Human Rights Council holds panel discussion on the realization of the right to health of older persons

16 September 2011

Hears Address by the Minister of Justice of Sudan

The Human Rights Council today held a panel discussion on the way forward in the realization of the right to health of older persons. It also heard an address by the Minister of Justice of Sudan.

Mohammed Bushara Dousa, the Minister of Justice of Sudan, reaffirmed the commitment of the Government of Sudan to work with the mechanisms of the Human Rights Council and all United Nations’ human rights mechanisms. The Government of Sudan, in declaring its recognition of South Sudan, had expressed its readiness to settle differences and all outstanding matters in the comprehensive peace plan to create good neighbourly relations between the two countries without outside interference. It was regrettable that this readiness was not reciprocated by the Sudanese People’s Liberation Movement. The report of the Office of the High Commissioner for Human Rights gave incorrect information on the events in South Kordofan and made the victims of the attack appear responsible for the violations.

Navi Pillay, United Nations High Commissioner for Human Rights, introducing the panel on the right to health of older persons, said that by 2050, 2 billion people, over 20 per cent of the world’s population, would be 60 or older. The situation of older persons was among one of most pressing policy issues for governments, public institutions and societies. Discrimination based on age was present in areas as vital as social protection policies, employment laws and access to public services. Ms. Pillay said that the unique requirements of older persons should be incorporated into national health systems, especially in low or middle income countries, and the international protection regime should be enhanced to ensure the respect and protection of all human rights regardless of age.

Anand Grover, Special Rapporteur on the right to health, said a rapidly ageing world population presented significant challenges for the global community, including the full enjoyment of human rights of older persons. There was currently no international instrument specifically concerning older persons’ rights. Implementing a right to health framework with respect to older persons would ensure that the discourse shifted from a needs-based to a human rights-based approach to enable a greater realization of the right to health of older persons. Mr. Grover expressed concern at violence directly associated to long-term home and institutional care and recommended establishing safeguards to ensure that free and informed consent was required for medical treatments.

Chinsung Chung, Member of the Advisory Committee of the Human Rights Council, highlighted the importance of implementation and the need to develop specific recommendations that could be acted on by United Nations agencies, civil society and other partners. A firm stance should be taken behind the belief that older persons’ right to autonomy was also a human right and older persons must have the freedom to make their own decisions about their use of social, legal and medical services, including decisions about end of life care.

Alexandre Kalache, Senior Advisor on Global Aging, New York Academy of Medicine, said that the right to health was not something for the elderly separated in a ghetto but pertained to all. Health in old age was the most fundamental of all rights, the right to live and Mr. Kalache noted that in Brazil’s constitution a rights based approach to health had been adopted that ensured the elderly benefited from care and health services and criminalized age discrimination in the provision of health care.

Helena Nygren-Krug, Health and Human Rights Advisor, World Health Organization, said a key challenge faced by the growth in the elderly population was the ingrained stigma and discrimination to which many elderly people were subjected to and which generated exclusion and led to the denial of a range of rights with an impact on health, including nutritious food, water and healthcare. Ms. Nygren-Krug stressed addressing the health needs of people at all stages of life.

Bridget Sleap, Rights Policy Adviser, Help Age International, said there was an exclusion of older people at three critical levels in health care provision and decision-making: as individuals being turned away at point of delivery, in sectoral policy making because of a lack of disaggregated data and in the human rights monitoring framework itself. Older people were discriminated against because they were not recognized as rights holders with profound consequences on health outcomes. Ms. Sleap proposed that the Human Rights Council consider creating a Special Rapporteur and a convention on the realization of the right to health of older people.

During the panel discussion speakers remarked that the discussion on the aging population was formerly concentrated in the developed world but was now a pressing need in the developing world which demanded global concerted action. The fight against discrimination was a cornerstone in the quest for the full realization of the human rights of older persons. Speakers called on the international community to add the right to health for the elderly to the Global Development Agenda and the Global Action Plan and some speakers said there was an immediate need for a legally binding universal instrument regulating the rights of older persons with a view to overcoming the remaining challenges for the promotion and protection of their human rights. In order to ensure the rights of older people, some speakers said that Member States should consistently implement existing instruments, notably the Madrid International Plan on Aging (2002), rather than develop new guidelines. Older persons should be encouraged to remain physically, politically, socially and economically active for as long as possible because the benefit not only for the individual but also for society as a whole could not be overestimated. Speakers asked about the concept of ‘active ageing’ and what best practices were identified to reorient ideas about ageing and the continuing contribution of older persons to society, including an active participation in the labor force. The growing number of elderly people aged 85 and over was a key challenge for Governments especially as among this group were a large number of elderly that were severely impaired physically and or mentally. The current paradigm for the elderly placed too much focus on retirement and health issues and not enough on the active participation and positive contribution that the elderly could play in society.

Brazil, China, Pakistan on behalf of Organization of Islamic Cooperation, Indonesia on behalf of Association of South East Asian Nations, Uruguay, Saudi Arabia, Senegal on behalf of African Group, Egypt on behalf of the Arab Group, Peru, the Holy See, Argentina, Nepal, Australia, Kuwait, Turkey, Venezuela, Bangladesh, the Russian Federation, Morocco, Qatar, Germany, Ecuador, Israel, the United States, Algeria, Cuba, Indonesia and Spain took the floor in the discussion.

Non-governmental organizations that also addressed the panel were the Federation of Cuban Women, European Disability Forum, the International Institute for Peace, and the International Association for Democracy in Africa.

The Council then met in a closed meeting in the framework of the Complaint Procedure.

The Council will meet at 9 a.m. on Monday, 19 September when it will hold an interactive dialogue with the High Commissioner for Human Rights on the visit of her Office to Yemen and an interactive dialogue with the Commission of Inquiry on Libya.

Introduction of the Panel Discussion

NAVI PILLAY United Nations High Commissioner for Human Rights, introducing the panel on the right to health of older persons, said the composition of the world’s population was changing dramatically. By 2050 2 billion people - over 20 per cent of the world’s population - would be 60 or older. It was clear that the situation of older persons should rank among the most pressing policy issues for governments, public institutions and societies at large. Although age was not explicitly listed as a prohibited ground of discrimination in most international human rights treaties, these lists were intended to be illustrative and non-exhaustive. Discrimination based on age was present in areas as vital as social protection policies, employment laws and access to public services. The intimate link to the right to health had particular relevance. Age often defined whether someone was allowed access to medicines, treatment, devices or long-term care.

Estimates showed that only one in five persons aged 60 or over had a pension. Even if a pension was available older persons often had to spend it entirely on medicines rather than adequate food, transportation or rent. The unique requirements of older persons should be incorporated into national health systems, especially in low or middle income countries. Most States still required comprehensive health policies, which would take into account prevention, rehabilitation and care of the terminally ill. Adequate access to palliative care was essential to ensure older persons could live and – ultimately - die with dignity. Members of the General Assembly had agreed that a gap existed in the international protection regime. Despite provisions that were already applicable to older persons in existing human rights instruments, panellists and experts had lamented an absence of specific standards on the rights of the older persons who, consequently, had largely remained neglected by human rights advocacy. The international protection regime must be enhanced to ensure the respect and protection of all human rights regardless of age.

Statements by Panellists

ANAND GROVER, Special Rapporteur on the right to health, said that his thematic study examined the growing importance of the right to health as it related to older persons and explored challenges relating to the realization of this right which would increase dramatically in the future if left unaddressed. A rapidly ageing world population presented significant challenges for the global community, including the full enjoyment of the human rights of older persons. There was currently no international instrument specifically concerning older persons’ rights. Older persons were regularly discriminated against and their particular needs often remained unrecognized partially due to this lacuna. Older persons must be viewed as rights-holders who may, at times, require support in order to claim their rights in a fashion similar to other populations. Failure to recognize older persons as rights-holders may lead to continued prejudice and discrimination against them with profound consequences for their future health and welfare. Mr. Grover recommended implementing a right to health framework with respect to older persons in order to ensure that the discourse shifted from a needs-based to a human rights-based approach, to enable a greater realization of the right to health of older persons. The enjoyment of the right to health was not age-dependent. It did not cease to exist once a person reached a certain age. The right to health approach was indispensable to the design, implementation, monitoring and evaluation of health-related policies and programmes, in order to mitigate the consequences of an ageing society and to ensure the enjoyment of this human right by older persons.

Health facilities, goods and services should be made available, accessible, affordable, acceptable, and of good quality for older persons; and States should ensure that older persons received age-friendly health care of a quality commensurate with that provided for other groups. The right to health approach should be accompanied further by a paradigm shift, working towards a broader conception of ageing that was active and dignified. As life expectancy increased, older persons would stay active longer than ever before in terms of occupational and non-occupational activities. Encouraging older persons to remain physically, politically, socially and economically active for as long as possible would benefit the individual and society as a whole. The study recommended recognizing ageing as a lifelong process and reflecting this idea in policy, legislation and resource allocation. States should allocate more resources to the provision of geriatric healthcare and ensure that healthcare workers were adequately trained to understand the right to health and deal with issues that may arise from ageing. As chronic illness and disability often increased with advancing age, primary care was generally the most appropriate point of coordination for the health related needs of older persons. Palliative care was another aspect which disproportionally affected older persons. Ensuring equitable access to quality primary health care that addressed the specific needs of the elderly was a core requirement in realizing the right to health of older persons. Mr. Grover expressed concern about reported and unreported violence directed associated to long-term home and institutional care. He recommended establishing safeguards to ensure that free and informed consent was required for medical treatments. Increasing rights-related awareness and empowering older persons was necessary to strengthen their participation in health policymaking and to promote networks of older persons.

CHINSUNG CHUNG, Member of the Advisory Committee of the Human Rights Council, said that every effort should be made to ensure recognition of the right to health of older persons at the State level, both explicitly and implicitly through policies, legislation and resource allocations. Ms. Chung highlighted the importance of implementation and the need to develop specific recommendations that could be implemented by United Nations agencies, civil society and other partners. Civil society partners had much to contribute through their on-the-ground experience and observations. Non-governmental organizations such as Help Age International and Global Action on Aging had conducted research on critical emerging topics related to older persons, pushed for policy changes and provided a wide range of assistance and resources to older persons. The establishment of a system of social protection that could afford older persons access to long-term care, whether institutional or home-based, required the adequate assessment of the long-term contributions of United Nations agencies, civil society and other parents.

Concerning putting in place policies and procedures for reporting, addressing and preventing abuse of older persons, Ms. Chung stressed the need for a process that was formalized and or institutionalized. Mechanisms were required to ensure that both abuses and best practices were regularly and systematically documented and that this documentation fed into policy debates and discussions at higher levels. Appropriate institutionalization processes were especially important in raising awareness and training both medical and non-medical communities on the treatment of older persons. Mechanisms must be formulated in a strategic yet culturally sensitive manner. Awareness building and training should not be limited to only medical professionals and non-medical workers but should also actively extend to older persons ensuring that they were made fully aware of their medical conditions and treatment options. A firm stance should be taken behind the belief that older persons’ right to autonomy was also a human right in and of itself. An understanding of the right to health of older persons should be grounded in the belief that older persons must have the right of freedom to make their own decisions about their use of social, legal and medical services, including decisions about end of life care. Ms. Chang said the value of this discussion would hinge on how such recommendations could be translated into implementable action plans that were practical, sustainable and truly rights-based. There was a need for an exploration of innovative sources of financing for these initiatives as well as how to maximize south-south knowledge exchange and build communities of champions, whether Government, religious or community leaders, around these issues.

The right to health should be based on the need for international recognition of the more fundamental and larger rights of older persons as universal human rights. However the international community had not yet formally and legally recognized the rights of older persons as human rights nor had States consistently incorporated these international standards into national legislation and policy action. The Special Rapporteur’s report on the right to health of older persons should put forth the broader discussion on the more general human rights of older persons before addressing the more specific right to health. Ms. Chung noted that existing human rights instruments lacked the capacity to effectively protect the rights of older persons, despite the prevalence of extensive discrimination against older persons.

ALEXANDER KALACHE Senior Advisor on Global Aging, New York Academy of Medicine, said he would illustrate the points he wished to make by a story.
The story took place in Rio de Janeiro and concerned the birthday of a woman aged 90, Lourdes. She was attended on by her four children who provided support and she danced the waltz with her private doctor. Lourdes was Mr. Kalache’s mother. He explained that his nanny Victoria would have turned 80 on the same date but Victoria had died at the age of 60 from heart disease and diabetes. This was a premature death from preventable causes. She would have depended on philanthropy for her health care. She died in 1988. That year Brazil had a new constitution setting in stone the right to health. Since then a lot more attention had been paid to the health of the elderly. A rights based approach to health had been adopted. Had Victoria been born 20 years later she would have benefited from care and health services and criminalization of discrimination on the basis of age in the provision of health care.

The right to health was not something for elderly separated in a ghetto but pertained to all. Yet on Monday and Tuesday a summit on preventable communicable diseases called by General Assembly was to be held in New York at the United Nations. Mr. Kalache was filled with horror that all documentation referred to improvements to prevent death before the age of 60. Health in old age was the most fundamental of all rights, the right to live. The Open-ended Working Group on the Right to Health in Age had produced two very intense debates but this was just a reminder of the way ahead.

HELENA NYGREN-KRUG, Health and Human Rights Advisor, World Health Organization, commended the Special Rapporteur on the right to health for his report. In almost every country, the proportion of people over 60 was growing faster than other age groups. Population ageing represented a major achievement. Yet it provided a number of challenges. A key challenge, deeply rooted, was the ingrained stigma and discrimination to which many elderly people were subjected to; and which generated exclusion and disadvantage and led to the denial of a range of rights with an impact on health, including nutritious food, water and healthcare. In the most extreme cases, it manifested itself in abuse, violence and neglect. Abuses against the elderly were increasingly being seen as a health issue and a human rights violation. Efforts to address domestic abuse and violence had revealed what were previously considered private matters; however, in many places elderly abuse remained hidden and was considered a taboo. It was important to harness elderly people’s contribution to society. In this context, the World Health Organization promoted a concept of active ageing. Consistent with a human rights based approach it did not only address the outcome, but it also considered the principle that must guide the process. The right to participate was central. And the word active referred to continuing participation in social, economic, cultural, spiritual and civic affairs. Active ageing aimed to extend healthy life expectancy and quality of life for all people as they aged. A life-course approach looked at the progressive change in the physical, mental and social structure of individuals.

This meant addressing the health needs of people at all stages of life. Security was another pillar of active ageing. Transforming the perception of older persons from a burden to a resource required recalling the commitment to freedom from want and fear. The 2010 World Health report, on health systems financing, supported countries in translating this commitment into practice. It demonstrated that compulsory prepayment provided the most efficient and equitable path forward and that avoiding direct payments for healthcare would facilitate the ability of older people to access prevention, treatment and care. Other barriers to access included gender, economic accessibility, and distance and transport costs. As a way of addressing some of these barriers, the World Health Organization also promoted community-based primary healthcare. Unfortunately, training for health workers included little instruction concerning the elderly. Mental health issues, including dementia, depression, and non-communicable diseases deaths were expected to rise substantially as populations aged. Thirty-six million of the 57 million global deaths each year were due to non-communicable diseases, mainly cardiovascular diseases, cancers, chronic respiratory diseases and diabetes. Common risk factors identified were tobacco use, unhealthy diets, harmful use of alcohol and physical inactivity. Next week the General Assembly would negotiate a political declaration on how to prevent and control non-communicable diseases. Ms. Nygren-Krug, echoing the Special Rapporteur, stated that in order to change the perception of older persons a paradigm shift was needed from responding to the needs of older persons to realizing the rights of older persons; and invited the Council to celebrate the World Health Day in April 2012, dedicated to the theme of ageing in health.

BRIDGET SLEAP, Rights Policy Adviser, Help Age International, said there was an exclusion of older people at critical levels in health care systems because older people were not recognized as rights holders. Ms. Sleap said a discriminatory attitude on behalf of health workers toward the elderly existed in many countries and cited the following examples: in Kyrgyzstan, ambulances discriminated against the elderly by not providing services to them; in a Bolivian survey health workers often referred to older people as children and not as active or independent adults; and older people displaced in northern Uganda due to civil unrest were not assisted to return to their place of origin because they were considered displaced due to confusion and old age. Ms. Sleap said that the health systems in many low and middle income countries paid little attention to the life cycle and the needs of older people. A critical issue was the lack of data gathered on health care systems, in particular on services offered to the elderly. For example in many countries HIV AIDS treatment was only offered to people aged between 15 and 49. And in a cross regional survey of 32 countries, health data was only available for 50 per cent of country, geriatric wards data in only 44 per cent, and Government health expenditure disaggregated by age in only 19 per cent.

A failure to monitor human rights, particularly the right to health in Member States, had led to elderly people becoming invisible in the health care system as no substantive data on the application of the right to health for older people existed. The report of the Special Rapporteur on the right to health provided a better understanding of the issue and the need for the training of health workers to reduce discriminatory attitudes against the elderly. Further steps that could be taken would be to require State parties to provide more information on the right of older people to access health in their treaty reporting while Special Procedures should examine how people’s right to health intersected with their mandates. The Universal Periodic Review Process provided an opportunity to review how older people were able to access their right to health. Ms. Sleap concluded by proposing that the Human Rights Council consider establishing a Special Rapporteur and a xonvention on the realization of the right to health of older people.

Discussion

Speakers said concern about the aging population was formerly concentrated mainly in the developed world but was now a pressing need in the developing world and demanded globally concerted action. Speakers sought a paradigm shift to active inclusive dignified aging. Affordable medicine should be ensured to all. The fight against discrimination was a corner stone in the quest for the full realization of the human rights of older persons. There was a strong correlation between older persons and those with disabilities. Article 25 of the United Nations Convention on the Rights of Persons with Disabilities protected the rights of older persons with disabilities to the necessary health service including those needed for prevention of disabilities. Some speakers spoke in support of creating international and Inter-American conventions on the rights of older persons or the creation of a United Nations Special Procedure. Some speakers said a human rights-based approach should be combined with sustainable social development in order to deal with addressing the right to health of the aged. Speakers called on the international community to add the right to health for the elderly to the Global Development Agenda and the Global Action Plan. Speakers said the elderly should be encouraged to be physically and socially active for own benefit and that of society as whole.

Older persons needed support of social institutions, families and communities. Sharia encouraged the care of the elderly and solidarity in the family. Older persons could not be considered a burden on society. Elderly persons held a privileged place in African society. The Catholic Church felt that the care for elderly persons should be an act of gratitude. Emphasis should be placed on the establishment of networks of support for older persons. Speakers asked if the weakness of social institutions and commercialization of care may have harmful effects and asked for specific examples and best practices of where financial constraints should not deter developing States on improving health systems for the elderly.

Non-governmental organizations (NGOs) stressed that they felt the report was in error in endorsing the idea of guardianship as it would infringe on the right to equal recognition before the law and impinge on the principle of informed consent.

Speaking in the discussion were Brazil, China, Pakistan on behalf of the Organization of the Islamic Conference, Indonesia on behalf of ASEAN, Uruguay, Saudi Arabia, Senegal on behalf of African Group, Egypt on behalf of the Arab Group, Peru, the Holy See, Argentina and Nepal

NGOs speaking in the panel were the Federation of Cuban Women and European Disability Forum

Remarks by Panellists

ANAND GROVER, Special Rapporteur on the right to health, noted that comments and interventions indicated the importance of a paradigm shift toward the right to health. There had been indications during the debate that some of the policies that had already been implemented could be followed elsewhere. It was important that all options available to improve the realization of the right to health of older people should be considered. Concerning the lack of resources, international cooperation was important; an example was the Global Fund. Concerning the claim that he had ignored the importance of informed concern, Mr. Grover noted that he had focused on the limited circumstances where the elderly person was unable to communicate his or her concerns. For him, as a lawyer and Special Rapporteur, the principle of informed concerned was fundamental. While some of the criticism to his report was unwarranted, Mr. Grover was pleased that these issues were being discussed.

CHINSUNG CHUNG, Member of the Advisory Committee of the Human Rights Council, said she agreed with the importance of the relationship between disability and aging. There was a responsibility of not only the State but also the family to care for an aging population. Ms. Chung said that a reconsideration of the gender perspective for older persons was critical and was pleased that many of the Member States and non-governmental organizations supported a human rights perspective to access to health services.

ALEXANDER KALACHE, Senior Advisor on Global Aging, New York Academy of Medicine, said he was delighted to hear numerous interventions referring to a life-course perspective and active ageing, including health, participation and security. Concerning the need for training for healthcare professionals, Mr. Kalache mentioned that it was not a question of having more geriatricians, but about the need for a better knowledge about ageing for all health professionals. While healthcare professionals were important, considerable care was provided by other actors, including women. The gender dimension was also important. In this regard, not only the majority of the elderly were women but also many of the care providers. It was important to go beyond the taboo concerning abuse against the elderly; and it was important to recognize its significance on the elderly, and its impact on women and children.

BRIDGET SLEAP, Rights Policy Adviser, Help Age International, said that despite policies to limit exclusion, it still existed in health care systems, such as informal fees to be paid when health care was free and complicated age and means tested criteria which restricted access to treatment for older persons.

HELENA NYGREN-KRUG, Health and Human Rights Advisor, World Health Organization (WHO), said she appreciated the broad concept of health expressed by the panel. In the constitution of WHO health was not just being absent of disease but a complete state of physical and social well being. This included in the mental aspect that had not been addressed so far in the panel. WHO was prepared to play its role.

Discussion

In the interactive dialogue, speakers asked how the panel could best protect older peoples’ rights to informed consent to treatment, especially the elderly from culturally diverse backgrounds. Elder citizens were full fledged members of families and therefore should be given the due respect and consideration they deserved. Speakers said there was an immediate need for a legally binding universal instrument regulating the rights of older persons with a view to overcome the remaining challenges for the promotion and protection of their human rights. The health concerns of the elderly should put an equal emphasis on physical and mental health; speakers said that the major causes leading to mental illness among the elderly were the death of a spouse or friends, seclusion from family, living in old homes and a lack of love, security and recognition. In order to ensure the rights of older people, Member States should consistently implement existing instruments, notably the Madrid International Plan on Aging (2002), rather than developing new guidelines where such a need was not clear. Policies should seek to put an end to all forms of discrimination against elderly people while at the same time the elderly should be included in society to promote life long learning and to strengthen their social status. Older persons should be encouraged to remain physically, politically, socially and economically active for as long as possible because the benefit not only for the individual but also for society as a whole could not be overestimated. The international community as well as Governments should do their utmost to realize the rights of older people on the basis of the existing framework of human rights covenants. Speakers asked about the concept of ‘active ageing’ and what best practices were identified to reorient ideas about ageing and the continuing contribution of older persons to society, including an active participation in the labour force. Older people’s rights to access justice and equality before the law and the rights to housing, privacy and a private life all required greater attention. The growing number of elderly people aged 85 and over was a key challenge for Governments, especially as among this group were a large number of elderly that were severely impaired physically and or mentally. The current paradigm for the elderly placed too much focus on retirement and health issues and not enough on the active participation and positive contribution that the elderly could play in society. Speakers asked what steps would be most effective to ensure that the elderly could have an active life.

Member States that spoke were Australia, Kuwait, Turkey, Venezuela, Bangladesh, the Russian Federation, Morocco, Qatar, Germany, Ecuador, Israel, United States, Algeria, Cuba, Indonesia and Spain.

Non-governmental organizations that spoke were the International Institute for Peace, and the International Association for Democracy in Africa.

Concluding Remarks

ANAND GROVER, Special Rapporteur on the right to health, said it had been a useful discussion. The most important point was that the right to health frameworks should guide future courses of action. There was a need to plan for dignified ageing long before it set in. An international instrument and Special Rapporteur mandate on this issue needed to be discussed further. The importance of tackling discrimination and informed consent issues could not be more emphasized. The Special Rapporteur
asked how they could make sure that the elderly could have home based care in spite of family erosion. For developing countries the care should be preventative to save money in the long run. International efforts such as those in global fund were needed. Large numbers of persons were aging. A paradigm shift meant bringing in laws, polices and other measures.

CHINSUNG CHUNG, Member of the Advisory Committee of the Human Rights Council, said the discussion should start from the perspective that all persons were valuable. Financing, particularly international financing for mechanisms and policy implementation, was critical to realizing the right to health of older persons. The role of the family should be highlighted in ensuring that elderly people enjoyed their full human rights.

ALEXANDER KALACHE Senior Advisor on Global Aging, New York Academy of Medicine, said one of the main issues was awareness of the rights of elderly persons. Awareness was very low. In the Open-ended Working Group in New York there was a fraction of the interest of the Member States at the Human Rights Council. Virtually no countries from Africa, the Middle East or Asia attended. International instruments were not adequate, if they were, the lack of focus on aging would not be seen. The Millennium Development Goals did not even mention the word aging or old age. Principles of active aging were encapsulated by the idea of age friendly cities that was being discussed at the upcoming Dublin conference.

HELENA NYGREN-KRUG, Health and Human Rights Advisor, World Health Organization, in concluding remarks, said that aging and health were already high on the agenda of many countries and welcomed the call from so many speakers for a stronger, internationally coordinated response on human rights and aging. Capacity should be built among health systems, both formal and informal, to provide services for older people. Ms. Nygren-Krug said that awareness was the fundamental root issue to address and urged all Member States to prepare for World Health Day on 7 April.

BRIDGET SLEAP, Rights Policy Adviser, Help Age International, said she agreed that there was a lack of awareness of the issues of aging and inadequacy of international protection for the issue. The right to health for the older person should be equitable in peacetime, conflict and post conflict situations and humanitarian responses. In principle the elderly were categorized as vulnerable but aid and support would usually be funneled at children, pregnant women and lactating women Mental health and mobility were often not considered in humanitarian response. This was well illustrated in the distribution of resources in humanitarian response where only 0.2 % of total resources were directed towards older people. A greater realization of older peoples’ right to health in national and international polices was needed.

Statement by Minister of Justice of Sudan

MOHAMMED BUSHARA DOUSA, Minister of Justice of Sudan, reaffirmed the commitment of the Government of Sudan to work with the mechanisms of the Human Rights Council and all United Nations’ human rights mechanisms. Sudan wished to engage in constructive dialogue and to listen to objective opinions that would allow the overcoming of obstacles to achieve human rights in the country. Humankind everywhere was different in culture, race, religion and belief; however there should be a convergence on ethical values and norms to make peace possible. The wars, conflicts and humanitarian crises faced by different regions of the world were only the result of the fact that these principles and values were not given a real chance. Now was the time to build a better future, one of equality and justice and on the basis of humanity without any exclusion or hatred for each other.

Sudan had learned a lot from the constructive dialogue and recommendations submitted in its Universal Periodic Review and Mr. Dousa said he would like to review the changes that had taken place in the county since the Universal Periodic Review. On 9 July 2011, following the results of the referendum on South Sudan, there had been the birth of a new country, South Sudan. The Government of Sudan, in declaring its recognition of South Sudan, had expressed its readiness to settle differences and all outstanding matters in the comprehensive peace plan to create good neighbourly relations between the two countries without outside interference. It was regrettable that this readiness was not reciprocated by the Sudanese People’s Liberation Movement, which on 19 May, started an attack against the Sudanese army, notably the joint forces in the Abyei region as they were withdrawing, accompanied by United Nations’ forces. This had led to deaths among the Sudanese and United Nations forces, had led to fear among civilians, and had been a breach of the agreement between the Government of Sudan and the People’s Liberation Movement.

Mr. Dousa said in May 2011, before the results of the election were announced for the Governor of South Kordofan, the Sudanese People’s Liberation Movement withdrew from the elections and launched an attack on the provincial capital, Kadugli. Lives were lost and many fled. However the Government of Sudan maintained its position by recognizing the State of South Sudan and was working to normalize the situation. Humanitarian assistance was made available through various international agencies and organizations in the capital and the Government of Sudan sent medical teams to support hospitals in the provinces. Neighbouring provinces around South Kordofan hosted the internally displaced persons who were assisted to return home.

The report of the Office of the High Commissioner for Human Rights gave incorrect information on the events in South Kordofan and made the victims of the attack appear responsible for the violations. Security arrangements stipulated that the Sudanese People’s Liberation Movement should withdraw to the independence borders of 1956 and they had not done this; rather support and incitement was given to the forces of the Sudanese People’s Liberation Movement in the Blue Nile in another attempt to destabilize the situation in Sudan.

In spite of these challenges the Sudanese Government had maintained its position that dialogue was the best way to resolve the problems. In May in Doha, capital of Qatar, an expanded conference for stakeholders was held with the Sudanese Government and the South Sudan Government, representatives of internally displaced people and international agencies and mediators from the African Union and United Nations. A peace settlement was signed on Darfur on 14 July with the Sudanese Liberation Justice Movement. According to Ibrahim Gambari, the head of the Joint Mission of the African Union and United Nation mission in Sudan, violence had decreased by 70 per cent. The Government of Sudan believed in the principles and standards of human rights as a basis to settle all national issues to guarantee equality, justice, freedom and transparency and respect of the highest level of human dignitary for all.

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