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　　A new report says African governments are ill prepared to handle the growing number of people over age 65. The African Development Bank is raising concerns over the lack of health insurance and pensions.
一份新的报告说，非洲政府还没准备好应对年龄65以上人口持续增加的问题。非洲开发银行对这个年龄层的人缺乏医疗保险和退休金忧心忡忡。
The report says the population in Africa, as in other parts of the world, is getting older. Currently, there are 36 million people on the continent 65 years and above. That’s 3.6 percent of the population, up from 3.3 percent 10 years ago. That could rise to 4.5 percent by 2030 and 10 percent by 2050.
这份报告说，非洲像世界其他地方一样都面临了人口老化。目前，非洲大陆65岁以上的人达到3千6百万人。这是占非洲总人口的3.6%，10年前这个数字只有3.3%。老龄人口可能在2030年前增加到4.5% ，在2050年前达到10%。
No safety nets
The African Development Bank says, “Aging is highly linked with long-term physical and mental disability and a number of long-term chronic¹ conditions.”
非洲开发银行说，“老化和长期身心障碍和许多慢性病都有高度相关”。
“Africa is not well prepared to care for its aging population right now. But…it needs to prepare for this phenomenon,” said Professor Mthuli Ncube, the African Development Bank’s chief economist².
努库比教授是非洲开发银行的首席经济学家。努库比说：“现在非洲人口老化的照顾工作还不完善，但非洲必须为这个现象作好准备。”
African nations spend far less on healthcare than developed nations do -- about $26 per person per year.
非洲国家的保健开支远比发达国家低，每年每人平均只有26美元。
“Not so many countries have well developed medical aid schemes for the elderly, whether they are privately³ provided schemes or indeed government schemes. And number two, if you look at the pension schemes, the pension industries, (they’re) not well developed in some of the countries. And here one is talking of a pension industry where both the employer and employee, while the employee is at a working age, contribute. These types of industries are also not well developed,” he said.
努库比说：“许多国家都没有发展老年人医疗体系，无论是私部门或政府提供的体系。其次，一些国家的退休金体系或产业也不健全。我们谈退休产业是还在工作年龄的雇员和雇主一同付的退休金。这种类型的产业也还没建立起来。”
The bank’s report says “contributory pension plans” cover very few people due to the nature of many jobs and livelihoods⁴. Most of the population works in the informal or agricultural sectors⁶ that offer little, if any, social security protection.
非洲开发银行的报告说，由于许多工作本身的性质，只有很少人受惠于退休金计划。大部分非洲人的工作都是非正式或者和农业相关，这些工作所能提供的社会保障很少。
The report adds that households headed by older Africans are among the poorest. For example, in Kenya and Tanzania, such households have a poverty rate over 20% higher than the national average.
这份报告还指出，由非洲老年人主掌的家庭是最贫穷的之一。例如，在肯尼亚和坦桑尼亚，这种家庭的贫穷率比全国平均高出了20%。
Time to act
Ncube said African governments failed to take action on health insurance and pensions because they were busy with economic reforms.
努库比说，非洲政府因为忙于发展经济，未能对医疗保险和退休金采取行动。
“If you look at what happened in Africa in the 80s, which is when quite a bit of the reforms were done, it was about economic structural⁷ adjustment. It was about macroeconomic stability. But now it’s time to move to the second phase, which is regulatory reforms. It’s about deepening capital markets, unleashing⁸ new institutions. All things that are regulatory need to be put in place as the second level of institution building,” he said.
努库比说：“上世纪80年代的非洲，当时一些关于经济结构的改革已经完成，那个目的是宏观经济的稳定。但现在应该要到第二阶段了，那就是管理改革，像深化资本市场、建立新的机构。所有这些管理措施都必须在建立制度的第二阶段完成。”
Another challenge for Africa is the decline of informal systems of social protection. That is, cash and support from both the extended family and community sources.
非洲另一个挑战是，社会保障的非正式体系在率退。那就是来自大家庭和社区的现金和支持变少。
“The extended family issue is still embedded⁹ in the African culture. But over time, it’s going to get eroded¹⁰ as middle class values set in, as urbanization accelerates. We estimate that the urban population will grow from something like 40 percent currently to closer to 75 percent in 50 years time. All of that erodes¹¹ the extended family culture and systems and all of that,” he said.
努库比说：“大家庭仍深植于非洲文化。但随着时间推移，受到中产阶级价值的影响以及都市化加速，它在逐渐式微。我们估计，都市人口将在50年的时间里从现在的40%变成75%。这些都将使大家庭文化和体系没落。”
As the extended family erodes, he said, the nuclear family will become dominant¹². A nuclear family is defined as a mother, father and children sharing living quarters.
随着大家庭没落，他说，核心家庭会变成主流。核心家庭的定义是居住在一起的父母亲和小孩。
The African Development Bank recommends governments help implement¹³ health insurance and pension plans.
非洲开发银行建议政府协助实施医疗保险和退休金计划。
“Even at the current level of population of just over a billion people, there is a burgeoning¹⁴ middle class. The middle class are naturally living longer. Even people who are in the rural areas are also beginning to live longer. So over time, the next 50 years, the issue of the elderly will become a problem,” said Ncube.
努库比说：“即使从现在10亿的人口水平来看，中产阶级在兴起。中产阶级本来就比较长寿。即使是在乡村地区，人们的寿命也开始变长，所以在未来50年，老年人口将形成一个问题。”
What’s more, there are fewer caregivers because of the millions who’ve died from HIV/AIDS. This can be seen in South Africa, Botswana, Lesotho, Zimbabwe and Swaziland.
更重要的是，非洲有数百万人死于艾滋病使得照顾老年人的人变少。这在南非、博茨瓦纳、莱索托、津巴布韦和斯威士兰都有这样的情况。
Ncube said African governments don’t have to handle the health insurance burden alone.
努库比说，非洲政府不一定得一肩担起医疗保险的重担。
“Not only is it an imperative,” he said, ”but also it’s an opportunity for the private sector⁵ to add its bit in this regard, you know, the launch of privately owned companies, health care insurance, medical insurance and all of that. All these are private sector opportunities that are there to be taken.”
努库比说：“不仅因为这很急迫，这对私部门来说也是参与例如成立私人企业、健康照顾保险、医疗保险的机会。这些都是私部门的机会。”
The report also recommends that African governments consider providing access to both free and subsidized health services, medications and long-term health care facilities for the elderly.
报告同时建议，非洲政府可以考虑对老年人提供免费和受补助的健康服务、医疗和长期健康照顾机构。