PARTICIPATE: a rights-based framework to include older people's health-care needs in humanitarian crises

The present paper concludes The Lancet Healthy Longevity Series on the health-care rights and needs of older people in humanitarian crises and outlines a rights-based framework for age-inclusive humanitarian public health approaches. The framework was shaped by an iterative process of consultation with key stakeholders and emphasises five fundamental rights that should guide humanitarian action. The fundamental rights include the rights to visibility and meaningful participation; non-discrimination; health; social care and protection from violence, exploitation, and neglect; and autonomy. We translate these fundamental rights into a concrete framework of actions, adopting the acronym PARTICIPATE, which aims to ensure inclusion and reduce excess mortality, morbidity, disability, exclusion, and care dependence among older people, while upholding their dignity, autonomy, and inherent worth in humanitarian crises. An accelerated commitment from humanitarian actors is urgently needed to meet the growing and diverse health-care rights and needs of older people, close gaps in health-care access, and embed accountability mechanisms for equitable, age-inclusive care. With consistent, rights-based engagement, genuine participation, and accountable systems, the humanitarian sector can uphold the rights and meet the health-care needs of older people, acknowledge their crucial roles and contributions, strengthen community resilience, and ensure justice across generations, thus remaining true to the core principles of humanitarian action.