Africa’s demographic shift isn’t just accelerating; it’s compressed. The population of people over 60 will nearly triple from 74 million to more than 225 million by 2050, the fastest rise globally. This piece highlights the erosion of traditional safety nets, the policy gaps this creates, and the practical steps needed to turn a looming crisis into a Longevity Dividend.
Introduction: Africa’s Silent Demographic Crisis
As each day passes, change is constant, but one truth remains: growing old is inevitable. This event is accelerating globally, pushing population ageing to the forefront of policy debates. For years, the discussion has rightfully focused on Asia and Europe, where the effects of shrinking birthrates are already being experienced, as exemplified by Japan, where almost a third of the population is over 65.
However, a crisis of a different nature is brewing on the continent, often cited as the world’s most youthful. In Africa, the demographic shift is not just accelerating; it is compressed. The number of people aged 60 and over is projected to nearly triple between 2020 and 2050, soaring from roughly 74 million to over 225 million. This growth rate will surpass every other region globally. Developed nations had a century or more to build social security systems; most African nations have barely a few decades. The World Health Organisation (WHO) noted that globally, the number of people aged 60 and older outnumbered children younger than 5 years in 2020, demonstrating the universal scale of the shift.
Without immediate, targeted global and domestic investment, this demographic acceleration risks becoming a humanitarian and economic crisis. This article examines the consequences of this accelerated shift, detailing the loss of traditional safety nets and the critical policy gaps in Africa's major economies, before proposing actionable solutions that could transform this crisis into a Longevity Dividend.
The Compressed Window and the Erosion of the Intergenerational Bargain
The rise in Africa’s older population is a marker of success, a testament to public health gains that have increased life expectancy significantly. The problem lies not in the numbers but in the lack of systemic preparation. This compressed window for adaptation is colliding head-on with the collapse of the continent’s primary care system: the extended family.
The bedrock of eldercare in Africa has always been the intergenerational bargain, where children provide financial and physical care for their parents in old age. This system is rapidly dissolving under immense strain from interconnected socio-economic changes:
- Rural-to-Urban Migration: Young, working-age adults are migrating to cities for economic opportunity, leaving older people in rural areas with little support.
- Changing Household Structure: As families urbanise and adopt smaller structures, the number of potential caregivers per older adult decreases drastically.
- Prior Health Epidemics: Previous epidemics like Covid-19, HIV/Aids have further strained family networks, leaving many older persons as caregivers to grandchildren in vulnerable "skip-generation" households.
These forces are dismantling the traditional safety net, forcing a growing number of older Africans into poverty and extreme vulnerability without an adequate public support system to replace it.
Policy Gaps in Income Security: Nigeria and South Africa
The most critical gap in Africa’s preparedness is income security. Most of the continent’s elderly population faces retirement without formal savings or pensions, exposing them to chronic poverty. The contrasting policies in South Africa and Nigeria highlight the extremes of this challenge: a functioning policy that is still incomplete, versus a policy that barely functions.
In South Africa, the government provides a crucial Older Persons’ Grant (OPG), a non-contributory, means-tested cash grant. The OPG is a recognised success in poverty alleviation, benefiting not only the elderly recipient but often the entire extended family through a vital intergenerational transfer of funds. However, the OPG addresses only income security while the publicly funded Long-Term Care (LTC) system remains fragmented, under-resourced, and deeply marked by historical socio-economic disparities. However, even though South Africa manages to prevent financial destitution, it fails to guarantee dignity and physical care for its frail elderly population.
The situation is more dire in Nigeria, which highlights the challenge of scale. Nigeria’s primary retirement system, the Contributory Pension Scheme (CPS), is mandatory only for a fraction of the working population, employees in firms with 15 or more staff. Given that most of the Nigerian labour exists within the informal economy and small-scale operations, the CPS covers only a tiny percentage of the total workforce. Consequently, Nigeria is preparing to host the continent's largest future older population without the fundamental financial mechanism required to support them, relying instead on a family system that is rapidly dissolving. This policy structure is designed for the few, not the millions, showcasing a deep misalignment with the African labour market reality.
Health System Strain and the NCD Burden: The Kenya Case
The unpreparedness extends critically to health infrastructure. As life expectancy rises, the burden of disease shifts from acute, infectious illnesses to chronic, age-related Non-Communicable Diseases (NCDs), a shift for which public health systems are deeply unprepared.
Kenya exemplifies this challenge. Rapid urbanisation and changing lifestyles are accelerating the onset of NCDs, such as cardiovascular disease and diabetes, among the elderly. The existing healthcare infrastructure, built on an acute care model, lacks a specialised workforce, consistent funding, and logistical capacity for chronic disease management and long-term care.
Across the continent, there is a severe shortage of a specialised geriatric workforce. Geriatricians, geriatric nurses, and rehabilitation specialists are rare. Without this capacity, the health costs associated with the ageing boom will overwhelm national budgets. The lack of integration between health services and social services further complicates matters, leaving the frail elderly without coordinated support.
Actionable Solutions: Policies for a Longevity Dividend
To prevent this demographic shift from becoming a crisis, African governments must implement proactive policies that leverage community strengths and acknowledge the reality of the informal economy. The focus must be on investment in human capital and hybrid social protection.
I. Hybrid Universal Pension Model
African nations must move beyond formal contributory schemes, which exclude the majority (as seen in Nigeria). Governments should implement a tax-financed, non-contributory Universal Basic Grant for all older persons (expanding Kenya’s Inua Jamii program). This should be funded by a broad-based tax (such as VAT) to capture revenue from the informal economy. This model ensures a baseline of income security and provides dignity to millions currently excluded.
II. Community-Based Long-Term Care Subsidies
To address the physical care gap highlighted by the South African case, governments must invest in professionalising and subsidising home and community-based care (CBC). This involves:
III. Providing public subsidies to older people for CBC services.
Establishing comprehensive training programs for local community workers in geriatric, palliative, and chronic disease management.
Formalising these roles with a guaranteed, reliable stipend, thereby creating a new, sustainable job sector (the "Care Economy") that utilises local community capacity.
IV. Geriatric Workforce Integration
To quickly address the health service strain (the Kenya NCD challenge), health ministries must implement mandatory geriatric and healthy ageing training modules for all graduating doctors, nurses, and especially Community Health Workers (CHWs). This strategy rapidly injects baseline geriatric competence into the primary care system, the frontline of chronic disease management, without waiting for the decades-long process of training specialised geriatricians.
Conclusion: Turning Crisis into Opportunity
The demographic future of Africa is not one of slow, manageable changes, but of rapid acceleration. The window for policy intervention is closing. The failure to reform social security and healthcare systems now, systems that currently rely on an eroding family structure, will lead to immense economic and human costs for the next generation.
By adopting integrated and hybrid social protection models, universal income grants, subsidised community-based care, and immediate geriatric training, African nations can begin to build a resilient and inclusive future. The goal is to move beyond viewing the elderly as a dependency burden and instead recognise the potential for a Longevity Dividend: an extended period of healthy, engaged, and productive lives. The time to invest in Africa's older generation is now.
Author
Christine Ine / Policy Analyst