People in OECD countries are living much longer. Because of falling fertility, there are more people in older age groups. At the same time, the shape of our lives is changing in the way time is allocated to work, learning, leisure and the giving and receiving of care. Taken together, these changes pose fundamental challenges for fiscal, economic and social policies. What are the effects of ageing on pensions, health and long-term care, and labour and capital markets? This publication examines these issues, assesses the fiscal implications of maintaining the {status quo,} examines obstacles to change and proposes a strategic framework to guide policy reform. Finally it outlines a policy development agenda to address the ageing challenge.