Keynote presented at the British Society for Population Studies Annual Conference, Swansea University, September 2025
The Middle East and North Africa (MENA) region is undergoing one of the world’s fastest demographic transitions. Countries such as Lebanon and Algeria are projected to experience a sharp rise in their ageing populations within just a few decades; a pace of change that poses both opportunities and challenges for societies, health systems, and policymakers.
In her keynote address at the BSPS Annual Conference 2025, Prof. Shereen Hussein explored how the region’s unique social, cultural, and economic contexts shape the meaning and experience of ageing, urging that “demography alone is not enough” to understand or respond to this transformation.
Hussein-BAPS-2Sep25The Pace and Nature of Change
Drawing on recent MENARAH research conducted with the World Bank (Hussein & Ismail, 2023), Prof. Hussein highlighted how MENA countries are ageing at unprecedented speeds. For instance, while Europe’s ageing process unfolded over a century, some MENA countries are experiencing comparable demographic shifts in under 25 years.
This rapid transition intersects with earlier onset of non-communicable diseases (NCDs), such as diabetes, cardiovascular disease, and dementia, influenced by lifestyle and environmental factors. These trends suggest that ageing in the MENA region begins earlier and may carry a heavier burden of care needs than traditional demographic models assume.
Cultural Perceptions and Lived Experiences
Beyond statistics, Prof. Hussein’s reflections, grounded in over 50 conversations with older adults, carers, policymakers, and researchers across the region, reveal deeply embedded cultural narratives around ageing. Respect for elders remains a defining social value, yet it is often expressed within a framework of dependency and limited autonomy.
As one participant shared:
“When my mother retired, we wanted to make life easier for her. We did everything for her … until she lost her ability to walk.”
Such stories illustrate how love and respect can unintentionally reinforce isolation, especially for older women. Gendered perceptions of ageing persist strongly: women are often viewed as “older” at younger ages than men, a bias shaped by appearance, caregiving roles, and the “double burden” of domestic and paid work.
Modernisation, Speed, and the Changing Social Contract
Prof. Hussein explored three overlapping theories, cultural norms, modernisation, and the pace of change, to explain shifting societal attitudes toward ageing. While modernisation and industrialisation can diversify perceptions of older age, abrupt social and economic change can also fuel resentment and competition over resources, especially in contexts of youth unemployment and social inequality.
The result is a complex landscape of ageing perceptions — where reverence and marginalisation coexist, and where rapid transitions challenge long-held intergenerational contracts.
Unmet Needs and the Future of Long-Term Care
Drawing from the newly published WHO 2025 report, Evidence Gaps on Unmet Health and Social Care Needs in the Eastern Mediterranean Region, co-authored by Prof. Hussein, Dr Mohamed Ismail and MENARAH collaborators, a worrying picture emerges.
While life expectancy is rising, healthy life expectancy lags behind — often by a decade or more. Women, in particular, live longer but spend more years in poor health and dependency.
The WHO analysis, covering 22 countries, reveals that:
- Unmet health care needs among older adults range from 10% in Iran to 84% among Syrian refugees in Lebanon, depending on context.
- Unmet social care needs (support with daily living) were reported at 9.5% in older adults in Iran, rising to almost 60% among patients with advanced cancer in the occupied Palestinian territory.
- Data are scarce and fragmented: only three countries (Egypt, Lebanon, and Palestine) are currently running national or large-scale studies on ageing and care needs (e.g., AL-SEHA and LSAHA).
The report highlights three levels of drivers behind these unmet needs:
- Macro-level: Conflict, instability, and the lingering effects of the COVID-19 pandemic.
- Meso-level: Service shortages, workforce gaps, poor affordability, and inadequate geriatric training.
- Micro-level: Gender, poverty, low education, and health literacy.
Women, widows, and those with multiple chronic conditions were consistently most affected, underscoring the intersectionality of gender and ageing.
A Call for Contextualised, Decolonised Ageing Policies
Prof. Hussein concluded with a call to decolonise policy narratives on ageing, moving beyond imported models to approaches that reflect the region’s cultural and socio-economic realities. Understanding what it means to be “old” in the MENA context requires a holistic lens, one that integrates demography, social care systems, gender relations, and intergenerational dynamics.
“Ageing is not just about numbers,” Prof. Hussein reminded the audience. “It is about lived experiences, social structures, and the values that define how we care for one another.”
About the MENARAH Network
The Middle East and North Africa Research on Healthy Ageing (MENARAH) Network brings together researchers, policymakers, and practitioners to promote evidence-based approaches to ageing and long-term care in the region.
Learn more at www.menarah.org or follow @MENARAH3.
Founder and Director
Shereen Husseinis a Health and Social Care Policy professor at the London School of Hygiene and Tropical Medicine (LSHTM), United Kingdom.
Shereen Founded the MENARAH Network in 2019, through an initial grant from the Global Challenge Research Fund, UKRI. She is a medical demographer with expertise in ageing, family dynamics, migration and long-term care systems. Shereen regularly collaborates with the United Nations, the World Health Organisation and the World Bank in policy and research focused on ageing in the Middle East and North Africa Region.
Shereen received her undergraduate degree in statistics and a postgraduate degree in computer science at Cairo University. She completed an MSc in medical demography at the London School of Hygiene and a PhD in quantitative demography and population studies at the London School of Economics and Political Science, United Kingdom.
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