Since the collapse of communism, Albania has faced two major demographic shifts. Its population has shrunk from 3.2 million in 1990 to 2.4 million in 2023, driven primarily by migration, with a net decline of approximately 20,000 annually. At the same time, declining fertility rates and large-scale net migration have accelerated population aging at an unprecedented rate: the share of those aged 65 and older rose from 7 to 14 per cent in just 17 years and from 14 to 20 per cent in only 7 years. Projections show that nearly 40 per cent of the population will be over 65 within just 6 years, the fastest ageing rate globally.
Based on the 2023 census5 and population projections, by 2050, those aged 65+ in Albania will constitute 26.4 per cent of the total population, with long-term care needs expected to grow from 90,900 in 2020 to 161,100 by 2050. However, existing municipal social care systems are severely under-resourced, serving just 1.6 per cent of those in need. Residential care institutions accommodate only 0.78 per cent of eligible elderly, and community care reaches just 1.8 per cent, with minimal support for home care services. With costs estimated at 1.08 per cent of GDP, urgent investment is needed to expand residential, community-based, and home-based care services and improve geographical coverage. Furthermore, a Survey of Loneliness conducted by UNFPA in partnership with INSTAT and University College London (UCL), found that while 18.5 per cent of older persons do not feel lonely, 58 per cent report feeling somewhat lonely, and 23.3 per cent describe themselves as lonely or extremely lonely. Elderly living alone in rural and remote areas, comprising 46 per cent of the 65+ population, are especially vulnerable, often lacking family support and access to formal care services. They also face disadvantages in pensions, healthcare access, and social protection programs.
5 Instat (2023). Albania Population and Housing Census 2023
Albania’s dependency ratio for older persons has risen from 16.4 in 2011 to 24.4 per cent in 2023, surpassing that of young people. The Ageing Index shows 102.5 older individuals for every 100 young people in 20236, with the older adults being the only age group growing amid an overall population decline. Fertility has remained below the replacement level of 2.1 children per women for three decades, dropping to 1.24 in 2023—one of the lowest in Europe. Natural population decline has also emerged, with deaths now surpassing births. Meanwhile, life expectancy has improved significantly rising from 75.3 to 77.3 years for men and from 79.8 to 80.9 years for women over the past decade. Infant mortality is low at 7 deaths per 1,000 live births, and maternal mortality is minimal.
6 Population aged 65 and older compared to population aged 0-14 years
Achieving sustainable development and demographic resilience requires addressing all aspects of population change to enable effective long-term planning. Development becomes increasingly unattainable when the main driver of progress, the youth, continue to leave the country at the current alarming rate. Data from the 2023 census shows that this trend persists, with net migration remaining steady at over 40,000 people leaving the country annually since 2021. Sustainable development is inconceivable without addressing the needs and aspirations of young people in the coming decade.
Pursuing sustainable development goals require addressing demographic resilience. In Albania, this means anticipating trends and designing policies to adapt to change. With UNFPA’s support, institutions are tackling the pressing challenges of providing affordable, high-quality long-term care for the rapidly ageing population. Access to such care is a cornerstone of social security and essential for a robust national social protection system.
UNFPA in Albania has mobilized efforts and resources across several areas to address ageing challenges, in alignment with the MIPAA7 and SDG targets:
7 Madrid International Plan of Action on Ageing 2002
1.Strengthening data systems:
Population data collection, projections, and vulnerability mapping form the basis for informed policymaking. UNFPA supports the census and advanced demographic analyses to guide evidence-based actions addressing inequalities and the needs of older persons.
2.Policy development and implementation:
The National Action Plan on Ageing (2020-2024) was the first to integrate long-term care for older persons. UNCT is collaborating with the government to draft the next plan (2025-2030), ensuring alignment with global best practices. Through the Leave No One Behind Joint Programme, UNFPA and other UN agencies help municipalities develop evidence-based social plans, incorporating comprehensive care strategies for ageing populations.
3.Institutional capacity building:
The Leave No One Behind program strengthens municipalities’ ability to develop local policies and to deliver integrated care services. UNFPA’s advocacy led to the establishment of the Population Parliamentary Group in July 2023, boosting legislative focus on population ageing.
4.Expanding access to social and health services:
With fewer than two per cent of older persons receiving formal care, UNFPA focuses on expanding residential, community, and home-based care services. Training programs for healthcare and social service professionals emphasize holistic and inclusive approaches.
5.Fostering public dialogue:
UNFPA launched a nine-part TV program on demographic challenges, raising awareness about ageing and engaging experts and decision-makers in meaningful discussions.
Efforts to address ageing directly support SDG 1 (No Poverty), SDG 3 (Good Health and Well-Being), SDG 10 (Reduced Inequalities), and SDG 11 (Sustainable Cities and Communities), while promoting intergenerational equity, a core principle of the 2030 Agenda. Targeted investments in ageing populations foster inclusive societies built on shared prosperity.
We share a collective responsibility to recognize the ageing population not just as beneficiaries but as active contributors to development. To this end, we urge all national institutions to:
Prioritize ageing in national development agendas.
Invest in universal social protection systems, emphasizing the expansion of long-term care services.
Strengthen national and regional collaboration for effective implementation of MIPAA commitments effectively.
United Nations Economic Commission for Europe
Palais des Nations, Geneva
