Management of the World Bank Group (the World Bank) thanks the Independent Evaluation Group (IEG) for the opportunity to provide comments on the IEG report, World Bank Support to Aging Countries. This evaluation is even more relevant in the context of the COVID19 pandemic that disproportionally affects the elderly. Management would like to provide the following specific comments.
Management is pleased with the evaluation’s assessment that the World Bank has made progress toward building a comprehensive framework to guide its support to aging countries, moving away “from a narrow focus on the sustainability of pension systems to a broader perspective encompassing the whole economy.” Management notes that as a key milestone, the 2015/2016 Global Monitoring Report offers a “dynamic definition” of aging, which “provides the World Bank with a strong business case to advise its clients to maximize the benefits of the first demographic dividend… and create the conditions for a second demographic dividend.” Management also notes that this definition has been used in a growing body of analytical work that “has helped countries recognize that population aging is a challenge that requires swift action, in some cases generating concrete responses by governments.” Management welcomes the suggestions of the evaluation to continue strengthening its engagement with clients.
Management notes that, although this report makes no recommendations (in the spirit of the Management Action Record reform), its analysis and suggestions are informing management’s actions. The paragraphs below summarize “the directions of travel” through, which management is taking the report’s two suggestions forward.
Suggestion 1: Better formulate the World Bank’s position with respect to population aging. This should facilitate dialogue with clients and potential partners and improve the World Bank’s capacity to provide support on this issue.
In response to this suggestion, the Human Development Vice Presidency (HDVP) is preparing a major analytical report to better formulate the World Bank’s value proposition on aging. The objective of the upcoming Healthy Longevity, Noncommunicable Diseases and Human Capital report is to review all aspects of human capital formulation. The world’s population has been aging at a dramatic speed, and governments are now engaging vigorously in policy interventions to make the additional years healthy and optimally productive, in order “to develop and maintain the functional ability that enables well-being through middle and older ages.” Older adults in good health make significant contributions to families, communities, and society as a whole. One significant positive aspect of longevity is that the productivity of older, knowledgeable, healthy adults enhances and increases the broader pool of human capital, thereby contributing to economic growth. This requires alignment with a wide range of Social Protection, Labor, and Pensions interventions to support productive inclusion during longer working careers. The HDVP is providing overall leadership and guidance to this work and would therefore be the natural champion to strengthen the aging agenda going forward.
Complementing this high-level report on population aging, management will continue ensuring that global knowledge informs country and regional policy making through dedicated analytical products. Experience shows that, although high-level reports can help shift global attention to a given topic, more focused reports are effective in stimulating country–level demand and prompting policy action. Although the above-mentioned flagship report will provide big-picture analysis, management will endeavor to translate the aging challenges into sectoral challenges that clients are (or soon will be) struggling with, such as the shifting disease burden brought about by the changing population structure, and that have clear government counterparts. Some of the most prominent sector challenges are in the areas of: (i) pension reform; (ii) rising prevalence of noncommunicable diseases (NCDs); (iii) increased demand for long-term care for the elderly, and improved delivery systems maximizing the use of technological solutions; and (iv) skills development and employment opportunities to support longer careers for an aging labor force. Among others, good emerging examples of this include the Romania strategy for the elderly and active aging, the Protecting Peoples and Economies publication, which provides guidance to prioritize integrated policy responses to COVID19 at the country level;, and the policy note for the elderly in Malaysia. ,
Suggestion 2: Improve the systematic production and use of diagnostic work to provide more regular analysis of the drivers and consequences of population aging to inform engagement with aging countries.
Management acknowledges the suggestion to produce more regular analysis to inform engagement with aging countries and will do so based on selectivity and country demand. The Healthy Longevity, Noncommunicable Diseases and Human Capital advisory services and analytics (ASA) is being organized around three streams of work, which will facilitate more regular analytics and their usage in country strategies. These streams are organized under three working groups, which are focused on: (i) better economic analysis and sectoral knowledge; (ii) better interventions and strategies; and (iii) better data and measurement. Nineteen background research papers will inform future knowledge products and policy engagement. Country prioritization on aging, like prioritization for any other topic, will be determined by client demand, policy dialogue, the World Bank’s comparative advantage, and the engagement of other development partners. Although doing more on aging and its impact on the economy and society may be a priority for some countries, given each country’s limited resources, the determination of whether more is appropriate in each context depends on assessing and deciding among competing priorities. For some countries, other priorities may take precedence. Management notes that half of the Systematic Country Diagnostic (SCD) reviewed by this evaluation included a discussion on aging. This finding is consistent with management’s view of the SCD as a diagnostic tool that by its nature is not expected to be exhaustive in its review of the development issues facing a country,, but rather selective of those issues that constitute the key development bottlenecks at the time that the SCD is prepared. Hence, there should be no expectation that every SCD and every Country Partnership Framework (CPF) will assess the drivers and consequences of aging. In this context, it is also worth noticing that interventions on aging—which is a cross-cutting multisectoral topic—may not be a principal focus of SCDs and/or CPFs, as appropriately-prioritized Bank-supported interventions may instead be embedded in other sectoral interventions that are prioritized in country engagements, such as access to affordable quality health care or to old-age income.
Management concurs with the evaluation’s finding that data shortcomings impede progress on the aging agenda and agrees with the suggestion to continue supporting countries to invest in high-quality data. The evaluation rightly concludes that although the data requirements to “properly analyze the multiple implications of population aging are substantial,” longitudinal data are “often unavailable or difficult to access.” This is a significant limitation in International Development Association countries and countries affected by fragility, conflict, and violence, and it is in some cases a primary reason for deprioritizing aging in analytical work. As the evaluation notes, the World Bank, together with other development partners, has supported client countries to produce longitudinal, good-quality, and comparable information, for example on health, but these data are often incomplete or difficult to access, including in some countries in the OECD. The World Bank’s recent publications on aging provide some examples where the World Bank has invested in longitudinal surveys and analytics for the aging population. The World Bank is also looking for innovative solutions to fill data gaps. For example, the World Bank has accelerated the use of national longitudinal phone surveys collecting information to track responses to socioeconomic impacts of COVID-19, and this could be a useful tool in various contexts, including gathering information on the aging population. Specific steps are also being taken under the Healthy Longevity, Noncommunicable Diseases and Human Capital ASA through the working group dedicated to better data and measurement, which is tasked to (i) focus on producing country-specific Healthy Longevity Dashboards including national burden estimates, country-specific economic burden of disease estimations, and data visualization, which would adopt top-line metrics derived from country data systems (for example, national cause of death data and United Nations/WHO demographic and disability data and educational outcomes to complement the Human Capital Index (HCI)), and (ii) document gaps in data sets for healthy longevity including data on functional dependency and distributional impacts of healthy longevity, and recommend priority investments to improve underlying data infrastructures in relevant countries.
- World Bank; International Monetary Fund. 2016. Global Monitoring Report 2015/2016: Development Goals in an Era of Demographic Change. Washington, DC: World Bank. https://openknowledge.worldbank.org/handle/10986/22547. A World Bank Group Flagship Report.
- The Concept Note was reviewed in April 2021, with an expected completion of 2023. At this time, the concept note is an “official document not for circulation.”
- World Bank. 2017. Results of the World Bank’s RAS Program in Romania 2012–2015. Washington, DC.
- World Bank. 2020. Protecting People and Economies: Integrated Policy Responses to COVID-19. Washington, DC. https://openknowledge.worldbank.org/bitstream/handle/10986/33770/Protecting-People-and-Economies-Integrated–Policy-Responses-to-COVID-19.pdf?sequence=7&isAllowed=y.
- World Bank. 2020. “3 ways to improve COVID-19 response to elderly care and persons with disabilities.” Blog.
- World Bank. 2020. A Silver Lining—Productive and Inclusive Aging for Malaysia. The Malaysia Development Experience Series. Washington, DC: World Bank Group. http://documents1.worldbank.org/curated/en/287981606116408851/pdf/A-Silver-Lining-Productive-and-Inclusive-Aging-for-Malaysia.pdf
- World Bank. 2020. “The Elderly Care Response to COVID-19: A Review of International Measures to Protect the Elderly Living in Residential Facilities and Implications for Malaysia.” Malaysia Covid-19 Social Protection and Jobs Note No. 2. https://openknowledge.worldbank.org/handle/10986/33861?show=full
- The World Bank jointly invested with the Government in China’s Health and Retirement Longitudinal Study, which studies the multiple dimensions of aging in China; The World Bank also analyzed various surveys (longitudinal, time-use) in the context of aging, with findings reported in (i) Where We’re Sixty-four: Opportunities and Challenges for Public Policies in a Population-Aging Context in Latin America (2020); (ii) Options for Aged Care in China (2018); and (iii) the Golden Aging (2015) in Europe and Central Asia (ECA).
- For example, the World Bank is leveraging the Living Standards Measurement Study—Integrated Survey on Agriculture (LSMS-ISA) program to support high-frequency phone surveys on COVID-19 in 5 African countries – Nigeria, Ethiopia, Uganda, Tanzania, and Malawi. https://microdata.worldbank.org/index.php/catalog/3712