www.thelancet.com Vol 379 April 7, 2012 1295 Submissions should be made via our electronic submission system at http://ees.elsevier.com/ thelancet/ agenda, there are worrying signs of discrimination against older people. Background documents from the UN High-Level Meeting in September, 2010, describe the deaths of people younger than 60 or 70 years as “premature mortality”, implying that deaths of people at older ages should receive a lower priority. If we do not challenge existing policy paradigms and the social attitudes that underpin them, population ageing might indeed lead to a crisis in the provision of health and welfare services. Instead, we should see it as a welcome opportunity to challenge outdated public perceptions, political priorities, and policy models. This challenge will include reorientating health and welfare models to deliver more effi cient, equitable, and sustainable interventions. It might also include the diversion of resources from consumer spending, which in many countries has risen spectacularly over the past 30 years, towards meeting the needs of vulnerable people, whatever their age. This is an overtly political challenge; responding positively to it will benefi t people of all ages in all societies.