Prioritising Health Equity for Older Persons and Carers in the Arab Region

On April 16, 2025, I had the privilege of participating in the Arab Forum for Sustainable Development (AFSD-2025), specifically the thematic session on Sustainable Development Goal 3 (SDG 3): “Delivering Healthcare in Emergencies.” This critical conversation brought together experts and policymakers from across the region to reflect on how health systems are responding—or failing to respond—in times of crisis.

As a panellist representing the MENARAH Network, I focused on the often-overlooked intersection of ageing, caregiving, and health equity in the Arab world. My contribution centred around a theme that is both timely and frequently absent from policy discourse: the social determinants of health, especially for older adults and their informal carers.

Shifting the Focus: Ageing and Care as Determinants of Health

In the Arab region, ageing is no longer a distant challenge. Our older population is projected to triple by 2050, reaching over 70 million. However, healthy ageing remains elusive. This is not solely a health systems issue—it is deeply rooted in social and economic conditions.

Older people and their caregivers, particularly women, face layered vulnerabilities in emergencies: displacement, disability, and poverty all magnify health and social care needs. Yet, they remain largely invisible in national health strategies and emergency plans.

During the COVID-19 pandemic, for example, mental health services for older adults were suspended in over half the countries in the region. In Jordan, 79% of COVID-19 deaths occurred among those aged 60 and above. These are not just statistics—they represent lives diminished or lost due to systemic neglect.

Informal Carers: The Gendered Face of Resilience

Another theme I emphasised was the indispensable role of informal carers, the majority of whom are women. These carers are the unsung heroes of crisis response, often providing 80–90% of long-term care under the most challenging conditions. Yet, they do so without training, income support, or inclusion in policy planning.

This lack of recognition not only jeopardises the wellbeing of caregivers but also compromises the quality of care received by older persons—especially during emergencies when care needs multiply and support systems collapse.

MENARAH’s Contributions to Understanding Ageing and Care

The MENARAH Network has been at the forefront of research and advocacy on these issues. Our initiative, The Meaning of Healthy Ageing in the MENA Region, explores culturally sensitive definitions of healthy ageing, engaging with older people, their families, and informal carers to inform effective policies and interventions.

In our research, Understanding Ageing Perceptions in the MENA Region: The Role of the MENARAH Network, we delve into how cultural norms, perceptions, and the practical application of care for older individuals often need improvement, resulting in limited opportunities for social engagement and increased vulnerability.

Furthermore, our work with the WHO Kobe on Addressing Unmet Health and Social Care Needs of Older People in the Eastern Mediterranean highlights the compounded challenges faced by older adults in conflict-affected nations, emphasising the need for comprehensive care frameworks.

025 reaffirmed that ageing and informal care are not peripheral issues—they are central to achieving health equity and social justice.

As crises become more frequent and complex, we must design health systems that are inclusive, resilient, and grounded in dignity for all—especially for those who have long been on the margins of care.