Draft first regional report on the implementation of the Montevideo Consensus on Population and Development

<strong>Draft</strong> <strong>first</strong> <strong>regional</strong> <strong>report</strong> on the implementation of the Montevideo Consensus on Population and Development
Summary
Lastly, the lack of progress with priority measure 11 relating to comprehensive sex education has meant,
among other things, a high frequency of risky sexual behaviours, some of which result in unwanted pregnancies
and sexually transmitted diseases, including HIV/AIDS, which, as section D shows, ceased to decline in this
group during the reference period.
C. Ageing, social protection and socioeconomic challenges
In the Montevideo Consensus on Population and Development, countries recognized the urgent need to rethink
social protection in order to urgently respond to the impact of demographic changes and prepare to meet the
needs of a population in transition. They thus agreed on 15 priority actions on ageing and social protection
(priority actions 18 to 32). Some of the topics covered by the priority measures include participation, social
insurance, education, health, care, dignified death, work, violence, discrimination and savings.
Social protection systems for older persons require the integration of three basic pillars: pensions, basic
health care and social services that foster autonomy. The three pillars act in concert to close gaps in protection
and build capacities. The pensions and health pillars are the minimum social standards that must serve as a
social protection threshold, which must be guaranteed directly by the State. Social services that foster autonomy
focus on prevention and reparation; they must be seen as a government responsibility and maintained via a
protection network that links the social protection threshold to other social and health benefits designed to
improve the well-being of older persons (Huenchuan, 2013).
A large proportion of older persons currently have no old-age pensions to protect them against the risk
of income loss as they age. Furthermore, social security coverage of the employed population is highly
unequal, increasing the likelihood that future generations will lack economic protection. The region has seen
notable progress with regard to the expansion of non-contributory pensions, which help to reduce some of
the economic risks arising in older age. However, it is necessary to continue strengthening mechanisms to
enhance protection in old age, especially for older women and rural populations.
Latin American and Caribbean countries are trying to deal with the problems of coverage in different ways,
but the trend is clear: the policy that appears to be having the greatest impact is the expansion of non-contributory
pensions. In addition to its impact on coverage, this policy change can have significant long-term effects
in countries with ageing populations. This is particularly important in countries where the low coverage of
contributory social security is complemented by non-contributory pensions, in a context of low contribution
coverage and density among the working-age population.
Health-care systems have been slow to adapt to the increased demand resulting from demographic,
epidemiological and technological changes. This translates into escalating health-care costs and spending and
the lack of universal access to appropriate and good-quality health services. Health-care coverage is uneven,
and even if older persons have health insurance they may be unable to go to a medical facility when they
need to. As the current generation of older persons becomes less self-sufficient, they worry about access to
medicines at an affordable price, to efficient health-care services that meet their needs, and to supervised
long-term care that respects their fundamental rights and freedoms as they become more dependent.
In this context, while the health care of older persons has been improving over time, there are still few
countries that meet their international human rights obligations. The right to health involves obligations; one
of them is the obligation to guarantee that right by means of legislative, administrative, budgetary and other
measures. As expressed by WHO in its 2015 World Report on Ageing and Health: “Comprehensive public-health
action on ageing is urgently needed. Although there are major knowledge gaps, we have sufficient evidence
to act now, and there are things that every country can do, irrespective of their current situation or level
of development. The <strong>first</strong> step will be to focus on optimizing functional ability: the goal of Healthy Ageing”
(WHO, 2015, p. 211).
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