Caring in Aging Societies: A Shared Policy Agenda Between Europe and Latin America

Toward a Care Society as a Political Problem, Not Merely a Social One

I. Recent Demographic Transformations in Latin America and Europe (2015–2025)

In 2015, when discussions of demographic change in Latin America were still unfolding from a position of relative comfort—the so-called demographic dividend—the region appeared, at least on paper, to offer an exceptional window for economic growth and the expansion of social rights. A decade later, the landscape has been transformed at a speed that few institutions were prepared to manage. Colombia, which around 2015 recorded a Total Fertility Rate of approximately two children per woman, has transitioned in record time to levels characteristic of aging countries. In 2024, births fell by around 13.7% compared to the previous year—the sharpest decline of the past decade—according to the National Administrative Department of Statistics (DANE, by its Spanish acronym). This is not the gradual decline anticipated by demographic textbooks, but an abrupt inflection that overflows the linear models traditionally used to conceptualize this transition.

This decline is difficult to explain through any single lens. Material conditions, cultural transformations, and the expansion of rights all play a role. Recent analyses of Colombia's fertility collapse show that what is at stake is not merely a private decision, but a broader shift in the life expectations of women and families. This shift is linked to the unequal and fragmented—across class, territory, and ethno-racial identity—expansion of access to education, labor markets, and reproductive autonomy. Yet these advances collide with structural barriers that impede their effective exercise, including the absence of care networks, adverse economic and housing conditions, and the persistent gender inequalities embedded in domestic organization—factors that continue to place the burden of raising children disproportionately on women.

The The Real Fertility Crisis report by the United Nations Population Fund (UNFPA) (2025) frames this as a crisis of agency rather than desire: many people want to have children, but postpone or forgo doing so for economic, labor-related, and care-access reasons. Adding further complexity, the distinctiveness of Latin America's situation lies not only in the direction of change, but in its temporal compression. In the span of a decade, the region has concentrated transformations that took two or three generations in several European economies, as documented in recent comparative analyses by the Economic Commission for Latin America and the Caribbean (ECLAC).

Across the Atlantic, Europe presents a different yet intimately connected picture. Its demographic transition consolidated decades ago and is now reflected in a structurally aged population. The median age is approaching 45 years, and Eurostat projections foresee a sustained increase in the population aged 65 and older through the middle of the century. In much of the continent, the debate has shifted from whether aging will occur to how to sustain—fiscally and socially—societies where the ratio of working-age individuals to older persons is steadily narrowing.

Hence a paradox long absent from the political agenda: Europe and Latin America share a care crisis along divergent trajectories, though with important points of convergence. Europe faces a deficit of caregivers in a context of high longevity and diminished family networks. Latin America, by contrast, still holds relatively young cohorts, but this population is increasingly absorbed by the labor market or emigrating, which erodes the family-based arrangements that historically absorbed care work. Neither trajectory should be read as a mirror image of the other. Indeed, Latin America and the Caribbean maintains its own agenda, firmly anchored in a rights-based framework and in structural gender inequality, and cannot be conceived as merely a delayed version of the European path. The shared outcome, however, is a growing misalignment between who needs care, who can provide it, and how prepared states are to recognize that care has ceased to be a private matter and has become a central question of public policy.

II. The Architecture of the Crisis: From Family Caregiving to Nascent Public Systems

In 2022, the European Union adopted the European Care Strategy, acknowledging that care can no longer be conceived as solely a health matter, but must be understood as a pillar of economic sustainability and social cohesion. The central political and institutional shift is that care is no longer framed as the private responsibility of families, but as a public policy problem subject to standards, regulation, and stable funding. The European average expenditure on long-term care stands at around 1.7% of GDP, with Nordic countries and the Netherlands exceeding 2% and 3% respectively, while others such as Spain remain below 1%. In this sense, Europe serves as a live laboratory for what happens when care is recognized as a public good before the crisis fully materializes: time is gained and institutions are built, but demographic pressure does not relent—and care was never strictly private; it was always organized politically, even through state omission.

Latin America enters this conversation from a different vantage point: not through anticipation, but through shock. The COVID-19 pandemic laid bare that the region's care infrastructure is nascent, fragmented, or simply nonexistent. What had sustained itself for decades on the unpaid labor of women suddenly appeared as a critical link in the sustainability of both social life and economic systems. In 2022, the XV Regional Conference on Women in Latin America and the Caribbean crystallized this turning point in the Buenos Aires Commitment: governments recognized care as a right—the right to care, to be cared for, and to engage in self-care—and situated it explicitly at the center of the social and economic agenda. This formulation goes beyond the care economy: it proposes a care society grounded in rights and in the political reorganization of who cares and under what conditions.

From that point, a cascade of institutional innovations followed. In Colombia, Bogotá's District Care System (SIDICU) became one of the first comprehensive efforts to organize dispersed services under the principle of co-responsibility. Mexico, for its part, has incorporated in its 2026 Federal Expenditure Budget the Cross-Cutting Annex 31 “Consolidating a Care Society” with resources equivalent to approximately 1.2% of GDP—though analysts note that much of this reflects a reclassification of existing programs rather than new funding. The region has succeeded in identifying the problem and beginning to design systems, but the gap between formal recognition and effective implementation capacity remains enormous. Deficits in infrastructure, personnel training, and financial sustainability mean that care tends to fit better in political discourse than in the daily lives of those who provide and receive it.

III. International Cooperation as a Facilitator (and as a Frontier) of Change

If demographic transformations connect Europe and Latin America, international cooperation helps explain why their care agendas are beginning to converge. UN Women has advanced national roadmaps for comprehensive care systems, contributing conceptual frameworks—co-responsibility, the care economy, women's economic autonomy—that are translated into laws, plans, and institutional arrangements. At the biregional level, the Care Pact between the European Union and CELAC, launched in Santa Marta in 2025, is the most visible symbol of this convergence—a political declaration establishing a framework for cooperation to promote the care economy and facilitate experience-sharing between regions.

When the Inter-American Development Bank (IDB) or the Development Bank of Latin America and the Caribbean (CAF) prioritize the care economy in their agendas—through financing for diagnostics, cost studies, or pilot programs—they not only provide resources but also define analytical frameworks and policy solutions. In this context, international financing operates in a dual manner: it enables countries with fiscal constraints to experiment with care systems, develop institutional capacity, and generate empirical evidence; at the same time, it channels interventions toward policy repertoires aligned with the priorities of the funders. For Latin America, this raises questions about the region's capacity to adapt these agendas autonomously—integrating elements of its historical trajectory in social rights and its specific patterns of inequality, such as persistent gender disparities, regional gaps, and existing legal frameworks—rather than limiting itself to transposing external models. The extent to which it achieves this appropriation will determine the long-term sustainability and relevance of its care systems.

IV. The Unanswered Political Question: Who Pays, and How?

Europe devotes an average of approximately 1.7% of GDP to long-term care, while various estimates—including those from the Mexican Institute for Competitiveness (IMCO) and ECLAC projections—suggest that Latin America would require between 1.8% and 2.5% of GDP to build minimally robust universal systems. This gap is not merely arithmetical: it reveals that the region starts from a historic shortfall in social investment and cannot improvise financing through marginal expenditure reallocation.

The deeper political question is not simply how much the care economy will cost, but who will bear that cost and through what redistributive arrangements. The options are well known but politically difficult: progressive tax reforms, the elimination of regressive exemptions, socially oriented borrowing, and payroll-based contributions that engage employers in financing care. As ECLAC and UN Women argue in their gender-equality fiscal agenda, tax systems reproduce gender biases, structural regressivity, insufficient weight on direct wealth and property taxes, and unassessed tax expenditures—such that financing care requires simultaneously examining public revenue and expenditure through a redistributive lens. The EU-CELAC Care Pact opens a window for this financing to enter the biregional agenda, but as a non-binding declaration it does not substitute for domestic decisions on taxation, spending priorities, and fiscal rules.

In practice, this means that governments will need to rewrite three components of their fiscal architecture. First, fiscal responsibility frameworks must stop treating care expenditure as a current cost and instead recognize it as an investment in human capital and health system sustainability. Second, tax policies must explicitly incorporate demographic aging when reviewing poorly targeted subsidies and making room for wealth taxes to finance old-age protection. Third, international cooperation must move beyond fragmented projects toward long-term co-financing commitments, in which multilateral organizations assume part of the political risk of expanding the care economy in fiscally constrained societies.

Ultimately, the care economy compels us to confront an uncomfortable but inescapable discussion. In societies that are aging and having fewer children, the fiction that care can continue to rest on the unpaid time of women is no longer tenable. This model is not only unsustainable going forward—it is structurally unjust at its origins, having always rested on gender inequality and the invisibilization of reproductive labor. Making care an enforceable right means recognizing it as a public good that requires taxes, clear rules, and clear priorities. The question is no longer whether countries can afford to invest between 1.8% and 2.5% of GDP in care, but whether they can afford not to.

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Ángela Guarín Aristizábal is an Associate Professor at the Alberto Lleras Camargo School of Government at Universidad de los Andes. She holds a Ph.D. in Social Welfare and a Master's in Social Work from the University of Wisconsin–Madison, and degrees in Sociology and Social Communication from Universidad Javeriana, Bogotá. Her research focuses on family structure changes, child and family social policies, gender studies, poverty, and inequality. Recent work examines child support systems in Colombia from a comparative perspective, gender-based violence, social protection, and migration. Her broader areas of expertise include care economy, public policy, and the wellbeing of vulnerable populations.

Nixon Daniel Vera García is a Researcher at the Alberto Lleras Camargo School of Government at Universidad de los Andes, where he holds a Master of Public Health (c), and degrees in Economics and Government & Public Affairs. His research interests span impact assessment, public policy, public health, regional and urban economics, conflict, development, and collaborative governance. He is a member of the Health Protect research network, an initiative funded by MRC UKRI and led by the London School of Economics that brings together researchers from Brazil, Argentina, Colombia, Ecuador, Mexico, and the United Kingdom. Health Protect focuses on understanding how poverty and inequality affect health in Latin America; by combining economic and health microsimulation models, the project evaluates the impact and cost-effectiveness of social protection policies on morbidity, mortality, and health inequalities.

The opinions expressed in this blog are solely those of the author and do not reflect the opinions of the EULAS Network.