Is there any major segment of the world's population more systematically excluded from discussions about the world's future than older men and women in developing countries? How do we explain the dehumanising, undemocratic and damaging prevalence of what MSF UK Director Marc Dubois described in his excellent personal blog this week as "See No Fogeys, Hear No Fogeys, Help No Fogeys"?
As I complete my first 100 days as the new Chief Executive of HelpAge International, I have seen first-hand that what my colleagues all told me when I joined was true - even the most sophisticated and well-intentioned international gatherings and processes still seem to possess a massive blind spot when it comes to ageing in the developing world.
In my role to date, I have spent time at two key external fora: Davos last week, and before that I went in late December to New York to meet those with the greatest insights and influence over what will emerge as the Post-2015 development framework and goals. Take the two together, and it makes a very frustrating picture, which I can summarise as follows:
At Davos, there was excellent and earnest discussion about population ageing, but none of it focused on developing countries. At the UN in New York, there was excellent and earnest discussion about developing countries, but none of it focused on ageing and older people.
Let's take the Davos discussions first. The implications of population ageing have been high on the agenda of the World Economic Forum for many years. It's exactly the sort of issue the organisers pride themselves on - multi-dimensional, profound, complex and, above all, immediate: by 2030 there will be 1 billion people over the age of 60 - more than children under 10. There were some outstanding discussions - on the implications for health, care and social security systems, on the terrifying prospect of ever greater prevalence of dementia, but also positive ones about how older people were increasingly key to the skilled labor market.
However, almost every word spoken focused on ageing in highly developed contexts. This was also reflected in the representation at the specialist meetings. I met and heard very few participants from Asia, Latin America, Central Europe, the Middle East and Africa at these sessions.
The recurrent theme was one of adaptation - how do social security and health systems, and formal labour markets evolve as demographic change takes root? Yet every discussion on adaptation began from the assumption that there are significant existing services, entitlements and systems already in place.
But what about the hundreds of millions of older people in countries without this social security architecture, and where little or no such services exist? By 2050, 80% of the world's population over 60 will be living in developing countries. What sort of older age can they look forward to?
I didn't find the answer to that question in New York in late December. There is interest in and understanding of the issue, there is no dispute over the demographic data that we quote, or the ethical points about inclusion that we make. But, as one very senior UN official said to me - "I agree, but nobody here wants to talk about this."
Dig deeper and people will say it's because the priority at New York is on youth, women and children. Building a better world for these key demographic groups is obviously vital, but why does this seem to entail ignoring older people? As Dubois puts it in his blog, "The way our brains work, it seems that if you are focused on one thing you will not see something else. The elderly have different needs from those of children, and you need to look in a different way."
In the end, that's all we want for older people in developing countries: inclusion. HelpAge International doesn't want or expect next year's gathering at Davos or the final Post-MDG framework to be primarily constructed around the needs and capabilities of older people in developing countries. But we do expect the current age blindness to fall away.
Given the rapid pace of ageing in developing countries, starting to think and talk about this is hardly crazy or special interest group lobbying. It's about inclusion, human rights, demographic reality and common sense.
Toby Porter is CEO of HelpAge International, a global movement for the rights of older people. Their Global AgeWatch Index (www.globalagewatch.org) is the first ever tool to measure the quality of life and wellbeing of older people around the world.