN DESA, has taken the lead to organize this celebration. This event themed, The Age of Longevity: Rebuilding Systems for Longer Lives, aims to examine how societies can ensure that the additional years gained translate into healthy, productive, dignified, and equitable lives for all. Today's discussion will explore how health systems, labor markets, social protection frameworks, and public financing arrangements can be better aligned with the realities of longer lives. This event will also highlight evidence on the factors that influence well-being in later life, including the social, economic, and environmental conditions that accumulate across the life course, the importance of prevention, and the cumulative effects of inequality on aging trajectories. It's so good to see our friends from Ambassador is with us this morning, and we really are very pleased with all your support through the years. Before I dive in, some housekeeping reminders. I have the privilege of introducing, and I think he's here, Mr. Zevdin Petosic. He's our new, I guess he's maybe not here yet. but we hope to see him. He's the independent expert on the enjoyment of all human rights by all the persons, Dr. Potocnik. We look forward to working with him and his office as we work together to advocate the longer lives of lived and resources, redesigned policies, rights and dignity. There are so many changes going on here at the UN and throughout the other missions around the world. So it's time for change, and we stand ready to bring the NGO Committee on Aging to support that. I'd like to remind everyone to use the headpieces in front of you or near your chair so that you can better hear all the speakers. I'm delighted to inform you that the UN Secretary General, Mr. Antonio Guterres, has sent a heartfelt message to all of us, and it's included in your folders. Also, the index cards included on your folders can be used to write down questions during the panel discussion, and they will be collected by NGO Committee on Aging volunteers and handed to the moderator. The volunteers have been a real special treat to us over the years, and we want to thank them for stepping up and helping us run these programs smoothly. A lot of people worked hard to make this IDOP a success. I'd like to thank all who contributed in time, talents, or treasure to today's commemoration with heartfelt thanks from the NGO Committee on Aging. Without further ado, it's my profound honor to invite to the lectern the chair of the 36th International Day of Older Persons, my colleague, Ariana LSA and to lead us through the events. Ariana.

Thank you, Bill, for your guidance and your support throughout the planning of this event. Distinguished ambassadors, esteemed delegates, honored guests, colleagues, and above all, older persons joining us here and watching live on UN Web TV around the world. Good morning, everyone. It is a true pleasure and a great honor to stand before you as we commemorate the 36th anniversary of the United Nations International Day of Older Persons. This year's theme, the age of longevity, rethinking systems for older lives, speaks to something extraordinary. More people are living long enough to experience chapter of lives that earlier generation could not even imagine. It invites us to think about what those years can hold and how our communities and institutions can help people make the most of them. The question is, are the systems around us ready for the lives many of us are now able to live? Advances in medicine, public health, nutrition, technology, and social services has opened the door to longer lives for millions of people. Yet, living longer should mean more than adding years. It should mean having the chance to remain healthy, connected, and engaged, to learn and create, to love and be loved, and to live with dignity, independence, and purpose. My name is Arianita Elezaj, and it's a profound honor to serve as the chair of the International Day of Older Persons. I am one of the representatives of the International Federation of Settlement Houses and Neighborhood Centers at the International Federation of Aging. Older persons are part of every community and every part of life. We work, we care for others, volunteer, learn, and contribute in ways that are varied as we are. This is why a conversation about longer lives should begin with older persons themselves and with the lives that we want to lead. When we ask whether our systems are ready, We are asking about very ordinary things. Can I get to places that matters to me? Can I remain in my home and community if I choose? If I need care and support, will it be there? Will I have the income to make choices rather than having choices made for me? These questions cannot be answered by healthcare alone. Also, healthcare is essential. We need services that support prevention, mental health, mobility, and quality of life, as well as treatment. We need to recognize the importance of social connections and respond to loneliness and isolation when they occur. We also need homes and neighborhoods that work for people as their circumstances change. And we need transport that makes those neighborhoods usable. A medical appointment, a grocery store, a community center, or a gathering with friends may be nearby on a map. That means little if we cannot safely get there. Work is another picture. A longer life does not come with one timetable for employment and retirement. Some people look forward to retiring. Others wish to continue working, reduce their hours, mentor colleagues, or begin a new career. Older persons who wish and are able to work should have access to decent work, free from age discrimination. And those who retire should be able to do so with security and dignity. Ageism remain a barrier to realizing the possibilities of longer lives. It can affect whether an older person is hired, whether a health concern is taken seriously, whether a service is designed for them, and whether their views carry weight in decisions about their own life. Those are real consequences, and they deserve our attention. Ladies and gentlemen, next year marks the 25th anniversary of the second World Assembly on Aging, where governments adopted the Madrid Political Declaration and the International Plan of Action. For us, this is more than a date on the calendar. Madrid recognized the human rights of older people, our place in the development, and our voice in shaping it. The anniversary is an opportunity to look at what has changed and to ask with honesty and ambition how those commitments are being felt in people's everyday lives. That question is driven by Member States, but it belongs to older persons too. Thank you to Member States for everything they do for us. And sometimes the most revealing question is a simple one. Imagine a society where an 80-year-old is asked, "What would you like to do?" instead of, "What can you still do?" That small change in the question says a great deal. It begins with a person's choices rather than assumptions about their limits. Next year, the Madrid Plan will be reviewed in five regional meetings across the world, from Santiago to Addis Ababa to Bangkok and Beirut. The meeting for the region that includes the United States will be held in Germany in September. Older persons and our representatives are planning to be there. We'll have the chance to say in our own words what is working, what is missing, and what we want to see change. We'll hear some of those voices today, alongside perspectives from governments, researchers, advocates, and the private sector. We'll move from the longevity economy to accessibility, dementia, health, and the ties between generations. these conversations do not often happen in the same room. We brought them together because no government, no researcher, community group, or company can respond to longer lives in its own. And later, your questions will help shape the discussion with our panelists. Before we begin, I'd like to thank the UN DESA Program on Aging for Aging Section for jointly organizing today's event. So much care and work has gone into bringing us together. I'm especially grateful to the Chief Program on Aging Section, Amal Abu-Rafah, whose leadership continues to inspire progress in this field. Thank you, Amal. To the focal point of this event, Alia Talal Musad, for her consistent and unwavering support and steadfast dedication. Thank you, Alia. My warm thank you goes to Shafan Fila and Minyan Huang for their hard work. to Lamin Lambrabat and Simon Miyengo and the BCSS team for the technical support they have provided in preparing for and delivering today's event. Thank you all. I am deeply grateful to my fellow members of the NGO Committee on Aging New York for the time, energy, and care they have given to today's event. My heartfelt thanks goes to our leader, Bill Smith, my co-chair, Christopher Hanway, and the day planning team, Erica Darr, Kahir Laugi, Nina Hassler, Luca Pertanava, Keso Mumlaze, Mary Beth Morissette, Linnea Storrum, Patricia Fletcher, and Alicia Dejong. I also want to thank Katie Wise, Sandra Timmerman, Robin Fenley, Bethany Brown, Cynthia Stuen, for their guidance, hard work, and support throughout the preparations. Thank you all for making this day possible. Finally, our sincere gratitude and appreciation to our supporters, AARP International, M&T Bank, International Longevity Centres Canada and Health Age Canada, the Centre for Palliative Care. We are grateful for your support in making today's event possible. Ladies and gentlemen, Member States have been at the forefront of advancing the social, economic and human rights of older persons. Argentina, has long been a strong advocate for older persons at the United Nations. I want to thank its permanent mission for that commitment and for generously sponsoring today's event. Thank you. It is my pleasure to invite His Excellency, Mr. Francisco Fabian Tropepe, Permanent Representative of Argentina to the United Nations, to deliver his remarks. Ambassador, the floor is yours.

Good morning, distinguished guests, colleagues, and friends. Dear Anita, LSI, dear William Smith, my colleagues, Ambassador and Ambassador Roberto Ampuero, thank you for being here today. It is my honor to be here with you today, and let me begin my second time in this International Day of Older Persons, by expressing my sincere appreciation to UNDESA, with a special recognition of its programme on ageing, and to the NGO Committee on Ageing in New York for organising this important commemoration of the 36th United Nations International Day of Older Persons. This year's theme, the age of longevity, rethinking systems and longer lives, invite us to look beyond the numbers and ask a more fundamental question. What do we do with longer lives that humanity is gaining? Global life expectancy has increased steadily for several decades and is expected to continue rising. This is in itself a remarkable achievement. But longer lives do not necessarily mean longer lives in well-being. The gap between life expectancy and well-being remains a major challenge with impact for health system, social life, employment, housing, infrastructure, and the sustainability of public finances. Yet, longevity should not be understood only as a challenge. it is also an extraordinary opportunity. When additional years of life are accompanied by good health, autonomy, participation and economic security, they can generate what has been described as a longevity dividend. This requires addressing longevity through integrated policies rather than through a fragmented sector-by-sector approach. Health policy should be linked to social protection, employment and lifelong learning should go hand in hand with economic security. Housing and infrastructure cannot be separated from autonomy and participation. It also requires us to place human right at the center of the discussion. They must allow older person live with dignity, exercise their rights, make decisions, remain connected to their communities and participate fully in society. We must also recognize that there is no single way of aging. Aging trajectories are diverse and shaped by social, economic and environmental circumstances. Policies, therefore, need to take into account different realities while ensuring that every person can enjoy dignity, autonomy and equal rights in later life. Argentina has long recognized that the dignity, well-being and right of older person must be at the heart of our national policies and our international commitments. Currently, the government of Argentina is implementing measures aimed at protecting the purchasing power of pensions. These measures are part of Argentina's broader effort to protect the income, dignity, and well-being of older persons, while threatening the sustainability of social security system. At the multilateral level, Argentina has maintained a longstanding commitment to ensuring that the human rights of older persons remain firmly anchored in the international agenda. After chairing the open-ended working group on aging for 14 years and successfully fulfilling its mandate with the adoption of decision 14/1 in 2024, my country subsequently led the adoption by consensus of Human Rights Council resolution 58/13. This resolution established the open-ended intergovernmental working group, also chaired by my country, with the mandate to elaborate a draft international legally binding instrument on the human rights for older persons. This effort reflects a simple but fundamental conviction. As we look at the future of longevity, Argentina remains committed to working with all partners to ensure that longer lives can become additional years of dignity, health, autonomy, and participation in society. We will continue to contribute to the broader human right discussion on aging. Today's meeting provides an important opportunity to reflect together on how we transform longevity from a challenge into an opportunity for all generations. Argentina is pleased to be part of that conversation. Thank you very much.

Thank you, Ambassador Tropepe, for your remarks and for Argentina's steadfast leadership on aging and older persons here in New York. We count on you, on that leadership, Excellency, to keep aging firmly on the General Assembly's agenda. Thank you. I now have the pleasure to welcome in His Excellency, Mr. Roberto Ampuero, Permanent Representative of Chile to the United Nations and Chair of the Group of Friends of Older Persons. Ambassador, the floor is yours.

Excellencies, distinguished delegates, representatives of civil society, academia, and the private sector, dear friends, it is an honor to address you on behalf of the Group of Friends of Older Persons And I thank the Department of Economic and Social Affairs for organizing this commemoration and for inviting our group to co-sponsor it. This year's theme, Rethinking Systems for Longer Lives," reflects one of the great achievements of our time. Across every region, people are living longer than ever before. This is the result of progress in health, education, science, and social policy. And it is something we should celebrate. Longer lives also invite us to reflect. The question before us is not only how many years we add to life, but how we add life to those years. How do we ensure that these additional years are healthy? active, secure, and dignified for everyone, everywhere? Answering that question requires us to look at our systems together. Health and long-term care, social protection, labor markets, education and lifelong learning, housing, transport, and digital inclusion. Many of these systems were designed for a shorter life course. Adapting them is a shared task for governments and one in which civil society, researchers, the private sector, and above all, older persons themselves have an essential role to play. Older persons are not only beneficiaries of policy. They are workers, caregivers, volunteers, mentors, innovators, and holders of knowledge and experience. Their participation enriches our families, our communities, and our economies. Listening to their voices makes our decisions better. Every country is living this transition in its own way, with its own realities and priorities. Yet, we all share the same hope. that our parents, our grandparents, and one day ourselves, can live these years with dignity, purpose, and the support of their communities. That shared hope is what brings us together today. The Group of Friends of Older Persons remains committed to serving as a space for dialogue, cooperation, and the exchange of good practices among Member States and all stakeholders, so that the well-being and contributions of older persons receive the attention they deserve. We take this opportunity to reiterate our support for the intergovernmental working group, mandated to elaborate a legally binding instrument on the human rights of older persons, whose second session is scheduled to take place at the end of this month in Geneva. We are confident that today's discussions will offer valuable ideas for building societies where every person can look forward for a longer life with confidence and hope. I wish us all a productive and inspiring exchange. Allow me now to say a few words in my national capacity on behalf of Chile. Like many countries, Chile is going through a rapid demographic transition. Our population enjoys one of the highest life expectancies in Latin America, and the number of Chileans over 60 continues to grow. We see this as a sign of progress and also as a call to prepare our institutions for the decades ahead. For Chile, this means strengthening the systems that support people throughout their lives, access to healthcare and long-term care, economic security in old age, opportunities to keep learning, and working for those who wish to do so, and communities that are accessible and welcoming for people of all ages. Families remain at the heart of this effort. In Chile, as in so many countries, families and caregivers, many of them older persons themselves, carry much of the responsibility of care. Recognizing and supporting their work is essential. We also believe that older persons should be active participants in shaping the policies that affect them. Their experience is a source of wisdom that our societies cannot afford to overlook. Chile is glad to share its experience and to learn from others in a spirit of cooperation and mutual respect. Let me close with the words of Frank Lloyd Wright, "The longer I live, the more beautiful life becomes. May our work help ensure that this is true for everyone. Thank you very much.

Thank you, Ambassador Amparo, for your remarks on behalf of the Group of Friends and Chile. We count on the group to bring member states together and keep the concerns of older persons prominent in General Assembly's agenda and discussions. And having had the pleasure to meeting the first lady of Chile during the high level week, I have a feeling that we are in the right hands. Thank you all. South America is leading the aging work. Thank you. It is now my pleasure to welcome His Excellency, Mr. Abdulaziz Al-Wassil, Permanent Representative of the Kingdom of Saudi Arabia to the United Nations and Chair of the Group of Friends on Aging and Sustainable Development to deliver his remarks. The floor is yours, Ambassador.

Excellencies, distinguished delegates, dear friends, ladies and gentlemen, I have the honor to deliver these remarks on behalf of the Group of Friends on Aging and Sustainable Development, the permanent missions of Azerbaijan, Albania, Bahrain, Canada, Egypt, Italy, Japan, Kuwait, Oman, Qatar, Saudi Arabia, the United Arab Emirates, and Uzbekistan. We thank DESA. the NGO Committee on Aging, and the Mission of Argentina for convening this 36th International Day of Older Persons, which our Group of Friends honor to co-sponsor. UNIDO provides an important opportunity to reflect on how to best ensure opportunities, dignities, and well-being for all older persons, today's youth, are tomorrow's elders. Preparing for population aging today is an investment in a better future for all generations. Our group of friends' mission is to alleviate population aging on international agenda and to support implementing the SDGs alongside the Madrid International Plan of Action on Aging, three pillars, older persons and development, advancing health and well-being into old age, and ensuring enabling and supportive environments. We welcome the international community's growing recognition of populations aging as a sustainable development priority. This year, for the first time in 13 years, the high-level political forums ministerial declaration included a stand-alone paragraph explicitly recognizing the opportunities and challenges associated with demographic shifts, including population aging. It also reaffirmed our collective commitment to intergenerational solidarity, inclusive dialogue, social cohesion, and social policies responsive to people of all ages. This recognition is particularly timely as we consider this year's UNIDROP theme, the age of longevity, rethinking systems for longer lives. Longevity touches virtually every aspect of public policy. Health systems, labor markets, social protection, education, housing, infrastructure, and physical sustainability. These issues cannot be addressed effectively in isolation. Pension reforms benefit from aligning with labor and health policies. Preventive health investments are most effective when connected to economic productivity and physical objectives. And social protection systems will need to adapt to longer lives and changing patterns of work. This requires a whole of government approaches. Together with a meaningful engagement by civil society, older persons themselves, the private sector, academia, and researcher. The scale of demographic transformation underway makes this imperative clear. The global population age 60 or over is projected to rise from approximately 1.2 billion in 2025 to more than 2.1 billion by 2050. The vast majority of this growth will occur in developing countries, where the population over 60 will rise 86 percent from approximately 900 million to 1.67 billion. Growth is fastest at the old ages. Population age 80 or over are expected to more than double, and the number of persons aged 100 years or older to increase more than fourfold by mid-century. These longer lifespans must be paired with longer health spans, the number of years people live in good health. Dementia provides an example of a creeping longevity challenge. Global cases are projected to rise from 57.4 million cases in 2019 to about 152.8 million by 2050, with a 367% rise of cases in the Middle East and North Africa, and 300% 57% rise in sub-Saharan Africa. We welcome this unit of spotlight on this topic. As the latest Secretary General report and following up to the second world assembly on aging highlights, when preventive health strategies on non-communicable diseases lead to longer lives, sustained health, social participation, inclusive labour market and effective social protection, they can generate a longevity dividend, shared gains across generations. Achieving that dividend requires us to rethink systems built for a different demographic era and to invest in prevention, inclusion and social development through our life course. As we approach the 25th anniversary of Madrid International Plan of Action on Aging, we should use this moment to strengthen its implementation and to mainstream aging across development strategies. There are some very positive indications. The recent Secretary General report on implementing the Decade of Healthy Ageing found positive trajectories since 2020. Legislation against age-based discrimination is now confirmed in 112 member states. Policy addressing national ageing-friendly environment and programme are in 106 states. Comprehensive assessments to support older persons are in 166 states, and national long-term care are in 110 countries. The most critical gap identified by the report is the longitudinal nationally representative data on older persons reported by only 44 states. Resources constraints remain the primary structural barrier to progress. More data will be critical to implement the cross-system policies required to rise to this challenge and seize the opportunities of longevity dividend for all. The opportunity for global development is clear, so that the potential but for In the absence of reform, average in government deficits could rise from 2.4% of GDP in 2025 to around 9.1% by 2060. The challenge before us then is not simply to manage the costs associated with aging. It is to create conditions in which longer lives produce benefits for individuals, societies, and economies. Finally, as we look toward MIPAA at 25, let us seize the age of longevity as an opportunity to build societies in which people not only live longer, but live healthier, more secure and more fulfilling lives with joyful golden years and in which no one is left behind. Thank you.

Thank you, Ambassador, for your remarks and for your leadership of the group. Its recent achievements have not gone unrecognized. We very much appreciate the work of the group, you and its members are doing to keep aging part of the sustainable development agenda and all the conversation here in New York. Thank you. Ladies and gentlemen, please join me in welcoming our keynote speaker, Hala Nazari, lead of the Longevity Economy at the World Economic Forum. Halla brings together leaders in business, finance, and health, as well as young leaders, to think about longer lives, what they mean in practice. We are delighted to have her here today. Ms. Nazari, the floor is yours.

Hi, everyone. Thank you so much to the organizers of this wonderful event for having me here today. I am much more used to sitting there and taking notes, so it's an honor for me to be up here and to share some thoughts with you. Six years ago, I started thinking about one question at the World Economic Forum. What are the financial implications of people living longer lives? Today, I want to share where that question has taken me. When we started, people were living up to 20 years longer than previous generations, but our financial systems hadn't caught up. Since my work centered around financial services, we began where you might expect, retirement and pension systems. But it became clear very quickly that this was much bigger than pensions. People were living longer, but not necessarily healthier. So health span and prevention became part of the financial picture. Years lived in poor health are expensive for individuals and for the systems that support them. Then we looked at work. Some people want to work longer because they simply aren't done at an age that was picked nearly a century ago. Others need to work longer because they haven't saved enough for what could be a 20 to 30 to 40 year retirement. But ageism is rampant. Finding a job in your mid-50s is hard. In your mid-60s, it's close to impossible. At the same time, responsibility shifted onto individuals. Many employers moved away from guaranteed pensions and handed people control of their own retirement savings without giving them the financial skills to manage it. Pensions, health, work, savings. Every thread we pulled led to another one on what an individual needs for a resilient and secure longer life. That's when we realized this is not a demographic crisis, as it is so often described. This is a design problem. We all see articles and stories about the gray wave, the demographic time bomb, the battle between generations. I understand these headlines make for an exciting story, but it is a flawed story. These ideas point us in the wrong direction. They make longer lives sound like a problem, when the real issue is that our systems were built for shorter ones. Most of our institutions were designed for a three-stage life: school, work, retirement. That made sense when retirement lasted a few years. However, it doesn't fit a life where people move in and out of work and learning for over 60 or 70 years. We have been using 20th century solutions for a 21st century reality and wondering why they aren't working. These systems were also built with a certain person in mind, a man with one employer, a formal contract, and retirement at 65. Most of the world's workers never look like that person. Many people work informally. They take time out to care for others, and they change careers or combine several jobs. As lives get longer and less predictable, the gap between the way systems are designed and the way people actually live becomes more visible and wider. But none of this is set in stone and unchangeable. Someone picked the retirement age. Someone wrote the benefit plan. Someone decided who gets health screenings and when. These were choices people made, and we can make different ones today. I am an optimist at heart, so I don't want to dwell on what's broken. I would rather focus on what we can redesign to make our social and economic systems more resilient, sustainable, and inclusive. Systems that work for people across all generations. Along the way, we changed the focus of our work at the Forum. The real issue before us became, what does a person need to stay healthy and financially secure in a 100-year life that is filled with dignity, purpose, and community? Those last three things became critical to everything we were doing going forward. While we started this looking at the financial implications, it became clear that we couldn't do it without dignity, purpose, and community. This also changes when we act. We tend to treat longevity as something that happens at the end of life. But a 100-year life is shaped at 30 and 40, 60 and 70, in whether someone can retrain, save, stay healthy, and stay connected. We need to design for the whole life, not just the last chapter. And this also gives us an opportunity to include the people who were left out the first time these systems were designed, gig workers, caregivers, women with interrupted careers. But this requires us to think, rethink, excuse me, to rethink several connected systems, not one at a time, but together. First, we need to move from treating illness after it occurs to doing more to prevent it in the first place. from reactive care to prevention. Prevention is not only an investment in financial resilience, productivity, and sustainable health. It is also how we help people live longer, healthier lives with greater independence, dignity, and quality of life. Second, we need to move from retirement planning to lifelong financial resilience. People need support to manage longer working lives, career transitions, caregiving responsibilities, unexpected shocks, and rising health costs. Financial security should give people the ability to make choices, not simply to survive a long life. Third, we need to rethink work and learning. Longer lives may mean longer working lives, but only if workplaces become more open to people of different ages. People need opportunities to reskill and move between work, education, and care. We also need to challenge and address the ageism that prevents capable and experienced people from contributing. Fourth, we need to recognize caregiving as essential social and economic infrastructure. Longer lives means that more people may spend time caring for children, parents, partners, or other family members. That care should not remain invisible or fall disproportionately to women. Caregivers need recognition, flexibility, and support. And finally, we need to think about where and how people live, whether housing is affordable and accessible, whether communities support connection, and whether people can remain independent and engaged as they age. These issues are often handled by different ministries, different institutions, and different sectors. Health is discussed separately from finance, employment is separated from social protection, housing is separated from care. But people do not experience their lives in silos. While our systems are fragmented, people's lives are not. Breaking silos was the next pivot we made in our work at the Forum. This year, the forum brought its work on the longevity economy and its work on health under one umbrella in a new global longevity initiative. It treats financial resilience and healthy aging as one design challenge, not two. And it is built on breaking down silos between health and finance, between public policy and private innovation, and between generations. To drive that, we are creating a new Longevity Leaders Alliance. CEOs of major companies, heads of international organizations and civil society, and especially finance and health ministers, all together in the same room, something that doesn't often happen, all focused on the same issue. No single ministry, company, or organization can get this topic right on their own. Longevity is a multi-stakeholder opportunity, and it will take government, business, and civil society working together to create resilient, equitable, and sustainable solutions for the next 100 years. This is also an important opportunity for countries now experiencing rapid demographic change. Countries that aged earlier are often adapting systems that were built for shorter lives. Countries going through this transition today can learn from those experiences and build longer lives into their systems from the start. That means designing pension coverage, health infrastructure, financial systems, labor markets, and social protections with longer lives in mind, not trying to retrofit them or adapting them later when it becomes a crisis. Longer lives are one of humanity's greatest achievements, we all know that. But the value of those extra years will depend on the choices we make now. Many of our systems were built 100 years ago for a very different world. Today, we need systems that allow people to remain healthy, connected, and financially secure throughout their lives. Systems that recognize care, make room for change, and give people the opportunity to contribute at every age. We owe older people more than additional years. We owe them dignity, independence, and the opportunity to remain part of the communities they helped build. And we owe younger generations systems that gives them a fair chance to live long, healthy, and fulfilling lives. This is our intergenerational responsibility. We have inherited systems designed for shorter lives. Now it is our responsibility to build better ones for the lives people are living today, and especially for the generations that follow. Thank you.

Thank you, Ms. Nazari, for your thought-provoking keynote and your leadership in the longevity economy. You have reminded us that preparing for longer lives begins well before old age, and that health and financial security needs to be considered together. We are grateful for this perspective you brought to us today. Thank you. I now have the pleasure to invite in Michael Halden, Chief Executive Officer of the Global Coalition on Aging, to introduce the next segment of the program. Mr. Halden, the floor is yours.

Thank you very much, distinguished ambassadors, honored guests, NGO committee. As CEO of the Global Coalition on Aging, it is my pleasure to introduce Amal Abou-Rafeh, Chief of the Program on Aging at UN DESA, Brianna Gilmore, Head of Global Accessibility Policy at Uber, a company we are proud to count as a GCOA member, and Jonathan Perry, Population Officer, UN DESA. Today's theme, Age of Longevity, Rethinking Systems for Longer Lives, emphasizes that we have reached a milestone that for the history of humanity has been unimaginable. Long lives as a matter of course. We now live in a world where there are more old than young. This is a signal achievement that demands we rethink health systems, work, finance, and yes, how we get around. So longer lives are healthier, more independent, financially secure, and lived with dignity. Governments cannot do this alone. Business has a real role, and this day is a perfect moment to reflect on that. A ride to the doctor, the pharmacy, or a grandchild's school can be the difference between independence and isolation, the path to a healthier aging. We will carry this conversation to Malaysia next month when the Global Coalition on Aging partners with the Malaysia Healthy Aging Society to have our Global Silver Economy Forum under the theme, Healthy Longevity for Economic Growth. Today, Amal, Brianna, and Jonathan speak about how the public and private sectors can work together to turn our longevity into a healthy longevity and healthy longevity into a source of economic growth, innovation, and hope.

Thank you.

Thank you, Mike. Ladies and gentlemen, this is billed as a fireside chat. As you can see, we have no fire. We're on a podium. And we're at the UN, so I ask you to use your imagination in joining our conversation today. Brianna, it's wonderful to see you again. We first met in San Sebastian, and I have to say, TikTok was right. Their cheesecake was really that good. But the New Yorker in me will never admit that. I also remember that I told colleagues that I was heading to meet Uber, and they asked me, where are you going? And a few minutes into my conversation with Brianna, I realized that I had made the exact same assumption. Uber is not a transportation company, it is a tech platform, which is also why I am extremely pleased and honored to have my dear colleague, Jonathan Perry, join us in the fireside chat. Jonathan is a social affairs officer in DESA. He and our colleague, Weishan Hu, and Weishan, #alhayatsaba, both authored a DESA policy brief called Decent Work in the Platform Economy, which is excellent, and I highly recommend that you all read it. So, Brianna, thanks for being with us today, and perhaps the best place is to really start with you. Tell us about yourself, a little bit about what Uber does, and your role as head of global accessibility policy.

Thank you, Amal, for inviting me today. I'm so glad to be here with you, Jonathan, and thank you to DESSA leadership for hosting this event. Your story of our first meeting and the confusion of your colleagues is very typical. When I told people that I was interviewing for a job at Uber, they all first said, "As a driver?" And then they were even more confused when I told them what I was interviewing for, because to most people, I was the most radical disability advocate that they knew. The idea of me working for a corporation was an impossibility. In fact, I started my career right here at the Observer Mission for the IOM, and then worked in healthcare policy, led supportive housing and decarceration initiatives through community-based programming. usually working with people with disabilities and older adults, really focusing on deinstitutionalization and ensuring community participation for people with various access needs. So I was incredibly confused when I saw my dream job description at Uber. They were looking for a healthcare advocate with lived disability experience and a background in urban planning. And I thought, I'm one of one, so I have to apply. And I actually had to redownload the app onto my phone in 2022 because I had boycotted Uber since 2013. And I went in with such an attitude to this interview. And my first interview, I met three people. I met a 20-year-career healthcare advocate who today runs the team that provides millions of non-emergency medical trips for patients to access care all over the world through thousands of community-based partnerships. I met a NASA trained data scientist who does and continues to push our work forward in the ways that electric vehicles can reduce carbon emissions through Uber's platform. And then I met a safety leader who had herself lost her father through an impaired motorist accident, who's worked for years to develop the safety measures core to our platform that power the 40 million trips that we provide every single day, and has since earned the highest road safety rating from the FIA because of her work. And so this confusion persisted. I was like, I have missed something. I've missed something here. And almost five years later, I still consider it such a privilege to have had the opportunity to change my mind about what Uber really meant in our communities and the opportunities endemic to it. So today, I set strategy for accessibility and the rights of older persons to access our platform. I work with our program leaders and policy leaders all around the world to make that a reality, and I'm doing the work that I always dreamed of doing, creating opportunities for the social determinants of health in our community and our mobility systems.

That's fantastic. And today, yes. Today we're commemorating the International Day of Older Persons, so an Uber ride for an older person, like Mike said, is a lot more from getting one place to another. It's about going to your doctor's appointment, going to get your groceries, or in my mom's case, for the driver to help pick up the groceries after she's shopped them on her way back, connecting with friends, with family, with community. So how has Uber come to understand that a very human role. And do you have a story on experience that you can share and how that shaped or influenced the approach to the job that you do?

Think that you realize that you actually just listed all of the reasons that all of us access transportation. That's it. That's where we go. We go to healthcare, we go to work, we access food, we see our families, and we participate in community life. And that's for older adults as well. The only one that you missed is actually access to other forms of transportation to get to those things as well, which is a huge driver of Uber is to trip chain, is to get to other public forms of transportation and to the airport. And this is the same for older adults. story is an Uber story, that the ways that we move, getting from point A to B, from one place to another, that is a deeply human story. The reasons that we leave our homes and go into our communities, that's always about our motivations, our sense of self, our identities. And older adults, they don't lose those things. They don't lose those personal identities and their motivations to leave their homes. What happens is the risk profile changes. And all of a sudden, as we age, we grow concerned about our own reliability, the reliability of the world around us, concerns about privacy and safety, and even affordability can really impact the way that we access the things that matter the most to us. And these are core to all of the work related to accessibility. People with disabilities daily have to navigate those complex systems, privacy, safety, reliability, affordability. We're always making those trade-offs and negotiations as we access the world around us. And as I say internally to my colleagues at Uber, this is also Uber's story. That type of interdependence is what Uber does. Uber's story is an accessibility story of the ways that people choose to move into their communities and choose to access work. I really, I find it my greatest privilege that I am now like a story keeper at Uber. I have heard everything, like everything that you couldn't even imagine related to Uber. But I will tell one fun story. I was trying to limit the number of stories that I but this one's on my mind a lot. I recently met an 80-year-old woman here in Boston who had recently learned to use the Uber program. Her daughter taught her. Her husband had passed six years ago, and she was ready at 80 years old to start dating again. But she didn't think that it was appropriate to be in the car with a man in the early stages of dating. And so she had to learn how to use Uber. And now she's so proud because she can arrive and leave her date in style through Uber Black. And she was incredibly grateful for this. And it just reminds me of my favorite Uber statistic. A researcher found two years ago that the launch of Uber has been causal to a 3% increase in the marriage rates of people with disabilities, not correlative, causal. just because we have the opportunity to leave our homes without asking our parents to give us a ride to a date. Those are real social determinant numbers. And I'll say another story that drives me is my own story. I was a caregiver for my father for 12 years before the advent of Uber. And I remember the countless days, countless days where I had to make the impossible trade off between forgoing a trip to the grocery store or to the pharmacy to pick up one of his prescriptions to stay home with him or leaving him on his own to risk a fall or worse, just so I could get those essential needs met. And I remember what caregiving and aging looked like before Uber, and that keeps me moving forward.

Thank you, Brianna, for sharing that wonderful personal story as well. So as you know, older persons are workers and drivers, as well as riders in the platform economy. And our recent policy brief, which Amal was generous to mention, which I printed out here, recognizes that platform work, work like platforms like Uber provides, provides a huge flexibility and a lot of income opportunities for people, older persons as well. But that these opportunities can be uneven and sometimes precarious and sometimes lack provision of access to social protection. So for older persons, especially pension contributions that can really guarantee that income security in older years. So what attracts older persons to this type of work and how can we balance both in partnership between the private sector and institutions like the UN, how can we balance that flexibility and that opportunity with the need to provide decent work and fair and dignified work for older persons?

Jonathan, thank you for this question and for your work. I've really enjoyed reading your briefing. I think Uber is best kind of explained as a microcosm of whatever else is happening in the world. Whatever's happening in the world is happening in the Uber platform. And we can see this with older earners as well. So about 15% of the world's population is over the age of 60. 15% of earners on Uber are over the age of 60. And of course, we anticipate that number to grow as longevity increases. And all workers access gig work or platform work for various reasons. That's true for older adults, but we do see some through lines. We know that older adults access earning on Uber for socialization and to stay active. They realize that they've retired too early and they want to stay in their communities, and they decide to drive on Uber. There's a number of emerging researchers in this area who have also found that, of course, older earners are using platform work to supplement Social Security benefits. They're using it in later in life career transitions before a pivot to consulting or opening their own business. And they're also using it to push off the receipt of social care benefits. So I think that older earners are realizing that their longevity projections look much different than they had planned for in retirement, and they're delaying the receipt of benefits through platform work. We know that older adults choose to drive on Uber for some unique reasons compared to other drivers. They report disproportionately that they find greater job satisfaction in supporting their communities. And almost ubiquitously, they report the greatest satisfaction in their role helping other people with disabilities and older adults in their communities. So we think there's unique opportunities to really shape incentives and the role of older adult workers on their platform in a way that actually enhances access and safety users through those interactions. Uber has worked very hard to tailor benefits in different places based on need, right, where a person who's working full-time on the platform might benefit from something like a healthcare stipend, whereas an older adult worker who wants flexibility might already have those benefits accruing to them. And so we need to balance those things. In different areas, we've paid for injury prevention insurance, we have paid leave benefits, we also offer healthcare stipends in many many localities and we really think the best way forward is actually platform standards across industries because we're able to shape these things on our own but working together with governments and with international bodies like like you've been doing through your work would really create the same opportunities through other platforms it might also create the opportunity for portable benefits especially because most of our earners don't just earn on one platform they earn across platforms and so I really think that you're the policy brief that you created lays the foundation for that type of architecture that we can create moving forward, especially as we learn the unique needs of older earners on these platforms.

Yeah, thanks so much. And I'm really glad you mentioned the portability of benefits. I think that's really a crucial, crucial part of the story and one that the ILO in the recent International Convention 193 on international standards in the platform economy sets out very clearly. So it's really great to hear you mention that as well. And so what does this mean for women drivers or older women drivers as well who may value that flexibility but also maybe have particular safety concerns or maybe experience greater income insecurity as well?

Yeah, that pair, that concern about safety and income insecurity is of course foundational to our platform and we have some unique experience in recent years trying to design features that get at this. In India, for example, we had worked for years with NGOs and microcredit organizations to ensure that women had access to be able to rent or own their own vehicles to drive on the Uber platform. And after years of doing this work, the local team revealed to us that the number of women earners on the platform in 2021 was 20. 20 women. in all of India earning on the platform. And we had missed something, of course, so significant as that there were perceptions but real vulnerabilities that women experienced with the idea of driving alone in a car with men. It was seen as inappropriate culturally. And of course, there were major impediments with spouses and other family members who had sincere concerns for women who wanted to earn on the Uber platform. And so we designed, over the course of a couple of years, a feature called Women Preferences. and now in India, women drivers can set the preference to only be paired with other women riders. Today, we have thousands of women who earn on the Uber platform in India alone. And we've rolled out this feature in the US as well as other countries. I was just driving with a woman in Washington, DC last Friday night who said that her husband used to worry about her going out to drive at night, but she can never sleep and she always earns more at night. And so as soon as women's preferences was rolled out, now she feels so proud. and excited that she can spend her evenings working. So, even in a place like the United States, this feature is really imperative to support the economic security and the flexibility of benefits while promoting safety for women.

Thank you, Brianna. We actually had a question from the floor if the figures you had mentioned earlier were global or U.S. based.

Which ones?

Which ones, Erica?

Sorry. Of.

Course. went to talking about India.

So sure, maybe the about older earners, perhaps yes, 15% is global. And that's an average. And in some markets, we see much a much higher rate of older earners. For instance, in Japan, our rate, I think is over 30% for older is over 60, particularly because we primarily deploy through taxi associations. And so a lot of people are aging into Uber work, especially as we integrate with taxis around the world, who have a much higher a higher age range of earning.

Colleagues, we're really running out of time. Jonathan and I had a lot more questions to ask you, but we'll continue this conversation after. I do not want to take away from the wonderful program we have ahead. I'd only wrap up with a final question, Brianna, that if we were to invite you here to the International Day five years from now, what changes would you like to see in Uber that you could point to with pride?

Yes, absolutely. So just I think the main thing that will be for continued conversation really is our role in social determinants of health broadly. As I mentioned, we have a health team, we partner with healthcare organizations, but also city and states to ensure that people's benefits that they receive for transportation, food access, prescription, and over-the-counter pharmacy can actually be delivered straight to their doors. And our teams really talk about this as supporting the social determinants of health, is that we want to be a part of the logistics framework, the architecture of what creates age-friendly cities. And so my challenge the challenge that I see for Uber and my own work is also a challenge that I can pose to anyone here and technologists. And it's this number that I think about every day, which is that every year up to 5 billion healthcare appointments are missed because of transportation disruptions in the world, 5 billion. And that does not even take into account the number of appointments missed because of, you know, a lack of food access, a lack of the ability to have pharmacy delivered. It doesn't count the caregiver hours spent in that transportation and the other hours of work missed because of caregiver benefits. And so I think of this as our work because if we can solve for health care, we can also solve for access for other social determinants of health. And so in my work, I ask myself, like, what would I have to do differently today if not a single older person in my community five years from now missed a health care appointment because they couldn't get a ride? And so that's also the challenge that I pose to you. What would you have to change? As our keynote speaker said, Somebody wrote those benefits plans that doesn't provide for full access for full participation and what we know keeps people healthy and well in their communities.

Well, what a fantastic conversation. We look forward to inviting you both again to the day. Sorry we had to cut it short, but thank you very much. Ladies and gentlemen, join me in thanking our panel. Thank you.

Thank you, Amal, Brianna, and Jonathan. Before we move to our next presentation, I would like to remind everyone to use the earpieces that is next to you to hear all the conversation. Our next presentation turns to dementia. As more people live longer, more families will face it. But there is also growing understanding on how health, education, and social connections through life can affect dementia risk, alongside advances in early detection and treatment. Defeating Dementia is an upcoming PBS documentary. It brings us closer to people living with the disease and those working to change it. Please welcome Chris Durrance, filmmaker at Wellbeing's WETA, and Linda Lee Jacobs, a registered nurse, a patient advocate, and co-founder of Cure MAPT Frontotemporal Dementia, who is featured in the documentary. Thank you both.

Thank you so much. Thank you, Mr. Chairman, thank you, Ambassadors. distinguished guests, and above all, the DESA program at the United Nations for organizing such a wonderful day. It's an honor to be here and an honor to present a part of our forthcoming documentary on dementia. This is going to be a landmark series. Astonishingly enough, there hasn't been a major piece, a major piece of reporting on this hugely consequential healthcare issue, an issue that affects millions of Americans, as we heard from the ambassadors earlier, tens of millions worldwide. There hasn't been anything like that in 15 years, more than 15 years. It couldn't be more timely. It comes when the disease rates are soaring. We have in America 10,000 baby boomers retiring every day. We have family care partners put under enormous pressure. But it also comes at a time of great hope, a time when there are the first ever disease-modifying medicines available, a time when there are blood tests that remarkably can give you a sense of whether you have an indication of Alzheimer's while there is still time to do something about it. It comes when we are understanding more and more about prevention strategies, prevention that can be done in midlife to change the course of these diseases while there's still time. So as we celebrate Older Persons Day worldwide, I'm delighted to share you a clip from the film and to introduce Lindy Lee Jacobs. Lindy is A remarkable person. Dementia first came into her life when she started caring for her mother, Alison. So let's watch a short clip about Lindy, and then Lindy and I will have a conversation about her life and her work since then. Thank you.

She wouldn't remember how to finish her sentence, so she'd say, "Okay, well, we're just gonna drive the car across the, you know, the da-da-da-da-da." And she would kind of just do these hand motions as well. But when she started having the behavioral changes, that is when other people started noticing. There was no filter. She was asking people for money. She would make comments on their clothes or their hair and tell people just really inappropriate things. As a 22-year-old, I just was like, "What is wrong with you? Like, you are not yourself. This is not okay." She, you know, said, "Well, my mom had this dementia, but I don't have it." She would say it like that. She didn't see anything wrong with her actions or her behaviors. It just was her life. The doctor pulled out my mom's MRI, and she just said, "Well, her MRI is normal. I would not give her a diagnosis of frontal temporal dementia or any other dementias. Basically, she's just not coping well with her divorce, and she's very hyperfixated on it." I found out she was in jail on the Tuesday before Thanksgiving. Her cellmate, she just said, "I believe your mom has dementia. I just hope you get this letter so you can get her out." So she received a dementia diagnosis from someone that was her cellmate for two weeks before a physician ever made that diagnosis. From first symptoms to diagnosis was eight years. During those eight years, she spent $150,000. She was a victim of financial exploitation, sexual exploitation. She had gone through 17 different jobs. All of her friends that she had had for 25 years wanted nothing to do with her. They ostracized her. She just really went from being this powerhouse of a woman to someone that became emotionally distraught. She was so sad. Like, there was just this sense of intense desperation for connection.

Lindy, you're many things. You're a nurse, you're a mother of two, You're a wife. But I guess above all in your mind, you're your mother's daughter. We saw a bit in the clip, the story of your mother's journey through dementia. But what would you like people to know about your mother before that?

Sure. She was.

Yes. So my mom's name is Allison Lee. And Before dementia started changing her, my mom had her master's degree as a physical therapist, specifically working with the elderly population, doing home care visits. She enjoyed being able to help others. She was the first to open a door. We were taught from a very young age that when we are out in public, we are of service to others, that we are always looking to help others, and so that was something that was ingrained in us from a very young age. And she wanted to be known for her demeanor as being one of servitude, of being a community member that is lending a hand. So, I mean, when I was 11 years old, I became a personal care assistant for a neighbor child who had spinal muscular atrophy because this was a way that the family could get services for their daughter by having me be a paid PCA versus just a regular babysitter. And so at that age, we also were participating in charity golf tournaments to raise money for spinal muscular atrophy, and I was the babysitter of the children in the wheelchairs, helping with toileting needs, things like that. And so from a very young age, I was taught this notion of caregiving, of servitude, of being of service to others. And I think there's also something with my mother being a physical therapist from a very young age. You're never supposed to say that, you know, you play doctor as a child. Sometimes that has other connotations, but health, the health system, the body, all of that was just of such deep interest to me. But I think it was also because from a very young age, I saw my mother caring for others, and I wanted to have an aspect of that to be a part of my persona.

Thank you. And so often when -- it strikes me with your story, so often when people think of dementia, the first word that comes to mind is Alzheimer's. The first thing that comes to mind is memory loss. But what we see -- what we see in your story, in Alison's story, is something very different. you talk about how hard it was to get people to listen, to get to understand what was going on.

Yes. You know, when my mom first started having symptoms, I was just graduating college. I mean, truly, it probably started when I was 21 to 22 years old. And at that time, my youngest sister was a high school student. And so she probably noticed the symptoms the most, like, demonstratively, with my mom being manipulative and her parenting style kind of changing. And, you know, so I graduated college. I am a registered nurse, so I was working in the health care system. I understood how to help individuals with disabilities in a health care setting, going through social workers and things like that. And when we tried to do that for my mom, or even just speaking to her primary care physician, the laws of HIPAA don't-- they prohibit the ability for a family member that's not approved on the medical chart to talk to the physician, even if it's a concern. And so I, you know, tried multiple times to get a hold of her primary care physician. I tried different avenues, but as you can see in the photo and or in the video clip that you played of my mom, that was actually on her 60th birthday. So that was just two years before she passed away. But in a public eye, that's, you know, that she looked normal. There was another photo where it had my mom and my nephew was one, and that was in 2009, and that is when she started having symptoms. And so to the outside eye, she does not fit the mold of someone that has what we typically think of as dementia. And specifically when it's something that is changing your behavior, your personality, your ability with executive functioning to know right from wrong, people see it more as a mental health illness, a midlife crisis. She had been going through a divorce, so they called it an adjustment mood disorder or obsessive compulsive disease. And so I think We've siloed our thinking into dementia is always equated to memory loss. And we think of it as always a disease of the elderly. And what that has done is then the families that are trying to seek assistance when the person is under the age of 65 and isn't on Medicare. They don't -- that is not the first thing the primary care physicians expect is that you're looking at a dementia diagnosis. They go down all the other avenues first.

I think it's important to say, yes, it's absolutely -- these are conditions that impact midlife very much as well as older age. Midlife in terms of the care partners, midlife in terms of the many hundreds of thousands, at least in this country, who are impacted by dementias before the age of 65. And midlife also because as our distinguished colleague from the World Economic Forum was saying earlier, this is also the time of opportunity. This is a time when prevention strategies can be implemented that will change the course of these conditions in older life, provide a better health span. For you, Lindy, what do you want people to know about frontotemporal dementia? It's thought of as a rare disease, but it really isn't.

No, I think frontotemporal dementia is actually the most common form of dementia for those diagnosed under the age of 65. And so, it is one of the earlier onsets. The challenge with it is the way that it presents. But it does oftentimes also present as motor symptoms. So those that develop things like tremor or weakness, where it falls more on like the Parkinson's or the ALS spectrum, they are able to seek care and diagnosis much earlier. But when it's impacting your personality or your behavior, it is often dismissed. On average, it takes 3.8 years to obtain an accurate diagnosis, especially with those that present with a behavioral variant, which is what my mother had. And I would say even with behavioral variant, that average is probably significantly longer. You see that shortened period of average years to testing because those that develop motor symptoms decrease that average. But frontotemporal dementia is something that it impacts the frontal lobe of the brain. So when we think of Alzheimer's disease, it's affecting a completely different region of the brain. similar underlying proteins. However, it's just impacting different regions. And the regions where it impacts Alzheimer's is where your memory function is. With FTD, it's affecting your frontal lobes, so right up here, which is, if we look in the context of history, we think of those frontal lobotomies, what they used to do for individuals with psychiatric disease, thinking that that was going to fix it. But your frontal lobe is in charge of your executive functioning, your ability to be in public and know what's appropriate, what's inappropriate, your ability to have personal boundaries, social boundaries, verbal boundaries. It can impact your language skills. So sometimes it, you know, in the case of, you know, probably the most famous person that's been diagnosed, which is Bruce Willis, it was a language component, which, is trouble finding words, not being able to speak in sentences, but not able to track that one word, or being able to have issues getting your speech out. And so oftentimes, you think of the condition of aphasia as a secondary symptom of someone who's had a stroke. So again, a disease of the older generation typically thought of. So when people are presenting in their 40s and 50s, You know, they're still, you know, they have dependent children living in the home. They're still, you know, a huge provider in financially for the family. The insurance structure is not set up for any of that. And so it just does not put those frontline healthcare workers down a dementia pathway. They try everything else first. And nor are there specific biomarkers, truly. I mean, we're just evolving into a space where Alzheimer's disease has blood tests, where it is accessible at the frontline office. But if you get referred to a neurologist, the insurance structure is that you're waiting eight months before you're in to see a neurologist. And in that eight-month period of time, most people cancel that appointment, or the office cancels the appointment, or something else happens. Or you also allow time where fear creeps in. And sometimes not knowing is easier than confronting. And so I think we're missing a huge window where that window of getting in to see a specialist is not helping the case of reducing our average of symptom onset to disease diagnosis.

And you, as we see in the clip, you yourself decided to get tested. And I think a lot of people would have been paralyzed. I think I would have been by the outcome, by the result. Can you talk about what it inspired you to do, how you've chosen to live your life since hearing that news?

So in 2018 is when my mom was finally diagnosed with frontotemporal dementia. And then within the following year, her sister had started developing symptoms. And, you know, throughout my adolescent years, my grandmother was sick with the same disease. And so we had always speculated it could be genetic. And so once my mother's sister developed symptoms and was diagnosed, we knew for sure this was a genetic component. I'm a registered nurse, so my background is very scientifically focused. And I was just really hoping it was a recessive gene. I was hoping that maybe this was a 25% chance of inheritance. And our genetic counseling appointment in 2019 made it very clear that this was autosomal dominant, meaning that anybody that is a first-line generation has a 50% chance of inheritance. 50% chance is a coin toss. I mean, the odds are they're never in your favor, truly, in that kind of a bargain. And while my mom was alive, I knew that I was not in a place to learn that information. When she was diagnosed, I had a six-month-old baby and a three-year-old. I was just trying to sleep through the night at that point. But I am not somebody that-- I need knowledge. I work in the health care system. I understand the way it works. And I just kind of like concrete answers, and I want to know it to be able to move on. But also my husband was incredibly supportive. He just said, he goes, "You're gonna live your life like you're gonna get it anyways. So why not just know and let's plan. Let's plan accordingly. We can, you know, just because your mom's story happened the way that it did does not mean that this has to happen with you." And oftentimes I do think about if my mom would've known a genetic component was coming for her. that element of time for her to prepare, she would have done things so differently. Her journey would not have looked that way. And so for me, I was presented an opportunity through research to get my genetic testing results. And the timing was-- I mean, there's no good time to find that out. But I did my genetic testing four weeks after my mother passed away from the disease in 2021, and it was over a Zoom call. And the geneticist got on the call, and she said, well, you know, she kind of just zoomed in on my test results, and it just said positive. She said, well, I'm really sad to tell you that you tested positive, which means that in your case, you have a 99% chance to develop symptoms, most likely in the same time frame your mom did, so late 40s, early 50s. And not only could you get FTD, but you might also get progressive supranuclear palsy and corticobasal degeneration, which are two motor neuron diseases. Do you have any questions? And for me, this was also the first week my daughter was in kindergarten. She was not adjusting well. And I think I'm not one that's usually lost for words, and I had nothing left to say. And I'm a Midwesterner, so we're very nice, right? And I just-- I couldn't speak. And I just wanted to get off this call. And my husband knew my results because he came in from the garage with my daughter, who refused to go to school. And he could hear me crying from upstairs. And for that first day, I say, I threw myself a 24-hour pity party. But not really, because also, I still had a toddler who needed her diapers changed and demanded snacks. I had a kindergartner who was not adjusting well. I still had to just suck it up and do life. And so, which I think is really where a lot of resilience come from, is having children that just-- They don't really care what this says because they still need their needs met. And so that first 24 hours, I just, I cried. I, you know, I had a lot of conversations. I told my husband, I said, I don't want you to ever feel stuck with me just because we signed marriage vows that said in sickness and in health, you know, I don't think that you should have to feel trapped. And I was fearful of other people finding out. And then after 24 hours, I went to bed and woke up the next day and I was like, okay, well, it is what it is. There's nothing I can do to change this. And in that same day, I had a meeting with a psychiatrist, 'cause they have to check on your mental health status after finding out big news. And she said, "Well, what does this mean for you?" And I was like, "Well, this is going to change me. There's no way this isn't going to change me. But I'm not going to let it take me down. I'm going to change it and I'm going to make something of this. I don't know what that is, but I'm going to make something with this. And at that time, I didn't necessarily have the ability to focus on it because we were still planning my mother's funeral. But on my mom's funeral, so this was September 9th, my mom's funeral was October 3rd. October 8th is when we sent our first e-mail to an FTD specialist that was doing CRISPR technology. And we just said, can you tell us more about the work you're doing? And that was the igniting force for me was I understood science. I understood the health care field. But I never understood FTD from a biology standpoint because I was so busy keeping my mom alive and out of trouble. and dealing with all the legal things that I realized, like, the thing that I am the most confident in, I know nothing about. And so that is what really started my journey was I sent an e-mail to Dr. Claire Cleland at UCSF who said, how can I help? And in the following e-mail, I sent my genetic testing results, so personal health information over e-mail, which is not It's frowned upon typically. And a family photo, because I wanted her to see who is sending the e-mail. I wanted her to see the value in my daughter's eyes to say, this is worth fighting for. And I think in health care, I've also seen people that have been placed with impossible odds, and yet somehow they find the possibility. And I just, I was like, how can I do this so that my daughters have a possibility? in all realms, like a possibility to have a mom in their 20s, like when they're planning their wedding, like to enjoy having me there. I don't have photos of my mom at my wedding. I didn't want her there. It was too hard, you know? The photos of me and my daughter, I was mad because she showed up to the hospital without asking if she could come visit. I don't want my daughters to have that guilt or that cloud over shrouding their adult years with their relationship with me. And they don't, even if I get FTD, it doesn't have to be that way. We can experience this disease differently by preparing now. And that has kind of been my mission is how I'm a, I love being organized. I'm very type A. So how do I do this? How do I get everything buttoned, perfect, seamless? so that when my family has to step in to be my care partner or my caregiver, they know my wishes. They have everything laid out. They just have to apply the framework that I've laid before them. And so, I mean, in doing that, you know, oftentimes we plan for the future, right? Like we always think about the future, but I don't think in-depthly about the future. I think about the next year, but I plan for the present. I live for the present, and I think, what can I be doing now?

And since then, you've become a tireless advocate for research. You've brought families together. You've built a nonprofit. You've literally given your body to research. I don't know how many lumbar punctures you've done, but it's in the dozens, isn't it? In every trial, you're a part of every trial in this country. What is, given all that, what is the one thing you'd like the people here today and the people watching worldwide to know about you, about your hope for the future? Is it your children?

Absolutely. I started this journey solely to save my daughters. I never assumed that there would be a treatment in my lifetime. I knew I was working against a clock and it was timeline that I had no, I had no way of stopping it. I can't do the science myself. I can participate. I can give whatever I can, but I don't, I'm not independently wealthy. I can't fund the science. I can't, all I can give is my time, my story, and in the hopes that it is for my daughter. And I just still reflect back on, you know, there's this component of a legacy, and for the longest time, this work has been, in honor of my mom to try and get her legacy back. But also, it's to leave a legacy so that when disease symptoms start with me, I will be remembered for who I was and not what I become.

Our film, Defeating Dementia, is going to be on PBS on 330 local stations around this time next year. It's part of an important public media project called WellBeings, which was initiated by WETA, the DC, the Washington DC public media station. It's going to be accompanied by a massive, as with all their projects, a massive public engagement, outreach, and education campaign. So we'll be reaching colleges and schools in this country and around the world. I'd like to thank our sponsors and partners as well for making this possible. Without them, it really would not be, you know, within reach to meet the ambitions of this project. And we hope that you'll join us on that journey. And above all, thank Lindy for sharing her story today. Thank you.

Good morning. I think it's still good morning, Your Excellencies. Can you hear me? Distinguished guests, colleagues, advocates, and friends. My name is Chris Hanway. I am the vice chair of the NGO Committee on Aging in New York and a member of the board of the International Federation of Settlements and Neighborhood Centers. And it's a privilege to join you today at the United Nations as we mark International Day of Older Persons and celebrate the immeasurable contributions that older adults make to our families, our communities, and our societies. As someone who has spent much of my career working alongside neighborhood centers, settlement houses, and community-based organizations, I know that strong communities are built across generations. Older people are not simply recipients of services. They are leaders, mentors, caregivers, volunteers, advocates, and keepers of wisdom whose voices must be heard in shaping our collective future. And they are living considerably longer. Today's panel brings together, the next panel, brings together respected leaders and experts who are helping to advance that vision. They will explore both the challenges and opportunities presented by the notion of rethinking systems for longer lives and resilient societies in this, the age of longevity. It's my pleasure to introduce our moderator, Gregor Sneddon, Secretary General of the International Federation on Aging. Mr. Sneddon is a recognized global leader in the healthy aging movement with decades of experience spanning humanitarian response, community development, public advocacy, and civil society leadership. Before joining the IFA, he served as executive director of HelpAge Canada, where he championed the rights and wellbeing of older persons, particularly those in underserved communities. Through his leadership, he has become a respected voice for dignity, equity, and lifelong inclusion. Gregor, thank you for guiding today's conversation. And now I invite Gregor, who will introduce our panel and our distinguished panelists to join us on the stage. You can see they're already here. As we begin what promises to be an engaging and important discussion, please join me in welcoming them.

Thank you, and good morning and good afternoon, good evening to everyone with us Today, it's a privilege to moderate this conversation on the age of longevity, rethinking systems for longer lives. The International Federation on Aging drives global intersectoral collaboration on healthy aging and longevity. Longer lives are a triumph to be celebrated, but are we system ready? I'm headed this Sunday off to the World Bank and IMF annual meeting to advocate for longevity, resilience, and economic global reform. and also preparing for our 2027 18th IFA Global Conference on Aging, which will be in Asia Pacific. But before I go, for anyone who is from Canada, you'll know that we're celebrating our Thanksgiving this weekend. And gosh, I started to realize, you know, it's quite an affair. We sent out our invitations. We have a whole battalion of folks coming, but gosh, am I ready? Have I shopped for all the ingredients? Is the house going to be clean? What about Mrs. Krasinski getting up our steps with her walker? I hadn't quite thought that through yet. Or do we have enough chairs? Or Mr. Salamas, he has some hearing challenges. How are we going to make sure he's comfortable? Did I order the turkey? Is it halal for our Muslim friends? What about the vegetables and setting the table? What about the guests with peanut allergies, for goodness sakes? The vegetarian and gluten-free options? Well, ready or not, here they come. Global population aging is rapidly accelerating. This is no speculation. The UN Secretary General, as he's been already quoted this morning in his 2026 report calls longevity a defining demographic transformation, affecting health systems, labour markets, social protection, education, infrastructure, and public finance, and calls for whole-of-government approaches and integration into medium and long-term planning. Are we ready? We indeed can celebrate that we have become remarkably successful at adding years to human life. But are those years lived in good health, in security and freedom? And are those opportunities, those options available to all? Are our institutions adapting? Institutions and structures designed for a different demographic reality, a world that no longer exists. So the question before us is not simply how do we react and respond to more older people. It is a much larger question. How do societies become resilient to the defining demographic transformation? How do we anticipate longer lives and changing age structures while protecting rights, widening opportunity and maintaining and enhancing social and economic sustainability? That makes longevity not only an aging issue. There is only one alternative to aging, after all. It is a development issue, an economic issue, and ultimately a question about how we organize our world through the life course. And important to this conversation, longer life is not automatically healthy or equitable longevity. The gap between global life expectancy and healthy life expectancy was already 9.6 years in 2019, and outcomes differ enormously within and between countries. Longevity can expose and extend existing inequalities, or, with the right choices and investments, create new possibilities for health, contribution, participation, security and connection across generations. And we need to be making those choices now. Because ready or not, here we come. Our four speakers allow us to examine that position from our four complementary perspectives. How we redesign the life course, how we create health and capacity across longer lives, How we understand the economic relationships between generations. And finally, how these questions look through the demographic and development rights and rights realities of the African continent. Each of our panelists will share their perspectives for approximately 10 minutes. And after their contributions, time permitting, we will bring those perspectives together into conversation and open the discussion. So let us begin with the architecture of the life course itself. Emilio Umeoka is an ambassador for the Stanford Center on Longevity's New Map of Life initiative, with leadership experience across Brazil, Asia Pacific, and Silicon Valley. His work now focuses on longevity, innovation, and the multi-generational workforce. Emilio, In the new map of life, the new map of life starts from a provocative premise. As lives become longer, we should not simply stretch the institutions and conventions designed for shorter lives over more years. We need to redesign the map itself. So what would it mean to redesign education, work, caregiving, and retirement around longer and more flexible lives, rather than asking people to fit longer lives into systems designed for the past? Over to you.

Thank you, Gregor, and thank you, the organizers, for the invitation. Let me quickly say something about the Stanford Center on Longevity. where we envision a world where people thrive across century-long lives, healthy, purposeful, and engaged. While we mentally sharp, physically fit, and financially secure. As being mentioned, by 2030 in the US, 65 pluses will outnumber 18 or younger. And according to the UN, by 2050, one in every six person will be over 65. Japan recently crossed 100,000 people over 100 years old. And from the opening discussions from the ambassadors of Argentina and Chile, Latin America is the region that's aging the fastest. Brazil, in the next 30 years, will be the sixth oldest country in the world. But instead of a burden, what are the economic and social benefits generated by people living, working, and engaging longer? And how do we see the role of employers, government, civil society, and individuals supporting longer lives? As Hailey has mentioned, we cannot solve a problem, a 100-year problem, with the reality of a 65-year model. For that, the Center of Longevity has created the new map of life. I'll take the opportunity and walk you through quickly some of the main tenets. How do we leverage the use of diversity? How do we leverage the benefits of having different generations? In the workforce, you have up to five generations working together. How do we build multi-generational communities and engagements? bringing different generations to solve problems, break these barriers of us versus them. And also look at a different way in terms of the 50 pluses, not in terms of a monoblock, but people in different stages in life. How we look at the alignment of health span to lifespan, that's another big one, and unfortunately, the US went backwards. Today, this gap is 14 years. And in the UK, it's 12 years. So there's still a big gap. And even if I'm coming from Silicon Valley, I'm not focused on biohacking and trying to live to 120 or 150 years. That's not going to solve. It's how we reduce and improve this gap between healthspan and lifespan. Building financial security from start. mean, we, a professor at Stanford, Anna Maria Lusardi, has made us some surveys, and 50% of people do not actually understand the impact of inflation, compounded interest, and portfolio management. How can we drive financial literacy early enough? How we can build cities for the future? How we can create communities where there's intergeneration connection? where there's accessibility and integration versus segregation. Singapore is one of the use cases that I usually like to mention. There's a district called Queenstown where it promotes healthy longevity, enables purposeful longevity, and it creates intergenerational bonding where older generations, they can volunteer in the daycare to take care of younger couples' children. As we live to 100 years, we'll have to work 60 years. So what are the major implications of working 60 years? You have longer breaks, pauses for learning, relearning, reskilling, caregiving, taking care of your children, your parents, and yourself. Implications on healthcare, implications on social security, Currently in the US, there are five people working for every one retiree. In 30 years, there will be two workers for one retiree. Unless we change some of the policies and adapt, and it takes time to adapt them, it will be very hard to sustain financial security. Look at what Denmark has done or Singapore. Both have moved alignment of retirement to lifespan. But Singapore will start in 2030 and Denmark will start in 2040. But they already said 70 years will be the minimum ceiling. As we live longer, we need to create ways to support transitions. Transitions will be super important and very many transitions will happen. As we say in the new map of life, transitions will become a feature and no longer a bug in their lives. Learning throughout life, what I call moving from a lifelong learning to a long life learning. And one of the key examples of what I'm seeing in terms of higher education, because there was in 2025, a 15% cliff in terms of students coming to higher education is how can universities extend the learning period for aligned to lifelong learning? One of the great examples is Mirabella at Arizona State University. They built a 20 story building where you can buy your apartment there and gives you the right to have a student ID and you can actually attend classes. So there are great cases of former lawyers, former medical doctors, former Broadway choreographers helping and integrating with students. One thing that excites me a lot is all the scientific and technological breakthroughs that are happening. Not only in terms of prediction, when you look, some researchers at Stanford, they were able to predict that somebody would test positive, COVID positive, two days before, just based on the symptoms. But some of the studies I'm seeing, when you look at wearables, for example, whether you're measuring your sleep, or looking at accessibility with glasses. I was talking yesterday to some of the panelists about directional hearing in the glasses, where you turn your head and actually increases the volume. So accessibility will be a key component on how we can use technology. GLP-1s and the impact on obesity. One in every eight Americans now are using GLP-1s. Biomarkers, if you look, there are companies looking at biomarkers for cancer, 50 cancers, for example. But more important, they're looking at the 12 most aggressive cancers to be detected in earlier stages. That will help the way we look. And those 12 cancers, they're very aggressive. They make two-thirds of the deaths related to cancer. But at the end of the day, how can we make this more equal? Today, basically, the place you're born, the zip code you're born, basically determines how long you will live. And minorities are really struggling with that. If you look at 65 plus, one third of the population here in the US lives below the poverty minimum of 32,500 for a family of five, for a family of four. And 50% minorities live below that poverty line. Finally, as we invest, how do we invest in future centenarians? Yesterday at the end of the dinner, we were sharing grandchildren's picture, right? So how do we work and pave a better future with them and for them? I'll just walk very quickly on where I spend time. As Gregor mentioned, I work with mostly companies with boards. where I have network access, I understand how companies operate and do change management. And there's a business imperative for them to also focus on the 50 plus. There's the 50 plus economy that today holds two thirds of the purchasing power and only 5% of the marketing budget. My final question is, are you ready? So when I'm talking to CEOs, they're looking at their agenda. Their agenda basically is composed of a few things. They look at their talent. They look at innovation, growth, and cost control. How is the company readiness? Are they ready? Do they have the marketing team? Do they understand this segment? Do they have the right people and talent? processes in place, the talent pool, job descriptions, interview process, do they work with flexible hours, healthcare coverage, but what are the things they're doing to prepare their own managers to manage several generations and to create this engagement between learning across generations. With that, I'll pass it on back to you, Gregor. Thank you very much.

Thank you, Mr. Umeoka. That gives us the first piece of the puzzle. Longevity is not simply an extension of older age. It potentially changes the architecture of education, work, caregiving, retirement, and participation across the whole life course. But there's an obvious condition attached to that vision. Additional years create opportunity only if people have sufficient health, resources, and functional ability to use them. Our next speaker takes us from the architecture of longer lives to the conditions that determine what those lives actually become. Dr. Linda Fried directs the Robert N. Butler Columbia Aging Center and co-chaired the National Academy of Medicine's Global Roadmap for Healthy Longevity. Her work asks one of the central questions before us: can healthier, longer lives create a new demographic dividend for society as a whole? Dr. Fried has described the possibility of a third demographic dividend, a society in which longer, healthier lives create benefits not only for older people, but for people of every generation. Dr. Fried, what would have to be true for longer lives genuinely to produce that third dividend, rather than simply adding years of ill health or inequality? The floor is yours.

Well, thank you, and good afternoon. I'm honored to be able to join you all here. I think that there are -- we're confronted with a mental framework in many settings that, as we've heard before, aging is a challenge to be dealt with. But, in fact, the evidence that's been building over the last decades suggests that It is heavily an opportunity. And I think as we think across systems, there is a unifying theory that has been building, that we could create a new demographic dividend for everyone to benefit from. Now, we've already been going through lots of transitions. Through profound improvements in child survival over the last century with resulting declines in fertility, our world has progressed through a first demographic dividend to a second one with a growing share of children who survived adulthood and can constitute the workforce that powers economies. But as we've heard before, the next round of profound transformations, our systems are not designed for. And many in the second demographic dividend around the world and locally need help. There are four pillars of transformation that are central to turning transforming for older age into transforming to successful lives at each age because of longevity and not despite it. And they are Not surprising to this audience, investing in human capital across the entire life course. Adding to the vision of human capital investments, the necessity for healthy aging. Enabling older people to learn, adapt to, and benefit from new technologies. and building a new kind of social infrastructure that creates connection and cohesion, but just as importantly, offers valued, significant roles for older adults to pay it forward and leave a better world. The essential challenge, as was just said by Mr. Umeoka, is to make these opportunities available to everyone. Now, there are some cognitive frameworks that need to change before we can design. Much of the focus globally on population aging begins with thinking a lot about declining fertility resulting in smaller populations and a shrinking proportion of people of traditional working age, with many concerns about the impact on a nation's economy. But there are other ways to analyze even this transition. Consider first the concern that if older people continue working, they will take jobs from younger people. The fact is, the evidence does not support that simple zero-sum view. The OECD finds no evidence that workforce aging displaces young workers, but rather older adults in the workforce strengthen economies, leading to more jobs. This is one of many examples ahead of us where we do not have to choose between generations. The second question that is often on people's lips is whether older people's work is of sufficient quality that it can compensate for a decline in younger workers. And increasingly the evidence says that they can, but only if we invest in the conditions that make longer work working lives possible and successful. This includes evidence that older workers are productive and can bring complementary skills, experience, and perspectives to age diverse teams, and that these teams themselves are often more innovative and productive. It includes realizing the potential of older workers requires adapting work where necessary, particularly in physically demanding jobs. while we also maintain health into older age and invest in skills throughout life. And the latter requires training older as well as young workers to use new technologies. New evidence shows that technology adoption by older workers boosts productivity by 6% and adds five years of additional productive labor. And as has been mentioned, future potential requires continued investment in education. Higher educational attainment by older people extends their participation in the workforce. But the evidence on education, of course, goes well beyond this. Research by Lutz and colleagues across 165 countries found that rising educational attainment was a primary driver and facilitator of economic growth broadly, while age structure changes played a secondary role. As part of their evidence, they considered the experience of the Republic of Korea as an example. Using data from 1970 to 2017, Their work estimated that if there had been the same population aging in the Republic of Korea, but without their major educational improvements, income per capita would have been approximately one third of the level they achieved. Similar simulations for Nigeria similarly estimated that combining South Korea's educational and aging changes could produce a 65% increase in GDP per capita for Nigeria. But education alone without aging would account for an estimated 29% increase. Further, if the country experienced comparable aging but without educational improvement, they would see an estimated 25% decline in GDP. These are examples and simulations, but they provide a powerful principle, that education, as with other innovations, is not simply preparation for youth, it's an investment for our whole lives. And in aging societies, as Mr. Umeoka said, making education lifelong can help sustain the demographic dividend rather than leave it to diminish. The second major transformation is health. And as you've heard, the world as well as this country is increasing a large and widening gap between the length of our lives and the length of our healthy lives. That gap represents enormous loss of human potential, particularly since we now know that it is possible to live a long life with more health. A large part of this requires making younger people healthy first. Preventing disease and disability across the whole life course is possible and it increases the likelihood that people reach older age healthy and then that they remain healthy. We also now know what we didn't know when I was in medical training, which is that prevention works and matters at the oldest ages. Altayara and Silas analyzed data from 180 countries and found that although a larger share of people 55 to 69 was associated with lower real per capita GDP growth, this initial finding was moderated when people in that same age group were healthier. And if the highest levels of good health were achieved, there was no difference in GDP growth with aging or without it. And in fact, to set a goal, if we lowered disability levels by 5%, you could reduce or even eliminate the economic slowdown associated with population aging. The implication of this is critical, that age structure does not determine economic destiny, that health and human capability matter. We know from guidance from the WHO where to focus to start, which is on the prevention of non-communicable diseases with high return on investment and high likelihood of success when done well. Consistent as well With the World Report on Aging and Health and the goals of the Decade of Healthy Aging, which we are halfway through, we need systems that promote health as well as prevent disease, that build intrinsic capacity in people's functional abilities. And in the near future, I expect we will have scientific advances that can increase the opportunity for health itself. Lowering disease and improving health requires medical care, including appropriate geriatrics expertise, but it also requires public policy and public health-led population-based solutions for communities and health sectors. So healthy longevity is an all of society responsibility. It is also the key in the lock. It gives people more years in which they can contribute on the things that matter most to them, paying it forward for future generations. And this is the fourth opportunity that receives far less attention, the unrealized social capital of older age. The challenge is not whether older people have capabilities to contribute or seek to do so. The challenge is whether we have institutions that create those meaningful opportunities for those capabilities to be used to the degree that people value and to increase societal thriving. Around the world, there are many innovative models appearing. I'll mention two. One, of course, from Canada Help Age. and HelpAge International, which effectively fosters collaboration among older people, building mutual support, economic improvement, and community well-being. Another I can speak to is Experience Corps, in the U.S. since 1996, offering highly scientifically designed, high-impact roles for older volunteers to support children's academic success in school. Evaluations show high impact in terms of school behavior, literacy, and teacher effectiveness, but also from a public health point of view, delivering roles that improve people's health. These examples matter because they demonstrate something larger than the value of any one program. They demonstrate the potential of developing novel social infrastructure for older age that contributes roles that enable older people to give younger ones a hand up at scale, at the scale of a fifth of the population with a desire to give back. And they show that catalyzing the social capital of older people can benefit all ages and the future. So I'll conclude by saying that this brings us to a larger proposition, There is evidence that we can move from longevity as a challenge to longevity as a dividend for all ages. The evidence indicates that population age structure alone does not determine whether societies prosper, that what matters is what we do with those capabilities within that age structure. and how we actually build to amplify what people want to do and the ways in which they want to contribute. And it points to a very different way of thinking about demographic change so that we focus on building, designing for the opportunities. I'll end by saying that in combination, there is evidence that these investments can transform longer lives into a source of human and societal value for all ages. I have called that possibility that can emerge from these transformations a third demographic dividend. In this stage, older people have the health and opportunity to contribute in the roles they believe matter. Young people can benefit from these contributions as well as investments in a life of health. Generations become more connected and older people can fulfill their desire to give back and build a better future for the generations that follow. This is a unifying theory perhaps for understanding what societies can gain from longevity. to drive to a place where all ages can thrive because of longevity, not despite it. Thank you.

Thank you, Dr. Frieda. A transition, a shift in thinking from longevity as a challenge to a dividend for all ages. Health in later life is not something that suddenly appears or disappears at 65. It's produced over decades through prevention, our environment, opportunity, education, income, relationships, health care, public policy. And if health is partly the foundation that makes longer life participation possible, The next question becomes, what does that mean economically? Longevity changes not only how we live but how resources flow between individuals, families, generations, the state and the world. We have now heard that longer lives require institutional redesign and that their benefits depend substantially on health, but demographic change also changes the economic relationships between generations. who produces, who consumes, who provides care, who pays taxes, who raises public transfers, and how resources move within families. Professor Ronald Lee is a demographer and economist at the University of California, Berkeley, and co-founder of the National Transfer Accounts Project, which examines these intergenerational resource flows across more than 80 countries. Professor Lee, debates about population aging are often reduced to one word, cost. What does the evidence actually tell us about the economic consequences of longer lives, and what do conventional dependency ratios or fiscal narratives fail to show us?

Well, thank you very much, Gregor. I'd like to talk about that. Longer lives are great, but they're accompanied around the world by low and falling fertility. And as we know, that brings serious population aging. But the challenges for population aging are not just demographic. And I want to talk about how our economic life cycles change with rising incomes, economic development. As incomes rise, older people are working a lot less and they're consuming a lot more relative to younger adults. And as incomes rise, societal support systems shift from familial support for older people to public transfer programs. And I want to show that process. In the high-income countries now and coming up soon for a number of upper middle-income countries, Population aging and public transfer programs are really quite out of control and on a collision course, unsustainable and politically treacherous to reform. So I also want to talk about some ideas on that front. I think the challenge is that we have to change our cultural values and expectations around old age. We have to restructure these unsustainable public programs. We need public programs. We should continue those. It's also for the younger and lower income countries to avoid these problems from the start, to take careful note of the terrible troubles and problems that the high income countries are in now and try to avoid them by taking a different path. I think work is part of life, and it should be part of older people's lives as well, particularly given our increasing health and longevity and all that we have to offer to the economy and the society. Okay, so I'm going to be drawing on material from the National Transfer Accounts, NTA, which describes how people produce and consume and save and share across the generations throughout their lives. And there are teams estimating National Transfer Accounts in over 80 countries all over the world. And they have had important support and collaboration from DESA, including publishing now three different manuals on how to do NTA and NTTA and so on. Seven countries have incorporated NTA in official national statistics. Another 13 countries in Africa are sort of something close to doing so. And then finally, before I get into this, I want to say that the views I'm expressing here are my own. They're not those of NTA or DESAs or anyone else's. And some of them seem to not always be very welcome. Well, here is a view on the age shape of labor income for just here some different countries around the world. And they're all, they're standardized within each country, as will the next diagrams be, by dividing by average labor income at ages 30 to 49 in each country. Now what you see here is that in lower income countries, in Senegal, the Philippines, Mexico, an upper middle income country, you see that older people are contributing a lot of labor income still. But you see in, well, here illustrated by France, but this is true throughout the high income countries, older people pretty much stop working after 60 or the early 60s. That red arrow is just showing that decline. Now, let's look at consumption, the same sort of diagram. Here we have Nigeria and Indonesia. In these countries, you see older people consuming a bit less than younger adults. I'm not saying that's a good thing, it may be elder poverty. You see in Costa Rica a fairly flat age profile of consumption. And then you see Japan. Compare on the blue line what is being consumed in Japan at age 40 to what's being consumed at age 85. An enormous increase at old age. And again, this is not just Japan, it's certainly the US, it's certainly Sweden and Germany and many other high income countries. Why is this? Well, this is a big, not the only reason, but a very big part of the reason. This is showing total healthcare costs by age for by this is average and over countries and different income groups. So you'd see the lower income countries fairly flat and you just see how that line is getting steeper and steeper. And then the US is kind of off the charts. So this is counted as part of consumption and It's a very big part. This is the sum of public and private expenditures. It's not all public by any means. But this is a big part of what's driving those high rates of consumption by older people. And now if you put these together, okay, here's comparing Nigeria and Japan, you see how the size of the gap between what people earn with their labor and what they consume, how the size of that gap has grown, and it's continuing to grow. And again, this isn't particularly Nigeria and Japan, just to make it concrete. Now, how was that gap filled? Well, it's partly filled with asset income, which is very important. Assets can be a farm, a store, a house. It doesn't have to be financial, but financial assets are important too. But what in the low income countries, what you see here is that family net transfers, family support is very important. In fact, a person age 90 here is getting something like 50% of prime age labor income in in net family transfers. But okay, by the time you got to high income countries, that has dropped essentially to zero. In fact, in many high income countries, the elderly are making family transfers to their children and grandchildren. On the other hand, you see what's happening to public transfers. They start out close to zero in the low income countries. And then, you know, it's a substitution. The public sector is substituting for what had been done by the private. I'm not saying that's bad. It's what happens, and there are advantages to public transfers too. Now, I also want to point out that in the low-income countries, the support for older people is becoming positive about age 70 or in the early 70s. But in the high income countries, it's becoming positive and much greater after age 60 or so. So yeah, these are all important changes that are taking place in addition to population aging that amplify the effect of population aging. Now, there are enormous differences across countries in how the elderly are supported. And I've just taken a few here, South Korea, France, Colombia, Philippines. And the green is the percent of family transfers, the percent of consumption after age 65 covered by family transfers. The purple is public. The blue is labor income. The brown is asset income minus whatever people are saving. If you add together the labor income and the asset income used to pay for consumption, then you get a measure that I'm calling financial self-reliance. To the extent that the elderly are financially self-reliant, then there really isn't an important economic impact of population aging. You look at the Philippines. 97% financially self-reliant. In fact, in the public sector, the elderly are-- pay more taxes than they receive in benefits. And you can see that the family transfers are quite low there. Colombia is 21%. A number of years ago, Sweden, by this measure, was 2%. financially self-reliant, relying almost totally on public transfers. That's changed a lot in recent years. In any event, I want to point out this variation, including, well, I don't have it in this graph, but Singapore is very interesting. They went the route of zero net public transfers. I see my time is almost up. Oh, my time is up. Oh, all right. I'll leave the solutions for the discussion. Thank you.

Thank you. Thank you, Professor Lee. That's an important reminder that demography does not hand us a predetermined economic outcome. The consequences depend on health, productivity, labor participation, family transfers, social protection, taxation, savings, and the choices societies make about how responsibilities are shared. But even the phrase "societies make choices" needs qualification because societies are all starting from very different places, as you showed in your graph. The longevity transition, however, is global. but it's certainly not uniform. Our final panelist brings us to that essential question of context. This perspective is essential because there is no single global longevity transition. Dr. Olabusayo Akinola leads the Social Welfare, Drug Control and crime prevention division within the African Union Commission's Department of Humanitarian Affairs, Health and Social Development. Her work spans social protection, aging, disability, inclusion, and wider questions of social vulnerability, and she is directly engaged in implementation of the African Union's 2026 strategic policy framework and plan of action on aging. That framework provides an important continental rights-based foundation. And at the same time, many African countries are at an earlier stage of population aging than countries in Europe or East Asia. Yet, by 2050, the African continent is projected to be home to over 250 million older people, the second highest in the world. That creates different challenges, but also an important opportunity. systems being built today can be designed for the demographic realities of tomorrow rather than retrofitted later. So, Dr. Akinola, if we take rights and the AU framework as the starting point, what does demographic resilience require in practice? What should African governments be building now in social protection, health care, labor, market data, communities and public systems? so they're prepared for longer lives before population aging becomes much more advanced.

Thank you, Greg. I'm not-- hello, everyone. I'm not used to sitting, unfortunately, when I'm making my presentation. So please kindly permit me to take the podium. Thank you.

Please, you're welcome.

Okay, good afternoon. Good afternoon. Yes, you have to answer me because I flew 18 hours for this 11 minutes presentation. And because. Thank you. And because today is the day of celebration, I've also been checking our wellness check. We've been sitting for almost three hours. Kindly stand up please and do me the honor to stand. Kindly look at the face and the eyes of your beautiful, handsome neighbor. And try and check where will you be, where will they be in the next 30 years, you know? Can you see? I think you are with the wrong neighbor. Can you check the next neighbor to see where they will be in the next 30 years, you know. Thank you. Please take your seat, distinguished delegates, participants, and excellencies. Thank you. So yes, we are here this afternoon to celebrate today. And we're trying to bridge a gap. And the gap, when we are talking about bridging the gap in longevity, is looking at the seven different generations that we have. I don't know if we have the generation alpha here. Those are the generations of clock heads, the beta generations, the alpha generations, and all that. So bringing the past to our present to affect our future. And so I'll just be giving us the regional perspective to longevity and everything that has to do with aging. So unfortunately, I'll also have to look back because I'm standing. So, yes, this is my presentation overview, but I will not bore us with that. So, I work, as introduced, I work with the African Union, and this African Union, for some of us that might not know, is an inter-agency organization, intergovernmental organization of 55 member states. It was formed in 2002 as a successor to the Organization of African Unity. And also it was formed just basically for continental and regional integration, intra and institutional collaboration and cooperation, to mention a few. Yes, as introduced by Greg, Africa, this statistics actually was, I think, I got it from 2018 or 2020. So this is six years ago. that Africa is home to about 1.3 billion people and half a billion, 500, almost 500 million are aged 15 to 35 years. And these are referred to as youth, according to the African Youth Charter. And the 25 years, we have about 60%, almost 60% to be 25 years and below. And to your to your right, to my left, I'm trying to coordinate properly, we can see the age and gender disaggregated data based on the pyramid there. And then, like Greg mentioned, actually, currently, we have about 74 million individuals, persons, that are age 60 and above. And so we have the protocol to the African Charter on Human and People's Rights on the rights of persons, on the rights of older persons that categorize older persons as people or individuals that are age 60 years and above. And it is projected that would have over 200 million persons that are older than 60 years in 2050 and roughly about 9%. So yes, if we check the global life expectancy is around 74 years. I hope my statistics is accurate. However, the life expectancy in Africa is about 64 years. So what it means is if I am defined to be an older person at age 60, maybe most likely I'm expected to live Maybe more than, you know, just four years more in the context that I'm talking about. And so the disability adjusted life years and the years of life lived in disability in Africa needs to be looked into. Yes, we already have the foundation. We have the rights, we have the protocol, like I mentioned, the protocol to the African Charter on Human and People's Rights on the rights of older persons. We have the social protection framework, also the protocol to the African Charter on Human and People's Rights on the rights of the citizens to social protection and social security. We have different national healthy aging strategies, the normative frameworks, and then the social That is the last one is the intergenerational social solidarity. So we do not lack the framework. We have the MIPA, we have the frameworks, we have the protocols, we have the conventions and the strategy. Most of these documents have been ratified, assented to, ceremoniously signed, but never domesticated. The implementation of these documents sitting somewhere in the corner of someone's table is far from the reality. These documents are not domesticated. They are not integrated. And sometimes we wonder how the policies and the commitments actually translate into action. So mentioning again the AU protocol on the rights of older persons and all the things that it has. And so it's talking about equality and non-discrimination. dignity, protection from abuse, health, and majorly dignity and protection from abuse. Because we see individuals or persons older from 60 years and above, as you know, we call older persons like they are other persons, but they are our families, they are friends, they are neighbors, they are colleagues, and hopefully they are us in the future. Yes, This is the social protection framework for the African Union and it runs through the life course. So before the work, before old age, your transition in old age and outside the formal systems. And what Africa is actually doing already, we are looking at healthy aging. We have now the protocols and the frameworks like I mentioned, and countries are currently developing the national healthy aging strategies and adapting the health systems. We have the legal protection frameworks. we have the social pensions, continental advocacy, community of care and intergenerational approach. The Africa's existing social contract looks at family. So in Africa, we really do not have care homes, maybe very few of them. So what it means is that the elderly or the older persons actually live in the house. They become like the kinsman or the head of the home and actually being catered for by the family. So sometimes we that the burden of care that is not paid for by the families. But actually we have care support, intergenerational responsibility, community, traditional and faith institutions, and the state. But we're trying to see that the enormous burden on family can be taken over, whereby all the intersectionality between the family, community, traditional and faith institutions, and state are very clear and held with longevity. So like we've been saying all along, longevity is a human rights issue. It talks about dignity, it talks about social protection, talking about equality, participation, health and autonomy. And what does the age of longevity require? So it requires building on intergenerational solidarity and social cohesion. to design health and care systems for the entire life course, looking at the disability adjusted life years and years of life lived with disability. I'll give a personal example. My dad was sick for about 17 years and when he died, I was crying and my brother said, "I think you're very selfish." I said, "Why?" He said, "He had lived his life in sickness, so why not allow him to rest?" So if I count the 17 years, is it about living longer or living healthier? Or for those of us that are in the informal economy, informal space, there is no pension. So what are we talking about when we're looking at longevity, apart from bridging the generational gap, is the lives of years lived in absolute health, if there's anything like that. And then to strengthen social protection for longer lives and then protect the rights, voice, and dignity of older persons. Am I doing well with the time? So, yes, we have from aging policy to longevity policy. So, like I said, we have the policies, we have the frameworks. Can we move away from the MIPA? Can we move away from those documents that have been signed and ratified? So can we move from care to contribution? Let's start moving from health systems to healthy agents, and then the generations to accountability. We move from pensions to income security, and let's start to look at institutions that are actually age inclusive. And then our commitments being moved to accountability and actions. The African longevity model, this is the model because of the time, I would not go through it. We have our foundations, our systems, our rights, and our future. So we are not just preparing for the aging population. We know we are the youthful, most youthful continent, but we know that also in the next few years to come, will be the second most largest when it comes to aging. And so we're not looking, not just preparing for an aging population, but we're trying to see how we can have a longer lives that is lived in health, in dignity, and also reducing the vulnerabilities that the age system actually exposes us to. So the implementation gap is that we have continental frameworks, we have human rights instruments, we have aging policies, we have the health, the aging strategies, we have social protection programs, and we have family and community systems. What we do not have here is we don't have universal ratification. And sometimes when these documents are ratified, We come, we ratify, we sign, we take the pictures, they are not domesticated. The document sits on someone's table. So yes, we need to move from ratification to domestication, implementation and integration of these documents. And then we have a sustainable financing. We need wider social protection coverage, we need community and long-term care, better age disaggregated data. So this is also a challenge. We do not have an absolute evidence when it comes to the number of the aging population. How many minutes? One minute. Okay, I think I'm good. So yes, we do not have that. A lack of data. When there's no data, there's no evidence. And when there's no evidence, we cannot drive the policy in the right direction. So we need meaningful participation and also protection from abuse and discrimination. And a call for action, this is my last slide. So please join us for the Pan-African Dialogue Series on Aging and Development, which is a continental policy dialogue platform. And this was endorsed by the ministers of social development, labor and employment, and it will be moved to the heads of government to be made into a decision so that this platform becomes a space for policy dialogue, knowledge exchange and collective action. And also to join us as we have the 2027 Regional Conference on Aging in Africa. Thank you for this time, though 11 minutes, but yes, what I would like to say in those days, they say, I have two outages just to end. At the first is when I was growing up, my dad used to tell me, you know what, the way you sit in a picture is the way the picture will come out. That means is the level of preparation that you see yourself. Unfortunately, when he died, there was no artificial intelligence at that time. So I don't know how to tell him that even when I don't sit for the picture, I can appear in the picture. This is artificial intelligence. And also adding this adage that the way you lay your bed is the way you will lie on it. So, but this still remains even though the AI one or the picture one does not remain. So if I don't lay my bed properly, I would not lie on it properly. I'm advocating for my future so that I can lie on my bed properly. Thank you, excellencies.

Thank you, Dr. Akinola, the fantastic. And the next Pan-African dialogue is actually on October 15th. I think we now have four pieces of a much larger picture. Mr. Umeoka has challenged us to reconsider the architecture of the life course. Dr. Fried has shown us that the real dividend lies not simply in more years, but in creating health and capacity that allows those years to be well lived. Professor Lee has reminded us of the economic consequences of aging are shaped by institutions and how resources flow within and between generations. And Dr. Akinola has grounded that conversation in rights and implementation and the very different development context in which demographic change is unfolding. There's no single longevity transition, and therefore there can be no single blueprint for responding to it. I'm afraid we are out of time to engage in discussion. However, the NGO Committee on Aging welcomes your questions to be sent to them. Their e-mail address is on the package that you've received and would welcome your questions. You can send them directly to Bill as well. I'm sure he'd love to answer those. Yes, thank you, Bill. I You know, Dr. Akinola, you spoke about the past affecting the future, bringing the past to affect the future. And I also wonder about, can we bring that future to affect the present, to inform the choices that we make now? Can we let that future, that sure future, inform our choices? Because, you know, demography does not determine our destiny. Longer lives themselves do not determine our future. The systems, the investments, institutions, and the choices we build around them do. The age of longevity is already here, and becoming ready for it means more than adapting health or aging policy. It means building the capacity of our societies, our economies, to respond to this defining demographic transformation while protecting rights, expanding opportunity, and strengthening solidarity across generations. Ultimately, the measure of success, making our bed for the future is will be whether people everywhere can live not merely longer lives, but lives of health, dignity, participation, security, purpose, and connection. let's not wait until the last minute because we need to make those choices now to welcome that arriving future. So welcome International Day of Older People and for anyone celebrating or hosting Canadian Thanksgiving, don't wait until the last minute.

Thank you, Gregor, and thank you to all the panelists for their thought-provoking conversation. Thank you. Dear all, As we approach the end of today's program, I warmly thank the moderator, the panelists, and I would like to express our sincere appreciation to the volunteers whose work has carried us through this morning. From welcoming guests to keeping the program moving, our attention and care have made this a fitting occasion to mark the International Day of Older Persons. Additionally, I'd like to tell all of you to keep in your thoughts James Collings, a strong advocate of older persons and a member of the NGL Committee on Aging who passed away in September. It is now my great pleasure to invite Ms. Masumi Ono, Chief Program of Service, the Division of Inclusions. of Inclusive Social Development at the UN DESA to deliver the closing remarks. Across aging, youth, persons with disabilities and family issues, Ms. Ono encourages colleagues to look beyond their individual areas of responsibility and consider what they can achieve together. Effective collaboration requires vision and engagement at every level of society, and Ms. Ono has been a model of that approach. With Ms. Ono's remarks, we'll bring this commemoration to a close. May we leave with fresh resolve and a sense of celebration for the longer lives we are here to make better. Ms. Ono, the floor is yours.

Thank you very much, Ariana. Excellencies, distinguished delegates, dear friends, thank you for joining today. I am grateful for the opportunity to come together to commemorate and celebrate older persons. As we have heard throughout today's discussions, increased longevity represents one of the most significant demographic transformations of our time. And we make many assumptions about what living longer means for us. Assumptions about our health and well-being, our work and family lives, and the opportunities and challenges we may face. But do those assumptions truly reflect our reality? Are we making choices at the policy level and in our own lives that respond to that reality. Are we aware of the choices available to us? Do we have the means to make them? And importantly, are those choices fair and just? Today's discussions has challenged us to rethink how we view longevity and the assumptions we make about it. And it has reminded me of something else. There is much that we should not take for granted. I do not take for granted that we have the space to bring people together across generations, across the public and private sectors, and from around the world to question our assumptions about longevity. I do not take for granted that we have the opportunity to share knowledge, experience, and ideas on issues that directly affect our lives and our future. I do not take for granted the hard-won progress we have made, nor the opportunities that greater longevity brings. And I do not take for granted that aligning our policies, investments, and institutions with our demographic realities requires all of us in this room and beyond. Before we close, allow me to acknowledge the people and partners who made today's event possible. Arianna and Bill, we certainly do not take for granted our long-standing partnership with you and the NGO Committee on Aging. Our profound gratitude goes to Argentina, the Group of Friends of Older Persons, and the Group of Friends on Aging and Sustainable Development for your generous sponsorship and continued leadership. Our sincere appreciation also goes to our keynote speaker, moderators, and panelists for sharing their valuable insights, and especially to the older persons whose voices and experiences have enriched our discussions today. And finally, to our team in DESA and all the colleagues who supported this event behind the scenes. We do not take your dedication for granted. Thank you all for being here. for contributing to this conversation and for helping us rethink not only what it means to live longer, but how we can ensure that living longer means living better. Thank you, and we end this program.