WASHINGTON, United States (CMC) — The Pan American Health Organisation (PAHO) and the Inter-American Development Bank (IDB) are urging countries across the Americas to strengthen long-term care systems, warning that fragmented services and inadequate public financing are leaving families to shoulder much of the burden of caring for people who need ongoing assistance.

A joint policy brief by the two organisations projects that 306 million people in the Americas, or more than one in four residents, will be aged 60 or older by 2050, increasing demand for long-term care.

“As the population ages, countries will need to expand services that help people maintain their autonomy, functional ability and quality of life, while supporting those who provide care,” the report stated.

The publication, released for the International Day of Care and Support on October 29, identifies fragmented health and social services and insufficient financing as major barriers to providing coordinated, affordable care.

PAHO said 88 per cent of countries responding to the 2025 midterm review of the United Nations Decade of Healthy Ageing reported including long-term care in national legislation, policies or plans, up from 61 per cent in 2020.

However, only 15 of PAHO’s 35 member states reported having a formal, publicly funded long-term care system. Of 27 countries responding to a separate question, only seven reported legally recognising informal caregivers and providing an entitlement to support.

“Investing in long-term care is not simply an expenditure,” said PAHO Deputy Director Mary Lou Valdez, adding that it can support families, strengthen the health workforce and advance universal health coverage.

The brief said families often fill gaps in formal services through unpaid care or direct payments. The economic value of informal long-term care is estimated at between 0.8 per cent and 4.9 per cent of annual gross domestic product (GDP).

It calls for closer coordination between health and social protection services, including shared assessments and care plans, clear responsibilities, quality standards and sustainable financing.

Uruguay’s National Integrated Care System, established in 2015, is cited as an example. It brings together government ministries, local authorities and civil society to coordinate care policies, services and financing. The system also uses standardised assessments to determine care needs and eligibility for support, with financing and co-payments linked to income.

PAHO said its Regional Policy on Long-Term Care 2025–2034 promotes better coordination, financing and quality of care through primary healthcare and community-based services, while supporting caregivers and helping people maintain their functional ability.

The organisations are scheduled to hold a high-level dialogue on October 29 to discuss how countries, including those in the Caribbean, can make long-term care more accessible, equitable and sustainable.