In this Article, we first propose a suite of policies and practices at the national and local levels designed to support healthy people liv- ing in aging societies. Changing the social, economic, and built envi- ronments would transform life prospects not only for older persons, but also would assure all of us that as we age, all of society will help us live well. Next, we then turn to global governance, inquiring how well the international community has responded to this remarkable demographic transition. How effective is the current, and proposed, architecture in facilitating a shift towards these public health policy goals? The international community entered the new millennium with optimism as the United Nations General Assembly declared 1999 the International Year of the Older Person.14 Reflecting on the journey from the new millennium to today, there has been undeniable— although decidedly inadequate—progress. The 2002 Madrid Interna- tional Plan of Action on Aging (“Madrid Plan”)15 framed aging poli- cies as integral aspects of economic development and human rights— a form of mainstreaming we support. Yet, more than a decade later, the United Nations processes have failed to yield concrete changes in law and governance.