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Building an Inclusive, Resilient Future for Every Generation

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Sarawak stands at a demographic crossroads. The state is ageing faster than most Malaysian regions and, for the first time in its history, is projected to become an “ageing state” as early as 2028, two (2) years ahead of the national projection of 2030. Data from the Department of Statistics Malaysia (DOSM) confirms that individuals aged 60 and above already constitute 14 per cent of Sarawak’s population, a figure markedly above the national average of 12 per cent. The median age of Malaysia’s population reached 31.3 years in 2025, while the old age dependency ratio for those 65 and over rose to 11.4. Sarawak’s population is ageing at a rate of 0.55 per cent per year, and the state is expected to reach 15 per cent senior citizens by 2030. In certain districts, the proportion is even more startling: Lubok Antu recorded the highest proportion of elderly residents in the entire country at 15.7 per cent in 2025. The Minister of Women, Early Childhood and Community Wellbeing Development, Dato Sri Hajah Fatimah Abdullah, has warned that the proportion of elderly residents is expected to double by 2028, when 16 per cent of Sarawakians will be 60 or older.

This demographic transformation, while a testament to improved healthcare and rising life expectancy, carries profound and multifaceted implications for Sarawak’s economy, social fabric, and development trajectory. The state government, under the leadership of Premier Sarawak Datuk Patinggi Tan Sri (Dr) Abang Haji Abdul Rahman Zohari bin Tun Datuk Abang Haji Openg, has articulated an ambitious vision of an age-friendly Sarawak. Yet, a critical examination reveals significant policy gaps, implementation loopholes, and systemic weaknesses that demand urgent attention. At the same time, a substantial suite of government initiatives, at both state and federal levels, has begun to form a coordinated response. This article provides a comprehensive critical analysis of Sarawak’s ageing society, incorporating the Premier Sarawak’s vision, policy frameworks such as the Post-COVID-19 Development Strategy 2030 (PCDS 2030), national health and social policies, and the global imperatives of the Sustainable Development Goals (SDGs) and Environmental, Social and Governance (ESG) principles. It anchors the discussion in the core values of resilience, authenticity, kindness, advocacy, and nurturing, arguing that Sarawak’s response to ageing must move beyond rhetoric and into measurable, compassionate, and strategically communicated action. It then sets out a series of comprehensive, practical, and achievable proposals to bridge the gap between policy ambition and ground reality.

Productivity, Dependency, and Fiscal Sustainability

The economic consequences of an ageing society are among the most urgent concerns for Sarawak. The state’s population growth is the lowest in the country, with the annual birth rate having declined sharply from 2.76 babies per couple in 2001 to 1.69 in 2023. Simultaneously, the number of newborns has halved from approximately 40,000 to 20,000 per year. This dual phenomenon of fewer births and longer lifespans is shrinking Sarawak’s working-age cohort while expanding the dependent elderly population. A contracting labour force translates into diminished economic output, a shrinking tax base, and mounting pressure on public finances. Malaysia’s labour force participation rate held steady at 70.9 per cent in early 2026, but elderly workforce participation for ages 60 to 64 remains below the 13th Malaysia Plan (RMK13) target of 38 per cent, signalling structural headwinds.

The Malaysian Employers Federation has cautioned that, if poorly managed, the ageing population could adversely affect the labour market, healthcare financing, and social security systems. Senior workers can bring valuable experience, loyalty, and soft skills to the workplace, but integrating them requires flexible work arrangements, ergonomic adjustments, and lifelong learning programmes. Without such measures, ageism persists, constraining senior employees’ ability to adapt and remain productive.

The fiscal burden is equally concerning. Healthcare expenditure in Malaysia reached USD12 billion in 2022, with geriatric care and elderly wellness identified as high-potential growth segments. Malaysia’s health expenditure as a percentage of GDP stood at 4.40 per cent in 2025, and BMI Research projects it to increase at a compound annual growth rate of 8.7 per cent over 2023–2028, driven largely by ageing-related healthcare demands. Japan’s experience offers a sobering case study: research published in Innovation in Aging demonstrates that frailty alone significantly escalates medical and long-term care expenditures, with cumulative costs in the frailty group averaging 1,190,000 yen per capita over a 17-month follow-up period. Sarawak is not immune. Premier Sarawak Datuk Patinggi Tan Sri (Dr) Abang Haji Abdul Rahman Zohari himself has acknowledged that “our cost on social benefits has to increase.” The 2026 State Budget allocation of an additional RM50 million for the Senior Citizen Health Benefit, and the RM1.26 billion federal allocation for senior citizen welfare under Budget 2026 (with monthly cash assistance of RM600 benefiting nearly 150,000 seniors nationwide), reflect the growing fiscal weight of ageing.

The economic implications extend to the investment climate under ESG frameworks. The “S” in ESG demands that companies and governments demonstrate social sustainability, including equitable treatment of ageing workers, age-friendly workplace policies, and inclusive social protection. Sarawak has committed to embedding ESG principles into its economic and industrial policies under PCDS 2030, yet there is limited evidence that ageing-specific social indicators are being systematically measured, disclosed, or linked to investment decisions. For a state seeking to attract green and socially responsible investment, this represents a significant gap in its ESG narrative.

Isolation, Caregiving Burdens, and Intergenerational Equity

Beyond economics, the social consequences of ageing are deeply human and profoundly consequential. Dato Sri Hajah Fatimah Abdullah has repeatedly expressed concern that the decline in birth rates and marriage rates, coupled with the surge in ageing, will have “big socio-economic implications for Sarawak in the years ahead.” An ageing society risks fracturing traditional family-based care structures, particularly in rural and longhouse communities where younger generations migrate to urban centres for employment. The resultant isolation of elderly individuals fuels loneliness, depression, and cognitive decline.

Mental health is a critical yet under-addressed dimension. Dato Sri Hajah Fatimah Abdullah has highlighted a serious misconception among many Sarawakians that mental health deterioration, such as dementia, is a normal part of the ageing process. There is also a lack of awareness that government hospitals offer memory clinic programmes capable of early detection and intervention. This knowledge gap is perpetuated by insufficient public awareness campaigns and the absence of a comprehensive community-based mental health strategy targeting older adults. The Alzheimer’s Disease Foundation Malaysia has initiated train-the-trainer programmes in Kuching, Sibu, Bintulu, and Miri to build community capacity in dementia care, intending to certify 128 trainers and benefit 1,600 caregivers annually by 2026. While commendable, this initiative is largely driven by non-governmental organisations and relies on philanthropic support, raising questions about its long-term sustainability and scale.

Rural-urban care disparities compound the social challenge. Approximately 42.5 per cent of Sarawak’s population resides in rural areas, where elderly residents experience significant difficulties accessing healthcare facilities due to poor transportation infrastructure. Studies focusing on Sarawak’s ageing population have highlighted significant disparities in health outcomes, access to health care, and social support systems between urban centres and rural longhouse communities. Regional variations are evident: nearly 2/3 of the elderly in Sabah suffer from arthritis, compared to less than half in Sarawak, indicating the need for targeted interventions.

Intergenerational solidarity, a cornerstone of Sarawak’s communal ethos, is also under strain. Dato Sri Hajah Fatimah Abdullah has called for greater youth involvement in supporting elderly initiatives. Deputy Health Minister Datuk Hanifah Hajar Taib echoed this sentiment, stressing that intergenerational solidarity is vital to ensure that the elderly receive the care, respect, and attention they deserve. Yet, translating these calls into structured programmes that bridge generations remain a policy gap.

Infrastructure, Accessibility, and Rural-Urban Disparities

Sarawak’s vast geography poses unique challenges for age-friendly development. The Premier Sarawak has committed to encouraging local authorities to design elder-friendly facilities, public spaces, and infrastructure that ensure accessibility, safety, and comfort for all. However, the gap between policy aspiration and ground reality is glaring.

Only four (4) Malaysian cities have been recognised as part of the WHO Age-Friendly Cities and Communities (AFCC) network: Taiping, Penang Island, Sibu, and Ipoh. Sibu’s admission to the network in 2023 represents an important milestone for Sarawak, but Kuching’s progress reports remain sparse despite its stated ambitions. Implementing interventions that evaluate age-friendly city frameworks based on WHO standards is imperative for fostering environments that facilitate healthy ageing.

The MyHOeME programme, a collaborative effort involving UiTM, the Ministry of Health, and the World Health Organization in Kapit, demonstrates what is possible. Conducted in a longhouse setting, the programme addressed the physical, mental, and social needs of older persons through occupational engagement. It won Diamond and Gold Awards at IIDEX2024, yet its scale remains limited to a single community. The challenge for Sarawak is to replicate such initiatives across hundreds of rural settlements.

Digital inclusion is another development gap. The Sarawak government’s push for full digitalisation in welfare assistance has inadvertently excluded elderly residents without smartphones or with limited digital literacy. Starting 1 January 2026, applications for selected welfare assistance became 100 per cent online via SarawakPass, raising concerns about accessibility for digitally excluded seniors. Research on digital inclusion among elderly consumers in Sarawak highlights significant barriers, particularly for rural elderly populations attempting to access healthcare and welfare services. Critics have pointed out that low-income seniors are required to purchase smartphones merely to access aid, defeating the purpose of welfare, and there have been cases where bedridden elderly individuals could not pass facial recognition verification on mobile applications.

Workforce development is an urgent priority. There is a high demand for nurses in critical and geriatric care in Sarawak, and the Centre of Technical Excellence (CENTEXS) in Dalat has been designated as Sarawak’s first training centre for the Malaysian Skills Certificate (SKM) Level 3 in elderly and palliative care, with the first intake in late 2025. Dato Sri Hajah Fatimah Abdullah has emphasised the urgency of training a dedicated, professional workforce to manage the surge in elderly care needs, particularly as more families opt for home-based care.

Government Plans and Initiatives

Both the Sarawak state government and the Malaysian federal government have articulated policy responses that represent a meaningful departure from reactive welfare models. Nevertheless, a critical examination reveals persistent implementation loopholes.

Under Sarawak government, the Kenyalang Gold Card (KGC) stands as the centrepiece. As of the end of 2024, a total of 357,867 Sarawakians aged 60 and above had registered for the card, with Kuching recording the highest number of cardholders. By September 2025, 342,419 held physical cards, accessing discounts and benefits through over 1,140 strategic partners. The card includes a Death Compassionate Assistance benefit of RM1,800, and by September 2025, 26,790 heirs had received this benefit, with total expenditure reaching RM73.04 million. In October 2025, the government launched a virtual KGC on the Sarawak Pass platform, enabling digital registration and immediate activation without waiting for physical cards. While this aligns with PCDS 2030 goals of a smart welfare system, it has deepened the digital divide.

The Senior Citizen Health Benefit (SCHB), a RM50 million scheme launched in May 2024, provides cashless outpatient treatment worth up to RM500 annually at over 290 panel clinics for seniors from households earning RM7,000 and below. By October 2025, 156,193 senior citizens had accessed healthcare services under SCHB at 263 registered clinics, with total expenditure reaching RM39.7 million. Premier Sarawak Datuk Patinggi Tan Sri (Dr) Abang Haji Abdul Rahman Zohari allocated an additional RM50 million in the 2026 State Budget to sustain and expand the programme. Yet its effectiveness has been marred by reported identity theft cases, the absence of secure verification mechanisms such as first-time password systems, and the exclusion of seniors unable to navigate the digital application process. The Sarawak Basic Needs Assistance (SKAS), providing annual support of RM250 to RM800, suffers from similar access barriers.

Beyond financial and healthcare assistance, the state has invested in community-based infrastructure through 29 Pusat Aktiviti Warga Emas (PAWE) and 8 Pusat Perkhidmatan Warga Emas (PPWE), serving as hubs for recreation, intergenerational activities, health programmes, and social connection. Residential care homes in Kuching and Sibu provide care, while the Home Assistance Service (KBDR), supported by 250 volunteers, has reached 665 seniors as of October 2025. At the local government level, Kuching South City Council (MBKS) has been proposed as a pilot for the Healthy Ageing Communities project, marking a significant step as Sarawak prepares to become an aged state.

At the national level, the 13th Malaysia Plan (RMK13) recognises long-term care (LTC) as a national strategy for the first time, proposing a sustainable LTC ecosystem governed by a central authority. It sets four (4) measurable targets for 2030: a 1.1 per cent population growth rate, 50,000 skilled caregivers, a 38 per cent workforce participation rate for those aged 60 to 64, and three (3) new commercialised products in medical gadgets for the elderly. The National Ageing Blueprint (NAB) 2025–2045 adopts a life-course approach encompassing six (6) key areas: economy, employment, education, social protection, health, and long-term care. A White Paper on the NAB was tabled in Parliament in early 2026, alongside a National Senior Citizens Action Plan 2026–2030 covering safety, lifelong learning, and intergenerational engagement. A Senior Citizens Bill is also being drafted. Prime Minister Datuk Seri Anwar Ibrahim has called for a paradigm shift in public policy, urging the nation to view longevity as a structural transformation.

Despite these initiatives, significant gaps remain. The SCHB identity theft case illustrates the absence of secure verification mechanisms. The complex application process and limited coverage have drawn consistent criticism. Digital exclusion systematically bars low-income, bedridden or rural seniors from KGC, SCHB and SKAS, despite the Welfare Department’s capacity to allow direct bank transfers for some groups. Perhaps the most significant gap is the absence of a dedicated Sarawak Ageing Blueprint. While the state is developing a Sarawak Older Persons Policy, no legally binding, state-specific ageing strategy with enforceable mechanisms and clear timelines yet exists. The PCDS 2030 mentions social inclusivity, but aspirations without enforcement remain rhetoric.

International Benchmarks and Lessons for Sarawak

International experience offers valuable lessons for Sarawak’s ageing policy architecture. Singapore’s 2026 policy streamlines aged care through 84 sub-regional “One-stop” touchpoints managed by Integrated Community Care Providers, offering a potential model for Sarawak’s rural outreach. Singapore’s CareShield Life long-term care insurance scheme provides basic financial support for severe disability, with automatic coverage for citizens aged 30 to 40 and subsequent cohorts joining upon turning 30. By 2026, Singapore will become a “super-aged” society with at least 21 per cent of the population aged 65 and above, providing a living laboratory in policy preparation.

Japan introduced its Long-Term Care Insurance (LTCI) system in 2000, built on three (3) concepts: support for independence, social insurance, and a user-oriented system. Japan’s experience demonstrates effective management of demographic transition through universal coverage and well-established payment systems, though challenges remain in scaling sustainability. A key lesson is that preparation for long-term care insurance should begin when the dependency ratio is still relatively low, as Japan’s “Gold Plan” demonstrated in the 1990s.

The WHO UN Decade of Healthy Ageing (2021–2030) provides a global framework focused on four (4) key actions: changing how we think, feel, and act towards age and ageing; developing communities that foster abilities; delivering person-centred integrated care; and providing access to long-term care. WHO will report progress in 2023, 2026, 2029, and 2030, and a stakeholder survey is currently open to shape the second half of the Decade. Sarawak’s initiatives should align with WHO’s recommended framework and indicators for measuring progress on healthy ageing.

Comprehensive, Practical, and Achievable Proposals Tailored to Sarawak

To bridge the gap between the Premier Sarawak’s aspirational vision and the lived reality of Sarawak’s elderly, a series of integrated policy actions is proposed, designed to be comprehensive in scope, practical in execution, and achievable within Sarawak’s administrative and fiscal constraints, while anchored in resilience, authenticity, kindness, advocacy, and nurturing.

A Sarawak Ageing Blueprint must be legislated by the second quarter of 2026, harmonised with the federal NAB 2025–2045, but tailored to Sarawak’s unique demographic profile, including legally binding targets, dedicated budget lines, and provisions for disaster preparedness for elderly residents. This embodies authenticity by making commitments measurable and advocacy by mandating older persons’ representation in oversight bodies.

Rural geriatric outreach should be scaled using the MyHOeME model, deploying mobile geriatric clinics to all rural districts, leveraging telehealth links to specialist services, and training community health workers in basic geriatric assessment and dementia screening. This operationalises nurturing by bringing care directly to the underserved and resilience by strengthening primary care capacity.

Offline access pathways must be mandated for all welfare schemes, ensuring that KGC, SCHB and SKAS applications can be completed via physical channels as a matter of right. Investment in senior-friendly digital literacy programmes delivered through PAWE and PPWE centres, using peer-to-peer training models that leverage tech-savvy seniors as community digital ambassadors, would close the digital inclusion gap.

A Time Bank model should be piloted in one (1) urban district, such as Kuching, one (1) semi-urban district, such as Sibu, and one (1) rural district, such as Kapit, enabling caregiving hours to earn credits redeemable for future care and creating a sustainable, community-driven care ecosystem. These manifests nurturing by valuing care work and advocacy by recognising caregivers as essential contributors.

Satellite geriatric training campuses should be established by expanding CENTEXS Dalat programmes to Sibu, Bintulu, and Miri by 2027, offering accredited certification for elderly and palliative care, and addressing the high demand for geriatric care nurses. This builds institutional capacity and resilience.

Intergenerational programmes must be embedded in education policy, requiring schools to adopt PAWE or PPWE centres for regular intergenerational activities, fostering oral history projects and digital mentoring. This nurtures intergenerational bonds and advocates for older persons as active contributors, aligning with SDG 10 (Reduced Inequalities) and SDG 11 (Sustainable Cities and Communities).

The SCHB scheme must be urgently reformed with enhanced security measures, including first-time password verification, a dedicated fraud investigation unit, a publicly accessible grievance platform, and proactive outreach in remote areas to identify and register eligible seniors. This demonstrates authenticity through transparent governance.

A Sarawak ESG-Aligned Ageing Index should be developed as a composite metric tracking elderly employment rates, age-friendly infrastructure coverage, healthcare access equity, and financial security. This would align with PCDS 2030’s ESG commitments, attract socially responsible investment, and provide a data-driven basis for continuous policy improvement.

An independent Office of the Commissioner for Older Persons should be created to investigate complaints, conduct systemic inquiries, publish annual reports, and make binding recommendations, ensuring the voices of older persons are heeded.

Finally, strategic development communication must be integrated as a core function of policy design across all initiatives, using culturally resonant campaigns to combat misconceptions about dementia and ageing, and leveraging partnerships with organisations like the Alzheimer’s Disease Foundation Malaysia to scale train-the-trainer programmes. Communication must be the connective tissue that joins policy design with human dignity.

The Premier Sarawak’s Vision and a Values-Based Framework for Action

Premier Sarawak Datuk Patinggi Tan Sri (Dr) Abang Haji Abdul Rahman Zohari has articulated a compelling vision for an ageing Sarawak. At the Sarawak International Conference on Ageing 2025, he declared that “every older person must continue to be respected, protected, and included as an integral part of the social and economic fabric of our State.” He framed the rising number of older persons not as a crisis, but as “a sign of progress” that must come with “quality of life, dignity, and inclusion.” His long-term vision under PCDS 2030 is to create “a thriving society that is economically strong, socially inclusive, and deeply caring,” and he has positioned Sarawak as a potential “model for an age-friendly region.”

Yet these words carry weight only if they are reflected in measurable outcomes. The values that underpin a truly effective response must move from rhetorical aspiration to operational reality. Resilience means building robust systems that withstand demographic pressures; authenticity demands that commitments are matched by action, so that no elder is excluded from welfare by digital barriers or administrative negligence. Kindness is the design of public spaces and services that honour the human journey of ageing; advocacy amplifies the voices of the marginalised; and nurturing creates an ecosystem in which elderly Sarawakians flourish, not merely survive.

Bridging the Gap Through Strategic Development Communication

Closing the chasm between vision and reality requires strategic development communication embedded as a core function of policy design, implementation, and evaluation. This is not about publicity; it is about using communication to drive development outcomes. Six (6) interconnected principles must be adapted to Sarawak’s ageing context.

First, align messaging with development goals. All public campaigns should consistently reinforce the link between healthy ageing, economic productivity, and social cohesion under PCDS 2030. Second, foster inclusive stakeholder engagement and co-creation, replacing top-down information with two-way dialogue where the elderly themselves, caregivers, longhouse chiefs, and the private sector co-create policies through participatory forums. Third, catalyse sustainable behaviour and social change through culturally resonant, linguistically appropriate campaigns to combat the misconception that dementia is normal ageing, promote preventive health, and challenge ageist stereotypes. Fourth, strengthen institutional and community capacity by training healthcare workers, local council staff and volunteers not only in geriatric care but in communication skills that enable effective engagement with older persons. Fifth, build trust, transparency, and accountability by establishing responsive feedback mechanisms, clear reporting on fund utilisation, and an independent ombudsperson function; ethical communication is foundational to the social contract. Sixth, enable continuous improvement through data-driven evaluation, linking longitudinal research on ageing to a monitoring and evaluation framework that feeds real-time insights back into policy adjustments.

Alignment with SDGs, ESG, and the PCDS 2030 Framework

The Sarawak government has positioned PCDS 2030 as its central development blueprint. The ageing agenda finds its primary home under Social Inclusivity, but its tentacles extend into economic productivity and environmental accessibility. At the global level, SDG 3 (Good Health and Well-being) calls for strengthened geriatric care capacity and mental health services; SDG 10 (Reduced Inequalities) demands addressing rural-urban disparities in elderly care access and digital inclusion; and SDG 11 (Sustainable Cities and Communities) requires accelerating Kuching and other Sarawak cities’ progress toward WHO Age-Friendly City status. The UN Decade of Healthy Ageing (2021–2030) adds further impetus, and Sarawak should align its initiatives with WHO’s four (4) action areas and contribute data to the 2026 progress report, participating in the stakeholder survey to ensure its rural context is represented. The ESG “S” pillar, increasingly important to Sarawak’s industrial policy, must be systematically applied to ageing through transparent reporting, age-diversity metrics, and social impact assessments for major projects. The federal RMK13 and National Ageing Blueprint provide a supportive anchor, but Sarawak’s unique rural-hinterland context necessitates ambitious state-level adaptation.

Closing the Implementation Gap

Sarawak’s transition to an ageing society is not a distant prospect; it is an unfolding reality that demands immediate, coordinated, and values-driven action. With 14 per cent of the population already aged 60 and above and projections indicating this will rise to 16 per cent by 2028, the window for proactive policy intervention is narrowing. The economic, social, and development implications are profound, and the gap between the government’s aspirational rhetoric and the lived experience of many elderly Sarawakians remains worryingly wide. Yet there is also a growing architecture of response: the Kenyalang Gold Card (now with over 357,000 registered seniors), the Senior Citizen Health Benefit, community activity centres, skills training at CENTEXS, the emerging Sarawak Older Persons Policy, and the supportive federal framework under RMK13 and the National Ageing Blueprint.

The critical task now is to close the implementation gap, to secure digital equity, protect beneficiaries from fraud, scale rural outreach, legislate a binding state blueprint, and invest in the care workforce. The 10 integrated proposals advanced here offer a practical, achievable pathway to transform the ageing challenge into an opportunity for inclusive, sustainable, and compassionate development. Strategic development communication, deployed with intentionality, can be the connective tissue that joins policy design with human dignity. The Premier Sarawak’s words ring as both a promise and a test: “We want Sarawak to be a place where people not only live longer, but they also live better.” The measure of Sarawak’s success will be whether those words become the daily reality for every elderly Sarawakian, from the bustling streets of Kuching to the quiet longhouses of the interior, and whether Sarawak can serve as a model for age-friendly development in the Global South as the UN Decade of Healthy Ageing approaches its midpoint in 2026.

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