Africa

The question of who should be responsible for meeting the rapidly growing need and expenses for elderly care remains a contentious issue in many countries. Credit: Shutterstock.

By Joseph Chamie
PORTLAND, USA, Apr 15 2026 (IPS)

Who should be responsible for providing care and covering expenses for the elderly? Should it be governments, the elderly themselves, their families, a combination of the three, or a new societal arrangement?

As populations age and more elderly individuals live longer lives, there are relatively fewer workers and less tax revenue, causing governments to struggle with the challenge of providing care for the elderly. This struggle is particularly notable in the provision of nursing care and health services.

The challenge is mainly driven by the growing demand for care, workforce shortages, and rapidly rising costs. These issues are expected to become increasingly difficult to sustain in the upcoming years.

Furthermore, this challenge is complicated by age discrimination towards elderly individuals. This discrimination is increasingly prevalent and has a negative impact on older people’s physical and mental well-being. It is associated with earlier death, poorer physical and mental health, and slower recovery from disability in older age.

The proportion of the world’s population aged 65 years or older has doubled from 5% in 1950 to 10% today and is expected to reach 16% by 2050. Most of the world’s elderly are below the age of 75, with 41% in the age group 65 to 69 and 29% in the age group 70 to 74 (Figure 1).

Source: United Nations.

The increase in the proportion of elderly individuals is significantly greater in many countries. For example, in Japan, the proportion of elderly has increased six-fold since 1950. Similarly in Italy and China, the proportion of elderly has tripled since 1950. By 2050, it is projected that approximately one-third of the populations of Japan, Italy, and China will be elderly (Figure 2).

Source: United Nations.

In addition to population ageing, life expectancy at birth for the world’s population has increased from 46 years in 1950 to 74 years in 2026. It is projected that by 2070, the global life expectancy at birth will nearly reach 80 years, with many countries, such as France, Japan, Italy, Norway, Spain, Sweden, and Switzerland, expected to reach life expectancies at birth of around 90 years.

Elderly individuals in need of care are more likely to be women, 80-years-old and older, and live in single households. Many of them experience social isolation while living at home, which negatively impacts their mental and physical health. Additionally, these individuals typically have lower incomes than the country’s average.

The cost of providing care for elderly individuals varies drastically across countries. Costs for care are mainly driven by labor costs, healthcare infrastructure, and government subsidies.

Governments, especially those leaning towards political conservatism, are hesitant to cover the increasing expenses associated with care for the growing numbers of elderly. In the United States, for example, the president recently announced that it’s not possible for the federal government to fund Medicare, Medicaid, and child care costs. Instead, he argued that the one thing the federal government must take care of is the country’s military spending

Many high-income countries rely on migrant workers with irregular work contracts, to fill labor gaps, often operating with limited legal protections and standardized training. The situation is further complicated by poor working conditions, comparatively low salaries, and a lack of recognition making recruiting and retaining care workers difficult.

High-income countries have relatively high annual costs for care, while low-to-middle-income countries typically rely on family members to provide assisted care for the elderly.

For example, in the United States, the average annual cost in an assisted living community is approximately $75,000. Care in Switzerland is also expensive, with nursing home costs averaging over 100,000 Swiss francs annually. Similarly in Germany, the average annual cost for nursing home care is roughly between 36,000 to over 48,000 Euros.

Among OECD countries, publicly funded elder care systems still leave nearly half of older people with care needs at risk of poverty, especially those with severe care needs and low income. Out-of-pocket costs represent, on average, 70% of an older person’s median income across OECD countries.

Governments, especially those leaning towards political conservatism, are hesitant to cover the increasing expenses associated with care for the growing numbers of elderly.

In the United States, for example, the president recently announced that it’s not possible for the federal government to fund Medicare, Medicaid, and child care costs. Instead, he argued that the one thing the federal government must take care of is the country’s military spending.

Conservative and authoritarian governments typically do not see much economic benefit from government spending on elderly care, as they perceive the elderly as a societal burden. They argue that health care costs for the elderly is negatively correlated with economic growth and tend to oppose publicly funded efforts for life extension, advocating for limited government spending in these areas.

Furthermore, these conservatives and government officials often stress the importance of individual responsibility and solutions from the private sector. They believe that the costs of caring for the elderly should be borne by the elderly and their families.

However, the total cost of care for the elderly is often unaffordable for most families. In many OECD countries, elderly individuals risk falling into poverty without substantial financial assistance from their governments.

Some countries, such as Germany, Japan, South Korea, and the Netherlands, have implemented mandatory enrolment in elder care insurance. These programs are typically funded through mandatory payroll contributions.

In many countries, however, informal care for the elderly is still provided by family members, with the majority being women. This informal care is facing increasing strain due to factors such as urbanization, declining fertility rates, dual-career families, workforce mobility, and rising financial costs, all of which are putting pressure on the capacity of families to care for elderly relatives.

Although the need for elder care is rapidly increasing worldwide, the ability of existing systems to respond to current and rising needs remains limited in many countries. Most individuals in need of care rely on families and informal caregivers for support, while care services remain expensive, unstable, and difficult to access. These circumstances place significant strains on families, caregivers, and health care systems.

Further complicating care systems is the fact that elderly individuals often suffer from chronic health conditions. Some common health issues experienced by the elderly include Alzheimer’s disease, arthritis, asthma, back and neck pain, cancer, cataracts, chronic obstructive pulmonary disease (COPD), dementia, diabetes, frailty, falls and injuries, heart disease, hearing loss, high blood pressure, high cholesterol, osteoarthritis, stroke, and urinary incontinence. Furthermore, as individuals age, they are more likely to experience multiple health conditions simultaneously (Table 1).

Source: World Health Organization.

In conclusion, as a result of population ageing and increased longevity, countries are facing the challenge of providing care for their elderly citizens. The question of who should be responsible for meeting the rapidly growing need and expenses for elderly care remains a contentious issue in many countries.

The general public believes that the government should take on the responsibility of providing care for the elderly. In contrast, many governments, concerned about the escalating fiscal burden, prefer that the elderly and their families themselves provide the necessary care and be responsible for the expenses. Still, others believe that a new societal arrangement is needed to provide care for the elderly.

Joseph Chamie is a consulting demographer, a former director of the United Nations Population Division, and author of many publications on population issues.

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For decades, five powerful actors—the United States, the Arab states, the European Union, AIPAC, and Israel’s own opposition—have all claimed to seek Israeli-Palestinian peace while enabling permanent occupation, together burying the two-state solution.

By Alon Ben-Meir
NEW YORK, Apr 15 2026 (IPS)

Every powerful actor in the Israeli-Palestinian conflict professes to seek peace. The US and EU repeat the two-state mantra, the Arab states invoke Palestinian rights, AIPAC proclaims its defense of Israel’s security, and Israeli opposition parties promise “responsible” leadership and stability.

Yet each, in its own way, has enabled and entrenched a destructive status quo—shielding Israel from accountability, normalizing permanent ruthless occupation, and rendering Palestinian statehood ever more illusory while fueling radicalization on both sides.

The US as the Prime Enabler

Successive US administrations have long recited support for a two-state solution, yet in practice, Washington has done more to bury that prospect than to realize it. For decades, the United States has shielded Israel from real international accountability while refusing to use its vast leverage to compel any meaningful movement toward Palestinian statehood.

By turning the “peace process” into an empty ritual, the US has provided cover for a status quo that is neither peaceful nor temporary.

At the same time, unconditional US military, financial, and diplomatic backing has enabled Israel’s relentless settlement expansion and creeping annexation of Palestinian land. American officials issue ritual complaints about settlements, but the financial and military aid kept flowing and the vetoes at the UN kept coming, signaling that no red line would ever be enforced.

This toxic mix of lofty rhetoric and impunity has locked both peoples into an ever more entrenched, zero-sum conflict and foreclosed the only viable formula—two states—for ending it.

The Gaza war has stripped away any remaining illusions. Even amid mass devastation and accusations of genocidal conduct, Washington has continued to arm and protect Israel diplomatically, becoming complicit in Israel’s war crimes. To be sure, in the name of protecting Israel, the United States has gravely imperiled Israel’s viability as a democratic state and its long-term security while setting the stage for the next violent conflagration, to Israel’s detriment.

The Arab States’ Shortcomings

The Arab states, though never tiring of affirming the justice of the Palestinian cause and the necessity of a two-state solution, have consistently fallen short of their words. Although they possess enormous strategic weight—withholding or granting diplomatic recognition, and opening markets, energy, airspace, and security cooperation—they have rarely used these tools to force Israel to choose between occupation and peace with the Palestinians.

This failure has signaled to Israel that it can normalize relations with some Arab states, à la the Abraham Accords, while maintaining its grip on Palestinian land without risking any backlash.

Even in the face of Israel’s genocidal war in Gaza, most Arab governments limited themselves to statements, summits, and carefully choreographed outrage that stopped well short of meaningful pressure.

The Arab states that normalized relations with Israel continued to protect key political and economic ties, while the front-line states—Egypt and Jordan—maintained security coordination that shielded Israel from real strategic isolation.

By doing so little when so much was at stake, Arab states have become, in effect, accomplices to the perpetuation of the conflict they denounce. Their inaction has left Palestinians without a credible Arab shield, allowed Israel to entrench settlement and annexation, and pushed the two-state solution—the only realistic path to a just peace and security for both Israel and the Palestinians—to the wayside.

The EU’s Shortsightedness

The European Union is Israel’s largest trading partner and a major source of investment, technology, and diplomatic legitimacy. Yet, it has systematically refused to wield this considerable leverage to force a choice between occupation and peace with the Palestinians.

Instead of linking market access, research cooperation, or association agreements to clear benchmarks on settlements and Palestinian rights, Brussels has largely confined itself to criticism and symbolic measures that Israel has comfortably ignored.

The EU’s posture has effectively insulated Israel from serious economic or diplomatic consequences for entrenching an apartheid one-state reality of perpetual domination.

At the same time, although individual EU states, including France, the United Kingdom, and Spain, have recognized the Palestinian state, they have done virtually nothing to turn that recognition into hard power; arms exports and trade preferences continue with Israel as usual. Recognition becomes a cheap, cost-free declaration rather than a meaningful constraint on Israeli policy.

Thus, EU passivity has helped normalize occupation and settlement expansion while leaving Palestinians without an effective European counterweight, making a genuine two-state solution ever more remote, to the detriment of both Israel and the Palestinians.

AIPAC’s Culpability

AIPAC presents itself as a friend of Israel. Still, by relentlessly reinforcing the country’s most hardline positions, it has turned “pro-Israel” into a rigid orthodoxy that equates any pressure on Israeli governments with betrayal, thereby narrowing the range of policies American lawmakers feel politically safe to support.

For decades, AIPAC has backed Israeli governments without qualification—endorsing military campaigns, providing political cover for settlement expansion, and supporting a maximalist posture toward the Palestinians.

It rallies Congress behind unconditional aid, arms transfers, and diplomatic protection. This has helped Israeli leaders believe they can permanently deepen occupation and de facto annexation while still counting on automatic American support.

AIPAC has refused to use its considerable leverage to press for peace-oriented concessions and territorial compromise. Instead, it has rendered the two state solution an empty slogan while supporting the Israeli policies that make it impossible. In doing so, AIPAC has directly contributed to the ever worsening conflict and put Israel’s security under constant threat.

Still, AIPAC has not awakened from its blind support that jeopardizes Israel’s very existence and, with that, scuttles any prospect for an Israeli-Palestinian peace.

Israeli Opposition Parties’ Dismal Failure

Israel’s opposition parties have failed to offer a credible, sustained alternative to the right’s permanent conflict paradigm, and in doing so have gravely weakened Israel’s chances for peace. Instead of forcefully championing a two-state solution, most opposition leaders tiptoe around the very words “Palestinian state,” intimidated by electoral backlash and the charge of being “soft” on security. Their political inaptitude has allowed the right to define what is “realistic,” narrowing the political options to endless occupation and recurrent war.

Thus, they have directly contributed to the current impasse, making the conflict ever more intractable. Without a major party willing to argue that Israel’s long-term security depends on a two-state solution, the public hears only variations of the same message: manage, contain, punish, but never resolve. This abdication cedes the strategic debate to the extremist Netanyahu and his messianic lunatics, who are creepingly implementing their scheme of greater Israel, which would bury any prospect for peace.

It is a dire reality for the country that the opposing parties failed to coalesce and present a united front to push for a two-state solution, even following the Gaza war, which has unequivocally demonstrated that after nearly 80 years of conflict, only peace would provide Israel with ultimate security.

Every leader from these parties feels they are the most qualified to be the prime minister, but has failed miserably to offer realistic plans to end the conflict.

By failing to unite, organize, educate, and mobilize Israelis around a clear two state vision, these parties are undermining Israel’s security, eroding its international standing, and endangering its very future as a Jewish, democratic state.

The record of these five enablers is devastating. They made a just peace ever more remote, pushing Israel precariously toward an apartheid one state reality it cannot sustain morally, demographically, or strategically, while abandoning the Palestinians to the cruelest, inhumane occupation.

They must change course now—or condemn Israelis and Palestinians to generations of bloodshed that will erase Israel’s reason for being and extinguish Palestinian nationhood.

Dr. Alon Ben-Meir is a retired professor of international relations, most recently at the Center for Global Affairs at NYU. He taught courses on international negotiation and Middle Eastern studies.

IPS UN Bureau

 

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Tömegek tüntetnek Pozsonyban Fico levélszavazás-eltörlő terve ellen: félnek a külföldi szlovákok demokratikus részvételének gyengülésétől. A javaslat azért fontos, mert a 2027-es parlamenti választások előtt átalakíthatja a részvételt az 5,4 milliós országban – hívta fel a figyelmet az Euronews.

Credit: Kristian Tuxen Ladegaard Berg/NurPhoto via AFP

By Inés M. Pousadela
MONTEVIDEO, Uruguay, Apr 15 2026 (IPS)

When Danish Prime Minister Mette Frederiksen addressed her supporters on election night on 24 March, she chose her words carefully. Losing four percentage points after almost seven years in power, she suggested, wasn’t so bad given there’s been a pandemic, a war in Europe and a confrontation with Donald Trump over Greenland. The reality was the Social Democrats had recorded their worst general election result since 1903. Meanwhile, the far-right Danish People’s Party (DPP) tripled its seat count, despite years of the Social Democrats leading a systematic crackdown on immigration to try to prevent it gaining support.

A historic result

While the Social Democrats came first on 21.9 per cent of the vote, they dropped from 50 to 38 seats. Their centre-right coalition partner, Venstre, had its worst result in its 150-year history. These are the two parties that have led every government since mainstream politics began copying far-right narratives on immigration. The bargain has benefitted neither.

Vote-switching data from exit polls told the story. The Social Democrats retained only around two thirds of their 2022 support. Their largest group of defectors — 13 per cent of their previous voters — switched to the Green Left, which now holds 20 seats as parliament’s second-largest party. Right-leaning voters switched to the DPP rather than rewarding the Social Democrats for delivering the immigration restrictions the DPP has long demanded. Time and again, evidence suggests that voters who are highly motivated about an issue tend to prefer parties that have always prioritised it over parties that have adopted it more recently out of electoral calculation.

The overall picture leaves neither bloc with a majority. The left-wing grouping holds 84 seats and the right holds 77, both short of the 90 needed to govern. Frederiksen has submitted her resignation as prime minister but, as leader of the largest party, has been charged with forming a new government. This is a task made harder by the conditions attached by Moderates leader Lars Løkke Rasmussen, who’s unwilling to join a government that does not include both left and right.

Twenty-five years of accommodation

The Social Democrats’ turn on immigration began in the aftermath of their 2001 election defeat. The party believed it was losing working-class voters to the far right over immigration and concluded it needed to compete on that ground. It framed anti-immigration policies as a defence of the welfare state, trying to emphasise solidarity rather than xenophobia, and over the next decade moved steadily rightward on this issue.

The nine seats the DPP got in 2001 became invaluable to centre-right Venstre leader Anders Fogh Rasmussen, who formed a minority government with its support. His government subsequently launched a wave of amendments to the Aliens Act, which was changed 93 times between 2002 and 2016 with the explicit goal of making Denmark less appealing to asylum seekers.

Throughout the 2000s and early 2010s, the DPP grew steadily, winning 20.6 per cent of votes in 2015 to become the biggest force on the right. Between 2015 and 2018, immigration law was amended over 70 times.

When Frederiksen became Social Democrat leader in 2015, she sought to outbid the DPP. By the 2019 election, the Social Democrats’ anti-immigration platform closely mirrored the DPP’s. And in the short term, it worked for them. They won the 2019 election while the DPP lost almost 12 percentage points. In losing, though, the DPP had won: its previously fringe positions on migration, belonging and identity had been absorbed into mainstream politics.

A rights-violating regime

On entering government in 2019, Frederiksen entrenched what the Social Democrats called a ‘paradigm shift’, moving from integration to deterrence, detention and return, with the stated goal of admitting ‘zero asylum seekers’. Denmark became the first European state to declare parts of Syria safe, enabling it to deport Syrian refugees to an active conflict zone. In 2021, parliament authorised the outsourcing of asylum processing to countries outside Europe. By 2024, Denmark was granting under 900 people asylum a year, the lowest figure in four decades, pandemic years excluded.

The human rights consequences have been documented by international civil society organisations and bodies such as the United Nations Committee Against Torture. Amnesty International has raised concerns about the forced return of asylum seekers to danger in violation of the 1951 Refugee Convention. The European Court of Human Rights ruled that Denmark’s three-year waiting period for family reunification for refugees with temporary protection status violates the right to family life. Policies targeting government-classified ‘ghetto’ areas — overwhelmingly low-income neighbourhoods with high concentrations of people from migrant backgrounds — have been challenged at the European Court of Justice on grounds of racial discrimination.

The harm has been intentional. A framework designed to make Denmark as unwelcoming as possible has placed tens of thousands of people in prolonged legal uncertainty, with documented effects on family stability and mental health. Under Denmark’s presidency of the Council of the European Union, Frederiksen pressed for similar policies across Europe and, alongside far-right Italian Prime Minister Giorgia Meloni, lobbied for a revised European Convention on Human Rights to enable easier deportation. Centre-left governments in Sweden and the UK have looked to Denmark as a model.

Normalisation, not neutralisation

The political calculation was that taking ownership of immigration would reduce its salience as an issue and deny the far right the fuel to grow. Instead, the move intensified demand, leaving opponents of migration taking ever more extreme positions while erasing the distinction between mainstream and far-right politics.

Denmark’s experience is a lesson other European centre-left parties appear determined not to learn. Twenty-five years of accommodation have produced a society in which far-right assumptions have become normalised, at enormous and ongoing cost to those whose rights are being stripped away. This is not a template; it is a warning.

Inés M. Pousadela is CIVICUS Head of Research and Analysis, co-director and writer for CIVICUS Lens and co-author of the State of Civil Society Report. She is also a Professor of Comparative Politics at Universidad ORT Uruguay.

For interviews or more information, please contact research@civicus.org

 

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