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NGLS
Interviews Dr. Astrid Stuckelberger, Chair of the UN NGO Committee on Ageing
Geneva & President of the Geneva International Network on Ageing
On
the occasion of the eighteenth
session of the Human Rights Council and the 20th annual celebration of the UN
International Day of Older Persons (1 October), a High-level Panel on Older
Women and the Right to Health was held on 26 September in
The panel, moderated by Hendrica Okondo, Global Programme Manager for Sexual and Reproductive Health and Rights (SRHR) and HIV/AIDS of the World Young Women’s Christian Association (World YWCA), featured as speakers: Monika Gehner, of the Ageing & Life Course Department of the World Health Organization (WHO); Dr. Astrid Stuckelberger, Chair of the UN NGO Committee on Ageing Geneva and President of the Geneva International Network on Ageing (GINA); Bridget Sleap of HelpAge International; Facundo Chavez Penillas of the International Disability Alliance; and Lois A. Herman of WUNRN. Statements were also delivered on behalf of the UN NGO Committee on Mental Health; Ferdous Ara Begum, Former Member of the Convention on the Elimination of All Forms of Discrimination against Women (CEDAW) and Chair on Working Group for General Recommendation on Rights of Older Women; and Anand Grover, the UN Special Rapporteur on the right to health.
Panelists highlighted the significant demographic changes that many societies are undergoing with the rapid ageing of their populations. As women form the majority of the ageing population, they drew particular attention to the “feminization of ageing” within an environment that was structurally gender-biased. The latter can drive older women into precarious situations such as violence, poverty, and discrimination, the panelists cautioned. For instance, Ms. Sleap pointed out that women often experience a lower economic status than men. This generally results in higher poverty rates among older women, which can undermine their access to healthcare. This warrants the imperative to better safeguard their rights, many speakers emphasized.
In his report, the Special Rapporteur on the Right to Health recognizes this imperative and calls for a shift from a needs-based approach to a gender- and rights-based approach in addressing the right to health of older persons. Moreover, it is imperative to ensure the integration of their rights into relevant national and international policies, he argued in the report. However, speakers repeatedly referred to the absence of systemic age and gender specific health policies at national, and more importantly, at the international level.
Dr. Stuckelberger, an expert who has been advocating for older women’s right to health for the last decade, stressed the absence of binding instruments at the international level alluding to age-specific rights. As the Chair of the UN NGO Committee on Ageing and President of the Geneva International Network on Ageing, she has led the request for a Special Rapporteur for older persons’ rights as well as the drafting of the CEDAW Committee’s General Recommendation No.27 on older women and protection of their human rights.
Following the event, NGLS interviewed Dr. Astrid Stuckelberger.
NGLS: Could you tell us about your past and current work on promoting the right to health of older women?
Initially, the first step was really starting to realize that by disaggregating data by sex and age groups, the differences in ageing between men and women became quite obvious. My first research that revealed the obvious gender difference was a World Health Organization (WHO) multicentric study on widowhood with the University of Geneva Geriatric Hospital about 20 years ago. This community-based intervention showed that men and women in old age do not respond in a similar way to widowhood or to grief and depression. While women, after a year of widowhood, cope and adapt smoothly and find resources in the community, men have a very difficult time and do not accept community intervention. In fact, after a year, there was a significantly higher mortality rate or remarriage among men – men either coped through new companionship or were at risk of dying. This really triggered reflection for me that has never stopped on “men-women differential ageing.” It is the title of a book I wrote on the subject, along with diverse articles and even my PhD.
I started to develop the imperative to address the vacuum and lack of instruments
for the rights of older women, while co-directing the Swiss National Research
Programme on Ageing. The results of the 30 studies were clear: older women were
at higher risk of poverty, had a lower education level, were more often alone
and isolated, and suffered more from chronic diseases and depression then men.
We also found that they were suffering double discrimination, being old and
being female which leads to neglect and sometimes abuse. Imagine in a country
like
Through collaboration with the WHO and NGOs at the UN in the Geneva International Network on Ageing (GINA), it became clear that similar evidence could be found at the global level when analyzing the available global data. From then on, I sought to find out what mechanisms were in place to protect the human rights of older women. I organized with the Office of the High-Commissioner for Human Rights (OHCHR) the publication of a booklet on the state of the art of the “Human Rights of Older Persons” in 1999. This publication, financed by the state of Geneva for the International Year of Older Persons, includes a foreword by Mary Robinson, the UN High Commissioner for Human Rights at that time, who said “By bringing together in one place the relevant economic, social and cultural rights, and the chief UN documents on ageing, we are reminded that older persons have distinct rights which must be respected just as much as all other human rights. The booklet is also a reminder that many older persons’ rights still remain to be vindicated. Countless older men and women, especially in developing countries, lead lives of hardship without access to proper health care or food. The nations of the world have pledged to remedy this situation and this publication serves as a timely reminder of the targets which have to be met.”
The main document mentioned was the 1995 General Comment No.6 on the Economic, Social and Cultural Rights of Older Persons (Doc E/1996/22, Annex IV) and the Specific Provisions of Article 3 of the Covenant mentioning equal rights of men and women, adapted by the Committee on Economic, Social and Cultural Rights.
From that point, it was clear that a lot had to be done first for human rights of older persons in general, and in particular the rights of older women. With the NGO Committee on Ageing, and in particular the chair at that time Danielle Bridel who was lobbying for a Convention on the Rights of Older Persons, we started our “crusade” to get the human rights of older men and women on the agenda of the United Nations in Geneva and organized panels and reports on a “Life Long concept of Human Rights.”
As I became chair of the NGO committee on Ageing, along with leading GINA, I put a lot of efforts – with the help of dedicated members – in writing two declarations, mixing the UN political language with the scientific argumentation. The first one in 2006 requested that the rights of older persons be put on the agenda of the UN – as an item of the Human Rights Council – and that a rapporteur would be nominated.
The second declaration in 2009 targeted specifically the Human Rights and Protection of Older Women with 34 NGOs co-signing the statement. This was also a desperate attempt to get the strong women’s lobby to place the issue of older women on their agenda, which worked well as CEDAW (the Committee on the Elimination of Discrimination Against Women) responded almost immediately to our statement and started requesting meetings. CEDAW also took it as a point on their agenda in their session during the fall of 2009 and one year later, on 19 October 2010, the CEDAW Committee adopted General Recommendation No. 27 on older women and the protection of their human rights. This was a true victory for the lobbying and work of the NGOs and scientific community at the United Nations. Available online: http://www2.ohchr.org/english/bodies/cedaw/docs/CEDAW-C-2010-47-GC1.pdf
NGLS: Could you tell us about the
GINA was launched on 1 October 1996 as an initiative of the World Health Organization and the Swiss Research Programme on Ageing. GINA is a flexible, informal and interdisciplinary network of organizations interested in various aspects of ageing. Its membership consists of organizations with programme activities focusing on issues linked to ageing.
The unique feature is to bring together local and international experts on ageing from the United Nations, NGOs and the academic and political world as well as representatives of older persons associations and other organizations concerned with advocacy, policy, research, training and/or services to older persons. GINA strives to encourage information, exchange and advocacy to address ageing at the United Nations and the international level.
GINA received an award from the UN Secretary-General for the achievement and success of its many activities during the International Year of Older Persons in 1999 and the international impact of its advocacy. Those activities, articles, documents and more are presented in the following open-source website http://sites.google.com/site/ginagenevaintlnetworkonageing/.
The gender perspective is part of all GINA’s work, publications, panels and advocacy. As president of GINA and chair of the NGO Committee on Ageing in parallel for the past 5 years, it has been easy to create synergies and collaborate closely with the two worlds. It has certainly helped in the success of bringing the human rights of older persons to the forefront of the Human Rights Council. In fact, for the past several years, we have organized the International Day of Older Persons at the United Nations or in WHO, and thanks to GINA the Association of former civil servants to the UN and former staff of WHO are very involved in those endeavors.
NGLS: What do you consider to be some of the key issues that make the health situation in which many elderly women find themselves so precarious?
The last 60 years have seen an unprecedented rise in life expectancy worldwide. Recent data of the UN Population Division indicate that there are already more people aged 60 years and over than young people under 15 in some regions of the world, and that the majority of older persons, especially in very old age are women.
Gender statistics worldwide provide clear and systemic evidence of the gendered nature of ageing and the specificity of the condition of women in old age. Their need for special rights and protection calls for urgent attention. Clear evidence exists of the “feminization of ageing” worldwide and this is generally acknowledged:
• women’s life expectancy is higher than men’s;
• the majority of those living beyond 80 years are women (often more than 70%
of that group);
• older women are more likely to be widowed, whereas men are more likely to die
while still married;
• women experience living alone in old age more than men with specific
physical, psychosocial and material needs;
• ageing women have a higher prevalence of chronic diseases, both physical and
mental, hence need more long term health care and treatment;
• older women suffer from higher poverty rates than men, although they have a
lifelong history of informal work and care in the family and in the community;
• data are not disaggregated by age and gender and few international studies
focus on differences in the aging experience of women compared to men.
Older women are the first victims of age-related human rights violations due to physical and psycho-social vulnerability and to their particular life conditions.
Older women frequently experience multiple and cumulative forms of discrimination and disadvantages during their life course: gender, age, illiteracy, poverty, ethnic origin, chronic diseases and disabilities which all interact.
Firstly there are more women reaching the age of 80 and over than men, with less education than men, fewer rights and less able to defend their rights: they are more often exposed to widowhood and loneliness and are subject to different types of discrimination and abuse (sexual, medical and financial). It has been brought to the attention of the international community that unprecedented forms of aggression are reported against older women and some are raped because they supposedly are not infected with HIV/AIDS.
Secondly, men and women age differently yet their specific needs are ignored. Old age for women is too often a period where discrimination is exacerbated by the cumulative effect of lifelong gender-based discrimination, in the family and professional life and through their physical vulnerability which leads to multiple abuse and neglect of their fundamental rights. For example, all too often through poverty, indecent working conditions or underpaid jobs with little or no access to formal social security, even when available, they lack a high enough income to survive in decent conditions until the end of their life. This includes fundamental needs such as adequate nutrition, housing and access to health care and treatment.
Considered no longer reproductively or economically useful, many older women are seen as a burden to their families and communities while their status is ignored by policy-makers, hence these women are marginalized, isolated and even abandoned. They are vulnerable to many forms of abuse, too often aimed at depriving them of their assets such as inheritance and property rights.
NGLS: What do you see as necessary changes to improve the existing approaches within the development community toward older women?
First, let’s be clear: there is no age-specific binding international legal instrument that would protect the rights of older women, nor older persons in general. The CEDAW recommendation is a very good step as it can be used and invoked by judges to protect women in the world, but it is not binding as such. It is a recommendation, like the 1995 document is a “comment.” Now those instruments must become internationally binding.
Furthermore, key UN documents, from the Universal Declaration of Human Rights (except article 25 on social security) up to the Millennium Development Goals, omit any mention of age.
It is also important to underline that the Beijing Declaration and Platform for Action in 1995 did not explicitly mention the issue of older women despite the fact that they face greater vulnerability to violence, poverty and discrimination on the labour market. Even World Bank documents do not mention older women in their poverty eradication programmes! Therefore we requested the improvement of efficient anti-poverty programmes and public health measures for older women in particular.
I can also add that when you revisit chronologically all UN documents, we can only acknowledge that hardly any UN outcome document mention specifically older women as a distinct category, when they are the majority of the growing global ageing population and the most vulnerable group.
In the NGO statement to the UN, we also firmly requested a set of measures such as a) reaffirming the importance of setting a working group to consider drafting a Convention on the Human Rights of Older Persons, including the rights of older women b) to designate a Special Rapporteur on the Specific Situation of Older Women at the Human Rights Council, including all aspects related to the violation of their human rights, c) to mainstream older women’s right in all the items of the work programme of the Human Rights Council and the UN agenda in general.
NGLS: Could you tell us about the main achievements of your advocacy work on women and ageing? What have been some of the difficulties that you have confronted throughout the process?
The main achievements came through active lobby work and the drafting of
important statements and publications. Those statements, as described above,
have really set a change and can be a model of hope for all NGOs – statements
where 34 NGOs co-sign is a real success as all those NGOs keep on the lobby
work. I must underline the admirable collaboration between the three NGO
Committees on Ageing in Geneva, New York (with the sub-committee on older
women) and Vienna – this collaboration has really been very positive and
constructive and to my view is the key to the success of today’s achievement.
We can also mention the role of the working groups of the UN Economic
Commission for Europe (UNECE) and the Ministerial Conference in
Last year, I participated in a UN meeting in
The achievements of this past decade of work and lobbying were crystallized
in 2010 and again this year. To mention:
In January 2010, a working paper was
prepared by Ms. Chinsung Chung, member of the Human Rights Council Advisory
Committee. It presents and underlines the necessity of a human rights approach
and effective United Nations mechanism for the human rights of the older
person. Ms. Chung is waiting for the Human Rights Council to approve and to go
ahead with a consistent report and recommendations.
Later in 2010, for the first time the
Independent Expert on the question of human rights and extreme poverty,
Magdalena Sepúlveda, in her annual report, addressed the role that social
protection systems play in reducing extreme poverty and contributing to the
realization of human rights of older persons. The report focuses in particular
on the relevance of social pensions. In this report, the Independent Expert
calls on States to recognize that social pensions are critical elements for the
progressive realization of the right to social security for older persons.
On 16 November 2010, a new Open-ended
Working Group on the Right of Older Persons was established by the UN Third
Committee of the General Assembly with a resolution on ageing
(A/C.3/65/L.8/Rev.1) in which the GA decided "to establish an open-ended
working group, open to all States Members of the United Nations, for the
purpose of strengthening the protection of the human rights of older persons by
considering the existing international framework of the human rights of older
persons and identifying possible gaps and how best to address them, including
by considering, as appropriate, the feasibility of further instruments and
measures." This group met in April and August 2011 and discussion is still
going on to see what to do with the thematic issue of older persons and the
human right of older persons….a very slow process, unfortunately with
resistance from some of the big ageing nations.
2011 has been an important year for
the right to health of older persons with the preliminary work of Dr. Anand
Grover and the commitment to address more thoroughly some of the most difficult
points of the right to health of old age in the future. For the International
Day of Older Persons the Rapporteur produced a very good press release making
the case that “Age is bad for your rights!” …very true!
NGLS: How do you view the UN’s role in promoting the right to health of older women?
The first step is more general. The United Nations, through its specialized programmes and agencies, must recognize and start working and publish information on the specific situation of older women and the need to put in place an age- and gender-specific instrument to protect their human rights and health. For example, UN Women should be the first to create a unit dedicated to older women; the International Labour Organization (ILO) should be tackling the situation of older women workers or women with no social security and protection; and the UN Refugee Agency (UNHCR) should establish a department that focuses on older persons and older widows among refugees. In fact, no programme within the UN system should be allowed not to mention older persons and women in particular.
The second step is to allocate a permanent body with the budget to address the right to health of older persons with a clear distinction of older women. The problem today is that we do not have enough data and there is a lack of conceptual and statistical argumentation to convince the policy-makers, although we know from small NGO studies and case reports that there is a huge need for specific health care for older persons. The discrimination, mistreatment, abuse and neglect of older women has to be better documented and collected. The least the UN could do in this regard – besides the very poor two official positions on ageing in the whole UN system – is to create a solid unit in Geneva that will work with OHCHR, WHO, the University of Geneva Geriatric Hospital and NGOs in mapping the situation and in monitoring this situation through the UN Human Rights Council pipeline. This unit or institution would not only report on the gaps in the right to health, but also on the specific and quantitative aspects where older women are discriminated and not given access to health or where delivery of services is clearly discriminating older women. It is imperative to prove that older women have no rights or their basic human rights are violated. Therefore, another idea is to set up a surveillance mechanism that would monitor the protection of their assets, especially for widows or older women alone in developing countries where they are unaware of their rights and where the literacy rate for older women is very low. Conflict zones where civil war has disrupted their life should get particular attention.
On a more methodological level, it is clear that a lot must be done. For example, the UN data must be systematically disaggregated by gender and age in all UN institutions reflecting the differential ageing between men and women. This calls for different policies to address the gaps. There are also concerns with the International Ethical Guidelines which need to be revised in order to address the cumulative factors of old age and gender in all programmes, studies and protocols (i.e. WHO, UNESCO, etc.). Ethical guidelines in biomedical research have not yet addressed the specificity of old age with gender in their protocols, which result in higher risks of registered and manufactured medical products for older women’s health in all regions of the world.
NGLS: To what extent does the Geneva International Network of Ageing collaborate with other NGO and civil society networks? What are the key challenges of such collaboration?
I see two huge challenges: the first one is to motivate NGOs to add the theme to their agenda. It is in a way similar with the UN. It is very surprising to see that old age does not attract the attention of many. Everyone wants to focus on children and totally forget their grand parents and great grand parents as if the family is only made up of two generations! Today we have four to five generations living together. So I have tried to find many explanations for this phenomenon, such as the fear of death at the end of old age. I often hear that old age is not “sexy” and therefore, it “does not look good” to talk about this subject! The worst comment came from an economist who told me “why focus on old age, there is no return on investment” – this is a very poor approach of humanity, knowing through research how important older generations are for the sound development of the young generations!
The second challenge is ignorance of old age. Ageing is a complex science. It is certainly easier to defend women and children, as old age requires home work in order to understand the factors involved, embracing a life course approach, and an end-of-life perspective. Science is more than ever needed to understand old age and ageing. It is a fascinating subject as it is the result of cumulative advantages and disadvantages in life and the result of the achievements of a life time – in fact, it may well be the most important period of our life. Getting civil society to understand how important it is to include older persons and to “think five generations” living together with transgenerational transmission is a true existential challenge!
NGLS: What is your key message for the broader NGO /CSO community on the right of older women to health?
First, health is wealth for a nation! If older women are in good health, they can contribute to society. They have proven to play key roles in families as substitutes of mothers or with HIV-AIDS orphans. Depriving older women of their right of health is depriving a nation of an important pillar of the family and of society. Older women are our mothers, grand-mothers but they are also known to be the natural doctors of the family and the care-takers of children, husbands and even their own very old parents. Therefore, investing in older women’s right to health is investing in the right to health of the whole family and setting a step towards a more just and cohesive society where the lifelong right to a healthy human development is the backbone of a sustainable future.
In fact, we could also say that the fight to get the theme of old age recognized as a specific subject within the UN is comparable to the process women encountered to make their voice and specificities accepted. The only problem is that we need many more associations of older persons to stand and speak up for their rights….
2012 is an important year for advancing the case of older persons and older women!
First, it is the MIPAA+10 year, which will create an opportunity to evaluate and monitor the achievements made within the decade following the UN World Assembly on Ageing and the adoption of the Madrid International Plan of Action on Ageing (MIPAA). A UNECE Ministerial meeting will take place in Vienna in September 2012.
2012 is also the European Year for Active Ageing and Solidarity between Generations. The year aims at promoting an active ageing following a huge anti-age discrimination campaign which also tries to create better opportunities and working conditions to enable women and men to continue their work beyond the retirement age and combat exclusion by fostering active participation.
So let’s hope that 2012 will be a turning point for the recognition of older men and older women’s right in the United Nations.
Websites:
Website of GINA:
http://sites.google.com/site/ginagenevaintlnetworkonageing/
Website of the NGO committee on ageing:
https://sites.google.com/site/unngocommiteeonageinggeneva/
Astrid Stuckelberger website:
http://sites.google.com/site/stuckelberger