The Big Picture: Ageing in South-East Asia
The WHO South-East Asia Region is undergoing a rapid demographic shift. The proportion of people aged 60 years and above is expected to nearly double by 2050 — rising from around 11.3% in 2024 to about 20.9%.
Longer life spans are a sign of progress: improvements in fighting infectious diseases, expanding health care access, and social development have all played a part. But living more years also brings new challenges. Many older adults face chronic illnesses, mobility limitations, needs for long-term or palliative care, and social isolation.
To respond, WHO South-East Asia and its Member States adopted a new declaration in October 2025: the Colombo Declaration on ‘Healthy Ageing through strengthened primary health care’.
Key Commitments: What the Colombo Declaration Says
The Colombo Declaration lays out several commitments and actions that Member States vow to pursue. It aligns with WHO’s Regional Strategy on Healthy Ageing 2024-2030.
Some of the core features include:
- Embedding healthy ageing into national policies and primary health care (PHC)
- Governments will make PHC systems “age-responsive”, meaning they provide services from health promotion and prevention through to rehabilitation, long-term care, and palliative care.
- PHC is emphasized as the most inclusive, effective way to reach older adults and ensure universal health coverage.
- Four priority areas to guide action
- Combating ageism — challenging stereotypes and discrimination.
- Fostering enabling environments — physical, social and policy environments that support older people.
- Delivering integrated, person-centred care — tailored to older persons’ needs, preferences, and stages of life.
- Ensuring access to long-term care — for those who need it, without financial hardship.
- Health workforce and caregiving
- Building competencies in geriatric care, gender-sensitive care.
- Supporting both paid and unpaid caregivers.
- Enabling multidisciplinary, community-based teams to deliver care across stages of ageing.
- Financing, resource allocation, and partnerships
- Prioritizing domestic investment in healthy ageing programs with innovative financing mechanisms.
- Exploring cross-ministerial cost sharing, public-private partnerships.
- Embedding healthy ageing in national budgets, health care plans, social protection systems.
- Data, monitoring, digital health, and rights
- Strengthening data systems to track how well policies are working.
- Using digital health innovations to improve access, efficiency, quality of care.
- Ensuring that policies are rights-based, gender sensitive, inclusive, and reflect lived experiences of older people.
Why This Matters: Benefits and Risks
Benefits
- Health and social gains: Older people who remain functional and healthy can contribute to their families, communities, and economies. They are a societal asset, not just a cost.
- Reduced burden of care: Preventive, primary care can lessen the need for expensive hospital or long-term care services. Rehabilitation and early interventions matter.
- Economic sustainability: As populations age, social protection systems and health budgets will be stretched. Early action helps maintain system viability.
- Social inclusion and dignity: Fighting ageism, enabling meaningful participation, preserving choices, and respecting older persons’ rights improve well-being and mental health.
Risks / Challenges
- Resource constraints: Many countries in South-East Asia may lack enough funding, skilled health workforce, or infrastructure for long-term care.
- Implementation gaps: Translating declarations into action often stalls due to lack of coordination, weak primary care systems, few data, or policy incoherence.
- Financial protection: Ensuring older people do not face catastrophic out-of-pocket costs remains a challenge.
- Cultural and societal barriers: Ageism, gender inequities, social stigma can undermine policies unless addressed.
- Inequalities: Rural or marginalized populations may be left behind unless programs are inclusive.
WHO’s Strategy 2024-2030: The Roadmap
The WHO South-East Asia Regional Strategy on Healthy Ageing 2024-2030 provides the long-term framework for achieving the Declaration’s goals.
It includes:
- Seven domains of action: Law, Policy & Governance; Community; Financing; Service Delivery; Workforce; Rights in Humanitarian Crises; Data, Information & Evaluation.
- Enablers such as stakeholder collaboration (governments, civil society, academic institutions, private sector), innovation, and leveraging digital tools.
- Regular monitoring and evaluation to track progress, adjust plans, and ensure accountability.
What Member States and WHO Are Doing Now
Several activities and efforts are underway, or planned, to put the strategy into practice:
- A ministerial roundtable was held in Colombo (October 2025), where countries adopted the Declaration.
- Prior to that, a participatory dialogue (on Oct 12) included older people, caregivers, communities representing lived experiences, whose input shaped the Declaration.
- Training health workers in geriatric and gender-sensitive care is being emphasized.
- Some countries are already integrating older persons more explicitly in health planning and social protection.
- Exploring policy reforms, budgetary allocation, and innovative financing to support long-term and palliative care.
Looking Ahead: Goals and Measures
By 2030, through implementation of the Declaration and the strategy, the aim is:
- To have strong primary health care systems that provide age-responsive services across prevention, promotion, rehabilitation, and long-term/palliative care.
- To reduce ageism significantly via laws, regulation, public awareness, and intergenerational programs.
- To deliver person-centered care that respects dignity, choice, and gender sensitivities.
- To ensure older adults are protected financially when they need long-term care.
- To build systems that are resilient, well-staffed in geriatric skills, and have good quality data to plan and evaluate interventions.
Implications for Countries & Citizens
For governments in South-East Asia, the commitments mean shifting priorities:
- Health ministries must work with social welfare, finance, housing, and other sectors to build environments favourable to older people.
- Budgets must allocate funds for age care, training, long-term and palliative care, and monitoring systems.
- Civil society and academia have a role in research, community programs, raising awareness on ageism, and supporting older people’s participation.
For citizens, especially older people, this could mean:
- Better access to quality healthcare at earlier stages (not waiting until illness is severe).
- More services in communities, so they don’t have to travel far or become isolated.
- More dignity, respect, rights, and social inclusion.
- Protection against financial burden if long-term care needed.
Challenges to Delivering on Promises
- Ensuring financial sustainability: Countries will need to generate domestic resources, possibly reform health financing or insurance to cover ageing care.
- Workforce issues: training enough people with geriatric care skills, ensuring gender sensitivity, ensuring caregivers are supported.
- Infrastructure: hospitals, long-term care facilities, home care, rehabilitation services, palliative care. These often lag.
- Data and measurement: without good data on older persons’ health, disability, functional ability, it’s hard to monitor what works or where gaps lie.
- Overcoming social/cultural norms: ageism, neglect of older persons, gender disparities.
Conclusion: A Turning Point
The adoption of the Colombo Declaration by WHO South-East Asia Member States marks a meaningful turning point. It’s not only a recognition that the population is ageing fast, but also a commitment to shape policies that make ageing healthy, dignified, and inclusive.
With the commitments focused on primary health care, integrated and person-centred services, financing, workforce, data, and rights, there’s a strong foundation. However, much depends on how quickly and how well countries translate promises into action.
If the path is followed faithfully, by 2030 the Region could see:
- Improved quality of life for older adults
- Reduced health inequalities
- Less financial burden on families
- Health systems better prepared for ageing populations
Yet, failure to act could leave many older adults vulnerable — facing high disability, neglect, or financial hardship. Given how fast the demographic change is occurring, delays cost more, and impact even more.
Ultimately, “healthy ageing” through strengthened primary health care isn’t just a health sector issue. It’s about building societies that value older people, respect their dignity, and ensure that stretching lives are also enriching ones.
