By Sanyaolu Oluwatamilore Oluwabusola
“Leave no one behind.”
This is one of the most repeated promises in global development.
I attended a webinar recently, and this came up. It was the SHE & Rights series, hosted by the Global Centre for Health Diplomacy and Inclusion (SAHEDi) and Citizen News Service (CNS), and was held on October 16. Partners included the Global Alliance for the Rights of Older People (GAROP), the Global Network of People Living with HIV (GNP+), the International Planned Parenthood Federation (IPPF) and ARROW. It asked how older persons, in all their diversity, are treated in two processes: the Universal Periodic Review (UPR) and the drafting of a legally binding treaty on the human rights of older persons.“Leave no one behind.”
The host opened by questioning how comfortably we say it. The phrase, she argued, implies that someone was left behind by accident. But given systemic barriers, prejudice, and patriarchy, those who end up behind are, in her words, left there knowingly.
The Universal Periodic Review (UPR) provides a global mechanism for holding states accountable for their human rights obligations. However, older persons remain largely overlooked in this process. Since the first review cycle in 2008, only 681 of more than 124,000 recommendations have addressed older persons, representing approximately 0.5 per cent. This gap raises questions about how consistently governments recognise and address the rights, protection, and dignity of older people in their human rights commitments. With the fourth cycle under way and the next review session scheduled for November 2026, there is an opportunity to bring greater attention to the human rights of older persons and push for stronger action.
Rachel Rieille, Data Manager at SAHEDi, demonstrated how the underrepresentation of older persons in human rights reviews extends to health through the Health and Rights Observatory. This free, open-source tool organises UPR recommendations by health theme and compares them with health indicators. Of approximately 29,000 health-related recommendations worldwide, only 144 address the health of older persons, the smallest share among the groups tracked by the tool. Yet governments accept 92 percent of these recommendations, compared with 82 percent of health recommendations overall. This suggests that the problem lies less in governments rejecting recommendations and more in the limited attention given to older persons in the first place.
There are signs of progress. The number of recommendations addressing older persons’ health increased from seven out of 2,956 health-related recommendations in the first cycle to 76 out of approximately 10,000 in the current cycle. Although these recommendations still represent a small fraction of the total, the increase points towards greater recognition of older persons’ health needs.
Khaled Hassine, Secretary of the Intergovernmental Working Group at the UN human rights office in Geneva, explained part of why the numbers are so low. Older persons are often invisible in data and statistics, so their needs go unseen. At the root sits ageism: stereotyping that feeds age discrimination and overlaps with racism, sexism and ableism. What is not counted is rarely budgeted for.
Rachel used Nigeria as a demonstration country, bringing the discussion closer to home. Nigerians can use the Observatory to examine the recommendations made to the government, see which commitments relate to health, and consider how effectively the government has addressed them. This offers an entry point for civil society organisations, advocates, and citizens to track progress, identify gaps, and call for stronger action on the health and rights of older persons.
This is not a new idea!
In 1948, while the Universal Declaration of Human Rights was being drafted, Argentina, which now chairs the working group, put a draft Declaration of Old Age Rights before the UN General Assembly.
Dr. Pam Rajput, a feminist leader and emeritus professor at Panjab University, traced the long gaps that followed: the first international plan of action on ageing in 1982, the Madrid Plan in 2002, and a working group on ageing set up around 2010.
A 2016 report by the UN's independent expert on older persons then recommended a global legally binding framework. In 2025, the Human Rights Council established the Intergovernmental Working Group (IGWG) to draft one.
The process is now moving. The first substantive session, held in July, drew 202 written submissions. The second runs from October 26 –30, 2026, in Geneva. There, member states are expected to name facilitators to gather content on five elements:
the preamble
the definition
state obligations
the catalogue of rights
implementation and monitoring
A call for written input is expected afterwards. Brazil takes over as chair on January 1, 2027, and a zero draft is targeted for about a year from now, which the Secretary called very ambitious. A third session is planned for July 2027. The chair's own view, quoted in the session, was that success depends not only on the legal quality of the text but on whether it inspires trust and is politically inclusive, legally sound and respectful of diversity.
Rose Gahire, co-chair of GAROP, set out why a binding treaty matters:
Explicit protection. Ageism can deny people independence, push them out of work, exclude them from policymaking and leave them behind in conflicts and disasters.
Overlapping discrimination. A treaty can address it rather than treat older persons as one uniform group.
Autonomy and participation. Her simple principle was nothing about older persons without older persons.
Daily life. Accessible health services, long-term care, and palliative care must be part of it.
She also made a point that resonated with me as an African. Respect for elders and family solidarity are deeply held values across our societies, but cultural respect alone cannot guarantee legal protection. The African Union's protocol on older persons offers a regional foundation that a global convention could reinforce, provided the new treaty builds on existing protections and never weakens them.
Dr. Rajput's reflection on the Universal Declaration stayed with me.
Article 1 originally began “All men are born free and equal.” Hansa Mehta of India objected, and it became “All human beings....”
Dr. Rajput asked whether the underlying mindset has really changed. By her reading of the same UPR analysis, recommendations focused on women fare only slightly better than those on older persons. And can we truly say, she asked, with a hand on our hearts, that no one has been left behind?
Her answer to the fear of starting from scratch was practical: we do not have to. The Inter-American Convention on Older Persons (2015) already names intersecting grounds of discrimination, including race, ethnicity, indigenous identity, disability, sexual orientation and gender.
A 2023 UN DESA expert report formally recognised intersectionality. The treaty should build on these rather than wait to rediscover them.
Rose's list of intersecting factors reads like a map of who gets forgotten: socioeconomic status, disability, gender, race, ethnicity, indigeneity, migration or displacement, geography, sexual orientation and gender identity. Dr. Rajput gave the lifetime view. Older women may never have gone to school because of gender discrimination, and may carry the financial strain of decades of unpaid work. Ageing does not create inequality. It collects it.
The lived-experience panel is where the framework became human, starting with three voices from the HIV community.
Nicoletta Policek of Prisma, a European community-driven observatory on ageing and HIV, has lived with HIV for 42 years. She called the chance to age a community achievement, not just a scientific one. Her point was that age is political: who decides what a dignified old age looks like, and whose lives fall outside that decision? She proposed putting the authority to identify problems and judge progress in the hands of people ageing with HIV, supported with training, fair payment and protection of identity. Their documented evidence could then become specific questions for governments in the UPR, such as how they prevent discrimination against older people with HIV in long-term care. She warned against governments celebrating participation while leaving civil society unfunded, or quietly shifting public responsibility onto unpaid community labour. And she said plainly: "I don't want to be invisible."
Tariro Kudatza of the Zimbabwe National Network of People Living with HIV and TB People Zimbabwe described older people living with HIV, TB and conditions like hypertension and diabetes all at once. Many lived through years without medication, then through harsh early treatments. Care, she argued, must go beyond viral suppression to integrated, person-centred, peer-supported services. TB in older people is too often dismissed as ‘just ageing’, so diagnostics must come to their doorstep.
She also stressed that ageing is not gender-neutral. Older women carry caring burdens and economic dependence, men face masculinity norms that delay care, and transgender and gender-diverse older people face compounded stigma. She criticised donors who talk mostly about prevention and young people, leaving older survivors out of budgets. Her call was for a response that "ages with the people it serves."
Daxa Patel of India's HIV community cited figures showing the share of people living with HIV who are 50 or older rising from 17% in the year 2000 to 36% of around 2.5 million today. She named the gaps: no health insurance designed for people living with HIV, no social protection scheme for older people living with HIV, and eligibility processes scattered across departments and paperwork. Her answers were peer support networks, linking HIV care to healthy-ageing services, community-led monitoring that documents denial of care, and policies tailored to marginalised older women. As she put it, their rights are not negotiable, and their dignity is not optional.
Ishwari Swar of the Senior Citizens Welfare Association of Nepal made the case that ageing is not a story only of wealthy countries. In Nepal, people aged 60 and above grew from 5.19% of the population in 1961 to 10.21% in 2021, as life expectancy rose from 37 years for men and 39.9 for women to 71 and 73. At the same time, young people migrate to cities and abroad, leaving villages populated largely by older people. Older women, especially widows in remote areas, face poverty, lack of property ownership, and abuse.
Nepal has a Senior Citizens Act, but implementation at the ward level is weak, with no disaggregated data or dedicated budget.
Then she told the story of Seti, a widow in a remote village who raised three sons alone. They left to work in the Gulf and India, the remittances stopped, and the calls faded. When a chronic chest illness worsened, there was no young person and no emergency vehicle to get her down the mountain to a hospital. A 76-year-old neighbour, also a widow, brought her tea and what food she had.
When Seti died, tradition required strong young men to carry her body to the riverbank. There were none, so eight elderly neighbours, all in their seventies, did it themselves. A walk that normally takes 30 minutes took almost four hours. As the smoke rose, the remaining elders sat wondering who would carry them.
“Who will carry us?” is not only Nepal's question. The host observed that the situation is similar across much of the Global South. A right written into law means little if it never reaches the last village on the mountain trail.
The session also included a government voice. Dr. Imran Pambudi of Indonesia's Ministry of Health, Director for Vulnerable Groups, described a life-course approach.
Indonesia has over 35 million citizens above 60, nearly 12% of the population and mostly women. The figures below are as he reported them:
Integrated primary care operating in over 9,200 community health centres
A free health check-up programme that has reached more than 12 million older persons, screening cognition, mobility, nutrition, vision, hearing and psychological wellbeing
Nearly 70% of community health centres offering community-based long-term care, including home-based care
932 disability-friendly primary health centres
More than 6,500 primary care facilities and 129 hospitals providing services for survivors of violence
He closed with a five-part path forward: integrated primary care, early detection followed by treatment, active ageing, sustainable long-term care financing with caregiver support, and accessibility for people with disabilities and survivors of violence. Above all, he said, listen to older people themselves. He called ageing "a triumph of human development", not a burden.
These are government-reported figures, and the UPR is exactly the place where such claims can be tested against the experiences of people like Seti. That is where the community-led monitoring described by Nicoletta and Daka becomes essential.
Dr. Rajput closed with a reminder I found disarming. If someone tells her that grey hair means she has nothing to contribute, she answers that she has as much to offer as ever.
Experience and wisdom should be valued, not retired. Tariro had named the opposite danger earlier, a quiet divide in the HIV response between young people on one side and older survivors on the other.
Dr. Rajput's answer was continuity: older generations share experience, younger ones pick it up, and together they build an advocacy network for humanity. The word in human rights, she reminded us, is human.
Shades of Us is a Pan-African storytelling organisation using a multimedia suite of storytelling approaches to advocate for gender equality and justice, grounded in social and behaviour change communication. This session landed close to home for three reasons.
First, the 0.5% problem is partly a storytelling problem. Policy neglects what the public rarely sees. It made me ask how often our own stories, or any media, place an older woman at the centre rather than in the background as ‘grandmother’.
Second, it sharpened a question our gender work must keep asking: which women? Older women, women with disabilities, women living with HIV, and displaced women are carrying lifetimes of accumulated disadvantage. In the AFMA session on care that we attended, the question was who cares for the caregiver. Here, it becomes who carries her when she grows old.
Third, it offers a standard for how we tell stories. Nicoletta's insistence on community-controlled evidence, consent, fair payment, and protected identity is the ethic any storyteller working with marginalized communities should hold.
Furthermore, this session has left us with practical reflections we could look to implement. Some of which include possibly
Using the Health and Rights Observatory to see what Nigeria has been asked about older persons' health, and where our work can connect.
Building intergenerational conversation into our Mobile Cinema screenings and podcast episodes, with older people as storytellers, not only subjects.
Including older women in the displaced communities we will be working with through our COHUMAN partnership.
Following the IGWG through its webcast, and considering contributing lived experiences from the communities we work with when the call for written input opens.
For other civil society leaders and media organisations, the ‘so what’ is timing. The treaty text will be shaped between now and 2027, and its eventual implementation will depend on public understanding and demand. Evidence and stories from African communities will only be in the room if someone brings them.
Rose Gahire ended with a line that I keep returning to: human rights do not diminish with age, and dignity has no expiry date. If people are left behind knowingly, then they can also be included deliberately, through data that counts them, laws that name them and stories that centre them.
The question the session left me with is not whether older persons deserve rights. They already hold them. It is whether the rest of us are ready to give those rights the visibility they deserve.
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