The proposed UN Sustainable Development Goals are designed to replace the Millennium Development Goals and are due to come into effect later this year. You can view the “Open Working Group Proposal for Sustainable Development Goals” here. In particular, have a look at goal 3.4 which reads:

“Goal 3. Ensure healthy lives and promote well-being for all at all ages

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3.4 by 2030 reduce by one-third pre-mature mortality from non-communicable diseases (NCDs) through prevention and treatment, and promote mental health and wellbeing” That sounds very good. Who could possibly be against the goal of reducing pre-mature mortality from non-communicable diseases (cancer, strokes, diabetes, dementia etc)? Well, according to an open letter published in The Lancet, an international group of ageing specialists is against it. On what grounds? On the grounds that this goal will lead to countries prioritising health care for the young at the expense of the elderly. The Telegraph newspaper explains:

“However because many [NCDs] are age-related illnesses people who succumb to those diseases from the age of 70 are not deemed to have died prematurely and so are not included in the target.” That is, any money that a country spends on reducing mortality from NCDs for patients over the age of 70 will not go towards helping that country achieve goal 3.4 (somewhat in contradiction to the heading of goal 3 which promises well-being “for all at all ages”). As the signatories of the letter warn:

“Put simply, it tells policy makers, particularly in poorer countries that older people do not matter” Although the guidelines will not be binding, health experts warn that the UN will not be happy with countries who fail to comply. And, if aid money is spent in developing countries to advance the UN Sustainable Development Goals, goal 3.4 means that that money will be going to the under 70s when it comes to NCDs. This is the danger that the letter to The Lancet is warning us about:

“Prof Peter Lloyd-Sherlock, professor of social policy and international development at the University of East Anglia, and lead author of the letter, said: ‘This premature mortality target is highly unethical, since it unjustifiably discriminates against older people. We already know that there is age discrimination in cancer care and surgery and these targets give that the stamp of approval. The targets are not quite set in stone yet, so we have a final opportunity to impress upon the UN the need to alter this explicitly ageist health target. If this doesn’t happen, people aged 70 and over will become second-class citizens as far as health policy is concerned.’…

The letter warns that the UN target: ‘has the potential to undermine cherished, fundamental principles of universality and health as a right for all.’” The prioritising of health care for the young, the fit and those with many years of “quality” life left of course happens to some extent already. There are only so many health care dollars to go around and some prioritisation needs to occur.  However, as the populations of many countries continue to age, 70 years old can hardly be said to be the end of the road: Tom Gentry, policy advisor at AgeUK notes that even the average 70-year-old is expected to live for at least another decade. As we age, the pressure on the health resources of a country will only continue to increase. Will we continue to prioritise care for those who are younger? What will this UN Sustainable Development Goal do for attitudes about the value of geriatric care? What impact will our ageing populations have on palliative care - worthwhile or a drain on scarce resources? And will the allure of “voluntary” euthanasia continue to grow for countries which have a burdensome ageing population and too few taxpayers to pay for it?