The demand for long-term care is surging across the Americas as the region's population ages rapidly. Projections indicate that by 2050, 306 million individuals in the Americas, representing more than one in four residents, will be aged 60 or older. Despite this demographic shift, a significant gap remains between policy recognition and actual service delivery. While 88% of countries in the region have incorporated long-term care into their legislation, policies, or plans, only 15 out of the 35 member states of the Pan American Health Organization (PAHO) possess a formal and publicly funded system for these services.
This disparity is the central focus of a joint report by PAHO and the Inter-American Development Bank (IDB), titled "Governance and Financing of Long-Term Care." The document highlights that fragmented services and insufficient public funding are leaving families to bear the brunt of both the responsibility and the financial costs. Although progress has been made in policy recognition, with 88% of responding countries reporting inclusion of long-term care compared to 61% in 2020, implementation lags behind. Furthermore, only seven of the 27 countries that responded to a specific inquiry reported legal recognition for informal caregivers and their right to receive support.
The report identifies that health and social protection services often operate independently, lacking coordinated assessments or care plans. This fragmentation results in individuals receiving assistance from various providers without the necessary continuity. Consequently, families frequently fill these gaps by providing unpaid care or paying directly for services. The economic value of this informal long-term care is estimated to represent between 0.8% and 4.9% of the annual Gross Domestic Product (GDP) in the region.
Mary Lou Valdez, Deputy Director of PAHO, emphasized that investing in long-term care is not merely an expense but a crucial investment in healthier people, stronger families, and more resilient societies. To address these challenges, Uruguay serves as a notable example of coordination. Established in 2015, its National Integrated Care System brings together ministries, local governments, and civil society under a shared governance structure. The system utilizes standardized assessments to determine care needs and eligibility, linking public funding and co-payments to income levels while enforcing quality standards and training requirements for care workers.
PAHO is currently supporting countries in strengthening long-term care policies and integrating services into health systems. Its Regional Long-Term Care Policy 2025-2034 promotes approaches to improve coordination, financing, and quality of care through primary health care and community services. The strategy focuses on maintaining individuals' functional capacity and providing essential support to caregivers.
Sources: UN News Spanish.