By Himanshu Rath
Ageing is not a peripheral issue; it is central to the region’s development trajectory.
South Asia is home to nearly one-fourth of the global population, which stands at a decisive moment in its human rights journey. Comprising India, Pakistan, Bangladesh, Nepal, Sri Lanka, Bhutan, Maldives, and Afghanistan, the region reflects extraordinary cultural diversity and democratic aspirations. Yet it continues to grapple with structural inequalities, restricted civic spaces, gender injustice, economic vulnerability, and conflict. Among these challenges lies an often-overlooked but urgent concern: the human rights of older persons, particularly in India.
A demographic shift transforming the region
Ageing is no longer a phenomenon confined to high-income nations. By 2050, nearly four out of five older persons worldwide will live in low- and middle-income countries. South Asia exemplifies this shift. India alone has more than 150 million people aged 60 and above, and this number is expected to exceed 300 million by mid-century. Bangladesh and Pakistan are witnessing similar demographic acceleration, while Sri Lanka faces rapid ageing alongside limited fiscal capacity.
Across the region, social protection systems remain fragile, pension coverage is uneven, healthcare infrastructure is overstretched, and informal employment dominates working lives, leaving millions without financial security in old age.
For many older persons, human rights violations are not dramatic incidents; they are embedded in daily life. Long queues for insufficient pensions, unaffordable medicines, inaccessible public transport, digital exclusion from essential services, and increasing social isolation reflect systemic gaps rather than isolated failures.
India: Constitutional promise, implementation gaps
India’s Constitution guarantees equality and dignity to all citizens. The Maintenance and Welfare of Parents and Senior Citizens Act, 2007, and pension schemes under the National Social Assistance Programme signal legislative commitment. However, significant gaps remain between policy intent and lived reality.
A large proportion of older Indians rely entirely on informal family support. Pension amounts in many states remain inadequate to meet basic needs. Healthcare expenditure remains modest relative to demand, and out-of-pocket medical costs continue to burden households heavily. Rural older persons often travel long distances for treatment, while urban poor elders struggle with affordability.
Digital governance reforms, Aadhaar-linked services, online banking, and digital documentation have improved administrative efficiency but have unintentionally deepened exclusion for many seniors unfamiliar with technology. Without assisted service models, digitalization risks marginalizing those it aims to serve.
Gender intensifies vulnerability. Older women, especially widows, face higher poverty rates, limited property rights enforcement, and social abandonment. In many communities, older women remain invisible in data systems and policy prioritization.
During the pandemic, these vulnerabilities were exposed when older persons faced disproportionate mortality, restricted mobility, disrupted healthcare access, and heightened loneliness. The crisis underscored how fragile support systems can become under stress.
Broader human rights concerns in South Asia
The ageing challenge unfolds within a wider human rights context marked by persistent strain across the region:
While these issues receive considerable attention, ageing rarely occupies a central place in national human rights dialogues, despite its growing demographic and social significance.
Moving beyond survival
In resource-constrained environments, governments often prioritize minimal survival support, food security schemes, modest pensions, and primary healthcare. These measures are essential, but survival alone cannot define human rights.
A rights-based framework must go further. Older persons are entitled not only to subsistence but also to autonomy, participation, inclusion, and dignity. Policies must ensure:
Older persons are not passive beneficiaries of welfare. They are contributors to families, communities, and economies. Recognizing this contribution transforms the narrative from burden to empowerment.
Community-based innovations: Practical pathways
Across South Asia, community-embedded initiatives demonstrate that progress is possible even within fiscal constraints. Low-cost, volunteer-driven, culturally rooted interventions can effectively reduce isolation, promote preventive healthcare, and strengthen intergenerational bonds.
In India, civil society organizations have pioneered peer support groups, health camps, helplines, and digital assistance services that reach thousands daily. These models succeed because they build upon existing social capital rather than waiting for large institutional expansion.
Intergenerational engagement is particularly vital. Today’s youth are tomorrow’s elders. Fostering empathy and shared responsibility strengthens social cohesion and counters ageist attitudes. A society that protects its older citizens ultimately protects its own future.
The case for stronger legal frameworks
Globally, discussions continue regarding a binding international convention on the rights of older persons. Such an instrument could clarify standards, strengthen accountability, and elevate ageing within the human rights agenda. However, legal frameworks alone are insufficient.
Effective protection requires sustained financing, institutional capacity, and technical cooperation, particularly in low- and middle-income countries where demographic ageing is fastest. Representation from Asia-Pacific and African nations must shape global standards so that international instruments reflect the realities of ageing in resource-constrained settings.
National governments must align law with practical implementation. Without adequate budgets, trained personnel, and monitoring systems, even well-crafted legislation remains symbolic.
India’s leadership responsibility
As the largest democracy in South Asia and home to the region’s largest elderly population, India carries particular responsibility. Its judicial interpretations, welfare schemes, digital governance innovations, and community models can set precedents across neighboring countries.
India’s policy direction will influence regional norms. Expanding pension adequacy, strengthening primary and geriatric healthcare, investing in age-friendly urban planning, and integrating elder rights into mainstream human rights discourse can position the country as a leader in rights-based ageing policy.
A defining choice for South Asia
South Asia stands at a crossroads. Demographic transformation is irreversible. The question is whether governments and societies will allow ageing to deepen inequality, or transform it into an opportunity for solidarity and structural reform.
The true measure of progress will not lie in policy documents alone. It will be reflected in whether older persons in rural villages, urban slums, and informal settlements experience tangible improvements:
Human rights must evolve to meet demographic reality. Ageing is not a peripheral issue; it is central to the region’s development trajectory.
If South Asia embraces a rights-based, inclusive approach, it can convert demographic change into a force for intergenerational justice and social resilience. If it does not, the cost will be measured in deepened inequality, preventable suffering, and lost human potential.
The region’s human rights legacy will be defined by how it treats its most experienced citizens. The choice is urgent, and the time to act is now.
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(Himanshu Rath is the founder of Agewell Foundation, a not‐for‐profit organization working for the welfare and empowerment of the elderly in India)
