According to the United Nations, aging is an “unprecedented event in human history.” The year 2020 marks a historic turning point: the curves showing the proportion of people aged 65 and over on the one hand, and people under the age of five on the other, are crossing and heading in sharply divergent directions.

These changes, already underway in Europe and the Balkans, herald major health, social, and economic challenges in the coming decades, as well as a demographic decline that is already underway. To address these challenges, it will be necessary to confront inevitable changes in lifestyles, increase investment in social protection policies, reform institutions, and encourage technological innovation. Without specific public policy actions, the decline in the working-age population will make it more difficult to support retirees, age-related health problems will worsen, and the quality of life of older people will be reduced.

This research project aims to identify, describe, and clearly analyze the links between demographic dynamics and socio-economic issues in three countries in the Western Balkans. 

To this end, it focuses on population dynamics (mortality/morbidity, aging, migration) and patterns of (de)population and land use planning (territorial identities, urbanization/rural areas, particularly in relation to natural environments). It will also analyze their impacts and interactions with current and future socio-economic issues in each of the three countries concerned (women's access to the labor market, migrant remittances, changes in social protection systems, etc.).

The aim is to clearly identify, describe, and analyze these links, both to inform academic research and to inform public policy choices in the three countries concerned. AFD will also be able to use these results in its discussions with public authorities in Albania, Bosnia and Herzegovina, and North Macedonia.

The project is led by a scientific partner, the Center for Research and Policy Making (North Macedonia), who assembled a multidisciplinary team of experts in demography, migration, economics and financial policy, employment and labor mobility, gender equality, the environment, and social protection policies (health and retirement).

This multidisciplinary project (sociology, political science, economics) is structured around three components:

• Production of an academic literature review on the challenges of aging in the Balkans region (advances and scientific knowledge on the socio-economic, territorial, and migratory challenges related to aging at the regional level);
• Three country studies;
• Publications and promotional activities to disseminate knowledge on the one hand and fuel dialogue between AFD and its public partners on the other.

In many African countries, older people still represent a very small share of the population (3% in sub-Saharan Africa and 5.6% in North African countries). For a long time, they have been largely overlooked by public policies, which have focused instead on the most urgent needs of economic, social, and health development — primarily targeting children and young adults.

However, the number of older people is increasing — not only in absolute terms but soon also in relative terms, with aging projected to occur more rapidly than in other regions. The challenge now is to design and implement appropriate public policies to support this demographic shift, particularly in the areas of health and social protection.

New forms of coverage and protection are emerging — or becoming essential — such as cash transfers, which complement family-based solidarity systems, free healthcare and services for older adults, the expansion of so-called universal pension and retirement schemes, and more broadly, private support systems on which most older people on the continent must still rely.

This research project provides a framework for understanding population aging and related public policies across the African continent, from a comparative perspective. It examines the aging process, its associated challenges, the public policies addressing it, and the institutional frameworks in various countries, focusing on emblematic case studies that reflect diverse situations (South Africa, Cameroon, Cape Verde, Kenya, Morocco, and Senegal). The project also includes targeted analyses based on recent data, highlighting the contributions of demographic research to issues of health and social protection (notably pensions) for older adults.

The project resulted in a valuable overview for policymakers in AFD’s partner countries, contributing to broader reflections on the conditions under which different public policy models may or may not be replicated across the African continent.

The project is based on a comparative analysis of secondary demographic data drawn from existing sources — including research papers, reports, and scientific literature. By presenting the different trajectories of demographic transitions, it offers an overview of aging across the continent, including its timing and context, and explores the associated challenges for both national and local public policies. It highlights regional, national, and subnational variations in aging, in order to identify the areas that are either most advanced in this process or experiencing the fastest pace of change.

Focused case studies on a selection of countries representing different situations provide a systematic critical review along the following lines:

• a socio-demographic and health overview;
• a description of the institutional framework and public policies in place;
• a critical analysis of the social and health-related challenges of the aging process;
• and an exploration of how aging is transforming family structures — particularly regarding intergenerational transfers, migration patterns, and women’s labor participation.

The research project led to the following publications:

• The publication of the research paper “Africa Facing Its Aging Population: What Are the Challenges for Public Policy?” (in French, June 2024);
• The release of “How can healthcare for older people in sub-Saharan Africa be improved?” (April 2024);
• The publication of “Health Statistics on Older Adults in Sub-Saharan Africa: A Literature Review” (in French).

In July 2023, a webinar from the Research Conversations series presented the project’s initial findings (in French only):

Africa is expected to face the challenge of an aging population in the coming decades. The first and foremost challenge lies in expanding social protection coverage, which is currently the lowest in the world: only 17% of the population is covered. This low rate is partly due to the predominance of the informal economy, which hinders the development of a contributory social protection system — particularly in rural areas. There is now a pressing need to strengthen public policies aimed at expanding social protection to a broader share of the population, both in rural and urban areas.

However, the evolution of social protection systems — particularly in health and pensions — rests on several key pillars that remain uncertain and have historically been prerequisites for their expansion:

• First, the effective collection and use of tax revenues to finance social protection;
• Second, the promotion of stronger links between pension and health coverage;
• And finally, sustained economic growth driven by a development model — historically industrial and manufacturing-based — that enabled the establishment of such public policies.

Yet in Africa, this economic model, centered on formal employment, has not taken root. Moreover, the impacts of climate change are raising fundamental questions about this development path, making it even more difficult to design and implement aging-related public policies — just as they are becoming increasingly necessary.