Public health response to dementia

public health response

Chris Lynch, Deputy CEO & Director of Policy, Communications & Publications at Alzheimer’s Disease International, sheds light on the WHO Global action plan on the public health response to dementia 2017-2025

We are now at the halfway stage of the World Health Organization’s (WHO) Global action plan on the public health response to dementia 2017-2025, conceptualised following 10 years of advocacy for a global response to dementia by Alzheimer’s Disease International (ADI) and others worldwide. Each year since its launch, ADI has tracked the progress towards the global implementation of the seven action areas outlined in the plan through the annual report ‘From Plan to Impact’.

This year marks the fourth iteration in the series and unfortunately, demonstrates that there will need to be a monumental effort by the Member States if the 2025 deadline is to be achieved. Currently, there are only 43 national dementia plans globally, of which only 35 are in WHO Member States. To reach the original target set out in the plan, we will need 28 new plans every year until 2025. ADI continues to advocate at a global, regional and local level for the implementation of national dementia plans, as we fervently believe they are the best way to address dementia-related issues in each country, however, it is undeniable that the odds are stacked against us, unless there are swift and concerted efforts from all Member States who unanimously adopted the global plan in 2017.

Global response needed for dementia

Despite the challenge, ADI continues to advocate and to work with the WHO and partners at a global, regional and local level, including through our network of 105 federations and associations across the world. Globally, the combined cost of dementia is estimated to be in excess of U.S. $1.3 trillion dollars per year, a number expected to rise to $2.8 trillion dollars by 2030. There remain huge disparities in the quality and access to a timely diagnosis, support and awareness across regions of the world, an area which ADI will be highlighting in the World Alzheimer Report 2021, ‘The Journey through the diagnosis of dementia’. Perhaps most poignantly, every three seconds someone somewhere in the world develops dementia. Current forecasts suggest that by 2050, there will be 139 million people living with dementia, almost three times more than today. Averting a global health crisis requires a global response, comprised of action at all levels.

The COVID-19 pandemic has further underlined the need for national dementia plans, which also includes dementia-related design as an integral part of a national strategy. Older people and people with dementia have been disproportionately impacted by COVID-19, many in long-term care facilities. In Canada, of all COVID-19 deaths in 2020, dementia or Alzheimer’s was reported on 36% of death certificates; in Australia dementia constituted 41% of all COVID-19 deaths; 26% in the UK; and 20% in regions of Italy. Many governments are still to publish their data, and more worryingly, many are not capturing this data at all.

Encouraging dementia developments

Despite the inaction of some governments in developing national dementia plans, it is important to note that there have been some momentous achievements made over the past year. Between the period of May 2020-2021, during the pandemic, four new national dementia plans were launched in China, the Dominican Republic, Germany and Iceland and three more have been evaluated and updated. Others had made ground towards establishing their own national dementia plans or in Italy’s case, have finally received funding for their longstanding plan. Conversely, others have reached roadblocks or hurdles of which will need to be overcome.

Notably, this year also marks the development of the first new Alzheimer’s drug to have been approved by the FDA in the United States in over 20 years, and the first reported to address the disease rather than the symptoms. Notwithstanding the considerable number of hurdles that will need to be overcome, this conditional approval has brought with it news of further investment into the area in terms of research into the disease and a reinvigorated strive for new disease-modifying compounds. This is essential if we are to improve the lives of those living with dementia, ensuring independence for as long as possible, but also to address the $1.3 trillion dollars annual cost of dementia.

Accelerate the plan

Collectively, as a community of advocates, including those living with dementia and family and carers, researchers, scientists, health and care professionals, innovators and entrepreneurs, we need to build momentum, to work with and advocate governments to deliver on their commitment to adopting the WHO Global action plan on dementia and to finds ways to accelerate towards achieving the targets on the plan. Every three seconds that pass someone develops dementia and only with robust national dementia plans can governments prepare their health and care systems. Inaction by some governments globally is placing an undue burden on those living with dementia and their families and carers, as well as contributing to a global health crisis. There can be no more procrastination – the time to act is now!

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